Influence of nanoparticles on color stability, microhardness, and flexural strength of acrylic resins specific for ocular prosthesis

Denture Base Resin Coated with Titanium Dioxide (TiO2): A Systematic Review

Background

The main objective of this systematic review was to evaluate the effect of coating with titanium dioxide nanoparticles (TiO2 nanoparticle) on the surface condition of removable acrylic resin prosthetic base materials.

Methods

Our review is registered in the PROSPERO database under the identification code CRD42023397170. Electronic database searches of PubMed, Scopus and Science Direct including studies from January 2009 to January 2023 were conducted and supplemented with manual searches. Research questions were generated in accordance with the PICO strategy. The modified Consolidated Standards of Reporting Trials (CONSORT) checklist was used to evaluate the quality of the selected studies.

Results

Since the included studies were variable in design, a meta-analysis was not performed. The electronic searches retrieved 29 references that met the eligibility criteria, among which 5 studies matched the inclusion criteria for this review. Significant differences were detected between the TiO2 NP-coated and uncoated groups. The available data indicate that TiO2 NP coating elicits antimicrobial activity and improves the wear resistance of polymethylmethacrylate (PMMA) surfaces. Moreover, the nanoparticles provide high levels of glossiness and decelerate the process of color change of heat-cured acrylic resin, thus increasing the lifespan of dentures.

Conclusion

The collective results clearly indicate that TiO2 nanoparticle coating induces alterations in the surface properties of pure PMMA, enhancing the mechanical, physical and biological characteristics of the denture base material. Further studies are essential to identify the optimal thickness of coating and concentrations of nanoparticles for clinical applications.

Antifungal Effect of Polymethyl Methacrylate Resin Base with Embedded Au Nanoparticles

Full and partial restorations in dentistry must replicate the characteristics of the patient's natural teeth. Materials must have good mechanical properties and be non-toxic and biocompatible. Microbes, which can form biofilms, are constantly in contact with restorations. In this study, we investigate how well Candida albicans adheres to a polymethyl methacrylate (PMMA) resin base with gold (Au) nanoparticles. We synthesized Au nanoparticles and characterized them. The average size of Au nanoparticles embedded in PMMA was 11 nm. The color difference ΔE between PMMA and PMMA/Au composites was 2.7 and was still esthetically acceptable to patients. PMMA/Au surfaces are smoother and more hydrophilic than pure PMMA surfaces, and the isoelectric point of both types of surfaces was 4.3. Above the isoelectric point, PMMA/Au surfaces are more negatively charged than PMMA surfaces. The added Au nanoparticles decreased the tensile strength, while the hardness did not change significantly. Adhesion measurements showed that PMMA surfaces modified with Au nanoparticles reduced the extent of microbial adhesion of Candida albicans.

Effect of addition of titanium dioxide nanoparticles on the antimicrobial properties, surface roughness and surface hardness of polymethyl methacrylate: A Systematic Review

Background: Polymethyl Methacrylate (PMMA) denture-base resins have poor surface properties that facilitates microbial adhesion causing denture stomatitis. This systematic review aims to evaluate the effect of different sizes and percentages of titanium dioxide nanoparticles (TiO2NP) on the antimicrobial property, surface roughness and surface hardness of PMMA denture base resin.  Methods: A systematic search of English peer-reviewed articles, clinical trial registries, grey literature databases and other online sources was performed using the PRISMA-S Guidelines for In-Vivo and In-Vitro studies. Qualitative data synthesis was performed to analyse sample dimensions, acrylic used, treatments of nanoparticles, methods used for testing and effect of size and percentage of nanoparticle. Risk of bias assessment was done using modified Cochrane risk of bias tool. Results: Out of 1376 articles, 15 were included. TiO 2NP of size less than 30 nm was most frequently used. Both antimicrobial property and surface hardness improved irrespective of the size of the added TiO 2NP. Three studies reported increase in the surface roughness with less than 50 nm TiO 2NP.  3% TiO 2NP was most frequently used. On increasing the percentage, three studies reported an increase in antimicrobial property, while two studies found no change. With TiO 2NP greater than or equal to 3%, six studies reported an increase in surface hardness, while two reported increase in surface roughness. Large methodological variations were observed across studies. All studies except one were of moderate quality. Conclusions:   On addition of TiO 2NP to heat polymerized PMMA, the antimicrobial property and surface hardness improved irrespective of the size of the TiO 2NP, however, addition of nanoparticles less than 50 nm increased the surface roughness. Increasing the percentage of TiO 2NP increased the surface hardness but did not always increase the antimicrobial property. Addition of 3% TiO 2NP provided optimum results with regards to antimicrobial effect and surface hardness, but increase in the surface roughness.

Evaluation of microhardness in two types of denture bases after using sodium hypochlorite and NatureDent disinfecting agents

Background. Chemical agents, in combination with mechanical methods, play an important role in reducing microbial plaque on denture surfaces. However, these methods might change the mechanical behavior of acrylic resins, including microhardness and surface roughness. This in vitro study investigated the effect of two disinfectants, i.e., water and sodium hypochlorite, on the microhardness of conventional heat-cured and TiO₂ nanoparticle-reinforced acrylic resins. Methods. Sixty acrylic resin specimens were divided into two groups, and the samples in each group were randomly assigned to three subgroups (n=10). Heat-cured specimens and 1 wt% TiO₂ acrylic resin were prepared and immersed in three solutions: water, a solution prepared with NatureDent pills, and 1% sodium hypochlorite for 30, 60, and 90 days. Microhardness tests were performed on each sample at each immersion stage. The data were analyzed using descriptive statistical methods, three-way and one-way ANOVA, repeated-measures t test, and Tukey HSD tests using SPSS 17. P values<0.05 were considered significant. Results. All three independent parameters, including resin, solution, and time, significantly affected microhardness (P<0.05). The microhardness of both specimen types, i.e., conventional heat-cured and TiO₂ nanoparticle-reinforced acrylic resins, immersed for 30, 60, and 90 days, was the highest and lowest in water and hypochlorite solutions, respectively. Regarding 90 days, the microhardness values of conventional heat-cured and TiO₂ nanoparticle-reinforced acrylic resins were 17.050±0.094 and 19.953±0.053 in water, 15.675±0.069 and 18.965±0.037 in hypochlorite, and 16.713±0.122 and 19.39±20.113 in NatureDent solutions, respectively. Conclusion. Disinfecting two types of acrylic resin specimens decreased their microhardness as a function of immersion time for up to 90 days in the three solutions. However, the magnitude of hardness lost was less for TiO₂ nanoparticles-reinforced acrylic resin.

Influence of Different Beverages on the Color Stability of Nanocomposite Denture Base Materials

BACKGROUND

The effect of beverages on nanocomposite denture base materials is neglected. Therefore, this study aimed to investigate the influence of different beverages (coffee, tea, cola, and mineral water) on the color stability of nanoparticles-modified denture base materials (DBMs).

MATERIALS AND METHODS

A total of 280 specimens (n = 10/group) were prepared from heat-polymerized acrylic resin modified with different concentrations (3% and 7%) of zirconium dioxide (nano-ZrO2), titanium dioxide (nano-TiO2), and silicon dioxide (nano-SiO2) nanoparticles, while 0% was taken as a control. Color change (∆E) of the specimens was evaluated after simulating 6-month immersion time in four commonly used beverages, coffee, tea, cola, and mineral water, as experimental groups. Color stability was measured using a spectrophotometer, and then values were converted to National Bureau of Standards units (NBS units). The one-way ANOVA test was applied to compare color change (ΔE) results followed by Bonferroni's post hoc test (α = 0.05).

RESULTS

The results showed that the heat-polymerized acrylic resin modified with different types of nanoparticles showed lower color changes after being immersed in beverage solutions compared to the unmodified group (P < 0.001), so the color stability of heat-polymerized acrylic resin was significantly enhanced by the addition of several nanoparticles; nano-ZrO2 showed the lowest ΔE followed by nano-TiO2 and then nano-SiO2. Regardless of the filler type, 3% concentration showed lower mean ΔE than 7% concentration. Regarding the beverage solutions, the greatest color change was found in the coffee group followed by tea and cola, while water showed the least changes.

CONCLUSION

Modification of heat-polymerized acrylic resin with certain amounts of nano-ZrO2, nano-TiO2, and nano-SiO2 may be useful in improving color stability.

Incorporation of Chitosan Nanoparticles into a Cold-Cure Ortho-Dontic Acrylic Resin: Effects on Mechanical Properties

Improvement of the antibacterial properties of acrylic resins, used in the construction of removable orthodontic appliances, is an important strategy to reduce the incidence of caries and oral diseases in orthodontic treatments. The addition of antimicrobial agents to acrylic resins is one of the effective methods to enhance the antimicrobial properties of these materials. However, one main concern is that modification of acrylic resin has negative effects on its mechanical properties. Recently, chitosan nanoparticles (NPs), as biocompatible and biodegradable polysaccharides with remarkable antimicrobial properties, have been used in different areas of dentistry and medicine. This study aimed to investigate the effects of adding chitosan NPs on the mechanical properties of a cold-cure orthodontic acrylic resin. The chitosan NPs were added to the acrylic resin in various weight percentages: 0% (control), 0.5%, 1%, 2%, and 4%. The flexural strength, compressive strength, Vickers microhardness, and impact strength measurements were performed for all five groups. The results showed that adding up to 1% (w/w) chitosan NPs to an acrylic resin had no significant negative effects on its flexural strength and compressive strength, while it decreased these parameters at weight percentages of 2% and 4% (w/w). The results also revealed that modification of acrylic resin with chitosan NPs up to 4% had no significant negative effects on the microhardness and impact strength of acrylic resin. In conclusion, the addition of chitosan NPs up to 1% (w/w) had no significant negative effects on the mechanical properties of cold-cure acrylic resin.

The Effect of Nano Zinc Oxide Particles on Color Stability of MDX4-4210 Silicone Prostheses

Objective  This article aimed to study the effect of different concentrations of nano zinc oxide particles on the color change of MDX4–4210 facial silicone elastomer after artificial aging.

Materials and Methods  Silicone specimens ( N = 150) were fabricated by incorporating intrinsic pigments and divided into three groups—white, yellow, and red, each group consisting of 50 specimens ( n = 50). In each color, specimens were subdivided into five subgroups according to the quantity of zinc oxide nanoparticles (0, 0.5, 1.0, 1.5, and 2.0% weight), where the 0% weight served as the control in each group. All specimens were then subjected to artificial aging using an accelerated aging machine chamber for 12, 24, 48, and 72 hours. L*a*b* values of specimens were noted after a different aging period by a spectrophotometer and ∆ E * was calculated.

Statistical Analysis  Two-way repeated analysis of variance (ANOVA) was done to examine the effects under test conditions (concentration and aging time) of each color group. Then color, concentration, and the aging period were subjected to three-way repeated ANOVA to investigate the effects of different colors and concentrations on ∆ E *. Bonferroni’s test was performed to identify differences between groups. The significant level was at p = 0.05.

Results  The control group showed significantly higher ∆ E * values than the test groups. The 1.5% test group showed significantly lower ∆ E * compared with the others. The 0.5 to 2.0% of nano zinc oxide significantly decreased the color change of the silicone elastomer ( p < 0.05), but there were no significant differences among groups.

Conclusions  Incorporation of 1.5% of nano zinc oxide can improve the color stability of silicone prosthesis (MDX4–4210).

Advancements in Soft-Tissue Prosthetics Part B: The Chemistry of Imitating Life

Each year, congenital defects, trauma or cancer often results in considerable physical disfigurement for many people worldwide. This adversely impacts their psychological, social and economic outlook, leading to poor life experiences and negative health outcomes. In many cases of soft tissue disfigurement, highly personalized prostheses are available to restore both aesthetics and function. As discussed in part A of this review, key to the success of any soft tissue prosthetic is the fundamental properties of the materials. This determines the maximum attainable level of aesthetics, attachment mechanisms, fabrication complexity, cost, and robustness. Since the early-mid 20th century, polymers have completely replaced natural materials in prosthetics, with advances in both material properties and fabrication techniques leading to significantly improved capabilities. In part A, we discussed the history of polymers in prosthetics, their ideal properties, and the application of polymers in prostheses for the ear, nose, eye, breast and finger. We also reviewed the latest developments in advanced manufacturing and 3D printing, including different fabrication technologies and new and upcoming materials. In this review, Part B, we detail the chemistry of the most commonly used synthetic polymers in soft tissue prosthetics; silicone, acrylic resin, vinyl polymer, and polyurethane elastomer. For each polymer, we briefly discuss their history before detailing their chemistry and fabrication processes. We also discuss degradation of the polymer in the context of their application in prosthetics, including time and weathering, the impact of skin secretions, microbial growth and cleaning and disinfecting. Although advanced manufacturing promises new fabrication capabilities using exotic synthetic polymers with programmable material properties, silicones and acrylics remain the most commonly used materials in prosthetics today. As research in this field progresses, development of new variations and fabrication techniques based on these synthetic polymers will lead to even better and more robust soft tissue prosthetics, with improved life-like aesthetics and lower cost manufacturing.

Impact Strength and Dimensional Accuracy of Heat-Cure Denture Base Resin Reinforced With ZrO2 Nanoparticles: An In Vitro Study

Background:

Polymerization shrinkage and fracture are the two common trouble shoots with denture base resins. Polymerization shrinkage affects the dimensional accuracy and fit of the prosthesis. The effect of zirconia (ZrO₂) nanoparticles on polymerization shrinkage is not documented yet.

Purpose:

The aim and objective of this study were to evaluate the impact strength and dimensional accuracy of heat-cured poly methyl methacrylate (PMMA) on reinforcement with ZrO₂ nanoparticles.

Materials and Methods:

Conventional heat-cure denture base resin (control) and the polymer reinforced with 3, 5, and 7 wt% of ZrO₂ nanoparticles were prepared and used in this study. Forty bar-shaped specimens were prepared and tested for impact strength using Charpy’s type impact tester. Forty denture bases were fabricated and checked for dimensional accuracy by measuring the distance between the denture base and the cast in two different sections using the travelling microscope.

Results:

The impact strength decreased with increased concentration of ZrO₂ and found to be least at 7 wt% concentration (2.01 ± 0.26 J/mm²). The distance between the denture base and the cast significantly decreased both in the posterior palatal seal region (0.060 ± 0.007 cm) and mid-palatine section region (0.057 ± 0.006 cm) with ZrO₂ nanoparticles reinforcement and was found to be least at 7 wt% concentration.

Conclusion:

Reinforcement of heat-cured PMMA with ZrO₂ nanoparticles significantly increased the dimensional accuracy and decreased the impact strength.

Effect of Storage in Distilled Water for Three Months on the Antimicrobial Properties of Poly(methyl methacrylate) Denture Base Material Doped with Inorganic Filler

The colonization of poly(methyl methacrylate) (PMMA) denture base materials by pathogenic microorganisms is a major problem associated with the use of prostheses, and the incorporation of antimicrobial fillers is a method of improving the antimicrobial properties of these materials. Numerous studies have demonstrated the initial in vitro antimicrobial effectiveness of this type of material; however, reports demonstrating the stability of these fillers over longer periods are not available. In this study, silver sodium hydrogen zirconium phosphate was introduced into the powder component of a PMMA denture base material at concentrations of 0.25%, 0.5%, 1%, 2%, 4%, and 8% (w/w). The survival rates of the gram-positive bacterium Staphylococcus aureus, gram-negative bacterium Escherichia coli and yeast-type fungus Candida albicans were established after fungal or bacterial suspensions were incubated with samples that had been previously stored in distilled water. Storage over a three-month period led to the progressive reduction of the initial antimicrobial properties. The results of this study suggest that additional microbiological tests should be conducted for materials that are treated with antimicrobial fillers and intended for long-term use. Future long-term studies of the migration of silver ions from the polymer matrix and the influence of different media on this ion emission are required.