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1
Prosthetic Resin Polymers
Dr Layla Abu-Naba’a
PhD, MFDRCS
Assistant Professor of Prosthodontics
2
Demographic changes
Means an increased need for Prosthetic treatments
20
30
40
50
60
1941 1982 2025 2050
%
population
over
50
0
3
Prosthetic Uses
 Denture bases
 Denture teeth
 Relining Materials
 Repair of dentures
 Provisional acrylic
partial dentures
 Custom impression
trays
 Mouth guards
 Fluoride and
bleaching trays
 Facing on esthetical
crowns
 Provisional
restorations
 Removable tooth
movement devices
 Orthodontic retainers
6
4
Denture base function
Distributes pressure over a wider area
So reducing bone resorption
Retains artificial teeth
Replaces missing tissue
Forms a seal for retention
6
5
Denture Base materials
Carved ivory
Carved Wood
Vulcanite; dark, opaque
(Vulcanised rubber)
Highly cross-linked Acrylic resin
Other Resin and plastic
alternatives
0
6
Plastic acrylic teeth
Bind chemically to the denture
Can be adjusted
Not cause wear of opposing tooth
Good colour match
Minor resiliency
Wear under high force occlusion
May stain with time
6
7
Porcelain (high fusing ceramic)
Isosit (composite; xlinked acrylic) –
heavily xlinked
Experimental fiber-reinforced teeth
6
Other Teeth Materials
8
Maxillofacial prosthesis
Needed
After trauma
Surgical defects
Birth defects
Other materials
Silicone rubber
Vinyls with
plasticizers
6
9
Acrylic repair
Materials
Chemically cured acrylic
Light cured acrylic
6
10
Relining Materials
6
11
Provisional partial dentures
6
12
Impression trays
6
13
Record bases
Materials
Cold-curing acrylic resin
Other material
Shellac
Vacuum formed vinyl or polystyrene
Baseplate wax.
6
14
Occlusal Splints
Night guards
Bleaching and fluoride
application trays
6
15
Mouth guards
6
16
Orthodontic applications
 Removable tooth movement devices
 Orthodontic retainers
6
17
Facing of crowns
Provisional restorations
6
Other materials:
•Polycarbonate
•Aluminum
•Stainless steel
•celluloid
18
Polymer principles
19
Terminology
Monomer + monomer = polymer
Monomer1 + monomer2 = copolymer
Oligomonomer= 2-4 monomers
Poly = many
Mono = single
Mer = unit
Oligo =several
6
20
Types and molecular weight
Addition polymerisation:
No by products
Polymer mwt = Σ mwt monomers
Condensation polymerisation:
By products are produced and lost in
thefinal product
Polymer mwt ≠ Σ mwt monomers
6
21
Morphology
of spatial arrangements
Linear or chain polymerisation
Easily manipulated, stretched, bent,
thermoplastic, Hard
e.g. fitting surface of acrylic teeth- better
binding to denture base
Branched polymerisation
Easily manipulated, stretched, bent,
thermoplastic, More hard
6
22
Cross-linked polymerisation
Strong, stiff, thermoset, wear resistant
E.g. Denture base materials, Occlusal
surfaces of actylic teeth
Coiled chains
Flexible
e.g. impression materials
Morphology
of spatial arrangements
6
23
Crystalline polymers
Very regular arrangement in space:
strong,
stiff,
absorb less water.
Amorphous or glassy polymers
Irregular arrangement
Behaves as a brittle solid
Morphology
of spatial arrangements
6
24
Plasticizers effects
Added to stiff, glassy uncross-linked
polymers
Lowers glass transition temperature (Tg)
Become
rubber-like,
Flexible
less brittle
6
25
Dimensional and thermal
changes
Expansion on polymerization, exothermic
Contraction on polymerization
21vol.% If unfilled acrylic resin
6% denture resin
1-3% composites
Expansion on swelling in water
Expansion or warpage on thermal change
and reheating
6
26
Acrylic Resin Types
27
Ideal properties
Natural appearance
Easy processing
Easy to clean
Easy to repair
Inexpensive
Biocompatible
Resistant to bacterial
contamination
High strength, stiffness,
hardness, toughness,
fatigue resistance
•Low density
•Radiopaque
•High thermal
conductivity
•High modulus of
elasticity, impact
strength
•Abrasive resistance
•Dimensionally stable
•Accurate reproduction
of surface detail
28
Curing methods
Chemically cured
Tertiary amine ( dimethyl-p-toluidine or sulfinic acid)
(accelerator)
Benzoyl peroxide (initiator)
Hydroquinone (inhibitor)
Heat cured
Heat and pressure control
Avoids porosity
Maximizes conversion of monomer to polymer
Light cured
Photo-initiators (camphorquinone),
Blue light,
Used for: record bases, custom tray, denture repair
29
Heat cured acrylic resin
Powder ( can have limitless life)
Beads or granules of polymethyl methacrylate
Initiator (benzoyl peroxide)
Pigments/dyes (colour vitality as cadmium, iron, organic dyes)
Optical opacifiers (tio2/zno)
Plasticizers (ethyl acrylate (internal), dibutylphthalate (external) to
make dough easier)
Synthetic fibres (nylon)
Coloured fibres (blood vessels)
Liquid ( in dark bottle, avoid contamination by
powder)
Methyl methacrylate monomer
Inhibitor (hydroquinone)
Crosslinking agent
(diethylene glycol dimethacrylate, (1,4 butylene glycol dimethacrylate)
Bead Polymer
30
Chemical cured resin
Cure is initiated by a tertiarv amine (e.g. Dimethyl-
p-toluidine or sulfinic acid)
Absence of heat:
Lower molecular weight material
Lower strength properties
Higher residual monomer in the resin
Color stability is not as good- yellowing
Less contraction on cooling to room temp
Polymer beads are smaller
Faster dissolution in the monomer to produce a dough
Doughy stage is reached before the addition curing reaction –
mix viscosity is high and prevents the adaptation of the mix to
the mould walls or cast -keep readapting
Lowering of the glass transition temperature
Less build-up of internal strain
Highly susceptible to creep- distortion when in use.
31
Light activated materials
Components:
Urethane dimethacrylate matrix
Acrylic copolymer
Silica filler to control rheology
Forms
Sheets
Ropes
Curing
Light chamber- 400-500 nm
Photo-initiators (camphorquinone),
Teeth added in a second exposure over the base
Used for
Record bases
Custom tray
Denture repair
Hardness and impact strength ≈ heat cured resin
Elastic modulus < heat cured resin; deform under
mastication
Less shrinkage (3%) better fit
Less residual monomer
32
Auto-polymerizing, pour acrylic
Reducing agent (tertiary aromatic amine or barbituric
acid derivative, NN’-dimethyl-p-toluidine) reacts with
peroxide at room temp.
Excellent detail reproduction
To be able to pour in mold, balanced size, mwt,
plasticizers and xlink agents
Reversible hydrocolloid (agar) mold can’t resist teeth
movement during pouring
Hydro pressure flask reduces air bubbles and
monomer porosities
Difficult to dewax, less monomer binding to teeth
Shortcomings:
residual monomer
↓ Cross link densities
 Creep
 Variety of products
33
High-impact acrylic
A rubber phase is added (phase inversion)
Uniformly distributed
Rubber cored polymer
Types
Butadiene + styrene = polystyrene butadiene rubber
Butadiene + MMA
PMMA + polystyrene butadiene rubber + poly(2,3-
dibromopropyl methacrylate) for opacity
PMMA = lucitone 199
Lightly xlinked or no cross linking agent is added
Rubber has a craze inhibitory effect
34
Experimental types of acrylic
All aim to increase impact strength and stiffness
Glass reinforced acrylic (failed)
Fibers may irritate patient if denture fitting surface was
abraded
Carbon fibers
Black color- used only in lingual areas
Kevler fibres (poly-p-phenylene terephthalamide)
Straw color
Poor bond between fibers and matrix
Difficult to pack
Black shadow- used only in lingual areas
35
Experimental types of acrylic
Added Bis-GMA and fiber
Flexural strength ≈ ceramics
Can be used as lingual bars and connectors
Experimental (mwt polyethylene fiber-reinforced)
Neutral color
Low density
Biocompatibility
Surface treated to enhance fabrication
Time consuming
36
Types of acrylic
Other (polystyrene,epoxy, SS)
PMMA Adhesion to
Metal- use adhesive primers
untreated porcelain teeth with organo
silane compounds
37
Heat Cured Resin
38
Polymethyl methacrylate
Activation
Initiation
Propagation
Termination
MMA
Liquid
PMMA
Powder
Old and new
polymer chains
Intertwined at the
molecular level.
PMMA
Powder
Particle swells
MMA
Liquid
Acrylic dough (Cohesive gel)
Heat and pressure
(entanglements)
39
Setting reaction
Mixing of powder and liquid cause monomer diffusion and
softening of the surface of the powder producing the following
gelling stages:
Ratio P/L (2/1 wt%, 1.6 -1 vol%)
Sandy- initial melting of beads (not used)
Stringy or sticky- entanglements with swollen beads and
thickened interstitial monomer (not used)
Dough- gelation (used)
Rubbery- monomer penetrates to the core of beads,
plasticizing them, ↓Tg (not used)
40
Manipulation issues
P/L
Inadequate filling by monomer
Weak material properties
Porosity
↓P/L
Excessive polymerisation shrinkage
Poor fit
Light color as powder holds the pigments
41
Manipulation issues
Curing before monomer diffuse to bead
(before dough stage)
↓ flexural strength
cracks between linear polymerised interstitial gel and cross
linked beads
More shrinkage contraction by the loss of pressure produced
by the dough to compensate for it
Curing in dough stage
monomer penetrate the beads
dissolves beads allows cross-linking agent to penetrate
interpenetrating polymer network IPN.
Packing in the rubber stage
Less extrusion of excess acrylic from flask
Extra pressure in the mould
Fracture the cast
less flow around teeth
Dislodgment of teeth into mould
42
Manipulation issues
Control of color
Pigments position
Inside beads
surface of beads
– polymer should be added to the monomer slowly so it will not
washed off by too rapidly
Blood vessel resembling Fibers aggregate in the bottom
of bottle
– Shake powder well before use
Mould Lining
resin may penetrate rough plaster and adhere
a separating medium must be employed
solution of sodium alginate
tin foil.
43
Manipulation issues
Control of Processing strains
Shrinkage in restricted mould cause internal strain
On release of stress (flask opening) it may give
Crazing
Warpage
Distortion
These are reduced by the slightly extra packed material
that flow into shrinkage spaces when temperature is
higher than Tg (heated flask)
Manipulation further reduces strains by
Using acrylic teeth
Cooling the flask slowly
44
Flasking steps
Flasking
Dewaxing
Putting a separating medium
Placing acrylic dough
Packing
Heat curing
45
Wax-up
Flasking
Melt out the wax
Packing
Curing
46
Flasking for heat cured resin
Flasking options with acrylic dough:
Trial-packing, trimming, repacking
Packing-only
Poured resin (e.G., Lucitone fas-por)
Injection moulding
Heat and pressure control
Aim to produce radicals and initiate polymerization
Reaction is thermally activated and generates heat as
well
Reaction conversion is about 98 to 99.5%
MMA: tbp = 100c (p= 1 atm); 140c (p= 2 atm)
47
Heat curing cycles
Fast cycle
Cure at 71-72°C for 30-90 min
100°C for 30 min.
Slow cycle = cure at 71-72°c for 10 hrs
[A slow cycle is better with larger amounts of
material.]
[Generally, slow cures result in better
dimensionalaccuracy.]
Other cycles are done as recommended
by manufacturers
48
Heat curing cycles
Rapid heating:
Excess radical release
Extra xlinking and branching of interstitial
polymer
More residual monomer
Reduced toughness
Heat builds up from exothermic rxn
Porosity
Loss of strength
Bad esthetics (opaque and cloudy color)
Possible fouling
49
Heat curing cycles
Slow :
Sufficient radical release
Adequate xlinking and branching between high
mwt polymer chains
Increased toughness
Sufficient radical ends increase monomer
incorporation in growing chains
Xlinking agents polymerized, reducing their
plasticizing effect (in their non bound state) and
reduce creep
Produce an annealing effect easing stresses
produced from shrinkage, reducing crazing and
distortion
50
Heat curing cycles
Pressure control
Places compressive force
Compensates for polymerization shrinkage
Increase flow of dough around teeth, more
monomer wetting and surface dissolution,
stronger bond
Oozes out excess dough
Some hybrid systems begin polymerization
from one side to allow dough to cover for
shrinkage
51
Heat curing cycles
Microwave curing
Uses a microwave
Flasks are non metalic
Reduced time
52
Denture shortcomings
53
Denture Radiolucency
Problems when accidents displace fractured
segments
Lungs
Skull
stomach
Salts and fillers reduce esthetics, strength
Organo-metalics are toxic
Bromine containing organics lack heat stability, must be
added in quantities that plasticize the denture, causing creep
and water sorption
Phase separating bromo-polymer in beads reduce the
previous effects
54
Mechanical properties
Failure to Moderate strengths:
impact resistant denture is low
Low elastic and flexural modulus
lack of fracture toughness
30% of denture repairs involve midline fractures
which are most prevalent among upper dentures.
dropped denture does not necessarily break instantly
a crack continue to grow and failure due to flexural
fatigue.
Failure due to poor quality processing
Lack of bonding between the resin and the acrylic teeth
and weak interface
Crazes due to processing faults or exposure to solvents
is another possibility.
Creep
Reduced by cross linking
Heat cured < cold cured
55
Internal denture porosity
Inherent porosity:
Not seen by vision
1-2% of residual
monomer
Leaks
Replaced by fluids
Minimized by
Use heat cured resin
Pack denture under
correct pressure
Use correct P/L
Use the glaze after
polishing
56
Internal denture porosity
Irregular porosity:
Seen by vision
Not regular on
denture surface
P/L heterogeneity
Air incorporation
(spherical pores)
Minimized by
Use correct P/L
Add liquid first
Mix well
Cover the mix before
dough stage
Can use the vibrator
57
External denture porosity
Irregular surface
deficiencies:
Seen by vision
Insufficient pressure
Dough was not molded
correctly by hand leaving
surface blisters and pores
Insufficient dough
Minimized by
Mold dough by hand
into small areas
Place sufficient
material in flask
Pack under correct
pressure
58
External denture porosity
Irregular porosity:
Shrinkage by
polymerisation (5-8% vol
or 0.2 -0.5% linear)
Further shrinkage by
cooling to room
temperature
Can compensated for by
the post dam technique
Minimized to by
Pack under pressure
Slight extra denture
material can overcome
shrinkage and
maintain pressure
(single packing)
Pack in dough stage
59
Internal denture porosity
Gaseous porosity
Seen by vision
Volatisation of
monomer by
Localized MMA boiling
Common in thicker
portions
Minimized by
Avoid high processing
temperatures
Avoid extra monomer
than recommended for
P/L
Raise heat slowly and
evenly around the
flask
60
Gaseous porosity
Avoid high processing temperatures
0
20
40
60
80
100
120
140
160
0 10 20 30 40 50 60 70 80 90
100
Temperature
0
C
Time (min)
Correct
cycles
Incorrect
cycle
61
Crazing
Area of localised region of high plastic
deformation which may fill by voids
Crazed region can still support stress
As the voids in the crazed region grow, they become
separated only by thin fibrils of polymer
Fibrils fail and a crack is formed
Crack will grow under an externally applied load
Cause denture failure by brittle fracture.
Caused by
Internal strains in flask
Heat (due to polishing)
Differential contraction around porcelain teeth
Attack by solvents such as alcohol
Reversible Irreversible
CRAZE CRACK
62
Crazing
Avoid internal strain during polymerisation
Slow cooling of the flask
Use single trial packing
Use cross linked polymer types
Avoid extra stress during function
Use acrylic rather than porcelain teeth
Do not overheat on polishing
Keep denture away from solvents
Avoid denture drying
Polish after each adjustment
Use glazes for surface
Reversible Irreversible
CRAZE CRACK
63
Dimensional changes on
processing
Expansion on heating flask; heat evenly
Expansion on polymerization, exothermic
Contraction on polymerization (21vol.%);
Contraction on cooling to room temperature;
Expansion on swelling in water;
Expansion on thermal change to 32c.
Net result– should be near zero
64
Warpage on drying
Contraction on evaporation of
absorbed water
Don’t leave denture outside the mouth
dry
65
Adverse reactions to PMMA
Most common in dental
laboratories
Associated with regular
contact with monomer
when handling the
dough
Must avoid direct
contact
Rubber gloves may not
provide sufficient
protection
Barrier creams can help
Irritant contact
dermatitis
66
Adverse reactions to PMMA
Allergic contact dermatitis
Usually associated with
release of
residual monomer
Benzoic acid
Types
Immediate
Delayed hypersensitivity
(type IV)
Heat cured resin < chemical
cured
Must ensure full cure of denture
Avoid relining procedures
May use an extra cycle of
polymerisation – but denture
may warp
May need to consider
alternative material such as
polycarbonate if Delayed
hypersensitivity
67
Adverse reactions to PMMA
Further reading:
Hensten-petterson & jacobsen. J prosthet dent
1991; 65: 138
Kaber. Int dent J 1990; 40: 359
Http://www.Shef.Ac.Uk/uni/project/arrp/
68
Thermal properties
Low Thermal conductivity
during denture processing heat cannot escape – prone to
gaseous porosity
isolates from any sensation of temperature – throat burns
High Coefficient of Thermal Expansion
Porcelain teeth may be lost due the differential expansion
and action
Warpage if denture is cleaned with hot water
69
Water Sorption
PMMA will absorb water by polar nature (1.0-2.0%
wt)
May compensate for processing shrinkage
Weeks of continuous immersion in water to reach a
stable weight
Solubility
Solvents (e.G. Chloroform, alcohol)
Xlinked are insoluble in most of fluid intakes
Weight loss will occur, due to leaching of the
Monomer
Pigments and dyes.
70
Ideal properties achieved?
Natural appearance 
Easy processing 
Easy to clean 
Easy to repair 
Inexpensive 
Biocompatible 
Resistant to bacterial contamination x
High strength, stiffness, hardness, toughness X
Low density 
Radiopaque X
High thermal conductivity X
Dimensionally stable X
Accurate reproduction of surface detail 
71
More
DB bonding to alloy framework
Acrylic-metal leakage
72
Other Denture Base materials
73
Injection molded plastic
Types
Polycarbonates
Nylon
Advantage:
Consistent mwt
Substitute acrylics in sensitive patients
Disadvantage
Must use dry mold, slow heating and cooling
Under filled molds by inadequate spruing or underheating
Low melt temp cause high injection forces, moving teeth in
mold
Cost of equipment
Difficult to attach to teeth
Small market segment
Can explode if high heat and wet molds
Overheating cause depolymerization, oxidation, porosties
Loss of strength
Bad esthetics (opaque and cloudy color)
Possible fouling
74
Polycarbonates
Tough plastic
Injected in dry molds
A high melt viscosity
Problems in binding to teeth
May de-polymerize explosively in the
presence of heat and water
No cross linking –
Poor solvent resistance
Poor craze resistance
75
Nylons and polyamides
Polyamide = diacid + diamine
Conventional nylon failed
Excessive water sorption
Poor creep resistance
Biodegradation
Glass (beads or fibers) reinforced nylon
Less water sorption
Fibers better in stiffness(≈ acrylic) than beads
Fibers may irritate patient if denture fitting surface was abraded
76
Cellulose product
Camphor used as plasticiser
Warpage in mouth
Camphor leached out
Loss of color
Taste
Blistering
Staining
77
Phenol Formaldehyde (Bakelite)
Difficult to process
Lost its color with function
78
Vinyl resins
Low resistance to fracture
Fatigue failure
79
Relining Materials
80
Denture base reprocessing:
Hard and soft tissue changes every 5-8 years
Require modifying denture base:
Relining  resurfacing of the tissue surface
Rebasing  replacement of entire denture
base
81
Soft denture lining material
Uses:
After surgery
Immediate dentures
Sores
Undercuts which are not removed by surgery
Ill fitting denture
can be done
In lab
Chair side
82
Ideal lining material properties
Durability: but hardens in short time
(1-4w, 1-3 y)
Dimensional stability
Resistance to fouling
Water absorption
Osmotic presence of soluble material
Resistance of Biodegradation
Could it bond old acrylic
Inhibit candida growth
83
Lining materials–acrylic based
Glassy MMA + high conc. of plasticizers
Plasticizers:
Free: diffuse out reducing the resiliency
Bound in cured matrix – failed clinically
Has lower rate of polymerization
Phase separation
Water accumulate in plasticizer rich phase
Soluble impurities cause more osmotic pressure
Swells and distorts
Discoloration
Bad taste
Exothermic rxn
Bad taste
84
Lining materials–acrylic based
Soft acrylics that have ↓Tg
EMA (ethylmethacrylates)
Beads coploymer
Ethyl methacrylate + isobutyl methacrylate
Ethyl methacrylate + ethoxyethyl methacrylate
– Have unpleasant odour
Monomer
MMA Tg > room temp Less irritant to patients
Isobutyl methacrylate Tg < room temp (polished after placing
in iced water), Dimensional instability
Plasticizer in monomer trapped in beads (25-50%)
Phthalate ester – leach out by time
Avoid heat, strong bleaching agents that reduce resilience
85
Lining materials–acrylic based
Soft acrylics that have ↓Tg
Hydroxy EMA
Water is the plasticizer
Swelling of liner may make it distort
Ions enter and may crystallize inside matrices thus
hardening the liner
Polymerisable plasticisers
Beads ploymer
Ethyl methacrylate + isobutyl methacrylate or
Monomer
Alkyl maleate or
Alkyl itaconate + Tridecyl methacrylate +
2-diethylhexyl maleate, ethylene glycol dimethacrylate
86
Tissue conditioners
Differ from soft lining material by the following
Different viscoelastic properties
Flowable on insertion responding to
– Masticatory forces
– Lingual forces
– Border moulding forces
Increase viscosity on setting
Flows slowly responding to persistent heavy masticatory
forces after setting
– Useful to fill space after tissue swellings resolve
– Can be used as a functional impression
Reaction
Gel formation not polymerization
Alcohol swells beads and ↓ their Tg
Beads become tacky by entanglements and  cohesive
strength
87
Tissue conditioners
Differ from soft lining material by the following
Composition
• Old- plasticine
• Old- chewing gum
• Ethyl methacrylate copolymers
• Or small mwt polymers
Plasticisers:
ethyl alcohol or
aromatic esters (butylphthalyl butylglycolate)
hemical cleaning damages the liner
– Use plain soap and water
88
Tissue conditioners
Differ from soft lining material by the following
Alcohol problems:
Leak and replaced by water- so harden days up to 14 days
High conc. Can give a sting sensation
Can give a false positive on breathalyser test
Reduce leach of plasticisers by glazing or semiset MMA
Very susceptible to infection
– Incorporate antimicrobials as
» silver zeolite
» itraconazole
Chemical cleaning damages the liner
– Use plain soap and water
89
Silicon - RTV
Room temperature vulcanizing silicones (RTV)
Polymethyl siloxane polymer
It sets by crosslinking of existing polymers
Heat
Tetraethyl silicate
Condensation minimal xlinking
Poor tear resistance
Poor abrasion resistance
Poor adhesion to denture
Use adhesive or coupling agent
Osmotic pressure effects
Buckling and swelling with water
Poor resistance to cleansers
Biocompatible
Dimensional stability
May foul by Candida
90
Silicon – Heat cured
More xlinking
Poor tear resistance
Adequate adhesion to denture
Can use siloxane methacrylate as a binder to heat
cured additional silicon
Resistant to aqueous environment and Osmotic
pressure effects
better resistance to cleansers
Poor tear resistance
Poor abrasion resistance
91
Other acrylic products
92
Denture base hygiene
1. Clean with toothbrush and warm soap-
and-water
2. Use low abrasive cleaners
2. Avoid oxidizing or Cl-containing
materials
• Bleaching the color
• Reduces strengths of denture
• Reduces fatigue resistance
3. Diligently clean both the top and tissue-
borne surfaces
4. Clean with benzalkonioum
93
Thank you
94
References
Philips Science of Dental Materials
Dental Materials and Their Selection
Applied Dental Materials
Dental Materials. Clinical Applications for
Dental Assistants and Dental
Introduction to Dental Materials
RPD acrylic materials by Dr Stephen C.
Bayne
Dr Layla Abu- Naba’a

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Denture Base Resins.ppt

  • 1. 1 Prosthetic Resin Polymers Dr Layla Abu-Naba’a PhD, MFDRCS Assistant Professor of Prosthodontics
  • 2. 2 Demographic changes Means an increased need for Prosthetic treatments 20 30 40 50 60 1941 1982 2025 2050 % population over 50 0
  • 3. 3 Prosthetic Uses  Denture bases  Denture teeth  Relining Materials  Repair of dentures  Provisional acrylic partial dentures  Custom impression trays  Mouth guards  Fluoride and bleaching trays  Facing on esthetical crowns  Provisional restorations  Removable tooth movement devices  Orthodontic retainers 6
  • 4. 4 Denture base function Distributes pressure over a wider area So reducing bone resorption Retains artificial teeth Replaces missing tissue Forms a seal for retention 6
  • 5. 5 Denture Base materials Carved ivory Carved Wood Vulcanite; dark, opaque (Vulcanised rubber) Highly cross-linked Acrylic resin Other Resin and plastic alternatives 0
  • 6. 6 Plastic acrylic teeth Bind chemically to the denture Can be adjusted Not cause wear of opposing tooth Good colour match Minor resiliency Wear under high force occlusion May stain with time 6
  • 7. 7 Porcelain (high fusing ceramic) Isosit (composite; xlinked acrylic) – heavily xlinked Experimental fiber-reinforced teeth 6 Other Teeth Materials
  • 8. 8 Maxillofacial prosthesis Needed After trauma Surgical defects Birth defects Other materials Silicone rubber Vinyls with plasticizers 6
  • 9. 9 Acrylic repair Materials Chemically cured acrylic Light cured acrylic 6
  • 13. 13 Record bases Materials Cold-curing acrylic resin Other material Shellac Vacuum formed vinyl or polystyrene Baseplate wax. 6
  • 14. 14 Occlusal Splints Night guards Bleaching and fluoride application trays 6
  • 16. 16 Orthodontic applications  Removable tooth movement devices  Orthodontic retainers 6
  • 17. 17 Facing of crowns Provisional restorations 6 Other materials: •Polycarbonate •Aluminum •Stainless steel •celluloid
  • 19. 19 Terminology Monomer + monomer = polymer Monomer1 + monomer2 = copolymer Oligomonomer= 2-4 monomers Poly = many Mono = single Mer = unit Oligo =several 6
  • 20. 20 Types and molecular weight Addition polymerisation: No by products Polymer mwt = Σ mwt monomers Condensation polymerisation: By products are produced and lost in thefinal product Polymer mwt ≠ Σ mwt monomers 6
  • 21. 21 Morphology of spatial arrangements Linear or chain polymerisation Easily manipulated, stretched, bent, thermoplastic, Hard e.g. fitting surface of acrylic teeth- better binding to denture base Branched polymerisation Easily manipulated, stretched, bent, thermoplastic, More hard 6
  • 22. 22 Cross-linked polymerisation Strong, stiff, thermoset, wear resistant E.g. Denture base materials, Occlusal surfaces of actylic teeth Coiled chains Flexible e.g. impression materials Morphology of spatial arrangements 6
  • 23. 23 Crystalline polymers Very regular arrangement in space: strong, stiff, absorb less water. Amorphous or glassy polymers Irregular arrangement Behaves as a brittle solid Morphology of spatial arrangements 6
  • 24. 24 Plasticizers effects Added to stiff, glassy uncross-linked polymers Lowers glass transition temperature (Tg) Become rubber-like, Flexible less brittle 6
  • 25. 25 Dimensional and thermal changes Expansion on polymerization, exothermic Contraction on polymerization 21vol.% If unfilled acrylic resin 6% denture resin 1-3% composites Expansion on swelling in water Expansion or warpage on thermal change and reheating 6
  • 27. 27 Ideal properties Natural appearance Easy processing Easy to clean Easy to repair Inexpensive Biocompatible Resistant to bacterial contamination High strength, stiffness, hardness, toughness, fatigue resistance •Low density •Radiopaque •High thermal conductivity •High modulus of elasticity, impact strength •Abrasive resistance •Dimensionally stable •Accurate reproduction of surface detail
  • 28. 28 Curing methods Chemically cured Tertiary amine ( dimethyl-p-toluidine or sulfinic acid) (accelerator) Benzoyl peroxide (initiator) Hydroquinone (inhibitor) Heat cured Heat and pressure control Avoids porosity Maximizes conversion of monomer to polymer Light cured Photo-initiators (camphorquinone), Blue light, Used for: record bases, custom tray, denture repair
  • 29. 29 Heat cured acrylic resin Powder ( can have limitless life) Beads or granules of polymethyl methacrylate Initiator (benzoyl peroxide) Pigments/dyes (colour vitality as cadmium, iron, organic dyes) Optical opacifiers (tio2/zno) Plasticizers (ethyl acrylate (internal), dibutylphthalate (external) to make dough easier) Synthetic fibres (nylon) Coloured fibres (blood vessels) Liquid ( in dark bottle, avoid contamination by powder) Methyl methacrylate monomer Inhibitor (hydroquinone) Crosslinking agent (diethylene glycol dimethacrylate, (1,4 butylene glycol dimethacrylate) Bead Polymer
  • 30. 30 Chemical cured resin Cure is initiated by a tertiarv amine (e.g. Dimethyl- p-toluidine or sulfinic acid) Absence of heat: Lower molecular weight material Lower strength properties Higher residual monomer in the resin Color stability is not as good- yellowing Less contraction on cooling to room temp Polymer beads are smaller Faster dissolution in the monomer to produce a dough Doughy stage is reached before the addition curing reaction – mix viscosity is high and prevents the adaptation of the mix to the mould walls or cast -keep readapting Lowering of the glass transition temperature Less build-up of internal strain Highly susceptible to creep- distortion when in use.
  • 31. 31 Light activated materials Components: Urethane dimethacrylate matrix Acrylic copolymer Silica filler to control rheology Forms Sheets Ropes Curing Light chamber- 400-500 nm Photo-initiators (camphorquinone), Teeth added in a second exposure over the base Used for Record bases Custom tray Denture repair Hardness and impact strength ≈ heat cured resin Elastic modulus < heat cured resin; deform under mastication Less shrinkage (3%) better fit Less residual monomer
  • 32. 32 Auto-polymerizing, pour acrylic Reducing agent (tertiary aromatic amine or barbituric acid derivative, NN’-dimethyl-p-toluidine) reacts with peroxide at room temp. Excellent detail reproduction To be able to pour in mold, balanced size, mwt, plasticizers and xlink agents Reversible hydrocolloid (agar) mold can’t resist teeth movement during pouring Hydro pressure flask reduces air bubbles and monomer porosities Difficult to dewax, less monomer binding to teeth Shortcomings: residual monomer ↓ Cross link densities  Creep  Variety of products
  • 33. 33 High-impact acrylic A rubber phase is added (phase inversion) Uniformly distributed Rubber cored polymer Types Butadiene + styrene = polystyrene butadiene rubber Butadiene + MMA PMMA + polystyrene butadiene rubber + poly(2,3- dibromopropyl methacrylate) for opacity PMMA = lucitone 199 Lightly xlinked or no cross linking agent is added Rubber has a craze inhibitory effect
  • 34. 34 Experimental types of acrylic All aim to increase impact strength and stiffness Glass reinforced acrylic (failed) Fibers may irritate patient if denture fitting surface was abraded Carbon fibers Black color- used only in lingual areas Kevler fibres (poly-p-phenylene terephthalamide) Straw color Poor bond between fibers and matrix Difficult to pack Black shadow- used only in lingual areas
  • 35. 35 Experimental types of acrylic Added Bis-GMA and fiber Flexural strength ≈ ceramics Can be used as lingual bars and connectors Experimental (mwt polyethylene fiber-reinforced) Neutral color Low density Biocompatibility Surface treated to enhance fabrication Time consuming
  • 36. 36 Types of acrylic Other (polystyrene,epoxy, SS) PMMA Adhesion to Metal- use adhesive primers untreated porcelain teeth with organo silane compounds
  • 38. 38 Polymethyl methacrylate Activation Initiation Propagation Termination MMA Liquid PMMA Powder Old and new polymer chains Intertwined at the molecular level. PMMA Powder Particle swells MMA Liquid Acrylic dough (Cohesive gel) Heat and pressure (entanglements)
  • 39. 39 Setting reaction Mixing of powder and liquid cause monomer diffusion and softening of the surface of the powder producing the following gelling stages: Ratio P/L (2/1 wt%, 1.6 -1 vol%) Sandy- initial melting of beads (not used) Stringy or sticky- entanglements with swollen beads and thickened interstitial monomer (not used) Dough- gelation (used) Rubbery- monomer penetrates to the core of beads, plasticizing them, ↓Tg (not used)
  • 40. 40 Manipulation issues P/L Inadequate filling by monomer Weak material properties Porosity ↓P/L Excessive polymerisation shrinkage Poor fit Light color as powder holds the pigments
  • 41. 41 Manipulation issues Curing before monomer diffuse to bead (before dough stage) ↓ flexural strength cracks between linear polymerised interstitial gel and cross linked beads More shrinkage contraction by the loss of pressure produced by the dough to compensate for it Curing in dough stage monomer penetrate the beads dissolves beads allows cross-linking agent to penetrate interpenetrating polymer network IPN. Packing in the rubber stage Less extrusion of excess acrylic from flask Extra pressure in the mould Fracture the cast less flow around teeth Dislodgment of teeth into mould
  • 42. 42 Manipulation issues Control of color Pigments position Inside beads surface of beads – polymer should be added to the monomer slowly so it will not washed off by too rapidly Blood vessel resembling Fibers aggregate in the bottom of bottle – Shake powder well before use Mould Lining resin may penetrate rough plaster and adhere a separating medium must be employed solution of sodium alginate tin foil.
  • 43. 43 Manipulation issues Control of Processing strains Shrinkage in restricted mould cause internal strain On release of stress (flask opening) it may give Crazing Warpage Distortion These are reduced by the slightly extra packed material that flow into shrinkage spaces when temperature is higher than Tg (heated flask) Manipulation further reduces strains by Using acrylic teeth Cooling the flask slowly
  • 44. 44 Flasking steps Flasking Dewaxing Putting a separating medium Placing acrylic dough Packing Heat curing
  • 45. 45 Wax-up Flasking Melt out the wax Packing Curing
  • 46. 46 Flasking for heat cured resin Flasking options with acrylic dough: Trial-packing, trimming, repacking Packing-only Poured resin (e.G., Lucitone fas-por) Injection moulding Heat and pressure control Aim to produce radicals and initiate polymerization Reaction is thermally activated and generates heat as well Reaction conversion is about 98 to 99.5% MMA: tbp = 100c (p= 1 atm); 140c (p= 2 atm)
  • 47. 47 Heat curing cycles Fast cycle Cure at 71-72°C for 30-90 min 100°C for 30 min. Slow cycle = cure at 71-72°c for 10 hrs [A slow cycle is better with larger amounts of material.] [Generally, slow cures result in better dimensionalaccuracy.] Other cycles are done as recommended by manufacturers
  • 48. 48 Heat curing cycles Rapid heating: Excess radical release Extra xlinking and branching of interstitial polymer More residual monomer Reduced toughness Heat builds up from exothermic rxn Porosity Loss of strength Bad esthetics (opaque and cloudy color) Possible fouling
  • 49. 49 Heat curing cycles Slow : Sufficient radical release Adequate xlinking and branching between high mwt polymer chains Increased toughness Sufficient radical ends increase monomer incorporation in growing chains Xlinking agents polymerized, reducing their plasticizing effect (in their non bound state) and reduce creep Produce an annealing effect easing stresses produced from shrinkage, reducing crazing and distortion
  • 50. 50 Heat curing cycles Pressure control Places compressive force Compensates for polymerization shrinkage Increase flow of dough around teeth, more monomer wetting and surface dissolution, stronger bond Oozes out excess dough Some hybrid systems begin polymerization from one side to allow dough to cover for shrinkage
  • 51. 51 Heat curing cycles Microwave curing Uses a microwave Flasks are non metalic Reduced time
  • 53. 53 Denture Radiolucency Problems when accidents displace fractured segments Lungs Skull stomach Salts and fillers reduce esthetics, strength Organo-metalics are toxic Bromine containing organics lack heat stability, must be added in quantities that plasticize the denture, causing creep and water sorption Phase separating bromo-polymer in beads reduce the previous effects
  • 54. 54 Mechanical properties Failure to Moderate strengths: impact resistant denture is low Low elastic and flexural modulus lack of fracture toughness 30% of denture repairs involve midline fractures which are most prevalent among upper dentures. dropped denture does not necessarily break instantly a crack continue to grow and failure due to flexural fatigue. Failure due to poor quality processing Lack of bonding between the resin and the acrylic teeth and weak interface Crazes due to processing faults or exposure to solvents is another possibility. Creep Reduced by cross linking Heat cured < cold cured
  • 55. 55 Internal denture porosity Inherent porosity: Not seen by vision 1-2% of residual monomer Leaks Replaced by fluids Minimized by Use heat cured resin Pack denture under correct pressure Use correct P/L Use the glaze after polishing
  • 56. 56 Internal denture porosity Irregular porosity: Seen by vision Not regular on denture surface P/L heterogeneity Air incorporation (spherical pores) Minimized by Use correct P/L Add liquid first Mix well Cover the mix before dough stage Can use the vibrator
  • 57. 57 External denture porosity Irregular surface deficiencies: Seen by vision Insufficient pressure Dough was not molded correctly by hand leaving surface blisters and pores Insufficient dough Minimized by Mold dough by hand into small areas Place sufficient material in flask Pack under correct pressure
  • 58. 58 External denture porosity Irregular porosity: Shrinkage by polymerisation (5-8% vol or 0.2 -0.5% linear) Further shrinkage by cooling to room temperature Can compensated for by the post dam technique Minimized to by Pack under pressure Slight extra denture material can overcome shrinkage and maintain pressure (single packing) Pack in dough stage
  • 59. 59 Internal denture porosity Gaseous porosity Seen by vision Volatisation of monomer by Localized MMA boiling Common in thicker portions Minimized by Avoid high processing temperatures Avoid extra monomer than recommended for P/L Raise heat slowly and evenly around the flask
  • 60. 60 Gaseous porosity Avoid high processing temperatures 0 20 40 60 80 100 120 140 160 0 10 20 30 40 50 60 70 80 90 100 Temperature 0 C Time (min) Correct cycles Incorrect cycle
  • 61. 61 Crazing Area of localised region of high plastic deformation which may fill by voids Crazed region can still support stress As the voids in the crazed region grow, they become separated only by thin fibrils of polymer Fibrils fail and a crack is formed Crack will grow under an externally applied load Cause denture failure by brittle fracture. Caused by Internal strains in flask Heat (due to polishing) Differential contraction around porcelain teeth Attack by solvents such as alcohol Reversible Irreversible CRAZE CRACK
  • 62. 62 Crazing Avoid internal strain during polymerisation Slow cooling of the flask Use single trial packing Use cross linked polymer types Avoid extra stress during function Use acrylic rather than porcelain teeth Do not overheat on polishing Keep denture away from solvents Avoid denture drying Polish after each adjustment Use glazes for surface Reversible Irreversible CRAZE CRACK
  • 63. 63 Dimensional changes on processing Expansion on heating flask; heat evenly Expansion on polymerization, exothermic Contraction on polymerization (21vol.%); Contraction on cooling to room temperature; Expansion on swelling in water; Expansion on thermal change to 32c. Net result– should be near zero
  • 64. 64 Warpage on drying Contraction on evaporation of absorbed water Don’t leave denture outside the mouth dry
  • 65. 65 Adverse reactions to PMMA Most common in dental laboratories Associated with regular contact with monomer when handling the dough Must avoid direct contact Rubber gloves may not provide sufficient protection Barrier creams can help Irritant contact dermatitis
  • 66. 66 Adverse reactions to PMMA Allergic contact dermatitis Usually associated with release of residual monomer Benzoic acid Types Immediate Delayed hypersensitivity (type IV) Heat cured resin < chemical cured Must ensure full cure of denture Avoid relining procedures May use an extra cycle of polymerisation – but denture may warp May need to consider alternative material such as polycarbonate if Delayed hypersensitivity
  • 67. 67 Adverse reactions to PMMA Further reading: Hensten-petterson & jacobsen. J prosthet dent 1991; 65: 138 Kaber. Int dent J 1990; 40: 359 Http://www.Shef.Ac.Uk/uni/project/arrp/
  • 68. 68 Thermal properties Low Thermal conductivity during denture processing heat cannot escape – prone to gaseous porosity isolates from any sensation of temperature – throat burns High Coefficient of Thermal Expansion Porcelain teeth may be lost due the differential expansion and action Warpage if denture is cleaned with hot water
  • 69. 69 Water Sorption PMMA will absorb water by polar nature (1.0-2.0% wt) May compensate for processing shrinkage Weeks of continuous immersion in water to reach a stable weight Solubility Solvents (e.G. Chloroform, alcohol) Xlinked are insoluble in most of fluid intakes Weight loss will occur, due to leaching of the Monomer Pigments and dyes.
  • 70. 70 Ideal properties achieved? Natural appearance  Easy processing  Easy to clean  Easy to repair  Inexpensive  Biocompatible  Resistant to bacterial contamination x High strength, stiffness, hardness, toughness X Low density  Radiopaque X High thermal conductivity X Dimensionally stable X Accurate reproduction of surface detail 
  • 71. 71 More DB bonding to alloy framework Acrylic-metal leakage
  • 73. 73 Injection molded plastic Types Polycarbonates Nylon Advantage: Consistent mwt Substitute acrylics in sensitive patients Disadvantage Must use dry mold, slow heating and cooling Under filled molds by inadequate spruing or underheating Low melt temp cause high injection forces, moving teeth in mold Cost of equipment Difficult to attach to teeth Small market segment Can explode if high heat and wet molds Overheating cause depolymerization, oxidation, porosties Loss of strength Bad esthetics (opaque and cloudy color) Possible fouling
  • 74. 74 Polycarbonates Tough plastic Injected in dry molds A high melt viscosity Problems in binding to teeth May de-polymerize explosively in the presence of heat and water No cross linking – Poor solvent resistance Poor craze resistance
  • 75. 75 Nylons and polyamides Polyamide = diacid + diamine Conventional nylon failed Excessive water sorption Poor creep resistance Biodegradation Glass (beads or fibers) reinforced nylon Less water sorption Fibers better in stiffness(≈ acrylic) than beads Fibers may irritate patient if denture fitting surface was abraded
  • 76. 76 Cellulose product Camphor used as plasticiser Warpage in mouth Camphor leached out Loss of color Taste Blistering Staining
  • 77. 77 Phenol Formaldehyde (Bakelite) Difficult to process Lost its color with function
  • 78. 78 Vinyl resins Low resistance to fracture Fatigue failure
  • 80. 80 Denture base reprocessing: Hard and soft tissue changes every 5-8 years Require modifying denture base: Relining  resurfacing of the tissue surface Rebasing  replacement of entire denture base
  • 81. 81 Soft denture lining material Uses: After surgery Immediate dentures Sores Undercuts which are not removed by surgery Ill fitting denture can be done In lab Chair side
  • 82. 82 Ideal lining material properties Durability: but hardens in short time (1-4w, 1-3 y) Dimensional stability Resistance to fouling Water absorption Osmotic presence of soluble material Resistance of Biodegradation Could it bond old acrylic Inhibit candida growth
  • 83. 83 Lining materials–acrylic based Glassy MMA + high conc. of plasticizers Plasticizers: Free: diffuse out reducing the resiliency Bound in cured matrix – failed clinically Has lower rate of polymerization Phase separation Water accumulate in plasticizer rich phase Soluble impurities cause more osmotic pressure Swells and distorts Discoloration Bad taste Exothermic rxn Bad taste
  • 84. 84 Lining materials–acrylic based Soft acrylics that have ↓Tg EMA (ethylmethacrylates) Beads coploymer Ethyl methacrylate + isobutyl methacrylate Ethyl methacrylate + ethoxyethyl methacrylate – Have unpleasant odour Monomer MMA Tg > room temp Less irritant to patients Isobutyl methacrylate Tg < room temp (polished after placing in iced water), Dimensional instability Plasticizer in monomer trapped in beads (25-50%) Phthalate ester – leach out by time Avoid heat, strong bleaching agents that reduce resilience
  • 85. 85 Lining materials–acrylic based Soft acrylics that have ↓Tg Hydroxy EMA Water is the plasticizer Swelling of liner may make it distort Ions enter and may crystallize inside matrices thus hardening the liner Polymerisable plasticisers Beads ploymer Ethyl methacrylate + isobutyl methacrylate or Monomer Alkyl maleate or Alkyl itaconate + Tridecyl methacrylate + 2-diethylhexyl maleate, ethylene glycol dimethacrylate
  • 86. 86 Tissue conditioners Differ from soft lining material by the following Different viscoelastic properties Flowable on insertion responding to – Masticatory forces – Lingual forces – Border moulding forces Increase viscosity on setting Flows slowly responding to persistent heavy masticatory forces after setting – Useful to fill space after tissue swellings resolve – Can be used as a functional impression Reaction Gel formation not polymerization Alcohol swells beads and ↓ their Tg Beads become tacky by entanglements and  cohesive strength
  • 87. 87 Tissue conditioners Differ from soft lining material by the following Composition • Old- plasticine • Old- chewing gum • Ethyl methacrylate copolymers • Or small mwt polymers Plasticisers: ethyl alcohol or aromatic esters (butylphthalyl butylglycolate) hemical cleaning damages the liner – Use plain soap and water
  • 88. 88 Tissue conditioners Differ from soft lining material by the following Alcohol problems: Leak and replaced by water- so harden days up to 14 days High conc. Can give a sting sensation Can give a false positive on breathalyser test Reduce leach of plasticisers by glazing or semiset MMA Very susceptible to infection – Incorporate antimicrobials as » silver zeolite » itraconazole Chemical cleaning damages the liner – Use plain soap and water
  • 89. 89 Silicon - RTV Room temperature vulcanizing silicones (RTV) Polymethyl siloxane polymer It sets by crosslinking of existing polymers Heat Tetraethyl silicate Condensation minimal xlinking Poor tear resistance Poor abrasion resistance Poor adhesion to denture Use adhesive or coupling agent Osmotic pressure effects Buckling and swelling with water Poor resistance to cleansers Biocompatible Dimensional stability May foul by Candida
  • 90. 90 Silicon – Heat cured More xlinking Poor tear resistance Adequate adhesion to denture Can use siloxane methacrylate as a binder to heat cured additional silicon Resistant to aqueous environment and Osmotic pressure effects better resistance to cleansers Poor tear resistance Poor abrasion resistance
  • 92. 92 Denture base hygiene 1. Clean with toothbrush and warm soap- and-water 2. Use low abrasive cleaners 2. Avoid oxidizing or Cl-containing materials • Bleaching the color • Reduces strengths of denture • Reduces fatigue resistance 3. Diligently clean both the top and tissue- borne surfaces 4. Clean with benzalkonioum
  • 94. 94 References Philips Science of Dental Materials Dental Materials and Their Selection Applied Dental Materials Dental Materials. Clinical Applications for Dental Assistants and Dental Introduction to Dental Materials RPD acrylic materials by Dr Stephen C. Bayne Dr Layla Abu- Naba’a