Dental tissue conditioners are compliant, viscoelastic gels used primarily to form a soft cushion between the oral mucosa and the hard denture base. Their uses include the treatment of inflamed mucosa resulting from ill-fitting dentures and in treatment of denture related stomatitis. They are presented in powder/liquid format where the powder is usually poly(ethyl methacrylate) (PEMA) and the liquid is a mix of an aromatic ester (plasticiser, usually a phthalate) with ethanol. In use, the ethanol and plasticiser leach out with time causing the material to harden. In recent years there has been concern about possible toxic effects of the leached phthalate. Preliminary work has shown citrate plasticisers to be acceptable replacements for phthalates. Another disadvantage of the powder/liquid format is the porosity produced on mixing which can lead to microbial ingress and contamination. One possible solution would be to use a pre-gelled material which would have the advantages of easy application and reduced porosity. Candidal infections are a common etiological factor in denture related stomatitis. Earlier studies have shown it possible to release chlorhexidine diacetate (a broad spectrum antibacterial/antifungal agent) from powder/liquid tissue conditioners to treat these infections The aim of this study is to develop citrate-based pre-gelled and powder/liquid tissue conditioners and explore its use as potential drug delivery vehicle for chlorhexidine diacetate. The experimental pre-gelled system (EPGS) containing PEMA and acetyl tributyl citrate (ATBC) only showed stable Shore A hardness values over an 18 month time Abstract 5 period when stored at 7oC. The Shore A hardness and creep compliance ratio (flow) of EPGS indicated that it could be used as both a tissue conditioner and a temporary denture lining material, whereas experimental powder liquid system (EPLS), which contained 16 hours ball-milled PEMA powder and ATBC plus 5% ethanol, had more suitable properties for use as a tissue conditioner. Addition of chlorhexidine diacetate alone or with sodium fluoride did have an effect on the hardness and creep compliance ratio of the materials but these were within acceptable range. Both EPGS and EPLS containing 1% chlorhexidine had a higher percent release than those containing 9% chlorhexidine. The addition of sodium fluoride increased the release of chlorhexidine in all formulations.

Resultados de pesquisas prévias tem encontrado potencial aumentado para a consolidação de enxertos ósseos mediante desmineralização do material enxertado e/ou das superfícies de consolidação. Entretanto há carência de embasamento apoiado em evidências biológicas do benefício de tal procedimento. Para testar esta hipótese, o tecido ósseo da calvária de cobaias (Cavia porcellus) foi exposto ao condicionamento por ácido cítrico durante 15, 30, 90 e 180 segundos (grupos teste). Quarenta e cinco discos ósseos de três milímetros de diâmetro foram removidos dos animais, dos quais 36 foram condicionados com ácido cítrico pH 1 a 50% e nove não receberam condicionamento (grupo controle). Sobre nove discos de cada grupo foram cultivados pré-osteoblastos MC3T3-E1 durante 24, 48 e 72 horas (três discos de cada grupo em cada tempo). Análises da morfologia celular, do número de células aderidas sobre as superfícies e da área de cobertura destas superfícies por préosteoblastos foram realizadas à microscopia eletrônica de varredura. Observou-se aumento do número de células aderidas às superfícies com o tempo, independentemente de haver condicionamento ou de seu tempo de aplicação. Entretanto, essa diferença só foi estatisticamente significante intragrupos (p<0,05) e quando comparados os períodos de 24 e 72 horas de incubação. A área de cobertura das superfícies por células aumentou significantemente com o tempo somente nos grupos teste, também entre os períodos de incubação de 24 e 72 horas (p<0,01). O grupo controle apresentou-se com 50% ou menos de área de cobertura superficial em relação aos demais. A duração de aplicação do ácido não interferiu significantemente nesse parâmetro de avaliação, mas nos grupos 15 e 30, a área de recobrimento ósseo mais do que triplicou às 72 horas em relação às 24 horas (p<0,01), com cerca de 70% das superfícies cobertas por células, contra 30% no grupo controle. Conclui-se que a desmineralização óssea nos tempos de condicionamento estudados propicia um substrato sobre o qual as células pré-osteoblásticas adquirem morfologia compatível com estágio de diferenciação mais avançado, promovendo maior cobertura de área, o que aumenta o potencial para deposição de novo osso sobre essas superfícies em comparação ao tecido não condicionado. / Results of previous research has found increased potential for the consolidation of bone grafts by demineralization of the graft material and / or areas of consolidation. However there is a lack of foundation supported by biological evidence of benefits from such procedures. To test this hypothesis, the bone tissue of the calvaria of guinea pigs (Cavia porcellus) were exposed to conditioning by citric acid for 15, 30, 90 and 180 seconds (test group). Forty-five bone disks measuring three millimeters in diameter were removed from the animals, of which 36 were conditioned with citric acid pH 1 to 50% and nine did not receive conditioning (control group). About nine disks in each group were pre-cultured with MC3T3- E1 osteoblasts for 24, 48 and 72 hours (three discs of each group at each time point). Analysis of cell morphology, number of cells attached on the surface and the coverage area of these surfaces by pre-osteoblasts were performed on scanning electron microscopy. There was na increase in the number of cells attached to surfaces over time, regardless of conditioning or application time. However, this difference was not statistically significant intra-group (p <0.05) when comparing the periods of 24 and 72 hours of incubation. The coverage area of the surfaces of cells increased significantly with time only in the test groups, also among the incubation periods of 24 and 72 hours (p <0.01). The control group presented with 50% or less of surface area coverage compared to the other. The duration of application of the acid did not affect significantly this parameter of evaluation, but in groups 15 and 30, the bonearea covered more than tripled from 24 to 72 hours (p <0.01), with about 70 % of the area covered by cells, versus 30% in the control group. It was concluded that bone demineralization in the studied conditioning times provides a substrate on which cells acquire pre-osteoblastic morphology compatible with more advanced stage of differentiation, promoting greater coverage area, which increases the potential for deposition of new bone on these surfaces compared to the tissue-air basis.

Resultados de pesquisas prévias tem encontrado potencial aumentado para a consolidação de enxertos ósseos mediante desmineralização do material enxertado e/ou das superfícies de consolidação. Entretanto há carência de embasamento apoiado em evidências biológicas do benefício de tal procedimento. Para testar esta hipótese, o tecido ósseo da calvária de cobaias (Cavia porcellus) foi exposto ao condicionamento por ácido cítrico durante 15, 30, 90 e 180 segundos (grupos teste). Quarenta e cinco discos ósseos de três milímetros de diâmetro foram removidos dos animais, dos quais 36 foram condicionados com ácido cítrico pH 1 a 50% e nove não receberam condicionamento (grupo controle). Sobre nove discos de cada grupo foram cultivados pré-osteoblastos MC3T3-E1 durante 24, 48 e 72 horas (três discos de cada grupo em cada tempo). Análises da morfologia celular, do número de células aderidas sobre as superfícies e da área de cobertura destas superfícies por préosteoblastos foram realizadas à microscopia eletrônica de varredura. Observou-se aumento do número de células aderidas às superfícies com o tempo, independentemente de haver condicionamento ou de seu tempo de aplicação. Entretanto, essa diferença só foi estatisticamente significante intragrupos (p<0,05) e quando comparados os períodos de 24 e 72 horas de incubação. A área de cobertura das superfícies por células aumentou significantemente com o tempo somente nos grupos teste, também entre os períodos de incubação de 24 e 72 horas (p<0,01). O grupo controle apresentou-se com 50% ou menos de área de cobertura superficial em relação aos demais. A duração de aplicação do ácido não interferiu significantemente nesse parâmetro de avaliação, mas nos grupos 15 e 30, a área de recobrimento ósseo mais do que triplicou às 72 horas em relação às 24 horas (p<0,01), com cerca de 70% das superfícies cobertas por células, contra 30% no grupo controle. Conclui-se que a desmineralização óssea nos tempos de condicionamento estudados propicia um substrato sobre o qual as células pré-osteoblásticas adquirem morfologia compatível com estágio de diferenciação mais avançado, promovendo maior cobertura de área, o que aumenta o potencial para deposição de novo osso sobre essas superfícies em comparação ao tecido não condicionado. / Results of previous research has found increased potential for the consolidation of bone grafts by demineralization of the graft material and / or areas of consolidation. However there is a lack of foundation supported by biological evidence of benefits from such procedures. To test this hypothesis, the bone tissue of the calvaria of guinea pigs (Cavia porcellus) were exposed to conditioning by citric acid for 15, 30, 90 and 180 seconds (test group). Forty-five bone disks measuring three millimeters in diameter were removed from the animals, of which 36 were conditioned with citric acid pH 1 to 50% and nine did not receive conditioning (control group). About nine disks in each group were pre-cultured with MC3T3- E1 osteoblasts for 24, 48 and 72 hours (three discs of each group at each time point). Analysis of cell morphology, number of cells attached on the surface and the coverage area of these surfaces by pre-osteoblasts were performed on scanning electron microscopy. There was na increase in the number of cells attached to surfaces over time, regardless of conditioning or application time. However, this difference was not statistically significant intra-group (p <0.05) when comparing the periods of 24 and 72 hours of incubation. The coverage area of the surfaces of cells increased significantly with time only in the test groups, also among the incubation periods of 24 and 72 hours (p <0.01). The control group presented with 50% or less of surface area coverage compared to the other. The duration of application of the acid did not affect significantly this parameter of evaluation, but in groups 15 and 30, the bonearea covered more than tripled from 24 to 72 hours (p <0.01), with about 70 % of the area covered by cells, versus 30% in the control group. It was concluded that bone demineralization in the studied conditioning times provides a substrate on which cells acquire pre-osteoblastic morphology compatible with more advanced stage of differentiation, promoting greater coverage area, which increases the potential for deposition of new bone on these surfaces compared to the tissue-air basis.