A review on enhancements of PMMA Denture Base Material with Different Nano-Fillers

Figures & data

Figure 1. The treatment mechanism for (a) Titanate treated mechanism illustrating three sites of reaction. (b) Silane-treated illustrating one site of reaction

Table 1. Mean flexural strength (MPa), standard deviation, minimum and maximum values

Groups	Mean ±SD	Minimum	Maximum	P value
A(control)	85.10 ± 2.34	81	89
B (0.5%)	86.22 ± 1.71	85	90	0.85
C (1%)	85.20 ± 1.44	82	87	1.00
D (2.5%)	90.51 ± 3.36	84	95	0.000
E (5%)	80.15 ± 3.17	76	86	0.001

Table 2. Mean Vickers hardness number (kg/mm2), deviation, minimum and maximum values

Mean Vickers hardness number (kg/mm2),deviation, minimum and maximum values.				standard
Groups	Mean ±SD	Minimum	Maximum	P value
A(control)	14.33 ± 1.3	12.2	16.2
	3
B (0.5%)	15.11 ± 1.5	13	17.5	0.73
	5
C (1%)	15.58 ± 1.1	14	17.5	0.3
	4
D (2.5%)	16.46 ± 1.2	14.1	18	0.01
	6
E (5%)	17.57 ± 1.5	14.8	20.6	0
	7

Figure 2. Surface morphology of dentures reinforced by; a- 5wt. % and; b- 7wt. % of salinized nano ZrO2 filler (Safi & Moudhaffar, 2011)

Table 3. The summary of ZrO2 additive fillers and its effect on denture base acrylic resin

^Material/ZrO2	Increase/Improve	Decrease/Weaken/no effect	Comments
	Flexural strength (Asar et al., 2013,Asopa et al., 2015)	Flexural strength, impact strength,	Observable
^ZrO2	Impact strength, fracture toughness, and hardness (Asar et al., 2013,Franklin et al., 2005)	and surface hardness (Asopa et al., 2015,Al-Rais et al., 2005) Water solubility and water	improvement in denture base
	Water sorption and solubility(Vojdani et al., 2012)	sorption(Ayad et al., 2008,Asopa et al., 2015)	properties with
	Impact strength, Flexural strength and radio opacity		zirconia NPs
	(Hajian et al., 2011,Asar et al., 2013,Sehajpal & Sood, 1989)		incorporation.
^ZrO2 ^NPs	Compressive strength, fatigue strength, fracture		Silanized zirconia NPs
	toughness, and hardness (XJ Zhang et al., 2011,Salih et al., 2015,Ahmed & Ebrahim, 2014)		resulted in superior
	Color properties(Cierech, Kolenda et al., 2016)		mechanical
	Flexural strength, Impact strength, and hardness		properties and
^Salinized ZrO2 ^NPs	(Hajian et al., 2011,X Zhang et al., 2012) Surface roughness slightly increased and decreased		adequate surface properties of PMMA
	water sorption and solubility(Hajian et al., 2011,X Zhang et al., 2012,Vojdani et al., 2012)		denture base resin.
Zirconia nanotubes	Flexural strength (Ayad et al., 2008,Asopa et al., 2015)

Table 4. Viable cell counts of Candida albicans, Lactobacillus acidophilus and Streptococcus mutans biofilms in non-UV activated resin and following activation with UV irradiation in a conventional denture base acrylic resin (Naji, Behroozibakhsh et al., 2018)

Microbial strains (CFU ml^−1)(mean ± SD)
Non-UV irradiated samples				UV irradiated samples
Groups	C. alibicans	L. acidophilus	S. mutans	C. alibicans	L. acidophilus	S. mutans
Control	6.43 ± 0.020	6.36 ± 0.036	6.20 ± 0.020	6.33 ± 0.057	6.28 ± 0.036	6.17 ± 0.024
^TiO2^−2.5%	6.36 ± 0.016	6.27 ± 0.020	6.13 ± 0.013	6.14 ± 0.027	6.02 ± 0.017	5.86 ± 0.076
^TiO2^−5%	6.18 ± 0.040	6.07 ± 0.034	5.99 ± 0.038	4.86 ± 0.083	4.46 ± 0.141	4.39 ± 0.080

Table 5. The summary of TiO2 additive fillers and its effect on denture base acrylic resin

^Material/TiO2	Increase/Improve	Decrease/Weaken/no effect	Comments
^TiO2	Flexural strength, fracture toughness, and hardness (Murakami et al., 2013,Guo et al., 2012,Al-Rais et al., 2005,Safi & Moudhaffar, 2011)	Flexural strength(Guo et al., 2012,Al-Rais et al., 2005)	^TiO2 ^NP addition improves the mechanical and surface properties of denture base resin as well as thermal conductivity. An extra improvement was noticed with titanate coupling of agents.
^TiO2 ^NPs	Impact strength, water sorption and solubility (Murakami et al., 2013, Zhang & Matinlinna, 2011, Salih et al., 2015). Thermal stability, E-Modulus (Mohammed et al., 2016,XJ Zhang et al., 2011,Mohammed & Mudhaffar, 2012)	Flexural strength(Mohammed et al., 2016,XJ Zhang et al., 2011) and toughness (Mohammed et al., 2016,XJ Zhang et al., 2011)
Titanium Coupling agents	Transverse strength, hardness, water sorption and solubility (M Gad et al., 2016).	Surface roughness(Safi et al., 2012)
^BaTio3	Radio pacifier(Safi et al., 2012), thermal stable(Mohammed et al., 2016,Bian et al., 2007)	Fracture toughness(Safi et al., 2012), High density(Mohammed et al., 2016,Bian et al., 2007)

Figure 3. Mean and standard deviation of the growth of Candida albicans in each experimental group (Safi & Moudhaffar, 2011)

Figure 4. Mean flexural strength values with standard deviations (Elshereksi, Mohamed et al., 2014)

Figure 5. Scanning electron microscope (A) PMMA without nanoparticles, (B) PMMA with nanoparticle aggregations (Kamonkhantikul et al., 2017)

Figure 6. The mean values of mechanical characteristics for the control group and 1.5 % SWCNTS (Ibrahim, 2015)

Table 6. The summary of Nano carbon additive fillers and its effect on denture base acrylic resin

Material		Increase/Improve	Decrease/Weaken/no effect	Comments
Carbon Family	Nano Carbon	Flexural strength and Impact strength (Li et al., 2014)	Hardness (Ibrahim, 2015), cytotoxicity and biomedical issues (Wang et al., 2015), poor aesthetics attribute (Wang et al., 2015)	Carbon NPs and NTs improve denture base strength. Meanwhile, silanized NPs enhanced the properties of dentures. Nonetheless, it decreased with silanized nanotubes
	SWCNTs	Impact strength and transverse strength (Oei et al., 2012)	Hardness (Qasim et al., 2012)
	MWCNTs	Flexural strength and resilience (Hamedi-Rad et al., 2014)	No effect (flexural strength) (Wang et al., 2014)

Figure 7. (A) AFM shows average surface roughness of different groups of samples compared to 5wt. % of ZrO2 and control sample; (B) Comparison of the average surface roughness of the same group indicated in the field (A) (Nagao et al., 2011)

Table 7. The summary of HA additive fillers and its effect on denture base acrylic resin

Material/HA	Increase/Improve	Decrease/Weaken/no effect
Saline-treated HA powder	Flexural strength and flexural modulus (Tham et al., 2010,Pan et al., 2013) Impact strength, surface hardness (Karadi & Basima, 2017) Solubility and water sorption(Karadi & Basima, 2017)	Flexural properties on water storage (Pan et al., 2013) Transverse strength, surface roughness(Karadi & Basima, 2017)
HA NPs	Fatigue and compression strength, thermal conductivity (Kul et al., 2016,Salih et al., 2015) Ultimate compressive and yield strengths below 2.5%(Alnamel & Mudhaffer, 2014)	Wear rate(Zebarjad et al., 2011)

Figure 8. Differences between the control group composite and other groups of 0.05% Au and 0.2%Au composites (Da Silva et al., 2012)

Table 8. Hybrid reinforcement added materials

Hybrid type	Hybrid materials
Fibers	Glass fiber with polyethylene fibers(Chatterjee & Mishra, 2012,Kim et al., 2019,154)
Fillers	Al2O3 plus ZrO2 (Jagger et al., 1999,Mangal et al., 2019,Yu et al., 2012)
	ABWs plus Al2O3 (Jagger et al., 1999,Mangal et al., 2019,Yu et al., 2012)
	Silanized titanium dioxide TiO2with zirconium dioxide nanoparticles ZrO2 (Alhareb & Ahmad, 2011)
	HA with Al2O3(Shi et al., 2004)
	ZrO2 with TiO2(Wang et al., 2014)
Fibers with Fillers	Polyester fiber reinforced PMMA with (clay, glass powder, SiO2, or ZrO2)(Wang et al., 2015)
	Al2O3 added to plasma-treated polypropylene fiber(Karthick et al., 2014)
	Nano-HA particles, micro-zirconia, glass fiber, and Kevlar fiber. (PMMA- Nano-HA and glass fiber), (PMMA-ZrO2 and glass fiber) Glass fibers (GFs) and zirconium oxide nanoparticles(M.M. Gad et al., 2017)
	ZrO2 with (ZrO2 + Bis-GMA +TEGMA) nanofibers(Basima & Aljafery, 2015)
	Polystyrene (PS) fibers with salinized nano-zirconia(ZrO2)(Chen & Liang, 2004)
	Salinized ZrO2 plus salinized aluminum borate whiskers (ABW) (Safarabadia et al., 2014)
	Nitrile butadiene rubber particles NBR + salinized (aluminum oxide, Yettria stabilized zirconia, and silicon dioxide) (Salih et al., 2015)
	(PMMA + nano-HA and Kevlar fiber), (PMMA-ZrO2 and Kevlar fiber)(Safi, 2014, Mahmood, 2015, Ibrahim, 2015)

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