METHODS: A prospective study was conducted to evaluate the outcome of a new reconstruction technique that produces patient-specific hybrid polymethyl methacrylate-autologous cranial implant. Computer-assisted 3D modeling and printing was utilized to produce patient-specific molds, which allowed real-time reconstruction of bone flap with partial defect intra-operatively.
RESULTS: Outcome assessment for 11 patients at 6 weeks and 3 months post-operatively revealed satisfactory implant alignment with favorable cosmesis. The mean visual analog scale for cosmesis was 91. Mean implant size was 50cm, and the mean duration of intra-operative reconstruction was 30 minutes. All of them revealed improvement in quality of life following surgery as measured by the SF-36 score. Cost analysis revealed that this technique is more cost-effective compared to customized cranial prosthesis.
CONCLUSION: This new technique and approach produce hybrid autologous-alloplastic bone flap that resulted in satisfactory implant alignment and favorable cosmetic outcome with relatively low costs.
MATERIALS AND METHODS: Using a stainless-steel mold, disc-shaped wax patterns with dimensions of 10 mm in diameter and 2 mm thick (in accordance with ADA Specification No. 12) were created and prepared for a total of 75 acrylic samples. Dimensions of all 75 acrylic samples were checked with a digital Vernier caliper. About 25 samples of denture base material were immersed in three different chemical disinfectants: Group I: immersed in chlorhexidine gluconate solution, group II: immersed in sodium hypochlorite solution, and group III: immersed in glutaraldehyde solution. All samples were scrubbed daily for 1 minute with the appropriate disinfectant and submerged for 10 minutes in the same disinfectant. Between disinfection cycles, samples were kept in distilled water at 37°C. Color stability was measured using a reflection spectrophotometer. Surface roughness values were measured by a profilometer at baseline following 15 days and 30 days.
RESULTS: After 15 days, the color stability was better in chlorhexidine gluconate solution group (4.88 ± 0.24) than sodium hypochlorite solution (4.74 ± 0.18) and glutaraldehyde solution group (4.46 ± 0.16). The mean surface roughness was less in glutaraldehyde solution group (2.10 ± 0.19), followed by chlorhexidine gluconate solution group (2.48 ± 0.09) and sodium hypochlorite solution group (2.64 ± 0.03). After 30 days, the color stability was significantly better in chlorhexidine gluconate solution group (4.40 ± 0.02), followed by sodium hypochlorite solution (4.06 ± 0.16) and glutaraldehyde solution group (3.87 ± 0.17). The mean surface roughness was significantly lesser in glutaraldehyde solution group (2.41 ± 0.14), followed by chlorhexidine gluconate solution group (2.94 ± 0.08) and sodium hypochlorite solution group (3.02 ± 0.13).
CONCLUSION: In conclusion, the color stability was significantly better in chlorhexidine gluconate solution group than sodium hypochlorite solution and glutaraldehyde solution group. But the surface roughness was significantly lesser in the glutaraldehyde solution group, followed by the chlorhexidine gluconate and sodium hypochlorite solution group.
CLINICAL SIGNIFICANCE: The maintenance of the prosthesis requires the use of a denture disinfectant; therefore, it is crucial to select one that is effective but would not have a negative impact on the denture base resin's inherent characteristics over time. How to cite this article: Kannaiyan K, Rakshit P, Bhat MPS, et al. Effect of Different Disinfecting Agents on Surface Roughness and Color Stability of Heat-cure Acrylic Denture Material: An In Vitro Study. J Contemp Dent Pract 2023;24(11):891-894.
METHODS: Silanated, titanated and pure NBT at 5% were incorporated in PMMA matrix. Neat PMMA matrix served as a control. NBT was sonicated in MMA prior to mixing with the PMMA. Curing was carried out using a water bath at 75°C for 1.5h and then at 100°C for 30min. NBT was characterised via Fourier transform-infrared spectroscopy (FTIR), Transmission Electron Microscopy (TEM) and Brunauer-Emmett-Teller (BET) analysis before and after surface modification. The porosity and fracture toughness of the PMMA nanocomposites (n=6, for each formulation and test) were also evaluated.
RESULTS: NBT was successfully functionalised by the coupling agents. The TCA exhibited the lowest percentage of porosity (0.09%), whereas silane revealed 0.53% porosity. Statistically significant differences in fracture toughness were observed among the fracture toughness values of the tested samples (p<0.05). While the fracture toughness of untreated samples was reduced by 8%, an enhancement of 25% was achieved after titanation. In addition, the fracture toughness of the titanated samples was higher than the silanated ones by 10%.
CONCLUSION: Formation of a monolayer on the surface of TCA enhanced the NBT dispersion, however agglomeration of silanated NBT was observed due to insufficient coverage of NBT surface. Such behaviour led to reducing the porosity level and improving fracture toughness of titanated NBT/PMMA composites. Thus, TCA seemed to be more effective than silane.
CLINICAL SIGNIFICANCE: Minimising the porosity level could have the potential to reduce fungus growth on denture base resin to be hygienically accepTable Such enhancements obtained with Ti-NBT could lead to promotion of the composites' longevity.
METHODS: PMMA pellets were prepared with three separate concentrations of each of the two antibiotics tested. They were tested to determine the effect of increasing concentration of antibiotics on the biomechanical properties of PMMA and antibiotic activity by measuring the zone of inhibition and broth elution assay.
RESULTS: Ceftaroline PMMA at 3 wt%, three-point bending was 37.17 ± 0.51 N ( p < 0.001) and axial loading was 41.95 N ± 0.51 ( p < 0.001). At 5-wt% vancomycin-PMMA, three-point bending was 41.65 ± 0.79 N ( p = 0.02) and axial loading was 49.49 ± 2.21 N ( p = 0.01). Stiffness of ceftroline-loaded PMMA in low and medium concentration was significantly higher than the vancomycin. The zone of inhibition for ceftaroline was higher than vancomycin. Ceftaroline at 3 wt% eluted up to 6 weeks (0.3 ± 0.1 μg/ml) above the minimum inhibitory concentration (MIC) and vancomycin at 2.5 wt% eluted up to 3 weeks, same as MIC, that is, 0.5 ± 0.0 μg/ml.
CONCLUSIONS: Ceftaroline, loaded at similar concentrations as vancomycin into PMMA, is a more potent alternative based on its more favourable bioactivity and elution properties, while having a lesser effect on the mechanical properties of the cement. The use of 3-wt% ceftaroline as antibiotic laden PMMA against MRSA is recommended. It should be noted that this was an in vitro study and to determine the clinical efficacy would need prospective, controlled and randomized studies.