Effect of build orientation on the wear resistance and hardness of denture teeth fabricated using digital light processing: An in vitro study.

PURPOSE: This in vitro study investigated the effect of build orientation on the wear resistance and hardness of denture teeth fabricated using digital light processing (DLP) compared to other denture tooth materials. METHODS: Disc-shaped specimens were prepared using denture tooth monomers and DLP devices in three build orientations: 0°, 45°, and 90°. Specimens of the same shape were fabricated using denture tooth materials for subtractive manufacturing, commercially available polymethylmethacrylate (PMMA) resin, and composite resin. The wear resistance was evaluated as the wear volume loss after 50,000 wear cycles using a ball-on-disc wear device in water for two-body wear and poppy seed slurry for three-body wear. The Vickers hardness values of the materials were measured. Two-way and one-way analyses of variance were performed for wear resistance and hardness, respectively, followed by Tukey's honest significance test. RESULTS: The interaction between the denture tooth resins and maximum wear volume was significant (P < 0.01). The 0° build orientation exhibited the lowest wear volume in the three-body wear test and the highest hardness among the three build orientations. The 0° DLP-fabricated specimens demonstrated significantly less wear volume than that of the PMMA specimens and a wear volume comparable to that of the milled specimens. However, the 0° DLP-fabricated specimens showed significantly lower hardness than that of the milled and PMMA specimens. The composite resin specimens exhibited the highest wear resistance and hardness. CONCLUSIONS: A 0° build orientation is recommended for DLP-fabricated denture teeth compared to 45° and 90° orientations to achieve greater wear resistance and hardness.

Effect of Postrinsing Times and Methods on Surface Roughness, Hardness, and Polymerization of 3D-Printed Photopolymer Resin.

OBJECTIVES: This in vitro study investigated the effects of different postrinsing times and methods on the surface roughness, surface hardness, and degree of polymerization of materials manufactured via stereolithography (SLA). MATERIALS AND METHODS: A total of 288 disk-shaped specimens were manufactured using an SLA three-dimensional (3D) printer. The specimens were randomly divided into nine groups (n = 32) based on rinsing times and methods. The groups were categorized into three rinsing methods: automated, ultrasonic, and hand washing, with rinsing times of 5, 10, and 15 minutes using a 99% isopropanol alcohol as a solvent. Linear roughness (Ra) and area roughness (Sa) were measured using a 3D confocal laser microscopy; the roughness morphology was evaluated by using scanning electron microscopy. Vickers hardness (VHN) tests were performed using a Vickers microhardness tester. Fourier-transform infrared spectrometry was used to determine the degree of conversion of treated specimens. STATISTICAL ANALYSIS: Data were statistically analyzed using two-way analysis of variance. The post hoc Tukey tests were conducted to compare the differences between groups (p < 0.05). RESULTS: The choice of the rinsing time and method affected the surface properties of the SLA photopolymer resin. The 15 minutes of ultrasonic method exhibited the highest Ra scores (0.86 ± 0.1 µm), while the 15 minutes of automated method presented the highest Sa scores (1.77 ± 0.35 µm). For the VHN test, the 15 minutes of ultrasonic method displayed the highest VHN score (18.26 ± 1.03 kgf/mm2). For the degree of polymerization, the 15 minutes of automated method was initially identified as the most effective (87.22 ± 6.80). CONCLUSION: To facilitate the overall surface roughness, surface hardness, and degree of polymerization, the optimal choice of postprocessing rinsing time and method for achieving a clear photopolymer resin was determined to be the ultrasonic method with a rinsing time of 15 minutes.

Effect of gum-chewing exercise on maintaining and improving oral function in older adults: A pilot randomized controlled trial.

Background/purpose: Gum chewing has been found to improve oral function. Nevertheless, few randomized controlled trials have investigated the effects of gum-chewing exercises on oral function in older adults. This study aimed to examine the effect of gum-chewing exercises on oral function in older adults. Materials and methods: This was a single-blind, randomized controlled trial, conducted from November 2021 to January 2022. A total of 130 participants were divided randomly into the intervention and control groups. The intervention group was told to chew experimental gums for one month, while the control group was instructed to chew experimental tablets for one month. Maximum bite force, occlusal contact areas, oral dryness, tongue pressure, tongue and lip functions (number of times each of the following syllables is pronounced per second:/pa/,/ta/, and/ka/), masticatory function, subjective masticatory function, and gum-chewing time were measured at baseline and one month following intervention to assess outcomes. Results: One month following the intervention, tongue pressure was significantly higher in the intervention group than in the control group (P = 0.027). In the within-group comparisons, maximum bite force (P < 0.001), unstimulated saliva flow (P < 0.001), tongue and lip functions (/pa/: P < 0.001;/ta/: P < 0.001;/ka/: P < 0.001), color scale value (P = 0.019), and ΔE value (P = 0.024) were significantly increased in the intervention group. Conclusion: The results suggest that gum-chewing exercises can improve oral functions in older adults, although additional increases in masticatory load may be necessary to establish a more effective oral function training method using gum-chewing exercises in older adults.

Effect of support structures on the trueness and precision of 3D printing dentures: An in vitro study.

Purpose Additive manufacturing has revolutionized the fabrication of complete dentures. However, this process involves support structure, which is a construction part that holds the specimen during printing, and may prove to be disadvantageous. Therefore, this in vitro study compared the effect of support structure reduction on various volume and area distributions of a 3D-printed denture base to determine optimal parameters based on accuracy.Methods A complete maxillary denture base construction file was used as reference. Twenty denture bases were 3D printed under four conditions (total n=80): no support structure reduction (control), palatal support structure reduction (Condition P), border support structure reduction (Condition B), and palatal and border support structure reduction (Condition PB). Printing time and resin consumption were also recorded. The intaglio surface trueness and precision of all acquired data were exported to a 3D analysis software, and the dimensional changes to the denture base were analyzed using the root-mean-square estimate (RMSE) to assess geometric accuracy and generate color map patterns. Nonparametric Kruskal-Wallis and Steel-Dwass tests (α=0.05) analyzed the accumulated data.Results Control had the lowest RMSE values for trueness and precision. Nevertheless, it demonstrated a significantly lower RMSE than that of Condition B (P=0.02) in precision. Owing to negative deviation at the palatal region, Conditions P and PB had higher retention than Control and Condition B regarding the color map pattern.Conclusions Within the limitations of this study, the reduction of palatal and border support structures showed optimal accuracy with resource and cost savings.

Improvements in Maximum Bite Force with Gum-Chewing Training in Older Adults: A Randomized Controlled Trial.

No specific methods have been officially proposed for the prevention and improvement of oral hypofunction. Therefore, in this randomized controlled trial, we aimed to develop a gum-chewing training program and determine its effects in older adults. A total of 218 older adults, aged 65-85 years, were randomly allocated to the intervention or control groups. The intervention group chewed the experimental gum daily, whereas the control group consumed the experimental granular food daily. The outcome assessments measured the maximum bite force, occlusal contact areas, oral dryness, tongue pressure, tongue and lip functions, masticatory function, and gum-chewing time. The measured values for each outcome were compared between groups using the Mann-Whitney U test and within groups pre- and post-intervention using the Wilcoxon signed-rank test. A total of 211 participants completed the study. After 2 months, the intervention group had a significantly higher maximum bite force than the control group (p = 0.01), indicating that gum-chewing training improved maximum bite force in older adults. This was determined using one type of bite force measuring device. Therefore, it is suggested that gum-chewing training has a high potential to improve oral hypofunction.

Prediction accuracy of incisal points in determining occlusal plane of digital complete dentures.

PURPOSE: This study aimed to predict the positional coordinates of incisor points from the scan data of conventional complete dentures and verify their accuracy. MATERIALS AND METHODS: The standard triangulated language (STL) data of the scanned 100 pairs of complete upper and lower dentures were imported into the computer-aided design software from which the position coordinates of the points corresponding to each landmark of the jaw were obtained. The x, y, and z coordinates of the incisor point (XP, YP, and ZP) were obtained from the maxillary and mandibular landmark coordinates using regression or calculation formulas, and the accuracy was verified to determine the deviation between the measured and predicted coordinate values. YP was obtained in two ways using the hamular-incisive-papilla plane (HIP) and facial measurements. Multiple regression analysis was used to predict ZP. The root mean squared error (RMSE) values were used to verify the accuracy of the XP and YP. The RMSE value was obtained after cross-validation using the remaining 30 cases of denture STL data to verify the accuracy of ZP. RESULTS: The RMSE was 2.22 for predicting XP. When predicting YP, the RMSE of the method using the HIP plane and facial measurements was 3.18 and 0.73, respectively. Cross-validation revealed the RMSE to be 1.53. CONCLUSION: YP and ZP could be predicted from anatomical landmarks of the maxillary and mandibular edentulous jaw, suggesting that YP could be predicted with better accuracy with the addition of the position of the lower border of the upper lip.

Effect of post-rinsing time and method on accuracy of denture base manufactured with stereolithography.

PURPOSE: This in vitro study investigates the effect of different post-rinsing times and methods on the trueness and precision of denture base resin manufactured through stereolithography. MATERIALS AND METHODS: Ninety clear photopolymer resin specimens were fabricated and divided into nine groups (n = 10) based on rinsing times and methods. All specimens were rinsed with 99% isopropanol alcohol for 5, 10, and 15 min using three methods-automated, ultrasonic cleaning, and hand washing. The specimens were polymerized for 30 min at 40℃. For trueness, the scanned intaglio surface of each SLA denture base was superimposed on the original standard tessellation language (STL) file using best-fit alignment (n = 10). For precision, the scanned intaglio surface of the STL file in each specimen group was superimposed across each specimen (n = 45). The root mean square error (RMSE) was measured, and the data were analyzed statistically through one-way ANOVA and Tukey test (α < .05). RESULTS: The 10-min automated group exhibited the lowest RMSE. For trueness, this was significantly different from specimens in the 5-min hand-washed group (P < .05). For precision, this was significantly different from those of other groups (P < .05), except for the 15-min automated and 15-min ultrasonic groups. The color map results indicated that the 10-min automated method exhibited the most uniform distribution of the intaglio surface adaptation. CONCLUSION: The optimal postprocessing rinsing times and methods for achieving clear photopolymer resin were found to be the automated method with rinsing times of 10 and 15 min, and the ultrasonic method with a rinsing time of 15 min.

The Patient's Denture Assessment (Thai version) is a valid and reliable tool for evaluating the outcome of treatment with complete denture.

BACKGROUND: Complete tooth losses are still being major problems which resulted in lesser quality of life especially for elderly patients. However, there are still lack of questionnaire to evaluate the treatment outcome from the patient's aspect. The objective of this study is to evaluate the reliability and validity of the Patient's Denture Assessment-Thai version (PDA-T), then use this questionnaire to assess patient satisfaction with complete denture treatment outcome also investigates the factors involving their satisfaction. METHODS: The subjects comprised 120 edentulous adult patients (49 men/71 women; average age 70 years-old) from the Prosthodontic and the Geriatric Dentistry and Special Patients Care Clinic at the Faculty of Dentistry, Chulalongkorn University during 2019 March‒2020 March. The patients were divided into two groups: the group experienced (Exper) (n = 54) with wearing complete dentures, and the non-experienced (NonExper) group (n = 66). The patients used the validated PDA-T to self-assess their treatment at different times. The Exper group completed the questionnaire at t0 (during treatment), t0.5 (2‒8-weeks after t0), and t1 (final follow-up). The NonExper group completed the questionnaire only at t1. RESULTS: In the Exper group, Cronbach's α and average inter-item correlation was 0.95 (range 0.76‒0.95) and 0.47 (range 0.57‒0.83), respectively. The intraclass correlation coefficients (n = 18, 95% confidence interval) were 0.98 overall. The paired t-test (p < 0.05) between t0 and t1 indicated a significant difference between t0 and t1 in every PDA-T topic, and the effect size was 1.71. In the NonExper group, the Pearson correlation analysis indicated no significant correlation between the patients' demographics and masticatory function. CONCLUSION: The reliability and validity of the PDA-T indicate it is a valuable tool for evaluating complete denture treatment. Treatment success affected the patients' satisfaction but was not associated with the type of doctors, genders, ages, or educational level.