[Effect of Aging on the Mechanical Properties of CAD/CAM-Milled and 3D-Printed Acrylic Resins for Denture Bases].

PURPOSE: The purpose of this study was to investigate the mechanical properties of acrylic resins at different aging times for denture bases manufactured using the conventional method, microwave processing, milling, and 3D printing. MATERIALS AND METHODS: A total of 160 rectangular samples (64 Å~ 10 Å~ 3.3 ± 0.03 mm) were prepared, divided among the four main resin groups, and subdivided into four analysis times (T0, T1, T2, and T3), resulting in 10 samples per subgroup. The samples were stored in distilled water at 37° ± 2°C for 24 hours (T0), then subjected to thermocycling at temperatures of 5° ± 1°C and 55° ± 1°C in different numbers of cycles: 5,000 (T1); 10,000 (T2); and 20,000 (T3). The mechanical properties evaluated were surface microhardness, flexural strength, and modulus of elasticity. Statistical differences between resin groups and aging time were evaluated using two-way analysis of variance (P < .05). RESULTS: The 3D-printed resin showed the significantly lowest values of microhardness, flexural strength, and modulus of elasticity compared to other resins (P < .001). CONCLUSIONS: The CAD/CAM-milled denture resin showed mechanical properties similar to those of traditional resins (conventional and microwave-processed). The 3D-printing resin did not show adequate mechanical properties for long-term clinical use. Despite this, new studies are developing better properties of this resin for long-term use.

Evaluation of Different Polymerisation Methods of Ocular Prosthesis Acrylic Resins on Subcutaneous Tissue Inflammatory Response in Rats.

Objectives: This study aimed to evaluate the influence of different polymerisation methods of acrylic resin for ocular prostheses on the subcutaneous tissue inflammatory response of rats. Methods: The study was conducted at the Basic Sciences Department, Araçatuba Dental School, São Paulo State University (UNESP), Brazil, from 2016 to 2018. The samples were prepared by water bath (WB), microwave energy (MW) or autopolymerisation (AP) (n = 20 samples per group). The inflammatory response (cell count and immunohistochemical analysis of interleukin [IL]-1ß, IL-6, tumour necrosis factor [TNF]-α, IL-17 and macrophage inflammatory protein-3α) was analysed by the implantation of a sample from each group in the subcutaneous tissue of 20 Wistar rats and evaluated after seven, 15, 30 and 60 days. The quantitative and qualitative data were analysed using analysis of variance and Tukey tests (P <0.05) and visual comparison, respectively. Results: There was a moderate inflammatory infiltrate for the MW and AP groups and a light infiltrate for the WB group after seven days. The inflammatory infiltrate and the immunolabeling of tested targets decreased gradually during the 60-day period. The AP group had the highest immunolabeling of TNF-α (seven days), IL-1ß and IL-17 (at 15 and 30 days) and IL-6 (at 30 and 60 days). The WB and MW groups showed greater immunolabeling at 15 and 30 days, while the MW group also had high results at 60 days. Conclusion: Polymerisation by microwave energy and by chemical activation resulted in a higher inflammatory response.

Characterisation of a new plasma-enhanced film to improve shear bond strength between zirconia and veneering ceramic.

The aim of this study was to develop and characterise a new plasma-enhanced chemical vapor deposition (PECVD) film for improving shear bond strength (SBS) between yttria-stabilised tetragonal zirconia (Y-TZP) and veneering ceramic. In total, 192 Y-TZP samples (13 × 5.4 × 5 mm) were divided into 6 groups: control - no treatment (C), airborne-particle abrasion with 27 µm aluminum oxide particles (Al27), 110 µm aluminum oxide particles (Al110), and 250 µm aluminum oxide particles (Al250), application of liner for zirconia (L) and the PECVD film application (P). The Y-TZP surface was characterised by means of Scanning Electronic Microscopy (SEM), Energy-dispersive Spectroscopy (EDS), atomic force microscopy (AFM), surface profilometry and surface-free energy (SFE). SBS between Y-TZP and veneering ceramic was tested before and after thermocycling (20,000 cycles of 5 and 55 °C), and failure mode was also evaluated. Data were analysed by ANOVA and Tukey's HSD test (α = 0.05). Data analysis showed that PECVD film had no effect on surface roughness of Y-TZP (p > 0.05 vs control), whilst the other groups presented higher roughness values (p < 0.05). All treatments increased SFE, except the Al27 group. The highest SBS was presented by the P group (p < 0.05), and values were similar to those of the Al27 group (p = 0.107). Mixed failures were prevalent in all groups, and premature failures were found only in Al groups after thermocycling. Whilst PECVD treatment did not affect Y-TZP surface roughness, high SBS between Y-TZP and the veneering layer was observed. Therefore, PECVD treatment is a promising alternative to improve the performance of bi-layer zirconia-based restorations.

Effects of mouth rehabilitation with removable complete dentures on stimulus perception and the electromyographic activity of the orbicularis oris muscle.

STATEMENT OF PROBLEM: Many elderly individuals are rehabilitated with removable complete dentures, which require an initial adaptation period for both oral perception and the perioral muscles. Studies assessing the changes in stimulus perception and the electromyographic (EMG) activity of the orbicularis oris muscle shortly after conventional complete denture insertion are lacking. PURPOSE: The purpose of this clinical study was to evaluate the effect of mouth rehabilitation with removable complete dentures on stimulus perception and the EMG activity of the orbicularis oris muscle. MATERIAL AND METHODS: This study was approved by the Human Research Ethics Committee of the Araçatuba Dental School (São Paulo State University). Fifteen participants who had worn their removable complete dentures for at least 5 years and needed rehabilitation with new prostheses were enrolled in the study. A perception questionnaire was applied, and surface EMG examinations of the orbicularis oris muscle during rest, suction of water with a straw, and pronunciation of the syllables /bah/, /mah/, /pah/, and the word 'Mississippi' were performed before (T0) and 30 (T1) and 100 (T2) days after insertion of the new prostheses. The data were analyzed with the Cochran Q test, McNemar test, 2-way repeated measures ANOVA, and honestly significant difference (HSD) Tukey test (α=.05). RESULTS: Significant improvement was reported in the perception questionnaire in terms of the oral discomfort sensation in the T2 period. EMG activity decreased during rest and suction after insertion of the new prostheses. A statistical difference between the upper and lower fascicles of the orbicularis oris muscle was detected, with a decrease of EMG activity between the T0 and T1 periods on the lower fascicle, except for when pronouncing the /pah/ syllable. CONCLUSIONS: Mouth rehabilitation with removable complete dentures decreased oral discomfort and, depending on the oral function, decreased or increased EMG activity of the orbicularis oris muscle. In addition, the lower fascicle was more active than the upper fascicle during rest and most functional activities.

Influence of adding nanoparticles on the hardness, tear strength, and permanent deformation of facial silicone subjected to accelerated aging.

STATEMENT OF PROBLEM: The efficiency of adding nanoparticles to silicone protection has proven to prevent color degradation. However, reports of other physical property changes in facial silicone are scarce. PURPOSE: The purpose of this in vitro study was to evaluate the influence of adding nanoparticles on the hardness, tear strength, and permanent deformation of a facial silicone. MATERIAL AND METHODS: Specimens were made for each test, with 140 for the hardness test, 140 for the permanent deformation test, but 280 for the rupture test. This higher number was due to the fact that the first 140 specimens were ruptured and unusable after the initial reading. ZnO, BaSO4, and TiO2 nanoparticles at concentrations of 1% and 2% of silicone were used, as well as specimens without nanoparticles that consisted of only oil paint and of only silicone. Outcomes were measured before and after 1008 hours of accelerated aging. Data were analyzed by nested analysis of variance (ANOVA) and Tukey honest significant differences test (α=.05). RESULTS: Results showed that the presence of nanoparticles influenced the properties of the assessed groups. The nanoparticles decreased hardness values. The highest values of tear strength were observed for the groups with addition of BaSO4. The 1% ZnO group without oil paint showed the lowest values of permanent deformation. CONCLUSIONS: Based on the findings of this in vitro study, the use of ZnO nanoparticles is recommended, since they did not negatively affect the properties of the materials evaluated.

Phantom eye syndrome: a review of the literature.

The purpose of this literature review was to describe the main features of phantom eye syndrome in relation to their possible causes, symptoms, treatments, and influence of eye amputation on quality of life of anophthalmic patients. For this, a bibliographical research was performed in Pubmed database using the following terms: "eye amputation," "eye trauma," "phantom eye syndrome," "phantom pain," and "quality of life," associated or not. Thirteen studies were selected, besides some relevant references contained in the selected manuscripts and other studies hallowed in the literature. Thus, 56 articles were included in this review. The phantom eye syndrome is defined as any sensation reported by the patient with anophthalmia, originated anophthalmic cavity. In phantom eye syndrome, at least one of these three symptoms has to be present: phantom vision, phantom pain, and phantom sensations. This syndrome has a direct influence on the quality of life of the patients, and psychological support is recommended before and after the amputation of the eyeball as well as aid in the treatment of the syndrome. Therefore, it is suggested that, for more effective treatment of phantom eye syndrome, drug therapy should be associated with psychological approach.

Effect of different disinfectants on the microhardness and roughness of acrylic resins for ocular prosthesis.

BACKGROUND: Ocular prosthesis materials should have specific properties for their indication and durability; therefore, it is important to investigate their physical behaviour when affected by several disinfectants. OBJECTIVES: This study evaluated the influence of different disinfecting solutions on the microhardness and surface roughness of acrylic resins for ocular prosthesis. MATERIALS AND METHODS: Fifty samples simulating ocular prostheses were fabricated with N1 resin and colourless resin and divided (n = 10) according to the disinfectant used: neutral soap, Opti-free, Efferdent, 1% hypochlorite (HYC) and 4% chlorhexidine (CHX). Samples were stored in saline solution at 37°C and disinfected during 120 days. Both microhardness and roughness were investigated before, after 60 days and 120 days of disinfection and storage. Microhardness was measured using a microhardner and the roughness with a roughness device. RESULTS: N1 resin showed lower microhardness when compared with colourless resin (p < 0.05). HYC and CHX groups exhibited the highest change of microhardness and roughness values (p < 0.05). An increase in roughness and reduction in microhardness of ocular acrylic resins were observed after both periods of disinfection and storage (p < 0.05). CONCLUSION: Both disinfection/storage periods affected the microhardness and roughness values of the samples.

Effect of thermal cycling and disinfection on colour stability of denture base acrylic resin.

OBJECTIVES: The purpose of this study was to investigate the effect of thermal cycling and disinfection on the colour change of denture base acrylic resin. MATERIALS AND METHODS: Four different brands of acrylic resins were evaluated (Onda Cryl, QC 20, Classico and Lucitone). All brands were divided into four groups (n = 7) determined according to the disinfection procedure (microwave, Efferdent, 4% chlorhexidine or 1% hypochlorite). The treatments were conducted three times a week for 60 days. All specimens were thermal cycled between 5 and 55°C with 30-s dwell times for 1000 cycles before and after disinfection. The specimens' colour was measured with a spectrophotometer using the CIE L*a*b* system. The evaluations were conducted at baseline (B), after first thermal cycling (T1 ), after disinfection (D) and after second thermal cycling (T2 ). Colour differences (ΔE) were calculated between T1 and B (T1 B), D and B (DB), and T2 and B (T2 B) time-points. RESULTS: The samples submitted to disinfection by microwave and Efferdent exhibited the highest values of colour change. There were significant differences on colour change between the time-points, except for the Lucitone acrylic resin. CONCLUSIONS: The thermal cycling and disinfection procedures significantly affected the colour stability of the samples. However, all values obtained for the acrylic resins are within acceptable clinical parameters.

Hyperbaric oxygen therapy treatment for the fixation of implant prosthesis in oncology patients irradiated.

OBJECTIVES: This study aimed to present a clinical report of an irradiated oncologic patient who underwent hyperbaric oxygen therapy to be rehabilitated with implant-supported prosthesis. MATERIALS AND METHODS: A 67-year-old man was admitted at Oral Oncology Center (FOA-UNESP) presenting a lesion on the mouth floor. After clinical evaluation, incisional biopsy and histopathological exam, a grade II squamous cell carcinoma was diagnosed. The patient was subjected to surgery to remove the lesion and partial glossectomy. Afterwards, the radiotherapy, in the left/right cervicofacial area of the supraclavicular fossa, was conducted. After 3 years of the surgery, the patient was submitted to hyperbaric oxygen therapy. Then, four implants were installed in patient's mandible. Five months later, an upper conventional complete denture and lower full-arch implant-supported prosthesis were fabricated. CONCLUSION: The treatment resulted in several benefits such as improving his chewing efficiency, swallowing and speech, less denture trauma on the mucosa and improving his self-esteem.

Rehabilitation with ear prosthesis linked to osseointegrated implants.

BACKGROUND: The absence of an ear, which can be the result of a congenital malformation, surgical tumour resection or traumatic injury, is a significant aesthetic problem. Attachment of ear prostheses with adhesives can cause local irritation for the wearer and affect the colour of the prostheses. Use of implants in craniofacial reconstruction can improve the retention and stability of prostheses giving to patient greater comfort and security relative to adhesive attachment. OBJECTIVE: The aim of this report was to present a clinical case of a mutilated patient who was rehabilitated by means of installing an ear prosthesis fixed through osseointegrated implants. MATERIALS AND METHODS: The patient had two implants installed in the mastoid region that were linked by a bar, and a clip-type system was used. The ear prosthesis was constructed from medical-use silicone, pigmented to match the patient's skin colour and linked to the retention system. CONCLUSION: The patient's rehabilitation was satisfactory from both a functional and an aesthetic point of view, making it possible for the patient to return to a normal social life and regain lost self-esteem.

Effect of disinfection and storage on the flexural strength of ocular prosthetic acrylic resins.

OBJECTIVE: To evaluate the influence of chemical disinfection and storage duration on the flexural strength of acrylic resins commonly used to make ocular prostheses. METHODS: A total of 260 samples were manufactured with N1 resin and colourless resin. Both resins were thermopolymerised using a microwave oven. Samples were stored and periodically disinfected and were divided into groups: control (no disinfection) (I), neutral soap (II), Opti-free (III), Efferdent (IV), 1% hypochlorite (V) or 4% chlorhexidine (VI). The flexural strength was measured before and after 60 and 120 days of storage. Data were analysed by anova and Tukey test (0.05). RESULTS: The flexural strength of the N1 resin was higher than that for the colourless resin. There was a significant difference in the flexural strength before and after 60 and 120 days of storage with disinfection, regardless of the resin and disinfectant. Group I in the initial period exhibited greater flexural strength, with significant difference only in group VI after 120 days. CONCLUSION: It can be concluded that the flexural strength only changed after 120 days of storage for samples disinfected with chlorhexidine. However, all flexural strength values obtained herein were acceptable clinical limits for the acrylic resins.

Influence of opacifiers on dimensional stability and detail reproduction of maxillofacial silicone elastomer.

BACKGROUND: We evaluated the influence of chemical disinfection and accelerated aging on the dimensional stability and detail reproduction of a silicone elastomer containing one of two opacifiers. METHODS: A total of 90 samples were fabricated from Silastic MDX 4-4210 silicone and divided into groups (n = 10) according to opacifier content (barium sulfate or titanium dioxide) and disinfectant solution (neutral soap, Efferdent, or 4% chlorhexidine). The specimens were disinfected 3 times per week during 60 days and then subjected to accelerated aging for 1008 hours. Dimensional stability and detail reproduction tests were performed after specimens' fabrication (baseline), chemical disinfection and periodically during accelerated aging (252, 504, and 1008 hours). The results were analyzed using 3-way repeated-measures ANOVA and the Tukey HSD test (α = 0.05). RESULTS: All groups exhibited dimensional changes over time. The opacifier (p = .314), period (p < .0001) and their interactions (p = .0041) affected the dimensional stability of the silicone. Statistical significant dimensional differences occurred between groups with (0.071) and without opacifiers (0.053). Accelerated aging influenced the dimensional stability of the samples. All groups scored 2 in the detail reproduction tests, which represents the fully reproducing of three test grooves with accurate angles. CONCLUSIONS: Incorporation of opacifiers alters the dimensional stability of silicones used in facial prosthetics, but seems to have no influence on detail reproduction. Accelerated aging is responsible for most of the dimensional changes in Silastic MDX4 4210, but all dimensional changes measured in this study remained within the limits of stability necessary for this application.