IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59

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IP Annals of Prosthodontics and Restorative Dentistry

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Review Article
Denture base reinforcing materials - A review

N Prajwala1, *, C Ravi Kumar1 , M Sujesh1 , D Chalapathi Rao1 , L Pavani1

1 Dept. of Prosthodontics, Mamata Dental College, Khammam, Telangana, India

ARTICLE INFO ABSTRACT

Article history: Poly methyl methacrylate (PMMA) is one of the most widely used materials for fabricating dentures.
Received 18-05-2020 Though it has its success in meeting esthetic requirements, it is still far from ideal to meet mechanical
Accepted 25-05-2020 requirements of a denture. The fracturing of dentures can be caused by mechanical properties of acrylic
Available online 11-06-2020 resin or by a multitude of factors leading to failure of PMMA. The quest for an alternative material or a
chemical modification or use of different denture base material reinforcements of PMMA, provides a clear
picture about various developments that have taken place in this field.
Keywords:
Denture base materials © 2020 Published by Innovative Publication. This is an open access article under the CC BY-NC license
Reinforcing materials (https://creativecommons.org/licenses/by-nc/4.0/)
Fiber reinforcements
Nanofillers

1. Introduction mechanical properties by reinforcing with various materials.

So, this review article aims at compiling different materials
Biomaterials research has progressed steadily in the past few
from articles published through the years 1971 to 2017.
decades and is leading to an improvement in human
life expectancy. Dental work includes changing existing
materials or designing new and improved products for The use of hypoallergenic resins overcame the issues
prosthetic applications. Dentures made of PMMA were of monomer allergy. Therapeutic use of thermoplastic
popular because of their ability to be molded with ease, resins has increased. 3 4 Smith (1957) reported on glass
excellent esthetics and satisfactory mechanical properties. reinforcement of PMMA by mixing discrete fibres with
An ideal denture base material is the one that possesses the dough or by lamination with glass cloth. Jennings
biocompatibility, excellent esthetics, superior mechanical & Wuebbenhorst (1960) reported on the reinforcement
properties especially modulus of elasticity, impact strength, of pedodontic prosthetic appliances with stainless steel
flexural strength and hardness, sufficient bond strength with mesh, braided wire plate, a stainless steel lingual bar and
artificial teeth, ability to repair and dimensional accuracy. 1 2 stainless steel wire. Schreiber (1971), in a preliminary
Poly methyl methacrylate is as yet the most overwhelm- report on the reinforcement of PMMA with carbon fibres,
ingly utilized denture, but, it has certain drawbacks like discussed the use of acrylic resin composite prepegs.
thermal shrinkage, poor mechanical and fatigue strength, Bucknall (1977) discussed the addition of rubbers to
brittle on impact, poor color stability of self-cured resins, PMMA. Bowman & Manley (1984) confirmed that the
residual monomer allergy, porosity, poor conductors of reinforcement of upper dentures with carbon fibre/PMMA
heat and requirement of mechanical retention. 3 4 Plenty of inserts significantly reduced the number of breakages.
research literature is available on denture base resins and Fraunhofer (1984) determined the effect of reinforcing
considering their inherent drawbacks, several researches autopolymerizing acrylic resin with flat braided two strand
have been conducted to improve their physical and brass wire and orthodontic wire. Vallittu & Narva (1997)
* Corresponding author. reported a composite that consists of glass fibres and aramid
E-mail address: prajwalanakka@gmail.com (N. Prajwala). fibres reinforced in resin matrix. 5

https://doi.org/10.18231/j.aprd.2020.014
2581-4796/© 2020 Innovative Publication, All rights reserved. 52
 Prajwala et al. / IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59 53

2. Classification mechanisms of toughness improvement in rubber-modified

acrylic polymers. 6 7 In these polymers, the resin matrix
Denture base reinforcing materials are broadly classified is filled with a rubbery particle which has a modulus of
into: Non-metals and Metals. elasticity lower than that of the polymer matrix. Therefore
A. Non- Metals the reinforced polymer will have a lower modulus compared
1. Rubber reinforced PMMA to the unmodified polymer. The most significant advantage
2. High impact resins of this modification is an increase in toughness and ultimate
3. Fiber reinforced resins elongation in comparison with the relatively brittle resin
i. Carbon/ Graphite fiber reinforced acrylic material. 8
ii. Aramid fiber reinforced
iii. Polyethylene fiber reinforced 2.2. High Impact Resins
iv. Highly drawn linear polyethylene fibers
v. Polypropylene fiber reinforced Rubber reinforced (butadiene-styrene polymethyl
vi. Polyamide fiber methacrylate) particles grafted to MMA for improved
vii. Glass fibres bond with PMMA. They have greater impact strength &
viii. E Glass fibers (Electrical grade) fatigue properties and so, they are indicated for patients
4. Hypoallergenic resins who drop their dentures repeatedly e.g. parkinsonism.
5. Resins with modifies chemical structure Available as powder-liquid system & processing is samilar
6. Thermoplastic resins to heat-cure resins.
i. Thermoplastic Nylon
ii. Thermoplastic acetal 2.3. Fiber Reinforced Resins
iii. Thermoplastic acrylic
iv. Thermoplastic polycarbonate Poor impact strength and poor fatigue resistance is primary
7. Nanomaterials issue with PMMA. A research by Johnston et al. reveals
i. Nanofillersrconia that within a few years of manufacture 68 percent dentures
-Alumina (Al2 O3 ) break. Mostly they are due to a combination of fatigue and
- Zirconia (ZnO2) impact. Fiber reinforcement leads to an improvement in
- Silica (SiO2 ) strength.
- Nanodiamond
- Carbon
- Halloysite
ii. Nanofibers
- Glass nanofibers
- HA
- Polyacrylonitrile and PMMA nanofibers
B. Metals
1. Metal fiber reinforced resins
2. Metal inserts
i. Stainless Steel wires
ii. Brass wires
3. Nanofillers
i. Silver
ii. Copper
iii. Titanium (TiO2 )
iv. Gold Fig. 1: Multifibered polyethylene strands
v. Platinum
vi. Palladium

2.3.1. Position & placement of fibers

2.1. Rubber Reinforced Poly Methyl Methacrylate
In the weak area of denture, fibers are placed [Figure 3]
(PMMA
Reinforcements are placed 90 degrees to the fracture
Sufficient impact strength and fracture toughness are most [Figure 4]
essential for denture base resins. One of the main drawbacks Unidirectional fibers are stronger [Figure 5]
of PMMA denture bases is low fracture toughness. Many Mesh is to be placed on the exterior of resin surface
studies have been performed to evaluate the toughness and [Figure 6]
54 Prajwala et al. / IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59

Table 1:
Type of fibers Available as Advantages Disadvantages
1. Metal fiber Thin filaments of Use of full lengths of metal fibers gives Resin becomes unesthetic
diameters from 1 to the best reinforcement for strength. 9 and there is poor adhesion
80 micrometers between metal & resin &
metal is prone to corrosion. 9
2. Carbon/ Graphite Chopped, Flexural, impact strengths are Unesthetic, polishing is
fiber continuous, woven, increased. Addition of these fibers difficult & weakens the
braided & tubular prevent fatigue, strengthens the resin denture.
and is easy to handle. 10
3. Aramid fiber Strength is increased. Unesthetic, polishing is
difficult.
4. Polyethylene fiber Multifibered strands Impact strength, modulus of elasticity No increase in flexural
(Figure 1). are improved 11 and good esthetics. strength. Placement of fibers
& finishing is difficult.
5. Highly drawn linear High tensile strength, notch
polyethylene fibers insensitivity & cracks do not propagate
through the fibers 12
6. Polypropylene fiber Improved impact strength and highest Wear resistance was highly
is when treated with decreased 13
plasma. 13 Silanized fiber improved its
transverse, tensile, and impact
strengths.
7. Polyamide fiber Aramid- biocompatible, Increase in Aramid- As fillers increased,
(Nylon and Aramid) flexural strength and modulus. Nylon- hardness decreased. Its
increased fracture resistance and yellow color is a drawback.
resistance to continual stress. 13
8. Glass fibers (Figure 2 Continuous fiber Improved flexural properties and Void formation in
). and roving, staple fatigue resistance. It has good fiber-polymer matrix because
fiber and chopped aesthetics & excellent polishing of poor impregnation of
strand mat. characterstics. They resist extreme fibers and polymerization
temperature and moisture. 14 shrinkage.
9. E Glass fibers Mesh and Fiber They are transluscent thus, providing
(Electrical grade) esthetics. Because of glass fiber
bonding, improved strength. 15
10 Glass nanofibers Improvements in strength, modulus, Incomplete wetting by resin,
Nanofibers and toughness. Crack propagation is which compromises strength
inhibited by the fibers with as the result of air inclusion
simultaneous reinforcement of the and voids 22 . Another
matrix. 16 17 drawback of nanofibers is
11 HA Dispersion of HA nanofibers into a inadequate dispersion into
resin matrix at low mass can the resin matrix that leads to
significantly improve the mechanical the creation of bundles.
properties of the composite. 18 19 These bundles may even act
12 Polyacrylonitrile PMMA is surrounded by a dental resin as defects 23 24
(PAN) and PMMA matrix. After curing, linear PMMA
nanofibers chains become interpenetrated and
entangled with the cross-linked resin
matrix network and produce a strong
nano interface linking force with
strong interfacial adhesion between
nanofibers and resin matrix. 20 21
 Prajwala et al. / IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59 55

Fig. 2: Glassfibers

Fig. 5: Unidirectionalfibers are stronger

Fig. 3: Fiber placed in weakest area

Fig. 6: Mesh placed on exterior of prosthesis

diffusivity. 29 Addition of 11-14% of several compounds

of either bismuth or uranium or 35% of an organo-
zirconium compound impart radiopacity equivalent to that
of aluminium. 30 Addition of Triphenyl Bismuth (Ph3 Bi) is
a promising new additive to provide radiopacity. 31

2.5. Thermoplastic Resins

This new procedure, during which a fully polymerized basic
material is softened by heat and injected afterwards, has
Fig. 4: Fiber at 90◦ to fracture opened up a new chapter in making dentures. 31

2.5.1. Advantages
2.4. Hypoallergenic Resins
They provide excellent esthetics with tooth or tissue colored
Addition of hydroxyapatite fillers increases fracture materials and are very comfortable for the patient. These are
toughness. 25 Addition of Al2 O3 fillers increases the flexural stable, have high fatigue endurance, high creep resistance,
strength & thermal diffusivity that could lead to more patient excellent wear characteristics & solvent resistance. They are
satisfaction. 26 The ratio of 2.2:1 by weight of powder non-porous so no growth of bacteria, and even if it is non-
to liquid was found to be the best ratio for mixing the porous, it still retains a slight amount of moisture to keep
material to give the best results in formulation. 27 28 Addition it comfortable against gums. They are unbreakable, flexible,
of ceramic or sapphire whiskers to improve thermal light weight and have very little or no monomer content. 31
56 Prajwala et al. / IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59

2.5.1.1. Thermoplastic nylon. The principal constituent colored properties.42

of thermoplastic nylon is polyamide. It uses Rapid
2.5.1.2.2. Adavntages. Thermoplastic acetal comes in 18
Injection which introduced the first flexite thermoplastic.
Vita shades + 3 pink shades, to match most people’s teeth or
Thermoplastic nylon is injected at temperatures from 274 to
gums and clasps are tooth coloured clasps so provide good
293o C. This material generally replaces the metal, and the
esthetics. Labial bars can replace bulky, un-aesthetic metal
pink acrylic denture material used to build the framework
swing-lock type bars. Acetal is flexible and hypoallergenic
for standard removable partial dentures. 32 Valplast &
(monomer free). The teeth and clasps can be injected
flexiplast are polyamides (nylon plastics), since then there is
together in resin, or into the existing denture adding many
a continued interest in thermoplastic dental materials. 33 , 34
new applications. Adjusting is usually not necessary. 39
2.5.1.1.1. Advantages. It is virtually invisible (translu-
2.5.1.2.3. Limitations. An injected resin major connector
cent allowing natural tissue to show through), and there
for temporary partials is no longer recommended because
are no metal clasps, only tissue coloured clasps that blend
the major connectors must be rigid while resin is flexible and
with natural teeth, thus provides excellent esthetics. 34–38
moreover it will not seal around the base of denture teeth
Nylon is unbreakable, light weight & does not warp or
allowing seepage of fluid under and around the teeth. Their
become brittle. Because of its flexibility & incredible
use is limited in resin anterior teeth because it does not have
patient comfort, nylon is ideal for patients considering a
the natural translucency. 39
removable partial denture. In addition, it involves non-
invasive procedures & can be relined or repaired. Nylon 2.5.1.2.4. Applications . Acetal resin is very strong,
shows no discoloration over time & is non-porous so no resists wear and fracturing, and is quite flexible. These
growth of bacteria. 34–38 characteristics make it an ideal material for pre-formed
clasps for partial dentures, single pressed unilateral partial
2.5.1.1.2. Limitations. Nylon is little more difficult to
dentures, partial denture frameworks, provisional bridges,
trim & polish. Also it is not strong enough for conventional 49
tooth borne rest seats. 34 occlusal splints, and even implant abutments.

2.5.1.1.3. Lucitone frs flexible dental resin. Provides 2.5.1.3. Thermoplastic acrylic. Heat-cure PMMA shows
aesthetic partial dentures and very strong night guards when high water absorption, volumetric changes and residual
used with success injection system (closed flask system). monomer and porosity. 50 Even though Thermoplastic
Advantages are same as of valplast partial resin and it has acrylic has poor impact resistance, it has enough tensile and
more impact resistance. flexural strength. It is available in tooth and gingival colors
and has good esthetics. Acrylic doesn’t wear as much during
2.5.1.2. Thermoplastic acetal. Acetal was first proposed occlusal forces and consequently won’t maintain vertical
as an unbreakable thermoplastic resin removable partial dimension over long periods of your time. 50
denture material in 1971. Rapid injection system developed
the first tooth coloured clasps with thermoplastic fluoropoly- 2.5.1.4. Thermoplastic polycarbonate. It is a polymer
mer. 39 In 1986, Dental ‘D’ reintroduced tooth colored chain of bisphenol-A carbonate. It is similar to Acetal resin,
clasps using Acetal resin. Acetal as a homo-polymer has and is also strong, resists fracture, is flexible and does not
good short-term mechanical properties, but as a co-polymer wear. Polycarbonate is used for temporary crown & bridges.
has better long-term stability. The material has a good translucency and finishes very well,
providing improved esthetics. 39,49,50
2.5.1.4.1. Advantages. It doesn’t use monomer and a
catalyst in process so residual monomer doesn’t begin to
melt. It also has lesser water sorption property and so, no
offensive odour and does not cause redness of oral mucous
membrane. 39,49,50
2.5.1.4.2. Disadvantages . Complicated processing
equipments with greater distortion from water sorption,
Fig. 7: Single-walled and multi-walled carbon nanotubes (CNTs) high flexibility, low adhesion to acrylic teeth and low
hardness.
2.5.1.2.1. Mechanism of action. Resin clasps engage the 2.5.1.4.3. Applications of thermoplastic resins . Applica-
first third (or origin) of the undercut rather than the terminal tions of thermoplastic resins include:
third as in metal clasps allowing three to four times the
retention of metal. The clasp can then be placed more • Implant abutments
gingival increasing its aesthetic appeal beyond the obvious • Preformed partial denture clasp,
 Prajwala et al. / IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59 57

Table 2:
Nanofillers Advantages Disadvantages
1. Silver They exhibit broad-spectrum bactericidal, fungicidal Discolouration of resin
activities at very low concentrations and strength is
increased. 40
2. Copper Improved antibacterial, anti fungal properties of Discolouration of resin
resin. Increased tensile and flexural strength when
added in minimal concentrations
3. TiO2 Pleasing color, high biocompatibility, excellent
mechanical properties, low cost, high stability, and
appropriate antimicrobial effects 41 . Has great
oxidizing power under UV radiation, and can
decompose organic materials and bacteria 42 - 43
4. Alumina (Al2 O3 ) Improved thermal properties, flexural, tensile,
compressive, impact strengths, and surface hardness
of PMMA and decreased warpage. 13
5. Zirconia Impact, flexural, compressive strengths have Occasionally, low flexural
improved. Thermal conductivity fatigue strength, strength values have been
fracture toughness and hardness have increased. It reported.
also may have antifungal property. 13
6. Gold (Au) Almost doubles the flexural and thermal properties,
which could lead to more patient acceptance.
7. Platinum (Pt) Enhances mechanical properties and provides
antimicrobial properties. Its addition also increases
the bending deflection of denture base resin.
8. Palladium (Pd) Better bending strength than Gold and Silver. 13
9. Silicon Dioxide (SiO2 ) The mechanical properties and thermal properties of Excess amount lead to
PMMA were improved. Impact strength, transverse agglomeration and crack
strength and surface hardness were increased. propagation, which results in
reduced hardness and fracture
toughness. 13
10 Nano diamonds High hardness and thermal conductivity. Nano There is agglomeration of the
Diamonds increased the impact strength of PMMA, nanodiamonds, which may be
and also increased fracture toughness was seen. points of stress
concentration. 13
11 Copper nanotubes CNTs are strong, resilient, and lightweight. They The reinforcing effect of CNTs
have excellent mechanical and electrical may be restricted because of
properties 44 weak interfacial adhesion with
the resin matrix as well as the
tendency of nanotubes for
agglomeration, which causes
poor distribution throughout
the matrix. 45–48

• Flexible tooth born partial denture framework, according to dimension – those with all 3 dimensions
• Occlusal appliances, less than 100 nm [nanoparticles (Nps)]; those that have 2
• Orthodontic and sleep apnea appliances. dimensions less than 100 nm (nanotubes, nanofibers, and
• Provisional crowns and bridges, nanowires); and those that have one dimension less than 100
• Single cast partial dentures 51 nm (thin films, layers, and coatings). 53 Use of nanomaterials
in composites have achieved better esthetics and mechanical
2.6. Nanomaterials properties. 54

The concept of nanotechnology was first introduced in 1959 2.6.1. Nanofillers

by Feynman. Since then, nanotechnology has been widely Size, shape, surface area, concentration, and dispersion
used in many applications, including medical sciences, of nanofillers into resin matrix all affect its mechanical
and plays an important role in diagnosis, treatment, and properties. Alumina NPs, zirconia (ZrO2) NPs, titania
regenerative medicine. 52 A nanomaterial is an object, which (TiO2) NPs, silver NPs, gold NPs, Pt NPs, HA NPs, SiO2
at least one of its dimensions is at the nanometer scale NPs etc are introduced to improve the mechanical properties
(approximately 1 to 100 nm). Nanomaterials are categorized of PMMA. 13 Nanofillers are available in different shapes
58 Prajwala et al. / IP Annals of Prosthodontics and Restorative Dentistry 2020;6(2):52–59

such as cones, spheres, rods, tubes and flowers. Carbon metal wires. Gen Dent. 2008;56(1):51–5.
nanotubes (CNTs), ZrO2 nanotubes, TiO2 nanotubes, and 10. DeBoer J, Vermilyea SG, Brady RE. The effect of carbon fiber
orientation on the fatigue resistance and bending properties of two
halloysite nanotubes (HNT) are among the nanotubes used denture resins. J Prosthet Dent . 1984;51(1):119–21.
for reinforcement of dental materials. CNTs are classified 11. Segerstrom S. Carbon-Graphite fiber reinforced polymers for implant
into 2 main types according to the structure of the CNTs– superstructures. Dent Mater. 2007;23:1150–6.
single-walled and multi-walled (Figure 7). 55 12. Dixon DL, Breeding LC. The transverse strengths of three denture
base resins reinforced with polyethylene fibers. J Prosthet Dent .
1992;67(3):417–9.
2.7. Self Reinforcement 13. Gad M, Fouda S, Al-Harbi F, Näpänkangas R, Raustia A. PMMA
denture base material enhancement: a review of fiber, filler, and
Self-reinforced materials have been used in polyglycolic nanofiller addition. Int J Nanomed. 2017;Volume 12:3801–12.
acid resorbable screws and plates and collagen forming 14. Ladizesky NH, Ho CF, Chow TW. Reinforcement of complete
materials. Gilbert, Ney & Lautenschlager in 1995, has denture bases with continuous high performance polyethylene fibers.
J Prosthet Dent . 1992;68(6):934–9.
discussed this concept of self-reinforcement of polymers. 15. Karacaer O. The effect of length & concentrationof glass fibers on the
The concept is based on the idea of a fibrous material, mechanical properties of an injection & a compression molded denture
which is chemically identical to the matrix holding the base polymer. J Prosthet Dent. 2003;90(4):385–93.
fibres in place. The composite material consisted of high 16. Li X, Liu W, Sun L. Resin composites reinforced by nanoscaled fibers
or tubes for dental regeneration. Biomed Res Int. 2014;p. 542958.
strength, high ductility PMMA fibres embedded in a matrix 17. Gao Y, Sagi S, Zhang L. Electrospun nanoscaled glass fiber
of PMMA. The properties of unidirectional continuous form reinforcement of bis-GMA/ TEGDMA dental composites. J Appl
were evaluated and showed significantly greater tensile Polym Sci. 2008;110:2063–70.
18. Arcis RW, Lopez-Macipe A, Toledano M. Mechanical properties of
properties, flexural ductility, fracture toughness and fatigue
visible light-cured resins reinforced with hydroxyapatite for dental
strength compared with bulk PMMA. 5 restoration. Dent Mater. 2002;18:49–57.
19. Cucuruz AT, Andronescu E, Ficai A, Ilie A, Iordache F.
3. Conclusion Synthesis and characterization of new composite materials based
on poly(methacrylic acid) and hydroxyapatite with applications in
The progress in denture base resins have provided dentistry. Int J Pharm. 2016;510(2):516–23.
20. Cheng L, Zhou X, Zhong H. NaFloaded core-shell PAN-PMMA
encouraging results pertaining to its strength and esthetics. nanofibers as reinforcements for Bis-GMA/TEGDMA restorative
Many drawbacks of PMMA denture base resins have been resins. Mater Sci Eng C Mater Biol Appl. 2013;34:262–9.
conqured and it is certain that in future, research will offer 21. Vidotti HA, Manso AP, Leung V, do Valle AL, Ko F, Carvalho RM.
newer materials which are more biocompatible with better Flexural properties of experimental nanofiber reinforced composite are
affected by resin composition and nanofiber/resin ratio. Dent Mater.
mechanical endurance, offering better treatment and care to 2015;31:1132–41.
the patient. 22. Boyd SA, Su B, Sandy JR, Ireland AJ. Cellulose Nanofibre Mesh for
Use in Dental Materials. Coatings. 2012;2(3):120–37.
23. Chen L, Xu C, Wang Y. BisGMA/TEGDMA dental nanocomposites
4. Source of Funding
containing glyoxylic acid-modified high-aspect ratio hydroxyapatite
None. nanofibers with enhanced dispersion. Biomed Mater. 2012;7:45014.
24. Fong H. Electrospun nylon 6 nanofiber reinforced BIS-
GMA/TEGDMA dental restorative composite resins. Polymer.
5. Conflict of Interest 2004;45:2427–32.
25. Pfeiffer P, Rosenbauer EU. Residual methyl methacrylate monomer,
None. water sorption, and water solubility of hypoallergenic denture base
materials. J Prosthet Dent . 2004;92(1):72–78.
26. Tanoue N, Nagano K, Matsumura H. Use of a light-polymerized
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