Characteristics of denture thermoplastic resins for non-metal clasp dentures

Comparative Analysis of the Mechanical Properties and Biocompatibility between CAD/CAM and Conventional Polymers Applied in Prosthetic Dentistry

Modern media often portray CAD/CAM technology as widely utilized in the fabrication of dental prosthetics. This study presents a comparative analysis of the mechanical properties and biocompatibility of CAD/CAM (Computer-Aided Design/Computer-Aided Manufacturing) polymers and conventional polymers commonly utilized in prosthetic dentistry. With the increasing adoption of CAD/CAM technology in dental laboratories and practices, understanding the differences in material properties is crucial for informed decision-making in prosthodontic treatment planning. Through a narrative review of the literature and empirical data, this study evaluates the mechanical strength, durability, esthetics, and biocompatibility of CAD/CAM polymers in comparison to traditional polymers. Furthermore, it examines the implications of these findings on the clinical outcomes and long-term success of prosthetic restorations. The results provide valuable insights into the advantages and limitations of CAD/CAM polymers, informing clinicians and researchers about their suitability for various dental prosthetic applications. This study underscores the considerable advantages of CAD/CAM polymers over conventional ones in terms of mechanical properties, biocompatibility, and esthetics for prosthetic dentistry. CAD/CAM technology offers improved mechanical strength and durability, potentially enhancing the long-term performance of dental prosthetics, while the biocompatibility of these polymers makes them suitable for a broad patient demographic, reducing the risk of adverse reactions. The practical implications of these findings for dental technicians and dentists are significant, as understanding these material differences enables tailored treatment planning to meet individual patient needs and preferences. Integration of CAD/CAM technology into dental practices can lead to more predictable outcomes and heightened patient satisfaction with prosthetic restorations.

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.

Different Polymers for the Base of Removable Dentures? Part I: A Narrative Review of Mechanical and Physical Properties

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.

The Cytotoxic Effect of Thermoplastic Denture Base Resins: A Systematic Review

Partial or complete dentures are constructed from thermoplastic resins that are thermally processed and molded. This review examines the presently available evidence for the cytotoxicity of thermoplasticized denture base resins on human gingival epithelial cells, adipose cells, and fibroblasts; human amnion fibroblasts; and mouse fibroblasts. Electronic searches were performed on PubMed, Scopus, Web of Science, and Google Scholar databases to identify relevant articles to be included in the review until September 2022. Clinical, in vivo, and in vitro studies in English language were searched for. The quality of the studies was assessed using the Toxicological data Reliability Assessment tool (ToxRTool) developed by the European Commission's Joint Research Centre. GRADE assessment was used to evaluate the certainty of evidence. Seven in vitro studies were included in the review. The overall risk of bias was determined to be high, with the majority of studies assessed found to be reliable with restrictions or not reliable. Only two studies were considered reliable without restrictions based on ToxRTool assessment. The effect of thermoplastic denture base resins on viability and cell adherence of human gingival or amnion fibroblasts and mouse fibroblasts (L929s) is not significant. Conditioned media from unpolished specimens of resins were significantly more toxic to cultured cells than those from polished specimens. This may be of concern in cases of poor post-processing of dentures. Based on the limited evidence available, there is low-certainty evidence that thermoplastic denture base resins appear to be biocompatible and show insignificant cytotoxicity. Further well-designed trials adhering to standard reporting guidelines and using objective measures are necessary before outlining universal guidelines for best practice. Long-term in vivo and clinical assessment is necessary to corroborate laboratory findings with clinical outcomes. Denture base resins are in constant contact with oral tissues, and cytotoxic components released by the resins may irritate or inflame the tissues or provoke an allergic response.

Effect of cigarette smoke and denture cleansers on the surface properties and color stability of CAD-CAM and conventional denture base resins

This study aimed to evaluate the hardness, roughness, and color stability of heat- and microwave-polymerized polymethyl methacrylate (PMMA), polyamide, and CAD-CAM PMMA resins when exposed to cigarette smoke (CS) and immersed in a denture cleanser (DC). Specimens of each resins were divided into four subgroups (n=10). The DC and CS+DC specimens were immersed in a DC; the CS and CS+DC specimens were exposed to CS; and the control (C) specimens were kept in distilled water. Hardness, roughness, and color measurements were performed. DC and CS significantly affected the roughness and color of all resins (p<0.05). However, these did not affect the hardness of the CAD-CAM PMMA resin (p>0.05). The CAD-CAM PMMA resin presented the lowest roughness, highest hardness, and lowest ΔE₀₀ values. While the roughness of all resins exposed to CS when immersed in DC decreased, the ΔE₀₀ values of the conventional PMMAs also decreased. Although this decreases were not significant, it may be advisable to use DC for smokers to decrease discoloration and roughness especially for conventional PMMAs resins.

Factors influencing retention and durability of attachments for overdentures - adverse effects of cleansings, pH, and temperature: A systematic review

Aim

The objective of this systematic review is to show the current state of the art on which type of attachment loses retention the most and has reduced durability and which factor causes these problems the most.

Material and methods

This review followed the Preferred Reporting Items for Systematic Review and MetaAnalysis (PRISMA) guidelines and it was registered with the Open Science Framework (OSF) (osf.io/2e3q5). The databases used for the electronic search of articles were Pubmed, Science Direct, Embase, and Scopus. Articles were selected by 2 independent reviewers according to the inclusion criteria. The risk of bias was analyzed by using the Joanna Briggs Institute (JBI) adapted quasi-experimental study evaluation tool.

Results

The studies included in this review indicate that the use of cleansing solutions, high temperatures, and a more acidic pH decrease the durability of the attachments, mainly due to the loss of retention that occurs in different models and materials of the attachments, which requires their replacement in a shorter period.

Conclusion

Of all the factors studied, the cleansing solutions proved to be the factor that most altered attachment retention. Different saliva compositions did not influence retention values. Aging changes retention values for attachments, mostly with loss of values.

Changes in the Surface Texture of Thermoplastic (Monomer-Free) Dental Materials Due to Some Minor Alterations in the Laboratory Protocol-Preliminary Study

Contemporary thermoplastic monomer-free prosthetic materials are widely used nowadays, and there are a great variety available on the market. These materials are of interest in terms of the improvement of the quality features of the removable dentures. The aim of this study is to establish how minimal changes in the laboratory protocol of polyamide prosthetic base materials influence the surface texture. Two polyamide materials intended for the fabrication of removable dentures bases were used-Perflex Biosens (BS) and VertexTM ThermoSens (TS). A total number of 20 coin-shaped samples were prepared. They were injected under two different modes-regular, as provided by the manufacturer, and modified, proposed by the authors of this study. Scanning electronic microscopy (SEM) under four magnifications-×1000, ×3000, ×5000, and ×10,000-was conducted. With minimal alterations to the melting temperature (5 °C) and the pressure (0.5 Bar), in Biosens, no changes in terms of surface improvement were found, whereas in ThermoSens, the surface roughness of the material significantly changed in terms of roughness reduction. By modifying the technological mode during injection molding, a smoother surface was achieved in one of the studied materials.

Removable Partial Denture Frameworks in the Age of Digital Dentistry: A Review of the Literature

Alloys of cobalt chromium have been used for decades to create frameworks for removable partial dentures. While cobalt chromium has multiple advantages, such as strength and light weight, the casting process is laborious and requires special care to ensure that human error is minimized. Furthermore, the display of metal clasps in these frameworks may be considered a limitation at times, especially with esthetically demanding patients. The introduction of digital technology to manufacturing in dentistry has brought forward new methods of fabricating cobalt chromium frameworks, some of which eliminate the casting process. Moreover, the development of high-performance polymers for use as removable partial denture frameworks brings multiple advantages, but raises concerns over design guidelines and principles. This review examines alternatives to conventionally cast frameworks so that clinicians may make evidence-based decisions when choosing framework materials and fabrication methods in the rapidly advancing world of digital dentistry.

Comparison of the Effect of Denture Cleansers on Long-Term Water Sorption and Solubility of Polyetheretherketone with other Denture Base Materials

Objective: In this in vitro study, the effect of three denture cleansers (DCs) after immersion in a chemical solution applied to polyetheretherketone (PEEK) and other denture base materials (DBMs) on long-term water sorption and solubility was compared. Methods: Disk-shaped specimens (50±1.0-mm diameter and 0.5±0.1-mm thickness) were prepared from four DBMs (n=48). All specimens were randomly subdivided into four storage media groups (n=12): Corega tablet (CT), Protefix tablet (PT), 1% sodium hypochlorite (NaOCl) solution (SH), and control (distilled water, DW). Storage media were renewed thrice a day for 120 days and simulated for 1-year use of overnight immersion. Water sorption and solubility (µg/mm3) of DBMs before and after immersion in storage media were examined and obtained data were statistically analyzed using a multivariate analysis of variance, followed by multiple comparisons by a posthoc Tukey’s test (p

CAD/CAM Diagnostic Esthetic Functional Splint (DEFS) as a Removable Prototype to Evaluate the Final Prosthetic Rehabilitation: A Narrative Review

The main objective of this narrative review was to provide an overview of DEFS (Diagnostic Esthetic Functional Splint), namely CAD/CAM manufactured, “snap-retained”, tooth-colored splints available by materials exhibiting a certain degree of elasticity (like polycarbonates or acetal resins) for restoring function, esthetics and occlusion in several clinical situations, before or as an intermediate alternative to undergoing the final treatment. The search strategy included all papers dealing with snap-retained prosthetic systems and was based on a literature review of papers available in electronic databases (Pubmed/Medline, Evidence-Based Dentistry, BMJ Evidence-Based Medicine, Dynamed, Embase, BMJ Clinical Evidence, Web of Science, Scientific reports); eligible papers were researched on Opengreyand a manual search was performed, as well. From the electronic databases emerged 13,199 records, many of which were duplicates. The grey literature and the manual research did not produce any eligible article. After duplicates removal, 7690 records were obtained. Titles, abstracts and keywords were analyzed. The studies concerning the topic of interest were examined by the reviewers and discussed. Although no evidence-based data were found in the literature, according to the authors’ clinical experience, the DEFS (Diagnostic Esthetic Functional Splint) is a very promising solution in multiple clinical situations, due to its diagnostic, therapeutical, functional and esthetic versatility.

Linear Dimensional Change and Ultimate Tensile Strength of Polyamide Materials for Denture Bases

The aim of the current study was to evaluate the dimensional changes and ultimate tensile strength in three polyamide materials for denture bases fabrication through injection molding, subjected to artificial aging and different storage conditions. A total of 333 test specimens fabricated from Biosens (BS; Perflex, Netanya, Israel), Bre.flex 2nd edition (BF; Bredent, Senden, Germany) and ThermoSens (TS; Vertex Dental B.V., Soesterberg, The Netherlands)—n = 111 per material—were equally divided into three groups (n = 37) based on different treatments and storage conditions. Test samples allocated to the “Control group” were not artificially aged and stored in water for 24 h. Both “Treatment 1 group” and “Treatment 2 group” were subjected to thermocycling, the former dehydrated and the latter stored in water between cycle-sets. Linear changes and ultimate tensile strength were measured and analyzed for storage condition and material influence on the outcome variables. A Welch ANOVA test with Games–Howell post-hoc analysis was used to compare the influence of treatments across different materials. Significant differences were found for all three included materials with p values ranging from <0.05 to <0.001 for linear dimensional changes. The magnitude of alterations varied and was large for BS (Perflex, Israel) (ω² = 0.62) and BF (Bredent, Germany) (ω² = 0.47) and small but significant for TS (Vertex Dental B.V., The Netherlands) (ω² = 0.05). However, results seem to fall into clinically acceptable range. Significant differences were also observed for the ultimate tensile strength test with the same range of p-values. All three materials showed different initial ultimate tensile strengths and varying reaction to artificial aging and storage with the lowest alterations observed for BF (Bredent, Germany) (ω² = 0.05). Within the limitation of this study, it can be concluded that all three materials show different dimensional and mechanical properties when subjected to artificial aging and different storage. Although linear dimensions show significant changes, they seem to be clinically irrelevant, whereas the change in ultimate tensile strength after only 6-month equivalent clinical use was substantial for BS (Perflex, Israel) and TS (Vertex Dental B.V., The Netherlands).

Stress distribution and patient satisfaction in flexible and cast metal removable partial dentures: Finite element analysis and randomized pilot study

Purpose

To compare stress distribution in polyacetyl based flexible RPD (FRPD) with cast metal RPD (CRPD) by using three-dimensional finite element analysis (FEA) and patient satisfaction by using OHIP-14 questionnaire in participants with Kennedy's class I partially edentulous mandibular arch rehabilitated with CRPD and FRPD.

Material and methods

For FEA, 3D models of Kennedy's class I partially edentulous mandibular arch, CRPD in chrome-cobolt alloy, and polyacetyl based FRPD were geometrically modelled and subjected to a vertical load of 100 ​N bilaterally. The in vivo comparison of satisfaction was assessed by enrolling 22 participants with Kennedy's class I partially edentulous mandibular arch. After randomization, 11 participants were rehabilitated by CRPD (group C), and 11 participants by polyacetyl based FRPD (group F). OHIP-14 questionnaire in Hindi language was filled at 1 week and 1 year after denture insertion.

Results

Von Mises stress distribution in CRPD was maximum in mesial rest seat of the primary abutment (100 ​MPa) and minimum for edentulous ridge (7 ​MPa on bone and 6 ​MPa on mucosa). Von Mises stress distribution for polyaccetyl based FRPD was maximum in ridge (25 ​MPa) and minimum in periodontal ligament of the second premolar (3 ​MPa). Patient satisfaction in group F was significantly more than in group C at end of 1 year (P ​= ​.0158).

Conclusion

FRPD is useful in periodontally compromised abutment teeth and CRPD in resorbed ridge conditions. Patient satisfaction is more with polyacetyl based flexible RPD when compared with cast metal RPD at the end of 1 year.

Effect of Staining Solutions on Color Stability, Gloss and Surface Roughness of Removable Partial Dental Prosthetic Polymers

PURPOSE

To assess the effect of commonly used solutions on color stability, gloss, and surface roughness of removable partial dental prostheses polymers.

MATERIALS AND METHODS

Discs (n = 112) were made of a poly(etheretherketone) (PEEK) polymer, a polyamide, an acetal resin and a heat-cured poly(methylmethacrylate) PMMA acrylic resin polished according to manufacturers' instructions. Seven specimens of each material were immersed in coffee, red wine, coca cola and distilled water for 30 days at 37^ο C. Changes of color (ΔΕ*) and color coordinates L*α*b* after immersion were calculated with a colorimeter. Changes in the values of gloss and surface roughness parameters (Sa, Sz, Str, Sdr, Sci, Svi) were also measured. Two-way ANOVA and pairwise comparisons were used to evaluate the effect of material and staining solution on parameter value alterations (α = 0.05).

RESULTS

The two-way ANOVA revealed that the interaction between material and staining solution significantly affected color changes after immersion [F(9,96) = 44.67, p < 0.001]. PEEK presented the lowest color change (ΔΕ* = 3.83 ± 2) while polyamide had the highest color change overall (ΔΕ* = 14.59 ± 8.65) (p < 0.001). Coffee caused the highest color (ΔΕ* = 13.08 ± 6.98) and gloss changes (ΔG = -6.36 ± 19.2 GU) among different solutions (p < 0.001). PEEK showed the highest alteration of gloss (ΔG = -11.31 ± 15.49 GU), with significant difference with the other three materials (p < 0.001). Insignificant interaction of material and immersing solution was found for surface roughness parameters (p > 0.05).

CONCLUSIONS

Among the materials tested, PEEK seemed to be the most stable material when subjected to common, everyday staining solutions. Therefore, PEEK could be a viable solution for an RPDP framework fabrication, expanding the material list of prosthetic options. Further research and clinical trials are required to confirm the above statement.

Mechanical performance of experimental acrylic resins modified by nanoparticles after chemical and mechanical degradation

Background

Different materials have been incorporated into the polymethylmethacrylate matrix to improve its performance. The aim of this study was to evaluate the degree of conversion (DC), the flexural strength (FS), the elasticity modulus (EM), and the effect of exposure to food-simulating liquids prior to brushing simulation on the gloss loss (GL) of experimental acrylic resins modified by nanoparticles.

Material and Methods

Three different types of nanoparticles; silicon oxide (SiO2), cerium oxide (CeO2) and titanium oxide (TiO2) were added to a poly (methylmethacrylate) matrix, in proportions of 0.5wt%, 1wt% and 3wt% each, forming nine experimental groups. The acrylic resin was also tested as a control group. DC was investigated using Fourier transform infrared spectroscopy (FTIR). A three-point bending test was used for FS and EM. GL after chemical degradation and simulated brushing was evaluated using a glossmeter. Data were submitted to one and two-way ANOVA followed by Duncan’s post hoc test (α=0.05).

Results

All nanoparticle-modified groups showed higher values of DC. Ce1% showed higher values of FS and EM. All other groups showed similar or lower physical-mechanical properties (FS, EM, GL). Regarding type and wt%, CeO2 and TiO2 groups had better performances and were similar to each other.

Conclusions

Incorporating metal nanoparticles, especially CeO2, could improve the physical properties of the dental materials.

Key words:Polymethylmetacrylate, degree of conversion, flexural strength, elasticity modulus, gloss loss.

Bending Behaviour of Polymeric Materials Used on Biomechanics Orthodontic Appliances

This paper discusses the issues of strength and creep of polymeric materials used in orthodontic appliances. Orthodontic biomechanics is focused on the movement of individual teeth or dental groups as a result of the force applied by orthodontic appliances. Stresses in the construction of functional and biomechanical appliances is generated when using the apparatus in the oral cavity. The orthodontic appliance must maintain its shape and not be damaged during treatment so strength and creep resistance are fundamental properties. It was assumed that the clinical success of orthodontic appliances can be determined by these performance properties. The aim of the work was the experimental assessment of comparative bending strength and creep resistance of selected popular polymer materials used in the production of biomechanical orthodontic appliances. Four commercial materials manufactured by the world class producers were tested: NextDent Ortho Rigid (Vertex-Dental B.V., Soesterberg, The Netherlands) marked as "1A"; Erkocryl (ERKODENT Erich Kopp GmbH, Pfalzgrafenweiler, Germany)-"2A"; Vertex Orthoplast (Vertex Dental B.V.), blue, marked as "3A" and material with the same name as "3A" but orange, marked in the article as "4A". All the tests were carried out after aging in artificial saliva for 48 h at a temperature of 37 °C. Flexular strength and flexular modulus were made using the three point bending method according to the ISO 178 technical standard. Creep tests were carried out according to the method contained in ISO 899-2. The creep test was carried out in an artificial saliva bath at 37 °C. The creep tests showed significant differences in the strength, modulus and deformability of the tested materials. The strength reliability of the tested materials also varied. The research shows that the 2A material can be used for orthodontic applications in which long-term stresses should be lower than 20 MPa.

Influence of Various Chemical Surface Treatments, Repair Materials, and Techniques on Transverse Strength of Thermoplastic Nylon Denture Base

The process of repairing the fractured nylon denture bases and addition of acrylic teeth to the previously worn nylon denture bases has not been widely studied. This study aims to assess the transverse strength of nylon denture bases repaired by various resin materials, different curing techniques, and types of surface treatments. Materials and Methods. One hundred fifty thermoplastic nylon denture base samples were fabricated using plastic patterns measuring 65 × 10 × 2.5 mm (length, width, and thickness, respectively). These samples were then divided into three equal groups. Fifty samples were repaired by microwave heat-polymerization, fifty samples were repaired using the Ivomate autopolymerization, and the other fifty were repaired using light-polymerized acrylic resin. Each of these three groups was further divided into five subgroups of ten samples based on the type of surface treatment. The samples in the control group did not undergo any surface treatment, and the other four groups were chemically surface treated with monomer, acetone, ethyl acetate, and isopropanol, respectively. A three-point bending test was used to calculate the transverse strength values of the samples. Fourier transform infrared (FTIR) analysis was conducted to determine the component of functional groups between the polyamide nylon base and poly(methyl-methacrylate) PMMA repair materials. A polarizing microscope was utilized to investigate the mode of failure at the fracture surfaces. Results. The collected data were analyzed with one-way ANOVA and Sidak's multiple comparison test to show the differences among different groups. For surface treatments, the highest transverse strength values were obtained by monomer-treated samples (18.29 N/mm²); however, the lowest values were obtained in non-surface treated samples (5.58 N/mm²). While for repair techniques, the highest transverse strength values were obtained by microwave processing, followed by Ivomate and then the light-cured polymerization. The means were found to be significant (p < 0.001). FTIR analysis shows the presence of hydrogen bonding which is due to the ester and amid groups which enhance the bond strength of the surface-treated samples. The interface of the polarizing microscope images revealed a cohesive fracture within repair materials rather than the adhesive nature. Conclusion. The microwave-polymerized resin was considered as the most effective repair technique along with monomer chemical etchant which creates a tight adhesion between PMMA and nylon denture base in comparison to other groups.

Evaluation of various denture cleansers on color stability and surface topography of polyetherketoneketone, polyamide, and polymethylmethacrylate

The aim of this study was to evaluate the effect of sodium perborate effervescent tablets and citric acid solution on the color stability and surface topography of a new generation of high-performance polymer polyetherketoneketone (PEKK), thermoinjection-molded polyamide, and polymethylmethacrylate (PMMA). Fifty disc-shaped specimens were fabricated (10 mm × 2 mm) from PEKK (P group), polyamide (D group), and PMMA (M group). These groups were divided into five subgroups (n = 10) according to the storage media. The test groups were immersed in the following solutions: distilled water (Control), Corega, Protefix, Perlodent, and Curaprox. The color stability values (ΔE) were measured using a spectrophotometer before and after immersion in distilled water and four different denture cleansers for 8 hr/day for 140 days. Topography alterations after treatments were assessed with scanning electron microscopy (SEM). Data were analyzed by one-way analysis of variance (ANOVA) followed by Tukey's Honest Significant Difference test. The p < .05 was considered significant. All denture cleansers increased the ΔE values relative to the baseline values in the M, D, and P groups (p < .05). The Perlodent denture cleanser demonstrated the highest ΔE value in all groups, which was unacceptable. Curaprox denture cleanser showed the lowest ΔE value in the M and D groups (p < .05). Curaprox in all groups showed a ∆E value less than 3.7. For patients who have PEKK- and polyamide-based prosthesis, the use of citric acid-based cleansers may be more recommended than sodium perborate-containing cleansers because of its clinically acceptable color changes on polymers in terms of color stability.

Nonmetal clasp dentures: What is the evidence about their use?

The aim was to discuss the indications, contraindications, advantages, and disadvantages of Nonmetal clasp dentures (NMCDs), as well as the most relevant properties of its constituent materials. A search was conducted using the keywords: “nonmetal clasp dentures,” “thermoplastic resin,” “flexible resin removable partial denture,” “polyamide,” and “nylon” in databases PubMed/Medline, Lilacs, SciELO, and textbooks between 1955 and 2020. Theses and texts without reliable sources of publication were excluded. Once the analysis instruments were determined, the data were analyzed and discussed. NMCDs present high flexibility, easy adaptation to the abutments, color compatibility and biocompatibility with the oral mucosa, and absence of visible metal clasps. However, they need laboratory relining, grinding, and polishing, do not have criteria for its planning, become rougher and stained over time, and are able to traumatize supporting tissues. The association with metal components seems to be an alternative to increase the success of NMCDs by combining esthetics and biomechanical principles of conventional removable partial dentures. The lack of long-term clinical studies makes the professionals to rely solely on previous experiences or on the manufacturers' recommendations. It suggested that NMCDs must be indicated with caution when not used temporarily.

Attitude of dental professionals toward cast partial denture: A questionnaire survey in India

Aims:

The use of cast partial dentures (CPDs) has been decreased and its importance has been declined in the teaching curriculum. The purpose of this survey was to evaluate the attitudes of dental professionals toward conditions using CPDs in private practice in India.

Settings and Design:

Descriptive survey

Materials and Methods:

This survey consists of eight close-ended questions concerning the use of CPD by dental professionals practicing in India. The URLs of the questionnaire were shared via E-mail to dentists practicing throughout India, to obtain a response of 384 which is a predetermined sample size.

Statistical Analysis Used:

Statistical analysis was done using counts and percentages and the results were further analyzed statistically by the Chi-square test.

Results:

Nearly 42.79% of general dental practitioners (GDPs), 47.26% of prosthodontists, and 9.95% of other specialist dentists responded to the questionnaire. GDPs mostly preferred removable partial dentures (RPDs) (71.87%) and fixed partial dentures (57.22%), whereas prosthodontists preferred mostly implant (60.91%). GDPs mostly preferred flexible dentures (62.42%), whereas prosthodontists preferred CPDs 62.84%. Almost 52.50% of the GDPs mostly raised a cost issue and 63.11% of the prosthodontists had difficulty in adjustment with CPDs. Nearly 63.46% of the dentists told that implant-supported restorations are better options compared to CPDs; still, majority of the dentists (53.23%) were in favor that more importance for teaching CPDs in graduation curriculum should be given.

Conclusions:

This survey shows that in India a significant proportion of GDPs (71.87%) preferred RPDs, mostly flexible dentures (62.42%) due to their low cost compared to CPDs. Prosthodontists mostly preferred implants (60.91%) because they are more confident and better trained in these. It is recommended that more importance be given in teaching implants along with CPDs in graduation curriculum so that practitioners can better educate their patients about implants and their advantages over flexible dentures and their utilization in cases where patients are not willing for CPDs.

Properties and applications of dental polyamides

Introduction: By examining numerous thermoplastic and flexible materials that would aesthetically and functionally surpass acrylates used for the production of dental prostheses, polyamides were discovered as materials with great potential application in prosthodontics. The aim of this study was to describe polyamide materials used for the production of partial dentures. Material and methods: The main methodological approach of this study was a systematic search of the literature in two electronic databases: Google Scholar and PubMed using predefined keyword combinations. Results: The advantage of polyamide dentures is the comfort and ease of accommodation of the patient, with preserved optimal mechanical and physical properties. The dentures are flexible but rigid enough to be resistant to shock and fractures. Due to their low specific weight, polyamide dentures are light, extremely thin and do not interrupt patient speech. Excellent aesthetics are provided by a high choice of working colors and high translucency of the material, which ensures that the soft tissue that's covered by the denture base or clasp is seen through the prosthesis and gives it a more natural appearance in the patient's mouth. Conslusion: Polyamides, unlike acrylates, do not contain residual monomers, so they have an greater degree of biocompatibility. They can be used for the production of both complete and partial dentures, in combination with a Cr-Co skeleton, or crowns and bridges.

Vertical Displacement in Unilateral Extension Base Flexible Removable Dentures

The need for flexible thermoplastic denture base materials has increased due to patient demand for better esthetic outcomes. Designs aimed at improving esthetic outcomes can cause difficulties for prosthodontists, however, from the viewpoint of function and maintenance. Therefore, the purpose of this study was to investigate vertical displacement in unilateral extension base denture models, comparing that obtained by flexible removable dentures with that by conventional metal clasp dentures. Models of unilateral extension base flexible removable dentures for mandibular defects were prepared. Periodontal ligament and jaw mucosa were simulated using a silicone impression material. Four types of flexible removable denture, with or without a metal rest, and two metal clasp dentures made of acrylic resin as a conventional design were used as dental prostheses. The amount of vertical displacement in the defect areas was measured under a load of 50 N at the first and second molars. Among the 6 types of dentures investigated, the amount of vertical displacement was greater with flexible removable dentures than with metal clasp dentures. This vertical displacement tended to decrease significantly, however, with the use of a metal rest with the flexible removable dentures. Esteshot with a metal rest, in particular, showed the smallest amount of displacement in the flexible removable dentures (first molar, 0.265±0.007 mm; second molar, 0.423±0.008 mm). These results indicate the importance of the application of rests in unilateral extension base flexible removable dentures. It may be useful to employ a metal rest in conjunction with a flexible removable denture to reduce load on the underlying mucosa, as is done with conventional partial dentures.

Determination of Polyetheretherketone (PEEK) mechanical properties as a denture material

Purpose

To optimize the gypsum mold temperatures for pressed PEEK, and to estimate the impact, tensile strength and flexural properties of pressed and milled PEEK. Where appropriate, these properties were compared with those of PMMA.

Materials and Methods

Since the mold temperature could affect the properties of the injected parts, the temperature of 20 gypsum specimens was monitored using the multi-thermocouple system (n = 5). A total of 210 specimens were prepared for mechanical tests according to the ISO standard for denture base polymer (n = 10). The Izod impact, tensile strength, and flexural behavior were assessed. PEEK-OptimaNI1 (PEEK-pressed) was tested after processing via the pressing method at4 different mold temperatures. Machining PEEK-Juvora (PEEK-milled) specimens were prepared using the CAD-CAM production method. Data were analyzed via one-way ANOVA performed at a confidence level of 95% and a significant P-value of (P ≤ 0.05).

Results

In comparison to the furnace temperature more heat was required to preheat the gypsum mold up to 100, 150, 175 and 200 °C for pressing purposes. The highest impact strength was 5.7 kJ/m² for PEEK-pressed at 100 °C mold temperature and 4 kJ/m² for PEEK-milled. The latter had a higher tensile strength of 118 MPa. The best result for PEEK-pressed was 97 MPa at 200 °C mold temperature. Under a 4-point bending test, Young’s modulus of PEEK-milled was 5591 MPa, while the highest for PEEK-pressed was 4936 MPa at 200 °C mold temperature.

Conclusions

Compared to PMMA, given the superior mechanical properties of PEEK, it may become the material of choice for future use. Dentures constructed from PEEK polymer could well be routinely constructed in the near future.

Physical properties and color stability of injection-molded thermoplastic denture base resins

PURPOSE

The purpose of this study was to compare mechanical and physical properties of injection-molded thermoplastic denture base resins.

MATERIALS AND METHODS

In this study, six commercially available products (VA; Valplast, LC; Lucitone, ST; Smiltone, ES; Estheshot-Bright, AC; Acrytone, WE; Weldenz) were selected from four types of thermoplastic denture base materials (Polyamide, Polyester, Acrylic resin and Polypropylene). The flexural properties and shore D hardness have been investigated and water sorption and solubility, and color stability have evaluated.

RESULTS

For the flexural modulus value, ES showed the highest value and WE showed significantly lower value than all other groups (P<.05). Most of experimental groups showed weak color stability beyond the clinically acceptable range.

CONCLUSION

Within the limits of this study, thermoplastic denture base resin did not show sufficient modulus to function as a denture base. In addition, all resins showed discoloration with clinical significance, and especially polyamides showed the lowest color stability.

Effect of cleansers on denture base resins’ structural properties

Introduction:

We assessed the effect of different available denture cleansers on the roughness and hardness of polyetherketoneketone, thermoinjection-molded polyamide, and polymethylmethacrylate.

Materials and Methods:

A total of 150 disc-shaped specimens were fabricated (10 mm × 2 mm) from these three denture base resins, and divided into five subgroups ( n = 10) according to immersion procedures. One of these groups subjected to distilled water served as control, whereas other groups were subjected to daily cleansing with four denture cleansers (Corega, Protefix, Curaprox, and Perlodent) for 8 h a day for 140 days. The surface roughness and hardness values of specimens were recorded by measuring twice at baseline, and again after application of chemical solutions. Topography alterations after treatments were assessed with scanning electron microscopy. The data were subjected to statistical analysis and comparison among groups was done using Kruskal Wallis and Wilcoxon Signed Ranks tests. P-value <0.05 was considered significant.

Results:

The surface roughness of polyetherketoneketone, polymethylmethacrylate, and polyamide dentures was increased significantly by chemical solutions of denture cleansers. While the hardness value of polyetherketoneketone was not affected significantly after immersion in denture cleansers, those of polymethylmethacrylate and polyamide decreased significantly. Compared with Curaprox, the effervescent tablets significantly altered the surface hardness and roughness of polyamide.

Conclusion:

Denture cleansers can considerably alter the surface roughness and hardness of denture base resins and should be used carefully depending on the material.

Esthetic Clasp Cast Partial Denture

Denture esthetics as defined by Glossary of prosthodontics terms the effect produced by a dental prosthesis that affects the beauty and attractiveness of the person. [1] Removable partial dentures (RPDs) are the widely accepted and treatment of choice for most cases as it is both effective and affordable. Partially edentulous treatment planning includes both esthetics and masticatory function. A prosthesis that is highly esthetic will improve patient's motivation and acceptance. It is a very wrong notion to expect that patients will tolerate unesthetic partial dentures because good masticatory capability has been achieved. Esthetics plays a vital role in the success of partial dentures, and the length and mobility of the patient's lips play a significant role in achieving it. [2] Patients with short lips or highly mobile lips pose problems as esthetics are compromised because most clasp arms, denture borders, and other components will show when the patient smiles or speaks. [3] RPDs can easily look artificial; hence, special emphasis should aim toward restoring function, phonetics, esthetics with a long-term benefits which requires meticulous attention during fabrication. This case reports is an esthetic clasp designed for a cast partial denture for a young girl for esthetic and function.

Effects of relining materials on the flexural strength of relined thermoplastic denture base resins

PURPOSE

The aim of this study was to evaluate the effects of relining materials on the flexural strength of relined thermoplastic denture base resins (TDBRs).

MATERIALS AND METHODS

For shear bond strength testing, 120 specimens were fabricated using four TDBRs (EstheShot-Bright, Acrytone, Valplast, Weldenz) that were bonded with three autopolymerizing denture relining resins (ADRRs: Vertex Self-Curing, Tokuyama Rebase, Ufi Gel Hard) with a bond area of 6.0 mm in diameter and were assigned to each group (n=10). For flexural strength testing, 120 specimens measuring 64.0×10.0×3.3 mm (ISO-1567:1999) were fabricated using four TDBRs and three ADRRs and were assigned to each group (n=10). The thickness of the specimens measured 2.0 mm of TDBR and 1.3 mm of ADRR. Forty specimens using four TDBRs and 30 specimens using ADRRs served as the control. All specimens were tested on a universal testing machine. For statistical analysis, Analysis of variance (ANOVA) with Tukey's test as post hoc and Spearman's correlation coefficient analysis (P=.05) were performed.

RESULTS

Acry-Tone showed the highest shear bond strength, while Weldenz demonstrated the lowest bond strength between TDBR and ADRRs compared to other groups. EstheShot-Bright exhibited the highest flexural strength, while Weldenz showed the lowest flexural strength. Relined EstheShot-Bright demonstrated the highest flexural strength and relined Weldenz exhibited the lowest flexural strength (P<.05). Flexural strength of TDBRs (P=.001) and shear bond strength (P=.013) exhibited a positive correlation with the flexural strength of relined TDBRs.

CONCLUSION

The flexural strength of relined TDBRs was affected by the flexural strength of the original denture base resins and bond strength between denture base resins and relining materials.

Comparative Study Clarifying the Most Suitable Material to Be Used as Partial Denture Clasps

BACKGROUND

Removable partial denture's clasp is of particular importance as it affects the denture longevity during the function. The key of successful clasp selection is to select a direct retainer that will control tipping and torquing forces on the abutment teeth, provide retention against reasonable dislodging forces and are compatible with both tooth and tissue contour and the aesthetic desire of the patient. In this consideration, different materials employed for the clasp construction were compared mechanically.

AIM

This study aims to compare the most usable esthetic clasps mechanically to clarify the most suitable material to be used as partial denture clasps.

METHODS

Evaluation of surface roughness, retention and deformation has been investigated utilising different in-vitro methods. All these techniques provide valuable information regarding the mechanical properties of the materials tested. However, none of the in-vitro techniques can expose the tested materials to conditions similar to that of the oral environment (in-vivo) such as pH value and temperature variations.

RESULTS

Most commonly, RPD clasps are fabricated from the same alloy of the metal framework, as cobalt-chromium (CoCr) alloy although it is unaesthetic. Other methods consumed to avoid such esthetic mystery have included coating retainers with tooth-coloured resin or introduction of esthetic materials as Thermoplastic Acetal, Versacryl, and Thermopress.

CONCLUSION

It has been concluded that the non-metal Acetal resin retainer reveals superior mechanical properties.

Evaluation of the flexural mechanical properties of various thermoplastic denture base polymers

This study evaluated the flexural mechanical properties of various thermoplastic denture base polymers (six polyamides, four acrylic resins, polyester, polypropylene, and polycarbonate) by three different testing conditions; specimens were tested in water bath at 37°C (Wet/Water, by ISO 20795-1), or in ambient air (Wet/Air) after being immersed in distilled water for 50 h, or after desiccation for 7 days (Dry/Air). The mean ultimate flexural strength (UFS) and flexural modulus (FM) for most products ranged from 27 to 61 MPa and from 611 to 1,783 MPa respectively, which failed to meet the minimum requirements of the international standard, except for polycarbonate (89 and 2,245 MPa). The mean UFS and FM values were ranked Dry/Air>Wet/Air>Wet/Water (p<0.05). In conclusion, the flexural mechanical properties of denture base polymers varied with the products and were significantly affected by the testing medium (air or water) and specimen conditions (wet or dry).

Color stability of glass-fiber-reinforced polypropylene for non-metal clasp dentures

PURPOSE

The purpose of this study was to investigate the color stability of a glass-fiber-reinforced thermoplastic (GFRTP), for use in non-metal clasp dentures (NMCDs).

METHODS

GFRTPs composed of E-glass fibers and polypropylene with 2 mass% of pigments were fabricated using injection molding. According to our previous study on the optimum fiber content for GFRTPs, we prepared GFRTPs with fiber contents of 0, 10, and 20 mass% (GF0, GF10, and GF20). Commercially available NMCD and PMMA materials were used as controls. The color changes of GFRTPs at 24h, and at 1, 2, and 4 weeks of coffee immersion at 37°C were measured by colorimetry, using the Commission Internationale de l'Eclairage (CIE) Lab system. The color stabilities of the GFRTPs were evaluated in two units: the color difference (ΔE^∗) and National Bureau of Standards (NBS) units.

RESULTS

After immersion, none of the GFRTPs showed visible color change. From the colorimetry measurement using the CIE Lab system, the ΔE^∗ values of the GFRTPs were 0.65-2.45. The NBS values of the GFRTPs were 0.60-2.25, all lower than the threshold level of 3.0, demonstrating clinically acceptable color changes. On the other hand, an available polyamide-based NMCD material exhibited "appreciable" color change, as measured in NBS units.

CONCLUSIONS

The results indicate that the GFRTPs showed clinically acceptable color stability and might be satisfactory for clinical use. Therefore, GFRTPs are expected to become attractive materials for esthetic dentures.

The Influence of Thermocycling on the Flexural Strength of a Polyamide Denture Base Material

Objective

The aim of the present study was to evaluate the influence of thermocycling on the flexural strength of a polyamide base denture material.

Materials and methods

A polyamide denture base material (Valplast) was tested, whereas a PMMA material (Vertex) was used as a control. Thirty specimens of each material were fabricated for flexural strength testing according to ISO 1567. They were prepared and stored in water at 37°C for 48 hours. The specimens of each material were divided into three equal groups (n=10). Flexural strength testing was performed immediately after water storage and after thermocycling (5°C / 55°C, 2 c/min) for 3000 and 5000 cycles. A three point flexural test was performed on a universal testing machine at a crosshead speed of 5 mm/min. The final flexural strength was calculated using the formula: F_S = 3 PL/2 bd². A two-way ANOVA with post-hoc analysis using Tukey's procedure was applied at .05 level of statistical significance.

Results

A statistically significant reduction in flexural strength was recorded after thermocycling at 3000 cycles for PMMA and at 5000 cycles for both materials. The flexural strength of PMMA was significantly higher compared to polyamide for all the conditions tested (p<0.05).

Conclusion

Thermocycling had a significant adverse effect on the flexural strength of polyamide and PMMA denture base materials.

Investigation of the cytotoxicity of thermoplastic denture base resins

PURPOSE

The purpose of this study was to investigate the in vitro cytotoxicity of thermoplastic denture base resins and to identify the possible adverse effects of these resins on oral keratinocytes in response to hot water/food intake.

MATERIALS AND METHODS

Six dental thermoplastic resin materials were evaluated: three polyamide materials (Smile tone, ST; Valplast, VP; and Luciton FRS, LF), two acrylic materials (Acrytone, AT; and Acryshot, AS), and one polypropylene resin material (Unigum, UG). One heat-polymerized acrylic resin (Vertex RS, RS) was chosen for comparison. After obtaining extracts from specimens of the denture resin materials (Φ=10 mm and d=2 mm) under different extraction conditions (37℃ for 24 hours, 70℃ for 24 hours, and 121℃ for 1 hour), the extracts (50%) or serial dilutions (25%, 12.5%, and 6.25%) in distilled water were co-cultured for 24 hours with immortalized human oral keratinocytes (IHOKs) or mouse fibroblasts (L929s) for the cytotoxicity assay described in ISO 10993.

RESULTS

Greater than 70% viability was detected under all test conditions. Significantly lower IHOK and L929 viability was detected in the 50% extract from the VP (70℃) and AT (121℃) samples (P<.05), but only L929 showed reduced viability in the 50% and 25% extract from LF (37℃) (P<.05).

CONCLUSION

Extracts obtained from six materials under different extraction conditions (37℃, 70℃, and 121℃) did not exhibit severe cytotoxicity (less than 70% viability), although their potential risk to oral mucosa at high temperatures should not be ignored.

Effect of fiber content on flexural properties of glass fiber-reinforced polyamide-6 prepared by injection molding

The use of non-metal clasp denture (NMCD) materials may seriously affect the remaining tissues because of the low rigidity of NMCD materials such as polyamides. The purpose of this study was to develop a high-rigidity glass fiber-reinforced thermoplastic (GFRTP) composed of E-glass fiber and polyamide-6 for NMCDs using an injection molding. The reinforcing effects of fiber on the flexural properties of GFRTPs were investigated using glass fiber content ranging from 0 to 50 mass%. Three-point bending tests indicated that the flexural strength and elastic modulus of a GFRTP with a fiber content of 50 mass% were 5.4 and 4.7 times higher than those of unreinforced polyamide-6, respectively. The result showed that the physical characteristics of GFRTPs were greatly improved by increasing the fiber content, and the beneficial effects of fiber reinforcement were evident. The findings suggest that the injection-molded GFRTPs are adaptable to NMCDs because of their excellent mechanical properties.

Water sorption and solubility of polyamide denture base materials

Purpose: Some patients experience adverse reactions to poly(methyl methacrylate)-based (PMMA) dentures. Polyamide (PA) as an alternative to PMMA has, however, not been well documented with regard to water sorption and water solubility. The aim of this in vitro study was to measure water sorption and water solubility of two PA materials compared with PMMA, and to evaluate the major components released from the PA materials and the effect on hardness of the materials. Methods: Ten discs (40.0 mm diameter, 2.0 mm thick) of each material (PA: Valplast and Breflex; PMMA: SR Ivocap HIP) were prepared according to manufacturers' recommendations. The specimens were tested for water sorption and water solubility, according to a modification of ISO 20795-1:2008. Released substances were analysed by gas chromatography/mass spectrometry (GC/MS). Results: There were statistically significant differences among the materials regarding water sorption, water solubility and time to water saturation. Breflex had the highest water sorption (30.4 μg/mm³), followed by PMMA-material (25.8 μg/mm³) and Valplast (13.6 μg/mm³). Both PA materials had statistically significant lower water solubility than the PMMA. Both PA had a net increase in weight. Analysis by GC/MS identified release of the compound 12-aminododecanolactam from the material Valplast. No release was found from the Breflex material. Conclusions: The PA denture materials show differences in water sorption and solubility, but within the limits of the standard requirements. The PA showed a net increase in weight after long-term water sorption. The clinical implications of the findings are not elucidated.

Pressure transmission area and maximum pressure transmission of different thermoplastic resin denture base materials under impact load

PURPOSES

The purposes of the present study were to examine the pressure transmission area and maximum pressure transmission of thermoplastic resin denture base materials under an impact load, and to evaluate the modulus of elasticity and nanohardness of thermoplastic resin denture base.

METHODS

Three injection-molded thermoplastic resin denture base materials [polycarbonate (Basis PC), ethylene propylene (Duraflex), and polyamide (Valplast)] and one conventional heat-polymerized acrylic resin (PMMA, SR Triplex Hot) denture base, all with a mandibular first molar acrylic resin denture tooth set in were evaluated (n=6). Pressure transmission area and maximum pressure transmission of the specimens under an impact load were observed by using pressure-sensitive sheets. The modulus of elasticity and nanohardness of each denture base (n=10) were measured on 15×15×15×3mm³ specimen by using an ultramicroindentation system. The pressure transmission area, modulus of elasticity, and nanohardness data were statistically analyzed with 1-way ANOVA, followed by Tamhane or Tukey HSD post hoc test (α=.05). The maximum pressure transmission data were statistically analyzed with Kruskal-Wallis H test, followed by Mann-Whitney U test (α=.05).

RESULTS

Polymethyl methacrylate showed significantly larger pressure transmission area and higher maximum pressure transmission than the other groups (P<.001). Significant differences were found in modulus of elasticity and nanohardness among the four types of denture bases (P<.001).

CONCLUSIONS

Pressure transmission area and maximum pressure transmission varied among the thermoplastic resin denture base materials. Differences in the modulus of elasticity and nanohardness of each type of denture base were demonstrated.

Effect of surface treatment methods on the shear bond strength of auto-polymerized resin to thermoplastic denture base polymer

PURPOSE

Polyamide polymers do not provide sufficient bond strength to auto-polymerized resins for repairing fractured denture or replacing dislodged denture teeth. Limited treatment methods have been developed to improve the bond strength between auto-polymerized reline resins and polyamide denture base materials. The objective of the present study was to evaluate the effect of surface modification by acetic acid on surface characteristics and bond strength of reline resin to polyamide denture base.

MATERIALS AND METHODS

84 polyamide specimens were divided into three surface treatment groups (n=28): control (N), silica-coated (S), and acid-treated (A). Two different auto-polymerized reline resins GC and Triplex resins were bonded to the samples (subgroups T and G, respectively, n=14). The specimens were subjected to shear bond strength test after they were stored in distilled water for 1 week and thermo-cycled for 5000 cycles. Data were analyzed with independent t-test, two-way analysis of variance (ANOVA), and Tukey's post hoc multiple comparison test (α=.05).

RESULTS

The bond strength values of A and S were significantly higher than those of N (P<.001 for both). However, statistically significant difference was not observed between group A and group S. According to the independent Student's t-test, the shear bond strength values of AT were significantly higher than those of AG (P<.001).

CONCLUSION

The surface treatment of polyamide denture base materials with acetic acid may be an efficient and cost-effective method for increasing the shear bond strength to auto-polymerized reline resin.

Flexible Removable Partial Denture Prosthesis: A Survey of Dentists' Attitudes and Knowledge in Greece and Croatia

PURPOSE

The aim of this study was to investigate through a questionnaire the knowledge, attitudes and possible differences in the use of flexible RPDPs among dentists in Greece and Croatia.

MATERIAL AND METHODS

A questionnaire of 16 questions was originally created in English, translated into Greek and Croatian language following a two way translation and tested for apprehension, precision, clarity and homogeneity by a number of native English speaking Greek and Croatian dentists. Following the necessary corrections, the questionnaires replicated in two online surveys and their addresses with an informed consent were sent by emails to nearly 4000 dentists in each country to participate. Collected data were analyzed by chi-square tests at a= .05 level of significance.

RESULTS

378 dentists from Greece and 304 from Croatia participated in the study. 137(36.2%) dentists from Greece and 56(18.4%) from Croatia provided flexible RPDPs to their patients. Statistical analysis for all providers indicated no significant difference between genders (P>.05), significant differences between age groups (P<.01), years of practice (P<.05), specialization (P <.001), and instruction on flexible prostheses (P <.001). The analysis between the two countries showed differences for gender and age groups (P<.01) but no differences between experienced, specialized or instructed groups (P >.05).

CONCLUSION

The survey indicated differences between the two countries in the percentages of dentists using, selecting and providing RPDPs for their patients. Practitioners' age, years in practice and instruction were associated with the provision of the prostheses, while comfort, esthetics and cost were the reasons for deciding to use the flexible RPDPs.

CONCLUSION

Although dentists are not educated in their schools about flexible RPDPs, almost a third of them offer this treatment to their patients. Long term success of these devices depends on clinical education, more experience and definitely more research.

Fabrication and physical properties of glass-fiber-reinforced thermoplastics for non-metal-clasp dentures

Recently, non-metal-clasp dentures (NMCDs) made from thermoplastic resins such as polyamide, polyester, polycarbonate, and polypropylene have been used as removable partial dentures (RPDs). However, the use of such RPDs can seriously affect various tissues because of their low rigidity. In this study, we fabricated high-rigidity glass-fiber-reinforced thermoplastics (GFRTPs) for use in RPDs, and examined their physical properties such as apparent density, dynamic hardness, and flexural properties. GFRTPs made from E-glass fibers and polypropylene were fabricated using an injection-molding. The effects of the fiber content on the GFRTP properties were examined using glass-fiber contents of 0, 5, 10, 20, 30, 40, and 50 mass%. Commercially available denture base materials and NMCD materials were used as controls. The experimental densities of GFRTPs with various fiber contents agreed with the theoretical densities. Dynamic micro-indentation tests confirmed that the fiber content does not affect the GFRTP surface properties such as dynamic hardness and elastic modulus, because most of the reinforcing glass fibers are embedded in the polypropylene. The flexural strength increased from 55.8 to 217.6 MPa with increasing glass-fiber content from 0 to 50 mass%. The flexural modulus increased from 1.75 to 7.42 GPa with increasing glass-fiber content from 0 to 50 mass%, that is, the flexural strength and modulus of GFRTP with a fiber content of 50 mass% were 3.9 and 4.2 times, respectively, those of unreinforced polypropylene. These results suggest that fiber reinforcement has beneficial effects, and GFRTPs can be used in NMCDs because their physical properties are better than those of controls. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2254-2260, 2017.

Bond strength of a chairside autopolymerizing reline resin to injection-molded thermoplastic denture base resins

PURPOSE

This study evaluated the shear bond strength of a chairside autopolymerizing reline resin to injection-molded thermoplastic denture base resins.

METHODS

Four kinds of injection-molded thermoplastic resins (two polyamides, a polyethylene terephthalate copolymer and a polycarbonate) and PMMA, as a control, were tested. The eight types of surface treatment: ((1) no treatment, (2) air abrasion, (3) dichloromethane, (4) ethyl acetate, (5) 4-META/MMA-TBB resin, (6) air abrasion and 4-META/MMA-TBB resin, (7) tribochemical silica coating, and (8) tribochemical silica coating and 4-META/MMA-TBB resin) were applied to each specimen. The chairside autopolymerizing reline resins were bonded to disks of the injection-molded thermoplastic denture base resins. All of the specimens were immersed in water for 4 months and then thermocycled for 10,000 cycles in water between 5 and 55°C. The shear bond strengths were determined.

RESULTS

The shear bond strengths of the two polyamides treated using air abrasion, dichloromethane and ethyl acetate and no treatment were exceedingly low. The greatest bond strength was recorded for the polyethylene terephthalate copolymer specimens treated with tribochemical silica coating and 4-META/MMA-TBB resin (22.5MPa). The bond strengths of the other injection-molded thermoplastic denture base resins increased using 4-META/MMA-TBB resin.

CONCLUSIONS

Tribochemical silica coating and 4-META/MMA-TBB resin were the most effective surface treatments among all denture base resins tested.

Wear resistance of injection-molded thermoplastic denture base resins

Objective This study investigated the wear resistance of injection-molded thermoplastic denture base resins using nanoindentation instrument.

Materials and methods Six injection-molded thermoplastic denture base resins (two polyamides, two polyesters, one polycarbonate, one polymethylmethacrylate [PMMA]) and a PMMA conventional heat-polymerized denture-based polymer control were tested. Elastic modulus, hardness, wear depth, and roughness were calculated using a nanoindentation instrument.

Results Elastic modulus and hardness of the injection-molded thermoplastic denture base resins were significantly lower than those of the PMMA conventional heat-polymerized denture-based polymer. Wear depth of polycarbonate and PMMA conventional heat-polymerized denture-based polymer were significantly higher than that of other injection-molded thermoplastic denture base resins. The roughness of injection-molded thermoplastic denture base resins was significantly more than that of PMMA conventional heat-polymerized denture-based polymer after testing.

Conclusions Wear resistance of injection-molded thermoplastic denture base was low compared to PMMA conventional heat-polymerized denture-based polymers.

Assessment of clasp design and flexural properties of acrylic denture base materials for use in non-metal clasp dentures

PURPOSE

The purpose of this study was to investigate the possibilities of utilizing new acrylic denture base materials in resin clasps using three-point flexural tests and cantilever beam tests.

METHODS

Seven non-metal clasp denture (NMCD) materials and four acrylic denture base materials were used for three-point flexural tests and six NMCD materials and three acrylic denture base materials were used for cantilever beam tests. The flexural strength, elastic modulus, and 0.05% proof stress were measured by three-point flexural tests according to International Organization for Standardization (ISO) 20795-1. And load at 0.5mm deformation, elastic modulus were measured by Cantilever beam tests.

RESULTS

For the three-point flexural tests, only materials that met the conditions for both flexural strength and elastic modulus were the polycarbonate Reigning N (REN) and the acrylics Acron (AC), Pro Impact (PI), Procast DSP (PC) and IvoBase High Impact (HI) which are required in ISO 20795-1, Type 3 denture base materials. And for cantilever beam tests there was no significant difference between PI and either EstheShot (ES), EstheShot Bright (ESB), REN or Acry Tone (ACT) in load at 0.5mm deformation, and no significant difference between PI and either Lucitone FRS (LTF), ES, ESB, REN or ACT in elastic modulus.

CONCLUSIONS

The results thus suggested that some of the acrylic materials used as denture base materials may also be usable for NMCDs, and that the flexural properties of the acrylic material PI resemble those of ES, ESB and ACT, meaning that similar clasp designs may also be feasible.

Effects of thermal cycling on surface roughness, hardness and flexural strength of polymethylmethacrylate and polyamide denture base resins

BACKGROUND

The purpose of this study was to evaluate the effects of thermal cycling on the surface roughness, hardness and flexural strength of denture resins.

METHODS

Polyamide (PA; Deflex and Valplast) and polymethylmethacrylate (PMMA; QC-20 and Acron MC) denture materials were selected. A total of 180 specimens were fabricated and then divided into 3 groups. The first group (group 1) acted as a control and was not thermocycled. The second group (group 2) was subjected to thermocycling for 10,000 cycles in artificial saliva and 5,000 cycles in distilled water. The last group (group 3) was thermocycled for 20,000 cycles in artificial saliva and 10,000 cycles in distilled water. The surface roughness were measured with a profilometer. The hardness of the resins were measured with a Vickers Hardness Tester using a 100-gf load. The flexural strength test was performed using the universal test machine with a crosshead speed of 5 mm/min. Data were analyzed using statistical software. The results of the measurements in the 3 different tests were analyzed by Kruskal-Wallis test with Bonferroni correction. Multiple comparisons were made by Conover and Wilcoxon tests.

RESULTS AND CONCLUSIONS

There was a significant difference between the PMMA and PA groups in terms of surface roughness, hardness and transverse strength before and after thermal cycling (p&lt;0.001). Thermal cycling did not change the surface roughness, hardness and flexural strength values of either the PMMA or PA group (p&gt;0.001).

Color stability, water sorption and cytotoxicity of thermoplastic acrylic resin for non metal clasp denture

PURPOSE

The aim of this study was to compare the color stability, water sorption and cytotoxicity of thermoplastic acrylic resin for the non-metal clasp dentures to those of thermoplastic polyamide and conventional heat-polymerized denture base resins.

MATERIALS AND METHODS

Three types of denture base resin, which are conventional heat-polymerized acrylic resin (Paladent 20), thermoplastic polyamide resin (Bio Tone), thermoplastic acrylic resin (Acrytone) were used as materials for this study. One hundred five specimens were fabricated. For the color stability test, specimens were immersed in the coffee and green tee for 1 and 8 weeks. Color change was measured by spectrometer. Water sorption was tested after 1 and 8 weeks immersion in the water. For the test of cytotoxicity, cell viability assay was measured and cell attachment was analyzed by FE-SEM.

RESULTS

All types of denture base resin showed color changes after 1 and 8 weeks immersion. However, there was no significant difference between denture base resins. All specimens showed significant color changes in the coffee than green tee. In water sorption test, thermoplastic acrylic resin showed lower values than conventional heat-polymerized acrylic resin and thermoplastic polyamide resin. Three types of denture base showed low cytotoxicity in cell viability assay. Thermoplastic acrylic resin showed the similar cell attachment but more stable attachment than conventional heat-polymerized acrylic resin.

CONCLUSION

Thermoplastic acrylic resin for the non-metal clasp denture showed acceptable color stability, water sorption and cytotoxicity. To verify the long stability in the mouth, additional in vitro studies are needed.

Effects of cleansing methods on 3-D surface roughness, gloss and color of a polyamide denture base material

OBJECTIVE

The purpose of this study was to determine the effects of two denture cleansing methods on 3-D surface roughness, gloss and color of denture base materials.

MATERIALS AND METHODS

Thirty disks from nylon (Valplast) and 30 from heat-polymerized acrylic denture base material (Paladon 65) were made and 10 of each material were immersed in water (control), Val-Clean (peroxide cleanser) and Corega Extradent (peroxide cleanser) plus microwaving for a period simulating 30 days of daily cleansing. 3-D surface roughness, gloss and color parameters were measured before and after cleansing using an interferometric profilometer, a gloss meter and a colorimeter. The results were statistically analysed by regression, paired-t, Mann-Whitney and Kruskal-Wallis tests at α = 0.05 level of significance.

RESULTS

The results showed significant differences at baseline in L* and b* parameters between materials (p < 0.01), with a significantly lower gloss (p < 0.05) and higher roughness (p < 0.05) for Valplast. After cleansing, Δϵ* was significantly greater in Valplast than Paladon 65 (p < 0.05). Gloss of both materials decreased significantly within the Corega Extradent plus microwave solution (p < 0.05), while roughness increased significantly only for Paladon 65 (p < 0.05).

CONCLUSIONS

Valplast was found to have a significantly lower gloss and a higher roughness than Paladon 65 before cleansing. After cleansing, ΔE* increased more in Valplast than in Paladon 65, gloss of both materials decreased and roughness only of Paladon 65 increased within the Corega extradent plus microwaving method.