Which metal surface treatment improves the bond strength between metal alloys and acrylic resin in removable partial dentures? A systematic review.

STATEMENT OF PROBLEM: The union of the metal removable partial denture framework to the heat polymerized acrylic resin is related to prosthesis longevity. However, methods to enhance this bond are not clear to clinicians and dental laboratory technicians. PURPOSE: The purpose of this systematic review was to identify which metal surface treatments best increase the bond strength between heat polymerized acrylic resin and removable partial denture alloys. MATERIAL AND METHODS: This review was carried out following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and registered in the International Prospective Registry of Systematic Reviews (PROSPERO) database (CRD42022384926). Electronic searches were carried out independently, by 3 examiners in Medline/PubMed, Scopus, and Web of Science databases, and in the nonpeer-reviewed literature via ProQuest. RESULTS: The electronic searches resulted in 4143 articles, with 4055 after removing duplicates. After reading the titles and abstracts, 37 articles were selected for reading in full-text version, from which 6 articles were included. All studies evaluated materials for conventional acrylic resin denture base (heat polymerized), processed by water bath, bonded to metal. For the metal framework alloys, cobalt chromium (Co-Cr) alloys were used in 2 studies, titanium (Ti) in 2 studies, and Co-Cr and Ti in the other 2 studies. Different metal surface treatments were used as airborne-particle abrasion with aluminum oxide (particle sizes of 50 µm, 110 µm, and 250 µm) followed by the primer application and the isolated use of the primer, compared to the absence of isolated intervention or airborne-particle abrasion of the metal surface. Among the different primers used, those based on 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP) showed the highest acrylic resin-to-metal bond strength values. CONCLUSIONS: Airborne-particle abrading the metal with Al2O3 followed by applying a 10-MDP-based primer, increased the bond strength between metal framework alloys and heat polymerized acrylic resin denture base material.