Effect of water temperature on the fit of provisional crown margins during polymerization

Water temperature for fabrication of autopolymerizing polymethyl methacrylate (PMMA) interim fixed restoration affects cytotoxicity and residual methyl methacrylate (MMA)

Background/purpose

Clinically, dentists are suggested to immerse autopolymerizing interim fixed restorations in hot water during fabrication. However, this suggestion, without including the best temperature, mostly comes from clinical experience instead of scientific evidence. This in vitro study evaluated the effect of water temperature on the cytotoxicity of interim partial fixed dental prostheses (FDPs) and examined its correlation with residual MMA.

Materials and methods

Tempron was chosen as the autopolymerizing polymethyl methacrylate material. Tempron was mixed and then soaked in water at different temperatures, except control group (Controlair) was not being soaking in water. The specimens were incubated with conditioned medium. The concentration of residual MMA was determined by liquid chromatography-tandem mass spectrometry (LC-MS-MS). The cell viability of human gingival fibroblasts (HGFs) was evaluated by MTT assay.

Results

The 60 °C and 80 °C groups exhibited significantly higher cell viabilities than those of the other groups (P < 0.05) at 48 and 72 h. The concentration of residual MMA was highly correlated with this outcome: the higher the concentration of residual MMA detected in the eluates, the poorer the cell viability was; the longer the incubation time was, the stronger the correlation was between the concentration of residual MMA and the cell viability.

Conclusion

Autopolymerizing PMMA interim FDPs that are polymerized in water up to at least 60 °C could reduce cell toxicity. Higher water temperature could certainly decrease the amount of residual MMA, which is closely correlated with the outcome of cell viability.

Conditional Mitigation of Dental-Composite Material-Induced Cytotoxicity by Increasing the Cure Time

Light-cured composite resins are widely used in dental restorations to fill cavities and fabricate temporary crowns. After curing, the residual monomer is a known to be cytotoxic, but increasing the curing time should improve biocompatibility. However, a biologically optimized cure time has not been determined through systematic experimentation. The objective of this study was to examine the behavior and function of human gingival fibroblasts cultured with flowable and bulk-fill composites cured for different periods of time, while considering the physical location of the cells with regard to the materials. Biological effects were separately evaluated for cells in direct contact with, and in close proximity to, the two composite materials. Curing time varied from the recommended 20 s to 40, 60, and 80 s. Pre-cured, milled-acrylic resin was used as a control. No cell survived and attached to or around the flowable composite, regardless of curing time. Some cells survived and attached close to (but not on) the bulk-fill composite, with survival increasing with a longer curing time, albeit to <20% of the numbers growing on milled acrylic even after 80 s of curing. A few cells (<5% of milled acrylic) survived and attached around the flowable composite after removal of the surface layer, but attachment was not cure-time dependent. Removing the surface layer increased cell survival and attachment around the bulk-fill composite after a 20-s cure, but survival was reduced after an 80-s cure. Dental-composite materials are lethal to contacting fibroblasts, regardless of curing time. However, longer curing times mitigated material cytotoxicity exclusively for bulk-fill composites when the cells were not in direct contact. Removing the surface layer slightly improved biocompatibility for cells in proximity to the materials, but not in proportion to cure time. In conclusion, mitigating the cytotoxicity of composite materials by increasing cure time is conditional on the physical location of cells, the type of material, and the finish of the surface layer. This study provides valuable information for clinical decision making and novel insights into the polymerization behavior of composite materials.

Cell Type-Specific Effects of Implant Provisional Restoration Materials on the Growth and Function of Human Fibroblasts and Osteoblasts

Implant provisional restorations should ideally be nontoxic to the contacting and adjacent tissues, create anatomical and biophysiological stability, and establish a soft tissue seal through interactions between prosthesis, soft tissue, and alveolar bone. However, there is a lack of robust, systematic, and fundamental data to inform clinical decision making. Here we systematically explored the biocompatibility of fibroblasts and osteoblasts in direct contact with, or close proximity to, provisional restoration materials. Human gingival fibroblasts and osteoblasts were cultured on the "contact" effect and around the "proximity" effect with various provisional materials: bis-acrylic, composite, self-curing acrylic, and milled acrylic, with titanium alloy as a bioinert control. The number of fibroblasts and osteoblasts surviving and attaching to and around the materials varied considerably depending on the material, with milled acrylic the most biocompatible and similar to titanium alloy, followed by self-curing acrylic and little to no attachment on or around bis-acrylic and composite materials. Milled and self-curing acrylics similarly favored subsequent cellular proliferation and physiological functions such as collagen production in fibroblasts and alkaline phosphatase activity in osteoblasts. Neither fibroblasts nor osteoblasts showed a functional phenotype when cultured with bis-acrylic or composite. By calculating a biocompatibility index for each material, we established that fibroblasts were more resistant to the cytotoxicity induced by most materials in direct contact, however, the osteoblasts were more resistant when the materials were in close proximity. In conclusion, there was a wide variation in the cytotoxicity of implant provisional restoration materials ranging from lethal and tolerant to near inert, and this cytotoxicity may be received differently between the different cell types and depending on their physical interrelationships.

N-Acetyl Cysteine-Mediated Improvements in Dental Restorative Material Biocompatibility

The fibroblast-rich gingival tissue is usually in contact with or adjacent to cytotoxic polymer-based dental restoration materials. The objective of this study was to determine whether the antioxidant amino acid, N-acetyl cysteine (NAC), reduces the toxicity of dental restorative materials. Human oral fibroblasts were cultured with bis-acrylic, flowable composite, bulk-fill composite, self-curing acrylic, and titanium alloy test specimens. Cellular behavior and function were analyzed on and around the materials. Impregnation of the bulk-fill composite and self-curing acrylic with NAC reduced their toxicity, improving the attachment, growth, and function of human oral fibroblasts on and around the materials. These mitigating effects were NAC dose dependent. However, NAC impregnation of the bis-acrylic and flowable composite was ineffective, with no cells attaching to nor around the materials. Although supplementing the culture medium with NAC also effectively improved fibroblast behaviors, direct impregnation of materials with NAC was more effective than supplementing the cultures. NAC-mediated improvements in fibroblast behavior were associated with reduced production of reactive oxygen species and oxidized glutathione together with increased glutathione reserves, indicating that NAC effectively directly scavenged ROS from materials and reinforced the cellular antioxidant defense system. These results establish a proof of concept of NAC-mediated improvements in biocompatibility in the selected dental restorative materials.

Novel Tuning of PMMA Orthopedic Bone Cement Using TBB Initiator: Effect of Bone Cement Extracts on Bioactivity of Osteoblasts and Osteoclasts

Bone cement containing benzoyl peroxide (BPO) as a polymerization initiator are commonly used to fix orthopedic metal implants. However, toxic complications caused by bone cement are a clinically significant problem. Poly (methyl methacrylate) tri-n-butylborane (PMMA-TBB), a newly developed material containing TBB as a polymerization initiator, was found to be more biocompatible than conventional PMMA-BPO bone cements due to reduced free radical generation during polymerization. However, free radicals might not be the only determinant of cytotoxicity. Here, we evaluated the response and functional phenotypes of cells exposed to extracts derived from different bone cements. Bone cement extracts were prepared from two commercial PMMA-BPO cements and an experimental PMMA-TBB. Rat bone marrow-derived osteoblasts and osteoclasts were cultured in a medium supplemented with bone cement extracts. More osteoblasts survived and attached to the culture dish with PMMA-TBB extract than in the culture with PMMA-BPO extracts. Osteoblast proliferation and differentiation were higher in the culture with PMMA-TBB extract. The number of TRAP-positive multinucleated cells was significantly lower in the culture with PMMA-TBB extract. There was no difference in osteoclast-related gene expression in response to different bone cement extracts. In conclusion, PMMA-TBB extract was less toxic to osteoblasts than PMMA-BPO extracts. Although extracts from the different cement types did not affect osteoclast function, PMMA-TBB extract seemed to reduce osteoclastogenesis, a possible further advantage of PMMA-TBB cement. These implied that the reduced radical generation during polymerization is not the only determinant for the improved biocompatibility of PMMA-TBB and that the post-polymerization chemical elution may also be important.

In vitro evaluation of the marginal integrity of CAD/CAM interim crowns

STATEMENT OF PROBLEM

The accuracy of interim crowns made with computer-aided design and computer-aided manufacturing (CAD/CAM) systems has not been well investigated.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal integrity of interim crowns made by CAD/CAM compared with that of conventional polymethylmethacrylate (PMMA) crowns.

MATERIAL AND METHODS

A dentoform mandibular left second premolar was prepared for a ceramic crown and scanned for the fabrication of 60 stereolithical resin dies, half of which were scanned to fabricate 15 Telio CAD-CEREC and 15 Paradigm MZ100-E4D-E4D crowns. Fifteen Caulk and 15 Jet interim crowns were made on the remaining resin dies. All crowns were cemented with Tempgrip under a 17.8-N load, thermocycled for 1000 cycles, placed in 0.5% acid fuschin for 24 hours, and embedded in epoxy resin before sectioning from the mid-buccal to mid-lingual surface. The marginal discrepancy was measured using a traveling microscope, and dye penetration was measured as a percentage of the overall length under the crown.

RESULTS

The mean vertical marginal discrepancy of the conventionally made interim crowns was greater than for the CAD/CAM crowns (P=.006), while no difference was found for the horizontal component (P=.276). The mean vertical marginal discrepancy at the facial surface of the Caulk crowns was significantly greater than that of the other 3 types of interim crowns (P<.001). At the facial margin, the mean horizontal component of the Telio crowns was significantly larger than that of the other 3 types, with no difference at the lingual margins (P=.150). The mean percentage dye penetration for the Paradigm MZ100-E4D crowns was significantly greater and for Jet crowns significantly smaller than for the other 3 crowns (P<.001). However, the mean percentage dye penetration was significantly correlated with the vertical and horizontal marginal discrepancies of the Jet interim crowns at the facial surface and with the horizontal marginal discrepancies of the Caulk interim crowns at the lingual surface (P<.01 in each instance).

CONCLUSIONS

A significantly smaller vertical marginal discrepancy was found with the interim crowns fabricated by CAD/CAM as compared with PMMA crowns; however, this difference was not observed for the horizontal component. The percentage dye penetration was correlated with vertical and horizontal discrepancies at the facial surface for the Jet interim crowns and with horizontal discrepancies at the lingual surface for the Caulk interim crowns.

A comparative evaluation of the marginal accuracy of crowns fabricated from four commercially available provisional materials: An in vitro study

Purpose:

The purpose of this in vitro study was to evaluate and compare the primary marginal accuracy of four commercially available provisional materials (Protemp 4, Luxatemp Star, Visalys Temp and DPI tooth moulding powder and liquid) at 2 time intervals (10 and 30 min).

Materials and Methods:

A customized stainless steel master model containing two interchangeable dies was used for fabrication of provisional crowns. Forty crowns (n = 10) were fabricated, and each crown was evaluated under a stereomicroscope. Vertical marginal discrepancies were noted and compared at 10 min since the start of mixing and then at 30 min.

Observations and Results:

Protemp 4 showed the least vertical marginal discrepancy (71.59 μ), followed by Luxatemp Star (91.93 μ) at 10 min. DPI showed a marginal discrepancy of 95.94 μ while Visalys Temp crowns had vertical marginal discrepancy of 106.81 μ. There was a significant difference in the marginal discrepancy values of Protemp 4 and Visalys Temp. At 30 min, there was a significant difference between the marginal discrepancy of Protemp 4 crowns (83.11 μ) and Visalys Temp crowns (128.97 μ) and between Protemp 4 and DPI (118.88 μ). No significant differences were observed between Protemp 4 and Luxatemp Star.

Conclusion:

The vertical marginal discrepancy of temporary crowns fabricated from the four commercially available provisional materials ranged from 71 to 106 μ immediately after fabrication (at 10 min from the start of mix) to 83–128 μ (30 min from the start of mix). The time elapsed after mixing had a significant influence on the marginal accuracy of the crowns.

Effect of Heat Treatment on the Physical Properties of Provisional Crowns during Polymerization: An in Vitro Study

This study concerned the effect of heat treatment during setting on the physical properties of four resin-based provisional restorative materials: Duralay (polymethyl methacrylate), Trim II (polyethyl methacrylate), Luxatemp (bis-acrylic composite), and Protemp 4 (bis-acrylic composite). Specimens were prepared at 23, 37, or 60 °C for evaluation of flexural strength, surface roughness, color change and marginal discrepancy. Flexural strength was determined by a three-point bending test. Surface profile was studied using atomic force microscopy. Color change was evaluated by comparing the color of the materials before and after placement in coffee. A travelling microscope helped prepare standardized crowns for assessment of marginal discrepancy. Flexural strength of all tested materials cured at 23 °C or 37 °C did not significantly change. The surface roughness and marginal discrepancy of the materials increased at 60 °C curing temperature. Marginal discrepancies, color stability, and other physical properties of materials cured at 23 °C or 37 °C did not significantly change. Flexural strength of certain provisional materials cured at 60 °C increased, but there was also an increase in surface roughness and marginal discrepancy.

Estabilidade dimensional de uma resina acrílica para coroas provisórias em função de diferentes técnicas de processamento ao longo do tempo

INTRODUÇÃO: A estabilidade dimensional das resinas acrílicas influencia na adaptação das coroas provisórias e, consequentemente, no resultado do tratamento reabilitador. OBJETIVO: Avaliar a estabilidade dimensional, ao longo do tempo, de uma resina acrílica processada de diferentes maneiras. MATERIAL E MÉTODO: Cinco técnicas de polimerização da resina acrílica foram testadas: I - polimerização térmica utilizando líquido de polimerização rápida em mufla; II - autopolimerização sob pressão; III - autopolimerização utilizando pincel; IV - autopolimerização após mistura (pó + líquido) em pote Dappen e inserção em matriz de aço na fase arenosa; V - autopolimerização após mistura em pote Dappen com inserção na matriz metálica na fase plástica. Foram confeccionados dez corpos de prova para cada tipo de processamento. Avaliou-se a estabilidade dimensional por meio de matriz de aço inox confeccionada segundo a especificação nº19 da ADA. Os corpos de prova foram armazenados em água destilada a 37ºC e examinados nos períodos de 1 hora, 1, 7, 15, 10, 90 e 180 dias após a polimerização, com o auxílio de um microscópio óptico com aumento de 20×. Os resultados foram submetidos à análise de dupla variância (Teste de Tukey para Tempo e Técnica de processamento) em nível de 5% de significância. RESULTADO: Todos os grupos experimentais apresentaram alterações dimensionais entre o sétimo e o 15º dia; após esse período de tempo, houve alterações dimensionais estatisticamente significantes, para as diferentes técnicas estudadas. CONCLUSÃO: A estabilidade dimensional da resina acrílica não sofreu influência das diferentes técnicas de processamento avaliadas; entretanto, foi influenciada pelo tempo de armazenamento.

Effect of water temperature on the fit of provisional crown margins during polymerization: An in vitro study

AIM

To evaluate the effect of water temperature on the marginal fit of bis-acrylic composite provisional crown during resin polymerization.

MATERIALS AND METHODS

Precisely machined 10 brass master dies were designed to simulate molar teeth. Five brass dies were selected and precisely machined to simulate all ceramic crown preparation. An acrylic jaw replica was made in which brass dies were arranged equidistant from each other. A custom-made metallic tray was fabricated on the acrylic jaw replica to make polyvinyl siloxane impression matrix. Bis-acrylic composite resin provisional crowns were made using polyvinyl siloxane impression matrix. Provisional crowns were polymerized at room temperature (Group I direct technique, on dental stone cast; Group I indirect technique crowns) and at different water temperatures (Group II direct technique crowns). The vertical marginal gap between all the provisional crown margins and the finish line of brass dies was measured using a Research Stereomicroscope System.

RESULTS

The results were statistically analyzed using one-way analysis of variance (ANOVA) test and Newman-Keul's test. The results showed that crowns polymerized in 20°C and 30°C water had marginal gap approximately three times smaller than those polymerized in 30°C air, due to the reduced polymerization shrinkage.

CONCLUSION

This study shows that crowns polymerized in 20°C and 30°C water had mean vertical marginal gap approximately three times smaller than those polymerized in 30°C air. It was approximately closer to that of crowns fabricated by indirect technique. Warmer water also supposedly hastens polymerization.

Effect of water temperature and duration of immersion on the marginal accuracy of provisional crowns

BACKGROUND

Fabrication of fixed restorations is time consuming. It is vital that the prepared teeth be protected by means of an interim restoration till the time definitive prostheses can be delivered. Marginal adaptation is one of the most important requirements for an interim restoration.

METHOD

This study was done to investigate the effect of water temperature and duration of immersion on the marginal accuracy of provisional restoration fabricated in autopolymerizing resin. The experimental model simulating a clinical situation was made. The test material was autopolymerizing methyl methacrylate. Specimens were subjected to different water temperatures for 5 and 10 minutes', duration for continuing the polymerization. Marginal accuracy was determined by a travelling microscope under 100 × magnification.

RESULTS

The measurements were tabulated and statistically analyzed using two way ANOVA technique. Results showed significant difference at all water temperatures. Marginal gaps were least when crowns were polymerized at 20°C for 5 minutes.

CONCLUSION

Study concluded that polymerizing the polymethyl methacrylate resin provisional crowns by direct technique in the water maintained at 20-30°C temperature for 10 minutes resulted in better marginal fit and this method can be utilized in clinical conditions for better results.

Marginal accuracy of interim restorations fabricated from four interim autopolymerizing resins

STATEMENT OF PROBLEM

One of the most important requirements for interim restorations is good marginal adaptation. Polymerization shrinkage of interim restorative materials can jeopardize the marginal integrity of interim restorations.

PURPOSE

The purpose of this study was to compare the marginal accuracy of interim restorations made with 4 interim materials.

MATERIAL AND METHODS

A direct technique was used to fabricate 44 interim restorations with 4 materials: Protemp 3 Garant, Trim II, Tempron, and Acropars (n=11). The interim restorations were made on a prepared molar-shaped metal die with a vinyl polysiloxane impression as a matrix. Marginal discrepancy of interim restorations was measured at the midpoint of buccal, palatal, mesial, and distal surfaces of metal die finish line with a microscope at x100 magnification. Comparisons were made with 1-way analysis of variance and the Duncan multiple range test (alpha=.05).

RESULTS

The mean marginal discrepancies of Protemp 3 Garant, Trim II, Tempron, and Acropars were 0.059, 0.063, 0.068, and 0.102 mm, respectively. Acropars exhibited the most marginal discrepancies and was significantly different from the other materials tested (P<.001). However, there were no statistical differences between the other 3 materials tested.

CONCLUSIONS

Interim restorations made from the Bis-GMA and conventional acrylic resins tested produced comparable marginal fit. Acropars demonstrated significant increases in marginal gap size.

Effect of curing environment on mechanical properties and polymerizing behaviour of methyl-methacrylate autopolymerizing resin

Methyl-methacrylate autopolymerizing resin is used for multiple applications. Therefore, the mechanical properties of autopolymerizing resin should be assessed comprehensively including strength, stiffness and hardness. Any methods that effectively improve these mechanical properties are desirable. The objective of this study is to examine the effects of the curing environment: air or water with/without pressure, and air or water temperature during polymerization, on the strength, stiffness and hardness of autopolymerizing resin. In addition, we examined the polymerizing behaviour associated with the mechanical properties. Autopolymerizing methyl-methacrylate resin (Unifast II) was polymerized under the following conditions: in air and water with/without pressure at 10, 23, 30, 40, 60 and 80 degrees C. The resin specimens were subjected to a transverse test (three-point flexural test) and micro-Brinell surface hardness test. Fractured surfaces of the specimens after the transverse test were examined using a scanning electron microscope (SEM). The transverse strength and transverse modulus increased with increasing curing temperature in both wet and dry conditions. Pressured wet conditions increased transverse strength and transverse modulus over non-pressured wet and dry conditions. The resin polymerized in dry conditions showed higher surface hardness than the one polymerized in wet conditions at matching temperature. The SEM images of fractured surfaces cured at lower temperature exhibited porosity within the polymer base and cracks between the base and poly-methyl-methacrylate (PMMA) particulates. Surfaces of the resin polymerized in wet conditions were characterized with PMMA particulates having rougher surfaces suggestive of water incorporation. Raising temperature and pressuring during polymerization increase strength and stiffness of autopolymerizing resin. However, wet condition reduces surface hardness of resin compared with dry condition. These altered mechanical properties are associated with polymerization behaviour of the resin.

The effect of two polishing pastes on the surface roughness of bis-acryl composite and methacrylate-based resins

STATEMENT OF PROBLEM

A highly polished restoration surface is necessary to promote a plaque-free environment.

PURPOSE

The purpose of this study was to compare the surface roughness of 3 different bis-acryl composite-based and 3 different methyl methacrylate-based provisional crown and fixed partial denture resins after being polished with aluminum oxide and diamond paste.

MATERIAL AND METHODS

Six different materials were used (Iso-Temp, Protemp II, Structer 2, Dentalon Plus, Tab 2000 Kerr, Temdent). A total of 180 specimens were fabricated: 30 specimens of each material using circular stainless steel molds 10 mm in diameter and 2 mm high. Each material was mixed and polymerized according to manufacturer's instructions. The bis-acryl composite specimens were polymerized with a laboratory light-initiating unit for 30 seconds on each side (400 to 525 nm, 75 W quartz-halogen light source). All specimens were kept in a water bath at 37 degrees C for 45 minutes. Ten specimens of each group were left as untreated controls, 10 specimens of each group were polished with the aluminum oxide paste (Composite Polish), and 10 specimens of each group were polished with the diamond paste (Insta glaze). Surface roughness was determined with a profilometer. The data were analyzed with one-way analysis of variance (Post Hoc Scheffe's S test) (P<.001). In addition, the profilometric evaluations photographic images were recorded with a scanning electron microscope to examine the surface roughness after polishing.

RESULTS

The mean of the surface characteristics of the bis-acryl composites were 1.33 microm for aluminum oxide and 0.90 microm for diamond polishing paste; the mean of the results of the methyl methacrylate resins were 1 microm for aluminum oxide and 0.50 microm for diamond polishing paste. The difference between the mean values of bis-acryl resins groups and methacrylate-based resin groups were significant (P<.001). The difference between the subgroups of bis-acryl resins group (Iso-Temp, Protemp II, Structer 2) were not significant (P>.05). The difference between the subgroups of methacrylate-based resin group (Dentalon, Tab 2000, Temdent) were not significant (P>.05).

CONCLUSION

Within the limitations of this study, single-phase polishing of the bis-acryl composites tested and the methacrylate resins tested with diamond-based paste produced a smoother surface than when polished with aluminum oxide paste.

Effect of water temperature during polymerization on strength of autopolymerizing resin

STATEMENT OF PROBLEM

Breakage is a potential problem of provisional resin restorations. A method that effectively increases the strength of the resin is desirable.

PURPOSE

This study examined the effects of the curing environment, air or water, and water temperature during polymerization on the mechanical properties of autopolymerizing resin.

MATERIAL AND METHODS

After mixing the autopolymerizing methyl methacrylate resin for 10 seconds, it was placed in a stainless steel mold (2 x 2 x 25 mm). One minute and 50 seconds after the start of mixing, the mold containing the resin was placed under the following conditions: in air at 23 degrees C; or in water at 10 degrees C, 23 degrees C, 30 degrees C, 40 degrees C, 60 degrees C, and 80 degrees C. Six minutes after mixing began, the resin specimen was removed from the mold and the transverse test (3-point flexural test) was performed.

RESULTS

Alteration of conditions during polymerization revealed a significant effect on both the transverse strength and modulus of the resin (P <.0001). Both increased with an increase in water temperature. Water conditions of 60 degrees C to 80 degrees C produced more than 2 times greater transverse strength and modulus of the resin compared with polymerization in 23 degrees C air (P <.0001).

CONCLUSION

Polymerization of the resin in hot water greatly increased its mechanical properties. The method of placing resin restorations in hot water during polymerization may be useful for improving mechanical requirements and obtaining long-lasting performance.