EFFECT OF S GLASS FIBRE REINFORCEMENT ON THE
EFFECT OF S GLASS FIBRE REINFORCEMENT ON THE FLEXURALPROPERTIES OF COMPOSITES – AN IN VITRO STUDYDissertation submitted toTHE TAMILNADU Dr. M.G.R. MEDICAL UNIVERSITYCHENNAIIn partial fulfillmentFor the requirements for the degree ofMASTER OF DENTAL SURGERYBRANCH – IPROSTHODONTICS AND CROWN & BRIDGEMAY - 2018
CERTIFICATE - IThis is to certify that the dissertation titled “EFFECT OF S GLASS FIBREREINFORCEMENT ON THE FLEXURAL PROPERTIES OF COMPOSITES – ANIN VITRO STUDY” is a bonafide work done by Dr. M.KANMANI, Postgraduate student,during the course of the study for the degree of “Master of Dental Surgery” in Department of,PROSTHODONTICS AND CROWN & BRIDGE, KSR Institute of Dental Science andResearch, Tiruchengode during the period of 2015-2018, under our supervision and guidance.Dr. C.A.MATHEW, MDSDr. G.S.KUMAR, MDSGuide, Professor and Head,Principal,Dept. of Prosthodontics andCrown & Bridge,KSR Institute of Dental &Science and Research,KSR Institute of Dental Science andResearch,Tiruchengode – 637215.Tiruchengode – 637215.
DECLARATION BY THE CANDIDATEEFFECTTITLE OF DISSERTATIONOFSGLASSFIBREREINFORCEMENT ON THE FLEXURALPROPERTIES OF COMPOSITES – AN INVITRO STUDYPLACE OF STUDYK.S.R Institute of Dental Science and ResearchDURATION OF COURSE3 YearsNAME OF THE GUIDEDr. C.A.MATHEW M.D.SHEAD OF THE DEPARTMENTDr. C.A.MATHEW M.D.SI hereby declare that no part of the dissertation will be utilized for gaining financialassistance for research or other promotions without obtaining prior permission from thePrincipal, K.S.R Institute of Dental Science and Research, Tiruchengode. In addition, Ideclare that no part of this work will be published either in print or electronic without theguide who has been actively involved in this dissertation. The author has the rights reservedfor publishing the work solely with prior permission of the Principal, K.S.R Institute ofDental Science and Research, Tiruchengode.Head of the DepartmentGuideSignature of the candidate
CERTIFICATE - IIThis is to certify that this dissertation work titled “Effect of S Glass FibreReinforcement on the Flexural Properties of Composites – An In VitroStudy” of the candidate Dr. M.Kanmani with registration Number 241511251 for theaward of Master of Dental Surgery in the branch of Prosthodontics and Crown &Bridge. I personally verified the urkund.com website for the purpose of plagiarism Check. Ifound that the uploaded thesis file contains from introduction to conclusion pages and resultshows 2 percentage of plagiarism in the dissertation.Guide & Supervisor sign with Seal.
ACKNOWLEDGEMENTSFirst and foremost, I would like to express my sincere gratitude to my advisorDr.C.A.MATHEW, M.D.S., for his continuous support, patience and motivation. I could nothave imagined having a better advisor and mentor for my post-graduation. This dissertationcould not have been completed without his immense knowledge, generous and professionalassistance.I extend my sincere thanks to our Principal, Dr. G.S. Kumar, M.D.S., KSR Institute ofDental Science & Research, for the facilities he has done for the betterment of the students.I would also like to thank my department staffs including, Dr. Vidyasankari M.D.S., Dr.Muthuvignesh M.D.S., Dr. Suresh Kumar M.D.S., Dr. Maheshwaran M.D.S., Dr.Rajkumar M.D.S. and Dr. Vishwanathan M.D.S., I am so deeply grateful for their help,professionalism and valuable guidance throughout the course.I was at loss of words when I began to express my gratitude and appreciation for mywonderful senior Dr. Karrunakaran for his support and care. I extend my heartfelt thanks tomy colleague Dr. Yogananth and my dearest juniors Dr. Shanmuga Priya, Dr. Biju, Dr.Kasthuri, Dr. Dheepika, Dr.Ashna and Dr. Krishna Priya. They all gave me a stress freeenvironment to work, with their presence and guidance and I am always indebted to them. Ialso thank my post graduate friends from other departments Dr.Surya, Dr.Janani,Dr.Poojitha, Dr. Vijayasankari for sharing their opinions and their encouragement forcompleting this work.I would also like to thank non-teaching staff members in our department and staffmembers of library for their kind cooperation in my career as a post graduate student.
Finally I express my wholehearted gratitude to my parents Mr.V.Murugesan & Mrs.P.K.Parvathy and beloved sister Mrs.M.Anbumani for their constant faith in me withouthaving any second thoughts and allowing me to pursue my dreams.
CONTENTSS.NOTITLEPAGE NO.1.INTRODUCTION12STATEMENT OF PROBLEM33.AIMS AND OBJECTIVES44.NULL HYPOTHESIS55.REVIEW OF 9.DISCUSSION5210.SUMMARY AND CONCLUSION5811REFERENCES6012ANNEXURE- 16513ANNEXURE - 268
LIST OF FIGURESS.No1ContentsMaterialsPage No292Armamentarium293Sand Paper304Separating Sheets305Tissue Paper306Ruler307Glass Slab318Incubator319Digital Balance3110Light Curing Unit3211Universal Testing Machine - Zwick Roell3212Scanning Electron Microscope – Zeiss3313Mould Assembly placed On a Glass slide3414Packing of the Material into the Mould3415Material placement completed3416Placement of second glass slide over the packed material3517Polymerisation of the specimen3518Specimen Retrieval3519Long S glass fibres3620Chopped S glass Fibres (4 mm)3621Wetting the glass fibres using silane agent3622Wetted fibres were placed on the resin matrix3623Fibres were mixed into the resin matrix3624Group A specimens3725Group B specimens3726Group C specimens3727Group D specimens3828Group E specimens3829Specimens in distilled water3830Finished specimen39
LIST OF FIGURESS.No31ContentsSpecimen was placed between the supports for 3-point bending test32Fractured specimen3933Fractured segments Group A specimens showing complete fracture4034Fractured segments Group B specimens showing complete fracture4035Fractured segments Group C specimens showing complete fracture4036Fractured segments Group D specimens showing incomplete fracture4137Fractured segments Group E specimens showing incomplete fracture4138Fractured surface of the specimen (Group B) with the flexural strengthof 249 MPa; Yellow arrows indicate the presence of voids3941Fractured surface of the specimen (Group C) with the flexural strengthof 88 MPa; Yellow arrow indicates the presence of larger void.40Page No3942Fractured surface of the specimen (Group D) with the flexural strengthof 245 MPa; Yellow arrows indicate the distribution of fibres more42along the length of the specimen than in the transverse direction.41Fractured surface of the specimen (Group D) with the flexural strengthof 245 MPa; Yellow arrows indicate the presence of voids4243Fractured surface of the specimen (Group D) with the flexural strengthof 245 MPa; Yellow arrow indicates the partial adherence of fibre tothe resin matrix43
LIST OF TABLESS.NoContentsPage No.1.Composition of the materials used in the present study222.Weight and Volume proportion of glass fibres and composite resinused for the fabrication of specimens for control group and reinforcedgroups263.Mean and Standard deviation of Flexural strength (MPa) for theControl (A) and Reinforced groups (B, C, D and E)4.Minimum and Maximum values of Flexural strength (MPa) for theControl (A) and Reinforced groups (B, C, D and E)455.Results of Statistical analysis using One way-ANOVA for flexuralstrength456.Multiple inter group comparison using Post Hoc Test - TUKEY (HSD)for flexural strength467.Mean and Standard deviation of Flexural Modulus (GPa) for theControl (A) and Reinforced groups (B, C, D and E)478.Minimum and Maximum values of Flexural Modulus (GPa) for theControl (A) and Reinforced groups (B, C, D and E)489.Statistical analysis - one way ANOVA for flexural modulus4910.Multiple inter group comparison using Post Hoc Test - TUKEY (HSD)for flexural modulus5044
LIST OF GRAPHSS.NoCONTENTSPage No.1.Comparison of mean values of Flexural strength (MPa) forthe Control (A) and Reinforced groups (B, C, D and E)442.Comparison of mean values of Flexural Modulus (GPa) forthe Control (A) and Reinforced groups (B, C, D and E)48
LIST OF ABBREVATIONSFRCFibre Reinforced CompositesFPDFixed Partial DentureSiO2Silicon dioxideMgOMagnesium oxideCaOCalcium oxideRCTRandomized Control TrialANOVAHSDAnalysis of VarianceHonest significant differenceStdStandarddfDegree of umeWt.WeightMPaMega PascalGPaGiga PascalBis GMABisphenol A- glycidyl methacrylateTEDGMATriethylene glycol dimethacrylateUDMAUrethane DimethacrylatePMMAPoly Methyl MethacrylateHEMAHydroxy ethyl methacrylateMDPMethacryloyloxydecyl Dihydrogen Phosphate
TERMINOLOGIES1. Fixed partial dentureAny dental prosthesis that is luted, screwed, or mechanically attached or otherwise securelyretained to natural teeth, tooth roots, and/or dental implants/abutments that furnish theprimary support for the dental prosthesis and restoring teeth in a partially edentulous arch; itcannot be removed by the patient.2. Fiber-reinforced composite resinComposite resin impregnated with glass, carbon, or polyethylene fiber; fibers may becomposite resin impregnated by the provider or pre-impregnated by the manufacturer; dentalapplication includes resin-bonded prostheses and posts.3. Provisional restorationA fixed or removable dental prosthesis, or maxillofacial prosthesis designed to enhanceesthetics, stabilization, and/or function for a limited period of time, after which it is to bereplaced by a definitive dental or maxillofacial prosthesis; often such prostheses are used toassist in determination of the therapeutic effectiveness of a specific treatment plan or the formand function of the planned definitive prosthesis4. Flexural strengthForce per unit area at the point of fracture of a test specimen subjected to flexural loading5. Elastic modulusRelative stiffness of a material; ratio of elastic stress to elastic strain
INTRODUCTION
INTRODUCTIONThe increasing demands in esthetic dentistry along with the developments inmanufacturing technology have led to the production of many dental materials with improvedphysical and mechanical properties for clinical applications.In the recent years, the use of light cured composite resins has been rapidly increasingfor both the anterior and posterior restorations because of the advent of nano composites.Nano composites, either nanohybrid or nanofilled are superior in strength than traditionalhybrid composites and also have optimal polishability when compared to microfilledcomposites. Fillers in nanohybrid composite ranges from micron sized to nano sized particles.Fillers are added to the resin matrix as reinforcement to improve the physical and mechanicalproperties, to reduce polymerisation shrinkage, to reduce thermal contraction, to decreasewater sorption, to impart radiopacity and to optimize the viscosity of the resin matrix 1, 2.At present, glass fibres are the most commonly used and preferred reinforcing materialfor composites. Carbon/graphite, aramid, boron, metal fibres and polyethylene fibres are alsoused. Although carbon fibers are superior to glass and polyethylene fibers in increasing themechanical properties of resin composites, they pose an esthetical disadvantage because oftheir black appearance 3. Among the glass fibres, ‘E’ and ‘S’ glass fibres are commonly used.E stands for electrical grade and these fibres predominantly consist of SiO2 and CaO and Sstands for strength and the fibres are made of SiO2 and MgO 4.Glass fibres are classified into long-continuous and short-discontinuous; long fibres areagain sub-grouped into unidirectional-long, bidirectional-woven and braided fibres. Preimpregnated and non-impregnated fibres are also available. Mechanical properties of FRCsdepend on some factors like fiber orientations, amount of fibres, adhesion of fibres topolymer matrix, impregnation of fiber with the matrix polymer, fiber type, fibre’s aspect ratioand volume loading.1
INTRODUCTIONFRCs for dental applications has been discussed in the literature since the early 1960s.Forthe past three decades, many in vitro and in vivo studies have been conducted to determinevarious properties of FRCs and they have become a material of choice for clinicalapplications such as reinforcement of complete dentures and removable partial dentures,fabrication of fixed partial dentures, endodontic posts, periodontal splints and orthodonticretainer 5.The use of FRCs in clinical dentistry may solve many of the problems associated with ametal alloy substructure such as corrosion, toxicity, complexity of fabrication, high cost andaesthetic limitation 6. They are utilised more due to the enormous demands for conservation,esthetics and immediate restoration are increasing now a days. But still literature evidence inthe form of RCTs are lacking to support FRC as a definitive restoration 7.FRCs are also used for the fabrication of provisional restorations. Provisional restorationsmust satisfy the requirements of pulpal protection, positional stability, occlusal function,ability to be cleansed, margin accuracy, wear resistance, strength and esthetics 8. The strengthof provisional restorations is important, particularly when the patient must use the provisionalrestoration for an extended period to assess the prognosis, when the patient exhibitsparafunctional habits, when long-span prosthesis is planned or in full mouth rehabilitationcases.Flexural strength and modulus are important for both definitive and provisionalrestorations particularly in high stress bearing areas which are exposed to tension andcompression forces. Thus the aim of the present study was to investigate the effect of short-Sglass fiber reinforcement on the flexural properties of high strength nano hybrid composites.2
STATEMENT OF PROBLEM
STATEMENT OF PROBLEMGlass fibre reinforced composites have already become an alternative to traditionaldefinitive restorations and as effective long term provisional restorations. Many in vitro andin vivo studies have already been carried out to support the reinforcement of composite resinswith long unidirectional fibres. Composite resin reinforcement with short glass fibres, theirisotropic properties and their influence in improving flexural properties have not been studiedeffectively so as to come to a conclusion.3
AIMS AND OBJECTIVES
AIMS AND OBJECTIVESAIMSThe aim of this study is to determine the flexural properties of composite resins reinforcedwith S-glass fibres.OBJECTIVES1. To evaluate and compare the flexural properties of composite resin(Polofil NHT,Voco -Nanohybrid composite resin) with and without the reinforcement of short Sglass fibres (Endure fibres, Remuscence)2. To evaluate and compare the flexural properties of composite resin reinforced withshort S glass fibres with different volume proportions.4
NULL HYPOTHESIS
NULL HYPOTHESIS1. There is no significant difference in the flexural properties of composite resins withand without the reinforcement of short S glass fibres.2. There is no significant difference in the flexural properties of composite resinsreinforced with short S glass fibres with different volume proportions.5
REVIEW OF LITERATURE
REVIEW OF LITERATURE Altieri JV, Burstone CJ, Goldberg AJ, Patel AP (1994)9This in vivo pilot study was conducted in 14 patients to evaluate the survival rates of fixedpartial dentures for single tooth replacement fabricated using fibre reinforced composites.Two types of failures were observed from this study (i.e.) adhesive failure and cohesiveseparation. The longest survival rate among the given restorations was found to be 24 monthswhen replacing a missing mandibular molar. Behr M, Rosentritt M, Lang R, Handel G (2000)10This experimental study investigated the flexural properties of composites reinforced withtwo different systems (i.e.) manual adaptation (S-2 glass fibres) and vacuum/pressureadaptation (R glass fibres). Specimen testing was done after 24 hours in water, 30 days inwater and after thermo cycling. The vacuum/pressure system had resulted in high fibrecontent than manual adaptation but significant difference between the two groups was notobserved. So it was concluded that matrix composition and bond between matrix and fibreswere major determinants than fibre content. Vallittu PK, Sevelius C (2000)11This clinical study was conducted to evaluate the survival rate of fibre reinforced fixed partialdentures with a mean follow-up period of 14 months. The fibres were unidirectional E glassfibres. 31 laboratory fabricated prostheses were luted using resin cements which replaced themissing teeth in both the arches; both in the anterior and posterior regions. The retainers weregiven by means of inlays, surface retention, full coverage crowns and also by combinations.During the follow up period, 2 patients were reported with debonding of the prostheses withintact framework. So the authors concluded that the prostheses had functioned adequatelyduring the follow-up period and gave recommendations for further long term clinical studies.6
REVIEW OF LITERATURE Ellakwa AE, Shortall AC, Shehata MK, Marquis PM (2001)12In this study, composite resins reinforced with unidirectional polyethylene fibres wereassessed for flexural properties. The fibres were placed at two positions; at tensile side andaway from tensile side. The fabricated specimens were either water stored or dry stored for 2weeks. Both the dry and wet stored specimens of fibre reinforced groups showed higherflexural strength than unreinforced groups. Among the reinforced groups, the group withfibres placed on the tensile side showed late crack development and propagation. Haselton DR, Diaz-Arnold AM, Vargas MA (2002)13This experimental in vitro study was carried out to compare the flexural strength ofspecimens fabricated using 5 methacrylate based resins and 8 bis-acryl resins. The preparedspecimens were stored in artificial saliva for 10 days before performing the three pointbending test. From the results obtained, Provipont, a bis-acryl resin was found to have thehighest flexural strength (123.6 MPa) than the other tested materials. The strength obtainedfrom Provipont was statistically significant to all methacrylate resins and some bis-acrylresins (Unifast LC, Instatemp, Temphase and Provitec) and insignificant than that ofIntegrity, Protemp 3 Garant and Luxatemp (bis-acryl resins) Lassila LV, Nohrström T, Vallittu PK (2002)14This experimental in vitro study was carried out to analyse the flexural properties of fibrereinforced composites. The specimens were tested under three conditions- dry specimens,water stored specimens and reconditioned specimens after water storage. Flexural strengthvaried in relation to the duration of water storage and fibre-volume fraction. This article alsodiscusses about the nature of the polymer matrix and types of adhesives in influencing thewater sorption of the fibre reinforced composites.7
REVIEW OF LITERATURE Behr M, Rosentritt M, Handel G. (2003)15This experimental in vivo study was conducted to assess the survival rate of restorationsfabricated using fibre reinforced composites. Crowns, Inlay FPDs and conventional FPDswere fabricated and cemented. After 3-years follow up, the survival rate of molars and inlayFPDs was 82% and 72% respectively. By assessing the failures (fracture, wear anddiscolouration), the authors concluded that the fibre reinforced composites should only beused for provisional restorations. Hamza TA, Rosenstiel SF, Elhosary MM, Ibraheem RM (2004)16In this study, the authors compared the fracture toughness and flexural strength of 3provisional restorative resins reinforced using glass fibres and polyethylene fibres. From theresults obtained, the highest fracture toughness (2.74 MPa) was shown by PMMA resin Fibrestick (unidirectional E glass fibres) combination and the highest flexural strength (199.6MPa) by bis-acryl resin Construct (silianized plasma treated polyethylene fibres). Th
Among the glass fibres, ‘E’ and ‘S’ glass fibres are commonly used. E stands for electrical grade and these fibres predominantly consist of SiO 2 and CaO and S stands for strength and the fibres are made of SiO 2 and MgO 4. Glass fibres are classified into long-continuous
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