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 Table of Contents  
RESEARCH
Year : 2022  |  Volume : 22  |  Issue : 3  |  Page : 288-293

Effectiveness of denture cleansers on flexible denture base resins in the removal of stains colored by food colorant solution: An in vitro study


Department of Prosthodontics, Sri Sai College of Dental Surgery, Vikarabad, Telangana, India

Date of Submission04-Oct-2021
Date of Acceptance23-Nov-2021
Date of Web Publication18-Jul-2022

Correspondence Address:
Gujrathi Richa
Amsri Central Court, B Block-704, Old Lancer Lines, Near Srikara Hospital, Railway Colony, Chilakalguda, Secunderabad - 500 025, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jips.jips_480_21

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  Abstract 


Aim: The aim of the study was to compare the efficiency of three denture cleansers (Valclean, Polident and Clinsodent) in removal of turmeric stains from flexible denture base resins.
Settings and Design: In vitro – comparative study.
Materials and Methods: A total of 45 specimens of flexible denture base resins were fabricated and subjected to baseline colour measurements using spectrophotometer. Specimens were stained with turmeric and colour measurements of stained specimens were made. All the stained specimens were divided into three groups (n = 15) for removal of stains with three denture cleansers: Valclean, Polident, Clinsodent and colour measurements of cleansed specimens were made. The colour measurements (ΔE) values obtained were collected and statistical analysis was done.
Statistical Analysis Used: One-way ANOVA (Analysis of Variance), Tukey's post hoc test.
Results: One way ANOVA test revealed that the mean colour difference of three groups were statistically different with P value < 0.001. A further Tukey post hoc test revealed that the Valclean group had lesser mean scores than Polident and Clinsodent group.
Conclusion: It was concluded that Valclean showed statistically significant greater stain removal efficiency than Polident followed by Clinsodent.

Keywords: Denture cleansers, flexible denture base resins, turmeric stains


How to cite this article:
Richa G, Reddy K M, Shastry Y M, Aditya S V, Babu P J. Effectiveness of denture cleansers on flexible denture base resins in the removal of stains colored by food colorant solution: An in vitro study. J Indian Prosthodont Soc 2022;22:288-93

How to cite this URL:
Richa G, Reddy K M, Shastry Y M, Aditya S V, Babu P J. Effectiveness of denture cleansers on flexible denture base resins in the removal of stains colored by food colorant solution: An in vitro study. J Indian Prosthodont Soc [serial online] 2022 [cited 2022 Aug 12];22:288-93. Available from: https://www.j-ips.org/text.asp?2022/22/3/288/351284




  Introduction Top


Removable partial dentures fabricated using polyamide-based denture base materials are proved to be good alternative to rigid denture base materials used.[1] They provide reasonable esthetics and comfort with additional advantage of utilizing tooth and tissue undercuts without the use of metal clasps. Regardless of any material used for prosthesis fabrication, the dentures tend to stain by our food habits, and to a great extent, the amount of staining depends upon the level of finishing and polishing of the dentures. Polyamide-based denture base materials are difficult to finish and polish unlike rigid materials, which make them susceptible to stain by Indian foods containing spices and ingredients.[2] Home maintenance of the prosthesis fabricated from polyamide-based materials is thus of utmost importance to maintain odorless and stain-free prosthesis without damaging the inherent properties of dentures needed for longevity of the prosthesis.

There are numerous studies carried out to assess the efficiency of denture cleansers on poly methyl methacrylate, but there was not much of literature available on polyamide-based material on the efficiency of denture cleansers in the removal of stains.[3],[4] The present study was designed and carried out to assess the effectiveness of three commonly used denture cleansers having different pH (Valclean-acidic, Clinsodent-alkaline, and Polident-neutral) on Bre.flex 2nd Edition flexible denture base resins in the removal of turmeric stains to observe the color changes using the spectrophotometer.

With the knowledge gathered from the literature, it was hypothesized that all three denture cleansers: Valclean, Polident, and Clinsodent will be equally effective in the removal of turmeric stains from Bre.flex 2nd Edition flexible denture base resins.[5],[6],[7]


  Materials and Methods Top


Fabrication of specimens

A total of 45 specimens were fabricated of Bre.flex 2nd Edition flexible denture resin by the injection molding technique using Thermopress 400 machine [Bredent, GmbH, [Figure 1]]. After finishing and polishing of the specimens, initial color measurements [category a – unstained, [Figure 2]] were made using UV-VIS spectrophotometer [Labindia, UV 3092, [Figure 3]].
Figure 1: Thermopress 400 machine

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Figure 2: Specimens fabricated using Bre-flex 2nd Edition flexible denture base material

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Figure 3: UV-VIS spectrophotometer

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Application of stains to the specimens

Staining of the specimens was done by immersing them in the turmeric solution prepared by dissolving 3 g of turmeric powder in 100 ml of distilled water for 7 days to simulate weekly exposure time with beverages or food in the oral cavity (2 h × 7 days = 14 h). Second color measurements of stained specimens [category – b, [Figure 4]] were made using UV-VIS spectrophotometer [Labindia, UV 3092, [Figure 3]].
Figure 4: Stained specimens

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Removal of stains using denture cleanser

All the stained specimens were randomly divided into three groups containing 15 specimens each (n = 15) for the removal of stains using three different denture cleansers [Figure 5].
Figure 5: Denture cleansers

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  • Group 1 − Valclean (acidic denture cleanser)
  • Group 2 − Polident (neutral denture cleanser)
  • Group 3 − Clinsodent (basic denture cleanser).


Denture cleansing solution was prepared by dissolving one tablet of denture cleanser or one teaspoon of denture cleanser powder in 150 ml of warm water (45°C). All the specimens in Groups 1, 2, and 3 were immersed in their respective denture cleansing solution [Figure 6] for 10 days to simulate the denture cleansing action of 1 month (8 h/day for 30 days = 240 h). Third color measurements of cleansed specimens (category – c) were made using UV-VIS spectrophotometer [Labindia, UV 3092, [Figure 3]] after 10 days.
Figure 6: Specimens immersed in denture cleansers

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Color analysis

For evaluating color difference, the spectrophotometric readings were converted to International Commission on Illumination system (CIELAB). This system was based on three parameters for defining color: L, a, and b, they represented lightness, red-green component, and yellow-blue component of color, respectively. The color change (ΔE) of each specimen was calculated using the following equation:

ΔE = [(ΔL)2 + (Δa)2 + (Δb)2

Where ΔE was color change, +a represented red and −a represented green, while yellow corresponded to +b and blue to −b. ΔL, Δa, and Δb represented the color differences measured in L, a, and b values before and after immersion of specimens.

The color measurements (ΔE) values of three groups: Group 1 − Valclean, Group 2 − Polident, Group 3 − Clinsodent and three within group categories: Category a-unstained, Category b-stained and Category c-cleansed were collected.


  Results Top


All the color measurement values obtained were tabulated and subjected to the statistical analysis using SPSS (Statistical package for social sciences, IBM Corp. Released 2017. IBM SPSS Statistics for Windows, Version 25.0, Armonk, NY: IBM Corp.). One-way ANOVA test with Tukey's post hoc was performed to analyze mean color difference among three groups (Valclean, Polident and Clinsodent) and three within group categories (Unstained, Stained and Cleansed) of specimens [Table 1], [Table 2], [Table 3] and [Graph 1]. The confidence intervals were set to 95%, as P < 0.05 was considered statistically significant. The results revealed that Group 1 (Valclean) showed statistically significant lesser mean scores when compared to Group 2 (Polident) followed by Group 3 (Clinsodent) [Table 4] and [Graph 2].
Table 1: Mean and standard deviations of Group 1 (Valclean)

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Table 3: Mean and standard deviations of Group 3 (Clinsodent)

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Table 3: Mean and standard deviations of Group 3 (Clinsodent)

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Table 4: Mean, standard deviation of cleansed samples of three Groups (Valclean, Polident and Clinsodent)

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  Discussion Top


Staining of the denture by the food we consume could be a major cosmetic concern for denture wearers.[8],[9] Stains, which accumulate on their denture surface may lead to propagation of denture stomatitis.[10] Turmeric − a major food ingredient used by the Indian population is a common staining agent.[11],[12] For maintaining the prosthesis in healthy state, there is a need for denture cleanser to effectively remove stains from the prosthesis.[13],[14] Therefore, this study was conducted to compare and evaluate the efficiency of immersion type denture cleansers in removal of turmeric stains from Bre.flex 2nd Edition denture base resin.

Um and Ruyter[15] mentioned in their study that staining with turmeric is more because the colorant of turmeric is polar. Moreover, whenever the colorant is more polar, it stains more as denture base resins are hydrophilic attracting more water-soluble dyes on the surface. Moreover, the pH of turmeric solution was acidic (pH: 5.5). This indicated the influence of the acidic nature of turmeric on the samples, possibly by eroding the polished surface layer leading to more stain uptake. This finding was similar to the study conducted by Gispin and Caputo.[16]

Dentures can be cleaned mechanically, chemically, or combination of these methods. Although the most widely used method of denture cleansing seems to be the usage of soap and brush, but with increasing age, a large number of geriatric patients (who form the majority of denture wearers) have a loss of manual dexterity and are physically challenged, hence being unable to accomplish mechanical denture cleansing effectively.[17] Therefore, the usage of immersion type of cleansers helps them to keep the dentures clean and devoid of any deposits. Jagger and Harrison,[18] Peracini et al.,[19] and Hoad-Reddick et al.[20] also reported similar findings.

Surface roughness test (Ra) – Arithmetical mean roughness test was done in the present study to assess the effect of acidic (Valclean), alkaline (Clinsodent), and neutral (Polident) denture cleansers on the surface of Bre.flex 2nd Edition flexible denture base resins before and after the removal of turmeric stains. For unstained samples, the Ra value was 0.149 microns, Valclean had 0.399 microns, Polident had 0.222 microns, Clinsodent had 0.150 microns indicating with Valclean (acidic denture cleanser) the surface of the specimens fabricated using Bre.flex 2nd edition flexible denture base resins roughens.

Srinivasan and Gulabani[21] stated that the normal surface roughness value acceptable for dental prosthesis is ≤0.2 microns. Sharma et al.[22] reported that the surface roughness of samples was increased after immersion in sodium hypochlorite solution, which is in conformity to the present study. The reason could be explained by a mechanism that by the diffusion of hydrogen ions (H+) from an aqueous solution into the denture surface and loss of alkali ions (OH) from the denture surface into an aqueous solution to maintain electrical neutrality.[23],[24]

In the present study, the results demonstrated that the mean value of category - a (unstained) samples of Group 1 (Valclean-pH: 4.5) was 2.92 ± 0.37. The mean of category - b (stained) samples was 5.27 ± 0.22. The mean of category - c (cleansed) samples with valclean was 3.14 ± 0.13. The mean scores of category c (cleansed) samples with Valclean was significantly lesser than other two groups indicating more stain removal efficiency of Valclean. The probable cause for the efficient cleansing action of Valclean could be attributed to ingredients present in it. Valclean contains sodium hypochlorite, as an active ingredient. When dissolved in water, it decomposes releasing hypochlorous acid and due to bleaching action of chloride ions, it removes stains. Furthermore, Acidic pH of denture cleansers indicates presence of more H+ ions than OH ions in the solution. Therefore, hydrolysis is greater in the specimens immersed in acidic denture cleanser leading to greater amount of stain removal.[25] This could also probably contribute to more stain removal efficiency of Valclean compared to Polident and Clinsodent.

Mathai et al.[26] compared the efficacy of Valclean and Clinsodent in removing tea, coffee, turmeric, and paan stains from heat-cured clear acrylic resins. He concluded that denture cleansers containing sodium hypochlorite had the highest ability for removing stains from the denture surface with a bleaching effect, which are in conformity to the present study. Jagger et al.[27] also found that denture cleansers containing sodium hypochlorite had the highest ability for removing stains and irregularities and porosities present on the denture surface played a major role in reducing denture cleansing action and hence increased stain and plaque retention.

In contrast, Makhija et al.[11] concluded that denture cleansers containing sodium perborate along with sodium bicarbonate (Clinsodent) showed greater efficiency in the removal of tea and turmeric stains from heat-cured acrylic resins. The reason for variations in mean scores of the above-mentioned study could be because of the different type of material used by them (heat cured acrylic resins) when compared to the present study (flexible denture base resins).

The mean value of category - a (unstained) samples of Group 2 (Polident - pH:7) to be 2.84 ± 0.23. The mean of category - b (stained) samples was 5.52 ± 0.26. The mean of category - c (cleansed) samples with polident was 3.82 ± 0.16. The probable cause for the outcome of the results could be because of lesser cleansing action of ingredients present in it. Polident contain sodium perborate as an active ingredient. Sodium perborate when dissolved in water decomposes releasing peroxides which in turn decomposes releasing oxygen and due to bleaching effect of oxygen, it mechanically removes the stains from the dentures. Furthermore, neutral pH of polident indicate there are equal number of H+ ions than OH ions in the solution indicating lesser degree of hydrolysis.

Shah et al.[5] showed that the color changes of Valplast flexible denture base resins with polident were comparatively lesser to other denture cleansers used in the study indicating lesser cleansing action. However, in above-mentioned study, they did not stain the specimens before immersing them in denture cleanser as of the present study.

For Group 3 (Clinsodent - pH:11), the mean value of category - a (unstained) samples were 2.96 ± 0.26. The mean of category - b (stained) samples was 5.53 ± 0.27. The mean of category - c (cleansed) samples was 4.17 ± 0.17. The mean scores of category c (cleansed) samples with clinsodent were significantly greater than other two groups indicating lesser stain removal efficiency of clinsodent. The cause for obtaining the results could be lesser bleaching action of ingredients present in it. Clinsodent is sodium perborate-based denture cleanser and due to bleaching action of oxygen, it removes the stains from the dentures and alkaline pH of clinsodent indicate there are more OH ions than H+ ions in the denture cleanser solution indicating lesser degree of stain removal of the specimens immersed in clinsodent.

Mathai et al.[26] also reported lesser efficiency of clinsodent in removing tea, coffee, turmeric, and Paan stains from heat-cured clear acrylic resins, which is in conformity to the present study.

Limitations of the study

The present in vitro study had some limitations:

  • Storage media did not include saliva due to infection control considerations and hence did not simulate the oral environment entirely
  • The specimens were flat and did not resemble a prosthesis from an anatomical perspective
  • Turmeric stain was taken and scrutinized separately; this is not possible in the patient's dentures as there is a multifactorial influence in staining of dentures
  • Micro porosities present in specimens could have an effect on absorption of the stains. Although all specimens were finely polished and visually checked for porosity before testing
  • The effect of each cleansing agent on surface finish of specimens was not evaluated completely, this may need further study.



  Conclusion Top


Within limitations of the study, the following conclusions were drawn:

  • The hypothesis of the present study that all three denture cleansers: Valclean, Polident and Clinsodent will be equally effective in the removal of turmeric stains from Bre.flex 2nd Edition flexible denture base resins was rejected
  • Group 1 (Valclean) showed greater stain removal efficiency when compared to Group 2 (Polident) followed by Group 3 (Clinsodent).


Clinsodent and Polident can safely be used as denture cleanser for polyamide-based denture resins. Valclean should be used with caution.

Future scope of the study

The present in vitro study can be further extended into a clinical study to prove the efficacy of denture cleansers and also the efficiency of the denture cleansers used in this study can be further analyzed for colour variations after prolonged immersion in denture cleansers. Further, the effect of each denture cleanser can also be assessed on the surface finish of the flexible denture base resins.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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