Effect of Different Solutions on the Colour Stability of Nanoparticles or Fibre Reinforced PMMA

Current trends and research advances on the application of TiO2 nanoparticles in dentistry: How far are we from clinical translation?

The great potential of nanotechnology-based knowledge during the past decade has shown great potential to elevate human living standards and enhance healthcare conditions through diagnosing, preventing, and treating different diseases. Among abundant nanoparticles (NPs), inorganic NPs feature distinctive biological and physicochemical properties compared to their conventional counterparts which do not endow. TiO2 NPs possess excellent properties including low-cast, antibacterial properties, biocompatibility, and physicochemical stability. The present review highlights and discusses the current trends in applying TiO2 NPs in dentistry ranging from TiO2-based nanocomposite in endodontics, orthodontics, and biofilm prevention. Moreover, the potential of TiO2 NPs in developing new photodynamic therapy and the next generation of oral care products is outlined. In the end, the clinical translation of TiO2-based dental materials is brought to the forefront which is impetus and of great importance to developing inorganic NP-based dental materials.

Impact of different chemical denture cleansers on the properties of digitally fabricated denture base resin materials

PURPOSE

To compare the impact of three different chemical denture cleansers (CDCs) (Corega, chlorhexidine, and hydrogen peroxide) on the surface roughness, microhardness, and color stability of 3D-printed, computer-aided design and computer-aided manufacturing (CAD-CAM) milled, and heat-polymerized denture base material (DBM).

MATERIALS AND METHODS

A total of 420 disc-shaped specimens (10 ± 0.1 × 2 ±0.1 mm) were fabricated using three different construction techniques: three-dimensional (3D) printing (n = 140), CAD-CAM milling (n = 140), and heat-polymerization (n = 140). Sixty specimens (20 of each DBM) were used for baseline (pre-immersion) measurements (T1) for the tested surface properties (hardness [n = 10/material] and roughness [n = 10/material]). The remaining 360 specimens (n = 120/material) were investigated for surface roughness, microhardness, and color change after immersion for 1 year (T2) in distilled water or CDCs (n = 30/solution and n = 10/test). The data were analyzed using two-way ANOVA, one-way ANOVA followed by post-hoc Tukey's test at a significance level of less than 0.05.

RESULTS

Significant differences were observed in the effects of the tested CDCs on the surface roughness, micro-hardness, and color stability of varying DBM specimens (p < 0.05). Corega showed the highest surface roughness and color change in all DBMs while H2O2 resulted in the lowest microhardness for all DBMs. The lowest changes in all tested properties were seen with distilled water followed by chlorhexidine. A significant effect of type of cleanser, denture base material, and the interaction between the two was seen on all measured properties (p < 0.05).

CONCLUSIONS

The tested CDCs significantly affected the surface properties of all DBMs but at varying degrees. Corega produced the highest negative effect on roughness and color change while H2O2 dramatically affected the microhardness. Prolonged use of CDCs should be cautiously followed.

Effects of simulated long-term exposure to bottled, neutral pH electrolyzed oxidizing water on the properties of denture base resins

STATEMENT OF PROBLEM

Denture stomatitis can pose serious health risks, especially to older people. Chemical denture cleaning agents must be effective, yet not adversely affect the longevity of removable dentures. Ready-to-use (RTU) neutral pH electrolyzed oxidizing water (EOW) is an effective biocide against Candida albicans biofilms on denture resins, but the effects of daily disinfection with EOW on the physical and mechanical properties of resins have not been established.

PURPOSE

The purpose of this in vitro study was to investigate the effects of simulated long-term exposure to RTU EOW on the color, surface characteristics, and flexural strength of denture base resins.

MATERIAL AND METHODS

Heat-polymerized (HP), 3D printed (3D) and computer-aided design and computer-aided manufacture (CAD-CAM)-milled (CC) denture resin specimens (square: 20×20×3.3 mm; beam: 64×10×3.3 mm) were immersed in tap water (TW), RTU EOW (Neutral Anolyte ANK; Envirolyte; EOW), or a commercial denture cleaning tablet solution (Polident 3-Minute; Glaxo SmithKline; PD), mimicking a 5-minute once daily disinfection routine performed up to 3.0 years. Color and surface roughness were recorded (n=3, squares), and changes in color (∆E00) and surface roughness (∆Ra) were calculated. Flexural strength (n=12, beams) and surface hardness (n=18, beams) were measured with a universal testing machine. The fractured surfaces of specimens were examined by scanning electron microscopy and energy dispersive spectroscopy. Data were assessed by performing the Shapiro-Wilk or D'Agostino and Pearson normality tests. Two-way ANOVA or the Kruskal-Wallis test with a post hoc Tukey HSD or Dunn multiple comparisons (α=.05) was used for statistical analyses.

RESULTS

No significant changes were found in either color or surface roughness for HP, 3D, and CC resins after 1.5-year and 3.0-year immersion in any of the agents (P>.05). The surface hardness of 3D resins reduced by 14% with TW and by 23% with EOW and PD at 3.0 years. The flexural strengths of all 3 resins were unaffected by 3.0-year immersion (P>.05).

CONCLUSIONS

Simulated long-term immersion disinfection with RTU neutral pH EOW did not adversely affect the physical and mechanical properties of HP or CC denture resins.

Mapping the research landscape of nanoparticles and their use in denture base resins: a bibliometric analysis

BACKGROUND

Nanoparticles are increasingly used in dentistry for various applications, including enhancing the mechanical properties of denture base resins. This study aimed to comprehensively review and analyze the research landscape of nanoparticles and their effect on the flexural strength of denture base resins to identify key research areas and trends and to highlight the importance of collaboration between authors and institutions.

METHODS

A Bibliometric Analysis was conducted using the Keywords "Nanoparticle*" AND "Denture*" OR "CAD/CAM." The literature search from the WOS database was restricted to the publication years 2011 to 2022.

RESULTS

Key findings encompass an increase in research publications but a decline in citations. Saudi Arabia, China, and Iraq led this research, with specific institutions excelling. Notable journals with high impact factors were identified. Authorship patterns show variations in citation impact. Additionally, keyword analysis revealed that current research trends offer insights into influential authors and their networks.

CONCLUSIONS

The analysis of nanoparticles and denture base resins reveals a dynamic and evolving landscape that emphasizes the importance of collaboration, staying current with research trends, and conducting high-quality research in this ever-evolving domain.

Anti-Microbial Effect of AgBr-NP@CTMAB on Streptococcus Mutans and Assessment of Surface Roughness Hardness and Flexural Strength of PMMA

Purpose

To investigate the inhibition of Streptococcus mutans (S.mutans) and its biofilm by AgBr-nanoparticles (NP) @CTMAB (cetyltrimethyl-ammonium bromide) and evaluate the changes in Polymethyl methacrylate (PMMA)'s surface roughness (Ra), microhardness, and flexural strength during prolonged immersion in AgBr-NP@CTMAB for application in the denture cleaning industry.

Patients and Methods

The antibacterial activity of AgBr-NP@CTMAB against S.mutans was measured colony formation assay, OD600 and laser confocal microscopy. Changes in the specimens' values for surface roughness, microhardness, and flexural strength (MPa) were measured after immersion solutions for 180 or 360 days.

Results

The AgBr-NP@CTMAB solution exhibited a robust antibacterial effect on planktonic S. mutans, with a minimum bactericidal concentration of 5 µg/mL. The 10 µg/mL AgBr-NP@CTMAB solution efficiently inhibited S. mutans biofilm formation. (2) No significant difference in surface roughness after immersion in AgBr-NP@CTMAB (10 µg/mL and 20 µg/mL) comparing with distilled water (P > 0.05) and Polident had significantly higher than distilled water (P < 0.05). There was a significant decrease in the surface hardness of the PMMA specimens that were immersed in the Polident compared with those in distilled water (P < 0.05). While, no significant differences in surface hardness after immersion in the AgBr-NP@CTMAB (P > 0.05). The result of flexural strength suggested that there was no statistically significant difference (P < 0.05) between AgBr-NP@CTMAB as well as Polident and water.

Conclusion

AgBrNP@CTMAB can efficiently inhibit the growth of plankton S.mutans and biofilm formation, without affecting the flexural strength, microhardness, or surface roughness of PMMA. Therefore, AgBrNP@CTMAB holds promise as a new denture cleaning agent.

Denture Base Resin Coated with Titanium Dioxide (TiO2): A Systematic Review

Background

The main objective of this systematic review was to evaluate the effect of coating with titanium dioxide nanoparticles (TiO2 nanoparticle) on the surface condition of removable acrylic resin prosthetic base materials.

Methods

Our review is registered in the PROSPERO database under the identification code CRD42023397170. Electronic database searches of PubMed, Scopus and Science Direct including studies from January 2009 to January 2023 were conducted and supplemented with manual searches. Research questions were generated in accordance with the PICO strategy. The modified Consolidated Standards of Reporting Trials (CONSORT) checklist was used to evaluate the quality of the selected studies.

Results

Since the included studies were variable in design, a meta-analysis was not performed. The electronic searches retrieved 29 references that met the eligibility criteria, among which 5 studies matched the inclusion criteria for this review. Significant differences were detected between the TiO2 NP-coated and uncoated groups. The available data indicate that TiO2 NP coating elicits antimicrobial activity and improves the wear resistance of polymethylmethacrylate (PMMA) surfaces. Moreover, the nanoparticles provide high levels of glossiness and decelerate the process of color change of heat-cured acrylic resin, thus increasing the lifespan of dentures.

Conclusion

The collective results clearly indicate that TiO2 nanoparticle coating induces alterations in the surface properties of pure PMMA, enhancing the mechanical, physical and biological characteristics of the denture base material. Further studies are essential to identify the optimal thickness of coating and concentrations of nanoparticles for clinical applications.

Effects of two novel denture cleansers on multispecies microbial biofilms, stain removal and the denture surface: an in vitro study

BACKGROUND

The continuously increasing demand for removable denture appliances and the importance of adequate denture cleaning have led to the development of various denture cleansing products. The aim of this study was to evaluate the efficacy of two novel denture cleansing agents (GE and TM) and three commonly available cleansers (0.5% sodium hypochlorite; NaClO, 0.12% chlorhexidine gluconate; CHX, and Polident®; POL) on multispecies microbial biofilm formation, stain removal and physical properties of dentures.

METHODS

The antimicrobial activities of denture cleansing agents were determined against major oral opportunistic pathogens including Streptococcus mutans, Staphylococcus aureus, Escherichia coli and Candida albicans, using time-kill assays. Multispecies microbial biofilms grown on acrylic resins for 72 h were generated to determine the antibiofilm effects of cleansing agents by confocal laser scanning microscopy (CLSM). Evaluations of the tea and coffee stain removal properties and the alterations in the physical properties of dentures were also performed. The toxicity of cleanser residues released from denture acrylics to fibroblast cells was investigated using MTT assay.

RESULTS

All denture cleansing agents tested could effectively kill oral bacteria and Candida albicans. Furthermore, after immersion for more than 3 h, the cleansers Polident®, GE and TM could efficiently penetrate and inhibit multispecies denture biofilms with effects similar to 10 min of immersion in 0.5% NaClO. However, immersion in 0.12% CHX for 20 min showed less antibiofilm activity. The NaClO solution had the highest efficacy for removing stains from the artificial teeth. Conversely, the CHX solution enhanced tea and coffee staining, and the teeth immersed in this solution showed clinically unacceptable colour changes (ΔE > 5.5). However, the colour differences of teeth stained and immersed in POL, GE and TM cleansers were in the clinically acceptable range. There was no significant difference among the POL, GE and TM cleansers in terms of stain removal efficacy. The cleansers GE and TM did not alter the surface roughness and colour of the materials, moreover the residues of both cleansers did not exhibit cytotoxicity.

CONCLUSION

Two novel denture cleansing agents containing natural products, GE and TM exhibited effective antimicrobial activity, antibiofilm and stain removal capabilities without toxicity or disturbance of the physical properties of acrylics.

Understanding the Mechanical, Surface, and Color Behavior of Oral Bioactive Prosthetic Polymers under Biodegradation Processes

Changes in the properties of resin-based polymers exposed to the oral environment can emerge when chlorhexidine (CHX) is incorporated to develop bioactive systems for treating denture stomatitis. Three reline resins loaded with CHX were prepared: 2.5 wt% in Kooliner (K), 5 wt% in Ufi Gel Hard (UFI), and Probase Cold (PC). A total of 60 specimens were submitted to physical aging (1000 cycles of thermal fluctuations, 5-55 °C) or chemical aging (28 days of pH fluctuations in artificial saliva, 6 h at pH = 3, 18 h at pH = 7). Knoop microhardness (30 s, 98 mN), 3-point flexural strength (5 mm/min), and surface energy were tested. Color changes (ΔE) were determined using the CIELab system. Data were submitted to non-parametric tests (α = 0.05). After aging, bioactive K and UFI specimens were not different from the controls (resins without CHX) in mechanical and surface properties. Thermally aged CHX-loaded PC specimens showed decreased microhardness and flexural strength but not under adequate levels for function. The color change was observed in all CHX-loaded specimens that underwent chemical aging. The long-term use of CHX bioactive systems based on reline resins generally does not impair removable dentures' proper mechanical and aesthetic functions.

Assessing the Antifungal Activity of a Soft Denture Liner Loaded with Titanium Oxide Nanoparticles (TiO2 NPs)

Aim: Soft denture lining materials are susceptible to be colonized by different microorganisms, especially by Candida albicans (C. albicans), causing denture-induced stomatitis. This study was designed to evaluate the effectiveness of incorporating titanium dioxide nanoparticles (TiO2 NPs) into a soft denture liner towards reducing microbial activity. Method: A total of 40 PEMA-TiO2 nanocomposites samples were fabricated by adding 0.0 wt.% (control), 1.0 wt.%, 1.5 wt.%, and 2 wt.% TiO2 NPs to a heat cured soft denture lining material (polyethyl methacrylate, PEMA). The prepared samples were divided into four groups (n = 10) according to the content of TiO2 NPs. The uniformity of TiO2 NPS distribution within the denture liner matrix was assessed using a Scanning Electron Microscope (SEM). The viable count of C. albicans was evaluated to test the antifungal resistance of the developed composite. Results: The SEM images showed fairly homogeneous dispersion, with patches of TiO2 NPs agglomeration within the PEMA matrix and an increasing concentration of NPs with higher NP content. The particle map and EDX analysis confirmed the evidence of the TiO2 NPs. The mean viable count results for the control (0.0 wt.%) and 1.0 wt.%, 1.5 wt.%, and 2 wt.% TiO2 groups were 139.80, 12.00, 6.20, and 1.00, respectively, with a significant difference from the control group (p < 0.05). The antifungal activity also increased with the increase in the concentration of TiO2 NPs. Conclusions: The addition of TiO2 NPs into a heat-cured soft denture liner provided antifungal activity as evidenced by the reduced colonization of C. albicans. The antimicrobial activity of the liner material increased with the increased concentration of TiO2 NPS.

Color Stability of Zinc Oxide Poly(methyl methacrylate) Nanocomposite-A New Biomaterial for Denture Bases

(1) Background: The purpose of this in vitro study was to evaluate the color change and stability of a zinc oxide nanoparticle-poly(methyl methacrylate) (ZnO NP-PMMA) nanocomposite for denture base material after immersion in different dietary and cleaning agent solutions. (2) Methods: One hundred samples were prepared and divided into four equinumerous groups depending on the weight content of ZnO NPs. The color coordinates (CIE L*a*b*) were measured using a digital colorimeter, ColorReader (Datacolor AG Europe, Rotkreuz, Switzerland), before and after immersion of the specimens in five different solutions (distilled water, coffee, red wine, black tea, denture cleaning tablet solution) for 6 months. The color changes (ΔE) were calculated using Euclidean distance and analyzed by the Shapiro-Wilk test and the ANOVA/Kruskal-Wallis multiple comparison and adequate post hoc tests. (3) Results: All tested materials showed significant color changes after their exposure to all solutions. Color changes were greatest in the case of red wine and progressed with the duration of the study. (4) Conclusions: The modification of PMMA with ZnO nanoparticles is acceptable in aesthetic terms in 2.5% and 5% weight content; however, color changes are more noticeable with higher nanoparticle content and must be discussed with the patient prior to possible use.