Heat-polymerized Polymethyl Methacrylate Research Articles

The wettability of complete denture base materials constructed by conventional versus digital techniques: an in-vitro study

BackgroundDecreased salivary flow can make the patients uncomfortable with their complete dentures and affects the retention of the dentures. Milling and 3D printing have become an alternative to conventional denture construction techniques. The goal of this study was to evaluate the effect of conventional and digital techniques of the complete denture construction on the denture surface wettability with distilled water and saliva substitute before and after thermocycling.MethodsA total of 30 specimens were utilized in the present study. Specimens were divided according to the construction techniques into 3 groups (n = 10 each). Group I: Heat-polymerized polymethylmethacrylate (PMMA) group, group II: Milled group, and group III: 3-dimensional (3D)-printed group. All the specimens were subjected to 2000 cycles of thermal aging in a thermocycler. The wettability of all specimens to water and saliva substitute was measured via a contact angle goniometer (Olympus TGHM, Rame-hart Inc, USA) before and after thermocycling. Descriptive statistical analysis, plots, and the Shapiro-Wilk test were used to verify normality for each variable. One-way ANOVA was used to compare the 3 study groups, while paired samples t-test was used to compare the differences within each group (P < .05).ResultsThe smallest contact angle of drop of water to the denture base specimens before and after thermocycling were recorded in the milled group (53.0 ± 4.77 and 50.27 ± 2.30, respectively), followed by the heat polymerized PMMA group (85.65 ± 4.71 and 65.06 ± 2.27, respectively), and the 3D-printed group (91.34 ± 6.74 and 90.86 ± 8.57, respectively). While the smallest contact angle of drop of saliva substitute to denture base specimens was recorded in the milled group (56.82 ± 2.29 and 34.85 ± 7.51, respectively), followed by the 3D-printed group (72.87 ± 4.83 and 58.14 ± 9.58, respectively) and the heat polymerized PMMA group (83.62 ± 4.12 and 67.82 ± 4.93, respectively). There was statistically significant difference between the groups (P < .05). A significant decline in the average contact angle of drop of saliva has been reported in all groups after thermocycling. The contact angle values differed significantly between saliva substitute and distilled water in both 3D-printed and milled groups after thermocycling (P < .001).ConclusionsThe milled denture base material presented the best wettability to water and saliva substitute than the 3D-printed and the heat-polymerized PMMA materials. Saliva substitutes improve the wetting ability of denture base materials manufactured by CAD/CAM compared with water.

Comparative evaluation of flexural strength of heat polymerized polymethyl methacrylate (PMMA) denture base material reinforced with different percentages of silanized zirconium silicate nanoparticles – An in vitro study

Comparative evaluation of flexural strength of heat polymerized polymethyl methacrylate (PMMA) denture base material reinforced with different percentages of silanized zirconium silicate nanoparticles – An in vitro study

Post-processing of a 3D-printed denture base polymer: Impact of a centrifugation method on the surface characteristics, flexural properties, and cytotoxicity

ObjectivesTo investigate the impact of a centrifugation method on the surface characteristics, flexural properties, and cytotoxicity of an additively manufactured denture base polymer. MethodsThe tested specimens were prepared by digital light processing (DLP). A centrifugation method (CENT) was used to remove the residual uncured resin. In addition, the specimens were post-processed with different post-rinsing solutions: isopropanol (IPA), ethanol (EtOH), and tripropylene glycol monomethyl ether (TPM), respectively. A commercial heat-polymerized polymethyl methacrylate was used as a reference (REF). First, the values of surface topography, arithmetical mean height (Sa), and root mean square height (Sq) were measured. Next, flexural strength (FS) and modulus were evaluated. Finally, cytotoxicity was assessed using an extract test. The data were statistically analyzed using a one-way analysis of variance, followed by Tukey's multiple comparison test for post-hoc analysis. ResultsThe Sa value in the CENT group was lower than in the IPA, EtOH, TPM, and REF groups (p < 0.001). Moreover, the CENT group had lower Sq values than other groups (p < 0.001). The centrifugation method showed a higher FS value (80.92 ± 8.65 MPa) than the EtOH (61.71 ± 12.25 MPa, p < 0.001) and TPM (67.01 ± 9.751 MPa, p = 0.027), while affecting IPA (72.26 ± 8.80 MPa, p = 0.268) and REF (71.39 ± 10.44 MPa, p = 0.231). Also, the centrifugation method showed no evident cytotoxic effects. ConclusionsThe surfaces treated with a centrifugation method were relatively smooth. Simultaneously, the flexural strength of denture base polymers was enhanced through centrifugation. Finally, no evident cytotoxic effects could be observed from different post-processing procedures. Clinical significanceThe centrifugation method could optimize surface quality and flexural strength of DLP-printed denture base polymers without compromising cytocompatibility, offering an alternative to conventional rinsing post-processing.

Evaluating the antifungal effectiveness, leaching characteristics, flexural strength, and impact strength of polymethyl methacrylate added with small-scale silver nanoparticles - An in vitro study.

(1) To assess the release of stable silver nanoparticles (AgNPs) of small scale dimension added to heat polymerized polymethyl methacrylate (PMMA) in 6 months. (2) Assessing the influence of incorporating minimal concentrations of stable AgNPs with nanoscale dimensions into heat polymerized PMMA over a 6 month period on its antifungal efficacy (AF), flexural strength (FS), and impact strength (IS). Incorporating nanoparticles with a very small scale may have minimal impact on mechanical properties due to their diminutive size. However, the influence of these small scaled nanoparticles on antimicrobial efficacy and potential escalation in toxicity to host cells through leaching remains unexplored. AgNPs were prepared using an Ultrasonic Probe sonicator and the addition of ammonia to obtain stabilized AgNPs (< 0.01 nm) of small scale dimension. The characterization of these AgNPs involved ultraviolet visible spectroscopy, X ray diffraction, Zetasizer, and transmission electron microscopy with energy dispersive spectroscopy (TEM). The prepared AgNPs were then added in various percentages by weight (0%-0.5%) to fabricate 252 modified PMMA samples of sizes 10 mm × 3 mm (AF, n = 108), 65 mm × 10 mm × 3 mm (FS, n = 72), and 65 mm × 10 mm × 2.5 mm (IS, n = 72) as per ADA specification no. 12. These samples underwent testing for leaching out of AgNPs and efficacy against Candida albicans for 6 months. The effect on FS and IS was evaluated using the three point bending test and Charpy's Impact Tester, respectively. Intergroup comparison of CFU between various concentrations of AgNP was done using the Kruskal-Wallis ANOVA test succeeded by Mann-Whitney test for pair wise comparisons. Difference in CFU of various concentrations over 6 months was seen using one way ANOVA test. Intergroup comparison of FS and IS was performed using a one way ANOVA test, followed by a post hoc Tukey's test for pair wise comparisons. Repeated tests showed no leaching out of AgNPs from the denture base resin into the storage medium. All concentrations of AgNPs incorporated in resin showed inhibition of Candida growth. Intergroup comparison of FS and IS revealed highly statistically significant differences (F = 15.076, P < 0.01 and F = 28.266, P < 0.01) between the groups showing a reduction in strength. The AgNPs of small scale dimension incorporated into the denture base resin imparted a strong antifungal effectiveness against C. albicans, which did not decline during the study period and did not cause any release of nanoparticles. 0.5% showed the best antifungal efficacy. This may prove to be a viable and highly effective treatment for the prevention of Candida associated denture stomatitis. However, the inclusion of these particles resulted in a decrease in both FS and IS, and this reduction was directly proportional to the percentage of added AgNPs, with 0.5% demonstrating the least IS and FS.

Antifungal Effect and Durability of Chitosan Oligosaccharide Coating on Heat-cured Polymethylmethacrylate Surface

This study aimed to investigate the antifungal effect against Candida albicans (ATCC® 10231) and the durability of chitosan oligosaccharide (COS) coated on heat-polymerized polymethylmethacrylate (PMMA). The various concentrations of COS solution, 0.5, 1 and 2-fold of minimum fungicidal concentration (0.5, 1 and 2 MFC) were prepared and applied to PMMA specimens treated with sandblasting (SB), application of 3-aminopropyltriethoxysilane (APS), and a combination of both procedures (SB&amp;APS). The toothbrush abrasion test was done to evaluate the remaining COS (n=10). The antifungal effect was determined through the colony count method (n=3). The number of fungal colonies was recorded at 16 and 48 hours. Data were analyzed using two-way and one-way ANOVA at the 95% confidence level. The result of the toothbrush abrasion test revealed that COS concentration and surface treatment affected coating durability. APS and SB&amp;APS groups showed a high percentage of COS and significantly differed from SB groups (P = 0.00). For the antifungal effect, coatings with 1 MFC and 2 MFC demonstrated no difference, but coating with 0.5 MFC differed from others (P = 0.00). At 16 and 48 hours, PMMA coated with 1 MFC and 2 MFC by APS and SB&amp;APS methods inhibited C.albicans. COS can be coated onto PMMA using APS and can inhibit C.albicans. With further development, this method could be applied to treat denture stomatitis alternatively to conventional antifungal drugs. Keywords: Candida albicans, Chitosan, Oligochitosan, Polymethylmethacrylate, Silanes

An Investigation of Quality of Life of Head-and-neck Cancer Patients after Tumor Resection and Subsequent Prosthetic Rehabilitation: A Clinical Study

ABSTRACT Background: Head-and-neck cancer and its treatment can decrease the quality of life (QoL) of patients in consequence of the loss of structural and functional integrity of the oro- and nasopharyngeal region. Maxillofacial prosthetic treatment is advised when anatomical structures of the head and neck are not replaceable by living tissue, when recurrence is likely, when radiotherapy is administered, or when fragment of fractured bones are severely displaced. The aim of the study was to examine whether prosthetic rehabilitation of maxillofacial defects affects the QoL of patients using the University of Washington (UW)-QoL. Materials and Methods: This was the prospective interventional study using pre- and post-design using a convenience sampling method. The prosthesis was fabricated as per the clinical situation using heat-polymerized polymethyl methacrylate, maxillofacial silicone, or a combination of both. Results: The overall mean composite QOL score before rehabilitation was 68.05 ± 16.98 and after rehabilitation, it was 73.22 ± 11.28. Chewing and saliva (dryness of the mouth) had the lowest scores (55 ± 9.2, 62 ± 8.6, respectively) among all domains, whereas pain and anxiety had the highest scores (93 ± 3.7, 95 ± 1.5, respectively). The domains of appearance, speech, swallowing, chewing, saliva, and overall QoL showed statistically significant improvements postprosthetic rehabilitation. Conclusions: In the present study and selected population, the subjective analysis using UW-QOL showed that despite altered anatomy following resection and reconstruction, compromised physiology following chemoradiation, the oral cancer patients coped well and adapted to near-normal oral status after prosthetic rehabilitation. This was evident from their improved QOL after 1 month of prosthetic rehabilitation.

Effect of different polishing methods applied to denture base materials on microbial adhesion and surface roughness

Aim: The aim of our study was to investigate the effect of various polishing processes applied to different types of PMMA (polymethyl methacrylate) denture base materials on the surface roughness and microbial adhesion of the base material. Methods: Sixty specimens each were prepared from heat-polymerized conventional PMMA (G), heat-polymerized injectable PMMA (E), and prepolymerized CAD/CAM PMMA (C) denture base materials. All sample surfaces were sanded with 800, 1000, 1200, and 2500 grit silicone carbide abrasives. The specimens of each denture base material were divided into three subgroups (n=20) in which different polishing methods were applied. The first group was mechanically polished (M), and the other two groups were chemically polished with light polymerized glaze liquids [Palaseal (Ps), Optiglaze Color (Og)]. A profilometer device was used to evaluate the surface roughness. Colony counting was performed to evaluate bacterial colonization after one day. The data obtained from all these measurements were evaluated using an analysis of variance, and Bonferroni corrected test was used for multiple comparisons of means (p=0.05). The interaction between surface roughness and bacterial colonization was examined by the Pearson correlation test. Regression analysis was performed to determine the relationship between them. Results: When PMMA base materials were compared, the lowest average surface roughness (Ra) values and bacterial colonization values were obtained in Group C. When polishing methods were compared, the lowest average surface roughness values were obtained in Group M. As a result of bacterial colonization measurement, lower colonization values were obtained with standardized mechanical polishing compared to other groups. Conclusion: There was no difference between the different PMMA base materials in terms of surface roughness, but there were statistical differences in bacterial colonization. The results of our study showed that mechanical polishing gave better results than light-activated glazing agents. How to cite this article: Yarar S, Değer Y, Tekin S. Effect of different polishing methods applied to denture base materials on microbial adhesion and surface roughness. J Med Dent Invest 2023; 4: e230351. https://doi.org/10.5577/jomdi.e230351

Air-polishing technology is an effective alternative chairside method for cleaning dentures.

To investigate the efficiency and abrasiveness of air-polishing on different types of denture base acrylic resins and whether air-polishing can be an effective technique to clean dentures chairside. A total of 60 specimens were prepared (n = 20/group); heat-polymerized polymethyl methacrylate (PMMA) (G1), subtractive manufacturing (SM) (G2) and additive manufacturing (AM) denture base resins (G3). Equal number of specimens in each group were stained with permanent marker or nail polish and pumice mixture to mimic calcified biofilm. All specimens were treated using EMS Airflow® Prophylaxis Master with two different powders; erythritol or sodium bicarbonate powder, following manufacturer instructions. Efficacy of the powders and surface roughness of the specimens were measured. Scanning electron microscopy imaging was captured for qualitative observation. The highest efficacy for stain removal was found in erythritol powder on G1 (98.06% ± 1.304%). The lowest was found in the erythritol powder on G3 (91.83% ± 3.611%). The highest efficacy for biofilm removal was found in sodium bicarbonate powder on G3 (71.49% ± 8.607%), and the lowest was found in erythritol powder on G2 (11.64% ± 4.68%). Only AM resins had statistically significant increases in surface roughness with the use of erythritol powder (p < 0.001). The use of sodium bicarbonate powder significantly increases surface roughness of heat-polymerized (p < 0.025) and AM resins (p < 0.724). Air-polishing technology has shown to be effective and suitable for cleaning dentures. The sodium bicarbonate powder showed superior efficacy in cleaning dentures compared to the erythritol powder. Both powders show varyingly increase roughness depending on denture resin.

Surface, mechanical and chemical properties of modified denture resin using natural biopolymer.

This laboratory study determined the surface, mechanical and chemical properties of polymethyl methacrylate (PMMA) denture resin reinforced with micron-sized Gum Arabic (GA) powder in different weight ratios. This laboratory study was conducted at the Dental Health Department of the College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia from November 2022 to February 2023. Three experimental denture resins were prepared by incorporating GA powder in heat-polymerized PMMA powder using different wt.% (5, 10, and 20 wt.%). While pristine PMMA served as the control group. A total of ten bar-shaped specimens with dimensions of 65 mm × 10 mm × 3.5 mm were prepared for each study group. The surface properties (micro CT and SEM evaluation), mechanical properties (Nanohardness, elastic modulus and flexural strength) and chemical properties (FTIR) were conducted. The data were statistically analyzed using the one-way analysis of variance and Tukey's post hoc tests (p<0.05). The surface and bulk properties of experimental GA-reinforced PMMA resin materials deteriorated while the mechanical properties were also negatively altered using GA-based PMMA denture resin. A linear correlation was observed between weak mechanical properties and increasing wt.% of GA in denture resin. The incorporation of GA powder in denture resin might not be a viable option. The surface and mechanical properties of experimental PMMA composites were adversely affected compared to the control group.

Investigating the biocompatibility, flexural strength, and surface roughness of denture base resin containing copper oxide nanoparticles: An in vitro study

AimThis study aimed to evaluate the biocompatibility, flexural strength, and surface roughness of polymethyl methacrylate (PMMA) containing Copper Oxide Nanoparticles (CuO NPs) at different concentrations. Methods25 heat-polymerized PMMA wax patterns fabricated in 5 groups containing 0.5, 5, 50, and 500 μg/ml CuO NPs and nanoparticle (NP)-free PMMA discs were prepared. 5 growth mediums (DMEM with 10% FBS and 1% penicillin-streptomycin) without disks were also incubated similarly to serve as the control groups. The cytotoxicity of the discs was measured by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) assay on cultured Human Gingival Fibroblasts. The number of 1.3 × 104 cells were seeded in each well of 96-well plates (5 wells for the extract of each specimen). Days 1, 3, 5, and 7 were the intervals that the culture media were in direct contact with the PMMA discs for either 24 or 72 h. After that, a total of 40 specimens with 65 × 10 × 2.5 mm dimensions were prepared in five groups (n = 8). The specimens were subjected to a rugosimeter for the evaluation of surface roughness. The flexural strength test was performed using a universal testing machine. Microscopic evaluation was performed for the dispersion of the NPs. Non-parametric Kruskal-Wallis test and parametric one-way ANOVA test were used for data analysis. ResultsThe samples containing 500 μg/ml NPs showed the lowest percentage of cell viability at all incubation periods, while the highest cell viability was observed in NP-free PMMA 24 h after the seventh day of incubation. NPs at 50 and 500 μg/ml concentrations showed strongly significant differences in cytotoxicity compared to the 0 concentration and the control group (p < 0.001). Although all the samples demonstrated an increasing pattern of cell viability on the third, fifth, and seventh days, the percentage of cell viability was significantly lower after 72 h than after 24 h in all incubation periods (p < 0.001). NPs significantly increased flexural strength (p = 0.005) but did not affect the surface roughness of the PMMA discs (p = 0.396). SignificanceThe CuO NPs were cytotoxic only when applied in high concentrations, but presented a descending trend over time. No cytotoxic effect was observed in the experimental groups after seven days of incubation. Furthermore, CuO NPs increased flexural strength, but the surface roughness of the PMMA discs was not affected.

Flexural Properties of Heat-Polymerized PMMA Denture Base Resins Reinforced with Fibers with Different Characteristics.

Polymethylmethacrylate (PMMA) has been the most-widely used denture base material in prosthetic dentistry for the last 80 years. It is still one of the best alternatives when new methods are inapplicable. Due to the lack of some physical inadequacies occurring during cyclic use and accidental situations, various reinforcement strategies such as using nanoparticles, wires, fibers, and meshes have been investigated and reported. In this study, it was aimed to conduct a comparative investigation of the effect of fiber additives with different characteristics on the flexural properties of heat-cured PMMA denture base resins. Glass fibers (GFs), polypropylene fibers (PPFs), and carbon fibers (CFs) having 3, 6, and 12 mm lengths and 0.25, 0.50, and 1.0% concentrations (v/v) were used for the reinforcement of PMMA denture base resins. The flexural properties (flexural strength, flexural modulus, and maximum deformation) were determined using a three-point bending test, and three-way ANOVA analyses with Bonferroni corrections were performed on the test results. The morphologies of the fracture surfaces were analyzed using scanning electron microscopy. All three fibers exhibited reinforcement in the flexural strength (p < 0.001) and flexural modulus (p < 0.001) regardless of their length and concentration. The group with 1.0% 12 mm CF-reinforced PMMA exhibited the greatest flexural strength (94.8 ± 8.8 MPa), and that with 1.0% 3 mm GFs displayed the lowest flexural strength (66.9 ± 10.4 MPa) among the fiber-reinforced groups. The greatest value of the flexural modulus was displayed by the 1.0% 3 mm CF-reinforced resin (3288.3 ± 402.1 MPa). Although the CF-reinforced groups exhibited better flexural properties, CFs are not favorable for use as reinforcement in practice due to the dark gray discoloration of the denture base resin. It was concluded that PPF is a promising material for the reinforcement of heat-cured PMMA denture base resins.

Tensile Bond Strength between Different Denture Base Materials and Soft Denture Liners.

(1) Background: Various materials are available for CAD-CAM denture base fabrication, for both additive and subtractive manufacturing. However, little has been reported on bond strength to soft denture liners. Therefore, the aim of this study was to investigate tensile bond strength, comparing between different denture base materials and soft denture liners. (2) Methods: Seven different materials were used for denture base fabrication: one heat-polymerized polymethyl methacrylate, three materials for subtractive manufacturing, two materials for additive manufacturing and one polyamide. Two materials were used for soft denture lining: one silicone-based and one acrylate-based. The study was conducted according to the specification ISO No. 10139-2:2016, and the type of failure was determined. The Kruskal-Wallis test with Dunn's post hoc test was used to analyse the values of tensile bond strength, and Fisher's exact test was used to analyse the type of failure. p Values < 0.05 were considered statistically significant. (3) Results: The tensile bond strength values were not statistically significantly different combining all the materials used for denture base fabrication with the acrylate-based soft denture liner (p > 0.05), and the average values ranged between 0.19 and 0.25 Mpa. The tensile bond strength values of the different denture base materials and silicone-based denture liner were statistically significantly different (p < 0.05), and the average values ranged between 1.49 and 3.07 Mpa. The type of failure was predominantly adhesive between polyamide and both additive-manufactured denture base materials in combination with the acrylate-based soft liner (p < 0.05). (4) Conclusions: The use of digital technologies in denture base fabrication can have an influence on different tensile bond strength values for soft denture liners, with different types of failure when compared with heat-cured PMMA. Similar tensile bond strength values were found between the acrylate-based soft denture liner and denture base materials. Significant differences in tensile bond strength values were found between the silicone-based soft denture liner and denture base materials, where the additive-manufactured and polyamide denture base materials showed lower values than heat-cured PMMA and subtractive-manufactured denture base materials.

Flexural Strength and Vickers Microhardness of Graphene-Doped SnO2 Thin-Film-Coated Polymethylmethacrylate after Thermocycling

Removable dental prostheses are commonly fabricated using polymethylmethacrylate, a material that does not have favorable mechanical properties and needs reinforcement with particles such as graphene. The aim of this study was to evaluate the flexural strength (FS) and Vickers microhardness of a heat-polymerized polymethylmethacrylate coated with graphene-doped stannic oxide (SnO2) thin films using a thermionic vacuum arc method after thermocycling. Forty bar-shaped specimens (65 × 10 × 3 mm) were fabricated using a heat-polymerized denture base resin and divided into four groups according to the graphene-doped SnO2 thin film surface coating performed: No-coat (uncoated), Coat-15 s (coating duration of 15 s), Coat-20 s (coating duration of 20 s), and Coat-30 s (coating duration of 30 s) (n = 10). The thermionic vacuum arc method was used to coat both surfaces of the specimens of each test group with varying durations, and surface coating was verified using Fourier Transform Infrared Spectroscopy. Specimens were subjected to 10,000 cycles of thermocycling. Atomic force microscopy was used to evaluate the surfaces of all specimens before and after thermocycling. Microhardness values were measured five times and averaged. Then, each specimen was subjected to a three-point bending test, and FS values were calculated. Data were analyzed using one-way analysis of variance and Bonferroni tests (α = 0.05). Differences among test groups were nonsignificant when FS data were considered (p = 0.605). However, significant differences were observed among test groups when Vickers microhardness data were considered (p &lt; 0.001). Coat-30 s had the highest hardness (p ≤ 0.003), while the difference among remaining groups were nonsignificant (p ≥ 0.166). Graphene-doped SnO2 thin film surface coatings did not significantly affect the FS of tested heat-polymerized denture base resin but increased the Vickers microhardness when the coating duration was 30 s.

Effect of adding a hard-reline material on the flexural strength of conventional, 3D-printed, and milled denture base materials

Statement of problemNovel 3-dimensionally printed resin and milled polymethyl methacrylate materials have been marketed for computer-aided design and computer-aided manufacturing (CAD-CAM) denture base fabrication. However, information on the flexural strength of digitally fabricated denture base material is limited, and little is known about how they are affected by a hard-reline procedure. PurposeThe purpose of this in vitro study was to assess the flexural strength of 6 digitally manufactured denture base materials and to assess the effect of a hard-reline procedure on their flexural strength. Material and methodsA total of 140 strips of denture base material were fabricated from a conventional heat-polymerized polymethyl methacrylate (L199), 3 brands of milled polymethyl methacrylate (IBC, DSL, and ADH), and 3 brands of 3D-printed resin (DFD, ADB, and DrFD) (n=20). Ten specimens in each group did not receive any treatment, and 10 were relined with a hard-reline material (ProBase Cold Trial Kit). Specimens were then subjected to a 3-point flexural strength test using a universal testing machine at a crosshead speed of 5.0 mm/min. A 1-way ANOVA test followed by the Tukey multiple comparison test was used to detect the difference in flexural strength and the strain at fracture of the different types of denture base materials (α=.05). The comparison of flexural strength between with and without hard-reline was analyzed using an unpaired t test (α=.05). ResultsAll materials, with or without the hard-reline, met the International Organization for Standardization (ISO) 20 795-1:2013 standard for flexural strength (65 MPa). The milled materials (DSL>IBC≈ADH) showed higher flexural strength than the 3D-printed or conventional materials (DrFD>DFD≈ADB≈L199) without a hard-reline. No statistical difference in flexural strength was found among the hard-relined denture base materials (P=.164). All 3 milled materials showed reduced flexural strength after relining, while the relined conventional (L199) and 3D-printed materials (DFD and ADB) showed notably higher flexural strength; printed DrFD showed no significant difference (P=.066). In terms of strain at fracture, the milled materials displayed higher values than those of the conventional or 3D-printed materials (P<.05). ConclusionsAll digitally fabricated denture base materials were within acceptable limits for clinical use, even after hard relining. Flexural strength was highly dependent on the type of material. Hard relining affected the flexural strength of most of the digitally fabricated denture base materials.

Comparative Evaluation of Flexural Strength of Four Different Types of Provisional Restoration Materials: An In Vitro Pilot Study

With provisional restorations, properties such as flexural strength play a key role in maintaining the abutment teeth in position over the interim period until the final restorations are placed. This study aimed to evaluate and compare the flexural strength of four commonly used provisional resin materials. Ten identical 25 × 2 × 2 mm specimens were made from four different groups of provisional resin material, namely 1: SR Ivocron (Ivoclar Vivadent) cold-polymerized poly-methyl methacrylate (PMMA), 2: S Ivocron (Ivoclar Vivadent) heat-polymerized PMMA, 3: Protemp (3M Germany-ESPE) auto-polymerized bis-acryl composite, and 4: Revotek LC (GC Corp, Tokyo) light-polymerized urethane dimethacrylate resin. The mean values of the flexural strength of each group were calculated and the data were analyzed using one-way ANOVA and Tukey post hoc tests. The mean values (MPa) were as follows: for cold-polymerized PMMA, it was 125.90 MPa; for heat-polymerized PMMA, it was 140.00 MPa, with auto-polymerized bis-acryl composite 133.00 MPa; and for light-polymerized urethane dimethacrylate resin, it was 80.84 MPa. Thus, the highest flexural strength was recorded with heat-polymerized PMMA and the lowest flexural strength with light-polymerized urethane dimethacrylate resin, which was significantly low. The study did not detect a significant difference in the flexural strengths of cold PMMA, hot PMMA, and auto bis-acryl composite.

CAD-CAM complete denture resins: Effect of relining on the shear bond strength

ObjectivesThe aim of this study was to compare the shear bond strength of relined CAD-CAM complete removable dental prosthesis (CRDP) resins with conventional heat-polymerized polymethylmethacrylate (PMMA) resin. MethodsA total of 96 resin specimens in identical dimensions of 10 mm × 10 mm × 11 mm were fabricated for four study groups [#1- Conventional heat-polymerized group: n=24 (ProBase); #2- Milled#1: n=24 (Ivobase); #3- Milled#2: n=24 (Ivotion); #4- 3D-printed: n=24, (NextDent Denture 3D+)]. Twelve specimens in each group were sectioned in the middle to produce a 3 mm defect and then were relined using a conventional denture relining material. All specimens underwent thermocycling (5-55°C) for 10,000 cycles. The shear bond tests were carried out in a universal testing machine. One-way ANOVA and Tukey's test were used for statistical analysis (p<0.05). The two-parameter Weibull distribution values were calculated. ResultsRelined 3D-printed specimens had a significantly lower shear bond strength when compared with conventional (p=0.0003) and milled groups (Milled#1: p=0.0004; Milled#2: p<0.0001). There were no differences in the shear bond strengths between the milled and conventional groups. Weibull distribution presented the highest shape value for the non-relined Milled#1 (22.83) group and the lowest values for the 3D-printed relined group (4.001). ConclusionThe findings of this study conclude that the shear bond strength of the conventionally-relined 3D-printed resins used for fabricating CRDPs was inferior to the shear bond strength of conventionally-relined resins employed for manufacturing CRDPs using CAD-CAM milling and conventional heat-polymerization techniques. Clinical significanceWhen considering 3D-printing for the fabrication of CRDPs, it is recommended to employ it in clinical situations where a frequent need for denture relining is not expected.

Color Appearance of Various Provisional Restorative Materials for Rehabilitation Upon Aging.

Color stability of provisional restoration is crucial for full mouth reconstruction, which is probably influenced by aging. Therefore, this study evaluated the effect of aging on the color appearance of different provisional materials. Rectangular specimens (10 × 10 × 2 mm) were fabricated from computer-aided design-computer-aided manufacturing (CAD-CAM) (Vita CAD-Temp [VC], TelioCAD [TC], artBloc [RC]), autopolymerized (ProtempIV [PA], Luxatemp [LA], UnifastTrad [UA]), and heat-polymerized polymer (Major C&B [MH]). Each was divided into aging (AG, 5,000 thermocycles of 5°/55°C) and non-aging group (n = 21/group). Color parameters were determined using a spectrophotometer through the CIELAB system. The L*, a*, and b* data were calculated for color appearance (∆E), translucency parameter (TP), contrast ratio (CR), and opalescence parameter (OP) for each. An analysis of variance and multiple comparisons were determined for a significant difference in color appearance alteration of materials upon aging (α = 0.05). Statistically significant differences of L*, a*, b*, ∆E, TP, CR, and OP due to the effect of types of material (p < 0.05), aging effect (p < 0.05), and their interactions (p < 0.05) were indicated. Aging affects the color appearance, lightness, chromaticity, translucency, contrast, and opalescence of various types of provisional materials. Color appearance alteration of provisional materials was significantly indicated upon aging (p < 0.05) but within the perceivable limit of clinical acceptance (∆E diff < 3.0), except for PA and MH. Color stability of CAD-CAM-based poly-methyl methacrylate (PMMA) and autopolymerized PMMA upon aging were better than bis-acryl resin and heat-polymerized PMMA. The TP, CR, and OP alterations of tested materials upon aging were within the perceivable limit. Color appearance of provisional restorative materials was influenced by aging. The CAD-CAM-based PMMA and autopolymerized PMMA materials showed better color stability than bis-acryl provisional resin and heat-polymerized PMMA upon aging. Therefore, they were suggested as provisional materials for oral rehabilitation.

Digital versus Conventional Dentures: A Prospective, Randomized Cross-Over Study on Clinical Efficiency and Patient Satisfaction.

Digital technology facilitates the manufacturing of complete dentures; however, clinical and patient-reported outcomes are underreported. This prospective, randomized, single-blind cross-over study reports the clinical and patient-related outcomes of 10 edentulous patients receiving digital dentures prepared with the Vita Vionic System and conventional dentures produced from heat-polymerized polymethylmethacrylate resin. Clinical efficiency was stated based on the Sato score for quantitative assessment of complete denture quality. Patient satisfaction was evaluated with the oral health-related quality of life questionnaire (OHIP-20). We report here that the Sato score was slightly higher in patients receiving digital versus conventional dentures with a mean of 73.2 ± 12.3 and 67.4 ± 11.8, respectively (p = 0.16). Moreover, upper and lower stability was superior in digital dentures (p = 0.03 and p = 0.10, respectively), while denture polish was better in conventional dentures (p = 0.03). Quality of life was slightly higher in patients receiving conventional compared to digital dentures with an OHIP-20 of 101.7 ± 12.0 and 95.6 ± 24.2, respectively (p = 0.33). Taken together and when considering the low power of the study, our findings suggest a trend towards better clinical efficiency of digital compared to conventional dentures, while patient satisfaction remained unaffected by the type of manufacturing.

Comparative evaluation of the flexural strength of two different CAD/CAM-milled PMMA for long-term fixed provisional restorations

Aim:To determine and compare the flexural strength (FS) of heat-cured poly methyl methacrylate (PMMA) resin,CAD/CAM-milled PMMA resin, and CAD/CAM-milled PMMA resin reinforced with graphene. Materials and methods:In accordance with ISO 10477:2018, thirty rectangular samples with measurements of25 mm (l) x 2 mm (b) x 2 mm (h) were manufactured for the purpose of FS evaluation (Dentistry-polymer-basedcrown and veneering materials). PMMA resin samples that were heat-cured (Group-I; n = 10), CAD/CAM-milled(Group-II; n = 10), and CAD/CAM-milled PMMA resin reinforced with graphene (Group-III; n = 10) were producedand sorted according to the kind of material. Before testing, the samples were kept for a full day in distilledwater. For each of the thirty samples, a 3-point bend test was conducted utilizing a universal testing machine ata crosshead speed of 1.0mm/min till breakage. Utilizing a One-way ANOVA and thepost hocTukey HSD test, theFS data were tabulated and statistically analyzed. Results:For the test samples in Group I, the mean flexural strength was 550.29 MPa. For Group II the mean flexuralstrength was 1481.966 MPa. For Group III the mean FS was 1447.45 MPa. A comparative assessment of Group Itest samples, Group II test samples, and Group III test samples showed that the mean FS is highly significant(P&lt;0.001 ). On multiple comparisons, the mean FS difference between Group I test samples and Group II testsamples was observed to be highly significant (P&lt;0.01 ). The mean FS difference between Group I test samplesand Group III test samples was observed to be highly significant (P&lt;0.01 ). The mean FS difference betweenGroup II and Group III was observed to be insignificant (P&gt;0.05). Conclusion:CADCAM-milled PMMA resin showed the maximum FS followed by CADCAM-milled PMMAresin reinforced with graphene and heat-polymerized PMMA. Therefore, CADCAM PMMA–based polymerscould be utilized for long-term provisional restorations in comparison to heat-polymerized poly methylmethacrylate (PMMA) resin.

Comparative evaluation of impact strength of mechanically modified heat polymerized polymethyl methacrylate (PMMA) resin with addition of 0.5, 1, 2 wt% of silver nanoparticles (AgNPs): An in-vitro study.

Polymethyl methacrylate (PMMA) is one of the most widely used denture base material because of favorable esthetics and desirable characteristics such as easy handling. Acrylic resins, although, have some inherent disadvantages such as relatively poor physical and mechanical properties. The objective of the present study was to evaluate and compare the impact strength of unmodified and modified heat cure PMMA-based denture base material with addition of different concentrations of silver nanoparticles (AgNPs) (0.5, 1, 2 wt%). The present in-vitro study comprised of a total of 60 samples allocated to four groups with Group A samples consisting of heat cure acrylic resin without any modification (used as control); Group B samples consisting of heat cure acrylic resin modified with 0.5 wt% of AgNPs; and subsequently, Group C and Group D samples consisting of heat cure acrylic resin modified with 1 wt% and 2 wt% of AgNPs, respectively. The impact strength of the prepared acrylic samples was evaluated using Izod/Charpy Impact Tester, while the values obtained were tabulated and subjected to statistical analysis. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 17.0 (SPSS Inc., Chicago, IL, USA), while one-way analysis of variance and Tukey's multiple post-hoc procedures were used for statistical analysis. P < .05 was considered statistically significant. The highest impact strength was found in Group C samples consisting of heat cure acrylic resin modified with 1 wt% of AgNPs to be closely followed by Group B samples consisting of heat cure acrylic resin modified with 0.5 wt% of AgNPs. Group D samples consisting of heat cure acrylic resin modified with 2 wt% of AgNPs, although, revealed relatively lower impact strength compared to Group B and Group C samples. Within the limitations of the present study, it was concluded that the impact strength of mechanically modified heat polymerized PMMA resin was significantly enhanced with addition of varying concentrations of AgNPs, although, it was observed that with an increase in the concentration of AgNPs, a subsequent decrease in the tensile strength of the final polymer material was observed.