Surface roughness of acrylic resins used for denture base after chemical disinfection: A systematic review and meta-analysis

Investigation of the Surface Roughness and Hardness of Different Denture Teeth Materials: An In vitro Study

Background

Surface roughness and hardness are key factors that influence the clinical performance and durability of denture teeth. Understanding variations in these properties among different denture teeth materials can assist in selecting the most suitable materials for optimal patient outcomes. This study aimed to investigate the surface roughness and hardness of four commonly used denture teeth materials: acrylic resin, composite resin, porcelain, and nanohybrid composite.

Materials and Methods

Ten specimens were prepared for each denture teeth material, resulting in a total of 40 specimens. Surface roughness was assessed using a profilometer, and measurements were recorded in micrometers (μm). Hardness was determined using a Vickers hardness tester, and results were expressed as Vickers hardness numbers (VHN). The surface roughness and hardness data were analyzed using appropriate statistical tests (e.g., analysis of variance), with significance set at P < 0.05.

Results

The results revealed significant differences in both surface roughness and hardness among the different denture teeth materials (P < 0.05). Acrylic resin exhibited the highest surface roughness (mean ± standard deviation: 3.45 ± 0.78 μm) and the lowest hardness (mean ± standard deviation: 45.6 ± 2.3 VHN). Composite resin demonstrated intermediate values of surface roughness (mean ± standard deviation: 1.87 ± 0.54 μm) and hardness (mean ± standard deviation: 65.2 ± 3.9 VHN). Porcelain demonstrated the smoothest surface (mean ± standard deviation: 0.94 ± 0.28 μm) and the highest hardness (mean ± standard deviation: 78.5 ± 4.1 VHN). Nanohybrid composite displayed surface roughness and hardness values similar to composite resin.

Conclusion

This study demonstrated significant variations in surface roughness and hardness among the different denture teeth materials evaluated. Acrylic resin exhibited the roughest surface and lowest hardness, while porcelain demonstrated the smoothest surface and highest hardness. Composite resin and nanohybrid composite exhibited intermediate values. These findings provide valuable insights for prosthodontic practitioners in selecting denture teeth materials based on specific clinical requirements, aiming to achieve optimal aesthetics, reduced plaque accumulation, and improved wear resistance.

Efficacy of an impression disinfectant solution after repeated use: An in vitro study

Statement of problem

There are very few studies using Benzalkonium Chloride (BAC) as an active disinfection agent for immersion techniques and there are no studies investigating the efficacy of repeated use of a disinfectant solution.

Purpose

This study evaluated an impression disinfectant by testing bacterial contamination of disinfectant batches used in a clinical setting after repeated use.

Materials and methods

Liquid samples were collected from impression disinfectant solutions used to disinfect dental impressions taken at a university dental clinic. The experimental samples (500 ml from 1 L of solution) were collected from teaching and professional clinics and the in-house commercial processing laboratory and stored at room temperature each day of clinic operation over five weeks. To determine to what extent the disinfectant efficacy of the active product decreased over time, the following tests were carried out: a. Inoculation b. Gram staining technique c. Matrix Assisted Laser Desorption/Ionization Mass spectrometry (MALDI- MS). Microbial growth was monitored and photographed. A culture revival was made from colonies grown on sheep blood agar, to isolate pure colonies incubated for 24 h at 37 °C. Each morphologically distinct type of colony was gram stained and MALDI spectrometry analysis was performed using the VITEK MS (BioMerieux Inc.).

Results

Evidence of growth of bacteria was detected in teaching clinics' samples, and no growth from the professional clinic or the commercial laboratory.

Conclusions

The study demonstrated that impression disinfectanat solution tested is effective against common oral bacteria, despite some rare species such as Bacillus circulans, Bacillus horneckiae, Bacillus altitudinis/pumilus and Bacillus cereus showing evidence of survival in solutions used for disinfection of impressions. However, in a high use teaching clinic environment its efficacy deteriorated. Though a second level disinfection protocol in the commercial laboratory-maintained impression disinfection.

Evaluating the Translucency, Surface Roughness, and Cytotoxicity of a PMMA Acrylic Denture Base Reinforced with Bioactive Glasses

The colonisation of the surface of removable acrylic dentures by various types of microorganisms can lead to the development of various diseases. Therefore, the creation of a bioactive material is highly desirable. This study aimed to develop a denture base material designed to release bioactive ions into the oral environment during use. Four types of bioactive glasses (BAG)-S53P4, Biomin F, 45S5, and Biomin C-were incorporated into the PMMA acrylic resin, with each type constituting 20 wt.% (10 wt.% non-silanised and 10% silanised) of the mixture, while PMMA acrylic resin served as the control group. The specimens were subsequently immersed in distilled water, and pH measurements of the aqueous solutions were taken every seven days for a total of 38 days. Additionally, surface roughness and translucency measurements were recorded both after preparation and following seven days of immersion in distilled water. The cytotoxicity of these materials on human fibroblast cells was evaluated after 24 and 48 h using Direct Contact and MTT assays. Ultimately, the elemental composition of the specimens was determined through energy-dispersive X-ray (EDX) spectroscopy. In general, the pH levels of water solutions containing BAG-containing acrylics gradually increased over the storage period, reaching peak values after 10 days. Notably, S53P4 glass exhibited the most significant increase, with pH levels rising from 5.5 to 7.54. Surface roughness exhibited minimal changes upon immersion in distilled water, while a slight decrease in material translucency was observed, except for Biomin C. However, significant differences in surface roughness and translucency were observed among some of the BAG-embedded specimens under both dry and wet conditions. The composition of elements declared by the glass manufacturer was confirmed by EDX analysis. Importantly, cytotoxicity analysis revealed that specimens containing BAGs, when released into the environment, did not adversely affect the growth of human gingival fibroblast cells after 48 h of exposure. This suggests that PMMA acrylics fabricated with BAGs have the potential to release ions into the environment and can be considered biocompatible materials. Further clinical trials are warranted to explore the practical applications of these materials as denture base materials.

Different Polymers for the Base of Removable Dentures? Part II: A Narrative Review of the Dynamics of Microbial Plaque Formation on Dentures

This review focuses on the current disparities and gaps in research on the characteristics of the oral ecosystem of denture wearers, making a unique contribution to the literature on this topic. We aimed to synthesize the literature on the state of current knowledge concerning the biological behavior of the different polymers used in prosthetics. Whichever polymer is used in the composition of the prosthetic base (poly methyl methacrylate acrylic (PMMA), polyamide (PA), or polyether ether ketone (PEEK)), the simple presence of a removable prosthesis in the oral cavity can disturb the balance of the oral microbiota. This phenomenon is aggravated by poor oral hygiene, resulting in an increased microbial load coupled with the reduced salivation that is associated with older patients. In 15-70% of patients, this imbalance leads to the appearance of inflammation under the prosthesis (denture stomatitis, DS). DS is dependent on the equilibrium-as well as on the reciprocal, fragile, and constantly dynamic conditions-between the host and the microbiome in the oral cavity. Several local and general parameters contribute to this balance. Locally, the formation of microbial plaque on dentures (DMP) depends on the phenomena of adhesion, aggregation, and accumulation of microorganisms. To limit DMP, apart from oral and lifestyle hygiene, the prosthesis must be polished and regularly immersed in a disinfectant bath. It can also be covered with an insulating coating. In the long term, relining and maintenance of the prosthesis must also be established to control microbial proliferation. On the other hand, several general conditions specific to the host (aging; heredity; allergies; diseases such as diabetes mellitus or cardiovascular, respiratory, or digestive diseases; and immunodeficiencies) can make the management of DS difficult. Thus, the second part of this review addresses the complexity of the management of DMP depending on the polymer used. The methodology followed in this review comprised the formulation of a search strategy, definition of the inclusion and exclusion criteria, and selection of studies for analysis. The PubMed database was searched independently for pertinent studies. A total of 213 titles were retrieved from the electronic databases, and after applying the exclusion criteria, we selected 84 articles on the possible microbial interactions between the prosthesis and the oral environment, with a particular emphasis on Candida albicans.

Influence of abrasive dentifrices on polymeric reconstructive material properties after simulated toothbrushing

To assess the influence of dentifrices with different abrasiveness levels on the properties of dental reconstructive materials. Forty-eight cylinders were obtained from four polymeric materials, being two CAD/CAM acrylic resins (Ivotion-Dent and Ivotion-Base), one injected acrylic resin (IvoBase-Hydrid) and one light-cured resin composite (Empress Direct). Specimens were allocated to four subgroups for toothbrushing simulation according to the dentifrice relative dentin abrasivity (RDA) and silica content: (i) RDA 0 = 0%; (ii) RDA 50 = 3%; (iii) RDA 100 = 10%; and (iv) RDA 120 = 25%. Specimens were then subjected to toothbrushing. Surface analyses [surface roughness Ra (SR) and scanning electron microscopy (SEM)] along with hardness and optical properties [translucency parameter (TP) and contrast ratio (CR)] were evaluated before and after toothbrushing. Statistical analyses were performed using ANOVA and Tukey test. A significant increase in SR was observed after toothbrushing with higher RDA toothpastes for Ivotion-Dent (100 and 120) and IvoBase-Hybrid (120). Ivotion-Base and Empress Direct presented no significant differences in SR when analyzed as a function of timepoint and RDA levels. Hardness was not influenced by toothbrushing with different RDA dentifrices, except for Empress Direct with RDA 0 toothpaste, where a decrease in the hardness was observed. TP of Ivotion-Dent and Empress Direct significantly decreased after toothbrushing with higher RDA dentifrices and CR of Ivotion-Dent, Empress Direct and IvoBase-Hybrid significantly increased with higher RDA dentifrices. The levels of dentifrice abrasiveness affected differently the SR, hardness and optical properties of polymeric reconstructive materials after toothbrushing.

Effect of polishing and denture cleansers on the surface roughness of new-generation denture base materials and their color change after cleansing

PURPOSE

To evaluate the effect of polishing and denture cleansers on the surface roughness (Ra ) of new-generation denture base materials that are additively, subtractively, and conventionally fabricated, while also assessing their color change after cleansing.

MATERIAL AND METHODS

One hundred and fifty disk-shaped specimens (Ø10 × 2 mm) were prepared from five denture base materials (one subtractively manufactured nanographene-reinforced prepolymerized polymethylmethacrylate (PMMA) (SM-GC), one subtractively manufactured prepolymerized PMMA (SM-PM), two additively manufactured denture base resins (AM-DT and AM-ND), and one heat-polymerized PMMA (CV) (n = 30). The Ra of the specimens was measured before and after conventional laboratory polishing, while color coordinates were measured after polishing. Specimens were then divided into three subgroups based on the denture cleanser: distilled water, 1% sodium hypochlorite (NaOCl), and effervescent tablet (n = 10). The Ra and color coordinates were remeasured after nine cleansing cycles over a period of 20 days. The CIEDE2000 formula was used to calculate the color differences (ΔE00 ). Two-way analysis of variance (ANOVA) was used to analyze the Ra values before (n = 30) and after (n = 10) cleansing, while repeated measures ANOVA was used to analyze the Ra of material-time point pairs within each denture cleanser (n = 10). ΔE00 data after denture cleansing was also analyzed by using two-way ANOVA (n = 10) (α = 0.05).

RESULTS

Before polishing, Ra varied significantly among the materials. SM-GC and SM-PM had the lowest and AM-ND the highest Ra values (P < 0.001). Polishing significantly reduced Ra of all materials (P < 0.001), and after polishing, Ra differences among materials were nonsignificant (P ≥ 0.072). Regardless of the denture cleanser, the Ra of AM-DT, AM-ND, and CV was the highest before polishing when different time points were considered (P < 0.001). After cleansing, AM-ND had the highest Ra of all the materials, regardless of the cleanser (P ≤ 0.017). AM-DT had higher Ra than SM-PM when distilled water (P = 0.040) and higher Ra than SM-GC, SM-PM, and CV when NaOCl was used (P < 0.001). The type of cleanser significantly influenced the Ra of AM-DT, AM-ND, and CV. For AM-DT, NaOCl led to the highest Ra and the tablet led to the lowest Ra (P ≤ 0.042), while for AM-ND, distilled water led to the lowest Ra (P ≤ 0.024). For CV, the tablet led to lower Ra than distilled water (P = 0.009). Color change varied among the materials. When distilled water was used, SM-GC had higher ΔE00 than SM-PM and AM-DT (P ≤ 0.034). When NaOCl was used, AM-ND had higher ΔE00 than SM-GC, SM-PM, and AM-DT, while CV and SM-GC had higher ΔE00 than SM-PM and AM-DT (P ≤ 0.039). Finally, when the tablet was used, AM-ND and CV had the highest ΔE00 , while AM-DT had lower ΔE00 than SM-GC (P ≤ 0.015).

CONCLUSIONS

The tested materials had unacceptable surface roughness (>0.2 μm) before polishing. Roughness decreased significantly after polishing (<0.2 μm). Denture cleansers did not significantly affect the surface roughness of the materials, and roughness remained clinically acceptable after cleansing (<0.2 μm). Considering previously reported color thresholds, AM-ND and CV had unacceptable color change regardless of the denture cleanser, and the effervescent tablet led to perceptible, but acceptable color change for SM-GC, SM-PM, and AM-DT.

Effect of simulated brushing with dentifrices on surface roughness and the mass loss of acrylic resin: A systematic review and meta-analysis of in vitro studies

STATEMENT OF PROBLEM

Brushing with dentifrice is the most commonly used denture cleaning method. However, it can result in the mass loss of acrylic resin and an increase in surface roughness, which favors the adherence of microorganisms.

PURPOSE

The purpose of this systematic review and meta-analysis of in vitro studies was to assess the influence of simulated brushing by using dentifrices and water on surface roughness and the mass loss of acrylic resins.

MATERIAL AND METHODS

Searches were performed in PubMed, Scopus, Web of Science, Lilacs, Embase, Open Gray, and Google Scholar databases in September 2022. The study selection process, data extraction, and risk of bias analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol of this systematic review was registered in the Open Science Framework (DOI number 10.17605/OSF.IO/QD4GH). Meta-analysis was performed by using a random effects model (α=.05) in the RevMan (Cochrane Collaboration) software program.

RESULTS

A total of 14 studies were included in the qualitative synthesis and 2 studies in the quantitative synthesis. The manual toothbrush was the most analyzed (n=9), followed by the electric toothbrush (n=5) and denture brush (n=1). Denture base resin (n=8) was evaluated more than acrylic resin for the abrasiveness of toothpaste (n=6). Most studies used conventional toothpaste (n=12), whereas 6 used specific dentifrices. The period of brushing corresponding to 1 year was the most predominant (n=6). Surface roughness (n=13) was evaluated more than mass loss (n=4). In general, dentifrices resulted in greater surface roughness than water. According to meta-analysis results, brushing by using dentifrices reported higher mass loss values than brushing with distilled water (P<.05).

CONCLUSIONS

Brushing acrylic resins with dentifrice was more abrasive than brushing with water.

Effect of alkynyloxy derivatives of lawsone as an antifungal spray for acrylic denture base: An in vitro study

Objective

The purpose of this study was to (i) synthesize and develop an alkynyloxy derivative of lawsone as an antifungal spray and (ii) assess the antifungal spray's effectiveness in reducing the viability of Candida albicans (C. albicans) on polymethylmethacrylate (PMMA) specimens.

Methods

Lawsone methyl ether (LME) and its derivative, 2-(prop-2-ynyloxy)naphthalene-1,4-dione (compound 1) were synthesized and characterized. The synthetic compounds were screened for antimicrobial activities against C. albicans using the microtiter broth dilution method to determine the minimum inhibitory concentration (MIC) and minimum fungicidal concentration (MFC). Compound 1 was further formulated as an antifungal spray in three concentrations (100, 200, and 400 μg/mL). C. albicans biofilms were developed for 48 h on PMMA specimens. The efficacy of using an antifungal spray for 1 and 3 min to remove biofilm was assessed using colony counting and scanning electron microscopy (SEM). Chlorhexidine gluconate (CHX), polident®, and distilled water were used as positive and negative control cleansing solutions, respectively.

Results

LME and compound 1 showed comparable inhibition against C. albicans with a MIC of 25 μg/mL and MFC of 50 μg/mL. For immediate treatment, C. albicans was not detected on PMMA specimens when expose to 2% CHX and compound 1 (100, 200, and 400 μg/mL) antifungal spray for 3 min. However, after recolonization, a small number of viable cells were observed in denture soaked in compound 1 antifungal spray for 3 min group. Following recolonization, polident® and distilled water had comparable viable cell counts of C. albicans to the no treatment group. Scanning electron microscope (SEM) images revealed that CHX, polident®, and compound 1 caused cell damage in various forms.

Conclusion

Denture spray containing synthetic alkynyloxy derivative of lawsone is a promising antifungal agent for C. albicans biofilm removal from the PMMA surface.

Effect of Denture Disinfectants on the Mechanical Performance of 3D-Printed Denture Base Materials

Denture care and maintenance are necessary for both denture longevity and underlying tissue health. However, the effects of disinfectants on the strength of 3D-printed denture base resins are unclear. Herein, distilled water (DW), effervescent tablet, and sodium hypochlorite (NaOCl) immersion solutions were used to investigate the flexural properties and hardness of two 3D-printed resins (NextDent and FormLabs) compared with a heat-polymerized resin. The flexural strength and elastic modulus were investigated using the three-point bending test and Vickers hardness test before (baseline) immersion and 180 days after immersion. The data were analyzed using ANOVA and Tukey's post hoc test (α = 0.05), and further verified by using electron microscopy and infrared spectroscopy. The flexural strength of all the materials decreased after solution immersion (p < 0.001). The effervescent tablet and NaOCl immersion reduced the flexural strength (p < 0.001), with the lowest values recorded with the NaOCl immersion. The elastic modulus did not significantly differ between the baseline and after the DW immersion (p > 0.05), but significantly decreased after the effervescent tablet and NaOCl immersion (p < 0.001). The hardness significantly decreased after immersion in all the solutions (p < 0.001). The immersion of the heat-polymerized and 3D-printed resins in the DW and disinfectant solutions decreased the flexural properties and hardness.

Effects of long-term cinnamaldehyde immersion on the surface roughness and color of heat-polymerized denture base resin

STATEMENT OF PROBLEM

Cinnamaldehyde has been successfully used for the short-term disinfection of dentures; however, its long-term effects on the surface and color properties of denture base materials remain unknown.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of simulated immersion in cinnamaldehyde for up to 5 years on the surface roughness and color parameters of a heat-polymerized denture resin.

MATERIAL AND METHODS

Eighty Ø10×5-mm disk-shaped specimens were prepared from microwave heat-polymerized polymethylmethacrylate (PMMA) and immersed in 4 solutions (n=20): TW-tap water (control), SH - 0.5% sodium hypochlorite, PX-alkaline peroxide, and CA-cinnamaldehyde (27 μg/mL). The immersion protocol simulated 104 cycles (3.5 months), 913 cycles (2.5 years), and 1825 immersion cycles (5 years) of a daily immersion cleaning protocol, with immersion times ranging from 10 to 20-minutes. Surface roughness (Sa) and the color parameters of CIELab (L∗ a∗ b∗, ΔEab), CIEDE2000 (ΔE00), and the National Bureau of Standards (NBS) were analyzed at baseline (t=0) and after the immersion cycles. The data were analyzed by 2-way analysis of variance (ANOVA) for repeated measures and the Tukey post hoc test (α=.01).

RESULTS

Sa was significantly increased in all groups after 1825 cycles compared with baseline (P<.01), regardless of the solution. Only the time factor significantly affected ΔEab, ΔE00, and NBS parameters, which were below the perceptibility and acceptability thresholds. After a simulated 5-year immersion, the surface roughness and color values of CA-treated specimens were not statistically different from those of the other groups (P>.01).

CONCLUSIONS

Cinnamaldehyde solution (27 μg/mL) produced minor effects on the surface roughness and color parameters of a heat-polymerized denture base resin similar to those of 0.5% sodium hypochlorite and alkaline peroxide after a 5-year simulated immersion.

Do denture cleansers influence the surface roughness and adhesion and biofilm formation of Candida albicans on acrylic resin? Systematic review and meta-analysis

PURPOSE

To evaluate the influence of denture cleansers on the surface roughness, Candida albicans adhesion, and biofilm formation on denture base acrylic resins.

STUDY SELECTION

Electronic databases and gray literature were searched using an individual search strategy. In vitro studies that evaluated the effects of immersion in denture cleansers on the surface roughness (µm) and antimicrobial activity (CFU/mL) on samples of heat-polymerized denture base acrylic resins were included.

RESULTS

After screening, 17 studies were included, and a qualitative synthesis was performed. After assessing the risk of bias, only nine studies were included in the meta-analysis. The meta-analysis results showed that the evaluated solutions (0.5% sodium hypochlorite, 1% sodium hypochlorite, alkaline peroxide, and natural substances) did not influence the roughness of the acrylic resin. However, in the qualitative analysis, it was not possible to confirm an association between roughness and C. albicans adhesion and biofilm formation on the acrylic resin samples.

CONCLUSION

Denture cleansers did not affect the surface roughness of denture base acrylic resins.

Impact of Surface Changes and Microbial Adhesion on Mucosal Surface Finishing of Resin Denture Bases by Shot Blast Polishing Using Viscoelastic Media

Surface changes and microbiological effects following shot blast polishing with viscoelastic media of the mucosal surface of resin denture bases were examined. Average surface roughness (Ra) and the depth of surface removal of specimens were measured over time, and the clinical number of microbial adhesions on the mucosal surface of dentures was clinically assessed. The results obtained showed no changes in Ra after 20 s of polishing, Ra of <0.2 µm, and a depth of surface removal < 20 µm. This method of finishing did not affect the fit of the mucosal surface of the dentures. Furthermore, the adhesion of microorganisms to the mucosal surface of dentures was significantly suppressed. Shot blast polishing with viscoelastic media is useful for finishing the mucosal surface of resin denture bases.

CLEANING OF REMOVABLE DENTAL PROSTHESES - A SYSTEMATIC REVIEW

Objectives The aim of this systematic review was to provide an overview of the scientific evidence available from prospective clinical studies regarding denture hygiene interventions. Therefore, investigations addressing the efficacy of removing microorganisms and biofilms formed on the surface of removable dental prostheses (RDPs) and denture base materials in situ and their impact on the properties of denture base materials, such as color stability, surface roughness, and dimensional stability, were included. Methods A systematic literature search was conducted from June 1975-May 2020 and included articles published in English that have been indexed in the digital archives of PubMed and Cochrane (including PubMed, Embase, ICTRP, CT.gov). A complementary manual search of the initially retrieved studies was conducted. Inclusion criteria comprised prospective clinical trials with a minimum of ten participants investigating (1) approaches and methods to remove biofilms formed on the surface of RDPs and denture base materials in situ and/or (2) the influence of these biofilms on denture base materials. A total of forty-four studies were included in this systematic review, which was registered in the PROSPERO database (CRD42020189649). Results and Conclusions Data gathered from the systematic review indicate that the combined use of chemical and mechanical denture hygiene interventions is significantly more effective than single cleaning approaches. Only limited evidence is available from clinical studies regarding the effect of denture hygiene interventions on the properties of denture base materials.

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.