In the 1950s, composite restorations were made from PMMA. Significant polymerization induced volume shrinkage and heat release as well as the release of methyl methacrylate monomers resulting in marginal discoloration, pulp reactions, and secondary caries. In 1956, Bowen tried to reduce shrinkage by using a bigger monomer: the bisphenol A surrounded by two glycidyl groups. However, moisture tended to inhibit polymerization. Bisphenol A glycidyl methacrylate (Bis-GMA, Fig. 7.2) was obtained by substituting end groups with methacrylate functions and offered an excellent solution to the problem (Bowen, 1962; Soderholm and Mariotti, 1999). Bis-GMA has several advantages compared to PMMA, such as lower volatility, lower diffusion in dental tissues, and lower polymerization shrinkage because of its larger size, which explains its success. In addition, its tetrafunctional structure (i.e., two double bonds) makes it possible to obtain a crosslink network with better mechanical and physical properties. However, Bis-GMA shows a high viscosity (1200 Pa s) (Barszczewska-Rybarek, 2009) because of its large size, and rigidity due to the two aromatic rings and especially its hydroxyl groups creating strong hydrogen intermolecular bonds between them which significantly reduces the mobility and make the molecule more hydrophilic. As it will be seen later, this involves a low conversion degree (DC)-39% in the case of photopolymerization and a limited incorporation of fillers as well as difficulty to handle the material (Sideridou et al., 2002). Consequently, Bis-GMA is always associated with minor monomers such as triethylene glycol dimethacrylate-TEGDMA, with a viscosity of 0.011 Pa s FIGURE 7.1 Removable total denture.
Prosthetic rehabilitation of patients who have undergone head and neck cancer (HNC) surgery could be very challenging. The aim of this article is to present two HNC clinical cases rehabilitated with implant‐supported removable complete dental prosthesis with different types of CB.
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