Rigid Rod Polymer Fillers in Acrylic Denture and Dental Adhesive Resin Systems

Polymeric materials have been used in dental applications for decades. Adhesion of polymeric materials to each other and to the tooth substrate is essential to their successful use. The aim of this series of studies was two-folded. First, to improve adhesion of poly(paraphenylene) based rigid rod polymer (RRP) to other dental polymers, and secondly, to evaluate the usability of a new dentin primer system based on RRP fillers. Poly(paraphenylene) based RRP would be a tempting material for dental applications because of its good mechanical properties. To be used in dental applications, reliable adhesion between RRP and other dental polymers is required. In this series of studies, the adhesion of RRP to denture base polymer and the mechanical properties of RRP-denture base polymer-material combination were evaluated. Also adhesion of BisGMA-TEGDMA-resin to RRP was determined. Different surface treatments were tested to improve the adhesion of BisGMA-TEGDMA-resin to RRP. Results were based on three-point bending testing, Vickers surface hardness test and scanning electron microscope analysis (SEM), which showed that no reliable adhesion between RRP and denture base polymer was formed. Addition of RRP filler to denture base polymer increased surface hardness and flexural modulus but flexural strength decreased. Results from the shear bond strength test and SEM revealed that adhesion between resin and RRP was possible to improve by surface treatment with dichloromethane (DCM) based primer and a new kind of adhesive surface can be designed. The current dentin bonding agents have good immediate bond strength, but in long term the bond strength may decrease due to the detrimental effect of water and perhaps by matrix metalloproteinases. This leads to problems in longevity of restorations. Current bonding agents use organic monomers. In this series of studies, RRP filled dentin primer was tested in order to decrease the water sorption of the monomer system of the primers. The properties of new dentin primer system were evaluated in vitro by comparing it to commercial etch and rinse adhesive system. The results from the contact angle measurements and SEM showed that experimental primer with RRP reinforcement provided similar resin infiltration to dentin collagen and formed the resin-dentin interface as the control primer. Microtensile bond strength test and SEM revealed that in short term water storing, RRP increased bond strength and primer with BMEP-monomer (bis[2-(methacryloyloxy)-ethyl]phosphate) and high solvent concentration provided comparable bonding properties to the commercial control primers. In long term water storing, the high solvent-monomer concentration of the experimental primers decreased bond strength. However, in low solvent-monomer concentration groups, the long-term water storing did not decrease the bond strength despite the existence of hydrophilic monomers which were used in the system. These studies demonstrated that new dentin primer system reached the mechanical properties of current traditional etch and rinse adhesive system in short time water storing. Improved properties can be achieved by further modifications of the monomer system. Studies of the adhesion of RRP to other polymers suggest that adhesion between RRP and other dental polymers is possible to obtain by certain surface treatments.

Bonding of Composite Resin to Alumina and Zirconia Ceramics with Special Emphasis on Surface Conditioning and Use of Coupling Agents

Dental oxide ceramics have been inspired by their biocompability and mechanical properties which have made durable all-ceramic structures possible. Clinical longevity of the prosthetic structures is dependent on effective bonding with luting cements. As the initial shear bond strength values can be comparable with several materials and procedures, long-term durability is affected by ageing. Aims of the current study were: to measure the shear bond strength of resin composite-to-ceramics and to evaluate the longevity of the bond; to analyze factors affecting the bond, with special emphasis on: the form of silicatization of the ceramic surface; form of silanization; type of resin primer and the effect of the type of the resin composite luting cement; the effect of ageing in water was studied regarding its effect to the endurance of the bond. Ceramic substrates were alumina and yttrium stabilized zirconia. Ceramic conditioning methods included tribochemical silicatization and use of two silane couplings agents. A commercial silane primer was used as a control silane. Various combinations of conditioning methods, primers and resin cements were tested. Bond strengths were measured by shear bond strength method. The longevity of the bond was generally studied by thermocycling the materials in water. Additionally, in one of the studies thermal cycling was compared with long-term water storaging. Results were analysed statistically with ANOVA and Weibull analysis. Tribochemical treatment utilizing air pressure of 150 kPa resulted shear bond strengths of 11.2 MPa to 18.4 MPa and air pressure of 450 kPa 18.2 MPa to 30.5 MPa, respectively. Thermocycling of 8000 cycles or four years water storaging both decreased shear bond strength values to a range of 3.8 MPa to 7.2 MPa whereas initial situation varied from 16.8. Mpa to 23.0 MPa. The silane used in studies had no statistical significance. The use of primers without 10-MDP resulted spontaneous debonding during thermocycling or shear bond strengths below 5 MPa. As conclusion, the results showed superior long-term bonding with primers containing 10-MDP. Silicatization with silanizing showed improved initial shear bond strength values which considerably decreased with ageing in water. Thermal cycling and water storing for up to four years played the major role in reduction of bond strength, which could be due to thermal fatigue of the bonding interface and hydrolytic degradation of the silane coupled interface.

Fiber-reinforced composite fixed dental prostheses: Studies of the materials used as pontics

Fiber-reinforced composite fixed dental prostheses – Studies of the materials used as pontics University of Turku, Faculty of Medicine, Institute of Dentistry, Department of Biomaterials Science, Finnish Doctoral Program in Oral Sciences – FINDOS, Annales Universitatis Turkuensis, Turku, Finland 2015 Fiber-reinforced composites (FRC), a non-metallic biomaterial, represent a suitable alternative in prosthetic dentistry when used as a component of fixed dental prostheses (FDPs). Some drawbacks have been identified in the clinical performance of FRC restorations, such as delamination of the veneering material and fracture of the pontic. Therefore, the current series of studies were performed to investigate the possibilities of enhancing the mechanical and physical properties of FRC FDPs by improving the materials used as pontics, to then heighten their longevity. Four experiments showed the importance of the pontic design and surface treatment in the performance of FRC FDPs. In the first, the load-bearing capacities of inlay-retained FRC FDPs with pontics of various materials and thicknesses were evaluated. Three different pontic materials were assessed with different FRC framework vertical positioning. Thicker pontics showed increased load-bearing capacities, especially ceramic pontics. A second study was completed investigating the influence of the chemical conditioning of the ridge-lap surface of acrylic resin denture teeth on their bonding to a composite resin. Increased shear bond strength demonstrated the positive influence of the pretreatment of the acrylic surfaces, indicating dissolution of the denture surfaces, and suggesting potential penetration of the monomer systems into the surface of denture teeth. A third study analyzed the penetration depth of different monomer systems on the acrylic resin denture teeth surfaces. The possibility of establishing a durable bond between acrylic pontics and FRC frameworks was demonstrated by the ability of monomers to penetrate the surface of acrylic resin denture teeth, measured by a confocal scanning type microscope. A fourth study was designed to evaluate the load-bearing capacities of FRC FDPs using the findings of the previous three studies. In this case, the performance of pre-shaped acrylic resin denture teeth used as pontics with different composite resins as filling materials was evaluated. The filling material influenced the load-bearing capacities, providing more durable FRC FDPs. It can be concluded that the mechanical and physical properties of FRC FDPs can be improved as has been shown in the development of this thesis. The improvements reported then might provide long lasting prosthetic solutions of this kind, positioning them as potentially permanent rehabilitation treatments. Key words: fiber-reinforced composite, fixed dental prostheses, inlay-retained bridges, adhesion, acrylic resin denture teeth, dental material.

Retentiojärjestelmän optimointi kartonkikoneella

Diplomityössä tutkittiin kartonkikoneen retentiojärjestelmää ja eri mahdollisuuksia retention ja vedenpoiston tehostamiseen. Tavoitteena oli parantaa etenkin runkokerroksen retentiota ja vedenpoistoa. Työssä testattiin kilpailevan kemikaalitoimittajan mikropartikkelia kartonkikoneella. Lisäksi runkokerroksessa testattiin retentiotärkkelyksen vaikutus kartongin palstaumislujuuteen, suoritettiin käytössä olevan mikropartikkelin annostuksen optimointi sekä testattiin alunan käyttöä retentioainesysteemin tehoaineena. Kirjallisuusosassa tarkasteltiin pinta- ja kolloidikemian perusteita, retentioainejärjestelmiä ja niissä käytettäviä kemikaaleja sekä retentioaineilla tehtävään flokkaukseen vaikuttavia tekijöitä. Laboratoriokokeilla tutkittiin kokeellisessa osassa eri mikropartikkelijärjestelmien toimivuutta kartonkikoneen eri kerroksien massoilla. Toimivimmaksi osoittautuneella mikropartikkelilla suoritettiin pilot-koeajo runkokerroksen massalla. Lisäksi suoritettiin toinen pilot-koeajo, jossa tutkittiin mikropartikkelin vaikutuksia saostuman aiheuttajana. Pilot-koeajoissa saavutettiin samat retentiotasot kuin referenssisysteemillä lähes puolet pienemmällä kemikaalin kulutuksella. Kartongin laatuominaisuuksista huokoisuus, formaatio ja AKD-liiman retentio muuttuivat viiraretention mukaan. Saostumakoeajossa ei todettu retentioaineen vaikuttavan saostumien syntyyn. Täyden mittakaavan koeajossa tarkoituksena oli testata kilpailevan mikropartikkelin toimivuus kartonkikoneella. Koeajossa etsittiin optimaalinen mikropartikkelin annostus eri kerroksiin. Pintakerroksen tuhkaretentio nousi hiukan ja vedenpoisto parani. Runko- ja taustakerroksessa saavutettiin samat retentiotasot sekä vedenpoistot. Samat retentiotasot saavutettiin n. 25 % pienemmällä mikropartikkelin kulutuksella. Kartongin laatuominaisuuksista seurattiin palstautumislujuutta, formaatiota ja AKD-liiman retentoitumista. Kartongin palstautumislujuus heikkeni. Vastaavasti runko- ja taustakerroksen AKD-liiman retentio oli hiukan korkeampi koeajetulla mikropartikkelilla. Formaatiossa ei tapahtunut merkittäviä muutoksia. Jatkokokeet tehtiin kartonkikoneen runkokerroksessa. Kokeissa todettiin retentiotärkkelyksen vaikuttavan kartongin palstautumislujuuteen. Käytössä olevan mikropartikkelin annostelun optimointikokeissa ei saavutettu parannusta retentioon eikä vedenpoistoon. Mikropartikkelilla saavutetaan tietty retentiotaso, jonka jälkeen sillä ei ole enää vaikutusta retentiotasoon. Alunan annostelukokeissa ei alle yksi kg/t annosmäärällä ole vaikutusta retentioon ja vedenpoistoon.

Lasikuitupinnoitteiden ja vinyyliesterihartsien yhteensopivuuden tutkiminen

Diplomityössä on haettu tietoa lasikuitupinnoitteiden ja vinyyliesterihartsien yhteensopivuudesta ja sen testaamisesta. Lujitemuovikomposiitissa hartsi sitoo materiaalit yhteen ja antaa rakenteelle kemiallisen kestävyyden, sitkeyden ja välittää kuormitukset kuitujen kannettaviksi. Vaadittavan lujuuden rakenteelle antaa lasikuitu. Se päällystetään valmistusvaiheessa pinnoiteaineella, sizingilla. Sillä on ratkaiseva merkitys hartsin ja lasikuidun väliin syntyvän rajapinnan muodostumisessa kovettumisprosessin aikana. Käytännössä rajapinnan toimivuutta ja materiaalien yhteensopivuutta tutkitaan makromekaanisilla lujuustesteillä. Menetelmät perustuvat rajapinnan leikkaus¬lujuuden määrittämiseen, mutta myös murtumamekanismeihin perustuvia testi¬menetelmiä käytetään. Mikrotason menetelmät, jotka perustuvat yksittäisen kuidun ja käytetyn hartsin välisen adheesion mittaamiseen ovat yleistyneet, mutta niistä saatujen tulosten ei ole vielä todettu riittävästi korreloivan makro¬mekaanisten lujuustestien kanssa. Työssä tutkittiin kahta eri makromekaanista testimenetelmää. Testeissä havaittiin eroja valittujen lasikuitupinnoitteiden ja vinyyliesterihartsien välillä. Hauras hartsi oli herkempi lasikuitupinnoitteen kemialle. Kun yhteensopivuus vinyyli-esterihartsin ja lasikuitupinnoitteen välillä oli huono, saatiin sekä poikittaisessa vetolujuustestissä että Mode I murtumissitkeystestissä heikko tulos. Pyyhkäisy¬elektronimikroskoopilla suoritettu mikrotason analyysi murtopinnasta vahvisti saatuja tuloksia ja se osoittautui toimivaksi menetelmäksi kuvantamaan ilmiöitä, jotka vaikuttavat yhteensopivuuteen vinyyliesterihartsin ja pinnoitetun lasikuidun välillä.

Use of fiber-reinforced composite framework and thermochromic pigment in maxillofacial prostheses

The purpose of this investigation was to evaluate the possibility to enhance certain qualities of facial prostheses. Polymethyl methacrylate is still being used as base mate¬rial or clip carrier material, but it is hard and heavy, and debonding of the silicone from the acrylic base material is a frequent problem. This thesis aims to evaluate the use of fiber-reinforced composite (FRC) as framework material for maxillofacial silicone prostheses. FRC has been used as reinforcement in removable and fixed partial dentures since the 1990s. This material is lightweight and can be fabricated to compress the margins of the prosthesis slightly, to keep it tightly against the skin during jaw movements and facial expressions. Additionally, the use of a thermochromic pigment, colorless in room temperature and red in a cold environment, was studied in order to evaluate the possibility of using this color changing pigment in facial prostheses to mimic the color change of facial skin in cold weather. The tensile bond strength between pre-impregnated, unidirectional FRC and maxillofacial silicone elastomer was studied. Three different bonding agents or primers were compared. Bond strength was improved by one of the primers and by roughening the surface. The effect of a skin compressing glass fiber-reinforced composite framework on facial skin blood flow was studied by using a face mask, constructed with a compression pad corresponding to the outer margin of a glass fiber-reinforced framework beam of a facial prosthesis. The skin blood flow of ten healthy volunteers, aged 23-25 years, was measured during touch, light, and moderate compression of the skin, by using laser Doppler imaging technique. None of the compressions showed any marked effects on local skin blood flow. There were no significant differences between blood flow during compression and at baseline. Maxillofacial silicone elastomer was colored intrinsically with conventional color pigments: a control group containing only conventional pigments was compared to two test groups with 0.2 wt% and 0.6 wt% thermochromic pigment added. The color of the material was measured with a spectrophotometer in room temperature and after storage in a freezer. The color stability of the maxillofacial silicone elastomer colored with thermo¬chromic pigment was evaluated by artificial aging. The color dif¬ference of the L* (lightness) and a* values (redness), comparing color after the samples were stored at room temperature and in a freezer (-19°C), was statistically significant for both 0.2 wt% and 0.6 wt% thermo¬chromic pigment groups. The differences in the b* values (yellowness) were statistically significant for the 0.6 wt% group. Exposure to ultraviolet (UV) radiation led to visually noticeable and statistically signifi¬cant color changes (ΔE) in all color values in both test groups. The specimens containing thermochromic pigment were very sensitive to UV radiation. In conclusion, a framework of fiber-reinforced composite can successfully be bonded to maxillofacial silicone elastomer, and a framework beam, compressing the facial skin, did not remarkably alter the skin blood flow on healthy, young adults. The thermochromic pigment showed color change in maxillofacial silicone elastomer. However, artificial aging showed that it was too sensitive to UV radiation to be used, as such, in maxillofacial prostheses.