Department of prosthodontics, D. A. P. M. R. V. Dental college and hospital



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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.
Annexure-I
PROFORMA FOR THE REGISTRATION OF SUBJECTS FOR DISSERTATION.

1.

Name of the candidate and address ( In Block letters)

DR. DEEPAK SACHAN

POST GRADUATE STUDENT,

DEPARTMENT OF PROSTHODONTICS,

D.A. P. M. R. V.DENTAL COLLEGE AND HOSPITAL,

BANGALORE-560 078.


2.

Name of the institution

D. A. P. M. R. V. DENTAL COLLEGE AND HOSPITAL,

BANGALORE – 560078.

KARNATAKA.


3.

Course of study and Subject

MASTER OF DENTAL SURGERY (M.D.S) IN

PROSTHODONTICS.



4.

Date of Admission to course

03-05-2010

5.




Title of the topic

A microbiological evaluation of effectiveness of disinfectants on heat polymerised denture base resin- An invivo study



6.



Brief Resume of the intended work.
6.1 Need for the study.

Contact of dental prosthesis with oral tissues, saliva and blood creates a medium for growth of micro-organisms which can lead to various problems to patients ( like denture stomatitis ) as well as can cause cross infection between dental office and laboratory.

Prosthodontics has been cited as one of the dental specialties that most neglect cross- infection between the dental office and the laboratory. There are several routes of contamination such as the felt disks and pumice used in polishing and when prostheses are being sent for repairs to dental laboratories etc. To overcome the above mentioned problems various denture cleanser solutions were developed.

The aim of this study is to evaluate the effectiveness of denture cleanser solutions in disinfection of prosthesis(removable partial dentures and complete dentures). Two commercially available denture cleanser solutions (1% sodium hypochlorite and 3.78 % sodium perborate) will be compared with a disinfectant that is a herbal product .





6.2 Review of literature:


1. A study was conducted to evaluate the effectiveness of disinfectant solutions 1%sodium hypochlorite, 2% Chlorhexidine digluconate, 2% glutaraldehyde, 100% vinegar, tablets of sodium per borate-based denture cleanser and 3.8% sodium per borate in the disinfection of acrylic resin specimens contaminated in-vitro by Candida albicans, Streptococcus mutans, Streptococcus aureus, E.coli or Bacillus subtilis as measured by the residual colony forming unit. The study concluded that 1%sodium hypochlorite, 2% glutaraldehyde, 2% Chlorhexidine digluconate, 100% vinegar and 3.8% sodium per borate are valid alternatives for the disinfection of acrylic resin1.
2. A study was conducted to evaluate the effectiveness of infection control for cleansing and disinfecting removable dental prosthesis. Dentures of patients were placed in culture medium and incubated. The dentures were then scrubbed for 1 minute with Chlorhexidine gluconate , rinsed for 1 minute in sterile water and placed for 10 minutes in 4% Chlorhexidine gluconate, 1% sodium hypochlorite , biocide(iodophors) and amosan(alkaline peroxide). After disinfection, the samples were incubated. The 4%chlorhexidine gluconate, 1%sodium hypochlorite and amosan solutions were found to be effective to reduce growth of micro-organisms in 10 minutes immersion period. The least effective was biocide (iodophors)2.

3. A study was conducted to evaluate the efficacy of sodium hypochlorite in the reduction of denture stomatitis, Streptococcus mutans and Candida albicans after brushing the complete denture with coconut soap. The mucosal characteristics were evaluated after cleaning with coconut soap in group I. In the other group, analysis was made before and after cleaning the dentures with coconut soap and disinfection in a soak solution of 0.05 % sodium hypochlorite. The study concluded that brushing teeth with coconut soap and immersion in 0.05% sodium hypochlorite solution significantly reduced clinical signs of denture stomatitis3.








6.3 Objectives of the study.



  1. To determine the antimicrobial efficacy of a herbal product,1% sodium hypochlorite, 3.8% sodium perborate on heat polymerised acrylic dentures in clinical uses.

  2. To compare the efficacy of the conventional disinfectants with herbal product when used for disinfecting heat polymerised acrylic dentures in clinical uses.

7.



MATERIALS AND METHODS:






    1. Source of Data:

Two commercially available disinfectant solutions (Sodium hypochlorite and Sodium perborate) and one herbal product will be used.

Patients from outpatient Department of Prosthodontics, D.A.P.M.R.V.Dental college who are denture wearer[complete dentures or removable partial dentures] for more than six months are selected for study






7.2 Methods of collection of Data.


Materials:

  1. The microbial samples will be collected by rubbing denture surface using a sterile tooth brush with saline from selected patients visiting the Department of Prosthodontics, D.A.P.M.R.V.Dental college

  2. The clinical strains of micro-organisms will be obtained from culture.

  3. The disinfectants used are




1

Herbal product (optimum concentration)

2

1% sodium hypochlorite

3

3.8% Sodium perborate



EVALUATION OF EFFECTIVENESS OF DISINFECTANTS-

BEFORE DISINFECTION [CLINICAL STRAINS AND INCUBATION]

  • The microbial samples will be collected by rubbing the tissue surface of denture using a sterilized tooth brush with saline (10 ml) for 1 minute.

  • The resulting solution is transferred to a sterile test tube using a pipette

  • 0.01 ml of resultant suspension will be cultured on blood agar plate and incubated at 37°c for 24 hours and the number of colony forming units will be counted.



GROUPING: -

  • The dentures [RPD\CD]will be collected from selected patients and subjected to grouping :

Group

Sample size

Disinfectant

Duration

A

30

Herbal product(optimum concentration)

10 mins

B

30

1% sodium hypochlorite

10 mins

C

30

3.8% sodium perborate

10 mins

Total number of samples (n=30)= 90



AFTER DISINFECTION

  • Dentures will be immersed in the respective solutions allotted to their groups for the recommended time.

  • The samples will then be placed in sterile distilled water for 2 seconds to facilitate the removal of excess disinfectant.

  • Subsequently the sample will be collected by rubbing the tissue surface of the denture using a sterilized tooth brush with saline (10 ml ) for 1 minute.

  • The resulting solution is transferred to a sterile test tube using a pipette.

  • 0.01 ml of resultant suspension will be cultured on blood agar plate and incubated at 37°c for 24 hours and the number of colony forming units will be counted.

RESULTS

  • Growth of microorganism on dentures will be assessed as CFU/ml as mentioned below


GROUP


GROWTH OF MICRO ORGANISMS ON BLOOD AGAR

BEFORE DISINFECTION

(CFU/ml)


AFTER DISINFECTION

(CFU/ml)


A (1-30)



A 1

A 2


A 3

.

.



A 30

a 1

a 2


a 3

.

.



a 30

B (1-30)



B 1

B 2


B 3

.

.



B 30

b 1

b 2


b 3

.

.



b 30

C (1-30)




C 1

C 2


C 3

.

.



C 30

c 1

c 2


c 3

.

.



c 30


  • Results will be compared using ANOVA and paired t-test with each solution for comparing the amount of microorganisms using CFU before and after disinfection.



7.3 Does the study require any investigation or intervention to be conducted on patients or other human or animal? If so, please describe briefly.

Yes,The micro organisms will be collected from the dentures worn by the outpatients visiting the, Department of Prosthodontics, D.A.P.M.R.V.Dental College.




7.4 Has ethical clearance been obtained from your institution in case of being applicable?

Yes, it was placed before the ethical committee for clearance.

8.



REFERENCES:

  1. Francine Cristina da Silva et al: Effectiveness of Six different Disinfectants on Removing Five Micribial Speceies and Effects on the Topographic Characteristics of Acrylic Resin. Journal of Prosthodontics 2008;1-7

  2. A.C.Pavarina, A.C.Pizzolitto, A.L.Machodo, C.E.Vergani, E.T.Giampaolo. A control protocol: Effectiveness of immersion solutions to reduce microbial growth on dental prosthesis. Journal of Oral Rehabilitation 2003;30:532-536.

  3. W.Barnabe, T.D E Mendonca Neto, F.C.Pimenta, L.F.Pegoraro &J.M.Scolaro. Efficiency of sodium hypochlorite and coconut soap in removing Candida albicans from heat cure acrylic resin denture base material. Journal of Oral Rehabilitation 2004;31:453-459

  4. Debjit Bhowmik, Chiranjib, Jitender Yadav, K. K. Tripathi, K. P. Sampath Kumar. Herbal Remedies of Azadirachta indica and its Medicinal Application J.Chem. Pharm. Res., 2010, 2(1): 62-72



9



Signature of the candidate


10.

Remarks of the guide

11.



Name and designation of Guide (in block letters)
DR N. KALAVATHY, M.D.S

PROFESSOR & HEAD OF THE DEPARTMENT,

DEPARTMENT OF PROSTHODONTICS ,

CROWN AND BRIDGE AND IMPLANTOLOGY

D.A.P.M.R.V DENTAL COLLEGE AND HOSPITAL, BANGALORE





11.2

Signature of the Guide








11.3

Co-Guide (if any)

MISS SAVITHRI , MSc

DEPARTMENT OF GENARAL PATHOLOGY AND MICROBIOLOGY






11.4

Signature of the

Co-guide







11.5

Head of the Department

DR N. KALAVATHY, M.D.S

PROFESSOR & HEAD OF THE DEPARTMENT,

DEPARTMENT OF PROSTHODONTICS ,

CROWN AND BRIDGE AND IMPLANTOLOGY

D.A.P.M.R.V DENTAL COLLEGE AND HOSPITAL, BANGALORE






11.6

Signature of Head of the Department




12.

Remarks





12.1

Chairman





12.2

Principal

Dr.K.S.NAGESH, MDS

PRINCIPAL,

D.A.P.M.R.V DENTAL COLLEGE AND HOSPITAL, BANGALORE





12.3

Signature



Annexure (II)
CONSENT FORM


TITLE OF RESERCH PROJECT: A microbiological evaluation of effectiveness of disinfectants on heat polymerised denture base resin- An invivo study
PRINCIPAL INVESTIGATOR: Dr. Deepak Sachan
ADDRESS: Department of Prosthodontics,

Crown and Bridge and Implantology

D.A.P.M.R.V.Dental College and Hospital,

J.P. Nagar 1st phase, Bangalore.


DECLARATION BY THE PATIENT

I hereby, confirm that



  1. I was invited to participate in the above mentioned research project which is being undertaken by Department of Prosthodontics, crown and bridge D.A.P.M.R.V.Dental college , Bangalore.

  2. I have been explained the need and procedure of study in language known and understood by me.

  3. I have been informed that information is strictly confidential and although the findings will be reported on at scientific meeting or in the scientific publication that I will not be identified.

  4. I have informed that I have the right to refuse or withdraw from the study at any time without it affecting my future treatment. If I decide against participating, it will not be held against me and I will still receive treatment as specified.

  5. I have been informed that participation in the study will not result in any additional costs to me nor will I be paid.

  6. I have been informed that there is no risk involved in the study.

I HEREBY, CONSENT VOLUNTARILY TO PARTICIPATE IN THE ABOVE MENTIONED PROJECT.

Name and signature/ thumb print of patient. Signature of investigator


Date


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