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Effect of some curing methods on acrylic maxillary denture base fit

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 Eur. J. Prosthodont. Rest. Dent., Vol.18, No. 3, pp 132-138 © 2010 FDI World Dental Press Ltd.
Printed in Great Britain doi:10.1922/EJPRD_805Lynch07

Effect of Some Curing Methods on Acrylic Maxillary

Denture Base Fit
Fazal Ghani*, Masahiko Kikuchi†, Christopher D. Lynch‡ and Makoto Watanabe†

Abstract - The aim of this study was to investigate the fit of acrylic maxillary denture bases processed by the methods
of microwave, quick-wet-heat, slow-wet-heat, and self curing. Forty stone-casts were obtained using a mould of an
undercut-free acrylic resin master cast of an edentulous maxilla. Standard acrylic replicas patterns sealed on casts
and randomized to four groups (10 in each) were used to make denture bases using different processing methods for
each of the four groups. The resultant discrepancy of fit between the denture base and the casts were measured using a
silicone wafer. Varying fit discrepancies both within and between denture base groups was observed. The proportional
fit-loss in the palatal region was significantly greater than the sulcular areas for all materials tested (p<0.05). The fit-
loss observed was greater in microwave-cured bases than for other materials examined. Careful selection of appropri-
ate denture base materials and processing technique is important when providing complete dentures for edentulous
patients.

KEY WORDS: Acrylic resin processing methods, Processing changes, Denture base-fit.

INTRODUCTION that apart from the volumetric contraction occurring during

the conversion of monomer to polymer, there are other
Polymethylmethacrylate (PMMA) / acrylic resin is extremely factors involved in this dimensional change, including the
popular in the construction of contemporary removable inherent variations in the composition of acrylic resin as
prostheses, with up to 98% of conventional removable well as denture processing methods that bring dimensional
partial and complete dentures being made in this material1. changes with consequent inadequate fit of the denture
Intraoral retention of acrylic complete dentures is depend- base13-16.
ent on a number of factors including adhesion, cohesion,
surface tension and viscosity that are facilitated through Patient-based clinical studies have indicated that the techni-
a saliva film at the denture- tissue interface2-4. However, cal quality of completed dentures is not always correlated
for a denture to resist displacement forces exerted on it to patient satisfaction, but better-fitting prostheses have
during function, it is important that its intaglio, muscular been shown to be associated with improved nutritional and
and occlusal surfaces have been appropriately fashioned5. quality of life outcomes among edentulous patients17,18. Of
This will allow the denture base to be sufficiently retentive the possible denture base-cast fitting discrepancy meas-
to resist, amongst others, non-vertical denture displacing urement techniques available19-56, the use of the method
forces as occur during mastication. Notwithstanding both of a wafer of impression material for the assessment of
theoretical and practical investigations2-4, little agreement the fit/adaptation of the denture base is relatively simple,
has been reached on the nature of the factors that con- straightforward and inexpensive to perform. This technique
tribute to complete denture retention. However, it would has recently been validated and used for the assessment
appear that a well-fitting denture base is important4. This of the fit of full coverage crowns56. Other previously used
allows a thin film of saliva to lie between the well-fitting measurement methods employed feeler gauges, direct
denture base and the underlying denture bearing tissues. measurement of the gap between cast and base, Moiré
Assuming completion of an appropriate master impression, topogram and others subjective and invasive cast-base
satisfactory cast pouring and fabrication of an accurate sectioning methods. These and other more sophisticated
wax pattern, any subsequent ill-fit/ poor adaptation of techniques6,15,27,30,35,36,44-51 are not only complex nature but
the subsequently completed denture base would most lack universal applicability and problems which can con-
likely be related to changes in the acrylic resin that occur found results, such as the need for sectioning the casts
during its curing. Although it has been previously noted and denture bases as well as the inherent movement of
the dimensional change in acrylic resin is related to the the denture base during measurements.
selected processing technique, the exact amount of that While an ever-increasing range of new materials and
occurs in each individual method is unclear6-12. It is likely techniques now exist for fabrication of denture bases, it
is important to investigate the suitability of these for the
rehabilitation of the edentulous patient. Therefore, the
aim of this study is to compare the fit of maxillary acrylic
complete denture bases produced using commonly-used
*
PhD, FDSRCPSGlasg, MSc, CMP, BDS, BSc curing methods, such as microwave, quick-wet-heat, slow-
†
PhD, DDS wet-heat, and self curing.
‡
BDS, PhD, MFD RCSI, FDSRCSI

EJPRD 805-Lynch.indd 132 24/08/2010 11:43:52

 Effect of Some Curing Methods on Acrylic Maxillary Denture Base Fit

MATERIALS AND METHODS days and were removed from the water-bath only when
needed for the test procedure.
Fabrication of Acrylic Resin Denture Bases
A stone cast was produced (New Plastone, GC Corp, To- Assessment of fit of denture bases
kyo, Japan) using a commercially available rubber mould
of an edentulous maxilla. Undercuts were removed from For the assessment of the extent of fit and adaptation of the
this cast on setting, however, the labial and buccal frenae test denture bases to the resin test master cast, a cartridge
were left intact to act as anatomical landmarks and to fa- type hydrophilic polyvinylsiloxane impression material (Ex-
cilitate accurate location of bases later in the experiment. amixfine, GC Corp, Tokyo, Japan) was used. A controlled
A silicone mould was made of this stone cast, from which amount (3.5g) of the impression mix was evenly delivered
an acrylic resin test cast was produced. This was immersed across the intaglio of the test base. No impression adhesive
in water for 7 days, after which it was duplicated through was used. The surrounding environment was controlled at
a silicone mould contained in a rigid plastic casting ring a temperature of 24o C and relative humidity of 55 – 60 %.
to allow production of forty identical replica stone casts Initial manual pressure was applied to exude the excess
for this experiment. To produce each of the replica stone impression mix from the interface and then by transferring
casts identically, the silicone mould was left unused for a to a specially designed loading apparatus (Figure 1). Load-
period of 2 hours to allow its complete recovery before it ing in the apparatus was precise and controlled by applying
was poured again. On each replica stone cast a 3mm thick a 3 Kg preset load to the test base through a custom-fitting
denture base was patterned in modeling wax. These were adapter made in putty silicone impression material, and
sealed to their casts and invested in a metal denture flask was applied for 7 minutes. The exuded set material at the
using a quick setting hard dental stone (Plastone Fast-Set, peripheral borders was then precisely cut in a controlled
GC Corp, Tokyo, Japan) and alginate based separating manner using a sharp surgical scalpel blade before care-
agent (Acrosep, GC Corp, Tokyo, Japan). The wax-pattern fully removing the test base from the resin test master cast.
was boiled out, and each stone mould and denture flask The resulting thin impression wafer (Figure 2), representing
facilitated the production of a clear acrylic resin replica the fit discrepancy of the test denture base during each
patterns with the same standard thickness to fit each of test processing method, was removed for quantitative as-
the 40 test stone casts. sessment and analysis. For each test denture base, the fit
discrepancy was recorded 5 times to reduce error (i.e. 5
The transparent resin patterns were sealed to their stone impression wafers were produced for each mould).
casts. After necessary soaking, they were then assigned
to 4 groups of 10 casts each according to the following To determine the over-all fit discrepancy, as well as at its
curing techniques: distribution at various portions and aspects, each of the
whole impression wafers and their subsequent sections
Group 1 for processing by the microwave curing (MC) were weighed 5 times using digital analytical balance (Mit-
methods; tler Weighing Scale to weigh up to a fraction of 0.001g).
Group 2 for processing by quick-wet-curing (QWC); Using predetermined landmarks and lines crossing the
labial frenum, buccal frenum, the central deepest point of
Group 3 for processing by slow-wet-curing (SWC); the palate and the mid-palatal line, each of the sulcular
Group 4 by processing by self-curing (SC). portions and palatal portions of the wafers were sectioned
to represent the buccal (right and left sides), labial, anterior
Details of individual products used for each group are palatal and posterior palatal aspects in each of the test
reported in Table 1. All the resins used were those com- denture bases. Each of these cut specimens of the impres-
mercially supplied as polymer powder and monomer liquid sion wafers was weighed. Thus each of the 200 impression
systems that are routinely used in the dental laboratory wafers (50 in each of the 4 groups) was sectioned into
of the hospital for fabricating acrylic dentures. The sealed portions to represent the proportion of the relative misfit
acrylic bases and casts were invested using suitable denture in the described aspects of the test denture bases.
flasks: ‘FRP’ (fibre-reinforced plastic flasks) for Group 1,
and metal denture flasks for Groups 2-4. Following setting
of the investment material, the resin bases were removed. Statistical Analysis
Each mould was then carefully packed with the test acrylic
resin. Using thin soft cellophane film, all the flasks were It was hypothesized that all the test processing methods are
trial packed three times (with a packing pressure sequence equally effective in producing denture bases with identical
of 10, 10 and 25 kgcm-2, respectively, and removal of resin fit and adaptation. Statistical analyses of the data were car-
flash after the first and second trial packing steps). The ried out using SPSS Version 14.0 for Windows (SPSS, Inc.,
packed FRP flasks were kept tightly bolted using the Chicago, IL, USA). One-way analyses of variance (ANOVA)
polycarbonate bolts, while the packed metal flasks were and post hoc Tukey’s test were performed. The probability
kept tightly clamped until processed. Upon completion of levels of p< 0.05 were considered statistically significant.
the packing step, each of the metal flasks was clamped The inter-group variations in data when significant have
with a metal spring clamp using the spring-clamp-prong been shown with connecting asterix (*) in the relevant
device used for the purpose in the departments’ laboratory. figures (Figures 3-5).
Details of each curing cycle are reported in Table 1. The
completed bases from each group were finished with care
to preserve the peripheral outline and contour in relation
to the base model. The test denture bases and the resin test
master cast were all kept immersed in water for at least 7

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 Fazal Ghani, Masahiko Kikuchi, Christopher D. Lynch and Makoto Watanabe

Table 1. Acrylic resin products and curing methods used. Each group had 10 test specimens.
Group Curing Method Product Polymer: Curing details
Monomer Ratio

1 Microwave ACRON MCR, 100g: 43ml Cured for 3 minutes at a frequency of 2450 MHz in a 960W
(GC Corp, Tokyo Japan) output domestic microwave oven (Model EM535T, Sanyo Co,
Japan)
2 Quick-wet-heat ACRONR, 100g: 43 ml Flasks immersed in water in an automatic water curing unit
(GC Corp, Tokyo Japan) (Marathon, Dentronics, Tokyo, Japan). Water heated slowly
to reach 100°C in 2 hours, then maintained at 100°C for 48
minutes and then cooled back to room temperature.

3 Slow-wet-heat ACRONR, 100g: 43ml Flasks immersed in water in an automatic water curing unit
(GC Corp, Tokyo Japan) (Marathon, Dentronics, Tokyo, Japan). Water heated to 70°C
and maintained at this temperature for 9 hours and then
cooled back to room temperature.

4 Self-curing RepairsinR 100g: 50ml Flasks kept in a hydro-flask with controlled warm water at
(GC Corp, Tokyo Japan) 45oC under a pressure of 40 Kg.Cm-2 for 20 minutes.

RESULTS
The data collected are presented in Table 2 - 3 and il-
lustrated in Figures 3 - 5. These data and their graphic
illustration not only clearly show variations both within and
between groups but they also show that upon curing, the
test denture bases suffered fit discrepancy irrespective of
the processing method used. This was determined from the
mass of impression-wafer of the space between the intaglio
and tissue surface of the resin master cast and it ranged
between 1.6 – 1.8 g (Figure 3). It can also be seen that the
values for specimens cured by microwave energy were the
highest while those for the bases processed by the quick-
wet-heat-curing method were the lowest. Figure 3 shows
that the variations from the mean values of fit discrepancy
in the denture bases cured by the two water-curing meth-
ods and the self-curing methods were significantly lower
than those of bases cured by micro-waving (p<0.05). Fit
discrepancy values seen on the whole labial aspect (left &
right) were significantly larger in the bases processed by
micro-waving and self-curing. Values relating to the whole
anterior palate were significantly larger in bases processed
by the slow-wet-heat and self-curing methods. As shown
in Figure 5, significantly larger proportional fit-discrepancy
Figure 1. Apparatus for applying controlled load- values in the posterior palatal segment were seen in den-
ing to the test-specimens during the recording of fit ture bases processed by the micro-wave curing method
discrepancy for the test-denture bases.
as compared to the others in which the differences were
insignificant (p < 0.05).
It appeared that none of the curing methods could facilitate
the fabrication of denture bases with identical fit qualities.
The reason for these could be the inherent compositional
variations in the test resin systems as well as the dissimi-
larities of the test curing methods.

Discussion
While the variety of laboratory techniques and avail-
able denture base materials are continually increasing,
the challenge for clinicians of making a satisfactory and
well-fitting denture base remains. Failure to do so will
adversely affect the quality of life of patients and lead to
complaints of looseness at the chair-side18. Needless time
will be expended in modifying the completed denture and
Figure 2. An impression-wafer of the interface space representing the expense may be incurred in the provision of relines and
extent of the fit discrepancy of a test denture base. other laboratory procedures that may be indicated. While

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 Effect of Some Curing Methods on Acrylic Maxillary Denture Base Fit

Table 2. Extent of fit discrepancy as seen from the mass of impression wafer (g) in denture-bases and their various segments
during curing methods. (n =10 specimens in each of the 4 groups) and n = 50 (10 x 5 fit discrepancy recordings).
Segment Denture Base Group

MC QWC SWC SC
Mean + SD (%) Mean + SD (%) Mean + SD (%) Mean + SD (%)

Over-all 1.811+ 0.192 1.624 + 0.148 1.729 + 0.194 1.730 + 0.152

Over-all Labial & Buccal 0.832 + 0.103 (45.9) 0.720 + 0.072 (44.3) 0.779 + 0.076 (45.1) 0.804 + 0.103 (46.5)
Over-all Palatal 0.976 + 0.117 (53.9) 0.900 + 0.100 (55.4) 0.954 + 0.126 (55.2) 0.921 + 0.114 (53.2)
Over-all Labial 0.458 + 0.077 (25.3) 0.397 + 0.044 (24.4) 0.419 + 0.058 (24.2) 0.438 + 0.056 (25.3)
Over-all Buccal 0.374 + 0.049 (20.7) 0.323 + 0.043 (19.9) 0.360 + 0.029 (20.8) 0.377 + 0.060 (21.8)
Over-all Anterior Palatal 0.408 + 0.070 (22.5) 0.431 + 0.074 (26.5) 0.453 + 0.086 (26.2) 0.443 + 0.074 (25.6)
Over-all Posterior Palatal 0.564 + 0.078 (31.8) 0.468 + 0.055 (28.8) 0.501 + 0.055 (29.0) 0.487 + 0.080 (28.2)
MC = Microwave-cured. QWC = Quick-wet-heat-cured. SWC = Slow-wet-heat-cured. SC = Self-cured.
Figures in parentheses refer to proportions (%) of the over-all fit discrepancy in the relevant aspects of the denture bases.

Table 3. Data for the mean mass (g) of the test denture bases and their analyses. (n = 10).
Denture Base Group Mean + SD Group Comparison F-Value P - Value

MC 13.694 + 0.311 MC - QWC 0.979 0.01

QWC 14.673 + 0.904 MC - SWC - 1.007 0.008
SWC 14.701+ 1.002 MC - SC 0.344 0.330
SC 13.339 + 0.615 QWC - SWC 0.028 0.94
QWC - SC 1.333 0.001
SWC - SC 1.362 0.001

MC = Microwave-cured, QWC = Quick-wet-heat-cured, Slow-wet-heat-cured (SWC), Sc = Self-cured

Figure 3. Mean over-all fit discrepancy (g) in the test-denture-bases. Figure 4. Proportional Fit discrepancy in the vestibular and palatal aspects.
(MC = microwave cured, QWC= Quick-wet-heat-cured, SWC = slow-wet- (QWC= Quick-wet-heat-cured, SWC = slow-wet-heat-cured, SC = Self-
heat-cured, SC = Self-cured.) cured.)

the range of denture base materials is continually increas- In this study, we used mass of a silicone wafer rather
ing, with claims from manufacturers that newer materials than length as a measure of fit discrepancy. We justify our
are “faster” (and hence more economical), the quality of method in that is relatively simple, straightforward and
care afforded to patients should never be compromised. inexpensive to perform and has been used in other similar
Similarly the financial advantages obtained via ‘false econo- investigations56. A difficulty encountered in this study was
mies’ encountered in the utilization of ‘faster’ materials may that of producing test bases to standardized specifications.
be short-lived in the long term. It is noteworthy that within This was noted in the variation in the weight of the test
this study not only did the microwave-cured bases exhibit denture bases in the four groups (range = 13.34 – 14.7g).
the greatest overall fit discrepancy values, this technique The data and their analyses in Table 3 show that the mean
was also associated with the greatest degree of poor fit in mass of the silicone wafer recorded for the microwave and
the posterior palatal region – a clinically significant area self-cured bases were significantly lower than the mean
when attempting to optimize complete denture retention mass for the test bases produced by the other two meth-
via the postdam area. ods. This variation in mass of test bases may have been

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 Fazal Ghani, Masahiko Kikuchi, Christopher D. Lynch and Makoto Watanabe

Figure 5. Proportional fit discrepancy shown as the mass proportions of the labial, buccal and anterior and posterior palatal segments to the weight
of the over-all impression wafer. (MC = microwave cured, QWC= Quick-wet-heat-cured, SWC = slow-wet-heat-cured, SC = Self-cured.)

caused by difficulties encountered in the production of Due to the range of methods and procedures available
either the acrylic replica pattern or the subsequent denture for recording cast-base adaptation discrepancy through an
base. These difficulties may have included that of press- impression film, a variety of results have been reported in
ing to the same dimension of the acrylic resin mix when the literature: some being similar to these results, while
packing the split mould in each flask or due to difficulty others are not7, 12, 23, 33, 41-42, 49, 53-55. For example, Barco et
involved in finishing these patterns to the same precise al.53 recorded lower values of fit loss in case of maxillary
specification each time. Other variations could have been denture bases without teeth as compared to those with
encountered in the fabrication of the subsequent test teeth. They also observed substantial improvement in the
denture bases, including the use different resin materials fit of both bases without and those with artificial teeth
(with varied ingredients and densities) across the four test after relining them. In contrast, a similar study by Mainieri
groups, variations in the powder: liquid mixing ratios, or et al.12 found that the mean weight of impression wafers
by possible variations in the amounts of wax used when was 2.69g – much greater than the 1.6-1.8g range noted
sealing the bases to the stone casts, or by the difficulty of in this study. While Mainieri’s study indicates a large fit-
repeatedly pressing and packing precisely the moulds in discrepancy, this may be due to their choice of silicone ma-
flasks with resin mix. However, the variations in denture terial, which was different to material used in this study12.
base weight could also have occurred due to the early loss Mainieri’s study continued to reline the test bases, after
of unprocessed monomer or of the subsequent increased which a gap of 1.9 g weight remained12. This discrepancy
leakage/loss of the inevitable residual monomer in the is much closer to that being reported in this study; likely
microwave and self-cured test bases as compared to the explanations for the range of value reported may include
bases cured by the other methods of wet-heat-curing (either the use of a different impression material for recording
quick or slow) (Table 3). Due to the nature of the materi- of fit discrepancy, a dissimilar polymer: monomer ratio,
als involved, many of these confounding variables could quantity of resin and size, form, area and volume differ-
be encountered irrespective of the level of sophistication ence in denture bases, differing processing methods with
of measuring technique used. At the very least, as our ex- reference to heating methods, timings and temperatures,
periment was performed under controlled conditions, the and non consideration of subjecting the test specimens
results (i.e. masses of impression wafers produced) give a to the process of water-sorption. The mean mass values
comparative indication of fit discrepancies occurring fol- recorded by Takamata et al.33 are similar to those recorded
lowing the use of selected curing techniques. in the present study, despite the use of a dissimilar master
cast and an uncontrolled method for recording the extent

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 Effect of Some Curing Methods on Acrylic Maxillary Denture Base Fit

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