Impact of Nanoparticle Addition on the Surface and Color Properties of Three-Dimensional (3D) Printed Polymer-Based Provisional Restorations.

This study aimed to evaluate and compare the impact of additives such as ZrO2 and SiO2 nanoparticles (ZrO2NP or SiO2NP) on the hardness, surface roughness, and color stability of 3D printed provisional restorations. Two hundred samples in total were printed using 3D printed resins (ASIGA, and NextDent). Each resin was modified with ZrO2NPs or SiO2NPs in two different concentrations (0.5 wt% and 1 wt%), while one group was kept unmodified (n = 10). Disc-shaped (15 × 2.5 mm) samples were designed and printed in accordance with the manufacturer's recommendation. Printed discs were evaluated for color changes through parameters CIELAB 2000 system (ΔE00), hardness using Vickers hardness test, and surface roughness (Ra) using a noncontact profilometer. After calculating the means and standard deviations, a three-way ANOVA and Tukey post hoc test were performed at α = 0.05. The addition of ZrO2NPs or SiO2NPs to ASIGA and NextDent resins significantly increased the hardness at a given level of concentration (0.5% or 1%) in comparison with pure (p < 0.001), with no significant difference between the two modified groups per resin type (p > 0.05). The highest hardness value was detected in 1% ZrO2NPs with 29.67 ± 2.3. The addition of ZrO2NPs or SiO2NPs had no effect on the Ra (p > 0.05), with 1% ZrO2NPs showing the highest value 0.36 ± 0.04 µm with NextDent resin. ZrO2NPs induced higher color changes (∆E00), ranging from 4.1 to 5.8, while SiO2NPs showed lower values, ranging from 1.01 to 1.85, and the highest mean ∆E00 was observed in the 1% ZrO2NPs group and NextDent resin. The incorporation of ZrO2NPs and SiO2NPs in 3D printed provisional resins increased the hardness without affecting the surface roughness. The optical parameters were significantly affected by ZrO2NPs and less adversely affected by SiO2NPs. Consequently, care must be taken to choose a concentration that will improve the materials' mechanical performance without detracting from their esthetic value.

Effect of repair and surface treatments on the strength of digitally fabricated resin-based dental prostheses: A systematic review of in vitro studies.

OBJECTIVE: This review investigated the current literature pertaining to the repairability of computer-aided design-computer-aided manufacturing (CAD-CAM) milled and three-dimensional (3D) printed resin-based dental prostheses (RBDPs) as well as the appropriate surface treatment for each repair material that will produce adequate repair bond strength. DATA/SOURCES: PubMed, Web of Science, and Scopus databases were searched for published articles involving repair of CAD-CAM RBDPs between January 2010 and June 2023. Data were collected and analyzed to reveal the surface treatment effects, suggested repair materials, and strength of repaired RBDPs. STUDY SELECTION: Out of 164 retrieved titles, 11 studies were included, of which five investigated the repair of 3D-printed RBDPs, three investigated the repair of CAD-CAM milled resins, and three investigated both materials. Additionally, of the included studies, seven investigated denture base resins, three studied provisional restoration resins, and one evaluated 3D-printed intraoral splints. Various surface treatments were suggested, with air-abrasive methods being the most commonly used. Different materials for resin repair were proposed and used, including auto-polymerized, reline, and composite resins. For 3D-printed resins, repair with Bis-acrylic/Bis-GMA composites improved repair strength. CONCLUSION: Surface treatments positively affected the repair strength of conventional and milled RBDPs. However, challenges remain relevant to the repair of 3D-printed resins owing to composition mismatches and fabrication techniques. Therefore, further investigation is required to develop new 3D-printed resins. CLINICAL SIGNIFICANCE: CAD-CAM milled resins have satisfactory repair strength, which increases with surface treatment. The repair of 3D-printed resins has proven challenging even with surface treatments. However, composite resins are the materials of choice.

In Vitro Evaluation of Candida albicans Adhesion and Related Surface Properties of CAD/CAM Denture Base Resins.

OBJECTIVE: The aim of this study was to evaluate the surface roughness, contact angle, and adhesion of Candida albicans to computer-aided designing/computer-aided manufacturing (CAD/CAM) and heat-polymerized (HP) denture base materials. MATERIALS AND METHODS: Specimens were allocated to six groups based on the composition of studied denture base materials, HP acrylic resin, milled resins (AvaDent and IvoCad), and 3D-printed resins (ASIGA, FormLabs, and NextDent). Ten specimens per group were used for each test (n = 10/test). Surface roughness and contact angles were analyzed using profilometer and goniometer, respectively. Adhesion of C. albicans was counted using colony-forming unit (CFU/mL). Means and standard deviations were calculated, and then one-way analysis of variance (ANOVA), followed by Tukey's post hoc test. Correlation of Candida adhesion and surface parameters was determined by using Pearson's correlation analysis. RESULTS: No statistically significant difference was noted in surface roughness between HP, milled, and 3D-printed denture base resins except NextDent, which showed significantly higher roughness in comparison to all other resins (p = 0.001). In terms of contact angle, milled resins had the lowest value, followed by HP, ASIGA, and FormLabs, whereas NextDent showed the highest contact angle (p = 0.001). C. albicans adhesion showed no significant difference between all denture base resins. A positive and significant correlation was found between C. albicans adhesion and contact angle (p = 0.003), while no correlation was reported between C. albicans adhesion and surface roughness (p = 0.523). CONCLUSION: Adhesion of C. albicans was similar in all tested specimens. Surface roughness showed no significant difference between all groups except NextDent, which had the highest value. Milled denture base resins had the lowest contact angle among all groups.

Impact of different chemical denture cleansers on the properties of digitally fabricated denture base resin materials.

PURPOSE: To compare the impact of three different chemical denture cleansers (CDCs) (Corega, chlorhexidine, and hydrogen peroxide) on the surface roughness, microhardness, and color stability of 3D-printed, computer-aided design and computer-aided manufacturing (CAD-CAM) milled, and heat-polymerized denture base material (DBM). MATERIALS AND METHODS: A total of 420 disc-shaped specimens (10 ± 0.1 × 2 ±0.1 mm) were fabricated using three different construction techniques: three-dimensional (3D) printing (n = 140), CAD-CAM milling (n = 140), and heat-polymerization (n = 140). Sixty specimens (20 of each DBM) were used for baseline (pre-immersion) measurements (T1 ) for the tested surface properties (hardness [n = 10/material] and roughness [n = 10/material]). The remaining 360 specimens (n = 120/material) were investigated for surface roughness, microhardness, and color change after immersion for 1 year (T2 ) in distilled water or CDCs (n = 30/solution and n = 10/test). The data were analyzed using two-way ANOVA, one-way ANOVA followed by post-hoc Tukey's test at a significance level of less than 0.05. RESULTS: Significant differences were observed in the effects of the tested CDCs on the surface roughness, micro-hardness, and color stability of varying DBM specimens (p < 0.05). Corega showed the highest surface roughness and color change in all DBMs while H2 O2 resulted in the lowest microhardness for all DBMs. The lowest changes in all tested properties were seen with distilled water followed by chlorhexidine. A significant effect of type of cleanser, denture base material, and the interaction between the two was seen on all measured properties (p < 0.05). CONCLUSIONS: The tested CDCs significantly affected the surface properties of all DBMs but at varying degrees. Corega produced the highest negative effect on roughness and color change while H2 O2 dramatically affected the microhardness. Prolonged use of CDCs should be cautiously followed.

Knowledge of Saudi dental students and interns towards luting cements and their applications in fixed prosthodontics.

BACKGROUND: Enhancement of students' knowledge is essential in improving their clinical skills and performance. Thus, the curriculum should be prepared to achieve a better outcome. The current study aimed to determine the dental students' and interns' basic knowledge towards dental luting cements and their application in dental practice to improve the theoretical and clinical training sections. MATERIALS AND METHODS: A cross-sectional study was conducted among dental students and interns at three Colleges of Dentistry in the Kingdom of Saudi Arabia between September 2019-June 2020. An online questionnaire was used which included demographic data, questions about luting cement usage, cementation techniques, and commonly used cements in dental clinics. Descriptive analysis and chi-square test were used to show the association between level of dental education and the use of dental cements using SPSS software. The significance level was set at 5%. RESULTS: The total respondents were 626 dental students/interns of whom 78.8% were undergraduate dental students. Participants who reported undergraduate studies as the source of information were 79.7%. The type of restoration was the main factor in luting cement selection (62.6%). Concerning the isolation technique in cementing laminate veneers, 49.7% used dri-angles, cotton rolls and saliva ejectors. Dual-cure resin cement was the most common cement used in all the mentioned restorations except in pressed porcelain laminate veneers and cement-retained implant-supported restorations. CONCLUSIONS: Students' knowledge and practice in managing dental implants and porcelain laminate veneers need to be improved. The selection of a luting agent for a given restoration by students and interns was based on the basic knowledge, available cement, and the type of restoration. Awareness towards the management of short prepared teeth and custom-made cast posts and cores is also limited.

Evaluation of the Effect of Different Construction Techniques of CAD-CAM Milled, 3D-Printed, and Polyamide Denture Base Resins on Flexural Strength: An In Vitro Comparative Study.

PURPOSE: To compare the flexural strength of computer-aided design and computer-aided manufacturing (CAD-CAM) milled denture base resin (DBR), 3D-printed DBR, polyamide, and conventional compression-molded DBR. MATERIALS AND METHODS: Six denture base resins were used, one conventional heat-polymerized (Vertex), two milled CAD-CAM (AvaDent and Polident), two 3D-printed (Harz and NextDent), and one flexible polyamide (Polyamide). According to ISO 20795-1:2013, 60 specimens (65×10×3 mm) were constructed and divided into six groups (n = 10), according to DBR type. The flexural strength was measured using a universal testing machine and three-point loading test. Data were collected and analyzed using one-way ANOVA and Tukey's pair-wise post hoc tests (α = 0.05). RESULTS: One-way ANOVA results showed significant differences in flexural strengths between the tested DBRs (p˂0.001). Milled denture base resins (AvaDent and Polident) had significantly higher flexural strength values than the other groups (p˂0.001) and were followed by Vertex and NextDent, while Polyamide and Harz had the lowest values. Polyamide and Harz denture base resins had significantly lower flexural strength values than conventional denture base resin (p˂0.001). CONCLUSION: CAD-CAM milled DBRs showed the highest flexural strength when compared with conventional compression-molded or 3D-printed DBRs, while 3D-printed DBRs and polyamide showed the lowest flexural strengths.

Flexural Properties and Hardness of CAD-CAM Denture Base Materials.

PURPOSE: To compare flexural strength, elastic modulus, and surface hardness of computer aided design and computer aided manufacturing CAD-CAM milled, 3D-printed, and heat-polymerized denture base resins. MATERIALS AND METHODS: A total of 120 specimens were fabricated from heat-polymerized acrylic resin (HP), milled resin (Avadent and IvoCad), and 3D-printed resin (ASIGA, FormLabs, and NextDent). The specimens were divided into 6 groups according to the type of denture base material (n = 20/material) (10/flexural properties and 10/hardness). Flexural strength and elastic modulus of the specimens were evaluated by 3-point bending test and surface hardness by Vickers hardness test. To test flexural properties, the specimens were fabricated according to ISO 20795-1:2013 standards (64 × 10 × 3.3 ± 0.2 mm). The dimensions for hardness test were 15 × 10 × 2.5 ± 0.2 mm. Scanning electron microscope was used to evaluate the surface morphology of the fractured specimens. The means and standard deviations were calculated, followed by one-way ANOVA and Tukey post-hoc test (α = 0.05). RESULTS: Milled resins showed significantly higher values for flexural strength, elastic modulus, and surface hardness, followed by HP and then 3D-printed resins (p < 0.001). Within milled groups, flexural strength of AvaDent was significantly higher than IvoCad (p < 0.001), while elastic modulus and hardness didn't show significant difference. Within 3D-printed resins, ASIGA showed the highest flexural strength and elastic modulus, insignificantly with FormLabs (p = 0.595) and significantly with NextDent (p = 0.008). ASIGA also showed significantly the highest hardness among the 3D-printed groups. No significant difference was found between FormLabs and NextDent in flexural strength (p = 0.357), elastic modulus (p = 1.00), or surface hardness (p = 0.987). CONCLUSION: CAD-CAM milled resins had greater flexural properties and hardness compared to heat-polymerized acrylic resin and 3D-printed resins. Although 3D-printed samples showed the lowest values of tested properties, the flexural strength and modulus were above clinically acceptable values.

Highlights on Drug and Ion Release and Recharge Capacity of Antimicrobial Removable Prostheses.

This article aimed to review the ion and drug release, recharge abilities, and antimicrobial properties of drug/ion-releasing removable prostheses, and to assess their capability in preventing and inhibiting denture stomatitis as well preventing caries and reversing carious lesions. Data was collected from published scientific papers listed in PubMed database from January 1975 to December 2021. English full-text articles, involving clinical or in vitro studies, focusing on removable prostheses and are concerned with drug/ion release and rechargeability as a way to prevent or inhibit denture stomatitis or dental caries were included. The relevant articles reported that ion- or drug-modified polymethylmethacrylate acts as a reservoir for these ions and drugs and is capable of releasing significant amounts with sustained release effect. Recharging of modified resin resulted in greater sustainability of ion and drug release, thus improving the long-term effects of protection against demineralization and reducing the adhesion of Streptococcus mutans and Candida albicans. Modifications of removable prostheses with rechargeable ions and drugs enhance remineralization, hinder demineralization, and reduce microbial adhesion in difficult-to-access areas. Selection of denture base for clinical use will consider its ability to act as an ion/drug reservoir that is capable of release and recharge.

Students' Awareness of the Role of Phonetics in Construction of Removable Dental Prostheses: A Questionnaire-Based Cross-Sectional Study.

Phonetics plays a major role in the fabrication of prostheses. This study aimed to assess the knowledge of students regarding the role of phonetics in denture fabrication and to improve the educational process and the clinical application. The study was conducted at the College of Dentistry, Imam Abdulrahman Bin Faisal University, and involved a survey of 344 dental students and interns. The questionnaire contained 20 questions and was divided into three sections: general knowledge, clinical correlations, and clinical evaluations. The data were collected and analyzed statistically using independent t-tests, one-way ANOVA, and Tukey's post hoc tests. The response rate was 100%. Male and female students only differed significantly in terms of their scores for answers to general knowledge questions, with females achieving better results (p = 0.023). General knowledge varied significantly between fourth-year students and all other levels (p < 0.001), and fifth-year students and interns (p = 0.027). The clinical correlations varied significantly between fourth-year students and interns (p = 0.01), whereas the clinical evaluations varied between all the academic years and interns (fourth-year, p < 0.001; fifth-year, p = 0.003; and sixth-year, p = 0.017). The interns obtained the highest scores in all sections. There was a lack of awareness among dental students of some aspects of the role of phonetics in denture fabrication. The study highlights the deficiencies that need to be addressed and the need for adjustments to the curriculum related to removable prosthodontics in order to improve the knowledge of students regarding the role of speech in denture fabrication.

Fit, Precision, and Trueness of 3D-Printed Zirconia Crowns Compared to Milled Counterparts.

Precise fit of a crown and accurate reproduction of the digital design are paramount for successful treatment outcomes and preservation of clinician and technician time. The study aimed to compare the internal fit, marginal adaptation, precision, and trueness of 3D-printed zirconia crowns compared to their milled counterpart. A total of 20 monolithic 3 mol% yttria stabilized-zirconia crowns (n = 10) were made using computer-assisted design (CAD) followed by additive (3D-printed) and subtractive (milled) manufacturing. Digital scanning of the master die with and without a fit checker followed by image superimposition, and analysis was performed to evaluate internal and marginal adaptation in four areas (occlusal, axial, marginal, and overall). ISO 12836:2015 standard was followed for precision and trueness evaluation. Statistical analysis was achieved using a t-test at α = 0.05. Internal fit and marginal adaptation revealed no significant difference between the two test groups (p > 0.05). The significant difference in trueness (p < 0.05) was found between the two groups in three areas (occlusal, axial, and internal). The best and worst trueness values were seen with 3D-printed crowns at occlusal (8.77 ± 0.89 µm) and Intaglio (23.90 ± 1.60 µm), respectively. The overall precision was statistically better (p < 0.05) in the 3D-printed crowns (9.59 ± 0.75 µm) than the milled (17.31 ± 3.39 µm). 3D-printed and milled zirconia crowns were comparable to each other in terms of internal fit and marginal adaptation. The trueness of the occlusal and axial surfaces of 3D-printed crowns was better, whereas the trueness of fitting surface of milled crowns was better. 3D-printed crowns provided a higher level of precision than milled crowns. Although the internal and marginal fit of both production techniques were comparable, 3D printing of zirconia produced more precise crowns.

Physiomechanical and Surface Characteristics of 3D-Printed Zirconia: An In Vitro Study.

The objective of this study is to examine the physiomechanical and surface properties of 3D-printed zirconia in comparison to milled zirconia. A total of 80 disc-shaped (14 × 1.5 ± 0.2 mm) specimens (20 milled and 60 3D-printed (at three different orientations; horizontal, vertical, and tilted)) were manufactured from 3-mol% yttria-stabilized tetragonal zirconia. Five specimens per group were evaluated for crystalline phase, grain size, density, porosity, surface roughness, wettability, microhardness, and SEM analysis of the surface. Biaxial flexural strength (BFS) was measured (n = 15) followed by Weibull analysis and SEM of fractured surfaces. Statistical analysis was performed using one-way ANOVA and Tukey's post hoc test at α = 0.05. All groups showed a predominant tetragonal phase, with a 450 nm average grain size. There was no significant difference between groups with regards to density, porosity, and microhardness (p > 0.05). The tilted group had the highest surface roughness (0.688 ± 0.080 µm), significantly different from the milled (p = 0.012). The horizontal group presented the highest contact angle (89.11 ± 5.22°), significantly different from the milled and tilted (p > 0.05). The BFS of the milled group (1507.27 ± 340.10 MPa) was significantly higher than all other groups (p < 0.01), while vertical and tilted had a similar BFS that was significantly lower than horizontal (p < 0.005). The highest and lowest Weibull modulus were seen with tilted and milled, respectively. Physical properties of all groups were comparable. The surface roughness of the tilted group was higher than milled. The horizontal group had the highest hydrophobicity. Printing orientations influenced the flexural strength of 3D-printed zirconia. Clinical implications: This study demonstrates how the printing orientation affects the physiomechanical characteristics of printed zirconia.

Hydrophobicity of Denture Base Resins: A Systematic Review and Meta-analysis.

Objectives: The aim of this article is to review the factors that attract Candida albicans to denture base resin (DBR) and to verify the influence of different surface treatments, chemical modification, or structural reinforcements on the properties of DBR. Materials and Methods: Searches were carried out in PubMed, Scopus, WOS, Google Scholar, EMBASE, and J-stage databases. The search included articles between 1999 and 2020. This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The keywords used during the search were "Candida albicans," "Denture base," "PMMA," "Acrylic resin," "Surface properties," "hydrophobicity/hydrophilicity," "contact angle," and "surface free energy." English full-text articles involving in-vitro studies with different acrylic resin modifications were included, whereas abstracts, dissertations, reviews, and articles in languages other than English were excluded. A meta-analysis was performed where appropriate. Results: Out of the 287 articles, 21 articles conformed to inclusion criteria. Sixteen articles were subjected to meta-analysis using random-effects model at 95% confidence interval. Results showed that DBR coatings/plasma coatings were effective methods to modify surface properties with estimated contact angle (CA) of 59.37° [95% confidence interval (CI): 53.69, 65.04]/55.87° (95% CI: 50.68, 61.06) and surface roughness (R a) of 0.55 µm (95% CI: 0.52, 0.58)/0.549 µm (95% CI: 0.5, 0.59), respectively. Antifungal particle incorporation into poly(methylmethacrylate) DBR also produced similar effects with an estimated R a of 0.16 µm (95% CI: 0.134, 0.187). Conclusion: The three properties responsible for C. albicans adhesion to DBR were R a, CA, and surface free energy in terms of hydrophobicity. Therefore, the correlations between the hydrophobicity of DBR and C. albicans adhesion should be considered during future investigations for Candida-related denture stomatitis.

Flexural Strength of CAD/CAM Denture Base Materials: Systematic Review and Meta-analysis of In-vitro Studies.

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 in-vitro 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.

Closed Repair Technique: Innovative Surface Design for Polymethylmethacrylate Denture Base Repair.

PURPOSE: This study aimed to evaluate the repair strength of a newly introduced repair technique involving zero-gap repair width. MATERIALS AND METHODS: A total of 36 rectangular prism specimens with dimensions of 64 × 10 × 3.3 mm were prepared from heat-polymerized acrylic resin. Nine specimens were kept intact. The other specimens were sectioned into halves and modified to create repair gaps of 2.5-mm beveled (2.5B) as control, 0-mm beveled (ZB), and 0-mm inverse bi-beveled (ZIBB). The ZIBB group was prepared with a V-shaped internal groove on both halves (repair tunnel), while the intaglio and cameo surfaces were kept intact except for two small holes at the cameo surface for repair resin injection. The 2.5B and ZB groups were repaired conventionally while the ZIBB group was repaired by injecting repair resin into the tunnel through one of the holes until excess material oozed from the other hole. Repaired specimens were thermally cycled at 5 and 55°C for 10,000 cycles with 1 min dwell time. A 3-point bending test was conducted using a universal testing machine for flexural strength and elastic modulus measurement. Kruskal-Wallis/Mann-Whitney tests and ANOVA/post hoc Tukey tests were applied for data analysis (α = 0.05). RESULTS: The flexural strength of repaired specimens was substantially lower than that of intact specimens, and significant differences were present between repaired groups (p ˂ 0.05). ZB and ZIBB had higher flexural strength (p ˂ 0.001) and elastic modulus (p ˂ 0.05) than 2.5B. Among the ZB and ZIBB groups, ZB showed the highest flexural strength, and ZIBB had the highest elastic modulus. CONCLUSION: The closed repair technique improved the flexural strength and elastic modulus of repaired acrylic denture base.

Comparative Study of the Effectiveness of Laboratory-Formulated Polishing Pastes for Two CAD/CAM Ceramic Restorative Materials.

PURPOSE: To evaluate the effect of different polishing pastes with different particle sizes on the surface finish of two different CAD/CAM ceramics. MATERIALS AND METHODS: A total of 128 specimens were prepared of two CAD/CAM ceramics: lithium disilicate (12.4 × 14.5 × 2 mm) and monolithic zirconia (17.5 × 12.5 × 2.5 mm). They were divided randomly into 8 groups according to surface treatment (n = 8). Group 1 (control) was left as received after crystallization or sintering with no further surface treatment; Group 2 (glazed); Group 3 (positive control), where specimens were polished using standardized surface treatment (medium grit silicon carbide discs, rubber cup and pumice slurry, then rubber cup and toothpaste). For groups 4 to 8, in addition to silicon carbide and pumice slurry polishing, specimens were further polished using a diamond paste (DP), and polishing pastes of microzirconia (MZ), nanosilica (NS), nanodiamond (ND), and nanozirconia (NZ), respectively. Surface roughness (Ra ) was measured using noncontact profilometer. The mean values were compared using ANOVA and Post Hoc Tukey's test (α = 0.05). Specimens' surfaces were studied using a scanning electron microscope (SEM). RESULTS: Positive control group and MZ exhibited significant Ra of lithium disilicate compared to control (p ˂ 0.001), glazed (p = 0.001), DPs (p = 0.002), NS (p ˂ 0.001), ND (p ˂ 0.001), and NZ (p = 0.002). In the case of zirconia, positive control showed a significantly higher Ra compared to all other groups (p ˂ 0.001). No statistical difference was found between all other polishing techniques (positive control, glazed, DPs, NS, ND, MZ, and NZ) (p > 0.05). CONCLUSION: Polishing with ND, NZ, and NS lab-formulated pastes produced surfaces with comparable smoothness to control and glazed specimens for lithium disilicate and zirconia ceramic materials.

Strength and Surface Properties of a 3D-Printed Denture Base Polymer.

PURPOSE: This in vitro study evaluated the flexural strength, impact strength, hardness, and surface roughness of 3D-printed denture base resin subjected to thermal cycling treatment. MATERIALS AND METHODS: According to ISO 20795-1:2013 standards, 120 acrylic resin specimens (40/flexural strength test, 40/impact strength, and 40/surface roughness and hardness test, n = 10) were fabricated and distributed into two groups: heat-polymerized; (Major.Base.20) as control and 3D-printed (NextDent) as experimental group. Half of the specimens of each group were subjected to 10,000 thermal cycles of 5 to 55°C simulating 1 year of clinical use. Flexural strength (MPa), impact strength (KJ/m2 ), hardness (VHN), and surface roughness (µm) were measured using universal testing machine, Charpy's impact tester, Vickers hardness tester, and profilometer, respectively. Data were analyzed by ANOVA and Tukey honestly significant difference (HSD) test (α = 0.05). RESULTS: The values of flexural strength (MPa) were 86.63 ± 1.0 and 69.15 ± 0.88; impact strength (KJ/m2 )-6.32 ± 0.50 and 2.44 ± 0.31; hardness (VHN)-41.63 ± 2.03 and 34.62 ± 2.1; and surface roughness (µm)-0.18 ± 0.01 and 0.12 ± 0.02 for heat-polymerized and 3D-printed denture base materials, respectively. Significant differences in all tested properties were recorded between heat-polymerized and 3D-printed denture base materials (P < 0.001). Thermal cycling significantly lowered the flexural strength (63.93 ± 1.54 MPa), impact strength (2.40 ± 0.35 KJ/m2 ), and hardness (30.17 ± 1.38 VHN) of 3D-printed resin in comparison to thermal cycled heat-polymerized resin, but surface roughness showed non-significant difference (p = 0.262). CONCLUSION: 3D-printed resin had inferior flexural strength, impact strength, and hardness values than heat-polymerized resin, but showed superior surface roughness. Temperature changes (thermal cycling) significantly reduced the hardness and flexural strength and increased surface roughness, but did not affect the impact strength.

Double-layered acrylic resin denture base with nanoparticle additions: An in vitro study.

STATEMENT OF PROBLEM: Whether the addition of different antifungal nanoparticles to denture base materials may affect physical or esthetic properties of the resulting nanocomposite is unclear. PURPOSE: The purpose of this in vitro study was to determine how a new method of adding antifungal nanofiller affects the properties of the processed nanocomposite denture base material. MATERIAL AND METHODS: Heat-polymerized acrylic resin specimens were prepared according to each test specification. Zirconium dioxide nanoparticles (ZrO2NPs) and silver nanoparticles (AgNPs) were added in 0.5, 1.0, and 1.5% of acrylic resin powder. The specimens were divided into 2 groups according to the acrylic resin packing method: 1 layer packed conventionally in one step and 2 layers packed in 2 steps, first with unmodified acrylic resin and then by a thin layer of modified acrylic resin before the final closure. The control group was made of unaltered acrylic resin in 1 step. Flexural strength (FS), translucency, and surface roughness (Ra) were measured. A microbial assay was performed by using the direct culture and slide count methods. Three-way ANOVA and Tukey post hoc tests were used to identify statistical differences among groups (α=.05). RESULTS: The addition of ZrO2NPs and AgNPs in the 1- or 2-layer specimens reduced Candida albicans adhesion (P<.001). In the 1- and 2-layer specimens, FS significantly increased with ZrO2NPs. AgNPs decreased FS only in the 1-layer specimen (P<.001). Surface roughness was not changed for the 1- and 2-layer specimens with ZrO2NPs or the 1-layer specimen with 0.5% AgNPs (P>.05), while other AgNP groups exhibited increased surface roughness (P<.001). AgNPs significantly lowered translucency in the 1- and 2-layer specimens (P<.001), while ZrO2NPs decreased translucency only in the 1-layer specimen (P<.001). CONCLUSIONS: The addition of ZrO2NPs in the double-layer technique decreased Candida adhesion and improved FS without affecting surface roughness, while AgNPs decreased Candida adhesion and FS and increased surface roughness. Both nanofillers decreased the translucency except 0.5% ZrO2NPs, which did not change translucency when applied in 2 layers.

Antifungal Activity of Denture Base Resin Containing Nanozirconia: In Vitro Assessment of Candida albicans Biofilm.

OBJECTIVE: To evaluate the antimicrobial effects of different concentrations of zirconium dioxide nanoparticles (nano-ZrO2) reinforcement of poly(methyl) methacrylate (PMMA) on surface roughness and C. albicans biofilm. METHODS: 20 heat-polymerized acrylic resin discs were conventionally made and divided into 4 groups (n = 5) according to nano-ZrO2 concentration: control (0% filler) and 3 experimental groups (2.5% (Z2.5), 5.0% (Z5.0), and 7.5% (Z7.5)). An optical profilometer was used for surface roughness evaluation, followed by Candida adherence assay. Specimens were sterilized, then immersed in cultured yeast (C. albicans), and incubated at 37°C for 48 hours. After that, discs were rinsed before extracting the clustered pellets of Candida. The attached C. albicans was counted using the direct method after spreading on agar media and incubating for 48 hours. Statistical analysis was performed using one-way ANOVA and Tukey's post hoc test at α = 0.05. RESULTS: Surface roughness was significantly increased with all modified groups compared with control (P < 0.01), which showed the lowest roughness value (0.027 ± 0.004 µm). There was no significant difference in the roughness value among reinforced groups (2.5, 5.0, and 7.5%) (P > 0.05), with Z7.5 showing the highest roughness value (0.042 ± 0.004 µm). Candida count was reduced as the nano-ZrO2 increased but not significantly (P=0.15). CONCLUSIONS: The addition of different concentrations of nano-ZrO2 particles to PMMA increased the surface roughness compared with control; in contrast, insignificant reduction of C. albicans biofilm was detected.

Translucency of nanoparticle-reinforced PMMA denture base material: An in-vitro comparative study.

The aim of this study was to assess the translucency of denture base acrylic resin reinforced with zirconium dioxide (ZrO2NPs), silicon dioxide (SiO2NPs), and diamond (DNPs) nanoparticles. A total of 130 heat-polymerized acrylic discs (15×2.5 mm) were fabricated conventionally and divided into control and experimental groups according to nanoparticle type and concentration (0.5, 1, 1.5, and 2.5 wt%). Unmodified acrylic resin specimens served as control. All specimens were thermocycled (5,000 cycles). Translucency was measured using a spectrophotometer. ANOVA and post-hoc Turkeys' test were used for data analysis at α=0.05. The translucency of modified PMMA was significantly lower than control (p<0.05) except 0.5% ZrO2NPs and SiO2NPs (p>0.05) which exhibited the highest translucency values among modified groups. As the NPs concentration increased, the translucency decreased and the lowest value was seen with 2.5% DNPs (1.18±0.10). The addition of ZrO2NPs, SiO2NPs, and DNPs into denture base resin decreased the translucency.

Color Stability and Surface Properties of PMMA/ZrO2 Nanocomposite Denture Base Material after Using Denture Cleanser.

OBJECTIVES: This study aimed to evaluate denture cleanser effects on color stability, surface roughness, and hardness of PMMA denture base resin reinforced with nano-ZrO2. MATERIALS AND METHODS: A total of 420 specimens were fabricated of unreinforced and nano-ZrO2 reinforced acrylic resin at 2.5% and 5%, resulting in 3 main groups. These groups were further subdivided (n = 10) according to immersion solution (distilled water, Corega, sodium hypochlorite, and Renew) and immersion duration. Surface roughness, hardness, and color were measured at baseline (2 days-T 0) in distilled water and then after 180 and 365 days of immersion (T 1 & T 2) in water or denture cleansing solutions. Data was collected and analyzed using two-way ANOVA followed by Bonferroni post hoc test (α = 0.05). RESULTS: Surface roughness increased significantly after denture cleanser immersion of unmodified and nano-ZrO2-modified PMMA materials while hardness decreased (P < 0.001). The denture cleansers significantly affected the color of both PMMA denture bases (P < 0.001). The immersion time in denture cleansers significantly affected all tested properties (P < 0.001). Within denture cleansers, NaOCl showed the highest adverse effects (P < 0.05) while Renew showed the least adverse effects. CONCLUSION: Denture cleansers can significantly result in color change and alter the surface roughness and hardness of denture base resin even with ZrO2 nanoparticles addition. Therefore, they should be carefully used.