Ahmad M. Al-Thobity

Influence of incorporation of ZrO 2 nanoparticles on the repair strength of polymethyl methacrylate denture bases

Background Repeated fracture of the denture base is a common problem in prosthodontics, and it represents a nuisance and a time sink for the clinician. Therefore, the possibility of increasing repair strength using new reinforcement materials is of great interest to prosthodontists. Aim of the study This study aimed to evaluate the effects of incorporation of zirconia nanoparticles (nano-ZrO2) on the flexural strength and impact strength of repaired polymethyl methacrylate (PMMA) denture bases. Materials and methods One hundred eighty specimens of heat-polymerized acrylic resin were fabricated (90 for each test) and divided into three main groups: one control group (intact specimens) and two groups divided according to surface design (45° bevels and butt joints), in which specimens were prepared in pairs to create 2.5 mm gaps. Nano-ZrO2 was added to repair resin in 2.5 wt%, 5 wt%, and 7.5 wt% concentrations of acrylic powder. A three-point bending test was used to measure flexural strength, and a Charpy-type test was used to measure impact strength. Scanning electron microscopy was used to analyze the fracture surfaces and nano-ZrO2 distribution. The results were analyzed with a paired sample t-test and an unpaired t-test, with a P-value of ≤0.05 being significant. Results Incorporation of nano-ZrO2 into the repair resin significantly increased flexural strength (P<0.05). The highest value was found in the bevel group reinforced with 7.5% nano-ZrO2, whereas the lowest value was found in the butt group reinforced with 2.5% nano-ZrO2. The impact strength values of all repaired groups were significantly lower than those of the control group (P<0.05). Among repaired groups, the higher impact strength value was seen in the butt group reinforced with 2.5% nano-ZrO2. The bevel joint demonstrated mainly cohesive failure, whereas the butt joint demonstrated mainly adhesive failure. Conclusion Incorporation of nano-ZrO2 into the repair resin improved the flexural strength of repaired denture bases, whereas it decreased impact strength, especially with high nano-ZrO2 concentrations.

Zygomatic Implants as a Rehabilitation Approach for a Severely Deficient Maxilla

A gunshot injury is one of the main trauma injuries that affect the head and neck region. Severe esthetic, functional, and psychologic deficiencies are consequences of gunshot injuries. The use of implants anchored in the zygomatic bone has been advocated as an approach to the prosthetic rehabilitation of a severely deficient maxilla. This approach provides the patient with an immediate, high-quality, esthetic, and functional complete fixed prosthesis and eliminates the need for bone grafting. In this case report, a patient with a severely deficient maxilla caused by a gunshot injury was rehabilitated by placement of four zygomatic and two pterygomaxillary implants, which were immediately loaded with a complete fixed all-acrylic resin interim prosthesis. The definitive CM Prosthesis (CM Prosthetics) was constructed using computer-aided design/computer-assisted manufacture (CAD/CAM) technology.

Effect of software facilitated teaching on final grades of dental students in a dental morphology course

Objectives: To evaluate differences in students’ performance in a dental morphology course after the introduction of a 3D software-teaching program. Methods: This retrospective study took place at the College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia, from Augst 2013 to January 2016. The study included 3 groups of students taking the course during 3 different academic years: group 1, 2013-14 control; group 2, 2014-2015; and group 3, 2015-2016. The total sample size was 294 (n = 294; group 1 = 94; group 2 = 100; and group 3 = 100). Group 1 =students did not receive teaching facilitated by a software program, but groups 2 and 3 students were provided with the program’s CDs. The final examination grades of the students were statistically analyzed, retrospectively Results: The results demonstrated that the students who received software-facilitated teaching (groups 2 and 3) performed better than the students who did not receive it (group 1). Within the same year for groups 2 and 3, the number of students achieving good grades (>80%) was significantly higher than the students who achieved average grades (<79%), with p-values of 0.012 for group 2 and 0.009 for group 3. Conclusion: There is a positive correlation between the use of a teaching software program for students and their performance in final examinations. The addition of computer-based learning, as one of the teaching methods, could demonstrably boost students’ learning.

Efficacy of novel cleansing agent for the decontamination of lithium disilicate ceramics: a shear bond strength study

Abstract Purpose: To investigate the efficacy of Ivoclean as a ceramic cleansing agent, by assessing shear bond strength of pre-etched lithium disilicate (LD) ceramic to resin cement. Materials and Methods: Seventy LD discs (10 × 10 × 4 mm) were fabricated and etched using 5% hydrofluoric acid (HF) for 20 s. Ten specimens were not exposed to saliva and silicone disclosing medium (negative control). The other 60 specimens, divided into six groups (n = 10), were exposed to saliva for 20 s and silicone disclosing medium for 3 min. Following contamination, 10 specimens were not cleansed (positive control). The remaining five groups were exposed to one of the five different cleansing agents: 96% isopropanol, 37% phosphoric acid-30 s, 5% HF acid- 20 s, 5% HF acid- 120 s, and Ivoclean paste-20 s. All specimens were treated with primer and bonded to a self-curing resin cement. Before shear bond strength testing, all specimens were thermocycled (3000 cycles; 5–55°). Results: Contamination of pre-etched LD ceramic specimens significantly reduced the shear bond strength values from 22.39 ± 0.38 MPa (negative control) to 6.54 ± 0.90 MPa (positive control) (p < 0.05). Cleansing of contaminated ceramic specimens with 5% HF acid [20 s (19.28 ± 1.06 MPa) and 120 s (20.04 ± 1.09 MPa)] and Ivoclean (18.30 ± 0.97) provided significantly higher bond strength values than other cleansing methods with 37% phosphoric acid and 96% isopropanol (p < 0.05). Conclusion: Ivoclean and 5% HF acid were found to be effective in cleansing of LD ceramic surface by demonstrating maximum increase in shear bond strength values as compared to contaminated LD ceramics.

Inhibitory effect of zirconium oxide nanoparticles on Candida albicans adhesion to repaired polymethyl methacrylate denture bases and interim removable prostheses: a new approach for denture stomatitis prevention

Background Despite drawbacks, cold-cured acrylic resin is still the most common material used in denture repair. Zirconia nanoparticles were among the reinforcements added to increase the strength of the resin. The effect on Candida due to the addition of zirconia nanoparticles to the resin has not been investigated. Purpose The aim of this study was to evaluate the effect of zirconia nanoparticles added to cold-cured acrylic resin on Candida albicans adhesion. Materials and methods A total of 120 acrylic resin specimens with dimensions measuring 22×10×2.5 mm3 were prepared and divided into two equal groups. One group (repair) comprised heat-polymerized specimens that were sectioned at the center and prepared to create a 2 mm repair area that was repaired with cold-cured resin reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. The second group contained intact cold-cured acrylic resin specimens reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. Specimens were incubated at 37°C in artificial saliva containing C. albicans, and the effect of zirconia nanoparticles on C. albicans was assessed using two methods: 1) a slide count method and 2) a direct culture test. Variations in the number of living Candida were observed in relation to the different concentrations of zirconia nanoparticles. Analysis of variance (ANOVA) and post hoc Tukey’s tests were performed for data analysis. If the P-value was ≤0.05, then the difference was considered as statistically significant. Results It was found that C. albicans adhesion to repaired specimens was significantly decreased by the addition of zirconia nanoparticles (P<0.00001) in comparison with the control group. Intact cold-cured groups and groups repaired with cold-cured resin reinforced with 7.5% wt zirconia nanoparticles showed the lowest Candida count. Tukey’s test showed a significant difference between the repaired group and the intact cold-cured group, while the later demonstrated a lower Candida count. Conclusion The addition of zirconia nanoparticles to cold-cured acrylic resin is an effective method for reducing Candida adhesion to repaired polymethyl methacrylate (PMMA) denture bases and cold-cured removable prosthesis. Clinical significance Based on the results of the current study, zirconia nanoparticles have an antifungal effect, which could be incorporated in the repair material for repairing denture bases and in PMMA removable prostheses as a possible approach for denture stomatitis prevention.

Fabrication of an Implant-Supported Fixed Interim Prosthesis Using a Duplicate Denture: An Alternative Technique: Implant-Supported Fixed Interim Prosthesis

The fabrication of an implant-supported fixed complete denture prosthesis involves multiple clinical and laboratory steps. One of the main steps is to provide the patient with an interim fixed prosthesis to evaluate the patients esthetic and functional needs as well as to enhance the patients psychology before proceeding to the definitive prosthesis. Different techniques for fabricating interim prostheses have been described in the literature. This report describes an alternative technique that uses a duplicate denture made of self-curing acrylic resin to fabricate an implant-supported fixed interim prosthesis. The interim prosthesis was later used as a blueprint for the definitive implant-supported hybrid prosthesis.

Flexural and Surface Properties of PMMA Denture Base Material Modified with Thymoquinone as an Antifungal Agent: Properties of PMMA/Thymoquinone Denture Base

PURPOSE To evaluate the effect of addition of different concentrations of thymoquinone (TQ) on the flexural strength, elastic modulus, surface roughness, and hardness of PMMA denture base material. MATERIALS AND METHODS A total of 160 rectangular specimens were prepared from heat-polymerized acrylic resin, with dimensions of 65 × 10 × 2.5 mm3 for flexural strength testing and 10 × 20 × 3 mm3 for surface property testing. The specimens were divided into eight groups of 20 specimens: one control group without addition of TQ and seven test groups prepared by adding TQ to acrylic powder in concentrations of 0.5, 1, 1.5, 2, 2.5, 3, and 5 wt%. The polymer was added to the monomer before being mixed, packed, and processed using the conventional water bath method. A universal testing machine was used to measure flexural strength and elastic modulus. A profilometer and a Vickers hardness tester were used to measure surface roughness and hardness, respectively. One-way ANOVA and the Tukey-Kramer multiple-comparison test were used for statistical analysis, with statistical significance at p ≤ 0.05. RESULTS Addition of TQ to PMMA denture base material significantly decreased flexural strength and elastic modulus at high concentrations (p < 0.01), while no significant differences were observed at low concentrations (0.5%, 1% TQ) in comparison with the control group. At high TQ concentrations, surface roughness increased while hardness decreased (p < 0.0001), and no significant differences were observed at low concentrations (0.5%, 1% TQ) in comparison with the control group. The most favorable addition values were 0.5% and 1% TQ in all TQ groups. CONCLUSIONS Addition of TQ did not affect the flexural and surface properties of PMMA denture base material at low concentrations (0.5%, 1% TQ) and could be incorporated into PMMA denture base material as an antifungal agent.

Shear bond strength of bis-acryl resin provisional material repaired using a flowable composite

Abstract This study investigated the shear bond strength of a bis-acryl composite repaired with a flowable composite after different surface treatments. Sixty standardized cylindrical silicone molds were filled with bis-acryl resin provisional material and then divided into six groups (n = 10 per group) to undergo different surface treatments. After a surface treatment had been performed, the flowable composite was injected directly into the cylinder of each specimen, and the specimens were then cured over a 10-mm-thick glass slide for 20 s. The shear bond strength was determined using a universal testing machine at a crosshead speed of 1.0 mm/min by placing a knife-edged blade immediately adjacent and parallel to the adhesive interface between the repair material (flowable composite) and the bis-acryl resin provisional material. The mean shear bond strengths ranged from 8.98 to 17.14 MPa. The highest mean shear bond strength corresponded to the bonding group (17.14 MPa), whereas the air-particle abrasion group exhibited the lowest mean shear bond strength (8.98 MPa). Surface treatment of bis-acryl resins with bonding appears to be a promising approach for improving repair bond strength, and the bonding group exhibited the highest levels of bond strength.

Effect of zirconium oxide nanoparticles addition on the optical and tensile properties of polymethyl methacrylate denture base material

Background Polymethyl methacrylate (PMMA) is widely used for the fabrication of removable prostheses. Recently, zirconium oxide nanoparticles (nano-ZrO2) have been added to improve some properties of PMMA, but their effect on the optical properties and tensile strength are neglected. Objective The aim of this study was to investigate the effect of nano-ZrO2 addition on the translucency and tensile strength of the PMMA denture base material. Materials and methods Eighty specimens (40 dumbbell-shaped and 40 discs) were prepared out of heat-polymerized acrylic resin and divided into four groups per test (n=10). The control group for each test included unreinforced acrylic, while the test groups were reinforced with 2.5, 5, and 7.5 wt% nano-ZrO2. Acrylic resin was mixed according to manufacturer’s instructions, packed, and processed by conventional method. After polymerization, all specimens were finished, polished, and stored in distilled water at 37°C for 48±2 hours. Tensile strength (MPa) was evaluated using the universal testing machine while the specimens’ translucency was examined using a spectrophotometer. Statistical analysis was carried out by SPSS using the paired sample t-test (p≤0.05). A scanning electron microscope was used to analyze the morphological changes and topography of the fractured surfaces. Results This study showed that the mean tensile strength of the PMMA in the test groups of 2.5%NZ, 5%NZ, and 7.5%NZ was significantly higher than the control group. The tensile strength increased significantly after nano-ZrO2 addition, and the maximum increase seen was in the 7.5%NZ group. The translucency values of the experimental groups were significantly lower than those of the control group. Within the reinforced groups, the 2.5%NZ group had significantly higher translucency values when compared to the 5%NZ and 7.5%NZ groups. Conclusion The addition of nano-ZrO2 increased the tensile strength of the denture base acrylic. The increase was directly proportional to the nano-ZrO2 concentration. The translucency of the PMMA was reduced as the nano-ZrO2 increased. Clinical significance Based on the results of the current study, the tensile strength was improved with different percentages of nano-ZrO2 additions. However, translucency was adversely affected. Therefore, it is important to determine the appropriate amount of reinforcing nano-ZrO2 that will create a balance between achieved properties – mechanical and optical.

Effect of polymerization technique and glass fiber addition on the surface roughness and hardness of PMMA denture base material

The current study evaluated the effects of autoclave polymerization both with and without glass fiber (GF) reinforcement on the surface roughness and hardness of acrylic denture base material. Ninety disc specimens (30×2.5 mm) were prepared from Vertex resin and divided according to polymerization techniques into a water bath, short and long autoclave polymerization groups. Tested groups were divided into three subgroups according to the GF concentration (0, 2.5, and 5 wt%). Profilometer and Vickers hardness tests were performed to measure surface roughness and hardness. ANOVA and Tukey-Kramer multiple comparison tests analyzed the results, and p≤0.05 was considered statistically significant. Autoclave polymerization significantly decreased the surface roughness and increased the hardness of acrylic resin without GF reinforcement (p<0.05). However, 5 wt% GF addition significantly increased surface roughness and decreased hardness of the autoclave polymerized denture base resin (p<0.05). Surface properties of Polymethyl methacrylate (PMMA) denture base material improved with autoclave polymerization and negatively affected with GFs addition.