Maxillofacial Elastomer Research Articles

Effect of different disinfecting procedures on the hardness and color stability of two maxillofacial elastomers over time

Objective:Disinfection procedures often cause deterioration in a maxillofacial prosthesis. Color and hardness alterations could lead to a replacement of the prosthesis. Material and Methods:An experimental chlorinated polyethylene (CPE) and a commercial polydimethyl siloxane (PDMS) sample were treated with four different disinfection procedures for a period which simulates 1 year of clinical service. The applied disinfection procedures included microwave exposure and immersion in three solutions, sodium hypochlorite, neutral soap and a commercial disinfecting soap. Shore A hardness (ΔΗ) and color differences (ΔΕ) were determined before and after each procedure. All data were analyzed by Two Way Analysis of Variance (ANOVA) and Tukey's post hoc tests at a level of α=0.05. Results:The samples presented significant alterations in color and hardness after the different disinfection treatments. The color differences (ΔΕ) were at least eye detectable in all cases and clinically unacceptable in most of the cases, with values ranging from 1.51 to 4.15 and from 1.54 to 5.92 for the PDMS and CPE material, respectively. Hardness was decreased after all the disinfection procedures in the PDMS, while for the CPE, a decrement was observed after disinfection with sodium hypochlorite and neutral soap and an increment after microwave exposure and the disinfection with a commercial antimicrobial agent. The PDMS samples presented greater alterations in color and hardness after disinfection with sodium hypochlorite solution, while the microwave exposure caused negligible effects. The CPE samples were affected most after disinfection when treated with neutral soap, and more slightly when disinfected with sodium hypochlorite solution. Conclusions:The disinfection procedures caused alterations in color and hardness of the examined materials. The most suitable disinfection procedure for the PDMS material is microwave exposure, while disinfection with sodium hypochlorite solution is not recommended. The CPE material is suggested to be disinfected with sodium hypochlorite solution and the use of neutral soap is not recommended. Comparing the two materials, the PDMS material is most color stable, while the CPE material presented fewer changes in hardness.

Influence of Pigments and Pigmenting Methods on Color Stability of Different Silicone Maxillofacial Elastomers After 1-Year Dark Storage

The purpose of this study was to measure spectrophotometrically the color changes of pigmented maxillofacial silicone elastomers with different pigments and pigmenting methods after storing 1 year in the dark environment. Three maxillofacial silicones, Cosmesil M511 (CosM511), Cosmesil M522 (CosM522), and Multisil-Epithetic (Mult-Epit), were selected for this study. A total of 240 specimens were fabricated; 80 of each of the 3 elastomers (n = 5) (18 mm in diameter and 2 mm in thickness) were prepared in 6 colorant categories (5 colorant and 1 with no colorant). Specimens were stored in a black box representing a condition of total darkness and placed in a dark environment at ambient room temperature (22°C ± 10°C) and humidity (50% ± 10%) for 1 year. A color spectrophotometer was used to measure the ΔE* values of the test specimens to determine the color changes. The lowest color changes were observed in CosM511 in white color (ΔE* = 1.31) and in Mult-Epit in white color (ΔE* = 1.82) in extrinsic coloration group. The highest color changes were observed in yellow color in CosM511 (ΔE*= 21.61) and CosM522 (ΔE*= 23.78) in silicone pigmented intrinsic coloration method. In coloration methods, intrinsic silicone pigmented groups in all colors except brown in Mult-Epit had the highest ΔE* values. Significant color changes were observed in both pigmented and unpigmented specimens, which were stored in dark environment and not exposed to sunlight.

Optical Properties of Pigmented Polydimethylsiloxane Prosthetic Elastomers

Optical properties of facial prosthetic elastomers undergo significant changes mainly due to aging. The resulting changes in their appearance are the main reasons of facial prosthesis' replacement. The purpose of this study was to evaluate changes in the translucency parameter (TP) and color (ΔE*) of polydimethylsiloxane (PDMS) maxillofacial elastomers after exposure to 3 different aging conditions (time passage, accelerated "outdoor" aging, and accelerated "indoor" aging). The PDMS prosthetic elastomers tested in this study were low- (LTV) and high-temperature vulcanized (Episil and Mollomed, respectively) in various shades. Color changes (ΔE*) and translucency parameter (TP) were determined in the CIE L*a*b* system using a tristimulus colorimeter. Data were subjected to 2-way analysis of variance followed by Tukey post hoc test. In addition, TP values were analyzed by paired t tests. The significance level of α = 0.05 was set for all tests. Translucency parameter values for most samples were significantly changed after aging, and ΔE* values were characterized as unacceptable. Both aging procedure and material type affected the changes that occurred. Moreover, dark-shaded samples of both silicone materials revealed significant changes in TP values before and after aging. ΔE* was not significantly different among the same material samples but had significant differences between the 2 materials (Episil and Mollomed). Time passage did not significantly affect TP values contrary to the other 2 accelerated aging procedures. Between outdoor and indoor aging, no significant differences were detected. Accelerated outdoor and indoor aging caused significant changes in ΔE* and TP values. Significant changes were also detected between material types.

Effect of Time Passage on Some Physical Properties of Silicone Maxillofacial Elastomers

Changes in color and other physical properties of silicone facial prosthesis are the main reasons for its replacement. The purpose of this study was to investigate the effect of time passage on some physical properties such as tensile strength, modulus of elasticity, elongation at break, tear strength, hardness, color stability, and contrast ratio (CR) of 2 silicone facial elastomers after being sealed in glass containers and kept in the dark for 1 year. Specimens from 2 silicone elastomers (Silasto 30 and Premium 2) were made and stored in the dark. Tensile and tear strength tests were conducted according to International Organization for Standardization specification nos. 37 and 39, respectively, in a universal testing machine. Shore A hardness was measured according to the American Society for Testing Materials specification D 2240. Color changes (ΔΕ*) were determined in the CIE L*a*b* system using a tristimulus colorimeter, and CR also was calculated. Data were analyzed by paired and unpaired t-tests at a significance level of α = 0.05. Elongation at break, modulus of elasticity, and hardness were significantly changed, whereas changes in CR were observed only in 1 of the 2 elastomers. Tensile and tear strengths were not significantly changed for both of them. Within the limitations of this study, color changes (ΔΕ) were unacceptable. Most of the physical properties studied were significantly affected because of time passage. Mechanical and physical properties of silicone maxillofacial elastomers can be changed with time passage (natural aging in the dark). The average time of replacing a facial prostheses is 6 to 18 months; thus, it is important that the findings of this study covered a period of 12 months. Time passage seems to be a critical factor contributing to the overall deterioration of a silicone maxillofacial elastomer.

Effect of Chemical Disinfection and Accelerated Aging on Color Stability of Maxillofacial Silicone with Opacifiers

The purpose of this study was to evaluate the color stability of MDX4-4210 maxillofacial elastomer with opacifier addition submitted to chemical disinfection and accelerated aging. Ninety specimens were obtained from Silastic MDX4-4210 silicone. The specimens were divided into three groups (n = 30): Group I: colorless, Group II: barium sulfate opacifier, Group III: titanium dioxide opacifier. Specimens of each group (n = 10) were disinfected with effervescent tablets, neutral soap, or 4% chlorhexidine gluconate. Disinfection was conducted three times a week for 2 months. Afterward, the specimens were submitted to different periods of accelerated aging. Color evaluation was carried out after 60 days (disinfection period) and after 252, 504, and 1008 hours of accelerated aging, using a reflection spectrophotometer. Color alterations were calculated by the CIE L*a*b* system. Data were analyzed by three-way ANOVA and Tukey test (α= 0.05). Group II exhibited the lowest color change, whereas Group III the highest (p < 0.05), regardless of the chemical disinfection and accelerated aging periods. Opacifier addition, chemical disinfection, and accelerated aging procedures affected the color stability of the maxillofacial silicone.

Effect of Extraoral Aging Conditions on Mechanical Properties of Maxillofacial Silicone Elastomer

The purpose of this study was to investigate the effect of extraoral human and environmental conditions on the mechanical properties (tensile strength and modulus, elongation, tear strength hardness) of maxillofacial silicone elastomer. Specimens were fabricated using TechSil-S25 silicone elastomer (Technovent Ltd, Leeds, UK). Eight groups were prepared (21 specimens in each group; eight tensile, eight tear, five hardness) and conditioned differently as follows (groups 1 through 8): Dry storage for 24 hours; dry storage in dark for 6 months; storage in simulated sebum solution for 6 months; storage in simulated acidic perspiration for 6 months; accelerated artificial daylight aging under controlled moisture for 360 hours; outdoor weathering for 6 months; storage in antimicrobial silicone-cleaning solution for 30 hours; and mixed conditioning of sebum storage and light aging for 360 hours. The conditioning period selected simulated a prosthesis being in service for up to 12 months. Tensile and tear test specimens were fabricated and tested according to the International Standards Organization (ISO) standards no. 37 and 34, respectively. Shore A hardness test specimens were fabricated and tested according to the American Standards for Testing and Materials (ASTM) D 2240. Data were analyzed with one-way ANOVA, Bonferroni, and Dunnett's T3 post hoc tests (p < 0.05). Weibull analysis was also used for tensile strength and tear strength. Statistically significant differences were evident among all properties tested. Mixed conditioning of simulated sebum storage under accelerated artificial daylight aging significantly degraded mechanical properties of the silicone (p < 0.05). Mechanical properties of maxillofacial elastomers are adversely affected by human and environmental factors. Mixed aging of storage in simulated sebum under accelerated daylight aging was the most degrading regime. Accelerated aging of silicone specimens in simulated sebum under artificial daylight for 12 months of simulated clinical service greatly affected functional properties of silicone elastomer; however, in real practice, the effect is modest, since sebum concentration is lower, and daylight is less concentrated.

Translucency estimation for thick pigmented maxillofacial elastomer

Objectives : Human skin is multilayered and inhomogeneous and has a partially translucent structure. Since it is not straightforward to quantify the translucency for human skin as it is for translucent materials at a certain thickness, a laser light-diffusing method was developed to quantitatively approximate translucency of translucent pigmented maxillofacial materials, using a technique that would be applicable to human skin. A developed method of laser light diffusing area (LLDA) and the method of color difference due to edge loss (CDEL) were compared in accuracy of translucency estimations of thick pigmented maxillofacial elastomeric material. Methods : Thick specimens of 19 different shades of skin-colored maxillofacial elastomer (MFE) were made with a silicone elastomer and four commercially available pigments (tan, red, yellow and black). Translucency parameter (TP) values at a thickness of 1.5 mm on ideal black and white backings for each shade based on the CIELAB and CIE2000 color difference formulas were previously calculated, and were predicted by the regressions of TP onto the LLDA and CDEL measurements. Results : Both the LLDA and CDEL methods provided reasonably accurate (adjusted R 2 ≥ 0.919) estimations of TP, and no significant differences were found in the error variances of the regressions. Conclusions : The laser light diffusing method appears to be highly reliable for the estimation of translucency of maxillofacial elastomer, and the relationship of translucency to LLDA may be used to estimate the apparent translucency of any thick translucent material within the range of translucency studied. The laser light diffusing method as a non-contact and non-destructive method may be applied to quantitatively estimate the translucency of human skin and prosthetic elastomers, and further be incorporated into appearance matching of maxillofacial prosthesis to human skin.

Color stability of maxillofacial silicone with nanoparticle pigment and opacifier submitted to disinfection and artificial aging

The purpose of this study was to evaluate the color stability of a maxillofacial elastomer with the addition of a nanoparticle pigment and∕or an opacifier submitted to chemical disinfection and artificial aging. Specimens were divided into four groups (n = 30): group I: silicone without pigment or opacifier, group II: ceramic powder pigment, group III: Barium sulfate (BaSO(4)) opacifier, and group IV: ceramic powder and BaSO(4) opacifier. Specimens of each group (n = 10) were disinfected with effervescent tablets, neutral soap, or 4% chlorhexidine gluconate. Disinfection was done three times a week during two months. Afterward, specimens were submitted to different periods of artificial aging. Color evaluation was initially done, after 60 days (disinfection period) and after 252, 504, and 1008 h of artificial aging with aid of a reflection spectrophotometer. Data were analyzed by three-way ANOVA and Tukey test (α = 0.05). The isolated factor disinfection did not statistically influence the values of color stability among groups. The association between pigment and BaSO(4) opacifier (GIV) was more stable in relationship to color change (△E). All values of △E obtained, independent of the disinfectant and the period of artificial aging, were considered acceptable in agreement with the norms presented in literature.

Measuring the Color of Maxillofacial Prosthetic Material

Color information from different color-measuring systems varies during color matching in maxillofacial prosthetics. We studied the hypothesis that a non-contact measuring system and 4 contact color-measuring instruments perform comparably in accuracy and precision on measurements of pigmented maxillofacial elastomer specimens having human skin colors. Measurement comparisons in accuracy on opaque standard color patches were made in Phase I. In Phase II, the system with the best accuracy was used as the reference instrument, and comparisons in accuracy and precision on elastomer specimens were made. The CIEDE2000 color difference formula was used. Repeated-measures ANOVA with Tukey testing and linear regression analysis for CIELAB and color differences among the instruments were performed. The contact measuring systems perform differently in accuracy, possibly due to edge loss and other factors, but performed comparably in precision with the non-contact measuring instrument. This non-contact system is recommended for color measurement of maxillofacial prosthetic materials.

Color Difference Thresholds of Maxillofacial Skin Replications

The purpose of this study was to determine perceptibility and acceptability thresholds for color differences in light and dark skin-colored maxillofacial elastomers. A total of 15 pairs of light specimens (mimicking white, Asian, and Hispanic skin) and 15 pairs of dark specimens (mimicking African-American skin) were made using skin-colored maxillofacial silicone elastomers, combined with opacifiers and pigments. Color match/mismatch and acceptable/unacceptable mismatch of each pair of specimens were visually evaluated by 45 evaluators under controlled conditions of a viewing booth. Color differences were calculated using CIELAB and CIEDE2000 formulae. After calculating the model parameters, receiver operating characteristics (ROC) curves and area under the ROC curve (AUC) were analyzed. Repeated measures ANOVA and Tukey's HSD test were used in a statistical analysis (alpha= 0.05). CIELAB/CIEDE2000 perceptibility and acceptability thresholds for light specimens were 1.1/0.7 and 3.0/2.1, respectively. Corresponding values for dark specimens were 1.6/1.2 and 4.4/3.1, respectively. Differences in primary specimen color and type of threshold were found to be significant (p < 0.001). Only the primary specimen color effect was found to be significant in AUC comparisons. Within the limitations of this study, both main effects of threshold type (perceptibility and acceptability) and primary color (light and dark) on 50:50% color-difference thresholds of colored maxillofacial elastomers were found significant for both color-difference formulae used (CIELAB, CIEDE2000). In addition, significant interaction between the two main effects was found, indicating a stronger effect of skin type on acceptability than perceptibility thresholds. Primary specimen color (light vs. dark) was found to be the only significant main effect on the AUC of ROC curves constructed from logistic regression.

Concentration additivity of coefficients for maxillofacial elastomer pigmented to skin colors

Objective The purpose of this study is to determine a regression model which performs accurately for predicting Kubelka–Munk (K–M) absorption ( K) and scattering ( S) coefficients of pigment mixtures in maxillofacial elastomer (MFE). Methods Specimens at varying thicknesses of 19 shades of skin-colored MFE were made incorporating tan, red, yellow and black pigments. Using a non-contact 45°/0° spectral reflectance system, reflectance values were obtained and fit by non-linear regression to corrected K–M theory to determine observed K and S values. Predicted values were calculated using: first order linear regression model (M 1), second order square-factor model (M 2S), second order interaction-factor model (M 2I) and complete second order model (M 2C). Errors between observed and predicted values for each model at each wavelength studied are evaluated. Differences in color and the Translucency Parameter (TP) at a thickness of 1.5 mm based on CIE2000 color difference formula between observed and predicted values were also analyzed using repeated-measures ANOVA ( α = 0.05). Results M 2C shows less absolute differences in color and TP (1.5 mm) than those for the M 1 and M 2S models ( P < 0.05). Significance Within limitations of this study, the complete second order regression model performs accurately in concentration additivity of pigmented maxillofacial elastomer mixture. This regression model is recommended as a viable alternative in the application of colorant formulation based on corrected K–M model for improving appearance match of pigmented maxillofacial prosthesis to human skin.

Interfacial corrections of maxillofacial elastomers for Kubelka–Munk theory using non-contact measurements

Objective Reflectance measurements using a 45°/0° non-contact measuring system provide accurate data for translucent materials, yet the interfacial reflection corrections (IRCs) for Kubelka–Munk theory have not been evaluated using this system. The objective is to determine which IRC method for Kubelka–Munk theory (K-MT) models the spectral reflectance of pigmented maxillofacial elastomer (MFE) with least error. Method Samples at varying thicknesses of each of 19 shades of skin-colored maxillofacial elastomer were measured using this system on each of three backings. Reflectance values within the visible wavelength range for each shade were fit by non-linear regression to K-MT using different IRC methods: no IRC correction (No), IRC for opaque materials (Op) and IRC for translucent materials (Tr). Errors associated with each method were analyzed using repeated-measures ANOVA and a Bonferroni-corrected t-test. Results Average error mean square values over all wavelengths were 0.00038 for K-MT with no IRC, 0.00023 with Op IRC, and 0.00015 with Tr IRC. The No method gave a statistically higher error than either the Op or Tr method at all analyzed wavelengths, and the Tr gave a lower error than the OP at all analyzed wavelengths between 450 and 600 nm. The predicted CIELAB values of all the shades tested fell into the range of human skin color space. Significance Corrected Kubelka–Munk theory with the IRC for translucent materials proposed by Richmond provides higher accuracy on maxillofacial elastomer over the more important visible wavelengths. Color and translucency of maxillofacial elastomer can be predicted using corrected K-M theory.

Influence of pigments and opacifiers on color stability of silicone maxillofacial elastomer

Objectives To determine the effects of opacifiers and silicone pigments on the color stability of silicone A-2000 maxillofacial prosthetic elastomers subjected to artificial aging. Methods Seventy-five groups ( n = 5) were made by various combinations (5%, 10%, and 15%) of four dry earth opacifiers (Georgia kaolin, Gk; calcined kaolin, Ck; Artskin white, Aw; titanium white dry pigment, Td); and 1 silicone pigment white (Sw) with one of 5 silicone pigments (no pigment (control), red (Pr), yellow (Py), burnt sienna (Po), and a mixture of Pr + Py + Po). A reflection spectrophotometer was used for color measurements. Color differences (Δ E*) between baseline and after an energy exposure of 450 kJ/m 2 in an artificial aging chamber were calculated. A Δ E* = 3.0 was used as 50:50% acceptability threshold in result interpretation, while Δ E* = 1.1 was used as 50:50% perceptibility threshold. Means were compared by Fisher's PLSD intervals at the 0.05 level of significance. Color differences after aging were subjected to three-way analysis of variance. Results Yellow ochre mixed with all opacifiers at all intervals had increased Δ E* values significantly from 0.7–2.1 up to 3.8–10.3. When mixed groups were considered, at 5%, Gk exhibited the smallest color changes, followed by Td < Aw = Sw < Ck, respectively. At 10%, Aw < Td < Gk < Sw = Ck. At 15%, Td < Aw < Gk = Sw < Ck (< indicates p < 0.0001 and = indicates p > 0.05). The smallest color differences, observed for opacifier groups, were recorded for Gk at 5%, and Td and Aw at 10% and 15%. Overall, 15% Td exhibited the smallest, whereas 5% Ck exhibited the most pronounced color change after artificial aging. All Δ E* values were below the 50:50% acceptability threshold, indicating acceptable color stability. Color differences for 10% and 15% of Aw and Td were below 50:50% perceptibility thresholds, indicating excellent color stability. Conclusion Silicone pigments mixed with 10% and 15% Artskin white and titanium white dry pigment opacifiers protected silicone A-2000 from color degradation over time. Yellow silicone pigment significantly affected color stability of all opacifiers especially silicone pigment white and calcined kaolin.

Effect of nano-oxide concentration on the mechanical properties of a maxillofacial silicone elastomer

Contemporary silicone-based elastomeric prostheses tend to degrade over time because of the effect of mechanical loading. Little has been reported on how the mechanical properties of a maxillofacial prosthetic elastomer may be affected by the addition of nanosized oxide particles used as an opacifier. The purpose of this study was to evaluate the effect of different concentrations of nanosized oxides of various composition on the mechanical properties of a commercially available silicone elastomer. Nanosized oxides (Ti, Zn, or Ce) were added in various concentrations (0.5%, 1.0%, 1.5%, 2.0%, 2.5%, or 3.0% by weight) to a commercial silicone elastomer (A-2186), commonly used for fabricating extraoral maxillofacial prostheses. Silicone elastomer A-2186 without nanosized oxides served as a control group. Specimens (n=5) were polymerized according to manufacturer's recommendations and tested for tensile strength (ASTM D412) and tear strength (ASTM D624), and percent elongation in a universal testing machine. Uniformity of particle dispersion within the processed elastomer was assessed using scanning electron microscopic imaging. For each property, a 2-way ANOVA was performed evaluating the effect of oxide type and strength, and Fisher's PLSD test was used for pairwise comparisons (alpha=.05). SEM examination indicated that all 3 nanosized oxides distribute evenly throughout the silicone specimens, except for the 3.0% group, which are partly agglomerated. The 2.0% and 2.5% groups of all nanosized oxides demonstrated significantly higher tensile and tear strengths and percent elongation (P<.001) than the control group. CeO(2) had significantly lower tensile strength than TiO2 and ZnO (P<.05). The ZnO group had significantly higher tear strength than TiO(2) and CeO(2) (P <.05). Most of specimens became somewhat harder when compared with the control group. CeO(2) group had significantly higher Shore A hardness than TiO(2) and ZnO (P<.001). There was no significant difference of percent elongation among the type of nanosized oxides. Incorporation of Ti, Zn, or Ce nano-oxides at concentrations of 2.0% and 2.5% improved the overall mechanical properties of the silicone A-2186 maxillofacial elastomer.

Disinfection of maxillofacial silicone elastomer using a novel antimicrobial agent: recombinant human beta-defensin-3

Maxillofacial silicone elastomer, when used as a prosthesis, is in contact with wound surfaces and mucosa, and tends to be contaminated with microorganisms from a patient's saliva and blood. The aim of the study was to evaluate the efficacy of human beta-defensin-3 (HBD3) on the reduction of two resistant bacteria species from the surface of maxillofacial silicone elastomer. HBD3 cDNA was amplified from total RNA, which had been extracted from human gingival epithelium by means of reverse-transcription polymerase chain reaction (RT-PCR). Following this, the cDNA fragments were recombined in a prokaryotic expression vector. The constructed expression vectors pET-32a/HBD3 were transformed into Escherichia coli to obtain recombinant protein. After protein purification and refolding, the product was verified in classic antimicrobial experiments against Staphylococcus aureus and Candida albicans. Specimens made of silicone elastomer A-2186, which had been contaminated with S. aureus or C. albicans, were immersed in rHBD3 or 5.25% sodium hypochlorite (a positive control) for 5 min, 10 min, 30 min, or 60 min. The active recombinant HBD3 obtained in the current study eliminated the S. aureus and C. albicans microorganism from the surface of the maxillofacial elastomer after a 30-min immersion. There was no statistically significant difference between the rHBD3 group and the sodium hypochlorite 5.25% group. In conclusion, rHBD3 exhibits antibacterial activity against oral pathogenic strains that adhere to maxillofacial elastomer, and may, thus, contribute to the prevention of infections caused by S. aureus and C. albicans.

Effects of a hindered amine light stabilizer and a UV light absorber used in maxillofacial elastomers on human gingival epithelial cells and fibroblasts

Ultraviolet light absorber (UVA) and hindered amine light stabilizer (HALS) retard sun-induced pigment degradation in silicone elastomeric maxillofacial prostheses. HALS inhibits polymer degradation and UVA dissipates UV radiation. Their effects on oral cells are unknown. The purpose of this study was to evaluate the effects of UVA and HALS on membrane integrity, viability, and proliferation of human gingival fibroblasts and epithelial cells. Tinuvin 123 (HALS) and Tinuvin 213 (UVA) were assessed for cytotoxicity, individually and in a 1:1 ratio (used in elastomers; HALS/UVA). The cells were exposed to HALS, UVA, or HALS/UVA (or control media containing only the diluent), and colorimetric assays measured membrane damage, viability, and proliferation. The data (% cytotoxicity or % control) were analyzed using 3-way cross-classified fixed effects ANOVA (alpha=.05). HALS did not negatively affect either cell type. UVA or HALS/UVA (>or= approximately 0.004%) decreased viability by >or=90% in both cell lines; lower concentrations decreased activity in epithelial cells while increasing it in fibroblasts. UVA or HALS/UVA damaged membranes of both cell lines, but epithelial cells were more resistant. UVA or HALS/UVA inhibited proliferation of both cell types similarly. There was a slight synergistic effect of HALS and UVA on membrane damage in both cell lines, but generally not on other parameters. Although it is unknown if HALS or UVA leaches from silicone elastomers in vivo, these data suggest that relative resistance of epithelial cells to UVA-induced membrane damage, and UVA's stimulation of fibroblast viability at some concentrations, might provide some protective effect.

Interactions of pigments and opacifiers on color stability of MDX4-4210/type A maxillofacial elastomers subjected to artificial aging

The color instability and degradation of maxillofacial elastomers limit the function and cosmetic quality of facial prostheses. The purpose of this study was to measure the interactions of oil pigments plus dry earth opacifiers at 5%, 10%, and 15% by volume in stabilizing the color of MDX4-4210/type A silicone elastomers before and after artificial aging. In the first part of the study, each of 5 opacifiers (Georgia kaolin powder neutral, kaolin powder calcined, Artskin white, dry pigment titanium (Ti) white, or Ti white artists' oil color) at 10% concentrations were combined with each of 5 oil pigment types (no pigment, cadmium-barium red deep, yellow ochre, burnt sienna, or a mixture of the 3 pigments), for a total of 25 experimental groups of elastomers. In the second part of the study, 50 experimental groups of elastomers were made by combining 1 of 5 opacifiers at 5% and 15% concentrations with 1 of 5 oil pigments as in Part 1. Five specimens of each elastomer were tested, for a total of 375 specimens. In each part of the study, all specimens were aged in an artificial aging chamber. CIE L*a*b* values were measured by a spectrophotometer. The color differences (DeltaE*) were subjected to repeated-measures analysis of variance. Mean values were compared by Tukey-Kramer intervals (alpha = .05). In Part 1, when the opacifiers were tested at 10% concentration, Ti white oil color had the most color change, and dry pigment Ti white had the least; all other opacifiers were not significantly different from each other. In Part 2, at 5%, Ti white oil color had the most color change; all other opacifiers were not significantly different from the others. At 15%, Ti white oil color again had the most color change, followed by Artskin white, kaolin powder calcined, and Georgia kaolin; Ti white dry earth pigment had the least color change. Overall, 5% Artskin white had less color change than the 15%, whereas 15% dry pigment Ti white had less color change than the 5% (P < .001). The 5% and 15% of other opacifiers were not significantly different. At all 3 concentrations, oil pigments mixed with opacifiers helped protect the MDX4-4210/type A silicone elastomer from color degradation over time. Dry pigment Ti white remained the most color stable over time, followed by the pigments mixed with kaolin powder calcined, Georgia kaolin, Artskin white, and Ti white artists' oil color.

Color Stability of Dry Earth Pigmented Maxillofacial Silicone A‐2186 Subjected to Microwave Energy Exposure

The purpose of this study was to measure spectrophotometrically the color stability of pigmented A-2186 silicone maxillofacial elastomer with 10% by volume of titanium white dry earth opacifier before and after exposure to microwave energy over a simulated 1.5-year period of microwave sterilization. A-2186 silicone elastomer opacified with titanium white dry earth pigment, pigmented with 5 cosmetic dry earth pigment colors [no pigment (control) group (Pc), red (Pr), yellow ochre (Py), burnt sienna (Po), and a mixture of Pr + Py + Po color group (P3)], was used in this study. Each of the 5 experimental groups consisted of 5 specimens. All specimens were placed in a 250 ml glass beaker filled with 150 ml of water (replenished for each microwave exposure). An exposure of 6 minutes was used 18 times (simulating 1.5 years of microwave sterilization with one 6 minute exposure monthly). Reflectance values were measured by spectrophotometer. Three- and two-way analyses of variance with repeated measures were performed for the color difference (DeltaE*) with the factors of group/color/months, and group/months, respectively. Means were compared by Tukey Honest Significant Difference (HSD) multiple range test calculated at the 0.05 level of significance using SPSS. The trained human eye can detect color changes (DeltaE*) greater than 1.0. Most DeltaE* values of the red pigment group at all intervals and the mixed pigment group at 15- and 18- month intervals increased significantly greater than 1.0 (p < 0.001) compared with the control group. Yellow and burnt sienna groups remained the most color stable over time with DeltaE* values below 0.35. Lack of color stability of red dry earth pigmented A-2186 silicone maxillofacial elastomers was clinically significant after 12-month exposure to microwave energy as compared with yellow, burnt sienna, and opacified A-2186 dry earth pigments.

In vitro evaluation of color change in maxillofacial elastomer through the use of an ultraviolet light absorber and a hindered amine light stabilizer

Statement of problem External prostheses composed of silicone elastomers exhibit an unwanted color change over time. Purpose This study evaluated color stability when an ultraviolet light absorber and hindered amine light stabilizer were mixed in the maxillofacial elastomer containing either organic or inorganic pigments. Material and methods The materials used were an RTV silicone elastomer, 1 natural inorganic dry-earth pigment (burnt sienna) and 2 synthesized organic pigments (hansa yellow and alizarin red), ultraviolet light absorber (UVA) and hindered amine light stabilizer (HALS). Specimens (n=160) were fabricated in a custom mold and randomly assigned and exposed to weathering sites in Miami and Phoenix for approximately 3 months. Eight test groups (2 of each 4 material types with or without additives) of 10 specimens each were assigned to each site. L ∗, a ∗, b ∗ readings were obtained before and after weathering from a spectrocolorimeter. Nonpigmented elastomers served as the control. Three-factor ANOVA was conducted to examine interaction effects between weathering sites, specimen type, and the presence of additive (α=.05). Overall color change (ΔE) and change in color coordinates (ΔL ∗, Δa ∗, Δb ∗) of specimen groups with and without additive were analyzed with independent sample t tests. Results In specimen groups with the additives (UVA and HALS), color change decreased significantly ( P<.05) in burnt sienna and hansa yellow in Phoenix and in the control and hansa yellow in Miami. Additives did not affect color change in the alizarin red group. Conclusion UVA and HALS were shown to be effective in retarding color change in some circumstances.

In vitro evaluation of color change in maxillofacial elastomer through the use of an ultraviolet light absorber and a hindered amine light stabilizer*1

In vitro evaluation of color change in maxillofacial elastomer through the use of an ultraviolet light absorber and a hindered amine light stabilizer*1