A Technique for Retrofitting a Metal Ceramic Crown to an Attachment‐Retained Removable Partial Denture: A Clinical Report

In dental applications, precision attachments have been used to retain removable partial dentures (RPDs) for several decades. Various types of extracoronal attachments are commonly used in combination with fixed partial dentures and RPDs to achieve retention and stability. Fracture of the framework, fracture of the roots or teeth, and irretrievable decrease of retention are common reasons for a failed attachment‐retained RPD. Another complication of metal ceramic crowns with precision attachment is decementation of the crowns. When fixed components of the attachment‐retained RPD fail, the traditional treatment approach requires remaking both the fixed and removable components of the attachment‐retained RPD. This technique describes retrofitting of a metal ceramic crown to a resilient attachment‐retained RPD.     

Comparison of the Dimensional Accuracy of Injection-Molded Denture Base Materials to that of Conventional Pressure-Pack Acrylic Resin

Purpose : This study compared the linear dimensional changes of 3 injection-molded denture base materials to that of conventionally processed polymethylmethacrylate (PMMA) resin.
Materials and Methods : An impression of an aluminum maxillary edentulous arch was made with a condensation silicone impression material (Denture Elasticon) to fabricate a gypsum master cast that was replicated as a silicone mold. A maxillary complete denture with acrylic teeth was waxed to full contour on the master cast and replicated to make 40 wax dentures. ERA attachments cast in metal (Rexillium) with indices milled into the centers were waxed into 3 positions in each denture for recording dimensional measurements of the wax denture. Ten dentures were allocated to each of 4 groups; Group 1 was processed using conventionally processed PMMA (Microlon), Group 2 used injection-molded PMMA (SR-lvocap), Group 3 employed injection-molded nylon (Valplast), and Group 4 used injection-molded styrene (Northern). All processed specimens were stored at room temperature (25°C, ambient humidity) for 1 week (while still on the master cast) before anteroposterior and cross-arch measurements were made using the ERA reference points with a digital caliper. After separation from the master cast and following water storage at 37°C for 7 days additional measurements were made.
Results : An analysis of the results showed that the effect of processing was not the same for the 3 dimensions studied, regardless of which dimension was considered ( p < 0.0001). The pattern of dimensional changes associated with the material type was not the same between the wax and processing stages as it was for the change between the processing and decasting stages ( p < 0.0001).
Conclusions : Processing the denture base materials produced unequal deformation in different dimensions (anterior-posterior and cross-arch). Each material tested also responded differently to the processing stages.     

An In Vitro Analysis of Wear Resistance of Commercially Available Acrylic Denture Teeth

Posterior denture teeth wear faster than the anterior teeth, causing occlusal prematurities and loss of vertical dimension of occlusion. The loss of vertical dimension of occlusion lays more stress on the anterior alveolar ridge, which in turn increases the rate of residual ridge resorption and causes loss of alveolar ridge height in the anterior segment and compromises esthetics. Hence it is important for the clinician to choose acrylic resin teeth with high wear resistance. The objective of the study is to investigate and compare the wear resistance of three different commercially available acrylic resin denture teeth. 60 specimens were tested for wear resistance in terms of loss of weight and loss in volume on a wear and friction monitor for 5,000 cycle wear periods (total of 10,000 cycles) under a 0.20 kg load. Statistical analysis used: The findings were analyzed using one way analysis of variance (ANOVA) and Tukey HSD test. Comparison of weight loss and volume loss between Surana ultradent, Premadent and Dentek showed highly significant difference, Surana ultraddent having better wear resistance. Surana ultradent acrylic resin denture had highest wear resistance amongst the three groups of tested samples.     

Effect of Three Methods for Cleaning Dentures on Biofilms Formed In Vitro on Acrylic Resin

Purpose: The aim of this study was to evaluate the effect of three denture hygiene methods against different microbial biofilms formed on acrylic resin specimens.
Materials and methods: The set (sterile stainless steel basket and specimens) was contaminated (37°C for 48 hours) by a microbial inoculum with 10⁶ colony-forming units (CFU)/ml (standard strains: Staphylococcus aureus , Streptococcus mutans , Escherichia coli, Candida albicans, Pseudomonas aeruginosa , and Enterococcus faecalis ; field strains: S. mutans , C. albicans , C. glabrata , and C. tropicalis ). After inoculation, specimens were cleansed by the following methods: (1) chemical: immersion in an alkaline peroxide solution (Bonyplus tablets) for 5 minutes; (2) mechanical: brushing with a dentifrice for removable prostheses (Dentu Creme) for 20 seconds; and (3) a combination of chemical and mechanical methods. Specimens were applied onto a Petri plate with appropriate culture medium for 10 minutes. Afterward, the specimens were removed and the plates incubated at 37°C for 48 hours.
Results: Chemical, mechanical, and combination methods showed no significant difference in the reduction of CFU for S. aureus , S. mutans (ATCC and field strain), and P. aeruginosa . Mechanical and combination methods were similar and more effective than the chemical method for E. faecalis , C. albicans (ATCC and field strain), and C. glabrata . The combination method was better than the chemical method for E. coli and C. tropicalis , and the mechanical method showed intermediate results.
Conclusion: The three denture hygiene methods showed different effects depending on the type of microbial biofilms formed on acrylic base resin specimens.     

Rehabilitation of Anterior Edentulous Space by Glass Fiber Reinforced Composite Removable Partial Denture During Preadolescent Period: A Case Report

The loss of anterior teeth can be hurtful to the patient both psychologically and socially. In adolescent patients, temporary replacement of the teeth can minimize these concerns. Many approaches have been described for this temporary replacement. This article presents an alternative approach for oral rehabilitation of the preadolescent male who has edentulous space including median palatine suture in the anterior maxilla. High expectations regarding esthetics by the patient were successfully met by utilizing a glass fiber reinforced composite temporary removable partial denture. Restoration remained intact, with no discoloration or deterioration at 12 months recall.     

Effect of Tea, Coffee and Turmeric Solutions on the Colour of Denture Base Acrylic Resin: An In Vitro Study

Discoloration of acrylic resin denture base when it comes in contact with various food materials and beverages in the oral cavity may cause aesthetic concern to a denture wearer. The objective of this study was to evaluate the effect of tea, coffee and turmeric solutions on the colour of different brands of heat cure acrylic resin denture base materials commonly used in India. Spectrophotometer was used to evaluate the colour change. A significant difference was found when change in colour was statistically analysed.     

In Vitro Tensile Bond Strength of Denture Repair Acrylic Resins to Primed Base Metal Alloys Using Two Different Processing Techniques

Purpose: Approximately 38% of removable partial denture (RPD) failures involve fracture at the alloy/acrylic interface. Autopolymerizing resin is commonly used to repair RPDs. Poor chemical bonding of repair acrylic to base metal alloys can lead to microleakage and failure of the bond. Therefore, ideal repair techniques should provide a strong, adhesive bond. This investigation compared the tensile bond strength between cobalt‐chromium (Super Cast, Pentron Laboratory Technologies, Llc., Wallingford, CT) and nickel‐chromium (Rexalloy, Pentron Laboratory Technologies, Llc.) alloys and autopolymerized acrylic resin (Dentsply Repair Material, Dentsply Int, Inc, York, Pa) using three primers containing different functional monomers [UBar (UB), Sun Medical Co., Ltd., Shiga, Japan: Alloy Primer (AP) Kuraray Medical Inc., Okayama, Japan; and MR Bond (MRB) Tokyuyama Dental Corp., Tokyo, Japan] and two processing techniques (bench cure and pressure‐pot cure). Material and Methods: One hundred and twenty eight base metal alloy ingots were polished, air abraded, and ultrasonically cleaned. The control group was not primed. Specimens in the test groups were primed with one of the three metal primers. Autopolymerized acrylic resin material was bonded to the metal surfaces. Half the specimens were bench cured, and the other half were cured in a pressure pot. All specimens were stored in distilled water for 24 hours at 37°C. The specimens were debonded under tension at a crosshead speed of 0.05 cm/min. The forces at which the bond failed were noted. Data were analyzed using ANOVA. Fisher's PLSD post hoc test was used to determine significant differences (p < 0.05). Failure modes of each specimen were evaluated under a dissecting microscope. Results: Significant differences in bond strength were observed between combinations of primers, curing methods, and alloys. Primed sandblasted specimens that were pressure‐pot‐cured had significantly higher bond strengths than primed sandblasted bench‐cured specimens. The pressure‐pot‐curing method had a significant effect on bond strength of all specimens except Co‐Cr alloy primed with UB. The highest bond strength was observed for both Co‐Cr and Ni‐Cr alloys that were sandblasted, primed with MRB, and pressure‐pot cured. Co‐Cr alloys primed with UB had the lowest bond strength whether bench cured or pressure‐pot cured. Primed specimens generally experienced cohesive bond failures within the primer or acrylic resin. Nonprimed specimens generally experienced adhesive bond failures at the resin/metal interface. Conclusions: Within the limitations of this study, MRB provided the highest bond strength to both Ni‐Cr and Co‐Cr alloys. Generally, bond strength improved significantly when specimens were primed. Pressure‐pot curing, in most cases, resulted in higher bond strength than bench curing. The results of this in vitro study suggest that MRB metal primer can be used to increase bond strength of autopolymerized repair acrylic resin to base metal alloys. Curing autopolymerized acrylic under pressure potentially increases bond strength.     

Restoration of the Occlusal Vertical Dimension with an Overlay Removable Partial Denture: A Clinical Report

The process of tooth loss throughout life associated with severe occlusal wear may pose a challenge in the rehabilitation of partially edentulous arches. In these cases, many therapeutic procedures are necessary because each tooth must be restored to obtain the correct anatomical contour and recover the occlusal vertical dimension (OVD). A removable partial denture (RPD) with occlusal/incisal coverage, also known as an overlay RPD, is an alternative treatment option with fewer interventions, and, consequently, lower cost. This clinical report reviews the principles involved in the clinical indication for an overlay RPD, as well as the necessary planning and execution, to discuss the feasibility and clinical effectiveness of this treatment, identifying the indications, advantages, and disadvantages of this procedure through the presentation of a clinical case. The overlay RPD can be an alternative treatment for special situations involving partially edentulous arches in patients who need reestablishment of the OVD and/or realignment of the occlusal plane, and it can be used as a temporary or definitive treatment. The main advantages of this type of treatment are its simplicity, reversibility, and relatively low cost; however, further studies are needed to ensure the efficacy of this treatment option.     

Fracture Resistance of Three Ceramic Inlay‐Retained Fixed Partial Denture Designs. An In Vitro Comparative Study

Purpose: The fracture resistance of ceramic inlay‐retained fixed partial dentures (CIRFPDs) was studied. Materials and Methods: Thirty CIRFPDs were constructed using ice zircon milled ceramic material. Specimens were divided into three groups, 10 specimens each, according to the abutment preparation: inlay‐shaped (occluso‐proximal inlay + proximal box), tub‐shaped (occluso‐proximal inlay), and proximal box‐shaped preparations. Each group was then subdivided into two subgroups of five specimens each, according to the span of the edentulous area representing a missing premolar or molar. All specimens were subjected to a fracture resistance test. Results: CIRFPDs with inlay‐shaped retainers showed the highest fracture resistance values for missing premolars and molars. CIRFPDs with box‐shaped retainers showed lower fracture resistance values. Statistical analysis revealed a significant difference between the three tested CIRFPD designs. There was a statistically significant difference between CIRFPDs constructed for the replacement of molars and those constructed for the replacement of premolars. The CIRFPD constructed for the replacement of molars gave lower fracture resistance values with the three tested designs. All the fracture resistance values obtained in this study were superior to the assumed maximum mastication forces. Failure mode was delamination and chipping of the veneering material. Conclusions: There was a statistically significant difference between the three designs of CIRPFDs tested. There was a statistically significant difference between CIRFPDs constructed for the replacement of molars than those constructed for the replacement of premolars. The CIRFPDs constructed for the replacement of molars gave lower fracture resistance values with the three tested designs. All fracture resistance values obtained in this study were superior to the assumed maximum mastication forces.     

An In-Vitro Evaluation of the Flexural Strength of Heat-Polymerized Poly (Methyl Methacrylate) Denture Resin Reinforced with Fibers

Fracture strength of denture base resins is of great concern and many approaches have been made to improve the fracture resistance of acrylic resin dentures by strengthening them. Purpose of the study was to assess the effect of a Novel pre-impregnated glass fiber reinforcement system and nylon fiber reinforcement on the flexural strength of conventional heat-polymerized poly(methylmethacrylate) [PMMA] denture resin under dry and wet storage conditions. Forty specimens of standard dimensions were prepared for each of the four experimental groups; unreinforced conventional acrylic resin and the same reinforced with unidirectional Stick (S) glass fibers, woven Stick Net (SN) glass fibers and nylon fibers. Each group was further subdivided into two groups of 20 specimens each on the basis of storage conditions (dry and wet). All 160 specimens were then subjected to a 3-point bending test and flexural strength was calculated. Statistical analysis was carried out using student t test and 1-way analysis of variance (ANOVA). Stick and Stick Net glass fiber reinforcements enhanced the flexural strength of conventional heat-cured PMMA denture resin. Specimens reinforced with Stick glass fibers exhibited highest flexural strength followed by those reinforced with Stick Net glass fibers. Nylon fiber reinforcement decreased the flexural strength of acrylic resin. All the specimens in the four groups stored under wet conditions showed decrease in flexural strength in comparison to those stored in dry conditions. The reinforcement of denture base resin with pre-impregnated glass fibers may be a useful means of strengthening denture bases. Use of nylon as a reinforcement fiber is not desirable as it decreased the flexural strength of acrylic resin.     

Effect of Surface Treatment on the Flexural Strength of Denture Base Resin and Tensile Strength of Autopolymerizing Silicone Based Denture Liner Bonded to Denture Base Resin: An In Vitro Study

Silicone based denture liners are superior to acrylic based denture liners but it has a problem of failure of adhesion with the denture base. To evaluate the effect on the tensile bond strength of silicone based liner and flexural strength of denture base resin when the latter is treated with different chemical etchants prior to the application of the resilient liner. Rectangular specimens of heat cured PMMA (65 × 10 × 3.3 mm³) for flexural strength and (10 × 10 × 40 mm³) for tensile strength were fabricated and divided into four subgroups each. One subgroup of each type acted as a control and the rest were subjected to surface treatment with acetone for 30 s, MMA monomer for 180 s, methylene chloride for 15 s, respectively. Silicone based denture liner was processed between 2 PMMA specimens (10 × 10 × 40 mm³) in the space provided by a spacer, thermocycled (5^–55°C) for 500 cycles and then their tensile strength measurements and flexural strength measurements were done. 180 s of MMA monomer treatment was found to be most effective in improving the bonding between the liner and denture base resin as well as producing the lowest decrease in flexural strength of denture base resin. Chemical treatment of denture base resin improves the bond strength of denture liner but it also decreases the flexural strength of denture base. So careful selection of chemical etchant should be done so as to produce minimum decrease in flexural strength of denture base resin.     

Investigation into the Effect of Use of Metal Primer on Adhesion of Heat Cure Acrylic Resin to Cast Titanium: An In Vitro Study

The availability of adhesive primers capable of bonding chemically to base metal alloys without well defined passive oxide surface film has been improved significantly over the last decade. Therefore, the purpose of the study was to compare and evaluate the effect of metal primer on adhesion of heat cure acrylic resin to cast titanium. Shear bond strength test was conducted on 80 commercially pure titanium cast metal heat-cure acrylic resin discs treated with different surface treatments. The first group received no surface treatment (group I); the second group was subjected to sandblasting (group II); the third group was treated with bonding agent (alloy primer) (group III) and the fourth was treated with sandblasting and alloy primer (group IV). After the samples were surface treated, acrylic resin was mixed, packed and processed over the test area of cast titanium. Ten specimens of each group were immersed in distilled water for 24 h followed by thermocycling for 20,000 cycles. Shear bond-strength between the heat cure acrylic resin and titanium was evaluated using Instron universal testing machine. Debonded specimens of all the groups were subjected to SEM analysis. The bond failure (MPa) was analyzed by ANOVA and Duncan’s multiple comparison tests. Surface treatment with sandblasting, followed by the application of alloy primer showed maximum shear bond strength before and after thermocycling (24.50 ± 0.59 and 17.39 ± 1.56 MPa respectively).The bond strength values are found to be in decreasing magnitudes as group IV > group III > group II > group I. The following pretreatment to improve the shear bond strength of heat cure acrylic resin to titanium is recommended in order to attain the maximum bond strength in cast titanium frameworks for various prostheses: sandblasting, cleaning in an ultrasonic bath for 10 min and air drying followed by application of a bonding agent uniformly on the sandblasted cast titanium surface before packing with heat cure acrylic resin.     

Effect of Embedded Metal Reinforcements and Their Location on the Fracture Resistance of Acrylic Resin Complete Dentures

Purpose: This study evaluated the effect of metal reinforcement and its location on the flexural load at the proportional limit (FL‐PL) and the flexural deflection of maxillary acrylic resin complete dentures. Materials and Methods: Maxillary acrylic resin complete dentures reinforced with Remanium and without reinforcement were tested. The reinforcing material was embedded in the denture base resin in the doughy state and placed (1) under the ridge lap region; (2) in the anterior region; (3) in the middle region; and (4) in the anterior and posterior regions. The FL‐PL (N) and the flexural deflection (mm) at 100 N of the reinforced maxillary denture specimens were tested using a load testing machine at a 5.0 mm/min crosshead speed. The data were analyzed statistically using one‐way ANOVA; Tukey's post hoc comparisons test was applied when appropriate (95% confidence level). Results: The FL‐PL of the dentures without reinforcement (909 ± 195 N) and the dentures reinforced at the ridge lap (1094 ± 176 N) and in the middle (977 ± 215 N) regions were not significantly different (p > 0.05). The dentures reinforced in the anterior (1348 ± 205 N) and the anterior and posterior (1190 ± 191 N) regions had a higher FL‐PL than the dentures without reinforcement (p < 0.05) and were not significantly different from each other (p > 0.05). The efficiency (times) of the reinforcing material on the dentures without reinforcement was 1.08 to 1.48. The flexural deflection of the dentures without reinforcement (0.133 ± 0.014 mm), the dentures reinforced at the ridge lap (0.125 ± 0.014 mm), in the anterior (0.122 ± 0.009 mm), and in the middle (0.132 ± 0.015 mm) regions were not significantly different (p > 0.05), and the dentures reinforced in the anterior and posterior (0.117 ± 0.011 mm) regions had significantly lower deflection than the dentures without reinforcement (p < 0.05). Conclusion: The location of the metal reinforcement affected the fracture resistance of the maxillary acrylic resin complete dentures.