This paper reviews acrylic denture base resin enhancement during the past few decades. Specific attention is given to the effect of fiber, filler, and nanofiller addition on poly(methyl methacrylate) (PMMA) properties. The review is based on scientific reviews, papers, and abstracts, as well as studies concerning the effect of additives, fibers, fillers, and reinforcement materials on PMMA, published between 1974 and 2016. Many studies have reported improvement of PMMA denture base material with the addition of fillers, fibers, nanofiller, and hybrid reinforcement. However, most of the studies were limited to in vitro investigations without bioactivity and clinical implications. Considering the findings of the review, there is no ideal denture base material, but the properties of PMMA could be improved with some modifications, especially with silanized nanoparticle addition and a hybrid reinforcement system.

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Purpose: This in vitro study evaluated the flexural strength, impact strength, hardness, and surface roughness of 3D-printed denture base resin subjected to thermal cycling treatment. Materials and Methods: According to ISO 20795-1:2013 standards, 120 acrylic resin specimens (40/flexural strength test, 40/impact strength, and 40/surface roughness and hardness test, n = 10) were fabricated and distributed into two groups: heatpolymerized; (Major.Base.20) as control and 3D-printed (NextDent) as experimental group. Half of the specimens of each group were subjected to 10,000 thermal cycles of 5 to 55°C simulating 1 year of clinical use. Flexural strength (MPa), impact strength (KJ/m 2 ), hardness (VHN), and surface roughness (μm) were measured using universal testing machine, Charpy's impact tester, Vickers hardness tester, and profilometer, respectively. Data were analyzed by ANOVA and Tukey honestly significant difference (HSD) test (α = 0.05). Results:The values of flexural strength (MPa) were 86.63 ± 1.0 and 69.15 ± 0.88; impact strength (KJ/m 2 )-6.32 ± 0.50 and 2.44 ± 0.31; hardness (VHN)-41.63 ± 2.03 and 34.62 ± 2.1; and surface roughness (μm)-0.18 ± 0.01 and 0.12 ± 0.02 for heat-polymerized and 3D-printed denture base materials, respectively. Significant differences in all tested properties were recorded between heat-polymerized and 3D-printed denture base materials (P < 0.001). Thermal cycling significantly lowered the flexural strength (63.93 ± 1.54 MPa), impact strength (2.40 ± 0.35 KJ/m 2 ), and hardness (30.17 ± 1.38 VHN) of 3D-printed resin in comparison to thermal cycled heat-polymerized resin, but surface roughness showed non-significant difference (p = 0.262). Conclusion: 3D-printed resin had inferior flexural strength, impact strength, and hardness values than heat-polymerized resin, but showed superior surface roughness. Temperature changes (thermal cycling) significantly reduced the hardness and flexural strength and increased surface roughness, but did not affect the impact strength.

Background Polymethyl methacrylate (PMMA) is widely used for the fabrication of removable prostheses. Recently, zirconium oxide nanoparticles (nano-ZrO 2 ) have been added to improve some properties of PMMA, but their effect on the optical properties and tensile strength are neglected. Objective The aim of this study was to investigate the effect of nano-ZrO 2 addition on the translucency and tensile strength of the PMMA denture base material. Materials and methods Eighty specimens (40 dumbbell-shaped and 40 discs) were prepared out of heat-polymerized acrylic resin and divided into four groups per test (n=10). The control group for each test included unreinforced acrylic, while the test groups were reinforced with 2.5, 5, and 7.5 wt% nano-ZrO 2 . Acrylic resin was mixed according to manufacturer’s instructions, packed, and processed by conventional method. After polymerization, all specimens were finished, polished, and stored in distilled water at 37°C for 48±2 hours. Tensile strength (MPa) was evaluated using the universal testing machine while the specimens’ translucency was examined using a spectrophotometer. Statistical analysis was carried out by SPSS using the paired sample t -test ( p ≤0.05). A scanning electron microscope was used to analyze the morphological changes and topography of the fractured surfaces. Results This study showed that the mean tensile strength of the PMMA in the test groups of 2.5%NZ, 5%NZ, and 7.5%NZ was significantly higher than the control group. The tensile strength increased significantly after nano-ZrO 2 addition, and the maximum increase seen was in the 7.5%NZ group. The translucency values of the experimental groups were significantly lower than those of the control group. Within the reinforced groups, the 2.5%NZ group had significantly higher translucency values when compared to the 5%NZ and 7.5%NZ groups. Conclusion The addition of nano-ZrO 2 increased the tensile strength of the denture base acrylic. The increase was directly proportional to the nano-ZrO 2 concentration. The translucency of the PMMA was reduced as the nano-ZrO 2 increased. Clinical significance Based on the results of the current study, the tensile strength was improved with different percentages of nano-ZrO 2 additions. However, translucency was adversely affected. Therefore, it is important to determine the appropriate amount of reinforcing nano-ZrO 2 that will create a balance between achieved properties – mechanical and optical.

Objective. The aim of this study was to evaluate the effect of incorporation of glass fiber, zirconia, and nano-zirconia on the transverse strength of repaired denture base. Materials and Methods. Eighty specimens of heat polymerized acrylic resin were prepared and randomly divided into eight groups (n = 10): one intact group (control) and seven repaired groups. One group was repaired with autopolymerized resin while the other six groups were repaired using autopolymerized resin reinforced with 2 wt% or 5 wt% glass fiber, zirconia, or nano-zirconia particles. A three-point bending test was used to measure the transverse strength. The results were analyzed using SPSS and repeated measure ANOVA and post hoc least significance (LSD) test (P ≤ 0.05). Results. Among repaired groups it was found that autopolymerized resin reinforced with 2 or 5 wt% nano-zirconia showed the highest transverse strength (P ≤ 0.05). Repairs with autopolymerized acrylic resin reinforced with 5 wt% zirconia showed the lowest transverse strength value. There was no significant difference between the groups repaired with repair resin without reinforcement, 2 wt% zirconia, and glass fiber reinforced resin. Conclusion. Reinforcing of repair material with nano-zirconia may significantly improve the transverse strength of some fractured denture base polymers.

Background Despite drawbacks, cold-cured acrylic resin is still the most common material used in denture repair. Zirconia nanoparticles were among the reinforcements added to increase the strength of the resin. The effect on Candida due to the addition of zirconia nanoparticles to the resin has not been investigated. Purpose The aim of this study was to evaluate the effect of zirconia nanoparticles added to cold-cured acrylic resin on Candida albicans adhesion. Materials and methods A total of 120 acrylic resin specimens with dimensions measuring 22×10×2.5 mm 3 were prepared and divided into two equal groups. One group (repair) comprised heat-polymerized specimens that were sectioned at the center and prepared to create a 2 mm repair area that was repaired with cold-cured resin reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. The second group contained intact cold-cured acrylic resin specimens reinforced with 0% wt, 2.5% wt, 5% wt, and 7.5% wt zirconia nanoparticles. Specimens were incubated at 37°C in artificial saliva containing C. albicans , and the effect of zirconia nanoparticles on C. albicans was assessed using two methods: 1) a slide count method and 2) a direct culture test. Variations in the number of living Candida were observed in relation to the different concentrations of zirconia nanoparticles. Analysis of variance (ANOVA) and post hoc Tukey’s tests were performed for data analysis. If the P -value was ≤0.05, then the difference was considered as statistically significant. Results It was found that C. albicans adhesion to repaired specimens was significantly decreased by the addition of zirconia nanoparticles ( P <0.00001) in comparison with the control group. Intact cold-cured groups and groups repaired with cold-cured resin reinforced with 7.5% wt zirconia nanoparticles showed the lowest Candida count. Tukey’s test showed a significant difference between the repaired group and the intact cold-cured group, while the later demonstrated a lower Candida count. Conclusion The addition of zirconia nanoparticles to cold-cured acrylic resin is an effective method for reducing Candida adhesion to repaired polymethyl methacrylate (PMMA) denture bases and cold-cured removable prosthesis. Clinical significance Based on the results of the current study, zirconia nanoparticles have an antifungal effect, which could be incorporated in the repair material for repairing denture bases and in PMMA removable prostheses as a possible approach for denture stomatitis prevention.

Purpose To assess the effect of addition of different concentrations of nanodiamonds (NDs) on flexural strength, impact strength, and surface roughness of heat‐polymerized acrylic resin. Materials and Methods 120 specimens were fabricated from heat‐polymerized acrylic resin. They were divided into a control group of pure polymethylmethacrylate (PMMA; Major.Base.20) and three tested groups (PMMA‐ND) with 0.5%wt, 1%wt, and 1.5%wt of added ND to PMMA. Flexural strength was determined using the three‐point bending test. Impact strength was recorded by using a Charpy type impact test. Surface roughness test was performed using a Contour GT machine. One‐way ANOVA and Tukey's post‐hoc analysis (p ≤ 0.05) were used for statistical analysis. Results Acrylic resin reinforced with 0.5% ND displayed significantly higher flexural strength than the unreinforced heat‐polymerized specimens, acrylic resin reinforced with 1% ND and the 1.5% ND (p < 0.0001). The impact strength of unreinforced heat‐polymerized specimens was significantly higher than all nano‐composite materials (p < 0.0001) with no significant difference between 1% ND and the 1.5% ND (p > 0.05). The addition of 0.5% ND and 1% ND significantly decreased the surface roughness in comparison to both control and the 1.5% ND groups (p < 0.0001) while no significant differences between 0.5% ND and 1% ND (p > 0.05) were reported. Nano‐composite material (0.5% ND) showed significantly lower surface roughness when compared to other specimens. Conclusions The addition of NDs to acrylic denture base improved the flexural strength and surface roughness at low concentrations (0.5%), while the impact strength was decreased with ND addition.

Titanium dioxide nanoparticles (TiO2NP) have gained interest in the dental field because of their multiple uses in addition to their antimicrobial effect. One of the applications in dentistry involves the incorporation into poly methyl methacrylate (PMMA) resin. However, there is a lack of evidence on their effects on the behavior of the resulting nanocomposite. Therefore, the present review aims to screen literatures for data related to PMMA/TiO2 nanocomposite to figure out the properties of TiO2 nanoparticles, methods of addition, interaction with PMMA resin matrix, and finally the addition effects on the properties of introduced nanocomposite and evidence on its clinical performance. Regardless of the latest research progress of PMMA/TiO2 nanocomposite, the questionable properties of final nanocomposite and the lack of long-term clinical evidence addressing their performance restrict their wide clinical use. A conclusive connection between nanoparticle size or addition method and nanocomposite properties could not be established.