Offprint DZZ Deutsche Zahnrzliche Zeitschrift Volume 61, Issue 3 (2006) Page 147 150, 15.3.

2006, Postverlagsort Kln

F. Beuer, K.J. Erdelt, R. Friedrich, K. Kbele-Bogai, M. Eichberger, W. Gernet1

Retention and fracture resistance of acrylic denture teeth on the denture base
This in vitro investigation is intended to show the influence of preparation of denture teeth (macromechanical retention) and conditioning of the base surface of the tooth (chemical bond) on the failure of the acrylic-tooth bond. A total of 140 upper incisors (2 different manufacturers, 3/ 4 different types of preparation) were investigated with regard to their fracture resistance and bond strength to the acrylic base. Half of all the samples were artificially aged by thermocycling and all samples were tested until failure in a universal testing machine at an angle of 45. All of the teeth fractured, though not at the interface between the denture base and tooth. Macromechanical retention on the tooth base and bonding agent were not necessary to ensure retention of the acrylic teeth on the denture base. There were, however, significant differences in the fracture resistance of the tooth groups tested.

Keywords: denture teeth, acrylic tooth, bonding agent, fracture resistance

1 Introduction
The use of acrylic denture teeth has become established both in full denture prosthetics and partial denture prosthetics since the introduction of highly aesthetic teeth that are not prone to discoloration [7]. They are superior to porcelain teeth specifically due to the possibility of a chemical bond between the denture teeth and denture base. Suitable preparation of denture teeth proved to be a problem at the Department of Prosthetics of the Ludwig Maximilian University, Munich, Germany. In particular, anterior teeth that had come out of dentures fabricated in the student course often had to be repaired and fixed in position again after a short time in situ. Stricter monitoring of the students who fabricated these restorations did not achieve any marked improvement in the complaints. Technicians at the university observed, however, that there were frequent fractures of the actual denture teeth, particularly in the anterior region and mainly involving implant-borne, removable restorations. Both macroretention and micromechanical retention were options for preparing the denture teeth for fixation in the denture base. Manufacturers rec1

ommend roughening the areas that come into contact with the acrylic and preparing grooves or a central hole in the base of the tooth. Manufacturers also supply bonding agents, which are intended to improve the bond between the tooth and base. Due to their high filler content acrylic denture teeth now also have improved abrasion properties compared with previous teeth, which usually had a lower filler content. It is debatable whether this higher filler content, which is subjectively associated with a marked brittleness and difficulty during preparation, also detrimentally affects the fracture properties of the teeth.

2 Materials and methods

Generally anterior teeth from two manufacturers that have different manufacturing techniques should be tested. As identical tooth ranges as possible were selected and therefore 80 teeth from the Vitapan range (Vita Zahnfabrik/Bad Sckingen, Germany) and 60 teeth from the Mondial range (Heraeus Kulzer/Wasserburg, Germany) were examined. All teeth were uniformly roughened on the base section and cervical region using a

diamond rotary instrument with a 50 m grit size. Then 20 samples from the Mondial group and 40 samples from the Vitapan group were randomly selected and prepared basally using a channel cutter. The macromechanical retention on all teeth of this group was the same due to the defined channels. Twenty Mondial teeth and 20 Vitapan teeth from the group prepared with channels were wetted with Palabond bonding agent (Heraeus-Kulzer), the remaining 20 Vitapan teeth were conditioned with Vitacoll (Vita Zahnfabrik). This was to test the influence of the different bonding agents. A further 20 samples from the Mondial group and 20 samples from the Vitapan group were selected and a 3 mm deep drill hole prepared in the centre using a round bur (diameter 3 mm). A mark on the round bur ensured that all holes were drilled to the same depth. The Mondial group samples were conditioned with the bonding agent (Palabond) recommended by the manufacturer; the same procedure was followed with the Vitapan samples and they were wetted with Vitacoll. In order to fabricate the same base for all samples, a positive wax model was fabricated and an impression taken of it using addition-curing silicone. This pro-

Department of Dental Prosthetics, Ludwig Maximilian University, Munich, Director: Prof. Dr. Dr. h.c. W. Gernet

F. Beuer et al.: Retention and fracture resistance of acrylic denture teeth on the denture base

650.00

600.00

Fracture force

550.00

500.00

450.00

Channel + Cond. A

Hole + Cond. A

Without/Without

Conditioning
Figure 1 Test set up Figure 2 Fracture resistance of Mondial teeth Illustration:

duced a negative that was used as a mould for all samples. The prepared denture teeth were inserted in this mould and the base was filled with PalaXpress cold-curing acrylic (Heraeus Kulzer/Hanau, Germany) and then polymerised in a pressure pot at 2 bar and 45 C for 30 minutes. Ten samples from all the different sample groups of 20 were randomly selected and artificially aged. The samples were aged using 10000 thermocycles of 5C to 55C. All samples were then tested in a universal testing machine (Zwick/Ulm, Germany) with a feed rate of 0.5 mm/ min. The force application was the same as previously published and completed studies at an angle of 45 [3], whereby the incisal edge was used as the contact point for the indenter. Placement of polyethylene foil between the indenter and denture tooth was intended to distribute the force uniformly (see Fig. 1).

3 Results
All samples tested fractured at the junction between the denture base and acrylic tooth in the cervical area, i.e. the actual tooth fractured and the interface between the cold-curing acrylic and denture tooth withstood the loading. In order to check this fact, 3 samples with unprepared teeth were tested and in this case the acrylic tooth loosened from the base with a load of approx. 60 N. After preparation with a channel cutter and conditioning with the bonding agent recommended by the manufacturer, the Mondial teeth exhibited an

initial mean fracture resistance of 570.12 N ( 46.47) and when aged a mean fracture resistance of 378.10 N ( 60.84). This corresponds to a loss of resistance of about 34%; the difference was highly significant p = 0.000 (MannWhitney U test, significance level p < 0.05). The Mondial teeth, which were provided with hole retention and conditioned with Palabond, achieved a mean fracture resistance of 515.10 N ( 27.80) [initial] and 376.60 N ( 45.40) [after artificial aging]. If these teeth were only roughened and not prepared further, they achieved a mean fracture resistance of 564.72 N ( 57.29) without aging and after artificial aging 397.79 N ( 39.97). Even with this type of preparation the differences in fracture resistance between the samples before and after aging were statistically significant with p = 0.000 (hole retention) and p = 0.000 (only roughened). If the initial fracture resistance values of the Mondial teeth are compared with regard to the different methods of preparation, the difference between the group with hole retention and the two other groups is striking (see Fig. 2). This difference was significantly different when compared with both the channel cut (p = 0.009) and only roughening (p = 0.043). With the channel retention and bonding agent Palabond the Vitapan teeth exhibited a mean fracture strength of 471.49 N ( 61.17) [initial] and 363.53 N ( 56.65) [after artificial aging]. The fracture resistance after aging was 23% lower than the initial value and was also statistically significant (p = 0.002). If the conditioner Vitacoll recommended by

the manufacturer was used, mean fracture values of 480.66 N ( 38.99) [initial] and 373.40 N ( 46.61) [aged] were achieved. The bonding agent used did not produce any significant difference with values of p = 0.684 [initial] and p = 0.529 [aged]. The type of preparation used with the Vitapan teeth did not have any influence on the initial resistance (see Fig. 3), whereby all values were less than those achieved with the Mondial teeth. With hole retention and Vitacoll conditioning they achieved a mean fracture resistance of 457.73 N ( 35.47) [initial] and 353.72 N ( 29.77) [aged], while the samples that were only roughened achieved 459.12 N ( 52.54) [initial] and 345.93 N ( 50.11) [aged]. The Mondial teeth achieved significantly higher initial fracture resistances than the Vitapan teeth when prepared with the channel cutter and conditioned with Palabond bonding agent (p=0.002) and with roughening only (p=0.000). After artificial aging the fracture resistance of the Mondial teeth was also significantly higher than that of the Vitapan teeth (p = 0.043).

4 Discussion
The fact that all samples fractured and no denture teeth loosened from the acrylic base, suggests that conditioning does not have any influence in the event of denture tooth breaking out of the base. If a denture tooth loosens from the base, therefore, it has either been contaminated or it was not prepared at all. This is the only way a chemical bond

F. Beuer et al.: Retention and fracture resistance of acrylic denture teeth on the denture base

600.000

550.00

Fracture force

500.00

450.00

400.00

350.00

Channel + Cond. A Hole + Cond. B Channel + Cond. B Without/Without

Conditioning
Figure 3 Fracture resistance of Vitapan teethIllustration: Figure 4 Fracture surface of a Vitapan tooth

between the acrylic tooth and the denture base cannot be produced. There must therefore be another explanation for the general differences in the mean fracture strengths. The first possibility was the different dimensions of the two different teeth. As particular care was taken to ensure that the teeth had the same dimensions and all fracture surfaces were measured after the test and yet no differences were found, this was eliminated as a possible explanation. Another possible reason could be the different types of manufacture of the denture teeth, though the socalled Incom process (Heraeus Kulzer) should not be fundamentally different from the press process (Vita-Zahnfabrik). The composition of the acrylic is the most likely explanation, thus the Vitapan tooth is characterised as a very brittle, highly filled tooth, particularly in routine use. This is reflected in its good abrasion properties, but also in a reduced fracture resistance. The larger filler particles and their denser packing in the Vitapan teeth can be clearly seen (Fig. 4) in comparison with the Mondial teeth (Fig. 5), whose fracture surface comprises more matrix and fewer filler particles. The values of the fracture resistance of denture teeth may also not be fully achieved by partial dentures, though the maximum strength values in other studies achieved almost 300 N [8]. This leaves hardly any room for safety margins, as the aged teeth have fracture resistances of around 350 N.

Figure 5 Fracture surface of a Mondial tooth

5 Conclusion
The use of expensive bonding agents, which are offered by the teeth manufacturers, is not required to ensure an adequate bond of acrylic teeth to the denture base. The bonding agent has a certain cleaning effect at most and therefore prevents contamination, e.g. due to separating agent. The same success, however, can also be achieved using monomer. Denture teeth lose a significant proportion of their initial fracture resistance because of artificial aging. This remaining fracture resistance is, however, still sufficient to withstand any masticatory loading that occurs in the anterior region of a full denture. The maximum loading, which may occur with partial dentures, is very close to the mean fracture values of aged Vita teeth.

The publishing company retains all rights, including reprint, the photomechanical reproduction of this offprint and the translation. This text is a translation of a contract from the original German. The translators do not accept any liability for damages that may arise from using the English text of the contract. The original German text is definitive.

Contact address: Dr. Florian Beuer Poliklinik fr zahnrztliche Prothetik der LMU Mnchen Goethestr. 70 80336 Mnchen Germany Tel.: +49 (0) 89/1609550 flobeuer@gmx.de

F. Beuer et al.: Retention and fracture resistance of acrylic denture teeth on the denture base

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The publishing company retains all rights, including reprint, the photomechanical reproduction of this offprint and the translation. This text is a translation of a contract from the original German. The translators do not accept any liability for damages that may arise from using the English text of the contract. The original German text is definitive.