Silicone-based Resilient Liners Research Articles

A comparative study of patients satisfaction with conventional and relined mandibular complete dentures

Edentulous patients are usually satisfied with the service of a conventional maxillary denture but not the mandibular denture, particularly if the patients present with advanced atrophy of residual ridges, systemic diseases, chronic tissue soreness or maladaptive denture wearing experience. For such patients, the relining of hard heat cured mandibular dentures with long term resilient denture liners may be considered as a non-surgical alternative to pre-prosthetic procedures or implant supported prostheses. Purpose of The Study: The purpose of the study was to compare the satisfaction level of the patients provided with both conventional and relined mandibular dentures. Materials and Methods: The study was conducted on fifteen edentulous patients. Each patient was provided with one maxillary and two mandibular complete dentures i.e. one conventional and another relined with long term silicone-based resilient liner (Molloplast-B). Patients’ general satisfaction with the two mandibular dentures was evaluated using questionnaire. The data so collected was compared and analyzed statistically. Results: The overall analysis of the results obtained from the study suggested that the use of soft liners may promote a more satisfying life for edentulous patients. There was an improvement in patients’ general satisfaction rating, ability to chew &speak, fit and comfort with relined mandibular dentures as compared to conventional acrylic resin mandibular dentures opposed by conventional maxillary dentures and the majority of patients had a preference for the relined mandibular dentures.

BASIC PROBLEMS WITH THE USE OF RESILIENT DENTURE LINING MATERIALS: LITERATURE REVIEW

Complicated cases in the treatment of totally edentulous patients, as well as in the fabrication of obturators and epitheses, require the use of resilient lining materials (RLMs). These materials have several disadvantages, which is why many dental practitioners do not recommend them. The tendency to breaking the bond between the hard acrylic resin and the resilient liner is a fact with unpleasant consequences, mainly found with the use of cold-curing silicone-based resilient liners. Methods to improve the bond between the hard denture base and the RLM have been the subject of numerous publications. The efforts of the authors are focused in two directions: mechanical or chemical treatment of the denture base or a combination of both. Other commonly discussed problems with the use of RLMs are the difficult and even impossible repair and the retention of oral fluids, fungi and other microorganisms due to the porosity of RLMs. Despite the wide variety of tools offered by different manufacturers, the issue of optimal and high-quality mechanical treatment of the polymerized resilient material has not yet been fully resolved.

Effectiveness of silicone-based resilient denture liners on masticatory function: A randomised controlled trial

ObjectivesThis randomised controlled trial aimed to compare the masticatory function between the silicone-based resilient denture liner and conventional denture among edentulous patients. MethodsThe trial included edentulous patients who were willing to have a new set of complete dentures. Participants were randomly assigned to receive mandibular complete dentures with either a 1) conventional denture base (CD group) or (2) silicone-based resilient denture liner (RD group). Masticatory performance (evaluated with gummy jelly) and the maximum occlusal force were measured at baseline, on final adjustment, and at 3 months after the final adjustment. The outcomes were analyzed using two-way mixed analysis of variance and a paired t-test. The statistical significance was set at p < 0.05. ResultsThe masticatory performance was lower in the RD group than in the CD group; it increased significantly over time in the CD group, but not in the RD group. The maximum occlusal force in the RD group was significantly higher than that in the CD group; it increased significantly over time in the RD group, but not in the CD group. ConclusionsSilicone-based RD liners applied to mandibular complete dentures are effective in improving the maximum occlusal force but not the masticatory performance, as measured with gummy jelly. Clinical significancePrior evidence has suggested that mandibular complete dentures with resilient denture liners improve masticatory function. However, the results of this study indicate that difficulties may remain with the mastication of foods with a certain texture (e.g., gummy jelly).

Effectiveness of silicone-based resilient denture liners on the patient-reported chewing ability: A randomized controlled trial.

This randomized controlled trial (RCT) aimed to elucidate the effectiveness of silicone-based resilient denture liners on perceived chewing ability. The RCT included completely edentulous patients on both the maxilla and mandible, who were willing to fabricate a new set of complete dentures. A random permuted block method (block size: 4) was used to assign groups to receive maxilla conventional complete denture and mandibular with either a conventional complete denture (CD) or complete demure relined with silicone-based resilient denture liner (RD). The patient-reported chewing ability of six foods, soybean curd, fish sausage, soybean sprout, cubic rice cracker, hard rice cracker, and dry squid, on a 100-mm visual analog scale was measured and reported at the final adjustment and three months after the final adjustment. Mann-Whitney U test was used to analyze the differences between the CD and RD (p < 0.05). Edentulous patients wearing mandibular complete denture with RD had a higher patient-reported chewing ability than those wearing a CD, but the fish sausage did not in the RD three months after the final adjustment. It also took three months for the patient-reported masticatory ability to improve for cubic rice crackers, hard rice crackers, and dry squid and to show a difference between the RD and CD groups. Although limited to some food types, mandibular complete dentures relined with silicone-based liners improved patient-reported chewing ability.

Resilient liners may reduce pain and discomfort in the short term in patients who wear complete dentures

Furokawa S, Kimoto S, Furuse N, et al. The effects of silicone-based resilient denture liners on pain: a randomized controlled trial [published online ahead of print February 12, 2020]. J Prosthodont Res. https://doi.org/10.1016/j.jpor.2019.11.006.

The effects of silicone-based resilient denture liners on pain: A randomized controlled trial

PurposeThis randomized controlled trial aimed to study the effects of lining mandibular complete dentures with silicone-based resilient denture liners, especially with respect to sensation. MethodsThe trial included completely edentulous patients who were willing to fabricate new set of complete denture. A random permuted block method (block size: 4) was used to assign participants to one of the following groups: mandibular conventional denture (CD) group or mandibular denture with resilient denture liner (RD) group. The outcomes were evaluated using both, objective measures (current perception threshold (CPT) and pain threshold (PT)) for external stimuli measured using the Neurometer CPT® and subjective measures (physical pain and psychological discomfort measured using the Japanese version of Oral Health Impact Profile for Edentulous patients—OHIP-EDENT-J). The outcomes were measured twice, at immediately after completion of denture adjustments (first measurement), and 3 months after the completion of denture adjustments (second measurement). All outcomes were analyzed using the Student t-test. A p-value of <0.05 was considered statistically significant. ResultsCPT was significantly higher with RD than CD only at second measurement with frequency level of 2000 Hz and 5 Hz. The pain thresholds were significantly higher in the RD group than the CD group. The physical pain and psychological discomfort scores were significantly lower in the RD group than in the CD group. ConclusionThis study concludes that edentulous patients wearing mandibular complete dentures with silicone-based resilient denture liners dull perception mandibular ridge mucosa and felt less pain than those without the liners.

Adhesive evaluation of three types of resilient denture liners bonded to heat-polymerized, autopolymerized, or CAD-CAM acrylic resin denture bases

Statement of problemLevels of bond strength between different types of resilient denture liner materials bonded to different denture base acrylic resins, CAD-CAM acrylic resins in particular, have not been well reported. PurposeThe purpose of this in vitro study was to measure the tensile bond strength and durability of various combinations of 3 different resilient denture liners bonded to 3 different poly(methyl methacrylate) denture base materials. Material and methodsThe tensile bond strength of 3 resilient denture liners, namely Ufi Gel SC, Silagum-Comfort, and Vertex Soft, combined with heat-polymerized (Vertex Rapid Simplified), autopolymerized (Vertex Self-Curing), and computer-aided design and computer-aided manufacturing (CAD-CAM) (IvoBase CAD) denture base resins were tested by using a universal testing machine (total N=138). Half of the specimens were thermocycled between 5°C and 55°C for 1500 cycles before testing. After testing, modes of failure and interface surfaces were examined using light microscopy and scanning electron microscopy, respectively. Thermogravimetric analysis was carried out to analyze the differences in content between the 3 different denture base acrylic resins. ResultsThe mean tensile bond strength values ranged from 0.36 ±0.1 MPa to 1.51 ±0.46 MPa. CAD-CAM denture base materials showed the lowest range of bond strength when coupled to resilient denture liners (0.36 to 0.42 MPa). No statistically significant differences (P=.74) were found in bond strength between the thermocycled (0.71 ±0.23 MPa) and non-thermocycled groups (0.74 ±0.21 MPa). Silicone-based resilient denture liners exhibited the highest tensile strength with each type of denture resin. All 3 types of failure modes (adhesive, cohesive, and mixed modes) were observed. ConclusionsSilicone-based resilient denture liners produced the highest tensile bond strength to all denture bases tested. Resilient denture liners bonded to CAD-CAM denture bases produced the weakest tensile bond strengths. Thermocycling did not produce statistically significant differences in tensile bond strength of the resilient denture liners to the denture base resins.

Influence of ozone and paracetic acid disinfection on adhesion of resilient liners to acrylic resin.

PURPOSEThe aim of this study was to evaluate the effect of paracetic acid (PAA) and ozone disinfection on the tensile bond strength (TBS) of silicone-based resilient liners to acrylic resins.MATERIALS AND METHODSOne hundred and twenty dumbbell shaped heat-polymerized acrylic resins were prepared. From the mid segment of the specimens, 3 mm of acrylic were grinded off and separated parts were reattached by resilient liners. The specimens were divided into 2 control (control1, control7) and 4 test groups of PAA and ozone disinfection (PAA1, PAA7, ozone1 and ozone7; n=10). While control groups were immersed in distilled water for 10 min (control1) and 7 days (control7), test groups were subjected to PAA (16 g/L) or ozone rich water (4 mg/L) for 1 cycle (10 min for PAA and 60 min for ozone) per day for 7 days prior to tensile tests. Measurements of the TBS were analyzed using 3-way ANOVA and Tukey's HSD test.RESULTSAdhesive strength of Mollosil decreased significantly by application of ozone disinfection. PAA disinfection had no negative effect on the TBS values of Mollosil and Molloplast B to acrylic resin. Single application of ozone disinfection did not have any negative effect on TBS values of Molloplast B, but prolonged exposure to ozone decreased its adhesive strength.CONCLUSIONThe adhesion of resilient liners to acrylic was not adversely affected by PAA disinfection. Immersion in ozonated water significantly decreased TBS of Mollosil. Prolonged exposure to ozone negatively affects adhesion of Molloplast B to denture base materials.

The Effects of Er:YAG, Nd:YAG, and Ho:YAG Laser Surface Treatments to Acrylic Resin Denture Bases on the Tensile Bond Strength of Silicone-Based Resilient Liners.

The present study was to assess the effect of surface treatments of Er:YAG, Nd:YAG, and Ho:YAG lasers on the tensile bond strength of a silicone-based resilient liner to an acrylic denture in an in vitro setting. Experimental dumbbell-shaped specimens (75 mm) were produced by combining two acrylate pieces fabricated from heat-polymerized acrylic resin (36 mm) with 3 mm of Molloplast(®)-B filling between them. The specimens (n=200) were randomly divided in half for thermocycling, and each 100 specimen set was randomized into five groups (n=20) with different surface treatments: control (no surface treatment), sandblasting, Er:YAG laser, Nd:YAG laser, and Ho:YAG laser. A tensile bond strength test was performed. The effect of the laser surface treatments was examined with scanning electron microscopy. Only the Er:YAG laser increased the tensile bond strength compared with the other treatments. The other laser groups showed lower bond strengths. The Ho:YAG laser resulted in considerably reduced tensile bond strength. The scanning electron microscopy images showed that applying laser surface treatments modified the surface of the denture base resin. There was not an overall improvement with the use of the studied laser modalities in the adhesion quality of resilient denture liner to acrylic resin, although Er:YAG laser showed a potential to improve their adhesion. These laser modalities need to be subjected to further studies to determine optimal setup for use in prosthodontics.

The effect of poly(methyl methacrylate) surface treatments on the adhesion of silicone-based resilient denture liners

Different surface treatment protocols of poly(methyl methacrylate) have been proposed to improve the adhesion of silicone-based resilient denture liners to poly(methyl methacrylate) surfaces. The purpose of this study was to evaluate the effect of different poly(methyl methacrylate) surface treatments on the adhesion of silicone-based resilient denture liners. Poly(methyl methacrylate) specimens were prepared and divided into 4 treatment groups: no treatment (control), methyl methacrylate for 180 seconds, acetone for 30 seconds, and ethyl acetate for 60 seconds. Poly(methyl methacrylate) disks (30.0 × 5.0 mm; n = 10) were evaluated regarding surface roughness and surface free energy. To evaluate tensile bond strength, the resilient material was applied between 2 treated poly(methyl methacrylate) bars (60.0 × 5.0 × 5.0 mm; n = 20 for each group) to form a 2-mm-thick layer. Data were analyzed by 1-way ANOVA and the Tukey honestly significant difference tests (α = .05). A Pearson correlation test verified the influence of surface properties on tensile bond strength. Failure type was assessed, and the poly(methyl methacrylate) surface treatment modifications were visualized with scanning electron microscopy. The surface roughness was increased (P < .05) by methyl methacrylate treatment. For the acetone and ethyl acetate groups, the surface free energy decreased (P < .05). The tensile bond strength was higher for the methyl methacrylate and ethyl acetate groups (P < .05). No correlation was found regarding surface properties and tensile bond strength. Specimens treated with acetone and methyl methacrylate presented a cleaner surface, whereas the ethyl acetate treatment produced a porous topography. The methyl methacrylate and ethyl acetate surface treatment protocols improved the adhesion of a silicone-based resilient denture liner to poly(methyl methacrylate).

Effect of surface treatments on the bond strength of soft denture lining materials to an acrylic resin denture base

Adhesive failure between acrylic resin and resilient liner material is commonly encountered in clinical practice. The purpose of this study was to evaluate the effect of different surface treatments on the bond strength of 2 different resilient lining materials to an acrylic resin denture base. Ninety-six dumbbell-shaped specimens were fabricated from heat-polymerized acrylic resin, and 3 mm of the material was cut from the thin midsection. The specimens were divided into 6 groups according to their surface treatments: no surface treatment (control group), 36% phosphoric acid etching (acid group), erbium:yttrium-aluminum-garnet (Er:YAG) laser (laser group), airborne-particle abrasion with 50-μm Al2O3 particles (abrasion group), an acid+laser group, and an abrasion+laser group. The specimens in each group were divided into 2 subgroups according to the resilient lining material used: heat-polymerized silicone based resilient liner (Molloplast B) and autopolymerized silicone-based resilient liner (Ufi Gel P). After all of the specimens had been polymerized, they were stored in distilled water at 37°C for 1 week. A tensile bond strength test was then performed. Data were analyzed with a 2-way ANOVA, and the Sidak multiple comparison test was used to identify significant differences (α=.05). The effects of the surface treatments and resilient lining materials on the surface of the denture base resin were examined with scanning electron microscopy. The tensile bond strength was significantly different between Molloplast B and Ufi Gel P (P<.001). The specimens of the acid group had the highest tensile bond strength, whereas those of the abrasion group had the lowest tensile bond strength. The scanning electron microscopy observations showed that the application of surface treatments modified the surface of the denture base resin. Molloplast B exhibited significantly higher bond strength than Ufi Gel P. Altering the surface of the acrylic resin denture base with 36% phosphoric acid etching increased bond strength.

Conservative approach for the treatment of geriatric edentulous patient with grossly resorbed mandibular ridge

The construction of complete denture prosthesis for a geriatric patient with grossly resorbed mandible has always been a challenge to our profession. Poor mandibular ridges accompanied by thin and atrophic oral mucous membrane leads to increased bruising and damage under occlusal loading. Nutrition and diet play an important role in all edentulous patients, but particularly with the geriatric patient. This case report presents a conservative prosthodontic option that includes a modifi ed fi nal impression technique using admixed compound followed by permanent lining of the mandibular denture with a heat-cure silicone-based resilient soft liner along with dietary counseling.

Evaluation of tensile bond strength of heat cure and autopolymerizing silicone-based resilient denture liners before and after thermocycling

To assess the effect of simulated mouth conditions reproduced with thermocycling on the tensile bond strength of two silicone based resilient denture liners with acrylic resin bases. Two silicone-based soft denture liners (Mollosil - Chairside autopolymerization and Molloplast B - Heat polymerization) were tested. For each liner, 30 specimens with a cross-sectional area of 10 Χ 10 mm and thickness 3 mm were processed between two acrylic blocks (Trevalon). Specimens were divided into a control group that was stored for 24 hours in water at 37°C and a test group that was thermocycled (2500 cycles) between baths of 5° and 55°C. Tensile bond strength (kg/cm²) was determined in a universal testing machine using crosshead speed of 5 mm/min. The student t-test was used to determine the significance of the difference in bond strength between the two liners. The mean tensile bond strength for control and thermocycled specimens of the two liners were: Mollosil (6.82 kg/cm² and 8.41 kg/cm²) and Molloplast-B (16.30 kg/cm² and 13.67 kg/cm²), respectively. Comparison of bond strength of control specimens with thermocycled specimens of the liners indicated a significant difference for both Mollosil (P=0.045) and Molloplast-B (P=0.027). Comparison between control specimens of both liners and thermocycled specimens of both liners indicated a highly significant difference (P<0.001). Heat polymerized resilient denture liner Molloplast-B had higher tensile bond strength than autopolymerizing liner Mollosil regardless of thermocycling. The bond strength of Mollosil increased after thermocycling while that of Molloplast-B decreased after thermocycling. Although heat-polymerized denture liners require more processing time than autopolymerizing liners, but they display much better adhesion properties to denture base resin and should thus be preferred when soft liner has to be used for a longer duration of time.

The Effect of Aging by Thermal Cycling and Mechanical Brushing on Resilient Denture Liner Hardness and Roughness

The purpose of this study was to investigate the effects of aging on resilient denture liners. The aging effects were produced by using thermal cycling and mechanical brushing and were quantified as changes to surface hardness and roughness of resilient denture liners. A plasticized acrylic resin (Dentuflex) and two silicone-based (Molloplast-B, Sofreliner MS) resilient denture liners were examined. Pre- and post-test roughness and hardness measurements were recorded using a Surfcorder SE 1700 and Shore A durometer Teclock GS-709, respectively. Sixty specimens were manufactured; half were subjected to 3000 cycles in the thermal cycler (5 and 55 degrees C). The remaining specimens received 30,000 strokes applied by a mechanical brushing machine followed by 3000 thermal cycles. Representative specimens from each group were observed under scanning electron microscope (SEM). Data were examined by multiple ANOVA, split-plot analysis, and Tukey test (alpha= 0.05). Shore A hardness values for Dentuflex, Molloplast-B, and Sofreliner MS soft liners were different from each other (p < 0.05) before (79 +/- 2.9; 40 +/- 1.4; 33 +/- 0.7) and after (80 +/- 3.1; 40 +/- 1; 34 +/- 0.9) thermocycling. The surface roughness (in mum) of the same soft liner materials was significantly different (p < 0.05) at the start (2.2 +/- 0.4; 1.6 +/- 0.6; 0.2 +/- 0.1) but it was not different (p > 0.05) after tooth brushing (1.7 +/- 0.3; 1.7 +/- 0.4; 1.9 +/- 0.8) or thermocycling (1.6 +/- 0.5; 1.6 +/- 0.6; 1.5 +/- 0.5). Thermal cycling promoted increased hardness for Sofreliner MS and Dentuflex. Mechanical brushing promoted wear abrasion in Sofreliner MS and Dentuflex materials. Molloplast-B experienced no deleterious effects from either of the tests.

Effect of storage duration on the hardness and tensile bond strength of silicone- and acrylic resin-based resilient denture liners to a processed denture base acrylic resin

Two potential problems commonly identified with a denture base incorporating a resilient liner are a failure of the bond between the acrylic resin and resilient liner material and a loss of resiliency of the resilient liner material over time. This investigation evaluated the effect of storage duration on the tensile bond strength and hardness of acrylic resin- and silicone-based resilient liners that were either heat- or autopolymerized onto denture base acrylic resin. The denture liners investigated were a definitive acrylic resin-based heat-polymerized (Vertex Soft), interim acrylic resin-based autopolymerized (Coe-Soft), definitive silicone-based heat-polymerized (Molloplast-B), and definitive silicone-based autopolymerized (Mollosil Plus) resilient liner. The resilient liners were processed according to manufacturers' instructions. The resilient liner specimens for tensile bond strength testing (n=10) were 10 x 10 x 3 mm and were processed between 2 polymethyl methacrylate (PMMA) (Meliodent) blocks (40 x 10 x 10 mm). The resilient liner specimens for hardness testing (n=10) were 20 mm in diameter and 12 mm in height. Specimen shape and liner thickness were standardized. Specimens were stored for 1 day, 1 week, or 1, 3, or 6 months in water at 37 degrees C. Tensile bond strength was measured in a universal testing machine at a crosshead speed of 20 mm/min, and hardness was measured using a Shore A durometer. Two-way ANOVA and Tukey HSD tests were used to analyze the data (alpha=.05). The results indicated that there were significant differences both in the hardness and bond strength values of resilient liner materials. The definitive silicone-based heat-polymerized (Molloplast-B) resilient liner had significantly higher bond strength and lower hardness values than the others. Prolonged exposure to water produced significantly higher hardness values and lower bond strength values. Within the limitations of this in vitro study, specimens of resilient liners immersed in water demonstrated significantly (P<.001) lower bond strength values and higher hardness values over time.

Adherence of Candida albicans to denture base acrylics and silicone-based resilient liner materials with different surface finishes

This study evaluated the surface roughness and Candida albicans adherence on denture base acrylic resins and silicone-based resilient liners with different surface finishes. Four commercial denture base acrylic resins (three heat polymerized and one room temperature polymerized) and five silicone-based liner materials (two heat polymerized and three room temperature polymerized) (10 x 10 x 2 mm) were tested in this study. The materials were processed against glass or plaster or finished with a tungsten carbide bur. Surface roughness measurements were made using a profilometer with an optical scanner probe. All specimens were ultrasonically cleaned in water for 15 s, autoclave sterilized, and contaminated with C. albicans solution for adherence assay evaluation. The materials processed against the glass surface showed significantly lower surface roughness values (0.11 +/- 0.1-1.66 +/- 1.1 microm) than those of the materials processed against the dental plaster (2.61 +/- 0.2-6.12 +/- 2.8 microm) or roughening with a bur (1.48 +/- 0.2-7.05 +/- 1.2 microm; p < 0.05, one- or two-way analysis of variance). Also, the materials processed against the glass surface showed lower C. albicans adhesion (mean ranks 120.36) than those of the materials processed against the dental plaster (mean ranks 139.77) or roughening with a bur (mean ranks 143.06), but the differences were not statistically significant (p > 0.05, Kruskal-Wallis and Mann-Whitney). In all types of surface finishes, C. albicans adhesion on denture base acrylics was significantly less (mean ranks 90.18-90.40) than those of silicone liners (mean ranks 119.38-205.18; p < 0.01, Kruskal-Wallis).

The evaluation of microleakage and bond strength of a silicone-based resilient liner following denture base surface pretreatment

The failure of adhesion between a silicone-based resilient liner and a denture base is a significant clinical problem. The purpose of this study was to examine the effects of denture base resin surface pretreatments with different chemical etchants preceding the silicone-based resilient liner application on microleakage and bond strength. The initial effects of chemical etchants on the denture base resin in terms of microstructural changes and flexural strength were also examined. Forty-two polymethyl methacrylate (PMMA) denture base resin (Meliodent) specimens consisting of 2 plates measuring 30 x 30 x 2 mm were prepared and divided into 7 groups (n = 6). Specimen groups were treated by immersion in acetone for 30 (A30) or 45 (A45) seconds, methyl methacrylate monomer for 180 (M180) seconds, and methylene chloride for 5 (MC5), 15 (MC15) or 30 (MC30) seconds. Group C had no surface treatment and served as the control. Subsequently, an adhesive (Mollosil) and a silicone-based resilient denture liner (Mollosil) were applied to the treated surfaces, and all specimens were immersed in the radiotracer solution (thalium-201 chloride) for 24 hours. Tracer activity (x-ray counts), as a parameter of microleakage, was measured using a gamma camera. For bond-strength measurement, 84 rectangular PMMA specimens (10 x 10 x 40 mm) were surface-smoothed for bonding and treated with the different chemical etchants using the same previously described group configurations. The adhesive and the silicone-based denture liner were applied to the treated surfaces. Tensile bond-strength (MPa) was measured in a universal testing machine. Flexural strength measurement was performed with 49 PMMA specimens (65 x 10 x 3.3 mm according to ISO standard 1567) in 7 groups (n = 7), with 1 flat surface of each treated with 1 of the chemical etchants preceding adhesive application. The flexural strength (MPa) was measured using a 3-point bending test in a universal testing machine. The data were analyzed by 1-way analysis of variance and the Tukey HSD test (alpha = .05). Significant differences were found between the groups in terms of microleakage (P < .0001). The lowest microleakage was observed in group M180 (30,000 x-ray counts) and the highest in the control group (44,000 x-ray counts). The mean bond strength to PMMA resin ranged from 1.44 to 2.22 MPa. All treated specimens showed significantly higher bond strength than controls (P < .01). The flexural strength values all significantly differed (P < .05). All experimental specimens that had chemical surface treatments showed lower flexural strength than controls (P < .05). Treating the denture base resin surface with chemical etchants increased the bond strength of silicone-based resilient denture liner to denture base and decreased the microleakage between the 2 materials. Considering the results of both tests together, the use of methyl methacrylate monomer for 180 seconds was found to be the most effective chemical treatment.

Mechanical Properties and Bond Strength of Silicone-based Resilient Denture Liners

To evaluate the ease of manipulation and durability of 11 commercially available silicone-based resilient denture liners, extrusion force, hardness, weight change, and bond strength were determined. Extrusion force from the cartridge of each material ranged from 0.25 to 1.26 MPa at an extrusion rate of 1 cm/min. Durometer hardness, after set materials were stored in distilled water at 37 degrees C for one day, ranged from A5.9 to A47.7, and after four weeks their values increased by 4.0 to 275%. Bond strength ranged from 1.01 to 2.88 MPa after set materials were stored in distilled water at 37 degrees C for one day, but decreased to 0.59 to 1.99 MPa after 10,000 thermal cycles. These results suggested that except for one material, the rest of the evaluated materials exhibited good handling properties--for example, mixing and spreading of material can be done easily. However, some materials exhibited inadequate durability for clinical service, because hardness increased during storage and/or bond strength decreased after thermal cycling.

Effect of denture base surface pretreatment on microleakage of a silicone-based resilient liner

Microleakage between resilient liner and denture base resins is a significant clinical problem, often responsible for debonding of the resilient liner from the denture base resin. This study investigated the effect of 2 surface treatments, airborne-particle abrasion (APA) and wetting with methyl methacrylate monomer (MMA), on microleakage between a silicone-based resilient liner and denture base resin using a gamma camera imaging technique. Thirty-three specimens, each having 2 plates measuring 40 x 40 x 2 mm, were prepared by packing and processing an acrylic denture base resin (QC-20) into square plates following manufacturer's instructions. Specimens were divided into 3 groups (n=11) as APA-, MMA-, and control-treatment groups. For the APA group, the inner surfaces of both plates were airborne-particle abraded with 250-microm Al 2 O 3 particles and, for the MMA group, surfaces were treated with monomer (QC-20). Control specimens were not surface treated. Following application of an adhesive (Ufi Gel P-specific), a silicone lining material (Ufi Gel P) was prepared and applied to the inner surfaces of all 33 specimens. Eleven size-matched polymethyl methacrylate (PMMA) specimen blocks (40 x 40 x 6 mm) were prepared to calculate the level of residual radioactivity for the denture base itself, the entire outer surface count (OSC). All specimens and PMMA blocks were immersed in a radioactive solution (thallium-201 chloride) for 24 hours. Specimen activities (gamma-ray cts/sec, representing thallium-201 concentration) were then measured using a high-resolution gamma camera. The amount of OSC-subtracted total specimen counts was a direct indicator of the quantity of inward diffusing tracer. The subtracted values were analyzed using a 1-way analysis of variance (ANOVA) and Bonferroni multiple comparison tests (alpha=.05). OSC levels averaged 754 +/- 110 gamma-ray cts/sec. OSC-subtracted APA, control, and MMA values were 5,546 +/- 1,534, 3,392 +/- 738, and 1,405 +/- 392 gamma-ray cts/sec, respectively. All 3 groups were significantly different ( P <.05) from each other. Surface wetting with MMA showed the lowest microleakage values among all specimen groups. In terms of microleakage, surface treatment with MMA monomer preceding the adhesive application demonstrated lower values than adhesive application alone. APA pretreatment resulted in 4 times the microleakage found in MMA-treated specimens, and 1.5 times the microleakage of the untreated control. None of the surface pretreatments completely prevented microleakage. Microleakage between the silicone-based resilient liner and denture base resin can be quantitatively determined using the gamma camera imaging technique.

Randomized controlled clinical trial on satisfaction with resilient denture liners among edentulous patients

Purpose The purpose of this study was to measure patients' satisfaction and their preference between mandibular dentures with permanent silicone-based resilient denture liner (SR) and conventional heat-activated acrylic resin (AR), both opposed by acrylic resin-based maxillary complete dentures. Materials and Methods Twenty-eight edentulous patients who had fulfilled selection criteria and provided informed consent were enrolled in this trial. Subjects were allocated randomly to either arm of cross-over groups (AR-SR/SR-AR), stratified by gender, using a random permuted block within the strata method. The AR-SR group received AR denture treatment followed by SR denture treatment. The SR-AR group received treatment in the reverse sequence. The primary outcome was patient satisfaction measured on 100-mm VAS, analyzed by two-way ANOVA and the Bonferroni multiple comparison as a post hoc test. The secondary outcome was patients' preference, evaluated by chi-square goodness-of-fit test. An intention-to-treat analysis was performed. Results Twenty-five subjects were enrolled in the analysis. There were no significant differences between AR and SR dentures 1, 2, and 3 months after the completion of control. Eighteen of 25 patients preferred SR dentures. Conclusion Although there were no significant differences in patient satisfaction ratings between the two types of dentures, a significant majority of patients preferred those with a resilient denture liner.— Reprinted with permission of Quintessence Publishing.