title: Effect of sodium hypochlorite and Ricinus communis solutions on control of denture biofilm: A randomized crossover clinical trial.
abstract: BACKGROUND
  The prevalence of complete edentulism remains high in the elderly, and previous data have shown that poor denture hygiene is common among patients with edentulism.
  
  
  OBJECTIVE
  The purpose of this randomized crossover trial was to evaluate the efficacy of denture cleansers in terms of biofilm removal, antimicrobial action, and the remission of denture stomatitis.
  
  
  METHODS
  Fifty denture wearers with denture stomatitis were instructed to brush their dentures (brush and soap) and to soak them (20 minutes/14 days) in 4 solutions, as follows: C (control), 0.85% saline; SH1, 0.1% sodium hypochlorite; SH2, 0.2% sodium hypochlorite; and RC, 8% Ricinus communis. The biofilm in the intaglio surface of maxillary dentures was stained, photographed, and quantified by software (Image Tool). It was then collected (brushed with saline solution), and the obtained suspension was diluted (100to 10-3) and seeded (50 μL) in CHROMagar for Candida spp. After incubation, colony-forming units per milliliter values were calculated. Denture stomatitis remission was classified according to the Newton classification. Data were analyzed by Friedman (α=.05) and Wilcoxon tests and corrected by the Bonferroni test (α=.005).
  
  
  RESULTS
  SH1 (mean rank [MR]=1.98) and SH2 (MR=1.64) showed lower biofilm coverage than C (MR=3.73) that was similar to RC (MR=2.92). SH1 (MR=2.43) and SH2 (MR=2.10) showed antimicrobial action for Candida spp, and RC (MR=3.36) showed similar results to C (MR=3.51) and baseline (MR=3.50). Clinical signs of denture stomatitis were reduced by SH1 (MR=2.44), while SH2 (MR=2.56) and RC (MR=2.74) showed intermediate results.
  
  
  CONCLUSIONS
  The two sodium hypochlorite solutions were the most effective means of biofilm control. All tested solutions were effective in reducing the signs of denture stomatitis.
authors.affiliation: Doctoral student, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Carolina Noronha Ferraz de
authors.initials: CNF
authors.lastname: Arruda
authors.affiliation: Doctoral student, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Marcela Moreira
authors.initials: MM
authors.lastname: Salles
authors.affiliation: Doctoral student, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Maurício Malheiros
authors.initials: MM
authors.lastname: Badaró
authors.affiliation: Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Viviane
authors.initials: V
authors.lastname: de Cássia Oliveira
authors.affiliation: Specialized Laboratory Technician, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Ana Paula
authors.initials: AP
authors.lastname: Macedo
authors.affiliation: Associate Professor, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: Cláudia Helena
authors.initials: CH
authors.lastname: Silva-Lovato
authors.affiliation: Professor, Department of Dental Materials and Prosthodontics, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil. Electronic address: helenpar@forp.usp.br.
authors.forename: Helena
authors.initials: H
authors.lastname: de Freitas Oliveira Paranhos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018441:Biofilms / Q000187:drug effects*; D002368:Castor Oil / Q000627:therapeutic use*; D018592:Cross-Over Studies; D003820:Denture Cleansers / Q000627:therapeutic use*; D003778:Dentures / Q000382:microbiology; D004202:Disinfectants / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012278:Ricinus; D012973:Sodium Hypochlorite / Q000627:therapeutic use*; D013282:Stomatitis, Denture / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D003820:Denture Cleansers; D004202:Disinfectants; D002368:Castor Oil; D012973:Sodium Hypochlorite