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DR.VINAMRA DHARIWAL
14-05-2008
DEFI ITIO :
According to GPT - VI, Denture Base is defined as the part of Denture that rests on the foundation tissue and to which teeth are attached. Denture Base Material is any substance of which denture base may be made
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HISTORY
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WOODEN DENTURES
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In 1794 John Greenwood began to swage gold bases for dentures. Made George Washington's dentures.
George washingtons last dental prosthesis. The palate was swaged from a sheet of gold and ivory teeth riveted To it.The lower denture consists of a single carved block of ivory. The two dentures were held togther by steel Springs.
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CERAMIC
ADVANTAGES over wood, bone , ivory were -Could be shaped using additive technique rather than subtractive (carving). -Additive technique facilitated correction of denture base surface. -this permitted more intimate contact with underlying soft tissues. -Could be tinted to simulate the colors of teeth and oral soft tissues. -stable in oral environment. -Minimal water sorption, porosity, and solubility. -Smooth surface provided hygienic properties.
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Among the drawbacks BRITTLENESS was most significant, fractures were common, often irreparable.
ELSO GOODYEAR
vulcanite dentures in 1864.
Vulcanized hard rubber was discovered and introduced as denture base material (Ebonite). It ruled dentistry until about 1940(during which Vulcanite, Metal and Porcelain became the standard combination.
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Disadvantages It absorbs Saliva and becomes unhygienic due to bacterial proliferation. Esthetics were poor. Dimensionally unstable. Objectionable taste and odor
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CELLULOID DENTURES
In 1868 John Hyatt, A US Printer, discovered the first plastic molding compound, called celluloid. He made it by dissolving nitrocellulose under pressure
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Other cellulose compounds were cellulose acetate, acetate butyrate, ethyl cellulose. Substitute for vulcanite was unsuccessful as It absorbs stains and odors in the mouth, Gradually turns black and was flammable.
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In 1909, another promising organic compound was found. This was phenol formaldehyde resin discovered by Dr. Leo Bakeland . BAKELITE. Disadvantages Variable strength , Lack of uniform quality Variable color , Dimensional instability. Vinyl chloride and vinyl acetate dentures were available from 1932.
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DISADV: 1.Poor esthetics. 2.Increased chances of discoloration if poorly maintained. 3.Casting shrinkage had to be taken in consideration. 4.Relining and rebasing is difficult.
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Listing requirements
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REQUIREMENTS
Requirements of a denture base material can be listed under the following headings: Physical properties Mechanical properties Chemical properties Biological properties Miscellaneous
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PHYSICAL PROPERTIES:
1.AppearanceAn ideal denture base should be capable matching the appearance of the oral soft tissues-depending on whether the base will be visible when the mouth is opened. 2. Glass transition temperature: Should be high enough to prevent softening and distortion during use. 3. Dimensional stability: Should have good dimensional stability in order that the shape of the denture does not change over a period of time. Factors influencing dimensional instability are temperature, internal stresses, continued polymerization &water sorption.
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4.Specific Gravity: Should have a low value of specific gravity in order that dentures should be as light as possible. This reduces the gravitational displacing forces which may act on an upper denture. 5. Thermal Conductivity: A high value would enable the denture wearer to maintain a healthy oral mucosa and to retain a normal reaction to hot and cold stimuli.
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Radio-opacity: The denture base should ideally be RADIOPAQUE. It should be capable of detection using normal diagnostic radiographic techniques. This might be helpful in detection of denture if accidentally swallowed.
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MECHANICAL PROPERTIES
1. 2. The denture base should be rigid therefore a high value of modulus of elasticity is advantageous. A high value of elastic limit is required to ensure that stresses encountered during biting and mastication do not cause permanent deformation. A combination of high modulus and high elastic limit would allow the denture base to be fabricated in thin sections.
3. The denture base should have sufficient flexural strength to resist fracture. Fractures of upper dentures occurring through the midline of the denture are due to flexing.
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4. The base material should have an adequate fatigue life and a high value of fatigue limit. 5. The denture base should have a good impact strength. Impact strength is the ability of the denture base to resist fracture. 6. The denture base material should have sufficient abrasion resistance to prevent excessive wear of material by abrasive denture cleansers or food stuffs.
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CHEMICAL PROPERTIES:
1. Base material should be chemically inert . 2. It should, naturally, be insoluble in oral fluids and should not absorb water or saliva since this may alter the mechanical properties of the material and cause the denture to become unhygienic.
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BIOLOGICAL PROPERTIES:
The denture base materials should not be harmful to the technician involved in its handling in the unmixed or uncured states. The set denture base should be non toxic and non irritant to the patient. The base ideally should be impermeable to oral fluids. If a degree of absorption occurs however, the base should not be able to sustain the growth of bacteria or fungi.
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MISCELLANEOUS PROPERTIES:
An ideal denture base should be relatively inexpensive. It should have a long shelf life. Material should be easy to manipulate and fabricate without having to resort to using expensive processing equipments. It should be easy to repair, if fractures do occur. In addition the denture base should have color stability, absence of taste and odor, adhesion to plastics, metals and porcelains.
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All through the history of the making of dentures, we find a constant struggle of packing all the properties in a single material
Dental material lecture
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In 1937 Dr. Walter Wright gave dentistry its very useful resin. It was polymethyl methacrylate which proved to be much satisfactory material tested until now.
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1.Biological considerations: The resin should be tasteless, odorless, non-toxic and non-irritating to the oral tissues. Should be insoluble in saliva or any other fluids taken into the mouth. Should be impermeable to oral fluids. Should inhibit growth of micro-organisms.
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2. Physical properties: Adequate strength and resilience to resist biting| chewing forces, impact forces and excessive wear. Should be dimensionally stable. Specific gravity should be low.
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3. Aesthetic properties: Should exhibit sufficient translucency or transparency to match the appearance of the oral tissues. Should be capable of being tinted or pigmented. Color stability.
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4. Handling properties: The material should not produce toxic fumes or dust during handling. Ease of manipulation. Oxygen inhibition, saliva contamination and blood contamination should have little or no effect on the final outcome. Should be easy to polish. Should be capable of being easily and efficiently repaired if fracture occur.
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5. Economic considerations: Cost and processing method should of the resin should be low. Processing equipment should be simple and inexpensive.
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o resin has yet met all of these ideal criteria. Methacrylate polymers fulfill the aforementioned requirement reasonably well.
POLYMER RESINS
DEFI ITIO : A polymer is a long chain organic molecule. It is produced by the reaction of many smaller molecules called monomers, or mers. If reaction occurs between two different but compatible monomers the polymeric product is called a COPOLYMER. Resin : A broad term used to describe natural or synthetic substances that form plastic materials after polymerization (GPT-7th edition).
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METHYL METHACRYLATE The acrylic resins are derivative of ethylene and contains a vinyl group (-c=c-) Polyacids tends to imbibe water, due to polarity related to carboxyl group. Water tends to separate the chain and cause softening and loss of strength. Methyl methacrylate is a transparent liquid at room temp. Physical properties -Molecular wt=100 -Melting point=-48 C -Boiling point=100 C -Density=0.945g/ml at 20 C -Heat of polymerization=12.9 Kcal/mol
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POLYMETHYL METHACRYLATE
Transparent resin, transmits light in UV range to a wavelength of 250 nm. it has got remarkable clarity. Hard resin, knoop hardness no of 18 to 20. Tensile strength is 60 MPa Density is 1.19 g/cm cube. Modulus of elasticity 2.4 GPa(2400 MPa) It is chemically stable and softens at 1250C It can be molded as a thermoplastic material between 125 and 200 C Depolarization takes place at approx 450 C . Absorbs water by imbibition Non crystalline structure possess high internal energy. Polar carboxyl group can form hydrogen bridge to a limited extent with water.
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2.Addition polymerization
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STAGES OF POLYMERIZATION
INDUCTION PROPAGATION TERMINATION CHAIN TRANSFER
Dental material lecture
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COPOLYMERIZATION:
When 2 or more chemically different monomers combine to form macromolecules or COPOLYMERS, the reaction is said to be COPOLYMERIZATI ON.
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CROSS-LINKING:
Cross-linking is formation of molecular networks through joining or bridging linear polymers through certain reactive side chains. Cross-linkage provides a sufficient no., of bridges between the linear macromolecules to form a three-dimensional network that alters the strength, solubility, and water sorption of the resin.
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POWDER Polymer of PMMA in the form of spheres or beads. Benzoyl peroxide is attached to it (initiator) 0.5% Plasticizer is incorporated (methacrylate or acrylate monomer). Coloring pigments cadmium/ organic dyes/ iron are added for esthetics.
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LIQUID
Methyl methacrylate monomer Cross linking agent Ethylene glycol dimethacrylate(5-15%).they are added to avoid crack or craze produced by stresses during drying. Inhibitor Hydroquinone (trace) to avoid premature polymerization and enhance shelf life.
As a rule,heat activated denture base are shaped via compression molding technique.
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HEAT ACTIVATED DENTURE BASE RESINS Composition: Powder: 1. prepolymerized spheres of poly(methylmetha-acrylate). 2 . Initiator benzoyl peroxide Liquid: 1 . Unpolymerized methyl metha acrylate. 2 . Inhibitor hydroquinone to prevent undesirable polymerization or setting of the liquid during storage. 3 . Cross linking agent glycol di methacrylate.
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Activator: heat. Thermal energy required for polymerization may be provided using a. water bath b. micro wave oven. Polymer : monomer ratio 3 : 1. This ratio will reduce volumetric shrinkage from 21% to 6%
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Processing techniques : Commonly employed technique to shape a heat activated resin - compression molding technique. The other technique is injection molding technique, For which specially designed flask is used. Commonly used resin is polystyrene resin. After shaping denture base resin is polymerized.
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Polymer monomer interaction When polymer and monomer are mixed it passes through following stages Sandy Stringy Dough like Rubbery or elastic Stiff
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Dough forming time According to ANSI/ADA specification no 12 for denture base resins requires that this consistency be reached in less than 40 min from start of mixing time. In clinical use it is achieved in less than 10 min. Working time Time that a denture base remains in a dough like stage.ANSI/ADA specification no 12 requires the dough to remain moldable for 5 min.
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2)AUTOPOLYMERIZI G/COLD CURE POLYMETHYL METHACRYLATE (POUR RESI ) Composition same as the heat cure version with following differences 1)The powder contains beads of polymer that have a lower molecular wt. and benzoyl proxide (initiator) 2) The liquid contains a chemical activator ,tertiary amine such as dimethyl-para-toluidine. Upon mixing tertiary amine causes decomposition of benzoyl peroxide.
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Dentures processed have more residual monomer (1-4%),but lower dimensional change. Decreased transverse strength (residual monomer act as plastisizer). Compromised biocompatibility (residual monomer) Color stability inferior (teriaty amine susceptible to oxidation), stabilizing agents should be added
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Fluid resin and compression molding technique can be employed for the fabrication of denture. Also used as repair material
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CHEMICALLY ACTIVATED DENTURE BASE RESINS: Activator: addition of tertiary amine(di methylpara-toluidine) to the liquid component. Advantage: greater dimensional accuracy because of less complete polymerization there by less shrinkage. Processing shrinkage: chemical cure = 0.26% heat cure = 0.53%
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DIS ADVANTAGES: 1. Degree of polymerization not as complete as heat cured ones more of free monomer which leads to a. tissue irritation. b. acts as a plasticizer resulting in decreased transverse strength and dimensional instability. Free monomer chemical cure = 3 5%. heat cure = 0.2 0.5% Can be over come by ensuring complete polymerization- holding the flask under pressure for minimum of 3 hrs though initial hardening occurs in 30 min.
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2.Color stability is inferior to that of heat cured one presence of tertiary amine which oxidises easily. Discoloration can be minimized by addition of stabilizing agents to prevent oxidation. Processing techniques: 1 .compression molding technique. 2 .fluid resin technique employs a pour able, chemical cured resin. Supplied as powder and liquid, which when mixed in proper ratio yield a low viscosity resin. resin is poured into the mold cavity subjected to increased atmospheric pressure and allowed to polymerize.
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Advantages: Improved adaptation to the underlying soft tissues. Decreased damage to prosthetic teeth and denture bases during deflasking. Reduced material cost. Simplification of flasking, deflasking and finishing procedures. Disadvantages: Shifting of teeth during processing. Air entrapment within the resin. Poor bonding between the denture base and the teeth. Technique sensitive.
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Electron micrograph of high impact denture Base showing size and shape of polystyrene-butadiene Rubber inversion phase.
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5) RAPID HEAT POLYMERIZED POLYMER Same as conventional material except that they contain altered initiation system. These initiator allow them to be processed in boiling water for 20 min. A problem with these is that areas of the base thicker than approx.6mm have a high level of porosity. Short duration of heating also leaves a higher level of residual monomer,3-7 times greater than conventional heat cured denture base.
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POLYMERIZATION VIA MICRO WAVE ENERGY: Technique employs a specially formulated resin and a nonmetallic flask. A conventional microwave oven is used to supply the thermal energy required for polymerization. Advantage is the speed, with which polymerization is accomplished. Micro wave polymerization is an effective way of processing acrylic resins. Resultant denture bases appear extremely dense Significant porosity was reduced when conventional resins were polymerized using microwave. Micro wave processed dentures provide best fit to be compared with auto polymerizing resin.
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Light activated denture base resins: Composition: composite having a matrix of a. urethane-di-methacrylate. b. micro fine silica. c. high molecular weight acrylic resin monomers. d. fillers-acrylic resin beads. e. initiator-camphoro quinone Activator visible light.
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Single component denture base resin is supplied in sheet and rope forms and packed in light proof pouches to prevent inadvertent polymerization. It cannot be flasked in a conventional manner as the normal investing medium is an opaque material. Hence teeth are arranged and the denture base is molded on an accurate cast. Subsequently the material is exposed to a high intensity visible light source far an appropriate period. various methods were used to adapt these resin sheets to cast but vacuum forming produce the best adaptation.
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8) FIBER REI FORCED POLYMER Glass, carbon/graphite, aramid and ultrahigh molecular wt polyethylene have been used as fiber reinforcing agents. Metal wires like graphite has minimal esthetic qualities. Fibers are stronger than matrix polymer thus their inclusion strengthens the composite structure. The reinforcing agent can be in the form of unidirectional, straight fiber or multidirectional weaves.
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Physical properties of denture base resins: 1. Polymerization shrinkage: when pure monomer is polymerized there is a volumetric shrinkage of 21% but when mixed with polymer in 3:1 ratio it reduces to 7% and this is distributed uniformly to all surfaces , hence produce clinically satisfactory results.
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Whereas linear shrinkage exerts significant effects on denture base adaptation. Based on the above value-7%, this should be 2%. Thermal shrinkage is the primary cause for the linear shrinkage.
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2.POROSITY: Presence of surface and subsurface voids compromise the physical, aesthetic, and hygienic properties of a processed denture base. Could be due to: a. inadequate mixing of polymer and monomer---large voids resulting from localized polymerization shrinkage. Can be minimized by ensuring the greatest possible homogeneity of the resin.(proper polymermonomer ratio).
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b. rapid heating of the resin--- causes localized subsurface porosity near the center of the investment mass. c. inadequate pressure or insufficient material in the mold during polymerization -----irregular large voids, make the denture more opaque.
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3. WATER SORPTION: PMMA absorbs relatively small amounts of water when placed in aqueous environment. Ingress of water is by diffusion. this causes a slight expansion of the polymerized mass and also water interfere with entanglement of polymer chain , thereby act as plasticizer. Water sorption=0.69mg\cm2.
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4. SOLUBILITY: Though soluble in some solvents , virtually insoluble in oral fluids. 5. CRAZING: Stress relaxation may sometimes produce small surface flaws or micro cracks ----CRAZING. Adversely affect aesthetic and physical properties. Imparts a hazy appearance, also predisposes to fracture. Generally begins at the surface of a resin, oriented at right angles to tensile stress.
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6. STRENGTH: Depends on composition, processing technique and oral environment. 7. CREEP: Denture resins when subjected to sustained load, the material exhibits an initial deflection. If the load is not removed,additional deformation may occur over time----CREEP.Creep rate increase with in temperature, applied load, residual monomer and presence of plasticizer.
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ADVA TAGES OF DENTURE BASE RESINS: Ease of manipulation and processing. Good esthetic quality. Rebasing and relining possible. Cost effective. Disadvantages: Poor thermal conductivity Polymerization shrinkage. Bulk. Color instability.
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Internal plasticization by co-polymerization may improve strength properties. Cross-linking is a special case of co-polymerization. In general cross-linking lowers strength and flexibility but increases solvent resistance, softening point and hardness
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One disadvantage of cross-linking is the reduction of bonding between acrylic resin teeth and the base which may occur particularly with a cold curing base material Reinforcement by glass fibers is easily accomplished. This is done by mixing discrete fibers with dough or by combination with glass cloth
Specially primed glass is necessary to bring out good adhesion to the resin and to maintain it particularly in wet conditions. In the dough fiber method, the percentage of glass which can be incorporated is limited to about 20% by weight because of reduction of flow of the dough
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Alternatives to methacrylate materials Most alternatives to polymethacrylate are vinyl acrylic, polysterene, acrylic styrene, acrylonetrile copolymers . EW PLASTIC MATERIAL High impact methacrylates (IM): These are basically similar to standard methacrylate but have a higher impact and fatigue strength. Epoxy resins (E): The general properties of these materials are strength, hardness, toughness, low curing shrinkage and good adhesion to metals. The disadvantages for dental use are the toxicity, the yellow colour which darkens further, high water absorption, poor adhesion to vinyl polymers
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ylon materials: They were found to be unsatisfactory for denture base because of high molding shrinkage which led to warpage, high water absorption and yellowing. High impact polystyrene (IS): This is an elastomer graft copolymer with styrene. It is basically similar to polysterene and injection molded in a similar way. High density polythene (DE): This is stiffer stronger variety of polyether. Polypropylene (PP): this is a hydrocarbon polymer similar to polyethylene but stiffer and stronger. Polyacetal (A): Also called polyformaldehyde. It has lower water absorption with good resilience and toughness, and resistance to fatigue
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Polycarbonate (PE): It is thermoplastic material with low water absorption and very high impact strength and toughness. Chlorinated polyether: It has very low water absorption and low mold shrinkage with excellent resistance to staining and chemical agents
Eclipse prosthetic resin system is a new method of fabricating dentures from Dentsply International. It is being marketed as an indirect build-up method for fabricating dentures that is monomer-free and flask-free. Eclipse is a light-cured system that does not contain any ethyl-, methyl-, butyl-, or propyl-methacrylate monomers. System uses three resins to form the denture: Baseplate Resin, Set-up Resin and Contour Resin. The resins were developed to handle like wax, yet be cured into a denture base material without investing and flasking.
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VALPLAST Valplast is a flexible denture base resin that is ideal for partial dentures and unilateral restorations. The resin is a biocompatible nylon thermoplastic ,it eliminates the concern about acrylic allergies.
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MISCELLA EOUS RESI S A D TECH IQUES : 1. REPAIR RESINS: May be light or chemical or heat activated. Chemical resins are more preferred because they polymerize at room temperature. Heat and light activated should be kept in water- bath and light chambers respectively.
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2. RELINING RESIN DENTURE BASES: Relining involves replacement of tissue surface of an tissue surface of an existing denture . Rebasing is replacement of the entire denture base. May be heat, light, microwave energy activated resins
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Introduction
Dentures are rigid pieces of acrylic resin which are shaped to fit the soft tissue covering of the jaw and to be compatible with the functioning and ever-changing oral environment. -Heartwell
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Dentures need to be serviced to keep pace with changing foundation The clinical effort that aim at prolonging the useful life of complete dentures involve a refitting of the impression surface of the denture by means of a reline or a rebase procedure -Boucher
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Definitions
Relining the procedure used to resurface the tissue side of a denture with a new base material, thus producing an accurate adaptation to the denture foundation area. - G.P.T-7
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Relining it is the process of adding some material to the tissue side of a denture to fill the space between the tissue and denture base -Winkler
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Rebasing the laboratory process of replacing the entire denture base material on an existing prosthesis. -G.P.T-7 Rebasing is a process of replacing all the base material of a denture. -Winkler
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Material science
Denture liners
Hard liners
Soft liners
Acrylic
Silicone
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Soft liners
Acrylic
silicone
Heat activated
Chemically activated
Heat vulcanizing
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3. SOFT LINERS: Purpose ----to absorb some of the energy produced by masticatory impact. Commonly used are plasiticized acrylic resins. May be heat or chemical activated. Can be a. Short term liners. b. Long term liners. Chemical soft liner-----poly(methyl\ethyl methacrylate), supplied in powder form and liquid contains 60% to 80% of plasticizer(dibutyl phthalate)----SHORT TERM SOFT LINERS. Do not contain acrylic monomers.
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Heat- activated materials generally are durable and may be considered LONG TERM SOFT LINERS and not permanent liners. Supplied as powder-liquid system. Powderacrylic resin polymers and copolymers. Liquid----acrylic monomers and plasticizer When mixed form pliable resins. Plasticizer are prone for leaching which can be minimized by decreasing its content. Leaching makes a material rigid.
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When ethyl, n-butyl,and n-propyl are used, less plasticizer is required. Now, the most successful material is silicone rubber , can be heat or chemical activated. To promote adhesion between silicone and resin denture base , rubber cements are used. Other polymers used are polyurethane and polyphosphazine.
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Relining technique
IMPRESSION
FUNCTIONAL
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4. RESI IMPRESSIO TRAYS A D TRAY MATERIALS: Resin trays used to fit specific arches--custom trays. Most of the cases the material is chemical cure poly(methyl methacrylate). Recently, light activated urethane dimethacrylate resins have also been used but these are brittle and release fine powder particles during grinding.
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DENTURE CLEANSERS : 1. Dentifrices 2. Proprietary denture cleansers 3. Mild detergents 4. Bleaches 5. Vinegar. Both immersion and brushing technique are used. Most common is immersion type using cleansing powder or tablets.
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RESIN TEETH: 60% Of artificial teeth are made of acrylic or vinyl- acrylic resins with the a degree of cross- linking more than that in a denture base resin and thereby with increased stability and improved clinical properties. This increase is achieved by elevating the monomer(cross- linking agent)in the liquid. when compared with porcelain teeth, resin teeth are
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When compared with porcelain teeth, resin teeth : 1. Display more fracture toughness. Hence less likely to chip or fracture when denture is dropped. 2. Chemically bond with denture bases. 3. Easier to adjust and exhibit greater resistance to thermal shock.
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MAXILLO FACIAL MATERIALS: 1. Latexes : Soft , inexpensive materials but are weak, degenerate rapidly, exhibit color instability and cause allergic reactions. Recently developed synthetic latex --tripolymer of butyl acrylate, methyl methacrylate and methyl methacrylamide transparent,colorants can be sprayed to improve translucency and blending. Lengthy processing, short life are disadvantages.
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2. Vinyl plastisols : Plasticized vinyl resins---- colorants can be added to match skin tones . Disadv---- harden with age, uv light has adverse effects on these materials. 3.Polyurethane polymers : Most recent material to be used, requires accurate proportioning of three components. Has a natural feel and appearance. Disadv----susceptible to deterioration rapidly
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4. Silicone rubbers : 2 types are----1.Heat Vulcanizing 2.Room temperature vulcanizing. Room temperature supplied as single paste system colored by addition of dyed rayon fibers, dry earth pigments and oil paints. Not strong as heat vulcanizing. Heat vulcanizing supplied as puttylike that requires milling, packing under pressure and 30 minute heat application at 180 c. Better strength and color stability. Lengthy procedure, not economical.
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