Cumulative effect of disinfection procedures on microhardness and tridimensional stability of a poly(methyl methacrylate) denture base resin

Effects of disinfectants on physical properties of denture base resins: A systematic review and meta-analysis

STATEMENT OF PROBLEM

The disinfection of removable dental prostheses and orthodontic appliances is essential to preventing transmission of pathogens. However, whether different disinfection solutions and durations affect the physical properties of denture base resins is unclear.

PURPOSE

The purpose of this systematic review and meta-analysis was to statistically analyze the influence of disinfectants on the physical properties of denture base resins.

MATERIAL AND METHODS

A systematic search in Medline, Embase, PubMed, and Cochrane Library databases was conducted to evaluate the effects of chemical disinfection on the physical properties of denture base resins such as surface morphology, roughness, hardness, and flexural strength. Of 1909 studies, 44 studies were included in the systematic review and 41 in the meta-analysis. Heterogeneity was analyzed by using I2 statistics. The influence of different disinfection solutions and durations on the physical properties was further analyzed, and the risk of bias evaluated. Statistical analyses were performed by using the RevMan 5.4 software program with the standardized mean differences (SMDs) and 95% confidence intervals (CIs).

RESULTS

Of the 44 included studies, 40 studies were assessed as having a low risk of bias, and 4 had an unclear risk of bias. Meta-analysis results showed that compared with the control, disinfection could not significantly affect surface roughness and hardness within 60 minutes of immersion in disinfectant solutions or flexural strength within 30 minutes (roughness: P=.79, I2=0%; flexural strength: P=.08, I2=0%; hardness: P=.05, I2=19%). In addition, the physical properties were not significantly affected when glutaraldehyde, chlorhexidine, and peracetic acid were repeatedly used for more than 30 minutes.

CONCLUSIONS

Most of the disinfectants did not reduce the physical properties of denture base resin within 30 minutes of immersion. Glutaraldehyde, chlorhexidine, and peracetic acid are recommended if longer immersion or repeated disinfection is required.

Does microwave disinfection affect the dimensional stability of denture base acrylic resins? A systematic review

OBJECTIVE

To systematically evaluate the effect of microwave disinfection on the dimensional stability of denture base acrylic resins.

BACKGROUND

Microwave disinfection has been considered as an alternative method for disinfecting complete dentures to help prevent and treat denture stomatitis. However, data on the impact of microwave disinfection on the dimensional stability of acrylic resins are still scarce.

METHODS

The PubMed/Medline, SCOPUS and EMBASE databases were searched in order to assess articles published in English up to January 2021 (CRD42021212267). We included studies that have assessed the effect of microwave disinfection, on the dimensional stability of acrylic resins, comparing them with negative or positive controls.

RESULTS

A total of seven in vitro studies were included. The qualitative synthesis demonstrated that, in general, microwave disinfection produced more distortion on the materials than do immersion in sodium hypochlorite, chloride solution, chlorhexidine, and water immersion. However, considering the dimensional stability of the specimens, microwave disinfection at 500 W for 3 minutes, and at 450 W for 5 minutes, produced similar or better outcomes than did control groups.

CONCLUSION

In general, microwave disinfection promotes changes in the dimensional stability of denture base acrylic resins, and should thus be used with caution. However, microwave disinfection protocols at lower power settings (500 and 450 W) and exposure times (3 and 5 minutes) produces similar or less distortion than chemical disinfection. More studies are still required in order to evaluate the clinical and long-term implications of microwave disinfection.

Superficial and Inner Examination of a Microwave-Irradiated Dental Acrylic Resin and Its Metal-Polymer Interface

The aim of this study is to conduct an extended surface and cross-section characterization of a denture base acrylic resin subjected to 500, 650, and 750 W microwave irradiation for 2, 3, and 5 min to assess its morphological modifications. A commercial heat-cured powder was polymerized according to the manufacturer's specifications and distributed into 20 circular samples. A stainless-steel wire was partially embedded in half of the discs, in order to investigate the metal-polymer interface. High-resolution scanning electron microscopy (SEM) imaging, white light interferometry, roughness measurements and Fourier transform infrared spectrometry were employed for morphological and structural evaluation of the irradiated polymer. Superficial adaptation was discovered after 5 min exposure at 500 W, 650 W, and 750 W, revealing significant roughness correction for 750 W. SEM characterization revealed the inner alteration of the resin for the 750 W protocol and a metal-polymer gap developed regardless of the irradiation conditions. The considerable temperature fluctuations that the samples were subject to during the experiments did not essentially change the poly(methyl-methacrylate) bond structure.

Cumulative effect of microwave sterilization on the physical properties of microwave polymerized and conventional heat-polymerized acrylic resin

Aims:

To evaluate and compare the flexural strength and impact strength of conventional and microwave cured denture base resins before and after repeated sterilization using microwave energy to consider microwave curing as an alternative to the conventional method of sterilization.

Materials and Methods:

The conventional heat cure acrylic resin (DPI heat cure material) Group A and microwave-polymerized acrylic resin (Vipi Wave Acrylic resin) Group B were used to fabricate 100 acrylic resins samples using a standard metal die of (86 mm × 11 mm × 3 mm) dimensions. The criterion was flexural strength and impact strength testing which had Group A and Group B samples; 50 samples for flexural strength and 50 samples for impact strength measurement. For each criterion, five control samples were taken for Group A and Group B. The samples were stored in water before experimenting. The test samples were subject to four cycles of microwave sterilization; followed by flexural strength testing with a 3-point flexural test in universal testing machine (UNITEK 94100) and impact strength testing with impact testing machine (ENKAY Pr09/E1/16).

Results:

The physical properties had significant changes for conventionally cured denture base resins, whereas no changes found for microwave-cured resins after repeated sterilization cycles.

The Effect of Repeated Microwaving Disinfection on the Dimensional Stability of Acrylic Dentures

OBJECTIVE

The aim of this study was to evaluate the effect of repeated microwave disinfections on the dimensional stability of acrylic dentures.

MATERIALS AND METHODS

Three groups of dentures made of a heat polymerized acrylic resin were tested. I: dentures kept in water (control group). II: dentures microwaved daily while being immersed into water (wet disinfection). III: dentures microwaved daily without being immersed into water (dry disinfection).
Measurements were taken across three reference points, on two occasions: after curing and immersion in water for 24 hours, and one week later.
Data obtained were analyzed using one-way analysis of variance (ANOVA) and Scheffe's multiple range test.

RESULTS

The results showed that the microwave disinfection provokes dimensional changes of the same pattern (shrinkage). The dentures which underwent wet disinfection exhibited the greatest shrinkage (p<0.05).

CONCLUSIONS

Disinfection using microwave energy may cause dimensional changes (shrinkage) of complete dentures.
The microwave "dry disinfection" method can be safely applied in everyday practice since the dimensional changes which occurred seem to be of no clinical significance.

Effect of Disinfection on the Bond Strength between Denture Teeth and Microwave-Cured Acrylic Resin Denture Base

PURPOSE

Denture tooth debonding is a common complication for denture wearers; however, the effect of complete denture disinfection on bonding between denture teeth and acrylic resin remains unclear. The aim of this study was to evaluate the effect of disinfection methods on the bond strength between denture teeth and microwave-cured acrylic resin denture base.

MATERIALS AND METHODS

Three commercial brands of denture teeth (Trilux, Biolux, Vipi Dent Plus) and one microwave-cured acrylic resin denture base were tested. Each brand of denture teeth was divided into seven groups (n = 6; estimated by partial Eta squared). The specimenss of groups H and Cl were immersed in 1% sodium hypochlorite and 4% chlorhexidine digluconate for 7 days, respectively. In group Br, the specimens were subjected to toothbrush simulation under 200 g of force for 20,000 cycles. In groups Br-H and Br-Cl, the specimens were brushed and further disinfected with 1% sodium hypochlorite and 4% chlorhexidine digluconate, respectively. In control groups 1 (Co1) and 2 (Co2), the specimens were stored in distilled water for 50 ± 2 hours and 7 days, respectively. Shear bond strength testing was performed at the resin/tooth interface in a universal testing machine at a 1 mm/min crosshead speed. The failure pattern was quantified and classified into adhesive, cohesive, or mixed. Data were analyzed using two-way ANOVA and Tukey HSD test (α = 0.05).

RESULTS

Disinfection with 1% sodium hypochlorite (p = 0.031), brushing (p < 0.0001), and association of brushing with either 1% sodium hypochlorite (p < 0.0001) or 4% chlorhexidine digluconate (p = 0.01) reduced the bond strength between denture teeth and microwave-cured acrylic resin denture base. All commercial brands of denture teeth presented a similar bond strength (p > 0.05). The failure pattern was predominantly adhesive independent of the disinfection method and denture tooth brand.

CONCLUSIONS

Disinfection with sodium hypochlorite, brushing, and the association of mechanical and chemical methods reduced the bond strength between denture tooth and microwave-cured acrylic resin denture base.

The Effect of Microwave Disinfection on Denture Base Polymers, Liners and Teeth: A Basic Overview

The aim of this paper was to overview the current scientific knowledge concerning the effect of microwave disinfection on denture related material properties. Cross-infection control in dentistry is a significant issue in everyday clinical practice due to the recent increase in some infectious diseases such as hepatitis B, C and AIDS and therefore numerous methods of disinfection have been used. The most widespread method of disinfection used in everyday practice is chemical, however, studies have suggested that chemical disinfectants alter the physical and mechanical properties of the acrylic resins and enable the growth and proliferation of certain bacteria. Therefore, microwaves were introduced as an easy to use-and-access, low cost, chemical free alternative. The question that arose was if and in what way the microwave irradiation affected the denture related material properties. Microwaving affects the denture resin bases, liners and teeth in different ways. The results showed that microwave disinfection could be a safe alternative for the disinfection of denture bases and liners compared to the chemical one, when the procedure is carried out in dry conditions, but could possibly cause dimensional changes of clinical significance on them when the irradiation takes place in wet environment. It also seems to have no detrimental effects of clinical importance on the flexural properties, impact strength and hardness of denture resins and the bond, flexural strength, porosity and hardness of denture liners. The effects of microwave disinfection on the hardness of denture teeth and teeth/denture bond strength are still controversial and no safe conclusions can be drawn.

Comparative evaluation of color change between two types of acrylic resin and flexible resin after thermo cycling. An in vitro study

Evaluation of the effect of different beverages (tea with sugar, coffee with sugar, and Pepsi), and immersion time cycles (2, 4, and 12 weeks) on color change property, and dimensional change of Vertex Dental BV, Netherlands heat cured acrylic resin, recently modified Vertex Dental BV, Netherlands heat cured acrylic resin with additive (20 % banana oil), and Valplast(®) flexible resin (FR) denture base materials by using artificial saliva cycle. The total samples of this study for color, and dimensional changes were 360 samples, divided into three groups according to the type of the material, Vertex Dental BV, Netherlands heat cured acrylic resin, modified heat cured acrylic resin (Vertex with additive 20 % banana oil), and Valplast(®) FR groups, each group contains 120 samples. The thermal cycling used in this study was as follows: The samples were incubated in distilled water at 37 ± 1 °C for 2 days for conditioning. Then, the samples were immersed in beverage solutions for 10 min daily at 50 ± 1 °C temperature for tea, and coffee with sugar, while for Pepsi at 20 ± 1 °C. Then, the samples were immersed in artificial saliva at 37 ± 1 °C for 5 h, and 10 min. This cycle was repeated three times daily, and then the samples were immersed in distilled water at 22 ± 2 °C room temperature for 8 h at night. This cycle was repeated for 2, 4, and 12 weeks. At the end of each time period, the immersed samples were tested to evaluate the color change property. Descriptive statistics, ANOVA, and Duncan's multiple range tests were used to analyze the collected data. The results of this study showed that, in comparison between the materials at different times for colors L*a*b* properties, there were significant differences at P ≤ 0.05 except in color b* at 12 weeks, which showed no significant difference at P > 0.05 between materials. And there was a significant difference in dimensional change at P > 0.05 for different beverages, and times of immersion. The largest color, and dimensional changes were observed in the Valplast(®) FR, whereas tea was found to be the most chromatic agent, and showed unaccepted color change (ΔE ≤ 3.7) in vitro study as compared with coffee, Pepsi, and artificial saliva solutions.

Effectiveness of denture cleanser associated with microwave disinfection and brushing of complete dentures: in vivo study

Complete dentures acts as a reservoir for microbial colonization, which may lead to systemic infections. Microwave irradiation has been used as an efficient method of denture disinfection. Even though current methods eliminate denture-base microorganisms, a recurrence rate of denture stomatitis (DS) is still observed among denture-wearing patients. It was hypothesized that microwave disinfection kills microorganisms but do not remove dead bacteria from the denture surface. To test this hypothesis, the biofilm found in the dentures of 10 patients with DS was evaluated. In addition, the effects of microwave irradiation plus brushing (MW+B) on the denture biofilm and the combination of denture cleanser with microwave irradiation and brushing (MW+DC+B) for the removal of denture-accumulating microorganisms were investigated. Microbiological data were analyzed statistically by nonparametric analysis (Friedman/Wilcoxon, α=0.05). MW+B and MW+DC+B were effective in reducing the rate of microorganisms (99.2% and 99.5% respectively), but without significant difference between them (p=0.553). However, it was observed that the complete removal of microorganisms from denture surface was only possible when all regimens were combined (MW+DC+B). Microwave irradiation in combination with soaking in denture cleanser and brushing effectively disinfected the dentures and removed denture biofilm.

Effect of autoclave postpolymerization treatments on the fracture toughness of autopolymerizing dental acrylic resins

INTRODUCTION

Microwave and water bath postpolymerization have been suggested as methods to improve the mechanical properties of heat and autopolymerizing acrylic resins. However, the effects of autoclave heating on the fracture properties of autopolymerizing acrylic resins have not been investigated.

PURPOSE

The aim of this study was to assess the effectiveness of various autoclave postpolymerization methods on the fracture properties of 3 different autopolymerizing acrylic resins.

METHODS

Forty-two specimens of 3 different autopolymerizing acrylic resins (Orthocryl, Paladent RR and Futurajet) were fabricated (40x8x4mm), and each group was further divided into 6 subgroups (n=7). Control group specimens remained as processed (Group 1). The first test group was postpolymerized in a cassette autoclave at 135°C for 6 minutes and the other groups were postpolymerized in a conventional autoclave at 130°C using different time settings (5, 10, 20 or 30 minutes). Fracture toughness was then measured with a three-point bending test. Data were analyzed by ANOVA followed by the Duncan test (α=0.05).

RESULTS

The fracture toughness of Orthocryl and Paladent-RR acrylic resins significantly increased following conventional autoclave postpolymerization at 130°C for 10 minutes (P<.05). However, the fracture toughness of autoclave postpolymerized Futurajet was not significantly different than its control specimens (P<.05). The fracture toughness of Futurajet was significantly less than Paladent RR and Orthocryl specimens when autoclaved at 130°C for 10 minutes.

CONCLUSIONS

Within the limitations of this study, it can be suggested that autoclave postpolymerization is an effective method for increasing the fracture toughness of tested autoploymerized acrylic resins.

Temperature of denture base resin under different protocols of microwave irradiation

This in vitro study evaluated the temperature of dentures after different microwave irradiation protocols. Two complete dentures (one maxillary and one mandibular denture) were irradiated separately 4 times for each of the following 5 protocols: dentures immersed in water (G1- 6 min, G2- 3 min); dentures kept dry (G3- 6 min); dentures placed in the steam sterilizer (G4- 6 min, G5- 3 min). The final temperature of the dentures was gauged in a thin and in a thick area of each denture with an infrared thermometer. All groups presented an increase in the resin base temperature. The thin areas of the dentures underwent greater heating than the thick areas. There was no significant difference (p>0.05) between the final mean temperatures of dentures immersed in water for 6 (G1) and 3 min (G2). However, the final mean temperatures recorded in G1 and G2 exceeded 71°C and were significantly higher (<0.001) than the final mean temperatures recorded in the other groups. It may be concluded that denture base resins subjected to microwave irradiation immersed in water may be exposed to deleterious temperatures.

Microwave disinfection: cumulative effect of different power levels on physical properties of denture base resins

PURPOSE

This study evaluated the cumulative effects of different microwave power levels on the physical properties of two poly(methylmethacrylate) (PMMA) denture base resins.

MATERIALS AND METHODS

Eight sets of four PMMA specimens each (two polymerized in a water bath and two using microwave energy) were immersed in beakers containing 200 ml of distilled water. Each beaker was subjected to microwave irradiation for 3 minutes at a power level of 450,630, or 900 W. The surface roughness, surface hardness, linear stability, flexural strength, elastic modulus, impact strength, and fractographic properties were evaluated after either 6 or 36 simulated disinfection cycles. The data were statistically analyzed using ANOVA and the Tukey post hoc test (α= 0.05).

RESULTS

The polymerization method did not influence any property (p > 0.05) except linear stability. The surface roughness (p < 0.001) and hardness (p= 0.011) increased after 36 irradiation cycles at 630 or 900 W. The resin polymerized using microwave energy exhibited greater linear distortion (p= 0.012), and there was a cumulative effect on linear stability for both resins (p < 0.001). No significant change (p > 0.05) was observed in flexural strength; however, the elastic modulus decreased (p= 0.008) after 36 disinfection cycles. The impact strength and crack propagation angles displayed no significant differences (p > 0.05).

CONCLUSION

Within the limitations of this study, it can be concluded that microwave disinfection at 450 W to 630 W for 3 minutes is safe for PMMA.

A conventional microwave oven for denture cleaning: a critical review

INTRODUCTION

Denture cleaning should be quick and easy to perform, especially in long-term care facilities. The lack of proper oral hygiene can put older adults at higher risk from opportunistic oral infections, particularly fungal. As an alternative to regular brushing, the use of a microwave oven has been suggested for cleaning and disinfecting dentures.

OBJECTIVES

To synthesise and discuss the advantages and disadvantages of the use of a conventional microwave oven for cleaning and disinfecting complete dentures.

METHODS

A brief literature search focused on papers dealing with microwave therapy for denture cleaning through PubMed Central, Cochrane Database of Systematic Reviews, Google Scholar, Ovid MEDLINE(R) In-Process, and Scifinder Scholar.

RESULTS

One hundred and sixty-seven manuscripts published in English with full text were found, and 28 were accepted and discussed in the light of the advantages and disadvantages of the use of conventional microwave oven for cleaning and disinfecting complete dentures.

CONCLUSIONS

There was no standardisation for microwave use for denture cleaning. Manual cleaning still seemed to be the optimal method for controlling fungal infection and denture stomatitis. However, such a daily routine appeared to be underused, particularly in long-term care facilities.

Comparative adaptation accuracy of acrylic denture bases evaluated by two different methods

This study examined the adaptation accuracy of acrylic denture base processed using fluid-resin (PERform), injection-moldings (SR-Ivocap, Success, Mak Press), and two compression-molding techniques. The adaptation accuracy was measured primarily by the posterior border gaps at the mid-palatal area using a microscope and subsequently by weighing of the weight of the impression material between the denture base and master cast using hand-mixed and automixed silicone. The correlation between the data measured using these two test methods was examined. The PERform and Mak Press produced significantly smaller maximum palatal gap dimensions than the other groups (p<0.05). Mak Press also showed a significantly smaller weight of automixed silicone material than the other groups (p<0.05), while SR-Ivocap and Success showed similar adaptation accuracy to the compression-molding denture. The correlationship between the magnitude of the posterior border gap and the weight of the silicone impression materials was affected by either the material or mixing variables.