RESEARCH

Flexural strength of denture base resin reinforced with different fibers

sa YNDEM*, M. Tolga YCEL*, Filiz AYKENT #, A. Nilgn ZTRK# S Dihek Fak Derg, 2011;20:15-20
Flexural Strength of Denture Base Resin Reinforced with Different Fibers Background: Polymethyl methacrylate (PMMA) is the most commonly used denture base material. Despite its popularity the material is far from ideal mechanical properties. This in vitro study was performed to determine whether the flexural strength of a commercially available, heat-polymerized acrylic denture base material could be improved through reinforcement with 3 types of fibers. Methods: Ten specimens of similar dimensions were prepared for each of the 4 experimental groups: conventional acrylic resin and the same resin reinforced with glass, aramid, or carbon graphite fibers. Flexural strength was evaluated with a 3-point bending test. The results were analyzed with a 1-way analysis of variance. Results: All reinforced specimens showed better flexural strength than the conventional acrylic resin. Specimens reinforced with carbon graphite fiber showed the highest flexural strength, followed by aramid and glass fibers. Conclusion: Within the limitations of this study, the flexural strength of a heat-polymerized PMMA denture resin was improved after reinforcement with carbon graphite, aramid and glass fibers. Carbon/graphite and aramid fibers were used as reinforcement material for denture base polymers, but they are generally difficult to polish and are not of good esthetic quality. KEY WORDS Fiber reinforcement, aramid fibers, denture base. Polymethyl methacrylate (PMMA) is the most commonly used material in denture fabrication, and it adequately satisfies the esthetic demands. Color stability and ease of manipulation and polishing make it a desirable material (1,2). PMMA has been used in dentistry since 1930s as denture material and in medicine since 1950s as bone cement(3). In the past 30 years, fiber reinforcements mostly made of polyethylene(5), carbon-graphite(6), or glass(7) were used to obtain materials with improved mechanical properties not only in polymeric dental materials, but also aeronautical, civil, and automotive industry(4). However, good bonding between the
* Seluk niversitesi Dihekimlii Fakltesi Protetik Di Tedavisi A.D. # Seluk niversitesi Dihekimlii Fakltesi Protetik Di Tedavisi A.D. Submitted: February 17, 2011 Accepted for publication: April 12, 2011

reinforcement and the acrylic resin is crucial for a significant stiffening effect(8-10). Thus, the suggested inability to adequately impregnate fibers with polymer and monomer mixtures of high viscosity, such as PMMA, represents a significant disadvantage for the use of fibers as reinforcement for dentures(11). Although polymethyl-methacrylate (PMMA) has been widely used as a main component of denture base polymer for many years, fractures or cracks of this material were observed in clinical use(12). Most of the denture fractures occur inside the mouth during function, primarily because of resin fatigue(13,14). The denture base resin is subjected to various stresses during function; these include compressive, tensile, and sheer stresses. Some of the factors responsible for denture fracture include stress intensification, increased ridge resorption leading to an unsupported denture base, deep incisal notching at the labial frena, sharp changes at the contours of the denture base, deep scratches, and induced processing stresses(15). There have been many studies on the strength problem and they are summarized in the following two approaches. The first approach is to increase the strength of denture base polymer by adding a cross-linking agent of poly-functional monomer such as polyethylene glycol dimethacrylate. The second approach is to devise a reinforcement of denture base polymer with fibers or rods such as metal wires or metal nets(16,17). 15

Flexural strength of denture base resin reinforced with different fibers

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Various modifications of PMMA also have been tested to improve the existing material; these modifications include chemical modification to produce graft copolymer high-impact resins and mechanical reinforcement through the inclusion of glass fibers, sapphire whiskers, aramid fibers, carbon fibers, stainless steel mesh, nylon, or ultra-high-modulus polyethylene fibers(12). Numerous studies have evaluated the use of individual reinforcing fibers to improve the strength of the denture base(18,19). The null hypothesis was that the fiber reinforcement would not affect the flexural strength of denture base resins. This in vitro study was performed to compare the flexural strength of commonly used PMMA resins and that of PMMA resin reinforced with glass, aramid, and carbon fibers.

MATERIAL AND METHODS Test specimen preparation Ten specimens of similar dimensions (65 x 10 x 3 mm) were prepared for each of the 4 experimental groups: Conventional acrylic resin (Meliodent, Bayer Dental, Germany) and the same resin reinforced with glass (Camelyaf Glass Fiber, Kocaeli, Turkey), aramid (Kevlar; DuPont, Wilmington, Del), and carbon graphite fibers (Dost Kimya, Istanbul, Turkey). To prepare test specimens, firstly 40 wax patterns were duplicated from a special metal mold (Figure 1). Wax patterns (Figure 2) were then invested into metal flasks using type III dental stone (Begostone; Bego, Bremen, Germany), following conventional laboratory procedures. Strips from the un-impregnated fiber reinforcements were cut (55 mm of length, 5 mm of width) while main-

Figure 1. Special metal mold

Figure 2. Wax patterns

Figure 3. Carbon, Glass and Aramid fibers

Figure 4. Finished specimens

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S Dihek Fak Derg, 2011

Yndem, Ycel, Aykent, ztrk

taining the thickness as provided by the manufacturer (Figure 3) (20). Denture base acrylic resins were mixed according to the manufacturers directions and packed into the molds at the dough stage. The powder: liquid ratio of the heat-polymerized material was 10 g/4.5 ml, and the dough time was 10 minutes. The heat polymerization was performed by immersing the flasks in 65C water for 90 minutes, followed by another immersion in 100C water for 30 minutes. All reinforcing fibers were oriented in the long axis of the specimens (Figure 4). Finished specimens were stored in distilled water at 37 C for 28 days before testing. Three point bending test The flexural strength and flexural modulus were measured according to ISO 1567 standards using span length of 50 mm and crosshead speed of 5.0 mm/min. All specimens were tested for flexural strength with a 3-point bending test with a universal testing machine (TSTM 02500, Elista, Istanbul, Turkey) at a crosshead speed of 5 mm/min and the results were recorded with PC-computer software (Figure 5,6). The 3-point bending test was used to calculate the modulus of rupture (M), as follows M= 3Wl 2bd 2

the all reinforced groups. The highest flexural strength values were recorded for carbon graphite fibers, and the lowest flexural strength values were recorded for control specimens. PMMA resin is the material of choice for the fabrication of denture bases. However, fracture of the base may occur during function because of the poor transverse, impact, and flexural strengths of PMMA(18). One of

where W is the breaking load (N); l is the test span (50 mm), b is the width of the specimen (10 mm); d is the thickness of the specimen (3 mm). The indenter (Vickers) was used during application of the stress. The treated surface was placed on a jig consisting of 2 supports at the span distance of 50 mm. The data were evaluated with One-way analysis of variance (ANOVA) followed by Tukey HSD post hoc test (P=.05). RESULTS The results of One-way ANOVA indicated that there were statistically differences among test groups (P<.05). All fiber reinforced specimens showed higher flexural strength than the conventional acrylic resin (Figure 7). Specimens reinforced with carbon graphite fibers showed the highest flexural strength values (119.09 MPa), followed by aramid (112.21 MPa) and glass fiber (94.95 MPa). The lowest flexural strength value was recorded for control group (74.1 MPa). Only the carbon graphite and aramid reinforced denture resins did not differ significantly (P=.72). DISCUSSION This study controlled storage time and humidity, as all specimens were tested after 28 days of water storage. The data support rejection of the null hypothesis in
Figure 5-6. The performing of 3-point bending test Figure 5-6. The performing of 3-point bending test

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the most common causes for breakage of dentures is fatigue(21) (namely, continued flexing of the base during function, which leads to crack development). This fracture stems from the initiation and propagation of a crack, and it requires the presence of a stress raiser or localized stress. The prime and most frequent fracture of the upper denture occurs in the medial line and the fracture mechanism and the influence of the masticatory load which is applied onto the dentures are very similar to the three points bending test-short beam test(22). Denture fracture in clinical use occurs from a large transitory force caused by an accident or a small force during repeated chewing. The flexural test, impact test and flexural fatigue test were employed to examine these forces. The measurement conditions in this study were designed to simulate clinical conditions, where the thickness of the test specimens stays within the thickness range of actual denture base polymer, and the span of the impact and flexural test approximates to chewing(12). For that purpose different authors use different time periods of underwater storage, but the important influence of water on the flexural strength occurs during the first four weeks of immersion causing decrease of the flexural strength values. Since longer period of immersion does not perform a statistically significant decrease of flexural strength(23,24) 28 days immersion in water at 37C was used in this study. Immersion in water enables molecules of water to penetrate into the areas between the polymer chains, remain there, and act like wedges between these chains. Water entry in polymer material during immersion is primarily caused by diffusion, and partly by the polarity of the polymer chains that is caused by unsaturated molecules and unbalanced intermolecular forces. Penetration of water molecules may also cause softening of the denture base, as absorbed water can act as a polymethylmethacrylate (PMMA) plasticizer. Water absorption diminishes the mechanical properties of the material, resulting in lower flexural strength and lower modulus of elasticity(25). The flexural strength of a material is a combination of compressive, tensile, and shear strengths. As the tensile and compressive strengths increase, the force required to fracture the material also increases. Compared with conventional polymer materials, fiber reinforced polymers are successful in their application primarily because of their high specific modulus and specific strength. Because the modulus of elasticity of carbon fibers is very high, most of the stresses are received by them without deformation(18). Thus, in this study, carbon graphite specimens exhibited better flexural 18

strength than the other specimen groups. In the investigations by Carroll et al.(27) and Vallittu et al.(28), the flexural strength of the denture base polymer reinforced with metal or glass rod was higher than that of the unreinforced denture base polymer. The shape and diameter of the rod directly influenced the flexural strength, but the shape or diameter also limited its use. Shimozato et al.(29) found that the flexural strength of denture base polymer reinforced with carbon fiber increased by 35% compared to that of unreinforced denture base polymer. Inanaga et al. (30) found that the flexural strengths of denture base polymer reinforced with carbon fiber and aramid fiber increased by 6% compared to that of unreinforced denture base polymer. This study compared the flexural strengths of conventional PMMA resin and the same resin reinforced with glass, aramid, or carbon graphite fibers in loose form. Specimens reinforced with carbon graphite fibers showed the highest flexural strength values followed by aramid and glass fiber. These results are similar to those found by Carroll et al.(27) and Vallittu et al.(28) Shimozato et al.(29) and Inanaga et al.(30). CONCLUSIONS Within the limitations of this study, the flexural strength of a heat-polymerized PMMA denture resin was improved after reinforcement with carbon graphite, aramid and glass fibers. The type of preferable fiber depends on the type of prosthesis being fabricated. Carbon/graphite and aramid fibers were used as reinforcement materials for denture base polymers, but they are generally difficult to polish and are not of good esthetic quality. Thus their use was limited to locations where esthetics is not important.

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Farkl Fiberlerle Glendirilmi Akrilik Rezinin Eilme Direnci Ama: Polimetil metakrilat (PMMA) en yaygn kullanlan protez kaide maddesidir. Poplaritesine ramen mekanik zellikleri idealden uzaktr. Bu in-vitro alma, 3 farkl tipte fiber kullanlarak glendirilen s ile polimerize olan akrilik protez kaide materyalinin eilme direncini tespit etmek amacyla yaplmtr. Gere ve Yntem: Her bir grupta benzer llerde olacak ekilde 10 adet rnek toplam drt gruba ayrld. Bunlar; kontrol grubu olarak konvansiyonel akrilik rezin, cam fiberle glendirilmi akrilik rezin, aramidle glendirilmi akrilik rezin ve karbon grafit fiberle glendirilmi akrilik rezin grubudur. Eilme direnci 3-nokta eilme testi ile deerlendirilmitir. Sonular tek ynl varyans analizi kullanlarak analiz edilmitir. Bulgular: Btn glendirilmi gruplar, konvansiyonel akrilik rezin grubundan daha yksek eilme direnci gstermilerdir. Karbon grafit fiber en yksek eilme direncini gsterirken bunu aramid fiber ve cam fiber izlemitir. Sonu: Bu almannn limitleri dahilinde, karbon grafit fiber, aramid fiber ve cam fiberle glendirilmi PMMA akrilik rezinin eilme direnci artmtr. Karbon grafit fiber ve aramid fiber akrilik rezini glendirmek iin kullanlabilir fakat polisaj zorluu ve kt estetiklerinden dolay kullanm alanlar kstldr. Anahtar Kelimeler: Fiber glendirme, aramid fiber, akrilik rezin.
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Ladizesky NH, Ho CF, Chow TW. Reinforcement of complete denture bases with continuous high performance polyethylene fibers. J Prosthet Dent 1992; 68: 934-9. Ruyter IE, Ekstrand K, Bjork N. Development of carbon/ graphite fiber reinforced poly (methyl methacrylate) suitable for implantfixed dental bridges. Dent Mater 1986; 2: 6-9. Vallittu PK. Dimensional accuracy and stability of polymethyl methacrylate reinforced with metal wire or with continuous glass fiber. J Prosthet Dent 1996; 75: 617-21. Vallittu PK. Comparison of two different silane compounds used for improving adhesion between fibres and acrylic denture base material. J Oral Rehabil 1993; 20: 533-9. Debnath S, Wunder SL, McCool JI, Baran GR. Silane treatment effects on glass/resin interfacial shear strengths. Dent Mater 2003; 19: 441-8.

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Correspondence Address: sa YNDEM Seluk niversitesi Dihekimlii Fakltesi Protetik Di Tedavisi A.D. Kamps / KONYA Phone: +90-332-2410041/1194-1186 Fax: +90-332-2410062 e-mail: isayondem@yahoo.com

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