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d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 1091–1097

Available online at www.sciencedirect.com

journal homepage: www.intl.elsevierhealth.com/journals/dema

Linear and volumetric dimensional changes of


injection-molded PMMA denture base resins

Shadi El Bahra a,b,∗ , Klaus Ludwig a , Abdulaziz Samran a,c ,


Sandra Freitag-Wolf d , Matthias Kern a
a Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts
University at Kiel, Germany
b Department of Removable Prosthodontics, School of Dentistry, University of Damascus, Syria
c Department of Fixed Prosthodontics, School of Dentistry, University of Ibb, Yemen
d Institute of Medical Informatics and Statistics, Christian-Albrechts University at Kiel, Germany

a r t i c l e i n f o a b s t r a c t

Article history: Objectives. The aim of this study was to evaluate the linear and volumetric dimensional
Received 12 October 2012 changes of six denture base resins processed by their corresponding injection-molding
Received in revised form systems at 3 time intervals of water storage.
10 May 2013 Materials and methods. Two heat-curing (SR Ivocap Hi Impact and Lucitone 199) and four
Accepted 24 July 2013 auto-curing (IvoBase Hybrid, IvoBase Hi Impact, PalaXpress, and Futura Gen) acrylic resins
were used with their specific injection-molding technique to fabricate 6 specimens of each
material. Linear and volumetric dimensional changes were determined by means of a digital
Keywords: caliper and an electronic hydrostatic balance, respectively, after water storage of 1, 30, or 90
Denture base resin days. Means and standard deviations of linear and volumetric dimensional changes were
Injection-molding calculated in percentage (%). Statistical analysis was done using Student’s and Welch’s t
Linear dimensional change tests with Bonferroni–Holm correction for multiple comparisons (˛ = 0.05).
Volumetric dimensional change Results. Statistically significant differences in linear dimensional changes between resins
were demonstrated at all three time intervals of water immersion (p ≤ 0.05), with exception
of the following comparisons which showed no significant difference: IvoBase Hi Impact/SR
Ivocap Hi Impact and PalaXpress/Lucitone 199 after 1 day, Futura Gen/PalaXpress and PalaX-
press/Lucitone 199 after 30 days, and IvoBase Hybrid/IvoBase Hi Impact after 90 days. Also,
statistically significant differences in volumetric dimensional changes between resins were
found at all three time intervals of water immersion (p ≤ 0.05), with exception of the com-
parison between PalaXpress and Futura Gen.
Significance. Denture base resins (IvoBase Hybrid and IvoBase Hi Impact) processed by the
new injection-molding system (IvoBase), revealed superior dimensional precision.
© 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.


Corresponding author at: Department of Prosthodontics, Propaedeutics and Dental Materials, School of Dentistry, Christian-Albrechts
University at Kiel, Germany. Tel.: +49 431 5972877; fax: +49 431 5972860.
E-mail address: selbahra@proth.uni-kiel.de (S. El Bahra).
0109-5641/$ – see front matter © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.dental.2013.07.020
1092 d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 1091–1097

methacrylate) denture base acrylics, processed by their cor-


1. Introduction responding injection-molding system. This was done by
comparing the linear and volumetric dimensional change of
Poly (methyl methacrylate) acrylic resin is commonly used
the processed denture base materials at different time inter-
as removable denture base material. The relative ease with
vals of water storage.
which PMMA may be processed is one advantage of its use as
The null hypothesis was that there is no difference in
a denture base material [1]. To fabricate a denture base with
dimensional changes between the various acrylic resins used
an accurate fit to the oral supporting tissues, there must be
with their specific injection-molding systems.
good control of dimensional stability [2], since the retention
of complete dentures depends, to a large extent, on a good
base adaption and border seal to ensure retention by virtue of 2. Materials and methods
negative pressure [3,4].
Dimensional accuracy is therefore an important property Six denture base resins were selected for this study. The
of denture bases. However, when constructing denture bases materials, manufacturers, proportions of powder to liquid,
from acrylic resins, polymerization shrinkage of the resin and fabrication system, the type of polymerization, and the poly-
distortion of the denture base due to the release of inter- merization parameters are shown in Table 1.
nal stresses induced during processing procedures is virtually
unavoidable [5–8]. These adverse effects cause movement of 2.1. Specimen preparation
the artificial teeth position and increase the gap between the
denture base and underlying mucosa and might result in an In order to fabricate the specimens, a master die was
ill-fitting denture [9–13]. constructed using Invar* metal (CTE ≤ 2 ␮m/◦ C) with the
In contrast, wet storage results in a slight dimensional dimensions given in (Fig. 1).
increase of the denture base caused by water sorption of the *Invar - Controlled Expansion Alloy, Goodfellow, Ermine
acrylic resin. This phenomenon may partially compensate for Business Park, Huntingdon England
the polymerization shrinkage [14–17]. The shape of the master die, double-sided isosceles trape-
Conventional compression molding method has been zoid, enabled direct comparison of linear and volumetric
widely used for the fabrication of denture bases. However, dimensional changes. The vertical walls were fabricated with
a further source of dimensional change associated with this a 10-degree convergence to facilitate removal of the die from
technique can be the inevitable flash resulting from overfill- the investment after the flasking procedure.
ing of the mold, and consequently, more increase in vertical To compare the dimensional changes of the specimens,
dimension of occlusion (VDO) [18–20]. a total of 36 specimens were prepared with 6 specimens for
Attempts to overcome the problems associated with each resin. A wax injection sprue was attached to the shortest
processing of denture base acrylic resins have resulted in the (anterior) side of the master die. Sprue length and diameter
development of the continuous injection system by Pryor [21]. were determined according to manufacturers’ instructions of
Continuous-injection molding eliminates the flash of resin each studied denture base resin. Hereinafter, the master die
between the halves of the flask [20], and allows directional was directly invested in the denture flask by pouring the stone
control of the polymerization process through the flask design (Dura-Halbhartgips grün, Siladent Dr. böhme& Schöps, Goslar,
[22]. A constant flow of new material from the feeding sprue Germany) into the lower half of the flask and embedding the
compensates for the polymerization shrinkage [23]. Various master die in the stone of the lower half of the flask at the
injection-molded denture base materials and processing tech- same height as the level of flask edge. After the stone of the
niques are now available, each claiming to produce more lower half of the flask had set (45 min), the master die and the
accurate denture bases, and the method is more commonly
used.
Several studies evaluating the dimensional accuracy of
denture base materials processed by injection-molding tech-
nique have been conducted using different dimensional
change measuring methods. These changes have been,
mainly, attributed to: (1) the choice of processing system
[24–26], (2) type of polymerization [27].
Despite constant improvements in techniques and mate-
rials, the quest is still to develop a system that can totally
compensate for the processing shrinkage of denture bases [13].
Recently, a new injection device (IvoBase Injector, Ivoclar
Vivadent, Schaan, Liechtenstein) has been introduced to the
profession. This new “all-in-one” injector permits a fully auto-
mated, controlled injection and polymerization process of
newly developed PMMA resins (IvoBase Hybrid, IvoBase Hi
Fig. 1 – Dimensions of the master die used in this study.
Impact) which are coordinated with the system.
Left and right diagrams represent the top and side views of
The current study was conducted to compare the dimen-
the master die, respectively. “a” and “b” indicate the
sional stability of six commercially available poly (methyl
reference points for linear dimensional measurements.
d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 1091–1097 1093

exposed stone surfaces were isolated with Isofix 2000 separa-

Pneumatic injection, 35 min


temperature 40 ◦ C, dry heat

temperature 40 ◦ C, dry heat

Pneumatic injection, water


injection, 35 min, initiating

injection, 50 min, initiating


tor (Isofix 2000 No.1720, Renfert, Hilzingen, Germany).

Manual injection, 30 min,


30 ◦ C-40 ◦ C, bench-curing

30 min, water bath 55 ◦ C,

bath 90 min at 72 ◦ C and


Subsequently, the top half of the flask was placed on the

30 min in boiling water


Pneumatic injection,
bottom half, ensuring complete intimate contact and closure
Electromechanical

Electromechanical
Polymerization

pressure-pot 2 bar
of the halves, and filled with the same stone. All flasks, which
parameters

in boiling water
were used in our study to prepare specimens, were poured
by using vacuum-spatulated stone according to manufactur-
ers’ recommendations and a single pouring technique. After
the stone had set (45 min), the flask was heated and the two
halves of the flask were separated to flush out the wax sprue,
Polymerization

and to remove the master die. Two layers of Sodium alginate


polymerizing

polymerizing

polymerizing

polymerizing

polymerizing

polymerizing
(ISO-K blau, Candulor, Wangen bei Dübendorf, Switzerland)
were applied to the exposed stone surfaces and allowed to dry.
type
Auto-

Auto-

Auto-

Auto-
Heat-

Heat-
Thereafter, the flask was clamped and the powder/liquid mix-
ture of denture base material was prepared to be polymerized.
The investigated denture base resins were mixed according to
UNIPRESS Injection

the respective manufacturer’s instruction. The curing cycles


SR Ivocap Injection

Success Injection
IvoBase Injection

IvoBase Injection
Fabrication

Palajet Injection

were also set in accordance with the manufacturer’s instruc-


system

tions. After the completion of processing, the flask was cooled


to room temperature (24 ◦ C ± 1).
System

System

System

System

System

System

Following processing, the specimen was carefully removed


from the stone mold, and the injection sprue was sectioned
by means of a saw (Isomet 1000 precision saw; Buehler, Lake
Polymer:monomer

Bluff, IL, USA), leaving the specimen’s injection side without


any sprue remains (Fig. 2).
All specimens within each resin group were made from the
ratio

same batch number and stored in (37 ◦ C ± 1) distilled water for


34 g:20 ml

30 g:20 ml

20 g:30 ml

35 g:16 ml

30 g:15 ml

21 g:10 ml

1, 30, and 90 days before being tested.

2.2. Measurements
2010006210 (powder)
2010005960 (liquid)

The measurements obtained from the metal die were used


011095 (powder)

100506 (powder)
Batch no.

as the baseline readings, and all values were calculated with


010471 (liquid)

100406 (liquid)

these measurements as the starting point. All measurements


were carried out by the same investigator. At each time inter-
NM0188

NM0157

N35171

val the specimens were removed from the water and dried by
blotting with absorbent tissue.
Dentsply International Inc.,

2.3. Linear dimensional change measurements


Heraeus Kulzer Gmbh,
Schaan, Liechtenstein

Schaan, Liechtenstein

Schaan, Liechtenstein
Manufacturer

Schütz Dental Gmbh,


Table 1 – Description of tested denture base materials.

Using a digital caliper (Orion, Hahn + Kolb Werkzeuge,


Ivoclar Vivadent AG,

Ivoclar Vivadent AG,

Ivoclar Vivadent AG,

Rosbach, Germany

Stuttgart, Germany), that read to an accuracy of 0.01 mm, 3


Hanau, Germany

York, PA, USA


Abbreviation

IBHY

ICHI
IBHI

LUC
FUT

PLX
SR Ivocap Hi Impact
IvoBase Hi Impact
IvoBase Hybrid

Lucitone 199
PalaXpress
FuturaGen
Product

Fig. 2 – A processed specimen.


1094 d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 1091–1097

repeat readings of the distance between the two reference


points a and b (the tips of the 2 sharp corners at the metal
die) were recorded by the investigator, and the average of the
readings was considered the baseline reading (L0 ).
The prepared specimens were measured following the
same previously described procedure at each protocol interval,
and the mean of the 3 readings was used as the measurement
(L). Subsequently, the percentage of the linear dimensional
change (L) of the studied denture base resins was calculated
as follows:

L − L0
L (%) = 100
L0

Fig. 3 – Linear dimensional change values (−L%) of the


2.4. Volumetric dimensional change measurements denture base materials at three time intervals of water
immersion. Group codes see Table 1.
Archimedes’ principle was used to determine volumetric
dimensional changes. This has been achieved by using an elec-
tronic hydrostatic balance (UW620H, Shimadzu Corporation, dimensional change (V) of the studied denture base resins
Japan) which is accurate to the nearest 0.001 g and consists was calculated as follows:
of combination pans (upper and lower), pan frame, tank, tank V − V0
table, and frame supporters. The electronic hydrostatic bal- V (%) = 100
V0
ance can determine not only the weight but also the density
of specimens based on the buoyancy of a material in fluid,
which means the weight of displaced fluid. Solid specimen
2.5. Statistical analysis
submerged in the medium liquid, which is usually distilled
Since the measurements showed a normal distribution
water, receives buoyancy that equals to the weight of the
(Shapiro–Wilk test) but had differing variances depending
medium liquid of the specimen volume. When the weight of
upon the material, Student’s or Welch’s t test was utilized, as
solid specimen in air and the weight in the medium liquid
appropriate, for all comparisons of statistical significance for
are known, the density of the solid specimen can be obtained
linear and volumetric dimensional changes. The significance
with the density of the medium liquid. The balance computes
level was set at 5% (˛ = 0.05) with a Bonferroni–Holm correction
the solid specimen’s density () according to the below given
for multiple comparisons.
expression, and displays the result. This expression is derived
from Archimedes’ principle.
3. Results
Wa
= 
Wa − Wl l The reference die measurements are illustrated in Fig. 1. The
standard deviation of repeated measurements by using the
Wa : Solid specimen weight in air, Wl : Solid specimen weight
digital caliper and electronic balance were 0.01 mm and 0.2%,
in the medium liquid, l : Density of the medium liquid.
respectively. The linear and volumetric dimensional changes
Firstly, the master die has been weighed on the upper bal-
of all specimens made from the different denture base mate-
ance’s pan. Three weight readings were obtained, and their
rials, at the three time intervals of water immersion, were
mean was considered the baseline reading (W0 ). Secondly, the
smaller (denoted by negative sign) than the corresponding die
die was removed from the upper balance’s pan and placed in
values (Figs. 3 and 4).
the lower balance’s pan immersed in distilled water and the
displayed apparent density was noted. Three density readings
3.1. Linear dimensional change
were obtained, and the mean was considered the baseline
reading (D0 ). This procedure was done with extreme care to
The linear dimensional change mean values measured at the
ensure that no air bubbles adhered to the die’s surface. The
three time intervals of water immersion and standard devia-
volume of the die was calculated as follows:
tions are given in Table 2. After 30 days’ storage in water all
W0 specimens had a general trend of increased linear measure-
V0 =
D0 ments. Specimens continued to exhibit the same tendency of
increased linear measurements up to 90 days of water storage
The calculated volume of the metal die was used as the (Table 2).
baseline reading (V0 ). Statistically significant differences in linear dimensional
The prepared specimens were measured following the changes between resins were found at the three time inter-
same previously described procedure at each protocol interval, vals of water immersion (p ≤ 0.05), with exception of the
and the mean of the three readings was used as the mea- following comparisons (p > 0.05): IvoBase Hi Impact/SR Ivo-
surement (V). Subsequently, the percentage of the volumetric cap Hi Impact and PalaXpress/Lucitone 199 after 1 day,
d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 1091–1097 1095

Table 2 – Mean linear dimensional changes −L%, and standard deviations ( ) of test groups measured after storage in
water for 1, 30, and 90 days.
Product Abbreviation 1 day 30 days 90 days
IvoBase Hybrid IBHY −0.29 (0.01) a
−0.13 (0.02)a
−0.07 (0.02)a
IvoBase Hi Impact IBHI −0.35 (0.02)b −0.19 (0.03)b −0.09 (0.03)a
SR Ivocap Hi Impact ICHI −0.39 (0.05)b −0.33 (0.05)c −0.30 (0.05)b
FuturaGen FUT −1.11 (0.10)c −0.96 (0.11)d −0.87 (0.09)c
PalaXpress PLX −1.25 (0.07)d −1.08 (0.08)de −1.01 (0.08)d
Lucitone 199 LUC −1.28 (0.05)d −1.19 (0.06)e −1.14 (0.06)e
Means with different superscript letters in each column are significantly different at the 95% confidence level.

Table 3 – Mean volumetric dimensional changes −V%, and standard deviations ( ) of test groups measured after storage
in water for 1, 30, and 90 days.
Product Abbreviation 1day 30 days 90 days
IvoBase Hybrid IBHY −1.08 (0.09) a
−0.52 (0.08) a
−0.23 (0.09)a
IvoBase Hi Impact IBHI −1.39 (0.05)b −0.92 (0.07)b −0.56 (0.07)b
SR Ivocap Hi Impact ICHI −3.18 (0.15)c −3.08 (0.16)c −3.01 (0.15)c
PalaXpress PLX −4.75 (0.15)d −4.33 (0.20)d −4.14 (0.17)d
FuturaGen FUT −4.84 (0.17)d −4.49 (0.19)d −4.32 (0.22)d
Lucitone 199 LUC −6.94 (0.32)e −6.65 (0.33)e −6.58 (0.33)e
Means with different superscript letters in each column are significantly different at the 95% confidence level.

FuturaGen/PalaXpress and PalaXpress/Lucitone 199 after 30


days and IvoBase Hybrid/IvoBase Hi Impact after 90 days
4. Discussion
(Table 2).
The objective of this study was to assess the dimensional
changes of acrylic resin specimens fabricated with their spe-
3.2. Volumetric dimensional changes
cific injection-molding technique at three time intervals of
water immersion.
The mean volumetric dimensional change values measured
Generally, the dimensional changes of the denture base
at the three time intervals of water immersion and standard
materials had been evaluated by making specimens of vari-
deviations are given in Table 3. After 30 days’ storage in water
ous shapes [15,22,23,28]. However, many factors such as the
all specimens had a general trend of increased volumetric
shape of the palate [22], the thickness of the denture [7], the
measurements. Specimens continued to exhibit the same ten-
presence of teeth [9,10,29], the type of stone used for cast fab-
dency of increased volumetric measurements up to 90 days of
rication [30], and so on, affect the dimensional changes that
water storage (Table 3).
might occur during processing.
Statistically significant differences in volumetric dimen-
Therefore, to simplify the evaluation of the dimen-
sional changes between resins were found at the three time
sional changes of acrylic resins, specimens with a simple
intervals of water immersion (p ≤ 0.05) with exception of the
shape were used, rather than dentures or denture-shaped
comparison PalaXpress/FuturaGen at all three time intervals
specimens. Thus the results of the dimensional changes
(p > 0.05; Table 3).
could be directly attributed to the acrylic resin and to the
processing method [15,28] and was not influenced by other
factors.
The investigated processed resins exhibited dimensional
changes, but to a significantly different extent. Therefore the
hypothesis that there is no difference in dimensional changes
between the various acrylic resins used with their specific
injection-molding systems has to be rejected. However, all
resins were found to expand during the testing period. This
increase in either linear or volumetric dimensions can be
attributed to the water absorption. This was consistent with
findings of earlier studies [14–17,20].
Volumetric processing dimensional changes of inves-
tigated materials after 1 day of polymerization ranged
from −1.08% to −6.94%. Also, linear processing dimensional
changes of IvoBase Hybrid, IvoBase Hi Impact, and SR Ivo-
Fig. 4 – Volumetric dimensional change values (−V%) of cap Hi Impact after 1 day of polymerization were less than
the denture base materials at three time intervals of water 1%. These findings are in agreement with those of others
immersion. Group codes see Table 1. [1,17,23,31].
1096 d e n t a l m a t e r i a l s 2 9 ( 2 0 1 3 ) 1091–1097

The linear dimensional changes of SR Ivocap Hi Impact and latter two materials, which could contribute to the statistically
Lucitone 199 in our investigation were less than that reported different dimensional changes of them.
by Anderson et al. [15]. In contrast, the linear dimensional In this study, only simple-shape acrylic resin specimens
changes of FuturaGen and PalaXpress were greater than that were used. Accordingly, clinical studies should be conducted
reported by Venus et al. [26]. The differences in results between to establish correlation with laboratory findings. However,
studies could be due to the use of different specimen design for the clinical situation, it would be necessary to take into
or measuring conditions. account the influences on the dimensional accuracy of den-
FuturaGen and PalaXpress showed relatively high values tures from many other factors, such as the size and shape, the
of dimensional changes, in comparison with the other inves- thickness of the denture, and the presence of teeth.
tigated materials with the exception of Lucitone 199, although
these resin materials were already injected into the mold
under a considerable pressure. An explanation for such find- 5. Conclusions
ings can be the polymerization technique [24–26], and the
chemical composition of the material, since the exact nature On the basis of the results and conditions of this study, the
of the material is not disclosed by the manufacturer. As well as, following conclusions are drawn:
it might be attributed to the processing method conditions, in
which the flask clamping tools (flask closure) do not provide a 1. Dimensional precision of acrylic resins polymerized by
sufficient pressure applied to the flasks during polymerization the IvoBase system is more accurate than that of resins
process. processed by the other studied curing techniques.
FuturaGen and PalaXpress are auto-polymerizing denture 2. Despite the statistically significant differences in dimen-
base materials which have slightly different powder/liquid sional stability among the tested denture base materials,
mixing ratios, different respective polymerization protocols, further studies are required to reveal, whether these sig-
and injection-molding systems. However, these two materials nificant differences are clinically relevant.
did not exhibit statistically significant differences regarding
both volumetric dimensional changes at all three time inter-
vals, and linear dimensional changes after 30 days, whereas Acknowledgments
they showed statistically significant differences in linear
dimensional changes after 1 and 90 days of water immersion. Based on a DMD thesis submitted to the Christian-Albrechts
Accordingly, this could suggest that the linear dimensional University at Kiel. The authors wish to express appreciation
changes are not uniformly distributed within the processed for technical assistance and laboratory support from Dr. Mar-
denture base resins. tin Steiner, Rüdiger Möller, Frank Lehmann, Detlev Gostomsky,
IvoBase Hybrid and IvoBase Hi Impact denture base resin Reinhard Busch, and Karsten Radzinsky of Department of
materials exhibited the lowest values of either linear dimen- Prosthodontics, Propaedeutics and Dental Materials, School of
sional or volumetric dimensional inaccuracies in comparison Dentistry, Christian-Albrechts University at Kiel.
with the other evaluated materials, irrespective of water The study was financially supported by Ivoclar Vivadent,
immersion duration. This might be due to the chemical com- Schaan, Liechtenstein which provided also materials and
position of these two materials or the technique conditions, injection systems.
in which the dry heat and pressure applied to the flask, are
digitally controlled during processing procedure.
references
The differences shown in the post-polymerization dimen-
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are interesting. The two materials are manufactured by the
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