Journal of Prosthodontics - 2013 - Akin - Shear Bond Strength of Denture Teeth To Two Chemically Different Denture Base

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 5

Shear Bond Strength of Denture Teeth to Two Chemically

Different Denture Base Resins after Various Surface


Treatments
Hakan Akin, DDS, PhD,1 Faik Tugut, DDS, PhD,2 Umit Guney, DDS,3 & Turker Akar, DDS3
1
Associate Professor, Cumhuriyet University, Faculty of Dentistry, Department of Prosthodontics, Sivas, Turkey
2
Assistant Professor, Cumhuriyet University, Faculty of Dentistry, Department of Prosthodontics, Sivas, Turkey
3
Research Assistant, Cumhuriyet University, Faculty of Dentistry, Department of Prosthodontics, Sivas, Turkey

Keywords Abstract
Eclipse; Er:YAG laser; PMMA; UDMA; shear
bond strength.
Purpose: Debonding of acrylic teeth from the denture base remains a major problem
in prosthodontics. The objective of this study was to evaluate the effect of various sur-
Correspondence
face treatments on the shear bond strength of the two chemically different denture base
Dr. Hakan Akin, Cumhuriyet University, resins—polymethyl methacrylate (PMMA) and urethane dimethacrylate (UDMA).
Faculty of Dentistry, Department of Materials and Methods: Two denture base resins, heat-cured PMMA (Meliodent)
Prosthodontics, 58140 Sivas, TURKEY. and light-activated UDMA (Eclipse), were used in this study. A total of 60 molar
E-mail: drhknkn@hotmail.com acrylic denture teeth were randomly separated into four groups (n = 15), according
to surface treatment: acrylic untreated (group AC), Eclipse untreated (group EC),
This study was presented as a poster at the treated with eclipse bonding agent (group EB), and Er:YAG laser-irradiated eclipse
annual meeting of the World Congress for (group EL). Shear bond strength test specimens were prepared according to the
Laser Dentistry, Barcelona, Spain, April, 2012 manufacturers’ instructions. Specimens were subjected to shear bond strength test by
The authors report no conflicts of interest.
a universal testing machine with a 1 mm/min crosshead speed. The data were analyzed
The authors alone are responsible for the
with one-way ANOVA and post hoc Tukey-Kramer multiple comparison tests (α =
content and writing of the paper. 0.05).
Results: The highest mean bond strength was observed in specimens of group EB, and
Accepted April 14, 2013 the lowest was observed in group EC specimens. A statistically significant difference
in shear bond strength was found among all groups (p < 0.001), except between
doi: 10.1111/jopr.12081 groups EC and EL (p = 0.61).
Conclusion: The two chemically different denture base polymers showed different
shear bond strength values to acrylic denture teeth. Laser-irradiation of the adhesive
surface was found to be ineffective on improving bond strength of acrylic denture
teeth to denture base resin. Eclipse bonding agent should be used as a part of denture
fabrication with the Eclipse Resin System.

Various denture base materials and fabrication techniques have Nevertheless, brittleness and low impact resistance of the ma-
been used for many years. In 1937, polymethyl methacrylate terial has limited its application. A new UDMA denture base
(PMMA) resin was used with its simple processing technique, material, known as Eclipse (Dentsply Trubyte), has claimed
relatively low-cost fabrication process, and adequate esthetic to improve physical properties. Machado et al1 reported that
properties.1,2 However, in addition to the low impact strength Eclipse showed higher transverse strength than heat-cured
and low fatigue resistance of PMMA,3,4 patient allergic re- PMMA and Triad VLC resins. Moreover, Eclipse exhibited sig-
sponses to methyl methacrylate monomer (MMA)5,6 have led nificantly higher surface hardness,6 flexural strength,6-8 flexural
to efforts to produce new materials with better mechanical prop- modulus,6 and impact strengths7 than heat-cured PMMA resin.
erties than PMMA.3,4 Thus, in the early 1980s, light-activated Debonding acrylic teeth from the denture base remains a
urethane dimethacrylate (UDMA) resin was developed to elim- major problem in prosthodontics. The two components (base
inate contact allergies with its simple application.7-10 and teeth) have a different structure; their different processing
The first system of light-activated UDMA denture base poly- routes are one of the factors contributing to this discrepancy.2
mer, known as Triad VLC (Dentsply Trubyte, York, PA), at- There is no chemical bond between acrylic denture teeth and
tracted attention as a denture base material with its favorable es- Eclipse resin; therefore, mechanical retention is necessary. At-
thetic outcome, biocompatibility, and low bacterial adherence.6 tempts to improve bond strength between denture base and

152 Journal of Prosthodontics 23 (2014) 152–156 


C 2013 by the American College of Prosthodontists
Akin et al Bond Strength of Denture Teeth

teeth include mechanical preparation,11 etching or bonding with


chemicals,12-16 priming with MMA liquid,17,18 and wetting or-
ganic solvents of the tooth surface.19,20 Furthermore, the sur-
face of the PMMA can be altered by sandblasting21-26 and laser
irradiation.21,25,27,28 Both manipulations (increased surface area
and mechanical locks) should benefit the bond site and result
in stronger bonds.
Akin et al28 evaluated bonding properties between UDMA
and soft denture liner. Surface treatments were performed on
the surface of the UDMA specimens after light activation. Thus,
liner could penetrate into the irregularities or pits produced by
the surface treatments. Surface treatment should be applied on
denture teeth when evaluating bond strength between UDMA
and acrylic denture teeth. Lasers have different absorption rates Figure 1 A schematic diagram of the test specimen and testing appa-
for different materials. Therefore, for denture teeth, different ratus.
surface properties could be obtained from UDMA resin. The
purpose of this study was to evaluate the effect of various sur- system (Eclipse). Rectangular wax specimens (36 × 12 × 5
face treatments including bonding agent and laser irradiation mm3 ) were prepared, and teeth were fixed to them. Silicone
on the shear bond strength of acrylic denture teeth to two chem- molds were prepared with the wax specimens. The heat-cured
ically different denture base resins—PMMA and UDMA. The acrylic shear test specimens were prepared in the molds in
null hypotheses were (1) PMMA and UDMA denture base denture flasks and cured in a manner similar to that used in
resins have similar bond strength to acrylic denture teeth, and conventional denture construction. The heat-cured acrylic resin
(2) surface treatments are not effective in improving shear bond was processed according to the manufacturer’s instructions.
strength of the teeth to denture base resins. After the acrylic shear test specimens were removed, finishing
was performed.
Materials and methods Eclipse baseplate resin was preheated for 2 minutes, and the
silicone mold for 10 minutes, in an Eclipse Conditioning Oven
Preparation of acrylic denture teeth
(Dentsply Trubyte) heated to 55◦ C to allow for easier adapta-
Sixty molar acrylic denture teeth (Samet, Pharma Zahnfabrik, tion of the material. The separating agent (Al-Cote, Dentsply
Kayseri, Turkey) were ground on the ridge-lap area with a Trubyte) was then applied to the mold, and the warmed resin
tungsten carbide bur (H129FSQ, Brasseler, Savannah, GA) at was adapted into the mold using finger pressure. At that time,
approximately 40,000 rpm with air coolant to provide a uniform setup resin was flowed between the teeth and the base with a
surface for bonding. Their bonding surfaces were arranged in a hot instrument (Electric Waxer, Dentsply Trubyte). After cool-
5 mm diameter and measured with a digital caliper (Altas 905, ing, the specimens were removed from the silicone mold, and
Gedore-Altas, Istanbul, Turkey) to maintain a ±0.03 mm tol- any excess from around the teeth was removed. These speci-
erance. After initial grinding, acrylic denture teeth specimens mens were warmed in the oven (Eclipse Conditioning Oven,
were randomly separated into four groups (n = 15), according Dentsply Trubyte) at 55◦ C for 1 hour, and coated with air
to the surface treatments applied. Group AC—PMMA untreated barrier coating (Eclipse ABC, Dentsply Trubyte) to prevent
(control): No treatment was applied. This group served as an inhibition of polymerization by oxygen. The specimens were
acrylic control. Group EC—Eclipse untreated (control): No processed in a light-processing unit (Eclipse Processing Unit,
treatment was applied. This group served as an Eclipse control. Dentsply Trubyte) for 10 minutes. A total of 60 shear test
Group EB—bonding for Eclipse: The teeth were treated with specimens were obtained using this method. A schematic di-
a thin layer of Eclipse Bonding Agent (Eclipse, Dentsply agram of a test specimen can be seen in Figure 1. Specimens
Trubyte) according to the manufacturer’s recommendation. were stored in distilled water at 37◦ C for 48 hours before the
Group EL—Er:YAG laser irradiated Eclipse: bonding surfaces test.
of specimens were irradiated by Er:YAG laser (Smart 2940D
Plus; Deka Laser, Firenze, Italy). Shear bond strength test
Laser energy was delivered in pulse mode with a 2.94 μm
wavelength. A 4 mm diameter titanium articulated arm trans- The specimens were mounted in the custom jig of a universal
mission system was used with a 10 Hz repetition rate, 300 mJ testing machine (Lloyd LF Plus, Ametek Inc., Lloyd Instru-
energy, 3 W output power, and 700 μs pulse duration of 20 ments, Leicester, UK), and load was applied to the adhesive
seconds. The distance of application was 10 mm. Bonding sur- interface at a constant 1 mm/min crosshead speed until failure.
faces of teeth were cooled with the water spray at a 5 ml/min The maximum force to produce fracture was recorded, and the
rate during irradiation. bond strength (S) values (expressed in MPa) were calculated
using the formula S = F/A, where F is the force (in N) and
A is the adhesive area (in mm2 ). Moreover, modes of failure
Preparation of denture base specimens
were visually determined for every specimen after testing and
This study used a heat-cured PMMA resin (Meliodent, Bayer categorized into one of three categories: adhesive failure refers
Dental, Newbury, UK) and light-activated UDMA denture base to total separation at the interface between the acrylic denture

Journal of Prosthodontics 23 (2014) 152–156 


C 2013 by the American College of Prosthodontists 153
Bond Strength of Denture Teeth Akin et al

Table 1 Shear bond strengths in each group of specimens presented strengths than denture teeth without a bonding agent. More-
as means and standard deviations over, Hayakawa et al13 suggested that a bonding agent should
be applied when visible light-polymerized denture base resin
Groups N Mean (MPa) SD
is used with acrylic denture teeth. It could be explained that
Group AC 15 12.79a 1.7 monomer containing the greater amount of cross-linking agent
Group EC 15 6.25b 0.9 may improve the formation of a more extensive interpenetrat-
Group EB 15 17.26c 2.28 ing polymer network (IPN).29-31 Eclipse Bonding Agent con-
Group EL 15 7.12b 1.55 sists of methyl acetate, and Eclipse set-up resin consists of
urethane-based oligomers. The mechanism of the network be-
Groups with same superscript letters not significantly different (p > 0.05). tween methyl acetate and urethane-based oligomers should be
investigated in future studies using SEM analysis. Furthermore,
Table 2 Mode of failure in each group
Saavedra et al17 reported that application of an MMA-based
Groups N Adhesive failure Cohesive failure Mixed failure bonding agent improved bond strength between acrylic den-
ture teeth and denture base resin. In addition, Takahashi et al11
Group AC 15 – – 15 reported that application of dichloromethane resulted in a sig-
Group EC 15 14 – 1 nificant improvement in bond strength of acrylic denture teeth
Group EB 15 8 – 7
to denture base resin. Furthermore, due to chemical bonding
Group EL 15 11 – 4
between the acrylic tooth and the acrylic denture base, bond
strength of acrylic denture teeth to heat-cured PMMA denture
tooth and base material; cohesive failure refers to a full break base resin was found to be higher than to light-activated UDMA
in the base material or tooth; mixed failure refers to both. In ad- resin. This result is in accordance with the studies of Clancy
dition, the mean value and standard deviation of the specimens et al,14 Kawara et al,15 Cunningham,16 and Fletcher-Stark
were statistically evaluated by one-way ANOVA and post hoc et al.9
Tukey-Kramer multiple comparison tests (α = 0.05). The type of denture base resin14,15 and acrylic tooth
material,11 modification of ridge-lap area, or application of
bonding agent2,9,11,13,17 are the main parameters affecting bond
Results strength of acrylic teeth to denture base resin. Modification
Statistical results of the one-way ANOVA for shear bond of the ridge-lap area can be achieved through sandblasting
strength measurements of the groups are summarized in Table 1 and laser irradiation. Sandblasting and laser irradiation have
(df = 3, MS = 314.67, F = 110.247, p < 0.05). The highest been used to alter the surface of the PMMA with the inten-
mean bond strength was observed in specimens of group EB, tion of providing increased surface area and mechanical locks.
and the lowest was observed in group EC specimens. Tukey’s Theoretically, both manipulations (increased surface area and
HSD test showed that a statistically significant difference in mechanical locks) should benefit the bond site and result in
shear bond strength was found between groups AC and EC, stronger bonds.21 Storer23 and Usumez et al24 reported that
EB, and EL (p < 0.001). Analysis of the data also revealed no sandblasting the acrylic resin surface before the placement of
significant difference in bond strength between groups EC and a resilient lining material improved the strength of the bond
EL (p = 0.61); however, a significant difference was found be- with a slightly irregular surface providing mechanical locking
tween groups EC and EB (p < 0.001). Furthermore, modes of for the soft material. In addition, Akin et al22 reported that
failure are presented in Table 2. In groups EC, EB, and EL ad- 120 μm Al2 O3 particles are the best particle size to improve
hesive failures were the predominant failure mode (93%, 53%, bond strength between PMMA and liner. To the contrary, Amin
73%, respectively); however, group AC specimens resulted in et al25 and Jacobsen et al26 reported that roughening acrylic
100% mixed failure. No cohesive failures were observed in any resin base by alumina abrasion before applying a lining ma-
group. terial had a weakening effect on the bond. Furthermore, Akin
et al21 reported that altering the PMMA surface by Er:YAG laser
Discussion significantly increased the bond strengths in PMMA/silicone
specimens, whereas sandblasting before applying a lining ma-
The results obtained in the present study clearly demonstrate terial had a weakening effect on the bond. In addition, they
that heat-cured PMMA denture base resin without any surface demonstrated that other laser systems including Nd:YAG and
treatment exhibited a higher shear bond strength than light- KTP lasers are ineffective for strengthening the bond between
activated UDMA denture base resin without any surface treat- acrylic denture base and soft liner. Moreover, Tugut et al27 re-
ment, by which the first hypothesis was rejected. In addition, ported that Er:YAG laser treatment at 10 Hz, 3 W, and 300 mJ
bonding application on the tooth surface improved the bond with a long pulse duration (700 μs) on the adhesive surface
strength, whereas altering the tooth surface with an Er:YAG of PMMA effectively increased tensile bond strength between
laser was not effective in increasing shear bond strength of an resilient soft liner and the denture base. In another study,28
acrylic denture tooth to a denture base resin. Therefore, the Er:YAG laser treatment at 10 Hz, 3 W, and 300 mJ with a long
second hypothesis was partially rejected. pulse duration was shown to be an effective method for improv-
Consistent with the present study, Fletcher-Stark et al9 ing bond strength of UDMA and liner. Therefore, in the present
reported that acrylic denture teeth surface treated with study, Er:YAG laser surface treatment with Tugut et al’s27 and
Eclipse Bonding Agent demonstrated significantly higher bond Akin et al’s28 parameters were used.

154 Journal of Prosthodontics 23 (2014) 152–156 


C 2013 by the American College of Prosthodontists
Akin et al Bond Strength of Denture Teeth

The Eclipse system is composed of three types of resins— 4. Kim S-H, Watts DC: The effect of reinforcement with woven
baseplate, setup, and contour resins. First, a processed baseplate E-glass fibers on the impact strength of complete dentures
is light polymerized, and then the teeth are added with the setup fabricated with high-impact acrylic resin. J Prosthet Dent
resin. Subsequently, the contour resin is used to simulate the 2004;91:274-280
gingival tissues. The manufacturer recommended a 10-minute 5. Pfeiffer P, An N, Schmage P: Repair strength of hypoallergenic
denture base materials. J Prosthet Dent 2008;100:292-
curing time with a wavelength of 400 to 500 nm high-intensity
301
visible light for baseplate thicknesses of 8 mm or less.6 Further- 6. Ali IL, Yunus N, Abu-Hassan MI: Hardness, flexural strength,
more, the modifications (control, bonding agent application, and flexural modulus comparisons of three differently cured
and laser irradiation) were performed on only one of the den- denture base systems. J Prosthodont 2008;17:545-549
ture base materials (Eclipse) because debonding acrylic teeth 7. Machado AL, Puckett AD, Breeding LC, et al: Effect of
from light-activated UDMA denture base resin remains a ma- thermocycling on the flexural and impact strength of
jor problem due to the fact that there is no chemical bond be- urethane-based and high-impact denture base resins.
tween them. Therefore, this is a disadvantage for light-activated Gerodontology 2012;29:e318-e323
UDMA denture base resin against conventional PMMA denture 8. Diaz-Arnold AM, Vargas MA, Shaull KL, et al: Flexural and
base resin. In the present study, it was expected that this disad- fatigue strengths of denture base resin. J Prosthet Dent
2008;100:47-51
vantage could be tolerated by using surface modifications. Thus,
9. Fletcher-Stark ML, Chung K-H, Rubenstein JE, et al: Shear bond
surface modifications were only performed on light-activated strength of denture teeth to heat- and light-polymerized denture
UDMA denture base resin, and PMMA denture base resin was base resin. J Prosthodont 2011;20:52-59
used only as control group. 10. Ahmad F, Dent M, Yunus N: Shear bond strength of two
On the other hand, when failure modes were assessed, bond- chemically different denture base polymers to reline materials. J
ing agent-applied specimens showed 53% adhesive failure. Prosthodont 2009;18:596-602
Nevertheless, this adhesive failure proportion was raised for 11. Takahashi Y, Chai J, Takahashi T, Habu T: Bond strength of
control and laser-irradiated specimens (93% and 73%, respec- denture teeth to denture base resins. Int J Prosthodont 2000;
tively). These results are in accordance with those of Fletcher- 13:59-65
Stark et al.9 Consistent with the bond strength values in EC 12. Rached RN, Del Bel Cury AA: Heat-cured acrylic resin repaired
with microwave-cured one: bond strength and surface texture. J
specimens, the most adhesive failures were seen in these speci-
Oral Rehabil 2001;28:370-375
mens. These findings indicate a direct proportion between bond 13. Hayakawa I, Hirano S, Nagao M, et al: Adhesion of a new light
strength value and percentage of denture base cohesive failure. polymerized denture base resin to resin teeth and denture base
Furthermore, the higher bond strength value and the lower per- materials. Int J Prosthodont 1991;4:561-568
centage of acrylic denture tooth cohesive failure were seen. 14. Clancy JMS, Hawkins LF, Keller JC, et al: Bond strength and
All specimens were stored in distilled water at 37◦ C for failure analysis of light-cured denture resins bonded to denture
48 hours before testing. One of the limitations of this study was teeth. J Prosthet Dent 1991;65:315-324
that thermocycling and long-term water storage were not per- 15. Kawara M, Carter JM, Ogle RE, et al: Bonding of plastic teeth to
formed. Although these storage types are important to simulate denture base resins. J Prosthet Dent 1991;66:566-571
clinical conditions, the results of this study may be beneficial 16. Cunningham JL: Shear bond strength of resin teeth to heat-cured
and light-cured denture base resin. J Oral Rehabil 2000;27:
for the comparison of the effects of different surface treatment
312-316
methods. 17. Saavedra G, Valandro LF, Leite FP, et al: Bond strength of
acrylic teeth to denture base resin after various surface
Conclusions conditioning methods before and after thermocycling. Int J
Prosthodont 2007;20:199-201
Within the limitations of this study, Eclipse Bonding Agent 18. Papazoglou E, Vasilas AI: Shear bond strengths for composite
was shown to be useful as a part of denture fabrication with the and autopolymerized acrylic resins bonded to acrylic resin
Eclipse Resin System. Eclipse Bonding Agent enables Eclipse denture teeth. J Prosthet Dent 1999;82:573-578
resin to compensate for its disadvantage of acrylic tooth bond- 19. Rached RN, Powers JM, Del Bel Cury AA: Repair strength of
ing when compared to the PMMA denture base resin. Laser auto-polymerizing, microwave, and conventional
heat-polymerized acrylic resins. J Prosthet Dent 2004;92:79-82
irradiation of the denture teeth adhesive surface did not effec-
20. Minami H, Suzuki S, Minesaki Y, et al: In vitro evaluation of the
tively improve bond strength of denture teeth to denture base influence of repairing condition of denture base resin on the
resin. bonding of autopolymerizing resins. J Prosthet Dent 2004;91:
164-170
References 21. Akin H, Tugut F, Mutaf B, et al: Effect of different surface
treatments on tensile bond strength of silicone based soft denture
1. Machado C, Sanchez E, Azer SS, et al: Comparative study of the liner. Lasers Med Sci 2011;26:783-788
transverse strength of three denture base materials. J Dent 2007; 22. Akin H, Tugut F, Mutaf B, et al: Effect of sandblasting with
35:930-933 different size of aluminum oxide particles on tensile bond
2. Patil SB, Naveen BH, Patil NP: Bonding acrylic teeth to acrylic strength of resilient liner to denture base. Cumhuriyet Dent J
resin denture bases: a review. Gerodontology 2006;23:131-139 2011;14:5-11
3. Vallittu PK, Narva K: Impact strength of a modified continuous 23. Storer R: Resilient denture base materials. Part 1, introduction
glass fiber poly(methyl methacrylate). Int J Prosthodont 1997; and laboratory evaluation. Br Dent J 1962;113:195-
10:142-148 203

Journal of Prosthodontics 23 (2014) 152–156 


C 2013 by the American College of Prosthodontists 155
Bond Strength of Denture Teeth Akin et al

24. Usumez A, Inan O, Aykent F: Bond strength of a silicone lining 28. Akin H, Tugut F, Guney U, et al: Tensile bond strength of
material to alumina-abraded and lased denture resin. J Biomed silicone-based soft denture liner to two chemically different
Mater Res Part B: Appl Biomater 2004;71:196-200 denture base resins after various surface treatments. Lasers Med
25. Amin WM, Fletcher AM, Ritchie GM: The nature of the Sci 2013;28:119-123
interface between polymethyl methacrylate denture base 29. Vallittu PK, Ruyter IE: The swelling phenomenon of acrylic
materials and soft lining materials. J Dent 1981;9:336-346 resin polymer teeth at the interface with denture base polymers. J
26. Jacobsen NL, Mitchell DL, Johnson DL, et al: Lased and Prosthet Dent 1997;78:194-199
sandblasted denture base surface preparations affecting resilient 30. Murat MM, Ruyter IE: Evaluation of adhesion of chairside hard
liner bonding. J Prosthet Dent 1997;78:153-158 relining materials to denture base polymers. J Prosthet Dent
27. Tugut F, Akin H, Mutaf B, et al: Strength of the bond between a 2005;94:445-452
silicone lining material and denture resin after Er:YAG laser 31. Büyükyilmaz S, Ruyter IE: The effects of polymerization
treatments with different pulse durations and levels of energy. temperature on the acrylic resin denture base-tooth bond. Int J
Lasers Med Sci 2012;27:281-285 Prosthodont 1997;10:49-54

156 Journal of Prosthodontics 23 (2014) 152–156 


C 2013 by the American College of Prosthodontists

You might also like