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PURPOSE: Heat-activated polymethyl methacrylate (PMMA) is the most common and widely accepted denture base material. Two important drawbacks are the development of denture stomatitis and the high incidence of fracture of denture bases. The present study investigated the effect of adding 0.2% by weight of silver nanoparticles (AgNps) and using the autoclave method of terminal boiling on the flexural strength of heat-activated PMMA denture base resin. METHODS: A total of 40 samples of heat-activated PMMA blocks were divided into four groups, with 10 samples (n = 10) in each group. Group 1 consisted of unmodified heat-activated PMMA resin (PMMA-1) polymerized by the conventional method of terminal boiling (conventional curing); Group 2 consisted of 0.2% by weight AgNPs added to heat-activated PMMA resin (PMMA-2) polymerized by conventional curing; Group 3 consisted of PMMA-1 polymerized by the autoclave method of terminal boiling (autoclave curing); and Group 4 consisted of PMMA-2 polymerized by autoclave curing. The flexural strength was tested using a universal testing machine. Descriptive statistics were expressed as mean ± SD and median flexural strength. Kruskal-Wallis ANOVA with Mann-Whitney U post hoc test was applied to test for statistical significance between the groups. The level of significance was set at p<0.05. RESULTS: The results showed a statistically significant reduction in flexural strength in Group 2 compared to Group 1. The samples from Group 4 showed a statistically significant increase in flexural strength compared to Group 2. The Group 4 denture base had the highest flexural strength (115.72 ± 7.27 MPa) among the four groups, followed by Group 3 (104.16 ± 4.85 MPa). The Group 1 samples gave a flexural strength of 101.45 ± 3.13 MPa, and Group 2 gave the lowest flexural strength (85.98 ± 3.49 MPa) among the four groups tested. CONCLUSION: The reduction in flexural strength of the heat-activated PMMA denture base after adding 0.2% by weight of AgNP as an antifungal agent was a major concern among manufacturers of commercially available denture base materials. It was proved in the present study that employing the autoclave curing method of terminal boiling for the polymerization of 0.2% by weight of AgNp-added heat-activated PMMA denture base resulted in a significantly higher flexural strength compared to the conventional curing method of terminal boiling for polymerization. Unmodified heat-activated PMMA gave higher flexural strength values when polymerized by autoclave curing compared to the conventional curing method of terminal boiling.
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Objective To evaluate and compare the stability of the open tray impression coping within the set impression while attaching the lab analog when polyether (PE) heavy body and polyvinyl siloxane (PVS) putty impression materials were used and the implant platform was placed sub-gingivally at three different depths. Methods Two impression materials, PE and PVS, and custom-made plexiglass models with embedded single implants to simulate implant positioning depths of 0 mm, 2 mm, and 4 mm, sub-gingivally, were used in the study. Open tray impressions were made after attaching impression coping to the implant embedded in the model. Implant lab analog was attached to the impression coping in the set impression, and its stability was measured using a universal testing machine. Forty-two open tray impressions were made in six groups, with seven impressions in each group. Descriptive statistics such as mean and standard deviation were calculated. A comparison of the mean stability between the two impression materials at each depth was done using an independent t-test. Comparison of the mean stability between the three different subgingival implant depths in each material was done by one-way ANOVA with the Scheffe multiple comparison test (post-hoc analysis). The level of significance was set at p<0.05. Results The stability of the impression coping was measured as the force in Newtons required for the displacement of the analog attached to the impression coping embedded in the set impression. PE with the embedded impression coping at a depth of 0 mm gave the highest mean stability value (4.37+/-0.41), and the least mean stability was offered by PVS with the embedded impression coping at 4 mm depth (1.88+/-0.37). When an independent t-test was done to compare the mean stability values of PE and PVS, there was a statistically significant difference at 0 mm, 2 mm, and 4 mm. On doing one-way ANOVA to compare the mean stability between the different depth groups, there was a statistically significant difference between the three depth groups in PE and PVS. Scheffe multiple comparison tests (post-hoc analysis) revealed a statistically significant difference between 0 mm, 2 mm, and 4 mm subgingival depths of the impression coping placement in both PE and PVS. Conclusion The accuracy of the master cast is an important determinant for the precise fit and long life of the final prosthesis. In the case of maxillary anterior implant placements where deep subgingival placement of the implant platform is needed for aesthetic and functional reasons, the impression material should be selected carefully to ensure the stability of the impression coping. Among the materials included in the present study, the PE impression material offered the maximum stability for impression coping compared to PVS.
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Amputation of all or part of a limb may be due to systemic disease, vascular disease, infection, local injury or trauma. Partially amputated lower limbs present a variety of unique clinical and prosthetic challenges, because of distinctly different amputation levels of the lower limb. A female patient with history of Partial Foot Amputation (PFA) surgery at metatarsophalangeal joint level, due to crush injury reported for prosthetic rehabilitation. This case was successfully rehabilitated using room temperature vulcanizing (RTV) medical grade silicone for fabrication of foot prosthesis. Though limited in its function, it amply proves that the clinical and laboratory techniques used in fabrication of maxillofacial prosthesis can be effectively adapted for the fabrication of body prosthesis like toes and feet to enhance the quality of life of the patients. The patient was reviewed every year for three years.