Alfouzan AF, et al. J Adv Prosthodont. 2021 Jun;13(3):160-171. https://doi.org/10.4047/jap.2021.13.3.160

This study assessed the efficacy of five denture cleansers on the microbial adherence and surface topography of conventional and CAD/CAM denture base resins. Acrylic resin discs were fabricated using conventional, milling, and 3D printing methods (N = 180). The discs were contaminated with dual species of Candida albicans and Streptococcus mutans biofilm for 72 h and then disinfected with either of the denture cleansers (Fittydent cleansing tablets, 2% Chlorhexidine gluconate, 0.2% Chlorhexidine gluconate, 0.5% sodium hypochlorite, and 1% sodium hypochlorite (n = 10). Distilled water served as the control group. The colony-forming units of the microorganisms were calculated, followed by post-treatment surface roughness. Data were statistically analyzed using one-way ANOVA, paired t-test, and post hoc Tukey HSD test (α = 0.05). Among the denture cleansers, 2% Chlorhexidine gluconate, 0.5% sodium hypochlorite, and 1% sodium hypochlorite had the best cleansing effect on the resin discs and demonstrated zero growth of colonies for both the species. Comparing the material groups, the 3D-processed discs showed higher colony-forming units followed by the conventional and CAD/CAM milled group. The highest surface roughness was demonstrated by the 3D-printed discs (0.690 ± 0.08 μm), followed by the conventional (0.493 ± 0.11 μm) and the milled groups (0.301 ± 0.08 μm). The tested chemical denture cleansers affected the Candida albicans and Streptococcus mutans adhesion compared to control discs immersed in distilled water. The clinician may recommend to their patient to use 2% chlorhexidine gluconate for the disinfection of CAD/CAM PMMA denture base materials.

This study aimed to measure the effect of storage environment on the hardness, surface roughness and wear ability of CAD/CAM resin-matrix ceramics. A total of 200 rectangular-shaped specimens were obtained by sectioning 5 CAD/CAM blocks; Crystal Ultra (CU), Vita Enamic (VE), Lava Ultimate (LU), Cerasmart (CS) and Vita blocks Mark II (MII). Microhardness and surface roughness were measured at baseline and after 7 days of immersion either in saliva or cola (n = 10). The wear ability of the CAD/CAM materials against steatite-ceramics antagonist was determined using a chewing simulator. The data were statistically analyzed using factorial ANOVA followed by post hoc Bonferroni multiple comparison tests (p < 0.05). The independent factors significantly influenced the microhardness and surface roughness (p < 0.05). The highest VHN was observed in MII at baseline (586.97 ± 13.95), while CU showed the lowest VHN after 7 days of immersion in cola (68.3 ± 1.89). On the contrary, the highest Ra was observed after 120,000 chewing cycles for the VE specimens (1.09 ± 0.43 µm) immersed in cola, while LU showed the lowest Ra at baseline (0.07 ± 0.01 µm). The highest % mass loss of the antagonist was observed with MII immersed in cola (1.801%), while CS demonstrated the lowest % mass loss of 0.004% and 0.007% in AS and cola, respectively. This study confirms that the surface properties of tested CAD/CAM materials are susceptible to degradation in an acidic environment except for hardness and wear of CS material.

This study aimed to evaluate the airborne-particle abrasion surface treatment effects on the tensile bond strength (TBS) between resilient denture liner and CAD/CAM or conventional heat polymerized poly (methyl methacrylate) (PMMA) acrylic denture resins. A total of 48 dumbbell-shaped specimens (70 mm in total length, and 12 mm and 7 mm in diameter at the thickest and thinnest section, respectively) were prepared from CAD/CAM and conventional acrylic resins. Before relining with denture liner, 12 specimens from each material were surface-treated by 110 µm Al₂O₃ airborne-particle abrasion, and the remaining specimens served as control (no treatment). Following relining, all the specimens were aged by thermal cycling (1000 cycles, 5–55 °C). The TBS of denture liner to acrylic denture resins was tested in a universal testing apparatus at a 5 mm/min crosshead speed. The debonded surfaces were visually examined for the failure modes. ANOVA and multiple comparisons posthoc analysis tests were applied to determine the significant difference in TBS between the study groups (α = 0.05). A significant difference in TBS was observed between the control and surface treated groups (p < 0.001) for both acrylic resins materials. However, there was no statistically significant difference in bond strength between the acrylic resins materials (p = 0.739). Surface treatment with airborne-particle abrasion demonstrated increased TBS of the soft denture liners to acrylic resins. The TBS of conventional and CAD/CAM acrylic resins to soft denture liners were not considerably different.

This study evaluates the repair bond strength of resin-matrix and glass-matrix CAD/CAM ceramic materials based on two repair systems. Thirty specimens measuring 2.5 mm in thickness were prepared from Crystal Ultra (CU), Vita Enamic (EN), Lava Ultimate (LU), Cerasmart (CS), and Vitablocs Mark II (VM2) materials and aged for 5000 thermal cycles. Specimens were randomly allocated into three groups: control, Monobond-S (MS) primer, and Monobond Etch & Prime (MEP). Composite resin (Tetric N Ceram) (5 mm in diameter and 2 mm thick) was packed and light-cured onto treated specimen surfaces. Subsequently, the specimens’ shear bond strength (SBS) was evaluated, and failure modes was recorded. Statistical analysis was performed using factorial ANOVA and Tukey’s post hoc tests (a = 0.05). The factorial ANOVA revealed significant interactions between the material type and repair system, which was significant (p < 0.01). The highest and lowest SBS were obtained for CU (27.09 ± 1.11) and VM2 (4.30 ± 0.59) in MS and control groups, respectively. In all the groups, CU demonstrated higher SBS, whereas VM2 demonstrated lower SBS. There were no significant differences in SBS between EN and LU, and CS and CU in all the study groups (p > 0.05). The Monobond-S repair system provided non-significantly higher SBS compared to the MEP systems, except for VM2 and LU materials. The new resin-matrix CAD/CAM material demonstrated the highest SBS compared to the other materials for both conventional and MEP repair systems. Both repair systems showed clinically acceptable bond strength and allowed for successful repair of the resin-matrix ceramic materials.

The aim of the present study was to evaluate and compare the effect of thermal-cycling, mechanical brushing and beverage storage on the colour changes and surface roughness of conventional heat-polymerized and CAD/CAM PMMA used to fabricate complete dentures. A total of 100 specimens measuring 10 mm in diameter and 3 mm in thickness were fabricated from conventional PMMA resin (Heat-cured, Major. Base.20, Moncalieri, Italy) and CAD/CAM blocks (Opera system, Principauté de Monaco, French). The specimens were subjected to a combined surface treatment involving thermo-cycling, mechanical brushing, and immersed in either artificial saliva (AS), coffee, tea, Coca-Cola, or lemon juice. Colour differences (ΔE) and surface roughness (Ra) was determined using a spectrophotometer and non-contact profilometer, respectively. The data were analyzed using IBM SPSS v.20 (α = 0.05). Factorial ANOVA showed that independent factors, namely material, beverages, and the interaction between independent factors, significantly influenced ΔE (F = 76.862; p < 0.001) and surface roughness (F = 71.685; p < 0.001). The overall highest and lowest colour differences was obtained for CAD/CAM PMMA (ΔE = 1.93 ± 1.29) and conventional PMMA (ΔE = 1.41 ± 1.39) resins, respectively (p = 0.061). Conventional PMMA (1.22 ± 0.20) demonstrated significantly increased roughness compared to CAD/CAM PMMA (0.91 ± 0.17) (p < 0.001). Pearson correlation showed a low degree of correlation, which was non-significant for both the PMMA (r = 0.015; p = 0.917) and C-PMMA materials (r = 0.097; p = 0.505). CAD/CAM milled PMMA resins demonstrated greater colour change and lower surface roughness compared to conventional heat-polymerized PMMA resins. Specimens in tea and coffee demonstrated maximum colour changes and were perceivable by the human eye. On the contrary, specimens immersed in low pH acidic beverages namely Coca-Cola and lemon juice demonstrated maximum surface roughness.