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Flexural Strength of CAD/CAM Denture Base Materials: Systematic Review and Meta-analysis of Studies.Journal of International Society of... 2022Digital complete dentures fabrication techniques are expanding. This study aimed to review flexural strength (FS) of milled and 3D-printed denture base materials to... (Review)
Review
INTRODUCTION
Digital complete dentures fabrication techniques are expanding. This study aimed to review flexural strength (FS) of milled and 3D-printed denture base materials to answer the study question: is FS of computer-aided designing/computer-aided manufacturing (CAD/CAM) denture base comparable to conventional heat-polymerized materials?
MATERIALS AND METHODS
Search was done within different databases for articles published between January 2010 and June 2021 using specific keywords. Articles of studies in English language with methods following International Standards Organization standardization/ADA specifications for flexural testing of conventional and CAD/CAM (milled or printed) polymethyl methacrylate (PMMA) materials were included.
RESULTS
Out of the 61 studies, 9 were processed for data extraction and only 7 underwent meta-analysis. Two, six, and one study showed high, moderate, and low risk of bias, respectively. Random-effects model was used for analysis and resulted in the average FS of 120.61 MPa [95% confidence interval (CI): 109.81-131.41] and 92.16 MPa (CI: 75.12-109.19) for CAD/CAM milled and heat-polymerized PMMA, respectively.
CONCLUSION
Subtractive CAD/CAM technique of denture fabrication showed satisfactory FS values, whereas additive CAD/CAM method was comparable to conventional heat-polymerized technique with lower value, requiring further investigations and improvement. The clinical use of milled denture bases is an acceptable substitution to heat-polymerized PMMA, making the denture fabrication an easier and faster process.
PubMed: 35462750
DOI: 10.4103/jispcd.JISPCD_310_21 -
International Journal of Molecular... Sep 2022Polymethyl methacrylate (PMMA), a well-known polymer of the methacrylate family, is extensively used in biomedicine, particularly in odontological applications including... (Review)
Review
Polymethyl methacrylate (PMMA), a well-known polymer of the methacrylate family, is extensively used in biomedicine, particularly in odontological applications including artificial teeth, dentures and denture bases, obturators, provisional or permanent crowns, and so forth. The exceptional PMMA properties, including aesthetics, inexpensiveness, simple manipulation, low density, and adjustable mechanical properties, make it a perfect candidate in the field of dentistry. However, it presents some deficiencies, including weakness regarding hydrolytic degradation, poor fracture toughness, and a lack of antibacterial activity. To further enhance its properties and solve these drawbacks, different approaches can be performed, including the incorporation of nanofillers. In this regard, different types of metallic nanoparticles, metal oxide nanofillers, and carbon-based nanomaterials have been recently integrated into PMMA matrices with the aim to reduce water absorption and improve their performance, namely their thermal and flexural properties. In this review, recent studies regarding the development of PMMA-based nanocomposites for odontology applications are summarized and future perspectives are highlighted.
Topics: Anti-Bacterial Agents; Carbon; Denture Bases; Materials Testing; Methacrylates; Nanocomposites; Oxides; Polymers; Polymethyl Methacrylate; Surface Properties; Water
PubMed: 36142201
DOI: 10.3390/ijms231810288 -
Materials (Basel, Switzerland) Jun 2023(1) Background: Various materials are available for CAD-CAM denture base fabrication, for both additive and subtractive manufacturing. However, little has been reported...
(1) Background: Various materials are available for CAD-CAM denture base fabrication, for both additive and subtractive manufacturing. However, little has been reported on bond strength to soft denture liners. Therefore, the aim of this study was to investigate tensile bond strength, comparing between different denture base materials and soft denture liners. (2) Methods: Seven different materials were used for denture base fabrication: one heat-polymerized polymethyl methacrylate, three materials for subtractive manufacturing, two materials for additive manufacturing and one polyamide. Two materials were used for soft denture lining: one silicone-based and one acrylate-based. The study was conducted according to the specification ISO No. 10139-2:2016, and the type of failure was determined. The Kruskal-Wallis test with Dunn's post hoc test was used to analyse the values of tensile bond strength, and Fisher's exact test was used to analyse the type of failure. Values < 0.05 were considered statistically significant. (3) Results: The tensile bond strength values were not statistically significantly different combining all the materials used for denture base fabrication with the acrylate-based soft denture liner ( > 0.05), and the average values ranged between 0.19 and 0.25 Mpa. The tensile bond strength values of the different denture base materials and silicone-based denture liner were statistically significantly different ( < 0.05), and the average values ranged between 1.49 and 3.07 Mpa. The type of failure was predominantly adhesive between polyamide and both additive-manufactured denture base materials in combination with the acrylate-based soft liner ( < 0.05). (4) Conclusions: The use of digital technologies in denture base fabrication can have an influence on different tensile bond strength values for soft denture liners, with different types of failure when compared with heat-cured PMMA. Similar tensile bond strength values were found between the acrylate-based soft denture liner and denture base materials. Significant differences in tensile bond strength values were found between the silicone-based soft denture liner and denture base materials, where the additive-manufactured and polyamide denture base materials showed lower values than heat-cured PMMA and subtractive-manufactured denture base materials.
PubMed: 37444928
DOI: 10.3390/ma16134615 -
Journal of Oral Biology and... 2022To evaluate and compare the flexural strength, surface roughness and porosity percentage of acrylic denture base material modified with two antimicrobial agents,...
Evaluation and comparison of flexural strength, surface roughness and porosity percentage of denture base resins incorporated with Thymoquinone and silver nano-antimicrobial agents-an in vitro study.
AIM
To evaluate and compare the flexural strength, surface roughness and porosity percentage of acrylic denture base material modified with two antimicrobial agents, Thymoquinone (TQ) and Silver nanoparticles (AgNP).
MATERIALS AND METHODS
A total of 90 specimens were fabricated and divided into groups A, B and C with 30 specimens each. Of the 30 specimens, 10 specimens measuring 65mmx 10mmx 2.5 mm were used to study the flexural strength, 10 specimens measuring 10 mm × 20 mm × 3 mm to study surface roughness and 10 specimens measuring 10 mm × 20 mm × 3 mm to study porosity percentage. Group A specimens were made of unmodified denture base resin, group B and C were modified with 2.5% AgNP and 1% TQ respectively. The specimens were processed in the conventional manner. A universal testing machine was used to measure flexural strength and a profilometer was used to measure surface roughness. Porosity percentage was evaluated with help of a desiccator. The data obtained was subjected to statistical analyses using One-way ANOVA and the Tukey-post hoc test, with statistical significance at p ≤ 0.05.
RESULTS
Addition of 2.5% AgNP and 1% TQ to acrylic denture base resin significantly reduced flexural strength and increased the porosity percentage (p < 0.01) but within clinically acceptable limits. No significant difference was found in the surface roughness between the various groups tested.
CONCLUSIONS
Heat cured acrylic denture base resins modified with 2.5% AgNPs,1% TQ exhibited clinically acceptable flexural strength and surface properties and could be incorporated into the denture base material as an antimicrobial agent.
PubMed: 36110866
DOI: 10.1016/j.jobcr.2022.08.003 -
Journal of Dentistry (Shiraz, Iran) Mar 2015The purpose of this article was to review the biocompatibility, physical, and mechanical properties of the polyamide denture base materials. An electronic search of... (Review)
Review
The purpose of this article was to review the biocompatibility, physical, and mechanical properties of the polyamide denture base materials. An electronic search of scientific papers from 1990-2014 was carried out using PubMed, Scopus and Wiley Inter Science engines using the search terms "nylon denture base" and "polyamide denture base". Searching the key words yielded a total of 82 articles. By application of inclusion criteria, the obtained results were further reduced to 24 citations recruited in this review. Several studies have evaluated various properties of polyamide (nylon) denture base materials. According to the results of the studies, currently, thermo-injectable, high impact, flexible or semi-flexible polyamide is thought to be an alternative to the conventional acrylic resins due to its esthetic and functional characteristics and physicochemical qualities. It would be justifiable to use this material for denture fabrication in some cases such as severe soft/ hard tissue undercuts, unexplained repeated fracture of denture, in aesthetic-concerned patients, those who have allergy to other denture base materials, and in patients with microstomia. Although polyamide has some attractive advantages, they require modifications to produce consistently better properties than the current polymethyl methacrylate (PMMA) materials. Moreover, since there is a very limited knowledge about their clinical performance, strict and careful follow-up evaluation of the patients rehabilitated with polyamide prosthesis is recommended.
PubMed: 26106628
DOI: No ID Found -
Advances in Clinical and Experimental... 2015Acrylic resin is a widely used material in clinical practice, and a satisfactory biocompatibility is essential. When the resin polymerization reaction is incomplete,... (Review)
Review
Acrylic resin is a widely used material in clinical practice, and a satisfactory biocompatibility is essential. When the resin polymerization reaction is incomplete, residual monomers are released into the oral cavity. The aim of this study was to evaluate, through a literature review, the cytotoxicity caused by the denture base acrylic resin used, and its components. The selection of published studies was performed on the Pubmed database from January 2008 to July 2013. The keywords used were: "cytotoxicity and acrylic resins", "cytotoxicity and denture base resins" and "cytotoxicity and oral prosthesis". Inclusion criteria were: in vitro studies and literature reviews published in English that evaluated the acrylic resin cytotoxicity for denture base and its components. Studies with no reference to the search strategy were excluded. A total of 182 articles were found. Among these, only 13 were included for writing this review. The MTT test is the most common test used to evaluate acrylic resin cytotoxicity. Auto-polymerized resin is more cytotoxic than heat-polymerized resin because of its higher quantity of residual monomers which cause cell and tissue changes in the oral mucosa. However, more studies are necessary for the development of biocompatible materials.
Topics: Animals; Biological Assay; Cell Line; Cell Proliferation; Cell Survival; Denture Bases; Dose-Response Relationship, Drug; Humans; Polymethyl Methacrylate; Risk Assessment; Risk Factors; Time Factors; Toxicity Tests
PubMed: 26469114
DOI: 10.17219/acem/33009 -
Journal of Clinical Medicine Sep 2023Denture prostheses are an ideal and extensive reservoir for microorganisms to attach to their surfaces. The aim of the study was to elucidate interactions between...
Denture prostheses are an ideal and extensive reservoir for microorganisms to attach to their surfaces. The aim of the study was to elucidate interactions between materials for the fabrication of denture bases and the attachment of microorganisms, focusing on respiratory pathogens and species. Specimens (6 mm × 1 mm) with a standardized surface roughness (Sa = 0.1 µm) were prepared from heat-pressed polymethyl methacrylate (PMMA), CAD/CAM-processed PMMA, and CAD/CAM-processed polyether ether ketone (PEEK). The specimens were randomly placed in the vestibular areas of complete upper dentures in seven patients and were removed either after 24 h without any oral hygiene measures or after a period of four weeks. The microorganisms adherent to the surface of the specimens were cultivated and subsequently analyzed using mass spectrometry (MALDI-TOF). The means and standard deviations were calculated, and the data were analyzed using a two-way analysis of variance (ANOVA) and Tukey post-hoc test where appropriate (α = 0.05). There was a significant increase ( ≤ 0.004) in the total bacterial counts (CFU/mL) between the first (24 h) and the second (four weeks) measurements. Regarding quantitative microbiological analyses, no significant differences between the various materials were identified. Respiratory microorganisms were detected in all samples at both measurement time points, with a large variance between different patients. Only after four weeks, species were identified on all materials but not in all participants. species and respiratory microorganisms accumulate on various denture base resins. While no significant differences were identified between the materials, there was a tendency towards a more pronounced accumulation of microorganisms on conventionally processed PMMA.
PubMed: 37834772
DOI: 10.3390/jcm12196127 -
Dental and Medical Problems 2020Denture stomatitis (DS) is a multifactorial disease, but the proliferation of Candida albicans (C. albicans) is the main causative factor. Different modalities have been... (Review)
Review
Denture stomatitis (DS) is a multifactorial disease, but the proliferation of Candida albicans (C. albicans) is the main causative factor. Different modalities have been suggested for the prevention and treatment of DS. Among the different approaches that have been implemented to inhibit and control DS there are the topical application of antifungal agents, the surface modification of the denture base and the incorporation of antimicrobial agents into the denture base material. Antifungal agents can effectively control DS, but the recurrence of the disease is common. Accordingly, it has been suggested that coating the surface of the acrylic denture base may result in a decreased fungal adhesion. In recent years, nanotechnology has dominated the research, and several nanoparticles have demonstrated antifungal effects. Therefore, the aim of this article was to review the antifungal effects of the different methods that have been suggested for the prevention and/or control of DS as well as the antimicrobial activity of denture base acrylic resin additives, including nanoparticles. Studies reporting the incorporation of antifungal/antimicrobial agents into the polymethyl methacrylate (PMMA) denture base were included in this review. The PubMed, Web of Science, Google Scholar, and Scopus databases were searched for the articles published between January 2000 and December 2018 using the following key words: dental prosthesis, denture stomatitis, candidiasis, antifungal agents, biofilm formation, polymethyl methacrylate, and PMMA. The antimicrobial material incorporated into the resin may have a superior effect in preventing DS over simply coating the surface of the denture base. However, some antimicrobial fillers can have adverse effects on the physical and mechanical properties of the denture base resin.
Topics: Acrylic Resins; Antifungal Agents; Candida albicans; Denture Bases; Humans; Stomatitis, Denture
PubMed: 32307934
DOI: 10.17219/dmp/112861 -
Acta Stomatologica Croatica Sep 2015The aim of this paper was to overview the current scientific knowledge concerning the effect of microwave disinfection on denture related material properties.... (Review)
Review
The aim of this paper was to overview the current scientific knowledge concerning the effect of microwave disinfection on denture related material properties. Cross-infection control in dentistry is a significant issue in everyday clinical practice due to the recent increase in some infectious diseases such as hepatitis B, C and AIDS and therefore numerous methods of disinfection have been used. The most widespread method of disinfection used in everyday practice is chemical, however, studies have suggested that chemical disinfectants alter the physical and mechanical properties of the acrylic resins and enable the growth and proliferation of certain bacteria. Therefore, microwaves were introduced as an easy to use-and-access, low cost, chemical free alternative. The question that arose was if and in what way the microwave irradiation affected the denture related material properties. Microwaving affects the denture resin bases, liners and teeth in different ways. The results showed that microwave disinfection could be a safe alternative for the disinfection of denture bases and liners compared to the chemical one, when the procedure is carried out in dry conditions, but could possibly cause dimensional changes of clinical significance on them when the irradiation takes place in wet environment. It also seems to have no detrimental effects of clinical importance on the flexural properties, impact strength and hardness of denture resins and the bond, flexural strength, porosity and hardness of denture liners. The effects of microwave disinfection on the hardness of denture teeth and teeth/denture bond strength are still controversial and no safe conclusions can be drawn.
PubMed: 27688409
DOI: 10.15644/asc49/3/7 -
Journal of Prosthodontic Research Jan 2022The antifungal property of chitosan (Ch) in denture base resin (DBR) was well established. Ch influence on the mechanical properties of DBR is less studied in the...
PURPOSE
The antifungal property of chitosan (Ch) in denture base resin (DBR) was well established. Ch influence on the mechanical properties of DBR is less studied in the literature and is vital for clinical success of denture. This study estimates the effect of different concentrations of Ch on the flexural strength (FS), fracture toughness (FT), impact strength (IS) and surface roughness (Ra) in heat polymerized DBR.
METHODS
A total of 160 samples were divided into 4 groups (n =10) by weight percentage - Ch 0, Ch 5, Ch 10, Ch 15. FS and FT were estimated by three-point bending test. IS was determined by Charpy test. Ra was evaluated by non-contact laser surface profilometer. The tested samples were characterized by scanning electron microscope and Fourier transformation infra-red spectroscopy. Data were statistical analyzed with one-way ANOVA and Post hoc Bonferroni test.
RESULTS
FS, FT and IS improved with Ch addition when compared to control group. Ch5 showed higher "FS, FT, IS. (p<0.001)". Increased Ra was observed in Ch5 and Ch10 with significant statistical differences among the groups. (p <0.001) Ch15 displayed decrease in Ra compared to control group.
CONCLUSION
The addition of Ch to DBR improved the "FS, FT, IS at 5%wt and Ra at 15%wt" of Ch.
Topics: Chitosan; Denture Bases; Hot Temperature; Materials Testing; Surface Properties
PubMed: 33896890
DOI: 10.2186/jpr.JPR_D_20_00257