Css Prosto

8/13/2019 Css Prosto

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Modul : Prosthodonsi

Preseptor : drg. Hastoro Pintadi, Sp.Prost

Presentan : Lisna K. Rezky, S.KG

Clinical Science Session (CSS)

Gigi Tiruan Sebagian Lepasan


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ANALISIS JURNAL

Judul :

Clinical Survey of Acrylic Resin Removable

Denture Repairs with Glass-Fiber

Reinforcement

Author :

Katja K . Narva, DDSa, Pekka K . Vall i t tu , DDS,

PhD, CDTb, Hans Helen ius , MScc , An tt i Yl i-

Urpo , DDS, PhDdThe International Journal of Prosthodontics,

volume 14, Number 3, 2001


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PENDAHULUAN Damage in the acrylic resin denture base of

removable dentures is one of the most common(64%) causes of repair of dentures.

flexural fatigue phenomena as a cause of denturefracture.A study of fracture surface characteristics inremovable dentures supports the fatigue failuremechanism as a main causative factor for denturefractures.

Metal wire or mesh strengtheners have not proven

to reinforce denture base material effectively.15,8Clinically, the information obtained is important fromthe perspective of temporary removable partialdentures (RPD) or those used as permanentsolutions as well as from the perspective of the need

to reinforce tooth- or implant-supported overdentures.


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Fatigue resistance is related to the properties ofmaterials; for example, glassy materials have

relatively low flexural fatigue resistance. Denture

base polymers made from, eg, poly(methyl

methacrylate) (PMMA) polymer powder andmethyl methaclylate (MMA)butanediol

dimethacrylate (BDMA) monomers, are such

glassy materials at room temperature or at the

temperature of the oral cavity.10 To improvematerial


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properties in structural engineering applications, fiber

reinforced composites (FRC) are often used. Recently,FRCs have also been used in dentistry as reinforcementsof removable and fixed partial dentures.1131 FRC hashigh fatigue resistance. Because fatigue is the main failuremechanism of dentures, the use of FRC as areinforcement of dentures could be justified. An in vitro

study of the flexural fatigue resistance of the acrylic resinof RPDs suggests the clinical usefulness of FRCreinforcement.

The denture base can be reinforced in two ways: the entiredenture base can be reinforced, or the fiber reinforcementcan be accurately placed in the weak region of the

denture. The reinforcements can be defined as a total fiberreinforcement and partial fiber reinforcement (PFR),respectively (Fig 1). Total fiber quantity in dentureconstruction with PFR is low. To obtain a good reinforcingeffect with PFR, all of the strength-related factors of FRCsshould be carefully taken into consideration.


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Different types of fibers have been used to reinforcedentures: glass fibers, ultrahighmolecular weightpolyethylene (UHMWP) fibers, carbon/ and aramidefibers. Fiber type affects the strength of FRC bymeans of adhesion and mechanical properties of the

reinforcing fiber itself.1131 Glass fibers have beenshown to improve the mechanical properties of acrylicresin, especially fatigue resistance, impact strength,and flexural strength.1113,15,1820,35 This isbecause of good adhesion of the glass fibers todenture base polymer and a low percentage ofelongation at break of glass fibers. UHMWP fibershave relatively good mechanical properties, but theadhesion to the matrix polymers is insufficient, evenwhen plasma treatment of the fiber surface isperformed graphite fibers


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TUJUAN

The aim of this study was to evaluate clinicalusefulness and durability of continuous glass-

fiber reinforcement in repair of acrylic resin

removable dentures.


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METODE Fractured removable dentures without reinforcement, with

conventional metal-wire reinforcement, or with meshreinforcement were collected from two dental schools in Finland.The total number of dentures was 51 and the number of patientswas 48. There were 7 mandibular dentures and 44 maxillarydentures in the study, and of those, 28 were complete denturesand 23 were RPDs. The number of previous fractures wasobtained from the patient file. The inclusion criterion wasexistence of a fracture line in the acrylic resin denture base or afracture of the denture into two pieces.

During the repair, the dentures were reinforced with a polymer-preimpregnated E-glass fiber at the region of the fracture. Thefibers were used as partial fiber Reinforcement, ie, only the

weakest part of the denture was reinforced. The PFR was placedinto the region of the fracture of the denture base at a 90-degreeangle to the fracture line. The PFR was wetted with a smallamount of monomer liquid of mainly MMA (eg, Palapress,Heraeus Kulzer) and embedded with a mixture of polymerpowder and monomer liquid. The resin was polymerized in warm

water in a pneumatic curing unit for 15 minutes.


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Follow-up time varied from 4 months to 4.1 years.After the follow-up period, possible fractures and

discoloring were visually inspected. In the

examination of general shape of the denture,

possible fractures, hairline fractures, anddiscoloring of PFR were visually inspected.

Possible protrusion of the fibers and irritation of

the oral mucosa were also evaluated.

To evaluate the results, the mean number ofrerepairs in each denture per year was calculated

before and after the insertion of the PFR. The

number of repairs was compared by

nonparametric Wilcoxonssigned ranks tests.


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HASIL

In 88 % of the cases, there was no need foradjustment at the region of partial fiber

reinforcement, and the clinical condition of the

dentures was good. Glass fibers did not irritate

the oral mucosa. In the case of refracture orhairline fracture, positioning of the partial fiber

reinforcement was incorrect or the reinforcement

had been used incorrectly (the wetting of the

reinforcement with denture base resin wasinadequate).


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EVALUASI PERAWATAN

Perawatan gigi tiruan sebagian lepasan yangtelah dilakukan dalam keadaan baik, tidak ada

terjadi patahan, oklusi pasien tidak berubah.

Css Prosto

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