Effect of Denture Cleansers on Cobalt-Chromium Alloy

Surface: A Simulated Period of 5 Years’ Use

Patrı́cia Almeida Curylofo, DDS, MSc, Priscilla Neves Raile, DDS, MSc,
Glenda Lara Lopes Vasconcellos, DDS, MSc, PhD, Ana Paula Macedo, BSEE, MSc, PhD, &
Valéria Oliveira Pagnano, DDS, MSc, PhD
Department of Dental Materials and Prosthetics, Dental School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil

Keywords
Confocal laser scanning microscopy;
removable partial denture; scanning electron
microscopy; surface roughness.
Correspondence
Dr Valéria Oliveira Pagnano, Department of
Dental Materials and Prosthetics, Dental
School of Ribeirão Preto, University of São
Paulo, Avenida do Café, s/n, Monte Alegre,
14040–904, Ribeirão Preto, SP, Brazil.
E-mail: valpag@forp.usp.br.
This study was funded in part by the
Coordenação de Aperfeiçoamento de Pessoal
de Nı́vel Superior - Brasil (CAPES) - Finance
Code 001.
The authors deny any conflicts of interest in
regards to the present study.
Accepted October 11, 2018
doi: 10.1111/jopr.12996
Abstract
Purpose: To compare the effect of solutions of effervescent tablets (ET), cetylpyri-
dinium chloride (CPC), and experimental solutions of Ricinus communis on the surface
of cobalt-chromium (Co-Cr) alloys.
Materials and Methods: Fifty-five specimens of Co-Cr were prepared by the lost-
wax casting method using circular patterns (࢝12 × 3 mm). The specimens were
randomly divided into 5 groups: deionized water (control); 2% R. communis; 10%
R. communis; ET, and CPC. The surface roughness of specimens (n = 10) was
evaluated before immersion (baseline), and at simulated times of ½, 1, 2, 3, 4, and
5 years, by laser confocal microscope (Sa, μm) and profilometer (Ra, μm). The
surface topography and chemical composition (n = 1) was qualitatively analyzed
with scanning electron microscopy (SEM), and energy dispersive X-ray spectrometry
(EDS). Data were subjected to Kruskal–Wallis followed by Dunn tests, and Friedman
followed by Wilcoxon tests (α = 0.05).
Results: For Sa, there was no difference for the solution factor. For the time factor a
significant difference was found with 2% R. communis solution among baseline and
½, 2, 3, and 5 years (p < 0.001) and with 10% R. communis solution between 1 and
2 years (p = 0.007), with decreasing roughness over time. For Ra, cetylpyridinium
chloride exhibited less roughness than 10% R. communis solution in ½ (p = 0.048)
and 5 years (p = 0.013). In the SEM and EDS analysis the solutions did not present
deleterious effects or changes in the chemical composition on the surfaces.
Conclusions: Although a significant difference was found for the roughness, the
results, below 0.2 μm, are clinically acceptable. Thus, all solutions can be used safely
in removable partial denture cleaning for a period of 5 years.

Removable partial dentures (RPDs) have a complex structure
and are made up of different types of materials, which tends
to make them difficult to clean.1 Acrylic resin, although sus-
ceptible to surface changes,2 has been extensively studied with
various cleaning methods; however, in relation to the metal
surface, the literature is scarce, and there is still no consensus
regarding the most advisable cleanser.3 Thus, there is no clean-
ing protocol that can be proven safe and indicated for RPDs
that are widely used by the population.
The mechanical method of brushing, although the most com-
mon and accessible, may not be as effective for the unmotivated
elderly, or for people who are physically incapable of promoting
adequate cleaning of their prostheses, due to either manual or
visual limitations.4 Thus, chemical immersion is often used to
accompany or replace the mechanical method of cleaning, pro-
viding satisfactory results.5,6 In addition, chemical immersion
is easy to manipulate and allows access to the more retentive
areas that accumulate biofilm.5
Chemical solutions have proven antimicrobial action and are
effective in the removal of biofilm,7-9 having special importance
in the remission of denture stomatitis.10 However, it has been
reported that some cleansers promote adverse effects on the
metallic surface, making them impracticable for use in RPD
cleaning, since compatibility with the constituent materials of
the denture is an important requirement for denture cleansers.11
Effervescent cleansing tablets are commonly indicated and,
their use is often recommended in the literature.1,12 There are
reports that they do not provide deleterious effects in relation
to the hardness and surface roughness of the metal alloys,11,13
besides being effective in the removal of biofilm.14 However,
although these compounds are indicated by manufacturers for
denture cleaning, undesirable effects such as oxidation of the

142 Journal of Prosthodontics 29 (2020) 142–150 

C 2018 by the American College of Prosthodontists
Curylofo et al Effect of Denture Cleansers on Co-Cr

Table 1 Experimental groups

Commercial name Total immersion time

(Group) Manufacturer Composition Immersion time to simulate 5 years

Deionized water NA H2 O 20 minutes daily2,15,16 609 hours

(H2 O/Control)
Ricinus communis Instituto de Quı́mica R. Communis oil (Diluted in water) 20 minutes 609 hours
(2% Rc/ 10% Rc) EESC-USP, São daily9,20,21,23
Carlos, Brazil
Cepacol (CPC) Sanofi-Aventis CPC, disodium EDTA, sodium 10 minutes daily2,15,16 304 hours
Farmacêutica Ltda. saccharin, sodium phosphate,
Suzano, Brazil disodium phosphate, eucalyptol,
menthol, methyl salicylate, flavoring,
perfume, Cl 19140 (tartrazine),
alcohol, and water (without dilution)
NitrAdine (ET) Bonyf AG Vaduz, Citric acid, sodium lauryl sulfate, 15 minutes 2x per 130 hours
Liechtenstein lactose monohydrate, sodium week
bicarbonate, sodium chloride, (recommended by
potassium monopersulfate, sodium manufacturer)
carbonate, mint flavoring, PVP
(diluted in water)

metal surface15 and release of ions11,16 have been found. In
addition, they have a relatively high cost, which makes ac-
cess difficult for some. NitrAdine effervescent tablet has been
reported as having effective antimicrobial action against Can-
dida albicans,14,17 unlike other tablets.17 In addition, there are
reports that it does not cause adverse effects on the surface of
the acrylic resin.2,15,18
Mouthwashes are also among the products most used by the
population for cleaning dentures. Among them is cetylpyri-
dinium chloride (CPC), which has been reported as effective
against C. albicans in complete dentures immersed for a pe-
riod of 8 hours,8 besides not causing change of roughness in
cobalt-chromium (Co-Cr) alloy for 6 months of use with daily
immersions of 10 minutes.15 However, because mouthwashes
are not specific for denture immersion, adequate guidelines for
this use are not provided, and they may cause damage to the
components of a prosthesis when used for a long period (RPD
lifetime has been reported to be 5 years).1,19
For complete dentures, castor oil (Ricinus communis) has
been evaluated as a cleanser7,9,11,20-22 due to its antifungal and
antibacterial characteristics, confirmed by studies related to
endodontics.23 According to Pisani et al,21 R. communis can
be seen as an alternative, inexpensive, and safe substance to be
used by the population. Although there are studies related to
the proven antimicrobial action of castor oil7,9,24 and its adverse
effects on acrylic resin,20,25 its action on dental alloys and the
best concentration to be used have not yet been evaluated.
Thus, the aim of this study was to evaluate the effect of
the experimental cleaning aqueous solution of R. communis in
different concentrations (2%, 10%), of the effervescent tablet
(NitrAdine), and of CPC on the surface of Co-Cr alloy, for the
simulated period of 5 years. The null hypothesis was that there
would be no clinically relevant alteration of the Co-Cr alloy
surface due to the use of different cleaning solutions tested
during a simulated period of 5 years’ use.
Materials and methods
Table 1 presents the experimental groups used in the study
and their respective immersion times. Fifty-five wax patterns
were obtained (GEO; Renfert GmbH, Hilzingen, Germany) in
disk shape (࢝12 × 3 mm) from a metal mold. They were
incrusted and used to cast the Co-Cr alloy (64.8% Co, 28.5%
Cr, 5.3% Mo, 0.5% Si, 0.5% Mn, 0.4% C - DeguDent; Dentsply
Ind. e Com. Ltda., Petropolis, Brazil) by lost-wax technique as
described by Bezzon et al.26
The metal discs were polished with 220-, 400-, 600-, and
1200-grit sandpaper (Norton Abrasivos, Guarulhos, Brazil)
in a polishing machine (Aropol-E; Arotec, Wellington, New
Zealand), and by a lathe (Kota, Cotia, Brazil) with diamond
polishing paste with granulation of 2 to 3 μm (Saphir; Renfert
GmbH). A homogeneous surface was obtained with an initial
surface roughness between 0.04 and 0.10 μm. All metal discs
were cleaned by ultrasound (Ultra Cleaner USC 750; Unique,
São Paulo, Brazil) with isopropyl alcohol for 10 minutes, for
surface washing and removal of any residue.
The metal disks were randomly distributed in 5 experimental
groups (n = 11) according to the cleanser solutions used (Fig 1).
Initial surface topography analysis and qualitative evaluation of
the surface composition of the Co-Cr alloy was performed on
one specimen of each group by scanning electron microscopy
(SEM) and energy dispersive X-ray spectroscopy (EDS)11 and
measurement of the surface roughness values (n = 10). The
specimens were then placed in plastic containers with 150 mL
of cleanser solution. All solutions were maintained at room
temperature, except the solution with the effervescent tablet in
which the distilled water was heated to 37°C,13 according to
the manufacturer’s instructions, in an oven (DeLeo Laboratory
Equipment, Porto Alegre, Brazil). The solution was then kept
in the oven to maintain this temperature during the 8 hours of
action of the solution, after which the solution was exchanged.27

Journal of Prosthodontics 29 (2020) 142–150 

C 2018 by the American College of Prosthodontists 143
Effect of Denture Cleansers on Co-Cr
Figure 1 Flowchart of experimental design.
Figure 2 Matrix and positioning of the specimen.
Considering that over the 5-year lifetime of the RPD, it would
be subject to 1825 daily immersions,19 this experiment was
performed with consecutive immersions respecting the daily
immersion time of each group (Table 1). After each immersion
period to be evaluated, the specimens were washed in distilled
water for 10 seconds.
Surface roughness
The surface roughness analyses, both by laser confocal micro-
scope and by profilometer, were performed before the start of
the immersions and at periods corresponding to ½, 1, 2, 3, 4,
and 5 years. A Teflon matrix was used (Precision workshop;
Dental Materials and Prosthesis Department of FORP-USP)
(Fig 2) to standardize the positioning of the specimen. The
Teflon matrix had a position index that, at the time of analysis,
coincided with the lateral marking of the specimen, such that it
was always analyzed in the same position, making it possible
to divide the area of the specimen by means of its markings,
so that the confocal microscope readings were not impaired by
the profilometer analyses.
Confocal microscopy
The average surface roughness (Sa, μm) of the polished sur-
face of the Co-Cr specimens was measured by microscopic
analysis of the specimens (5× objective lens) with a laser con-
144 Journal of Prosthodontics 29 (2020) 142–150 
Curylofo et al
focal microscope (LEXT OLS4000; Olympus, Tokyo, Japan),
which allowed high-resolution 3D imaging of the surfaces of
the metallic specimens (n = 10). Measurements were taken
1500 μm from the reference marking at the lateral edge of the
specimen.
Profilometer
To evaluate the roughness by profilometer (Surftest SJ-201P;
Mitutoyo Corp., Kawasaki, Japan), 3 readings were obtained on
the polished surface of each specimen to obtain an arithmetic
mean of the profile roughness deviations (Ra, μm). The surface
analyzer was calibrated at a 0.8-mm sample length, 4.0-mm
percussion of measure, and 0.5-mm/sec speed.
Surface topography and chemical composition
One specimen from each experimental group was analyzed
by SEM (EVO 50; CARL ZEISS, Oberkochen, Germany) for
qualitative evaluation of the surface in relation to changes and
oxidation of the metallic surface, and with EDS in relation to
the chemical composition of areas of interest (500 Digital Pro-
cessing; IXRF Systems, Austin, TX). Analyses were conducted
at a magnification of 300x in the spot mode (EDS2004 Version
1.3 Software User´s Guide - IXRF Systems). The direct analy-
sis of the light elements was performed taking into account the
flatness and cleanness of the specimens, and also the proces-
sor characteristic (digital pulse). The ZAF correction factors
were used for element quantification.28 The acronym ‘ZAF’
describes a procedure in which corrections for atomic number
effects (Z), absorption (A), and fluorescence (F) are calculated
separately from suitable physical models.
Statistical analysis
The data were analyzed with statistical software (IBM SPSS 20;
SPSS Inc, Chicago, IL). The data showed a non-normal distribu-
tion (Shapiro-Wilk test), and were subjected to Kruskal–Wallis
followed by Dunn tests to compare solutions, and Friedman
followed by Wilcoxon tests to compare times. Multiple com-
parisons were adjusted by Bonferroni correction (α = 0.05).
C 2018 by the American College of Prosthodontists
Curylofo et al
Figure 3 Images obtained through the confocal microscope: I. Before
immersion; II. After simulated immersion of 5 years in the following so-
lutions: A, Deionized water; B, 2% R. communis; C, 10% R. communis;
D, Effervescent tablet; E, CPC.
Results
Surface roughness
Micrographs of the initial and final surface aspects of the Co-Cr
alloys immersed in different solutions were obtained by laser
confocal microscopy (Fig 3). The initial appearance of the Co-
Cr alloy surface was preserved in the final appearance, that
is, there were no significant alterations of topography, and the
Journal of Prosthodontics 29 (2020) 142–150 
C 2018 by the American College of Prosthodontists
Effect of Denture Cleansers on Co-Cr
integrity of the metal surfaces was maintained after the 5-year
immersion simulations in the different solutions used.
Table 2 shows the median and confidence interval (μm) and
results of the statistical analysis of surface roughness obtained
by confocal microscopy (Sa) before and after the immersion
simulations. Comparing the solutions at each time, there was
no statistically significant difference between any solution. In
the comparison of the times, there was a statistical difference
in surface roughness (Sa – median [confidence interval]) in the
2% R. communis solution from baseline (0.66 [0.59; 0.73]) to ½
(0.53 [0.46; 0.63]), 2 (0.55 [0.46; 0.63]), 3 (0.50 [0.45; 0.55]),
and 5 years (0.54 [0.47; 0.61]) (p < 0.001), with a tendency
to decrease over time. In the 10% R. communis solution there
was a significant decrease in the roughness from 1 (0.53 [0.47;
0.69)] to 2 years (0.50 [0.44; 0.65]) (p = 0.007); the other
times presented intermediate values. For CPC, a significant dif-
ference (p = 0.03) was observed among the times but when the
post-test was used, with adjustment for the number of pairwise
comparisons, no significant difference was found for surface
roughness (Sa).
Table 3 presents the results of the statistical analysis of sur-
face roughness obtained with the surface profilometer (Ra),
before and after the immersion simulation corresponding to
5 years. Comparing the solutions at each time, there was a
significant difference at baseline (p = 0.028); however, after
adjusting for the number of pairwise comparisons, no signifi-
cant difference was found for any pair. The CPC exhibited less
roughness (p = 0.048) than 10% R. communis solution at ½
(0.05 [0.05; 0.06]; 0.08 [0.07; 0.09]) and 5 years (0.05 [0.04;
0.06]; 0.08 [0.06; 0.09]) (p = 0.013). The other solutions pre-
sented intermediate values at ½ and 5 years. No difference was
observed among the solutions at 1, 2, 3, and 4 years. In the
comparison of the times, water showed a decrease in surface
roughness (Ra) between baseline (0.08 [0.06; 0.09]) and 1 year
(0.06 [0.05; 0.07]). In the other solutions, there was no sig-
nificant difference between surface roughness at the evaluated
times.
Surface topography and chemical composition
The analysis of the surfaces obtained through the SEM can be
visualized in Figure 4. There is an absence of apparent surface
changes, as well as no evidence of corrosion before or after
immersion in cleanser solutions.
The results of the chemical composition analyses of the Co-
Cr alloy obtained by EDS before and after immersion in the
cleanser solutions are presented in Table 4. According to the
quantitative analysis of the chemical elements, the chemical
elements retained final mass values close to the initial ones.
Discussion
In search of an RPD cleaning method that preserves the metallic
surface, this study evaluated the surface roughness of the Co-Cr
metal alloy commonly used in the construction of RPDs against
the use of chemical cleansers, such as 2% and 10% R. commu-
nis, effervescent tablet, and CPC. Since a roughness below 0.2
μm is considered clinically acceptable because it does not pro-
mote microbial adhesion,29,30 the null hypothesis of this study
145
146
Table 2 Median (95% confidence interval) of the surface roughness (Sa, μm) for the different times / cleanser solutions and statistical comparisons between the solutions

Baseline ½ year 1 year 2 years 3 years 4 years 5 years P∗∗

H2 O 0.55(0.52; 0.62)a,A 0.56(0.50; 0.65)a,A 0.57(0.49; 0.68)a,A 0.57(0.50; 0.67)a,A 0.60(0.53; 0.70)a,A 0.56(0.49; 0.68)a,A 0.57(0.47; 0.65)a,A 0.572
2% Rc 0.66(0.59; 0.73)a,A 0.53(0.46; 0.63)a,B 0.52(0.47; 0.56)a,AB 0.55(0.46; 0.63)a,B 0.50(0.45; 0.55)a,B 0.57(0.49; 0.59)a,AB 0.54(0.47; 0.61)a,B <0.001
10% Rc 0.52(0.43; 0.66)a,AB 0.52(0.45; 0.67)a,AB 0.53(0.47; 0.69)a,B 0.50(0.44; 0.65)a,A 0.52(0.44; 0.71)a,AB 0.54(0.47; 0.69)a,AB 0.52(0.44; 0.63)a,AB 0.007
ET 0.63(0.51; 0.69)a,A 0.59(0.52; 0.68)a,A 0.62(0.53; 0.75)a,A 0.60(0.52; 0.67)a,A 0.58(0.50; 0.69)a,A 0.62(0.51; 0.73)a,A 0.59(0.52; 0.74)a,A 0.489
CPC 0.51(0.48; 0.69)a,A 0.53(0.47; 0.63)a,A 0.57(0.49; 0.65)a,A 0.57(0.45; 0.63)a,A 0.56(0.46; 0.67)a,A 0.56(0.48; 0.65)a,A 0.51(0.44; 0.60)a,A 0.030
Effect of Denture Cleansers on Co-Cr

P∗ 0.246 0.788 0.482 0.682 0.417 0.756 0.476

*
Kruskal-Wallis test, comparison of solutions at each time
ab
equal lowercase letters indicate statistical similarities between solutions
**
Friedman test, comparison of the times for each solution
AB
equal capital letters indicate statistical similarities between times
H2 O - Deionized water (control); 2% Rc - 2% R. communis;10% Rc - 10% R. communis; ET- Effervescent tablet (NitrAdine) e; CPC - Cetylpyridinium chloride

Table 3 Median (95% confidence interval) of the surface roughness (Ra, μm) for the different times / cleanser solutions

Baseline ½ year 1 year 2 years 3 years 4 years 5 years P∗∗

H2 O 0.08(0.06; 0.09)a,A 0.07(0.06; 0.07)ab,AB 0.06(0.05; 0.07)a,B 0.06(0.06; 0.07)a,AB 0.07(0.06; 0.07)a,AB 0.07(0.05; 0.07)a,AB 0.07(0.06; 0.08)ab,AB 0.013
2% Rc 0.08(0.06; 0.08)a,A 0.06(0.05; 0.08)ab,A 0.06(0.05; 0.07)a,A 0.07(0.05; 0.07)a,A 0.06(0.05; 0.07)a,A 0.07(0.06; 0.08)a,A 0.06(0.05; 0.07)ab,A 0.271

Journal of Prosthodontics 29 (2020) 142–150 

10% Rc 0.08(0.06; 0.09)a,A 0.08(0.07; 0.09)a,A 0.06(0.05; 0.07)a,A 0.08(0.06; 0.09)a,A 0.07(0.06; 0.08)a,A 0.06(0.05; 0.08)a,A 0.08(0.06; 0.09)a,A 0.233
ET 0.08(0.06; 0.09)a,A 0.07(0.05; 0.09)ab,A 0.07(0.06; 0.07)a,A 0.07(0.06; 0.09)a,A 0.07(0.06; 0.08)a,A 0.07(0.06; 0.08)a,A 0.07(0.06; 0.08)ab,A 0.415
CPC 0.06(0.05; 0.07)a,A 0.05(0.05; 0.06)b,A 0.05(0.04; 0.06)a,A 0.06(0.05; 0.06)a,A 0.05(0.05; 0.06)a,A 0.06(0.05; 0.07)a,A 0.05(0.04; 0.06)b,A 0.252
P∗ 0.028 0.048 0.084 0.084 0.066 0.491 0.013
*
Kruskal-Wallis test, comparison of solutions at each time
ab
equal lowercase letters indicate statistical similarities between solutions
**
Friedman test, comparison of the times for each solution
AB
equal capital letters indicate statistical similarities between times
H2 O - Deionized water (control); 2% Rc - 2% R. communis;10% Rc - 10% R. communis; ET- Effervescent tablet (NitrAdine) e; CPC - Cetylpyridinium chloride

C 2018 by the American College of Prosthodontists

Curylofo et al
Curylofo et al
Figure 4 Electromicrographs: I. Before immersion; II. After simulated
immersion of 5 years in the following solutions: A, Deionized water; B,
2% R. communis; C, 10% R. communis; D, Effervescent tablet; E, CPC.
was accepted, since there were no clinically relevant differ-
ences between the chemical cleansers tested on the Co-Cr metal
surface during the simulated 5-year period. Several chemical
cleaning methods have proven to be beneficial, especially re-
garding antimicrobial action and removal of biofilm.7-9,17 How-
ever, at the same time that chemical cleaning is important for
the removal of biofilm, some studies imply that the surface of
the acrylic resin changes when using these cleansers.15,31
Journal of Prosthodontics 29 (2020) 142–150 
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Effect of Denture Cleansers on Co-Cr
Surface roughness favors the formation and accumulation of
biofilm,32,33 causing it to be strongly adhered to the base of the
denture33 and promoting the development of an inflammatory
process in the underlying mucosa.29 According to Teughels
et al,32 the initial adhesion of microorganisms in rough areas
occurs due to a lower incidence of shearing forces under these
conditions and, additionally, it makes the daily cleaning of the
denture, especially of RPDs, more complex.
In this study, immersion simulations were performed in the
cleansers from ½ to 5 years, corresponding to the RPD lifes-
pan noted in the literature.1,19 According to the results obtained
through the confocal microscope, there was no significant dif-
ference between the cleaning solutions in the 6 evaluated times
(Table 2); however, with the profilometer, the results indicated
a higher Ra in 10% R. communis when compared to CPC, both
at ½ and 5 years (Table 3). This result can be attributed to the
initial Ra of the 10% R. communis and CPC groups, which
presented the highest and lowest initial values, respectively,
but without significant difference when compared to the initial
roughness values of the other groups. Thus, the small rough-
ness changes observed at ½ and 5 years promoted significantly
different results between them; however, such roughness values
were considered within normal ranges, since they are clinically
acceptable (below 0.2 μm).29,30
The profilometer (Ra) calculates the mean deviation of a pro-
file, and the confocal microscope (Sa) calculates the arithmetic
mean of the surface deviation.34 The profilometer is a quanti-
tative method only, whereas the laser confocal microscope al-
lows high-resolution 3D images to be obtained for subsequent
quantitative and qualitative analysis of surface roughness. Re-
cently, studies related to several areas have used this apparatus
for surface analyses;34,35 however, none was performed with
a similar purpose to this study. Therefore, these two differ-
ent methods were used to evaluate, in addition to the surface
changes, the sensitivity of each technique, in order to help future
studies.
The confocal microscope was sensitive to surface changes,
allowed a greater area of analysis, better distributed the er-
ror, and did not induce different results, such as the difference
between 10% R. communis and CPC obtained when using the
profilometer. In this case, it is possible to consider that while the
Ra value was very close to the recommended value, there was
no significant surface change, as well as in all other evaluated
solutions.
The results found in this study for the effervescent tablet
corroborate Davi et al’s2 and Paranhos et al’s findings,18
that when assessing metallic surfaces of different dental al-
loys, such as pure titanium, nickel-chromium-molybdenum-
titanium, nickel-chromium, and nickel-chromium-beryllium,
that there was no influence of the effervescent tablet cleanser on
the surface roughness, and furthermore that it did not change the
brightness of the metallic surfaces. However, both studies sim-
ulated only 6 months of use. Nevertheless, in previous studies
with similar methodology, which also used NitrAdine effer-
vescent tablet, adverse effects such as oxidation15 and greater
release of ions16 were found in Co-Cr alloys. Such divergent
results may be related not only to the simulated immersion
period reproduced in these studies, but also to the change in
composition and mode of use of the effervescent tablet.
147
Effect of Denture Cleansers on Co-Cr
Table 4 Quantitative analysis (% by mass) of the chemical elements before and after the 5-year immersion simulation
Solutions Phases Co
H2 O Initial 64.274
Final 65.152
2% Rc Initial 63.663
Final 64.429
10% Rc Initial 64.537
Final 64.500
ET Initial 64.040
Final 65.258
CPC Initial 64.085
Final 64.758
H2 O - Deionized water (control); 2% Rc - 2% R. communis; 10% Rc - 10% R. communis; ET- Effervescent tablet (NitrAdine) e; CPC- Cetylpyridinium chloride.
Currently, the manufacturer recommends immersion only 2
times a week, that is, every 3.5 days, a fact that decreases the
exposure of the metal to the action of the constituent elements
of the effervescent tablet. Moreover, the new formulation has
the addition of sodium carbonate (neutral salt), which may
contribute toward preserving or decreasing the amount of
oxygen in the surfaces of metallic specimens, which may be
why the oxygen content did not increase as Felipucci et al’s
study.15 Furthermore, unlike most commercially available
effervescent tablets, which include sodium perborate or sodium
percarbonate as an oxygen-releasing agent, and an alkaline
detergent such as trisodium phosphate,36 NitrAdine contains
citric acid, responsible for breaking bridges of calcium ions
that act as chemical binding sites for the extracellular polymer
chains, contributing to its antimicrobial action,37 and sodium
lauryl sulfate, which is a detergent used in the solubilization
of proteins. Thus, it is possible that the different components
that contribute to its effectiveness14,36 do not change the Co-Cr
surface.
The solutions of 2% R. communis, and 10% R. communis
promoted significant changes of the surface roughness (Sa) as
a function of time, when the metallic specimens were evalu-
ated by the laser confocal microscope. Experimental solutions
presented a tendency to decrease roughness in ½, 2, 3, and
5 years in 2% R. communis, and 1 and 2 years in 10% R.
communis. According to Pisani et al,20 the loss of soluble com-
ponents during immersions may cause the formation of voids
or bubbles with a configuration of peaks and valleys responsi-
ble for the roughness, and when the solubilization happens in
the peaks, the final average roughness decreases, making the
specimen smoother. However, as previously mentioned, the dif-
ferences between times were occasional and not for all groups.
Additionally, there is no way to compare these findings with
other authors because none evaluated the action of R. com-
munis in dental alloy, this being a pioneering study in this
evaluation.
These results demonstrate that solutions of both 2% and 10%
R. communis (Table 3) provided clinically acceptable values of
roughness,29,30 and did not cause deleterious effects on the
Co-Cr surface. R. communis, despite its mechanism of action
still being unknown, is indicated to have an action compara-
ble to that of alkaline peroxide toward the antimicrobial ac-
148 Journal of Prosthodontics 29 (2020) 142–150 
Curylofo et al
Cr Mo O
28.006 5.318 0.950
28.104 5.357 0.570
27.936 5.819 1.083
27.970 5.889 0.563
28.163 5.231 0.794
27.842 5.956 0.549
28.059 5.765 0.854
28.078 5.196 0.565
28.326 5.686 0.934
28.051 5.625 0.548
tivity in complete dentures,7 and to 0.5% sodium hypochlorite
when used in root canals with pulp necrosis.23 R. communis
presents benefits such as low cost, biocompatibility, and deter-
gent properties.38 In this way, the solution of R. communis can
be safely indicated in the concentrations evaluated as an RPD
cleanser. It is cultivated in many countries, thus its production
and commercialization is feasible for denture users.
The cleanser 0.5 mg CPC is classified as a cationic surfactant
having antibacterial action.39 The results obtained in this study
corroborate Felipucci et al16 and Davi et al’s findings2 that the
surface of the dental alloys used in the manufacture of partial
dentures showed no change due to the use of this solution. In
addition, this solution does not cause oxidation in the Co-Cr
alloy or change the roughness of the acrylic resin,15 and can
thus be seen as an alternative for denture cleaning.
The simulated immersion periods varied according
to the manufacturers’ recommendations and literature
findings,2,9,16,18,20,25 and the solutions tested were selected
according to their properties. Our findings show the effects
of these cleansers over the lifetime of the denture, bring-
ing information on the adverse effects not yet reported in
the literature, since the studies found were of short-term
evaluations.2,13,15,16,18
Complementary qualitative analysis confirmed the findings
of the quantitative analysis; there were no changes in texture,
staining, oxidation, or any other deleterious effect promoted
by the solutions. From the EDS analysis, it was observed that
there was a tendency for the oxygen levels to decrease over
time immersed, confirming the absence of oxidation of the
metal surface. As a control solution, deionized water was used,
as in other works of the group,2,15,16,18 to avoid any interference
to the surface roughness due to the release of ions which would
occur when using tap or distilled water. According to the ob-
tained results, from different complementary methodologies,
the tested solutions did not promote adverse effects that could
harm the Co-Cr surface. It is expected that these results will be
associated with other variables, so that there is a consensus for
indication of RPD cleaning methods, considering its limitations
and means of action. Thus, it will be possible for the dentist to
safely indicate the best cleaning method for RPD users.
The focus of this study was to analyze the chemical im-
mersion method alone, that is, without associating it with the
C 2018 by the American College of Prosthodontists
Curylofo et al
mechanical method, seeking an objective evaluation of the
chemical methods of cleaning. Future in vitro studies should
be performed simulating oral cavity conditions such as biofilm
presence, temperature changes, and salivary pH, and in vivo,
to evaluate the effects and the acceptance of cleansers by RPD
users, to indicate their use as a viable alternative.
Conclusions
Based on the experimental conditions and methods used in the
present study, it was concluded that:
1. There was no change in surface roughness of the cobalt-
chromium alloy immersed in the solutions, for the simu-
lated period of 5 years’ use.
2. According to the images obtained by SEM and confo-
cal microscopy, the cleaning solutions evaluated did not
cause changes in the cobalt-chromium surface suggestive
of oxidation.
3. The cleaning solutions evaluated did not promote ad-
verse effects on the cobalt-chromium surface and could
be safely used under recommended use conditions over
a period of 5 years.
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