Mohammed M. Gad

PMMA denture base material enhancement: a review of fiber, filler, and nanofiller addition

This paper reviews acrylic denture base resin enhancement during the past few decades. Specific attention is given to the effect of fiber, filler, and nanofiller addition on poly(methyl methacrylate) (PMMA) properties. The review is based on scientific reviews, papers, and abstracts, as well as studies concerning the effect of additives, fibers, fillers, and reinforcement materials on PMMA, published between 1974 and 2016. Many studies have reported improvement of PMMA denture base material with the addition of fillers, fibers, nanofiller, and hybrid reinforcement. However, most of the studies were limited to in vitro investigations without bioactivity and clinical implications. Considering the findings of the review, there is no ideal denture base material, but the properties of PMMA could be improved with some modifications, especially with silanized nanoparticle addition and a hybrid reinforcement system.

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.

The Reinforcement Effect of Nano-Zirconia on the Transverse Strength of Repaired Acrylic Denture Base

Objective. The aim of this study was to evaluate the effect of incorporation of glass fiber, zirconia, and nano-zirconia on the transverse strength of repaired denture base. Materials and Methods. Eighty specimens of heat polymerized acrylic resin were prepared and randomly divided into eight groups (n = 10): one intact group (control) and seven repaired groups. One group was repaired with autopolymerized resin while the other six groups were repaired using autopolymerized resin reinforced with 2 wt% or 5 wt% glass fiber, zirconia, or nano-zirconia particles. A three-point bending test was used to measure the transverse strength. The results were analyzed using SPSS and repeated measure ANOVA and post hoc least significance (LSD) test (P ≤ 0.05). Results. Among repaired groups it was found that autopolymerized resin reinforced with 2 or 5 wt% nano-zirconia showed the highest transverse strength (P ≤ 0.05). Repairs with autopolymerized acrylic resin reinforced with 5 wt% zirconia showed the lowest transverse strength value. There was no significant difference between the groups repaired with repair resin without reinforcement, 2 wt% zirconia, and glass fiber reinforced resin. Conclusion. Reinforcing of repair material with nano-zirconia may significantly improve the transverse strength of some fractured denture base polymers.

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.

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.

A Novel Approach to Improve Repair Bond Strength of Repaired Acrylic Resin: An in Vitro Study on the Shear Bond Strength: New Approach to Improve Repair Bond Strength

PURPOSE To evaluate the combined effect of mechanical surface treatment with intermediate bonding agents (methyl methacrylate [MMA] and silane coupling agents) and ZrO2 nanoparticle (nano-ZrO2 ) addition to repair material on the shear bond strength (SBS) of repaired denture bases. MATERIALS AND METHODS Heat-polymerized acrylic resin was used to fabricate 130 cylindrical blocks (15 mm × 10 mm) and divided into a control group without treatment (C, n = 10), and 3 repair groups (n = 40/group) divided into specimens treated with alumina blasting alone (AB), specimens blasted with alumina combined with silane coupling agent (AB + SCA), or combined with MMA-based composite bonding agent (AB + MA). Treated groups were further subdivided according to nano-ZrO2 concentrations into 0 wt%, 2.5 wt%, 5 wt%, and 7.5 wt% added to repair resin powder. Repair resin monomer and polymer were combined and packed on the repair area and then placed in a pressure pot at 37°C for 15 minutes for polymerization. Shear bond test was performed using a universal testing machine. Scanning electron microscopy (SEM) was used to examine the effect of surface modifications on repair surfaces and to evaluate the topography of fracture surfaces. Tukey-Kramer multiple-comparison test was used to detect significant differences between groups (p ≤ 0.05). RESULTS SBS (MPa) of specimens treated with alumina blasting and application of intermediate agents were significantly higher than the control group (p < 0.05), while no significant differences were found between AB and control group (p > 0.05). Nano-ZrO2 addition significantly increased SBS except for AB, and 5%, 7.5% MA (p > 0.05). SEM evaluation showed that alumina blasting created rougher and more porous surfaces, while SCA and MA reduced the irregularities and fissures. CONCLUSION Application of bonding agents to repair surfaces after alumina blasting improved the repair bond strength and proved to be a possible new adhesive method for denture repair. Moreover, nano-ZrO2 addition in combination with surface treatment improved the repair bond strength.

Effect of Nanodiamond Addition on Flexural Strength, Impact Strength, and Surface Roughness of PMMA Denture Base: Nanodiamond Effect on PMMA Denture Base

PURPOSE To assess the effect of addition of different concentrations of nanodiamonds (NDs) on flexural strength, impact strength, and surface roughness of heat-polymerized acrylic resin. MATERIALS AND METHODS 120 specimens were fabricated from heat-polymerized acrylic resin. They were divided into a control group of pure polymethylmethacrylate (PMMA; Major.Base.20) and three tested groups (PMMA-ND) with 0.5%wt, 1%wt, and 1.5%wt of added ND to PMMA. Flexural strength was determined using the three-point bending test. Impact strength was recorded by using a Charpy type impact test. Surface roughness test was performed using a Contour GT machine. One-way ANOVA and Tukeys post-hoc analysis (p ≤ 0.05) were used for statistical analysis. RESULTS Acrylic resin reinforced with 0.5% ND displayed significantly higher flexural strength than the unreinforced heat-polymerized specimens, acrylic resin reinforced with 1% ND and the 1.5% ND (p < 0.0001). The impact strength of unreinforced heat-polymerized specimens was significantly higher than all nano-composite materials (p < 0.0001) with no significant difference between 1% ND and the 1.5% ND (p > 0.05). The addition of 0.5% ND and 1% ND significantly decreased the surface roughness in comparison to both control and the 1.5% ND groups (p < 0.0001) while no significant differences between 0.5% ND and 1% ND (p > 0.05) were reported. Nano-composite material (0.5% ND) showed significantly lower surface roughness when compared to other specimens. CONCLUSIONS The addition of NDs to acrylic denture base improved the flexural strength and surface roughness at low concentrations (0.5%), while the impact strength was decreased with ND addition.

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.

Impact of Denture Cleansing Solution Immersion on Some Properties of Different Denture Base Materials: An In Vitro Study: Immersion Impact of Denture Cleansing Agents

Purpose To evaluate the effect of several denture cleansing solutions on the color stability, surface roughness, and flexural strength of three denture base materials. Materials and Methods Twenty-seven specimens were prepared using heat-polymerized (HP) denture base material, 27 using autopolymerized (AP) denture base material, and 27 using visible-light-polymerized (VLP) denture base, creating a total of 81 specimens. The specimens were randomly divided into three groups (n = 27): the distilled water group (DWG), Corega group (CG), and Renew group (RG). Color changes (ΔE), surface roughness (Ra, nm), and flexural strength (MPa) of each specimen were measured using a spectrophotometer, an optical profilometer, and a universal testing machine, respectively. The results were statistically analyzed using a one-way ANOVA and a post hoc Tukeys test (α = 0.05). Results The only statistically significant color change detected was in the VLP resin treated with Corega and Renew. There was a significant increase in the surface roughness of all denture resin groups after immersion in Corega. Immersion in Renew significantly increased surface roughness only in the HP and AP specimens. The only significant reduction in flexural strength was detected in the HP resin after immersion in Corega (p < 0.05). Conclusions Within the limitations of this study, it can be concluded that Corega has a significantly greater negative impact than distilled water on the flexural strength of HP resin base materials. Renew significantly increased the surface roughness of AP and HP, while Corega increased the surface roughness of all resin materials.PURPOSE To evaluate the effect of several denture cleansing solutions on the color stability, surface roughness, and flexural strength of three denture base materials. MATERIALS AND METHODS Twenty-seven specimens were prepared using heat-polymerized (HP) denture base material, 27 using autopolymerized (AP) denture base material, and 27 using visible-light-polymerized (VLP) denture base, creating a total of 81 specimens. The specimens were randomly divided into three groups (n = 27): the distilled water group (DWG), Corega group (CG), and Renew group (RG). Color changes (ΔE), surface roughness (Ra, nm), and flexural strength (MPa) of each specimen were measured using a spectrophotometer, an optical profilometer, and a universal testing machine, respectively. The results were statistically analyzed using a one-way ANOVA and a post hoc Tukeys test (α = 0.05). RESULTS The only statistically significant color change detected was in the VLP resin treated with Corega and Renew. There was a significant increase in the surface roughness of all denture resin groups after immersion in Corega. Immersion in Renew significantly increased surface roughness only in the HP and AP specimens. The only significant reduction in flexural strength was detected in the HP resin after immersion in Corega (p < 0.05). CONCLUSIONS Within the limitations of this study, it can be concluded that Corega has a significantly greater negative impact than distilled water on the flexural strength of HP resin base materials. Renew significantly increased the surface roughness of AP and HP, while Corega increased the surface roughness of all resin materials.