EVALUATION OF WATER SORPTION AND SOLUBILITY OF COMPUTER AIDED DESIGN AND COMPUTER AIDED MANUFACTURING CAD/CAM DENTURE BASE MATERIALS

Year 2023, , 35 - 39, 25.12.2023

Filiz Yağcı , Aşkın Nur Tuğluk

https://doi.org/10.34108/eujhs.1308108

Abstract

With widespread use of digital technologies in dentistry, polymethylmethacrylate (PMMA) and polyetheretherketone (PEEK) block denture base materials are used for computer-aided manufacturing of removable dentures. It is suggested that the physical properties of these materials such as water sorption and solubility are superior to PMMA produced by the traditional heat polymerization method. In this study, it was aimed to compare the water sorption and solubility of block PMMA, Titanium Dioxide (TiO2) containing PEEK denture base materials and an indirect laboratory composite resin used for veneering of PEEK with heat polymerized PMMA.10×2 mm disc-shaped specimens were prepared from block PMMA, PEEK containing TiO2, indirect laboratory composite resin and heat polymerized acrylic resin. (n=40) After weighing the samples on an analytical balance, they were stored in distilled water at 37oC for 7 days. Then, the water sorption ratios were calculated by weighing specimens again. After the specimens getting completely dried, they were weighed again and the solubility ratios were calculated. Water sorption and solubility data were analyzed by Kruskal-Wallis and post-hoc Tukey tests (p=0.05). While block PMMA (1.372%) showed more water sorption than indirect composite resin (0.389%) and PEEK (0.212%); heat polymerized PMMA specimens (1.329%) showed more water sorption than PEEK (p<0.001). There was no significant difference in terms of water sorption between heat polymerized PMMA with block PMMA and indirect composite resin (p>0.05). Heat polymerized PMMA showed the highest water solubility value. PEEK showed less water solubility than block PMMA (p=0.003) and heat polymerized PMMA (p=0.000). Indirect laboratory composite showed less solubility than block PMMA (p=0.011) and heat polymerized PMMA (p=0.000). It is known that water sorption and solubility adversely affect the mechanical properties, microorganism uptake and coloration of the acrylic base in removable dentures. According to the results of this study, the fact that PEEK denture base containing TiO2 and indirect composite resin used for veneering its surface in gingival color show less water sorption and solubility than both PMMA materials may be advantageous for removable dentures in long term in terms of biological, mechanical and esthetic properties.

Keywords

Solubility, indirect composite resin, polymethylmethacrylate, polyetheretherketone, water sorption

BİLGİSAYAR DESTEKLİ TASARIM VE BİLGİSAYAR DESTEKLİ ÜRETİM (CAD/CAM) YÖNTEMİ İLE ÜRETİLEN PROTEZ KAİDE MATERYALLERİNİN SU EMİLİMİ VE ÇÖZÜNÜRLÜKLERİNİN DEĞERLENDİRİLMESİ

Abstract

Diş hekimliğinde dijital teknolojilerin yaygınlaşması ile birlikte hareketli protezlerin bilgisayar destekli üretimi için polimetilmetakrilat (PMMA) ve polietereterketon (PEEK) blok kaide materyalleri kullanılmaktadır. Bu materyallerin su emilimi ve çözünürlük gibi fiziksel özelliklerinin geleneksel yöntemle ısı ile polimerize edilen PMMA’dan daha üstün olduğu öne sürülmektedir. Bu çalışmada, blok PMMA, Titanyum dioksit (TiO2) içerikli PEEK kaide materyallerinin ve PEEK’in veneerlenmesinde kullanılan bir indirekt laboratuvar kompozit rezininin su emilimi ve suda çözünürlük değerlerinin ısı ile polimerize olan PMMA ile karşılaştırılması amaçlanmıştır. Blok PMMA, TiO2 içerikli PEEK, indirekt kompozit rezini ve ısı ile polimerize olan akrilikten 10×2 mm disk şeklinde örnekler hazırlanmıştır (n=40). Örnekler hassas terazide tartıldıktan sonra 7 gün süreyle distile suda 37oC’de saklanmıştır. Daha sonra hassas terazide tartılarak su emilimi oranı hesaplanmıştır. Çözünürlük ise örnekler tamamen kurutulduktan sonra tekrar tartılarak hesaplanmıştır. Su emilimi ve çözünürlük verileri Kruskal-Wallis ve post-hoc Tukey testleri ile analiz edilmiştir (p=0.05). Blok PMMA (%1.372), indirekt kompozit rezine (%0.389) ve PEEK’e (%0.212) göre daha fazla su emilimi gösterirken; ısı ile polimerize olan PMMA örnekler (%1.329) ise PEEK’e göre daha fazla su emilimi göstermiştir (p<0.001). Isı ile polimerize olan PMMA ile blok PMMA ve indirekt kompozit rezin arasında ise su emilimi açısından anlamlı fark görülmemiştir (p>0.05). Isı ile polimerize olan PMMA, en yüksek suda çözünürlüğü göstermiştir. PEEK örnekler blok PMMA’ya (p=0.003) ve ısı ile polimerize olan PMMA’ya (p=0.000) göre daha az suda çözünürlük göstermiştir. İndirekt kompoziti, blok PMMA’ya (p=0,011) ve ısı ile polimerize olan akriliğe göre (p=0.000) daha az çözünürlük göstermiştir. Su emilimi ve çözünürlüğün hareketli protezlerde akrilik kaidenin mekanik özelliklerini, mikroorganizma tutulumunu, renklenmesini olumsuz yönde etkilediği bilinmektedir. Bu çalışmanın sonuçlarına göre TiO2 içerikli PEEK ve yüzeyinin dişeti renginde veneerlenmesinde kullanılan indirekt kompozit rezinin kaide materyali olarak kullanıldığında her iki PMMA materyalden daha az su emilimi ve çözünürlük göstermesi biyolojik, mekanik ve estetik özellikler bakımından uzun vadede hareketli protezler için yarar sağlayabilir.

Keywords

Çözünürlük, indirekt kompozit rezin, polimetilmetakrilat, polietereterketon, su emilimi

References

• Murray MD, Darvell BW. The evolution of the complete denture base, Theories of complete denture retention-a review, Part 1. Aust Dent J 1993; 38:216-9. doi: 10.1111/j.1834-7819.1993.tb03067.x
• Lung CY, Darvell BW. Minimization of the inevitable residual monomer in denture base acrylic. Dent Mater 2005; 21:1119-28. doi: 10.1016/j.dental.2005.03.003
• Steinmassl PA, Klaunzer F, Steinmassl O, Dumfahrt H, Grunert I. Evaluation of currently available CAD/CAM denture systems. Int J Prosthodont 2017; 30:116-22. doi: 10.11607/ijp.5031.
• Kippax A, Watson CJ, Basker RM, et al. How well are complete dentures copied?. Br Dent J 1998; 185:129-33.
• Goodacre CJ, Garbacea A, Naylor WP, Daher T, Marchack CB, et al. CAD/CAM fabricated complete dentures: concepts and clinical methods of obtaining required morphological data. J Prosthet Dent 2012; 107:34-46. doi: 10.1016/S0022-3913(12)60015-8.
• Kattadiyil MT, Goodacre CJ, Baba NZ. CAD/CAM complete dentures: a review of two commercial fabrication systems. J Calif Dent Assoc 2013; 41:407-16. PMID: 23875432
• Kattadiyil MT, Jekki R, Goodacre CJ, Baba NZ. Comparison of treatment outcomes in digital and conventional complete removable dental prosthesis fabrications in a predoctoral setting. J Prosthet Dent 2015; 114:818-25. doi: 10.1016/j.prosdent.2015.08.001. PMID: 26412000.
• Bidra AS, Farrell K, Burnham D, Dhingra A, Taylor TD, et al. Prospective cohort pilot study of 2-visit CAD/CAM monolithic complete dentures and implant-retained overdentures: Clinical and patient-centered outcomes. J Prosthet Dent 2016; 115:578-86. doi: 10.1016/j.prosdent.2015.10.023. PMID: 26794695.
• Zoidis P, Papathanasiou I, Polyzois G. The use of a modified poly-etherether-ketone (PEEK) as an alternative framework material for removable dental prostheses. A clinical report. J Prosthodont 2016; 25:580-4. doi: 10.1111/jopr.12325. PMID: 26216668.
• Ichikawa T, Kurahashi K, Liu L, Matsuda T, Ishida Y. Use of a polyetheretherketone clasp retainer for removable partial denture: A case report. Dent J (Basel) 2019; 7:4. doi: 10.3390/dj7010004. PMID: 30609778.
• Harb IE, Abdel-Khalek EA, Hegazy SA. CAD/CAM constructed polyetheretherketone (PEEK) framework of Kennedy class I removable partial denture: A clinical report. J Prosthodont 2019; 28:e595-8. doi: 10.1111/jopr.12968. PMID: 30345575
• Papathanasiou I, Kamposiora P, Papavasiliou G, Ferrari M. The use of PEEK in digital prosthodontics: A narrative review. BMC Oral Health 2020; 20:217. doi: 10.1186/s12903-020-01202-7. PMID: 32741366
• Kurahashi K, Matsuda T, Ishida Y, et al. Effect of surface treatments on shear bond strength of polyetheretherketone to autopolymerizing resin. Dent J (Basel) 2019; 7(3):82. doi: 10.3390/dj7030082. PMID: 31374927
• Zoidis P, Bakiri E, Papathanasiou I, Zappi A. Modified PEEK as an alternative crown framework material for weak abutment teeth: a case report. Gen Dent. 2017; 65(5):37–40. PMID: 28862587.
• Kurtz SM, Devine JN. PEEK biomaterials in trauma, orthopedic, and spinal implants. Biomaterials 2007; 28(32):4845-69. doi: 10.1016/j.biomaterials.2007.07.013. PMID: 17686513
• Rosentritt M, Preis V, Behr M, et al. Shear bond strength between veneering composite and PEEK after different surface modifications. Clin Oral Investig 2015; 19(3):739-44. doi: 10.1007/s00784-014-1294-2. PMID: 25096670
• Miara P. Aesthetic guidelines for second-generation inlays and onlay composite restorations. Prac Periodont Aesthet Dent,1998; 10(4):423-31. PMID: 9655049.
• Yagci F, Balkaya H, Demirbuga S. Discoloration Behavior of Resin Cements Containing Different Photoinitiators. International Journal of Periodontics and Restorative Dentistry. May/June 2021. 41(3):e113-e120. doi: 10.11607/prd.5376. PMID: 34076647.
• Hada T, Kanazawa M, Iwaki M, et al. Comparison of Mechanical Properties of PMMA Disks for Digitally Designed Dentures. Polymers. 2021 26;13(11):1745. doi: 10.3390/polym13111745. PMID: 34073564.
• Mensitieri G, Apicella A, Kenny JM, et al. Water Sorption Kinetics in Polyaryl Ether Ether Ketone Jan 1989. J Appl Polym Sci, 37 381-92. doi.org/10.1002/app.1989.070370207
• Grayson MA, Clarence JW. The solubility and diffusion of water in poly(aryl ether-ether-ketone) (PEEK). Journal of Polymer Science Part B: Polymer Physics. 1987, 25.1: 31-41.
• Iskender N, Ersoz B, Aydın N. et al. Investigation of Water Absorption and Color Change of Indirect Composite Resins. EADS. 2021. 48 (2), 46–51.
• Sahin Z, Ergun G, Ataol A. CAD/CAM ile üretilmiş PEEK ve PMMA ile geleneksel protez kaide materyallerinin bazı fiziksel özelliklerinin karşılaştırılması. Mersin Univ Sağlık Bilim Dergisi 2021; 14(3):484- 494. doi: 10.26559/mersinsbd.926864.
• Lieberman A,Wimmer T,Schmidlin PR, Scherer H, Löffler P et al. Physicomechanical characterization of polyetheretherketone and current esthetic dental CAD/CAM polymers after aging in different storage media, J Prosthet Dent 2016;115(3):321-8.e2. doi: 10.1016/j.prosdent.2015.09.004. PMID: 26548869.
• Czasch P, Ilie N. In vitro comparison of mechanical properties and degree of cure of bulk fill composites. Clin Oral Investig 2013; 17(1):227-35. doi: 10.1007/s00784-012-0702-8. PMID: 22411261
• Stawarczyk B, Eichberger M, Uhrenbacher J, Wimmer T, Edelhoff D, et al. Three-unit reinforced polyetheretherketone composite FDPs: Influence of fabrication method on load-bearing capacity and failure types. Dent Mater J 2015;34:7-12 doi: 10.4012/dmj.2013-345. PMID: 25311236.
• Kalachandra S, Influence of fillers on the water sorption of composites, Dent Mater, 1989 Jul; 5(4):283-8. doi: 10.1016/0109-5641(89)90077-8. PMID: 2638273.