Effect of post-polymerization heat treatments on the cytotoxicity of two denture base acrylic resins

Polymeric Denture Base Materials: A Review

An ideal denture base must have good physical and mechanical properties, biocompatibility, and esthetic properties. Various polymeric materials have been used to construct denture bases. Polymethyl methacrylate (PMMA) is the most used biomaterial for dentures fabrication due to its favorable properties, which include ease of processing and pigmenting, sufficient mechanical properties, economy, and low toxicity. This article aimed to comprehensively review the current knowledge about denture base materials (DBMs) types, properties, modifications, applications, and construction methods. We searched for articles about denture base materials in PubMed, Scopus, and Embase. Journals covering topics including dental materials, prosthodontics, and restorative dentistry were also combed through. Denture base material variations, types, qualities, applications, and fabrication research published in English were considered. Although PMMA has several benefits and gained popularity as a denture base material, it has certain limitations and cannot be classified as an ideal biomaterial for fabricating dental prostheses. Accordingly, several studies have been performed to enhance the physical and mechanical properties of PMMA by chemical modifications and mechanical reinforcement using fibers, nanofillers, and hybrid materials. This review aimed to update the current knowledge about DBMs' types, properties, applications, and recent developments. There is a need for specific research to improve their biological properties due to patient and dental staff adverse reactions to possibly harmful substances produced during their manufacturing and use.

Evaluation of the cytotoxic and genotoxic effects of different universal adhesive systems

Objectives:

The objective of this study was to evaluate and compare the cytotoxicity and genotoxicity of different universal adhesive systems in the mouse fibroblast cell line L929.

Materials and Methods:

L929 (mouse fibroblast) cells were exposed to G-Premio Bond (GPB) (GC Europe, Belgium), Prime&Bond Universal (Dentsply Sirona, USA), Universal Bond Quick (Kuraray, USA), Single Bond (SB) Universal (3M ESPE, USA), and Tokuyama Universal Bond (TB) (Tokuyama, USA). Cell viability was assessed by the 2,3-bis-(2-methoxy-4-nitro-5-sulfophenyl)-2H-tetrazolium-5-carboxanilide test, whereas oxidative DNA damage was assessed by determining the 8-hydroxydeoxyguanosine level using an enzyme-linked immunoassay kit. Statistical analysis was performed by one-way analysis of variance, followed by Bonferroni post hoc tests.

Results:

Cytotoxic and genotoxic effects of TB and SB Universal groups were significantly higher than the other groups (P < 0.05). Among the adhesives tested, GPB (93.0 ± 1.3) had the least cytotoxicity, while TB (67.3 ± 3.0) had the most cytotoxic effect. In terms of genotoxicity, GPB (2.2 ± 0.3) had the least genotoxic effect, while Tokuyama Bond Universal (4.17 ± 0.4) had the most genotoxic effect.

Conclusions:

Universal adhesive systems used in dentistry have cytotoxic and genotoxic effects in live cells. Universal adhesive systems should, therefore, be used with caution due to their cytotoxic and genotoxic effects in clinical applications.

Influence of polymerization method on the cytotoxicity of three different denture base acrylic resins polymerized in different methods

Statement of Problem

Acrylic plastics are used for over 80 years for the manufacture of prostheses. This kind of material has some limitations, one of them is a residual monomer, that remains after the polymerization has been terminated, which can influence the biological properties of the final medical device.

The purpose

The aim of this investigations was a comparison of the residual monomer concentration and cytotoxic effect of three various acrylic materials which differ in the polymerization method (hot-cured, polymerized under pressure and at lower temperatures).

Material and methods

The cytotoxicity of three different acrylic resins from the same producer were tested on the in vitro model (VERO CCL-81) by MTT assay. The residual monomer of acrylic materials was detected by gas chromatography.

Results

The Superacryl Plus material polymerized in hot water has a residual monomer concentration of 0.67 ± 0.05%, Superpont C + B hardened under pressure of 2.61 ± 0.208%, and Premacryl Plus after cold curing process has 3.53 ± 0.27% of uncured MMA. The results revealed that the least cytotoxic effect were observed in case of a thermally polymerized material.

Conclusion

Material polymerized in high temperatures has lower residual monomer concentration and not affect cell cultures. Self-curing materials polymerized in lower temperature have a higher concentration of residual monomer, which reduces the number of living cells by 20%, which can cause allergic reaction shortly after new denture was prepared.

Properties of an acrylic resin after immersion in antiseptic soaps: Low-cost, easy-access procedure for the prevention of denture stomatitis

Denture stomatitis triggered by Candida species requires better preventive measures. This study evaluated the physical and biological properties of a denture base acrylic resin after immersion in antiseptic soaps. Acrylic resin specimens were prepared and stored in distinct solutions for 0, 7, 14, 21, and 28 days. The solutions were as follows: DW: distilled water at 37°C (control group); DS: cycles of daily immersion in Dettol soap for 8 hours at room temperature, followed by immersion in distilled water for 16 hours at 37°C; PS: cycles of daily immersion in Protex soap, as described for the previous group; LS: cycles of daily immersion in Lifebuoy soap, as described for the DS group. The parameters evaluated at each time point were the following: biofilm formation capacity by Candida albicans and reduction of preformed fungal biofilms, cytotoxicity, surface roughness, hardness, and color change. For the fungal adhesion phase, the type of soap had a statistically significant effect (p = 0.0292), but after 24 hours, no differences were found between solutions or between storage times. Regarding the efficacy of biofilm reduction, there was a significant difference when the groups were compared to each other (p = 0.014). Dettol and Lifebuoy eliminated the preformed biofilm on the specimens. Moreover, all the soaps were classified as non-cytotoxic (on HaCaT cell line) because there was no difference in cell viability between the different groups, except after 21 days, when a decrease in cell viability occurred, regardless of the type of soap. Regarding the roughness, there was no statistically significant difference (p > 0.05) between the groups. Lifebuoy decreased resin hardness regardless of storage time (p = 0.003). After 21 and 28 days of storage, there was an increase in hardness value, regardless of the type of soap. The specimens’ color, according to the National Bureau of Standards values, ranged from 0.27 to 0.58 (i.e., imperceptible or mild color changes). In general, the disinfectant soaps were not able to prevent biofilm formation, but all the soaps were effective in reducing the preformed biofilm. In addition, all soaps were non-cytotoxic and did not change surface roughness, hardness (except Lifebuoy), and color (except Lifebuoy). Therefore, immersion in two antiseptic soaps (Protex and Dettol) may be a cheap and easy procedure for preventing denture stomatitis.

Cytotoxicity of long-term denture base materials

Introduction:

The aim of this study was to evaluate the cytotoxic effect of various denture base materials following four different aging periods.

Methods:

In total, 48 disc-shaped specimens per each group were prepared: Group I: acrylic resin polymerized in cool water and heated up to 100°C over 45 min and boiled for 15 min; Group II: acrylic resin polymerized under pressure in 40°C–45°C water bath for 10 min; Group III: autopolymerized hard relining resin Cold Liner Rebase; Group IV: autopolymerized hard relining resin Truliner; Group V: soft relining resin DentuSil. Then the specimens were stored in water for 24 h or 15 days, or thermocycled 2500 times or 10,000 times. Cytotoxicity was evaluated with 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay using L929 cells after 72-h cell incubation. Cell viability percentages were counted and statistical analyses were performed. The results were also evaluated according to ISO standard 10993-5.

Results:

All materials showed similar cell viability percentages following 24-h water storage and 2500 and 10,000 thermal cycles. Following 15-day water storage, a statistically significant difference was observed between the materials. Comparisons of the aging periods for each material showed statistically significant differences. Groups III and IV showed moderately cytotoxic effect following 15-day water storage. The remaining groups showed slightly cytotoxic or non-cytotoxic effect.

Discussion:

Polymerizing acrylic resins under pressure can be an alternative to conventional polymerizing to ensure a faster denture repair while providing similar cell viability values. Heat-cured acrylic resins provide higher cell viability than hard chairside lining materials in a 15-day period.

Cytotoxic potential of denture base and reline acrylic resins after immersion in disinfectant solutions

STATEMENT OF PROBLEM

The daily immersion of dentures in disinfectant solutions can cause the incorporation of toxic substances in the acrylic resins, and studies evaluating the cumulative effect of disinfectant solutions on cell culture are lacking.

PURPOSE

The purpose of this in vitro study was to evaluate the cytotoxic potential of cell cultures of denture base and reline acrylic resins after immersion in disinfectant solutions.

MATERIAL AND METHODS

Disk-shaped specimens (14×1.2 mm) were obtained and divided into groups (n=9) according to the disinfectant solutions (distilled water [control], 2% chlorhexidine digluconate, 3.8% sodium perborate, 0.5% sodium hypochlorite, and apple vinegar) and to the storage period (0, 1, 3, and 6 months). Solutions were changed daily. After the different storage periods, specimens were immersed in culture medium for 24 hours, and extracts were obtained. Human keratinocytes were cultivated, and the cellular metabolism was evaluated by using Alamar Blue. Data were submitted to 3-way analysis of variance and Games-Howell post hoc tests (α=.05).

RESULTS

Both of the acrylic resins tested showed similar biocompatibility properties after immersion in different solutions (P=.400). Immersion in distilled water, 3.8% sodium perborate, and 0.5% sodium hypochlorite did not affect the cellular metabolism of the keratinocytes (P>.05), regardless of the immersion period and the type of acrylic resin (P>.05). Immersion in 2% chlorhexidine digluconate or apple vinegar resulted in high cytotoxicity over time, until the third month (P<.05), after which no changes were observed (P>.05).

CONCLUSIONS

The type of acrylic resin (base or reline) had no significant effect on the viability of cells. Vinegar and chlorhexidine digluconate solutions increased in cytotoxic effect over time, and were strongly cytotoxic after 6 months of immersion. Sodium perborate and sodium hypochlorite were noncytotoxic in all periods of time tested.

Evaluation of Surface Characteristics of Denture Base Using Organic-Inorganic Hybrid Coating: An SEM Study

STATEMENT OF PROBLEM

Despite the numerous positive features of acrylic denture base, there are a number of undeniable associated disadvantages. The properties of denture base have been improved through various interventions including application of different types of filler and coatings.

OBJECTIVES

This study aimed to evaluate the surface roughness, thickness and coating quality of organic-inorganic coating on the denture base through scanning electron microscopy. Moreover, the colour change was evaluated visually.

MATERIALS AND METHODS

The organic-inorganic hybrid coatings were prepared. Acrylic discs of 10×10 mm were fabricated. The test discs were dipped in the hybrid coating and cured. In order to evaluate the surface roughness and coating thickness, the surface and cross-section of the samples in both coated and control groups were subjected to scanning electron microscopy. The colour change and transparency were visually evaluated with naked eyes. The data were statistically analyzed by student's t test.

RESULTS

The hybrid materials perfectly covered all the surfaces of acrylic resin and established proper thickness. The coated group seemed smoother and flatter than the control group; however, the difference was not statistically significant ( for all parameters p > 0.05). It was quite a thin coating and no perceptible colour change was observed.

CONCLUSIONS

The hybrid coating maintained good binding, caused no noticeable discoloration, and thoroughly covered the acrylic resin surface with uniform delicate thickness. It also slightly improved the acrylic resin surface roughness.

Ultrasonic cleaning reduces the residual monomer in acrylic resins

Background/purpose

The residual monomer remaining in acrylic resin can cause an allergic reaction and is toxic to oral soft tissue. This study determined the effect of the duration of ultrasonic cleaning on the amount of residual methyl methacrylate monomer in one heat-polymerized acrylic resin, Meliodent, and three autopolymerized acrylic resins, Unifast Trad Ivory, Unifast Trad Pink, and Unifast III.

Materials and methods

Thirty-six disc-shaped specimens of each brand were prepared and randomly divided into six groups: control (no treatment), positive control, and ultrasonic treatment in 50°C water for 3 minutes, 5 minutes, 10 minutes, or 15 minutes. The residual monomer was extracted and analyzed using high performance liquid chromatography.

Results

There were no significant differences in the residual monomer amount in the Meliodent groups. The amounts of residual monomer in the autopolymerized acrylic resin positive control group and ultrasonic treatment groups were significantly lower than those of the control group for the Unifast Trad Ivory, Unifast Trad Pink, and Unifast III groups (P < 0.05). The amount of residual monomer was not significantly different between the ultrasonic treatment in 50°C water (3 minutes for Unifast Trad Pink and 5 minutes for Unifast Trad Ivory and Unifast III) groups and the positive control group (P > 0.05).

Conclusion

Ultrasonic treatment with 50°C water for 3–5 minutes for autopolymerized resin and 3 minutes for heat-polymerized acrylic resin reduced the amount of residual monomer similarly to previously recommended methods, using shorter treatment times.

Biocompatibility of a titanium dioxide-coating method for denture base acrylic resin

OBJECTIVES

Ease of denture cleaning is of paramount importance in geriatric patients and those with limited dexterity. We have previously investigated methods of coating dentures with titanium dioxide (TiO₂ ) and reported the effects (self-cleaning and antibacterial) of such treatments in in vitro studies. This study was to verify the biocompatibility of a TiO₂ -coated acrylic resin produced by the new coating method with spray-coating technique.

METHODS

Specimens were prepared from denture base acrylic resin and polished up to grit #1000. The TiO₂ -coating agent was sprayed onto the specimens using an airbrush gun. Specimens were then divided into 'polymethyl methacrylate (PMMA)', 'primer-coated PMMA' and 'TiO₂ -coated PMMA' groups to be evaluated for biological safety using a hamster oral mucosa irritation test, a guinea pig skin sensitisation test and a rabbit intracutaneous test. The biological reaction was scored.

RESULTS

Reaction scores were considerably <1.0, the acceptable limit set by the ISO, in all three tests. Indeed, in most samples, there was no deleterious effect at all.

CONCLUSION

These results tested on animals demonstrate that denture base resin coated with TiO₂ by this method does not cause irritation or sensitisation of the oral mucosa, skin or intracutaneous tissue and is therefore good biocompatibility for use in close proximity to oral mucosa and skin.

Polyamide as a Denture Base Material: A Literature Review

The purpose of this article was to review the biocompatibility, physical, and mechanical properties of the polyamide denture base materials. An electronic search of scientific papers from 1990-2014 was carried out using PubMed, Scopus and Wiley Inter Science engines using the search terms "nylon denture base" and "polyamide denture base". Searching the key words yielded a total of 82 articles. By application of inclusion criteria, the obtained results were further reduced to 24 citations recruited in this review. Several studies have evaluated various properties of polyamide (nylon) denture base materials. According to the results of the studies, currently, thermo-injectable, high impact, flexible or semi-flexible polyamide is thought to be an alternative to the conventional acrylic resins due to its esthetic and functional characteristics and physicochemical qualities. It would be justifiable to use this material for denture fabrication in some cases such as severe soft/ hard tissue undercuts, unexplained repeated fracture of denture, in aesthetic-concerned patients, those who have allergy to other denture base materials, and in patients with microstomia.  Although polyamide has some attractive advantages, they require modifications to produce consistently better properties than the current polymethyl methacrylate (PMMA) materials. Moreover, since there is a very limited knowledge about their clinical performance, strict and careful follow-up evaluation of the patients rehabilitated with polyamide prosthesis is recommended.

Histopathological changes by the use of soft reline materials: a rat model study

Aim

To assess the histopathological changes of rat palatal mucosa exposed to soft reline materials.

Methods

Forty-five adult female Wistar rats with controlled living conditions and fed ad libitum were employed. Palatal appliances of heat-polymerized acrylic resin Lucitone 550 were manufactured and worn by forty animals during 14 days. Five animals did not use the appliances (G1) and were used to control the appliance influence. One experimental group (n = 10) used the appliances without any relining material (G2) to control the material effect. Three experimental groups (n = 10) received the following soft reline materials below appliances: Dentusoft (G3), Dentuflex (G4), and Trusoft (G5). Appliances from half of each experimental group(n = 5) was immersed in water bath at 55°C for 10 min before use. Animals were slaughtered and the palates were fixed in 10% buffered formalin. Hematoxylin and eosin stained sections of 5 µm were analyzed by computerized planimetry. Cellular compartment, keratin and total epithelial thickness, and basement membrane length were measured to histopathological description.Analysis of variance and Tukey post-hoc test were used to data examination(α = 0.05).

Results

For heat-treatment groups, G4 showed less elongated ridges at the basal layer interface (p = 0.037) than G2. When comparing the conditions with and without heat-treatment, only G2 showed a significant decrease in the cellular compartment, keratin layer and total epithelium thickness (p<0.05).

Conclusion

The post-polymerization for Lucitone 550 was an effective method to reduce the changes in the rat palatal mucosa. The soft reline materials tested did not cause significant histopathological changes in the rat palatal mucosa.

In vitro evaluation of long-term cytotoxic response of injection-molded polyamide and polymethyle metacrylate denture base materials on primary fibroblast cell culture

OBJECTIVE

This study investigated the long-term cytotoxic response of thermoplastic polyamide and conventional polymethyle metacrylate (PMMA) denture base materials.

MATERIALS AND METHODS

Twenty discs were prepared for each polyamide, heat and cold cured PMMA denture base resins (totally 60) and divided into four sub-groups (n = 5). Cytotoxicity was assessed with the direct cell contact method using cell viability and neutral red (NR) uptake assay. Each sub-group was tested at initial and after being aged for 24 h, 1 week and 8 weeks with artificial saliva according to ISO 10993 standards.

RESULTS

There were no significantly difference among the materials and control groups after initial, 24 h and 1 week testing. In 24 h testing, only Deflex was more toxic according to the Control group (p < 0.05). After 8 weeks of aging with artificial saliva, all materials were significantly cytotoxic when compared to the control group. QC20 was more toxic than Deflex and SC Cold Cure (p < 0.05). There were significant differences between the 8 week aging group and the initial, 24 h and 1 week testing for all materials (p < 0.05).

CONCLUSIONS

Cytotoxicity of all tested denture base materials increased significantly after the long-term aging. Therefore, long-term aging may be useful to determine a dental material's toxicity. Polyamide denture base material had a similar toxicity profile with conventional heat- and cold-cured PMMA.

Real-time cell analysis of the cytotoxicity of the components of orthodontic acrylic materials on gingival fibroblasts

INTRODUCTION

The aim of this study was to evaluate the cytotoxicity of 3 orthodontic acrylic materials and 2 manipulation methods.

METHODS

The orthodontic acrylic materials Orthocryl EQ (Dentaurum, Ispringen, Germany), Orthoplast (Vertex Dental, Zeist, The Netherlands), and O-80 (Imicryl, Konya, Turkey) were prepared with 2 polymerization methods (doughing and spray on). Totally, 60 cylinders (5 × 2 mm), fabricated by using a different acrylic and method, were divided into 6 groups. Gingival fibroblasts were isolated from gingival connective tissue of systemically healthy subjects. Materials were incubated in Dulbecco's modified eagle's medium culture medium (Biological Industries, Beit Haemek, Israel) for 72 hours according to ISO 10993-5 standards (surface area to volume ratio of the specimen to cell-culture medium: 3 cm(2)/mL). Gingival fibroblasts were maintained with Dulbecco's modified eagle medium containing 10% fetal bovine serum. A real-time cell analyzer (RT-CES, xCELLigence; Roche Applied Science, Mannheim, Germany, and ACEA Biosciences, San Diego, Calif) was used to evaluate cell survival. After seeding 200 μL of the cell suspensions into the wells (20,000 cells/well) of the E-plate 96, gingival fibroblasts were treated with bioactive components released by the acrylic materials (1/1 and 1/2 dilutions) and monitored every 15 minutes for 121 hours. For the proliferation experiments, the statistical analyses used were 1-way analysis of variance (ANOVA) and Tukey-Kramer multiple comparisons tests.

RESULTS

There was no significant difference between the cell indexes of the control and study groups for the 1/1 and 1/2 dilutions at 21 and 32 hours. When evaluated at 68 hours, all 1/2 dilutions of acrylic materials showed statistically insignificant differences (P >0.05) except for Orthoplast (P <0.05). But all acrylic materials were different from the control group in the 1/1 dilutions (P <0.001). At 121 hours, all test groups were significantly different from the untreated control group (P <0.001).

CONCLUSIONS

The results indicate that the long cycle increased the cytotoxicity of the tested materials, and there was no significant difference between the spray-on and doughing methods on cytotoxicity.

Effect of reduced exposure times on the cytotoxicity of resin luting cements cured by high-power led

Objective

Applications of resin luting agents and high-power light-emitting diodes (LED) light-curing units (LCUs) have increased considerably over the last few years. However, it is not clear whether the effect of reduced exposure time on cytotoxicity of such products have adequate biocompatibility to meet clinical success. This study aimed at assessing the effect of reduced curing time of five resin luting cements (RLCs) polymerized by high-power LED curing unit on the viability of a cell of L-929 fibroblast cells.

Material and Methods

Disc-shaped samples were prepared in polytetrafluoroethylene moulds with cylindrical cavities. The samples were irradiated from the top through the ceramic discs and acetate strips using LED LCU for 20 s (50% of the manufacturer's recommended exposure time) and 40 s (100% exposure time). After curing, the samples were transferred into a culture medium for 24 h. The eluates were obtained and pipetted onto L-929 fibroblast cultures (3x10⁴ per well) and incubated for evaluating after 24 h. Measurements were performed by dimethylthiazol diphenyltetrazolium assay. Statistical significance was determined by two-way ANOVA and two independent samples were compared by t-test.

Results

Results showed that eluates of most of the materials polymerized for 20 s (except Rely X Unicem and Illusion) reduced to a higher extent cell viability compared to samples of the same materials polymerized for 40 s. Illusion exhibited the least cytotoxicity for 20 s exposure time compared to the control (culture without samples) followed by Rely X Unicem and Rely X ARC (90.81%, 88.90%, and 83.11%, respectively). For Rely X ARC, Duolink and Lute-It 40 s exposure time was better (t=-1.262 p=0,276; t=-9.399 p=0.001; and t=-20.418 p<0.001, respectively).

Conclusion

The results of this study suggest that reduction of curing time significantly enhances the cytotoxicity of the studied resin cement materials, therefore compromising their clinical performance.

Effect of leaching residual methyl methacrylate concentrations on in vitro cytotoxicity of heat polymerized denture base acrylic resin processed with different polymerization cycles

OBJECTIVES

Residual methyl methacrylate (MMA) may leach from the acrylic resin denture bases and have adverse effects on the oral mucosa. This in vitro study evaluated and correlated the effect of the leaching residual MMA concentrations ([MMA]r) on in vitro cytotoxicity of L-929 fibroblasts.

MATERIAL AND METHODS

A total of 144 heat-polymerized acrylic resin specimens were fabricated using 4 different polymerization cycles: (1) at 74ºC for 9 h, (2) at 74ºC for 9 h and terminal boiling (at 100ºC) for 30 min, (3) at 74ºC for 9 h and terminal boiling for 3 h, (4) at 74ºC for 30 min and terminal boiling for 30 min. Specimens were eluted in a complete cell culture medium at 37ºC for 1, 2, 5 and 7 days. [MMA]r in eluates was measured using high-performance liquid chromatography. In vitro cytotoxicity of eluates on L-929 fibroblasts was evaluated by means of cell proliferation using a tetrazolium salt XTT (sodium 3´-[1-phenyl-aminocarbonyl)-3,4-tetrazolium]bis(4-methoxy-6-nitro)benzenesulphonic acid) assay. Differences in [MMA]r of eluates and cell proliferation values between polymerization cycles were statistically analyzed by Kruskal-Wallis, Friedman and Dunn's multiple comparison tests. The correlation between [MMA]r of eluates and cell proliferation was analyzed by Pearson's correlation test (p<0.05).

RESULTS

[MMA]r was significantly (p<0.001) higher in eluates of specimens polymerized with cycle without terminal boiling after elution of 1 and 2 days. Cell proliferation values for all cycles were significantly (p<0.01) lower in eluates of 1 day than those of 2 days. The correlation between [MMA]r and cell proliferation values was negative after all elution periods, showing significance (p<0.05) for elution of 1 and 2 days. MMA continued to leach from acrylic resin throughout 7 days and leaching concentrations markedly reduced after elution of 1 and 2 days.

CONCLUSION

Due to reduction of leaching residual MMA concentrations, use of terminal boiling in the polymerization process for at least 30 min and water storage of the heat-polymerized denture bases for at least 1 to 2 days before denture delivery is clinically recommended for minimizing the residual MMA and possible cytotoxic effects.