ADVANCES IN PROSTHODONTIC BIOMATERIALS

CONTENTS
• INTRODUCTION
• LABORATORY MATERIALS
• FLEXIBLE DENTURE BASE MATERIAL
• MICROWAVE CURED DENTURE BASE RESIN
• ULTRA HIGH IMPACT HEAT-CUREED DENTURE BASE RESINS
• GLASS FIBER REINFORCED DENTURE BASE RESINS
• DENTURE TEETH
• COMPOSITE DENTURE TEETH
• TITANIUM ALLOY

• CASTING TITANIUM

• MACHINING TITANIUM

• WAXES

• LIGHT CURING WAXES

• MAGNETS IN PROSTHETIC DENTISTRY

• IMPLANT SYSTEM

• GINGIVAL RETRACTION SYSTEMS

• CERAMICS

• RECENT CORE MATERIALS AND TECHNOLOGIES

• MAXILLOFACIAL PROSTHESIS

• CONCLUSION

• REFERENCES
INTRODUCTION

Biomaterials in prosthodontics are used to replace lost teeth. With the wide range of prosthodontic
biomaterials available, clinicians often face challenges in selecting the most suitable material due to
a lack of solid scientific evidence and comprehensive knowledge. Many times, clinicians rely on
hearsay or recommendations from other practitioners and medical representatives. Evidence-based
practices should be promoted to enhance the confidence of dental professionals in using these
materials.

Ongoing advancements aim to refine existing materials and introduce new ones, ensuring that the
final restoration is both biocompatible and durable in the oral environment. Staying informed about
the latest trends in dental practices and material innovations is essential for benefiting both the
dentist and the patient.

Biomaterials can be defined as biological or synthetic substances that can be introduced into body
tissues as part of an implanted medical device or used to replace organs or bodily functions. The
following discussion will focus on the commonly used biomaterials in prosthodontics, highlighting
their current state and recent developments.

LABORATORY MATERIALS

DENTURE BASE RESINS

I. FLEXIBLE DENTURE BASE MATERIAL

Polyamide, a biocompatible nylon thermoplastic, is ideal for partial

dentures due to its softness, flexibility, and ease of insertion. Thin,
lightweight, unbreakable, and stain-resistant, it offers excellent
aesthetics without requiring tooth or tissue preparation, making it
both comfortable and hypoallergenic.

II. MICROWAVE CURED DENTURE BASE RESIN

This resin is handled like conventional resins until curing,
which is simplified by using a standard 500-watt microwave.
The process takes just 3 minutes, producing more accurate,
stronger denture bases. Heat from molecular vibr
III. ULTRA HIGH IMPACT HEAT-CUREED DENTURE
BASE RESINS

These resins were developed to meet the demand for high-

impact strength in denture base materials. Reinforced with
advanced materials and cured at specific temperatures, they
boast superior physical properties. They are easy to finish and
polish, ensure an accurate fit, and require a minimum of 2
hours for heat polymerization.
IV. GLASS FIBER REINFORCED DENTURE BASE RESINS

Various fibers, such as carbon, aramid, woven polyethylene, and

glass, are used to strengthen denture base resins. Carbon and aramid
fibers enhance strength but pose issues like poor aesthetics and
polishing difficulty. Woven polyethylene fibers are more aesthetic
but impractical to process in clinics. Silanated glass fibers are
preferred for their improved flexural properties and fatigue
resistance, making them ideal for reinforcing denture polymers.

DENTURE TEETH

I. COMPOSITE DENTURE TEETH

Micro-filled and nano-filled denture teeth offer varying hardness

and wear resistance. Knoop hardness values: 28.2–29.8 (micro-
filled), 22.7 (nano-composite), 18.9–21.6 (cross-linked acrylic),
and 18.6 (conventional acrylic). Wear depth: 90.5 µm (nano-
composite), 69.8–93.0 µm (micro-filled), 80.8–104.0 µm (cross-
linked acrylic), and 162.5 µm (conventional acrylic). Nano-
composite teeth are harder and more wear-resistant than acrylic but comparable to micro-filled and
most cross-linked composite teeth.
TITANIUM ALLOYS

I. CASTING TITANIUM

Titanium has a high melting point (16600 c) and is

melted using electric plasma arc or inductive heating in a
melting chamber filled with inert gas or held in a
vacuum. The molten metal then is transferred to the
refractory mold via centrifugal or pressurevacuum filling
II. MACHINING TITANIUM

Dental implants are typically machined from pure metal or alloy billets. Crowns and bridge
frameworks can also be crafted using computer-aided machining. Alternatively, electric discharge
machining shapes metal using a graphite die and spark erosion.

WAXES

I. LIGHT CURING WAXES

Wax patterns for removable partial denture frameworks can be

created directly on the cast using profiled waxes like TiLight or
LiWa (light-curing waxes). These waxes eliminate the need for
duplicating techniques, saving time. Suitable for all types of
metal work, including crowns, bridges, and implants, they cure
quickly under standard lab UV or halogen light. These waxes
are user-friendly, economical, strong, elastic, odorless, and stable.
MAGNETS IN PROSTHETIC DENTISTRY

Magnets are widely used in dentistry, particularly in orthodontics and

removable prosthodontics, due to their small size and strong attractive
forces. Common magnetic materials include Neodymium-Iron-Boron
(NdFeB), RE Alloy, and Samarium-Cobalt (Sm-Co), with Samarium Iron
Nitride being a promising option. Advances include encapsulating magnets
in inert alloys like stainless steel or titanium for improved biocompatibility.
IMPLANTS SYSTEMS

I. POROUS TITANIUM FOAM IMPLANTS

This screw-less dental implant system connects implant and

supra structure with a novel clipping mechanism. Fatigue of
material, resulting in loose or broken screws and unintended
malformations, is a possibility
II. CLIPPPING IMPLANT SYSTEMS

This screw-less dental implant system connects implant and

supra structure with a novel clipping mechanism. Fatigue of
material, resulting in loose or broken screws and unintended
malformations, is a possibility
III. SURFACE MODIFICATIONS

Dental implant surfaces are modified using techniques like titanium plasma spraying, acid etching,
laser sintering, and sandblasting. Coatings with titanium fluorapatite and hydroxyapatite improve
osseointegration. Anodic oxidation in an electrolytic solution increases the oxide layer thickness
(1-2 µm coronally, 10 µm apically) and creates a porous surface.

Biochemical modifications include bone morphogenetic proteins (BMPs) and growth factors to
enhance bone formation. RGD-containing peptides, which promote cell attachment by interacting
with integrin receptors, are also applied to implant surfaces. Growth factors like TGF-β1, IGF-1,
and BMPs stimulate bone cell activity, osteoinduction, and collagen synthesis. Platelet-rich plasma
(PRP), derived from autogenous blood, delivers concentrated growth factors (e.g., PDGF, TGF,
IGF) to enhance bone regeneration at implant sites.
GINGIVAL RETRACTION SYSTEMS

IV. EXPASYL

Expasyl is a temporary gingival retraction system that serves as an alternative to

traditional retraction cords. It is a painless, fast, and reliable method for
temporarily opening the sulcus. The paste, containing aluminum chloride,
separates the gingiva from the tooth without damaging the epithelial
attachment, preventing bleeding, gingival recession, or bone resorption.
V. MAGIC FOAM CORD

Magic Foam Cord is an expanding PVS material used for non-

hemostatic gingival retraction. It provides a quick, non-traumatic
method for retracting the gingival sulcus without the need for
packing cords. The material is syringed around the crown margins,
and a cap (Comprecap) is applied to maintain pressure. After 5
minutes, both are removed, and the tooth is ready for the final
impression. Advantages include easy application, effortless removal,
and no hemostatic chemicals to contaminate the impression.
VI. STAY PUT

Stay Put is a pliable retraction cord made of braided material with a

fine copper filament, allowing easy adaptation and preforming. It
stays in place in the sulcus, doesn’t unravel, and requires no
overlapping. It is non-impregnated but can be soaked in an
astringent or hemostatic solution as needed.

CERAMICS

I. IN-CERAM

In-Ceram offers three core materials: Spinel, Alumina, and

Zirconia. These are slip-cast onto a porous refractory die, partially
sintered, and then infiltrated with glass to enhance strength and
eliminate porosity. In-Ceram materials have higher fracture
toughness than conventional porcelain.
 • Spinel: For anterior inlays, onlays, crowns, and veneers.
• Alumina: For anterior and posterior crowns.
• Zirconia: For posterior crowns and FPDs.
Advantages of these glass-infiltrated cores include metal-free
construction, high flexural strength, toughness, and compatibility with any
luting cement.

II. EMPRESS

Hot-pressed Lucite-reinforced glass ceramic, ideal for anterior crowns,

bridges, and veneers. Offers high flexural strength and aesthetics but may
fracture in posterior regions.
III. TECHCEREM

Alumina core with high strength and translucency, achieved through

sintering at 1170°C. Versatile for various
restorations.
IV. CAD/CAM

Computer-aided design and manufacturing

technology, such as CEREC® 3D, creates all-
ceramic inlays, crowns, and veneers. Newer
systems offer better fit, finer materials, and
improved milling accuracy.

V. PROCERA SYSTEM

Uses densely sintered 99.9% alumina core for anterior and posterior
crowns, onlays, and inlays.
VI. CAPTEK SYSTEM

Eliminates the casting process in metal-bonded crowns. It involves a

gold alloy-filled wax strip, improving marginal fit and aesthetics.
RECENT CORE MATERIALS AND TECHNOLOGIES

IMPRESSION MATERIALS

I. DUSTLESS ALGINATE

Dustless Alginate contains high alginate content and glycerin, improving

impression quality while reducing excessive flow.
II. FLUORIDE CONTAINING ALGINATE

Fluoride-containing alginate with NaF or SnF2 releases fluoride effectively,

reducing enamel solubility without compromising material properties.
III. CHROMATIC ALGINATE

Chromatic alginate offers rapid processing, thixotropic flow, compatibility

with plaster, and smooth, detailed impressions. Phases: purple (mixing),
orange (processing), yellow (insertion).
IV. AUTO-MIX ALGINATE

AlgiNot is a time-saving, cost-effective alternative to traditional

alginate. It is not hand mixed, improving the handling
characteristics. Thus it saves time. This material is not affected
by the disinfectant, thus infection control is assured.
V. SILGIMIX

Silgimix, a vinyl polysiloxane-based alginate replacement,

allows disinfection, multiple pours, and electronic scanning.
Rubber-based impression materials like PVS are popular for
their stability, handling ease, elasticity, and detail reproduction.
PVS's hydrophobicity limits use with blood or saliva, addressed
by introducing hydrophilic polyvinyl siloxane.
VI. HYDROPHILIC POLYVINYL SILOXANE

Hydrophilic properties in impression materials are enhanced by

adding surfactants and hydrophilic monomers, reducing the contact
angle for better wettability and detail reproduction, even with oral
fluids. However, surfactants can hinder electroformed die preparation as metallizing powder
adheres poorly to hydrophilic addition silicone surfaces.
VII. VINYL POLY ETHER SILICONE

Vinyl Poly Ether Silicone, a hybrid of poly-vinyl siloxane and

polyether, combines hydrophilicity and rigidity from polyether
with flow and detail reproduction from polyvinyl siloxane.
Available in various consistencies, it supports single-step, double-
step, and putty-wash techniques. While manufacturers claim
superior properties, incomplete mixing may affect detail, and
further studies are needed for validation.

VIII. NANO-FILLED POLY VINYL FILLED SILOXANE

Nano-filled poly vinyl siloxane improves hydrophilicity, flow, detail, and precision. SENN, a vinyl-
polyether hybrid material, combines polyether for hydrophilicity and siloxane for stability and
precision, achieving these properties without surfactants.
MAXILLOFACIAL PROSTHESIS

I. ISOPHORONE POLYURETHANE

A unique polyurethane elastomer, based on cycloaliphatic diisocyanate, is a three-component kit

with high strength due to its cycloaliphatic isophorone structure. Its aliphatic nature enhances
sunlight resistance, and it is safe for both prosthodontists and patients.
II. SE-4524U

This silicone polymer requires moderate to high temperatures for cross-linking, initiated by an
organic peroxide. Examples include Silastics 44514/44515 (Dow Corning) and SE-4524U (General
Electric). High temperatures are necessary to decompose the peroxide catalyst during prosthesis
fabrication.

III. PDM SILOXANE

It is a type of HTV silicone that has physical and mechanical properties that exceeded values
considered clinically acceptable.
IV. Q7-4635, Q7-4650, Q7-4735, SE-4524 U
These are new generation of HTV silicones, which have improved mechanical and physical
properties. The processing characteristics of Q7-4635 and SE4524U were particularly favorable
because of their single component system with unlimited shelf life.
V. MDX 4-4210

Modified poly dimethyl siloxane (PDMS) elastomers are popular in maxillofacial clinics due to
significant improvements over older Silastic polymers. Cross-linking occurs via Si-H and Si-vinyl
units, initiated by a platinum catalyst. However, curing is inhibited by contaminants like amines,
sulfur, and tin compounds
VI. A-2186

It is a recently developed material whole physical and mechanical properties are inferior compared
to MDX 4-4210.
CONCLUSION

Advances in biomaterials and techniques offer numerous options, but dentists must select materials
that meet biological, functional, and aesthetic needs. Staying updated on biomaterials and their
handling is essential for providing quality patient care.

REFERENCES

• Dr. P. S. Manoharan, Dr. Balaji J. Advances in prosthodotnic biomaterials. Ann. SBV, July - Dec
2014;3(2)

• Artak Heboyan 1,*,Muhammad Sohail Zafar 2,3,Dinesh Rokaya 4 andZohaib Khurshid 5.

Insights and Advancements in Biomaterials for Prosthodontics and Implant Dentistry. Ann. SBV,
July - Dec 2014;3(2)

• Artak Heboyan1* and Francesco Bennardo2. New biomaterials for modern dentistry. 2023. BMC
oral health: 817

• Julfikar Haider, Rasha Dosh, Zena Wally. Current advances in dental biomaterials. 2023

• Abhinn Miglani*, Rozina Vishnani. Recent Advances in Dental Biomaterials. 2023. Journal of
research in medical and dental sciences. Volume 11, issue 3.