DAT210H OPERATIVE TECHNIQUE & APPLIED DENTAL MATERIALS
Polymer in denture-based
Muhamad Amir Faris Bin Adzhar
Matric Number: 1220573
Name of Lecturer:
Dr. Syafiq Alauddin
Dr. Wan Nor Syariza
Dr. Nusima
Year 2, Semester II, 2023/202
1. INTRODUCTION
About a month is needed for the denture process. Typically, the
procedure requires five appointments or more to be finished. The
initial diagnosis, a "try-in" to ensure appropriate colour, form, and
fit, placement of the final denture, minor adjustments, and the
creation of an impression and wax bite to determine the
dimensions and proper jaw position are all included in the
procedure. Even the best-fitting dentures will feel odd at first, so
new wearers of dentures need some time to get used to their new
"teeth." Soon after the final denture placement, speaking capacity
typically returns to normal.The portion of the denture that lies on the soft
tissues is called the denture base. When choosing the material for the fabrication of
denture base, it is ideal for the base material to require the aspects of physical,
chemical, mechanical, biological and miscellaneous properties.
However, what if after denture processing, there are white spots area on the upper
complete denture which indicate porosity of the denture. The porosity occurs on the
specific site of the distopalatal area of the upper denture. In some circumstances,
porosities resulting from a polymerization error in a complete denture are accidental
due to time restrictions, even if they are not purposeful. These flaws allow
microorganisms to colonise, impair mechanical and aesthetic qualities, and
occasionally even render the patient incapable of receiving care. In these situations,
having to remake the denture just before installation is discouraging for both the
patient and the accompanying doctor.
2. ACRYLIC DENTURE BASE MATERIALS
The denture base is that part of the denture which rests on the soft tissues and so
does not include the artificial teeth. Nowadays acrylic resin is used almost universally
for denture base construction. Most materials come in a set of a powder and a liquid
which has different composition respectively.
The powder usually composed of three things which is polymethylmethacrylate
(PMMA), the main component, an initiator (peroxide such as benzoyl peroxide) and
pigments (cadmium or iron salts, or organic dyes). The main component of the liquid
is methylmethacrylate (MMA), a monomer, which is a clear, colourless, low viscosity
liquid with a boiling point of 100.3°C. The liquid monomer also contains cross-linking
agent (usually ethyleneglycoldimethacrylate) and inhibitor (hydroquinone). The
inhibitor is used to achieve longevity of shelf life of the liquid by preventing the
random occurrence of polymerisation of monomer and cross-linking agent. The
radicals present in the liquid will react with the inhibitor and forms stabilised radicals
instead of reacting with the monomer. The activator is present only in the polymer of
type self-curing. It plays the role as an activator to the radicals which will initiate the
polymerisation of monomer.
Apart from serving as denture bases, the DBMs have multiple other uses in dentistry
such as secondary impression tray, orthodontic retainer, occlusal splint and palatal
obturator replacing lost tissue following maxillectomy. Polymeric denture base can be
classified into multiple types which are heat-processing polymers, autopolymerised
(self-cure) polymers, thermoplastic, light-activated polymers and microwave-cured
polymers.
2.1. HEAT-ACTIVATED DENTURE BASE RESINS
Heat-activated materials are used in the production of nearly all denture
bases. The thermal energy required to polymerize these materials can be
obtained using a water bath or microwave oven. PMMA resin solutions that
are heat-activated often contain both liquid and powder components.
The powder is made up of PMMA spheres that have already been
polymerized and a little amount of benzoyl peroxide, also known as the
initiator, which starts the polymerization process.
2.2. CHEMICALLY ACTIVATED DENTURE BASE RESIN
"Self-curing," "cold curing," or "auto-polymerizing" resins are other names for
chemically activated resins. The main distinction between heat-cured and
self-curing resins is that the former uses a chemical, such as N-
dihydroxyethyl para-toluidine, to speed up the polymerization reaction rather
than heat. The polymerization of chemically activated resin is never as
complete as that of heat-activated resin because the former usually has 0.2%
to 0.5% free monomer, whereas the latter has residual free monomer levels
of 3% to 5%.
2.3. INJECTION MOLDING DENTURE BASE RESIN
Waxed dentures are flasked and boiled out similarly to compression moulds.
An injection cylinder with high pressure is connected to an external flask
opening. Inside the cylinder is a mixture of denture base resin. The material
is injected under intense pressure into the mould cavity after it reaches the
appropriate consistency.
2.4. LIGHT-CURED DENTURE BASE RESIN
It is a composite consisting of urethane dimethacrylate, microfine silica, and
acrylic resin monomers with high molecular weight. Acrylic resin beads are
utilised as an organic filler material. Polymerization is initiated by
camphorquinone, and visible light acts as an activator.
2.5. MICROWAVABLE RESINS
These resins are activated by tertiary amines. They are being cured using
microwave energy in a new method. The resin needs around three minutes to
cure in a specific flask reinforced with fibres. Less water was absorbed, and
the resin shrank less after curing.
3. DEVELOPMENT & CAUSES OF POROSITY
Porosity in a heat cure denture base resin is not ideal, although quite prevalent
during denture fabrication A study found that after processing dentures during pre-
clinical training, 66% of the students experienced porosities (Maskey). Porosity in
acrylic denture bases damages acrylic resin prostheses because of the buildup of
internal tensions. Moreover, warpage and distortion of acrylic denture bases can also
result from porosity.
Acrylic resin porosity arises from multiple factors. It is dependent partly on the type of
material and partly on the polymerization process used to produce the bases for
acrylic dentures. Previous research has verified that specimens undergoing short
cycles of polymerization exhibit porosity. Porosity has two main causes: shrinkage
from polymerization (also known as contraction porosity) and monomer volatilization
(also known as gaseous porosity). Inadequate pressure, air inclusion during the
mixing and pouring processes, incorrect mixing of the powder and liquid
components, and residual monomer are some additional causes of porosity (Kasina
et al., 2014)
During the mixing stage, the aim is to achieve the “dough” state which can be
achieved with the right proportions. If the ratio of powder to liquid is too high, the
mixture turns "dry" and difficult to handle. It also would not flow when put under
pressure in the gypsum mould. Furthermore, not enough monomer is present in a
dry mix to completely bind the polymer beads together. Granular porosity—a term
used to describe the granular effect that could result on the denture surface—may
result from this. Granular porosity in the set material could result from monomer loss
during this phase. This has an opaque surface that is blotchy.
Porosity gaps distributed over the entire mass of the denture base can result from
using insufficient dough to generate an excess in the mould or from applying
insufficient pressure during the curing process. The porosity is referred as
contraction porosity.
The next stage is to polymerise the
monomer to produce the final processed
denture after the dough is filled into the
mould. Polymerisation or curing process is
carried out by placing the clamped flask in
either a water bath or an air oven. There
are many multiple choices of curing cycle
available for use and some facts need to
be paid attention to avoid problems
especially porosity. The monomer has a
boiling point of 100.3ºC. If the dough's temperature is increased noticeably over this
point, the monomer will boil and form round voids in the hottest area of the curing
dough. These will show up as gaseous porosity in the denture base that has
hardened.
According to Kasina et al. (2014) heat polymerized groups exhibit lower mean
percent porosity values than microwave polymerized groups, according to a
descriptive analysis of the mean percent porosity of all the groups. Additionally, it
also shows that denture bases treated with DPI Plain denture base resin have higher
mean percent porosity values than denture bases treated with Acralyn H cross linked
denture base resin. Thus, the study has proven that material formulation has the
potential to produce porosity regardless of the method of polymerisation used
(conventional water bath polymerisation and microwave polymerization).
Denture bases can be fabricated using a variety of processing methods, all of which
depend on taking precise impressions in order to produce dental casts. After that, a
resin record base is made on the mould, and the teeth are fixed by applying wax to
the record base. The teeth arrangement is contained inside a denture flask with an
appropriate investing medium. When the flask is opened, the wax is taken out and
the mould is cleaned. After injecting a resin denture foundation material into the
mould cavity, the denture base resin is polymerized.
4. PREVENTION
4.1. GRANULAR POROSITY
A powder to liquid ratio of 2.5:1 by weight is typically utilised to create a workable
mix while keeping shrinkage at a minimum. Proportioning is done by adding a
little amount of liquid to a dry, clean mixing vessel, then the powder needs be
added gradually so that each powder particle gets wetted by the monomer. After
that, the liquid is mixed and allowed to stand until it thickens enough to fill the
gypsum mould. Another crucial part of the procedure is to stop monomer
evaporation during this standing time by covering the mixing vessel with a lid.
4.2. CONTRACTION POROSITY
After working on the dough of the acrylic, the dough is placed into a two-piece
gypsum mould that has been coated with a mould-sealing compound. A trial
packing should be done and maintained under pressure using a spring-loaded
clamp. There are three key purposes for the imposed pressure. It guarantees that
dough fills the entire mould. By providing an excessively thick base, it prevents a
"raised bite" from forming on the denture and allows excess dough to be utilised,
effectively reducing polymerization shrinkage.
Another method to reduce the risk of contraction porosity is by injection moulding,
where the dough is forced into the mould. In the mould, sprue and vent holes are
created, and the metal flask is built to fit the injection moulding equipment. So,
whenever there is shrinkage during the curing process, extra material can be
injected to the flask from the sprue reservoir. Hence, mistakes such as
inadequate dough and insufficient pressure during packing cannot occur.
4.3. GASEOUS POROSITY
It is crucial to create a polymer with a high molecular weight and to achieve a
high degree of conversion from monomer to polymer. Low molecular weight
polymer and residual monomer can lead to poor mechanical characteristics and
adverse tissue responses. Thus, it is important to adhere to the manufacturer's
recommendations for curing cycles which they have decided the best for their
brand of denture base material to avoid gaseous porosity.
A commonly used technique involves heating the flask containing the dough for
seven hours at 70ºC, then three hours at 100ºC. The seven hours at 70 degrees
Celsius are when the majority of the monomer to polymer conversion happens.
During this time, the dough's temperature may even surpass 100 degrees Celsius
because of the polymerization exotherm.
5. CONCLUSION
To summarise, the study highlights the comprehensive process and considerations
involved in the fabrication of denture bases, focusing on the common issues of
porosity in acrylic denture base materials. Porosity, a frequent problem, can arise
due to various factors such as polymerization shrinkage and monomer volatilization.
The material composition and polymerization methods play significant roles in the
development of porosity. Heat-cured denture bases generally exhibit lower porosity
compared to microwave-cured ones, with specific material formulations influencing
the extent of porosity. Preventive measures, including maintaining the correct
powder-to-liquid ratio, applying appropriate pressure during the curing process, and
adhering to recommended curing cycles, are crucial in minimizing porosity. That
being said, porosity should never be disregarded as a possibility. Rebasing should
always be chosen over remake, particularly in situations where time is of the
essence. Proper material handling and adherence to manufacturing guidelines can
effectively reduce the incidence of porosity, ensuring better quality and longevity of
the dentures.
