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Vuksic J, Pilipovic A, Poklepovic Pericic T, Kranjcic J. The Influence of Contemporary Denture Base Fabrication Methods on Residual Monomer Content, Flexural Strength and Microhardness. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1052. [PMID: 38473524 DOI: 10.3390/ma17051052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024]
Abstract
(1) Background: Digital technologies are available for denture base fabrication, but there is a lack of scientific data on the mechanical and chemical properties of the materials produced in this way. Therefore, the aim of this study was to investigate the residual monomer content, flexural strength and microhardness of denture base materials as well as correlations between investigated parameters. (2) Methods: Seven denture base materials were used: one conventional heat cured polymethyl methacrylate, one polyamide, three subtractive manufactured materials and two additive manufactured materials. High-performance liquid chromatography was used to determine residual monomer content and the test was carried out in accordance with the specification ISO No. 20795-1:2013. Flexural strength was also determined according to the specification ISO No. 20795-1:2013. The Vickers method was used to investigate microhardness. A one-way ANOVA with a Bonferroni post-hoc test was used for the statistical analysis. The Pearson correlation test was used for the correlation analysis. (3) Results: There was a statistically significant difference between the values of residual monomer content of the different denture base materials (p < 0.05). Anaxdent pink blank showed the highest value of 3.2% mass fraction, while Polident pink CAD-CAM showed the lowest value of 0.05% mass fraction. The difference between the flexural strength values of the different denture base materials was statistically significant (p < 0.05), with values ranging from 62.57 megapascals (MPa) to 103.33 MPa. The difference between the microhardness values for the different denture base materials was statistically significant (p < 0.05), and the values obtained ranged from 10.61 to 22.86 Vickers hardness number (VHN). A correlation was found between some results for the material properties investigated (p < 0.05). (4) Conclusions: The selection of contemporary digital denture base manufacturing techniques may affect residual monomer content, flexural strength and microhardness but is not the only criterion for achieving favourable properties.
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Affiliation(s)
- Josip Vuksic
- Department of Removable Prosthodontics, University of Zagreb School of Dental Medicine, Gunduliceva 5, 10000 Zagreb, Croatia
- Department of Prosthodontics, University Hospital Dubrava, Av. Gojka Šuška 6, 10000 Zagreb, Croatia
| | - Ana Pilipovic
- University of Zagreb Faculty of Mechanical Engineering and Naval Architecture, Ivana Lučića 5, 10000 Zagreb, Croatia
| | | | - Josip Kranjcic
- Department of Prosthodontics, University Hospital Dubrava, Av. Gojka Šuška 6, 10000 Zagreb, Croatia
- Department of Fixed Prosthodontics, University of Zagreb School of Dental Medicine, Gunduliceva 5, 10000 Zagreb, Croatia
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Dib Zakkour S, Dib Zakkour J, Guadilla Y, Montero J, Dib A. Comparative Evaluation of the Digital Workflow and Conventional Method in Manufacturing Complete Removal Prostheses. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6955. [PMID: 37959552 PMCID: PMC10650844 DOI: 10.3390/ma16216955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 09/10/2023] [Accepted: 10/27/2023] [Indexed: 11/15/2023]
Abstract
The aging population in developed countries has increased the number of edentulous patients and, therefore, the need for prosthetic rehabilitation to improve their quality of life. Complete dentures are the main treatment option in these cases. The use of CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) in dentistry has improved clinical protocols and outcomes, achieving a reduction in work time and economic costs for the patients. The main objective of this review was to compare the characteristics of conventional and digital dentures, attempting to determine whether the use of new technologies represents an improvement in the properties of removable complete dentures. A bibliographic review was carried out in the PubMed/MEDLINE, Cochrane Library, Scielo, and Embase databases. With the initial search, 157 articles were obtained. After applying the inclusion and exclusion criteria, 64 publications were selected for this bibliographic review. The different conclusions of the studies consulted were compared regarding fit and retention, fracture resistance, surface roughness, biocompatibility, and aesthetics, taking into account the different methods of prostheses fabrication. In general, digital prostheses have shown better mechanical properties and, consequently, better biocompatibility and aesthetics than conventional prostheses. However, the obtained results were very heterogeneous, preventing a supported conclusion.
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Affiliation(s)
| | | | - Yasmina Guadilla
- Dental Clinic of the Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain; (Y.G.); (J.M.); (A.D.)
| | - Javier Montero
- Dental Clinic of the Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain; (Y.G.); (J.M.); (A.D.)
| | - Abraham Dib
- Dental Clinic of the Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain; (Y.G.); (J.M.); (A.D.)
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Le Bars P, Bandiaky ON, Le Guéhennec L, Clouet R, Kouadio AA. Different Polymers for the Base of Removable Dentures? Part I: A Narrative Review of Mechanical and Physical Properties. Polymers (Basel) 2023; 15:3495. [PMID: 37688123 PMCID: PMC10490543 DOI: 10.3390/polym15173495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 09/10/2023] Open
Abstract
Even before considering their introduction into the mouth, the choice of materials for the optimization of the prosthesis depends on specific parameters such as their biocompatibility, solidity, resistance, and longevity. In the first part of this two-part review, we approach the various mechanical characteristics that affect this choice, which are closely related to the manufacturing process. Among the materials currently available, it is mainly polymers that are suitable for this use in this field. Historically, the most widely used polymer has been polymethyl methacrylate (PMMA), but more recently, polyamides (nylon) and polyether ether ketone (PEEK) have provided interesting advantages. The incorporation of certain molecules into these polymers will lead to modifications aimed at improving the mechanical properties of the prosthetic bases. In the second part of the review, the safety aspects of prostheses in the oral ecosystem (fragility of the undercuts of soft/hard tissues, neutral pH of saliva, and stability of the microbiota) are addressed. The microbial colonization of the prosthesis, in relation to the composition of the material used and its surface conditions (roughness, hydrophilicity), is of primary importance. Whatever the material and manufacturing process chosen, the coating or finishes dependent on the surface condition remain essential (polishing, non-stick coating) for limiting microbial colonization. The objective of this narrative review is to compile an inventory of the mechanical and physical properties as well as the clinical conditions likely to guide the choice between polymers for the base of removable prostheses.
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Affiliation(s)
- Pierre Le Bars
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (L.L.G.); (R.C.); (A.A.K.)
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, 44000 Nantes, France;
| | - Octave Nadile Bandiaky
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, 44000 Nantes, France;
| | - Laurent Le Guéhennec
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (L.L.G.); (R.C.); (A.A.K.)
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, 44000 Nantes, France;
| | - Roselyne Clouet
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (L.L.G.); (R.C.); (A.A.K.)
- Oniris, CHU Nantes, INSERM, Regenerative Medicine and Skeleton, RMeS, Nantes Université, UMR 1229, 44000 Nantes, France;
| | - Alain Ayepa Kouadio
- Department of Prosthetic Dentistry, Faculty of Dentistry, Nantes University, 1 Place Alexis Ricordeau, 44042 Nantes, France; (L.L.G.); (R.C.); (A.A.K.)
- Department of Prosthetic Dentistry, Faculty of Dentistry, University Hospital Center, Abidjan P.O. Box 612, Côte d’Ivoire
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Tinastepe N, Malkondu O, Kazazoglu E. Hardness and surface roughness of differently processed denture base acrylic resins after immersion in simulated gastric acid. J Prosthet Dent 2023; 129:364.e1-364.e9. [PMID: 36604260 DOI: 10.1016/j.prosdent.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 01/04/2023]
Abstract
STATEMENT OF PROBLEM The effect of gastric acid on the surface properties of denture base acrylic resin is unknown. PURPOSE The purpose of this in vitro study was to evaluate changes in the surface roughness and hardness of denture base acrylic resins after immersion in simulated gastric acid. MATERIAL AND METHODS Acrylic resin specimens (n=10) were prepared with 3 different processing techniques (compression-molded, injection-molded, and computer-aided design and computer-aided manufacturing [CAD-CAM] milled) and exposed to either gastric acid or artificial saliva (control). Surface roughness and hardness were measured at baseline (T0) and after 24-hour (T24) and 96-hour (T96) immersion in the solutions. The surface roughness and hardness data were analyzed by 3-way ANOVA and the Tukey HSD test (α=.05). RESULTS At T24, the greatest change in surface hardness was observed for compression-molded specimens in gastric acid (P<.05). At T96, changes in hardness values were higher in compression-molded specimens than those in milled specimens (P<.05). Regarding surface roughness, at T24, compression-molded and injection-molded specimens showed higher values than milled specimens in gastric acid (P<.05). Concerning specimens in artificial saliva, compression-molded specimens showed significantly higher changes in roughness than those of the others (P<.05). At T96, injection-molded specimens had the greatest roughness values (P<.05). Among specimens immersed in artificial saliva, milled specimens showed lower roughness values than the injection-molded or compression-molded specimens (P<.05). CONCLUSIONS Gastric acid exposure adversely affected the roughness and hardness of all the acrylic resins evaluated. CAD-CAM milled specimens showed better resistance to acid exposure after 24 and 96 hours in terms of roughness and hardness.
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Affiliation(s)
- Neslihan Tinastepe
- Associate Professor, Department of Prosthodontics, School of Dentistry, Uskudar University, Istanbul, Turkey.
| | - Ozlem Malkondu
- Professor, Department of Prosthodontics, School of Dentistry, Yeditepe University, Istanbul, Turkey
| | - Ender Kazazoglu
- Professor, Department of Prosthodontics, School of Dentistry, Yeditepe University, Istanbul, Turkey
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Maruo Y, Yoshihara K, Irie M, Nagaoka N, Matsumoto T, Minagi S. Does Multifunctional Acrylate's Addition to Methacrylate Improve Its Flexural Properties and Bond Ability to CAD/CAM PMMA Block? MATERIALS (BASEL, SWITZERLAND) 2022; 15:7564. [PMID: 36363156 PMCID: PMC9657670 DOI: 10.3390/ma15217564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 10/21/2022] [Accepted: 10/25/2022] [Indexed: 06/16/2023]
Abstract
This study investigated the effects of a multifunctional acrylate copolymer-Trimethylolpropane Triacrylate (TMPTA) and Di-pentaerythritol Polyacrylate (A-DPH)-on the mechanical properties of chemically polymerized acrylic resin and its bond strength to a CAD/CAM polymethyl methacrylate (PMMA) disk. The methyl methacrylate (MMA) samples were doped with one of the following comonomers: TMPTA, A-DPH, or Trimethylolpropane Trimethacrylate (TMPTMA). The doping ratio ranged from 10 wt% to 50 wt% in 10 wt% increments. The flexural strength (FS) and modulus (FM) of PMMA with and without comonomer doping, as well as the shear bond strength (SBS) between the comonomer-doped PMMA and CAD/CAM PMMA disk, were evaluated. The highest FS (93.2 ± 4.2 MPa) was obtained when doped with 20 wt% of TMPTA. For TMPTMA, the FS decreased with the increase in the doping ratio. For SBS, TMPTA showed almost constant values (ranging from 7.0 to 8.2 MPa) regardless of the doping amount, and A-DPH peaked at 10 wt% doping (8.7 ± 2.2 MPa). TMPTMA showed two peaks at 10 wt% (7.2 ± 2.6 MPa) and 40 wt% (6.5 ± 2.3 MPa). Regarding the failure mode, TMPTMA showed mostly adhesive failure between the CAD/CAM PMMA disk and acrylic resin while TMPTA and A-DPH showed an increased rate of cohesive or mixed failures. Acrylate's addition as a comonomer to PMMA provided improved mechanical properties and bond strength to the CAD/CAM PMMA disk.
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Affiliation(s)
- Yukinori Maruo
- Department of Prosthodontics, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| | - Kumiko Yoshihara
- Health Research Institute, National Institute of Advanced Industrial Science and Technology, 2217-14 Hayashi-cho, Takamatsu, Kagawa 761-0395, Japan
| | - Masao Irie
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| | - Noriyuki Nagaoka
- Advanced Research Center for Oral and Craniofacial Sciences, Okayama University Dental School, Okayama 700-8558, Japan
| | - Takuya Matsumoto
- Department of Biomaterials, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
| | - Shogo Minagi
- Department of Prosthodontics, Okayama University, 2-5-1 Shikata-cho, Okayama 700-8525, Japan
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Biodegradation of Dental Resin-Based Composite—A Potential Factor Affecting the Bonding Effect: A Narrative Review. Biomedicines 2022; 10:biomedicines10092313. [PMID: 36140414 PMCID: PMC9496159 DOI: 10.3390/biomedicines10092313] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 09/04/2022] [Accepted: 09/15/2022] [Indexed: 12/02/2022] Open
Abstract
In recent years, although resin composite has played an important role in the restoration of tooth defects, it still has several disadvantages, including being biodegraded by saliva, bacteria and other enzymes in the oral cavity, which may result in repair failure. This factor is not conducive to the long-term survival of the prosthesis in the mouth. In this article, we review the causes, influencing factors and prevention methods of resin biodegradation. Biodegradation is mainly caused by esterase in saliva and bacteria, which breaks the ester bond in resin and causes the release of monomers. The mechanical properties of the prosthesis can then be affected. Meanwhile, cathepsin and MMPs are activated on the bonding surface, which may decompose the dentin collagen. In addition, neutrophils and residual water on the bonding surface can also aggravate biodegradation. Currently, the primary methods to prevent biodegradation involve adding antibacterial agents to resin, inhibiting the activity of MMPs and enhancing the crosslinking of collagen fibers. All of the above indicates that in the preparation and adhesion of resin materials, attention should be paid to the influence of biodegradation to improve the prosthesis’s service life in the complex environment of the oral cavity.
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Flexural Properties, Impact Strength, and Hardness of Nanodiamond-Modified PMMA Denture Base Resin. Int J Biomater 2022; 2022:6583084. [PMID: 35855810 PMCID: PMC9288300 DOI: 10.1155/2022/6583084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 06/21/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose. Investigate the effect of low nanodiamond (ND) addition and autoclave polymerization on the flexural strength, impact strength, and hardness of polymethylmethacrylate (PMMA) denture base. Methods. A total of 240 heat polymerized PMMA were fabricated with low ND concentrations of 0.1%, 0.25%, and 0.5%, and unmodified as control. The specimens were divided equally into group I: conventionally polymerized PMMA by water bath and group II: polymerized by the autoclave. The impact strength, flexural strength, and elastic modulus were tested using the Charpy-type impact-testing machine and three-point bending test, respectively. A scanning electron microscope (SEM) was used to analyze the fractured surfaces. Surface hardness was measured by a hardness tester with a Vickers diamond. The bonding and interaction between the PMMA and ND particles were analyzed by the Fourier-transform infrared (FTIR) spectroscope. ANOVA and post hoc Tukey test were used for data analysis (α = 0.05). Results. ND addition significantly increased the flexural strength of groups I and II (
,
); it was highest (128.8 MPa) at 0.25% ND concentration for group I and at 0.1% for group II. Elastic modulus increased at 0.1% ND for both groups (
,
), but the increase was statistically significant for group I only. Impact strength showed no significant change with the addition of ND in groups I and II (
,
), as well as surface hardness in group I (
). Hardness decreased significantly with 0.25%ND in group II. Conclusion. The addition of ND at low concentration increased the elastic modulus and flexural strength of conventionally and autoclave polymerized denture base resin. Autoclave polymerization significantly increased the flexural strength, impact strength, and hardness of unmodified PMMA and hardness of 0.5% ND group.
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Khan AA, Fareed MA, Alshehri AH, Aldegheishem A, Alharthi R, Saadaldin SA, Zafar MS. Mechanical Properties of the Modified Denture Base Materials and Polymerization Methods: A Systematic Review. Int J Mol Sci 2022; 23:5737. [PMID: 35628546 PMCID: PMC9143457 DOI: 10.3390/ijms23105737] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/15/2022] [Accepted: 05/19/2022] [Indexed: 12/22/2022] Open
Abstract
Amidst growing technological advancements, newer denture base materials and polymerization methods have been introduced. During fabrication, certain mechanical properties are vital for the clinical longevity of the denture base. This systematic review aimed to explore the effect of newer denture base materials and/or polymerization methods on the mechanical properties of the denture base. An electronic database search of English peer-reviewed published papers was conducted using related keywords from 1 January 2011, up until 31 December 2021. This systematic review was based on guidelines proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search identified 579 papers. However, the inclusion criteria recognized 22 papers for eligibility. The risk of bias was moderate in all studies except in two where it was observed as low. Heat cure polymethyl methacrylate (PMMA) and compression moulding using a water bath is still a widely used base material and polymerization technique, respectively. However, chemically modified PMMA using monomers, oligomers, copolymers and cross-linking agents may have a promising result. Although chemically modified PMMA resin might enhance the mechanical properties of denture base material, no clear inferences can be drawn about the superiority of any polymerization method other than the conventional compression moulding technique.
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Affiliation(s)
- Aftab Ahmed Khan
- Dental Biomaterials Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia
| | - Muhammad Amber Fareed
- Department of Restorative Dentistry, College of Dentistry, Gulf Medical University, Ajman P.O. Box 4184, United Arab Emirates;
| | - Abdulkarim Hussain Alshehri
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia;
| | - Alhanoof Aldegheishem
- Department of Clinical Dental Science, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (A.A.); (R.A.)
| | - Rasha Alharthi
- Department of Clinical Dental Science, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia; (A.A.); (R.A.)
| | - Selma A. Saadaldin
- Prosthodontics Division, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5B9, Canada;
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawarah, Medina 42353, Saudi Arabia;
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad 46000, Pakistan
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Fouda SM, Gad MM, Abualsaud R, Ellakany P, AlRumaih HS, Khan SQ, Akhtar S, Al-Qarni FD, Al-Harbi FA. Flexural Properties and Hardness of CAD-CAM Denture Base Materials. J Prosthodont 2022; 32:318-324. [PMID: 35567362 DOI: 10.1111/jopr.13535] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/02/2022] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To compare flexural strength, elastic modulus, and surface hardness of CAD-CAM milled, 3D-printed, and heat-polymerized denture base resins. MATERIALS AND METHODS A total of 120 specimens were fabricated from heat-polymerized acrylic resin (HP), milled resin (Avadent and IvoCad), and 3D-printed resin (ASIGA, FormLabs, and NextDent). The specimens were divided into 6 groups according to the type of denture base material n = 20/material, (10/flexural properties and 10/hardness). Flexural strength and elastic modulus of the specimens were evaluated by 3-point bending test and surface hardness by Vickers hardness test. To test flexural properties, the specimens were fabricated according to ISO 20795-1:2013 standards (64×10×3.3 ±0.2 mm). The dimensions for hardness test were 15×10×2.5 ±0.2 mm. Scanning electron microscope was used to evaluate the surface morphology of the fractured specimens. The means and standard deviations were calculated, followed by one-way ANOVA and Tukey post-hoc test (α = 0.05). RESULTS Milled resins showed significantly higher values for flexural strength, elastic modulus, and surface hardness, followed by HP then 3D-printed resins (P<0.001). In between milled groups, flexural strength of AvaDent was significantly higher than IvoCad (P<0.001), while elastic modulus and hardness didn't show significant difference. In between 3D-printed resins, ASIGA showed the highest flexural strength and elastic modulus, insignificantly with FormLabs (P = 0.595) and significantly with NextDent (P = 0.008). ASIGA also showed significantly the highest hardness among the 3D-printed groups. No significant difference was found between FormLabs and NextDent flexural strength (P = 0.357), elastic modulus (P = 1.00) and surface hardness (P = 0.987). CONCLUSION CAD-CAM milled resins had greater flexural properties and hardness compared to heat-polymerized acrylic resin and 3D-printed resins. Although 3D-printed samples showed the lowest values of tested properties, the flexural strength and modulus were above the clinically acceptable values. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Shaimaa M Fouda
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed M Gad
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem Abualsaud
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Passent Ellakany
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hamad S AlRumaih
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Soban Q Khan
- Department of Clinical Affairs, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Sultan Akhtar
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faisal D Al-Qarni
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahad A Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Srinivasan M, Kamnoedboon P, McKenna G, Angst L, Schimmel M, Özcan M, Müller F. CAD-CAM removable complete dentures: A systematic review and meta-analysis of trueness of fit, biocompatibility, mechanical properties, surface characteristics, color stability, time-cost analysis, clinical and patient-reported outcomes. J Dent 2021; 113:103777. [PMID: 34400250 DOI: 10.1016/j.jdent.2021.103777] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs). DATA Seventy-three studies reporting on CAD-CAM (milled/3D-printed) CDs were included in this review. The most recent literature search was performed on 15/03/2021. SOURCES Two investigators searched electronic databases [PubMed (MEDLINE), Embase, CENTRAL], online search engines (Google) and research portals. Hand searches were performed to identify literature not available online. STUDY SELECTION Studies on CAD-CAM CDs were included if they reported on trueness of fit, biocompatibility, mechanical, surface, chemical, color , microbiological properties, time-cost analysis, and clinical outcomes. Inter-investigator reliability was assessed using kappa scores. Meta-analyses were performed on the extracted data . RESULTS The kappa score ranged between 0.897-1.000. Meta-analyses revealed that 3D-printed CDs were more true than conventional CDs (p = 0.039). Milled CDs had a higher flexural-strength than conventional and 3D-printed CDs (p < 0.0001). Milled CDs had a higher flexural-modulus than 3D-printed CDs (p < 0.0001). Milled CDs had a higher yield-strength than injection-molded (p = 0.004), and 3D-printed CDs (p = 0.001). Milled CDs had superior toughness (p < 0.0001) and surface roughness characteristics (p < 0.0001) than other CDs . Rapidly-prototyped CDs displayed poor color-stability compared to other CDs (p = 0.029). CAD-CAM CDs d displayed better retention than conventional CDs (p = 0.015). Conventional CDs had a higher strain at yield point than milled CDs (p < 0.0001), and had superior esthetics than 3D-printed (p < 0.0001). Fabrication of CAD-CAM CDs required less chairside time (p = 0.037) and lower overall costs (p < 0.0001) than conventional CDs. CONCLUSIONS This systematic review concludes that CAD-CAM CDs offer a number of improved mechanical/surface properties and are not inferior when compared to conventional CDs. CLINICAL SIGNIFICANCE CAD-CAM CDs should be considered for completely edentulous patients whenever possible, since this technique offers numerous advantages including better retention, mechanical and surface properties but most importantly preserves a digital record. This can be a great advantage for older adults with limited access to dental care.
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Affiliation(s)
- Murali Srinivasan
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - Porawit Kamnoedboon
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Gerald McKenna
- Centre for Public Health, Queen's University Belfast, United Kingdom
| | - Lea Angst
- Clinic of General, Special Care, and Geriatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Martin Schimmel
- Department of Reconstructive Dentistry and Gerodontology, Clinic of Dental Medicine, University of Bern, Bern, Switzerland.; Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Mutlu Özcan
- Division of Dental Biomaterials, Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Frauke Müller
- Division of Gerodontology and Removable Prosthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Comparison of CAD/CAM and Conventional Denture Base Resins: A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11135990] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
At present, complete dentures (CDs) remain the only treatment available for the majority of edentulous patients. CDs are primarily fabricated using a conventional method using polymethylmethacrylate (PMMA) resin. The steps involved in PMMA polymerisation directly affect the quality of the resin prosthetic base and any error reduces retention and occlusal accuracy of CDs. Furthermore, when using the conventional technique, the residual monomer alters the resin mechanical properties and may cause mucosal reactions. Recently, computer aided design and computer aided manufacture (CAD/CAM) techniques were increasingly used to fabricate CDs by machining resin discs that have been manufactured under high pressure and temperature. This systematic review compares CAD/CAM and conventional CDs according to their mechanical, physical and chemical characteristics, as well as the clinical impact of any differences between them. A review was conducted according to the preferred reporting items for systematic reviews and meta-analyses checklist on 392 publications from both PubMed and backward research. Fifteen studies have been included. Results showed that CAD/CAM resins had globally better physical and mechanical properties than conventional resins. The use of machined resin could improve the clinical performance, maintenance and longevity of CDs. Further studies in clinical use would be required to complement these results.
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Hada T, Kanazawa M, Iwaki M, Katheng A, Minakuchi S. Comparison of Mechanical Properties of PMMA Disks for Digitally Designed Dentures. Polymers (Basel) 2021; 13:polym13111745. [PMID: 34073564 PMCID: PMC8199238 DOI: 10.3390/polym13111745] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 12/03/2022] Open
Abstract
In this study, the physical properties of a custom block manufactured using a self-polymerizing resin (Custom-block), the commercially available CAD/CAM PMMA disk (PMMA-disk), and a heat-polymerizing resin (Conventional PMMA) were evaluated via three different tests. The Custom-block was polymerized by pouring the self-polymerizing resin into a special tray, and Conventional PMMA was polymerized with a heat-curing method, according to the manufacturer’s recommended procedure. The specimens of each group were subjected to three-point bending, water sorption and solubility, and staining tests. The results showed that the materials met the requirements of the ISO standards in all tests, except for the staining tests. The highest flexural strength was exhibited by the PMMA-disk, followed by the Custom-block and the Conventional PMMA, and a significant difference was observed in the flexural strengths of all the materials (p < 0.001). The Custom-block showed a significantly higher flexural modulus and water solubility. The water sorption and discoloration of the Custom-block were significantly higher than those of the PMMA-disk, but not significantly different from those of the Conventional PMMA. In conclusion, the mechanical properties of the three materials differed depending on the manufacturing method, which considerably affected their flexural strength, flexural modulus, water sorption and solubility, and discoloration.
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Affiliation(s)
- Tamaki Hada
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.H.); (A.K.); (S.M.)
| | - Manabu Kanazawa
- Digital Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan
- Correspondence: ; Tel.: +81-3-5803-5379
| | - Maiko Iwaki
- General Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan;
| | - Awutsadaporn Katheng
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.H.); (A.K.); (S.M.)
| | - Shunsuke Minakuchi
- Gerodontology and Oral Rehabilitation, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan; (T.H.); (A.K.); (S.M.)
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