Denture Cream Research Articles

The influence of oral cavity physiological parameters: temperature, pH, and swelling on the performance of denture adhesives - in vitro study

BackgroundThe various physical and chemical conditions within the oral cavity are hypothesized to have a significant influence on the behavior of denture adhesives and therefore the overall comfort of denture wearers. As such, this study aims to understand the influence of oral cavity physiological parameters such as temperature (17 to 52 °C), pH (2, 7, 10), and denture adhesive swelling due to saliva (20–120%) on the behavior of denture adhesives. This study further aims to emphasize the need for a collective approach to modelling the in-situ behavior of denture adhesives.MethodsRheological measurements were carried out using the Super Polygrip Ultra fresh brand denture adhesive cream to evaluate its storage modulus (G´) and loss modulus (G´´) values at a range of physiologically relevant temperatures, pH values, and degrees of swelling, to represent and characterize the wide variety of conditions that occur within the oral cavity.ResultsRheological data was recorded with respect to variation of temperature, pH, and swelling. Overall, it can be seen that the physiological conditions of the oral cavity have an influence on the rheological properties of the denture adhesive cream. Specifically, our data indicates that the adhesive’s mechanical properties are weakly influenced by pH, but do change with respect to the temperature in the oral cavity and the swelling rate of the adhesive.ConclusionsOur results suggest that the collective inter-play of the parameters pH, temperature and swelling ratio have an influence on the behavior of the denture adhesive. The results clearly highlight the need for developing a multi-parameter viscoelastic material model to understand the collective influence of physiological parameters on the performance of denture adhesives. Multi-parameter models can also potentially be utilized in numerically simulating denture adhesives using finite element simulations.

Protective periodontitis: the possibility of prevention

Relevance. The isolation of prosthetic periodontitis among inflammatory periodontal pathology has significantly supplemented the generally accepted notions of dentists concerning the etiology and progression of dental prosthetics complications. Improving the methods of preventing inflammatory periodontal lesions caused by the presence of denture structures in the oral cavity is very relevant nowadays, especially in persons using removable dental prostheses. This applies to older age groups, which for financial reasons are more accessible removable acrylic dentures, which they have the opportunity to get at the expense of the budget of the region.Aim. This applies to those in the older age groups who, for financial reasons, have more access to removable acrylic dentures because of the possibility of obtaining dentures at the expense of the regional budget. Therefore, the aim of the study was to assess the possibility of using a new domestic denture fixation cream for the prevention of prosthetic periodontitis in patients using removable dentures.Materials and methods. 63 (18 male and 45 female) elderly patients (61-74 years old) with partial tooth loss on both jaws were examined. Partial removable acrylic dentures were made for patients 1st group (n = 30) and 2nd group (n = 33). The patients of the second group constantly used the domestic ASEPTA РARODONTAL denture fixation cream with herbal extract for 9 months of the study. Assessment of the impact of dentures on the oral tissues and periodontium was carried out on the basis of clinical examination and by studying the antimicrobial potential of saliva.Results. The use of partial removable acrylic dentures has been found to contribute to the occurrence of prosthetic periodontitis, which is associated with the technology used in their manufacture. It is possible to reduce the incidence of prosthetic periodontitis not only by timely correction of prosthesis but also by using adhesive means for fixation of prosthesis, the application of which permitted to reduce the occurrence of prosthetic periodontitis by 47,58% and to reduce the occurrence of inflammatory changes of gingiva in the restored teeth area by 16,06%. The research of the antimicrobial potential of saliva in persons who constantly used ASEPTA РARODONTAL denture fixation cream with herbal extract showed that the immune balance achieved before dental prosthetics can be maintained in the oral cavity.Conclusion. The results of the clinical and laboratory study allow us to recommend more widely the use of adhesive means for fixation of removable dentures, including the ASEPTA PARODONTAL cream with herbal extracts.

Effects of acrylic dentures on oral mucosa and salivary antimicrobial peptide content in denture wearers

Relevance. Aging of the body leads to the development of an imbalance in the secretory immunity of the oral mucosa, with the loss of natural teeth leading to an even more rapid decline in the host’s oral defense reactions. However, studies on salivary antimicrobial peptides in denture users and their potential role in protecting against the development of inflammation are still scarce at this time.Purpose. To evaluate the effects of full removable acrylic dentures on the oral mucosa and analyze the content of antimicrobial peptides in the saliva of wearers of such dentures.Materials and methods. Sixty-seven (21 men and 46 women) elderly patients (61 to 74 years old) with complete tooth loss were examined and divided into 3 study groups. In the 1st control group the patients did not use any dentures. Patients in groups 2 and 3 were made full removable acrylic dentures for the upper and lower jaws, and in group 2 from the first day of the adaptation period was used domestic denture fixation cream ASEPTA PARODONTAL. Assessment of the denture bed on the hard palate was performed visually using the Schiller – Pisarev test. Microbiological examination for Candida albicans was performed by PCR-diagnostics. The content of antimicrobial peptides in saliva was assessed using ELISA kits by Hycult Biotech.Results. The use of the adhesive cream was found to improve the condition of the palatal mucosa by 25% on the 15th day and by 50% on the 30th day of the adaptation period. Candida albicans was detected in oral material in more than 55% of patients in all groups during their initial examination. In the group of patients using denture fixation cream, a significant decrease in Candida albicans carriage was noted, while an increase in Candida albicans detection of up to 70% was noted in those not using the cream. There was also an increase in the level of cathelicidin LL-37 in the saliva of patients without the use of the cream and with a marked increase in inflammation. One month after dentures in patients without cream use the content of alpha-defensins (HNP 1-3) was significantly lower than that of the group with cream and the control group.Conclusion. On the basis of the carried out clinical and laboratory study, the domestic ACEPTA adhesive cream should be recommended for optimization of the adaptation period to removable acrylic dentures as well as for their permanent use.

Effect of a new domestic remedy for fixation of removable dentures on oral mucosal immunity

BACKGROUND: The persisting high incidence of complications in removable acrylic dentures should convince the researchers to understand the consequences of denture use on the oral health and whole organism.
 AIM: To examine the peculiarities of the oral mucosal immunity in patients with partial removable acrylic dentures and to evaluate the efficacy of the application of Asepta Prodontal denture fixation agent.
 MATERIAL AND METHODS: Mucosal immunity was studied in 93 (24 men and 69 women) elderly patients (aged 61 74 years) with partial tooth loss who were divided into three study groups. Patients in the control group 1 (n=30) did not use any dentures. Group 2 (n=33) had partial removable acrylic dentures and from the first day of the adaptation period were offered to use the domestic denture fixation cream Asepta Parodontal (ZAO VERTEX, Saint Petersburg, Russia). Partial removable acrylic dentures were also made for group 3 (n=30), but their adaptation period was conducted without the application of domestic Asepta Parodontal denture fixation cream.
 RESULTS: On day 15 of the adaptation period in groups 2 and 3, inflammatory changes in the denture bed mucosa were revealed in 9.1% and 56.7% of the cases, respectively. On day 30 of dynamic observation in groups 2 and 3, inflammatory changes in the prosthetic bed mucosa were noted in 6.1% and 40.0% of the cases, respectively. The average numbers of visits to the doctor for denture correction in groups 2 and 3 were 1.33 and 2.76, respectively. A significant increase was found in the levels of pro-inflammatory cytokines on day 15 of the study in the saliva of patients with removable dentures, who used them without the denture fixation agent Asepta Parodontal, whereas patients using Asepta Parodontal showed an increase only in interleukins (IL) 6 and 8. Moreover, on day 30 of the study, no differences from the control group were observed in the concentration of pro-inflammatory cytokines compared with the group using domestic denture fixation cream, and in the group without using the cream, no decrease in the level of pro-inflammatory cytokines was noted. The concentration of RAIL and IL-10 increased in group 3 on both day 15 and 30, whereas no significant differences were observed in the group using the cream.
 CONCLUSION: Better prosthetic bed condition, decreased concentration of pro-inflammatory cytokines with a simultaneous elevation of secretory IgA in the oral cavity, testifying to the decrease in inflammation, and an increase in the immunity of the oral mucosa was noted in patients using Asepta Parodontal denture fixation agent.

The Role of Denture Adhesives on the Oral Health of Partial Denture Wearers: A Numerical Study

AbstractRemovable partial dentures (RPDs) significantly influence the mechanical stress characteristics of the entire dental arch. Unlike normal teeth, they are not anchored firmly in the jaws and hence are prone to denture slippage. The aim of this study is to examine numerically using finite element (FE) method, the role of denture adhesive creams in the stress response of the dental structures, and to understand its impact on the oral health of denture wearers. For this purpose, computer tomography data of the jawbone and RPDs are utilized to develop corresponding 3D models, which are further used for FE simulations. The partial denture system is bonded onto the surface of the oral mucosa with the help of a viscoelastic adhesive layer and is also supported by three abutment teeth. The application of bite forces on the denture generates varying contact mechanical response to the stimulus, across the partial denture, which are compared with the clinical pressure pain threshold (PPT) value for soft tissue, which potentially lowers the risk of pain. The model with the denture adhesive shows better retention and are within the PPT and hence can potentially lower the risks associated with denture slippage.

127 Hypocupraemia-induced anaemia, sensory ataxia and cognitive impairment secondary to zinc-containing dental adhesive

A previously fit and well 67 year old male presented with a 5-month history of gradually worsening memory impairment and sensory gait ataxia on the background of recent symptomatic anaemia. He experienced multiple falls and became agitated and socially withdrawn over a 3-week period, resulting in hospital admission. On examination, he had sensory gait ataxia consistent with a dorsal column syndrome. He had a Montreal Cognitive Assessment score of 13. Serum analysis showed normocytic anaemia and leukopenia, severe hypocupraemia, reduced caeruloplasmin and normal zinc levels. Overuse of zinc- containing denture cream was identified as being a cause of excess zinc ingestion and resultant copper deficiency, leading to blood dyscrasia and myelopathy. The cream was withdrawn and IV copper followed by oral supplementation was implemented. Direct questions with regards to excess zinc in the diet and serological testing of copper and zinc should be considered in any patient with a dorsal column syndrome, particularly with concurrent anaemia. Copper deficiency may also have a role in exacerbat- ing pre-existing cognitive impairment.rnj1e16@soton.ac.uk

Total tooth loss and its treatment with removable dentures: features of the microbiota and mucosal immunity

The prevention of denture stomatitis is an important measure in the clinic of orthopedic dentistry, because at present, in spite of the availability of dentures on artificial supports, full removable dentures are still widely in demand. The study of oral microbiome and mucosal immunity in persons using full removable acrylic dentures was carried out, as it is important for scientifically substantiated development of ways to prevent denture stomatitis. Sixty-seven elderly patients with total tooth loss were examined and divided into 3 study groups. Patients in Group 1 (19 people) did not use any dentures. Patients in group 2 (25 people) had full removable acrylic dentures and from the first day of the adaptation period were offered to use the domestic denture fixation cream Acepta Parodontal. Patients of group 3 (23 people) were also made full removable acrylic dentures, but their adaptation period took place without the use of denture fixation cream. During the clinical-laboratory study it was established that the use of domestic Acepta Parodontal denture fixation cream in patients with full removable acrylic dentures during the adaptation period leads to a decrease in the level of inflammation in the oral cavity, contributes to an increase in mucosal immunity of its mucous membranes, as evidenced by the increased synthesis of secretory immunoglobulin A. At the same time, improvement of oral microbiota was noted, including reduction of detectability of Candida albicans as the main pathogen associated with denture stomatitis.

Cytotoxic Potential of Denture Adhesives on Human Fibroblasts-In Vitro Study.

(1) In recent years, there has been a significant increase in the availability of denture adhesives for stabilizing removable dentures. The aim of the present study was to assess the cytotoxicity of three denture adhesives on human fibroblasts. (2) Methods: Three denture adhesives were analyzed. Fibroblast cultures were established for the study and control groups in order to assess the incidence of necrosis and to evaluate the microscopic intracellular alterations induced. Following incubation with (study groups) or without adhesives (control group), trypan blue dye exclusion assay was used to determine the number of viable and/or dead cells. Microscopic specimens were stained with haematoxylin and eosin, scanned, digitally processed and then analyzed by a histopathologist. (3) Results: All three denture adhesives analyzed demonstrated various toxic effects in vitro on human fibroblast: quantitative evaluation—45.87–61.13% reduction of cell viability (p = 0.0001) and slight to moderate cytotoxicity in qualitative evaluation. (4) Conclusions: Denture adhesive creams demonstrated a toxic effect on human fibroblasts in vitro in quantitative and qualitative evaluation. In vivo observations are needed to find out if denture adhesives present a cytotoxic effect in patients.

Prevention of inflammatory changes in the denture-bearing mucous membrane

Relevance. Advanced clinical and cytological studies have not been conducted yet to examine denture adhesive effect on the prevention of inflammatory changes in the mucous membrane of the prosthetic bed, and thus, the prevention of denture-related stomatitis. Purpose: to assess the clinical and functional condition of the oral mucosa beneath the denture during the adaptation period using a denture adhesive cream to prevent inflammation of the denture bed mucous membrane.Materials and methods. The study clinically and cytologically (washing, scraping) assessed the condition of oral mucosa beneath complete acrylic dentures on days 14-16 and 28-30 of the adaptation period in 15 fully edentulous patients (main group), who used an adhesive cream after they were delivered their dentures, and in 21 fully edentulous patients (control group) who did not use the cream during the denture adaptation period. All the patients were elderly.Results. At different times of the adaptation period, the study more frequently detected inflammatory changes in the denture-bearing mucosa in subjects who did not use the denture adhesive cream. The cytological study confirmed the results of the oral clinical examination, as, at the end of the adaptation period, the number of cellular elements and various microorganisms was significantly lower in the main group than in the controls, which proved the effectiveness of the denture adhesive cream for the prevention of denture stomatitis.Conclusions. Regardless of sex, patients with complete acrylic dentures, who used a denture adhesive cream, had a lower bacterial accumulation on the prosthetic bed and inflammatory changes during the adaptation period, which allowed us to recommend the adhesive cream for the prevention of denture stomatitis.

Beyond Alzheimers: Memantine for treatment of behavioral disturbance in otherwise unspecified major neurocognitive disorder

<h3>Introduction</h3> Major neurocognitive dysfunction (NCD) currently affects up to 5.7 million people in the United States, with numbers expected to rise above 13 million by 2050¹. Unfortunately, behavioral disturbances are exceedingly common in patients with major NCD, representing a significant source of morbidity and mortality in this population. This is particularly burdensome to patients in hospitals and assisted-living facilities (ALFs), leading to increased lengths of stay and decreased quality-of-life measures². Furthermore, behavioral disturbance increases psychological stress and fatigue imposed on family and caregivers. Despite the overwhelming consequences of behavioral disturbance in major NCD, we have relatively few options for treatment, with many of these lacking robust supportive data. Memantine, an NMDA antagonist used in moderate-to-severe Alzheimer dementia (AD), has been shown to improve behavioral disturbance in AD patients³. In this case report, we describe the use of memantine for the treatment of behavioral disturbance in a patient with unspecified major NCD. <h3>Methods</h3> This is a case of a 76-year-old man with bipolar 1 disorder who presented with unspecified major NCD with behavioral disturbance characterized by threatening staff at his ALF when food preferences were not accommodated. He reported no symptoms and showed no signs of a manic or depressive episode. His initial MoCA score was 16/30. In the hospital, he exhibited a disruptive and confrontational attitude, hyperphagia with excessive carbohydrate consumption, forgetfulness with perseveration on requests for denture cream and Chapstick, and disinhibited sexual commentary concerning for frontotemporal dementia, but also had concern for vascular dementia given his hypertension and atrial fibrillation. He had a gradual decline in memory function over a period of several years, with MMSE scores trending from 29/30 to 20/30 over the past 7 years, raising concern for possible AD. He also exhibited intermittent paranoia. He refused brain MRI. Memantine 5 mg daily was started and increased by 5 mg each week until reaching 20 mg daily (10 mg BID). <h3>Results</h3> After beginning treatment with memantine, patient exhibited reductions in social isolation, disruptive/disinhibited behavior, intrusiveness, perseverative requests, and paranoia. MoCA score improved by 2 points after 2 weeks of therapy, and by 5 points after 7 weeks of treatment. <h3>Conclusions</h3> It was concluded that memantine may have the potential to improve behavioral disturbances in patients with unspecified major NCD. Furthermore, the clinically significant improvement in this patient's paranoia suggests that memantine may also augment the potency of clozapine. Notable also is memantine's favorable side-effect profile, making it a relatively safe drug without significant associated risks. Given the observed efficacy in this clinical case as well as the medication's safety, memantine warrants further exploration as a potential therapy to improve behavioral disturbance in patients with major NCD. <h3>Funding</h3> N/A

Consumption of dentures fixing agents and their impact on the oral mucosa of the prosthetic bed

The clinical and sociological study was conducted involving 283 (130 men and 153 women) patients aged from 45 to 92 years. All patients had acrylic removable dentures on one or both jaws. If patients had complaints about insufficient fixation of the denture, they were recommended to use a prosthesis fixing cream for daily use. After 14 days, patients were examined again for the dynamics of complaints, as well as changes in the mucous membrane of the prosthetic bed. Regardless of gender and age group patients using partial and complete dentures rarely (in 4.3% of cases) used dentures fixing agents, although 40.8% had poor fixation and (or) stabilization of removable acrylic partial and full dentures, and in 51.9% of cases inflammatory changes of the mucous membrane of the prosthetic bed were detected. Correction of removable dentures, as well as daily use of a denture fixation cream, made it possible within two weeks to reduce by 72.5% of patients complaints about poor fixation and (or) stabilization of removable dentures, as well as to eliminate existing inflammatory changes in 86.4% of patients.

Adhesive remedies for dentures. Myths and reality (laboratory research)

The research shows force-separation relation between layer thickness of Corega adhesive denture cream applied on lower jaw's models and denture basis itself. Four high strength die stone models with different wax isolation layers (0 mm; 0.3 mm; 0.5 mm; 1 mm) were prepared for further production of acrylic denture. Isolation thicknesses were verified by measuring light body c-silicone thickness, applied under each basis. Humidity and temperature of oral cavity were imitated during experiments. Mandible acrylic model with applied cream and denture was mounted on a tripod. A plastic 5-liter bottle was rigidly attached to denture basis with nylon straps. While experiment, bottle was filling with water until denture disassemble from jaw model. Results show that separation force increases with decreasing cream's thickness.

A Randomized Proof-of-Principle Bite Force Study of Two Experimental Denture Adhesives and a Commercially Available Adhesive.

To assess the efficacy of two experimental denture adhesive gels (adhesives 1 and 2) compared to a commercially available denture adhesive cream (positive control) and no adhesive (negative control). This was a single-center, randomized, four-treatment, examiner-blind, crossover study in participants with well-made and at least moderately well-fitting maxillary complete dentures. Incisal bite force until denture dislodgment was measured before application (baseline) and over the following 12 hours for each of the treatments. Between-treatment differences in the area over baseline (AOB) for the bite force at each time point were analyzed using an analysis of covariance model. The efficacy and safety analyses were based on results from 48 participants. Compared to the negative control, adhesive 1 showed a statistically significantly higher bite force AOB over 12 hours (AOB0-12h; primary endpoint), as well as for AOB0-6h and AOB0-9h (all P < .05), but not for AOB0-1h or AOB0-3h. Adhesive 2 was not significantly different from the negative control or from adhesive 1 for any measure of AOB. The positive control was associated with a significantly higher bite force AOB than either of the experimental adhesives for all time points (P < .05). Although the positive control was well tolerated, both experimental adhesives were associated with a larger number of oral adverse events. Only adhesive 1 was significantly better than the negative control, and its performance did not match that of the positive control. Adhesives 1 and 2 showed the largest number of oral adverse events.

Copper deficiency mimicking myelodysplastic syndrome.

Copper is an essential element for all living organisms, because it has key activities in the metabolic enzymes such as cytochrome oxidase and superoxide dismutase, and in the proteins essential for iron homeostasis such as ceruloplasmin and hephaestin. In humans, the daily copper requirement is low, therefore copper deficiency is not so frequently a condition. However, we should be aware that copper deficiency can cause hematological abnormalities and sometimes it may masquerade as a myelodysplastic syndrome (MDS). Copper deficiency is mainly associated with the conditions, such as gastric and bariatric surgery, parenteral hyperalimentation, enteroparthies with loss of proteins, hypoproteinemic status such as celiac disease, complications due to therapy with high doses of zinc and penicillamine, and chronic use of proton pump inhibitors. Copper deficiency can be associated with hyperzinchemia; in some cases, this condition could be a consequence of possible use of zinc based denture adhesives creams. The copper deficiency may also be the result of an inherited disorder, such as the Menkes disease.

The paper summarizes data on laboratory and clinical assessment of Corega dent Laboratory and clinical analysis of Corega denture adhesive cream mechanical properties

The paper summarizes data on laboratory and clinical assessment of Corega denture adhesive cream adhesive properties: adhesion strength and time of adhesive material fixing. Clinical assessment was based on Ulitovsky-Leontyev denture fixation index evaluated in 18 edentulous patients with full removable dentures 1 and 12 months after denture manufacturing. After one year of evaluation denture fixation in patients using Corega denture adhesive cream was 8-15% better (depending on alveolar bed anatomy) than in controls proving that Corega improves full denture adaptation to physiological atrophy of alveolar bone.

Optic Neuropathy, Myelopathy, Anemia, and Neutropenia Caused by Acquired Copper Deficiency After Gastric Bypass Surgery

Malabsorptive bariatric surgery is rapidly becoming a major cause of copper deficiency given the increasing prevalence of these procedures for morbid obesity. Acquired copper deficiency can present with clinically significant hematologic and neurological manifestations. Although hematologic manifestations of copper deficiency are rapidly reversible, significant neurological improvement after copper supplementation therapy is unusual and many patients remain debilitated and may only experience, at best, stabilization of the neurological manifestations. Here we present a case of an undiagnosed copper deficiency several years after bariatric gastric bypass surgery, in a patient who concomitantly used zinc-containing denture cream for several years, associated with anemia, neutropenia, myelopathy, respiratory failure, and bilateral optic neuropathy, which caused major vision loss. This patient was also a heterozygote carrier of the 5,10-methylenetetrahydrofolate reductase A1298C gene polymorphism, which may affect copper metabolism. Intravenous copper repletion resulted in rapid correction of hematologic indices. However, neurological manifestations, including vision loss responded only modestly to copper supplementation, despite achieving normal blood copper concentrations. Clinicians should consider copper deficiency in patients at risk, as in this case, as a delayed diagnosis can lead to irreversible disability due to neurological manifestations.

Denture fixative cream and the potential for neuropathy (dent update 2012; 39: 575–577)

Dental UpdateVol. 40, No. 2 Letters to the EditorDenture fixative cream and the potential for neuropathy (dent update 2012; 39: 575–577)Gavin P Winston, Stephan R JaiserGavin P WinstonSearch for more papers by this author, Stephan R JaiserSearch for more papers by this authorGavin P Winston; Stephan R JaiserPublished Online:27 Jun 2017https://doi.org/10.12968/denu.2013.40.2.144AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail View article

Denture fixative cream and the potential for neuropathy

The body requires zinc in small amounts to remain healthy. Because the body balances zinc and copper, people who ingest excessive zinc have resulting dangerously low levels of copper. An acute zinc overdose itself may be toxic and chronic zinc ingestion results in bone marrow suppression and degeneration of the spinal cord, usually resulting in crippling nerve damage. It's been called'human swayback disease' A case of a 54-year-old female whose nerve damage greatly reduced her mobility due to copper deficiency myelopathy as a result of the use of denture fixative cream, Fixodent, is discussed. Many cases of mysterious nerve damage turn out to be caused by overuse of popular denture products, e.g., Fixodent. Thus we are encouraging patients to read the manufacturer's leaflet and follow the instructions carefully.

57. Copper deficiency myeloneuropathy, malnutrition, and use of denture cream after gastric bypass

57. Copper deficiency myeloneuropathy, malnutrition, and use of denture cream after gastric bypass

Copper Deficiency Myeloneuropathy with Hypozincemia Due to Zinc Excess, Gastrectomy, and Low Serum Ceruloplasmin (P03.191)

Objective: We describe low serum zinc level in copper deficiency myeloneuropathy (CuDM) associated with excess zinc ingestion and prior gastrectomy. Background The malabsorption of copper occurs after gastrectomy or bariatric surgeries and can cause CuDM. The antagonistic relationship between copper and zinc is the basis for treatment of states of copper excess (e.g. Wilson9s disease) with zinc supplementation. Zinc excess due to long term denture cream usage can be the cause of CuDM. Design/Methods: Case Report: An 83 year old man developed progressive triple flexor spasms, severe sensory loss, and absent/diminished reflexes with Babinski signs over 5 years following gastrectomy 38 years previously, using zinc-based denture cream (three tubes weekly) for 30 years, and having hypoceruloplasminemia. Serum copper was 0.12 µg/mL (RI 0.75-1.45mcg/mL), ceruloplasmin 4.0 mg/dL (RI 15-30mg/dL), and serum zinc 0.58 µg/mL (RI 0.66-1.0mcg/mL). Results: Our patient had three causes for CuDM—hypocupremia, excess intake of zinc, and hypoceruloplasminemia. Patients with CuDM due to excess zinc ingestion may have normal to elevated serum zinc levels (Nations 2008). Hypozincemia was noted by Kumar, et al (Kumar 2004) in a patient following gastrectomy and poor copper absorption. Gastrectomy will, in addition to decreasing serum copper levels, also decrease serum zinc. Our patient demonstrated low serum zinc levels in the face of excess zinc ingestion and was likely the result of his prior gastrectomy. Conclusions: Excess ingestion of zinc interferes with the absorption of copper and can result in CuDM. Our patient with CuDM, related to prior gastrectomy, excess zinc ingestion, and hypoceruloplasminemia, had a low serum zinc level. This likely reflected decreased zinc absorption due to his prior gastrectomy. Low serum zinc does not exclude CuDM. Disclosure: Dr. Josiah has nothing to disclose. Dr. Salomon has nothing to disclose. Dr. Tacker has nothing to disclose. Dr. Gutmann has received research support from Novartis, Biogen Idec, Genzyme Corporation and Boehringer-Inglheim Pharmaceuticals, Inc.