Journal of Oral Rehabilitation 1999 26; 185–194
Review
The reinforcement of dentures
D. C. JAGGER, A. HARRISON & K. D. JANDT
Bristol
SUMMARY The material most commonly used for
the fabrication of complete dentures is poly
(methyl methacrylate) (PMMA). This material is
not ideal in every respect and it is the combination
of virtues rather than one single desirable property
that accounts for its popularity and usage. Despite
its popularity in satisfying aesthetic demands it is
still far from ideal in fulfilling the mechanical re-
quirements of a prosthesis. The fracture of dentures
may be due to the mechanical properties of the
acrylic resin or may be due to a multiplicity of
factors leading to failure of the denture base mate-
Introduction
The material most commonly used for the fabrication
of complete dentures is poly (methyl methacrylate)
(PMMA). This material is not ideal in every respect and
it is the combination of virtues rather than one single
desirable property that accounts for its popularity and
usage. Despite its popularity in satisfying aesthetic de-
mands whereby, with an appropriate degree of clinical
expertise and with the careful selection and arrange-
ment of artificial acrylic teeth, it is possible to produce
a prosthesis which defies detection, it is still far from
ideal in fulfilling the mechanical requirements of a
prosthesis.
Several studies have investigated the incidence and
types of fracture of dentures. Hargreaves (1969), in a
survey, reported that 63% of dentures had broken
within 3 years of their provision, there being a greater
proportion of partial than complete dentures. Darbar,
Huggett & Harrison (1994) in a survey distributed a
questionnaire to three laboratories, and reported that
© 1999 Blackwell Science Ltd
Division of Oral and Dental Science, Dental School, University of
rial. Generally, there are three routes which have
been investigated to improve the impact properties
of PMMA: the search for, or development of, an
alternative material to PMMA; the chemical modifi-
cation of PMMA such as by the addition of a rubber
graft copolymer; and the reinforcement of PMMA
with other materials such as carbon fibres, glass
fibres and ultra-high modulus polyethylene. The
following review of attempts to improve the me-
chanical properties of denture base material takes
account of papers published during the last
30 years.
33% of the repairs carried out were due to debonded/
detached teeth and 29% were repairs to midline frac-
tures more commonly seen in upper complete
dentures. The remaining 38% were other types of
fractures, the majority of which were repairs to upper
partial dentures, e.g. detachment of acrylic resin sad-
dles from metal in metal based dentures and fracture of
connectors in all acrylic resin partial dentures.
Fractures in dentures result from two different types
of forces, namely, flexural fatigue and impact. Flexural
fatigue occurs after repeated flexing of a material and is
a mode of fracture whereby a structure eventually fails
after being repeatedly subjected to loads that are so
small that one application apparently does nothing
detrimental to the component. This type of failure can
be explained by the development of microscopic cracks
in areas of stress concentration. With continued load-
ing, these cracks fuse to an ever growing fissure that
insidiously weakens the material. Catastrophic failure
results from a final loading cycle that exceeds the
mechanical capacity of the remaining sound portion of
185
186 D . C . J A G G E R et al.
the material (Wiskott, Nicholls & Belser, 1995). The
midline fracture in a denture is often a result of flex-
ural fatigue. Impact failures usually occur out of the
mouth as a result of a sudden blow to the denture or
accidental dropping whilst cleaning, coughing or
sneezing.
Fracture may be due to a multiplicity of factors
rather than the denture base material itself and these
factors have been discussed in detail (Jagger & Har-
rison, 1998). For example, any factor which increases
the deformation of a denture base (Kydd, 1956; Lam-
brecht & Kydd, 1962); additional factors which form
areas of stress concentration such as a large fraenal
notch, (Rees, Huggett & Harrison, 1990); dentures with
thin or under-extended flanges; poorly fitting dentures
or a lack of adequate relief; dentures with a wedged or
locked occlusion; poor clinical design and dentures
which have been previously repaired (Yunus, Harrison
& Huggett, 1994).
A review of the literature
The following review of attempts to improve the me-
chanical properties of denture base material takes ac-
count of papers published during the last 30 years.
PMMA has been established as the principal material
in denture base construction due to its good overall
processing as well as user friendly properties. Never-
theless it is generally recognized that despite fulfilling
aesthetic requirements, the impact and fatigue strength
of PMMA are not entirely satisfactory and this is
reflected by the expenditure on a large number of
denture repairs annually. Presently the Dental Practice
Board spends approximately £18 million annually to
repair about 1·2 million dentures (Dental Practice
Board, 1997). Generally there are three routes which
have been investigated to improve the impact proper-
ties of PMMA: the search for, or development of, an
alternative material to PMMA; the chemical modifica-
tion of PMMA such as by the addition of a rubber graft
copolymer; and the reinforcement of PMMA with
other materials such as carbon fibres, glass fibres and
ultra-high modulus polyethylene.
Alternative materials to PMMA
There are continuous efforts to improve PMMA and
desirable improvements include the enhancement of
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185–194
strength and stiffness, better dimensional stability, bet-
ter abrasion resistance and the achievement of radio-
pacity (Chow, 1996). Various polymers have been
developed for use as denture base resins to overcome
some of the mechanical deficiencies of PMMA such as
polyamides, epoxy resin, polystyrene, vinyl acrylic,
rubber graft copolymers and polycarbonate (Stafford et
al., 1980) and nylon (Stafford et al., 1986). In terms of
radiopacity, despite developments in radiopaque den-
ture base resins (Saunsbury, 1964; Holden, 1968;
Rawls et al., 1990), no satisfactory material is available
to date.
Chemical modification of PMMA
The reinforcement of glassy polymers with rubber is a
well established concept and the mechanisms of rein-
forcement have been discussed (Bucknall, 1977). The
addition of rubbers to PMMA produces a resin that
consists of a matrix of PMMA within which is dispersed
an interpenetrating network of rubber and PMMA. A
developing crack will propagate through the PMMA
but will decelerate at the rubber interface. The objec-
tive of the rubber reinforced or ‘high impact’ resins is
that they absorb greater amounts of energy at a higher
strain rate before fracture than the standard resins. A
problem is that the impact strength is often improved
at the expense of the Young’s modulus producing a
denture base with increased impact strength but which
is too flexible
Rodford (1986, 1990) discussed the development of
high impact strength denture base materials using a
low molecular weight (15–35000) butadiene styrene
rubber. This rubber could be incorporated up to 30%
by weight in methylmethacrylate without deleterious
effects on the handling characteristics such as a marked
increase in viscosity. The butadiene styrene also had
reactive (acrylate) end groups to facilitate grafting to
the PMMA. Stafford et al. (1980) in a review of the
properties of some denture base polymers, compared
five heat-cured denture base resins produced by manu-
facturers as higher strength resins with a standard
heat-cured resin, auto polymerizing resin, rapidly poly-
merizing heat-cured resin and a pour type resin. They
reported improvements in impact strength, dimen-
sional stability but less satisfactory results for fatigue
and transverse bend tests than conventional heat-
cured acrylic resin. PMMA has been modified so that it

could be used in a more versatile fashion and Bates et
al. (1977) reported on a review of the properties of the
‘pour type’ denture base resins. The addition of rubber
to PMMA as a method of reinforcement is to date the
most successful and widely accepted and is an alterna-
tive to the conventional PMMA denture base resin;
however, the high cost, often up to 20 times that of
conventional resin, restricts its routine use.
Addition of materials to PMMA
Carbon fibres. Carbon fibres were first made commer-
cially by Edison in the late 19th century by carbonizing
thin bamboo shoots and carbon fibres. The bulk of
carbon fibres is made from polyacrylonitrate by heating
in air at 200 – 250 °C and then in an inert atmosphere
at 1200 °C. This process removes hydrogen, nitrogen
and oxygen, leaving a chain of carbon atoms and thus
forming carbon fibres (Yazdanie & Mahood, 1985).
Carbon fibres can be added to PMMA as loose strands
or in woven mat form. Dry fibres are difficult to handle
but the fibres can be wetted with monomer to form
tows of wet fibre which have improved handling char-
acteristics. The tows of wet fibre can be laid side by side
and enclosed in a thin sheet of PMMA to form a
prepeg. Schreiber (1971), in a preliminary report on
the reinforcement of PMMA with carbon fibres, dis-
cussed the use of acrylic resin composite prepegs. Re-
sults showed an increase in transverse strength of 50%
compared to unreinforced acrylic resin specimens.
Schreiber (1974) reported the clinical application of
carbon fibre/PMMA denture bases to be successful and
recommended the regular use of this technique in
fracture prone prostheses. In support of this Bowman
& Manley (1984) confirmed that the reinforcement of
upper dentures with carbon fibre/PMMA inserts sig-
nificantly reduced the number of breakages. In their
study, 28 patients with a history of breakages were
fitted with carbon fibre/PMMA dentures. The mean life
of the reinforced denture was twice that of the unrein-
forced (P B0·001).
Yazdanie & Mahood (1985)studied the effect of car-
bon in strand and woven mat form on the transverse
strength of acrylic resin and concluded the properties
of reinforcement with carbon in strand form were
superior to woven mat form. The interface between
carbon fibres and PMMA is a source of potential failure
as for any method of reinforcement, and treatment of
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185 – 194
THE REINFORCEMENT OF DENTURES 187
carbon fibres with silane or other chemicals to produce
coated fibres has been tried to improve the adhesion to
acrylic resin
The use of specifically oriented fibres as reinforcing
agents for resins has been practised industrially for
decades. Resins which contain layered fibres of specific
orientation exhibit increased resistance to applied
stress. The effect of the orientation of the carbon fibres
on the fatigue resistance and bending properties of two
acrylic resins has been investigated (DeBoer, Vermilyea
& Brady, 1984). Findings of the investigation were in
agreement with that of Skirvin, Vermilyea & Brady
(1982) demonstrating an increase in flexural fatigue
resistance of fibre reinforced resins. The increase in
flexural fatigue resistance with longitudinally fibred
specimens was greater than that demonstrated by
Skirvin et al.(1982) in specimens with random fibre
arrangement. Carbon fibres placed perpendicular to the
direction of the applied stress produced the most fa-
vourable combination of increased resistance to bend-
ing and to flexural fatigue. However, production of
properly oriented fibres centred in the resin was tech-
nically difficult and produced less predictable property
improvements than resulted from randomly dispersed
fibres. Wylegala (1973) investigated the addition of
three types (untreated, untreated chopped and surface
treated) of carbon fibre for the reinforcement of acrylic
resin denture base material. He reported an increase in
transverse strength with the addition of surface treated
carbon fibre but a decrease in transverse strength with
untreated fibres.
Ruyter, Ekstrand & Bjork (1986), in a search for an
alternative to a gold framework on titanium implants,
discussed the development of a carbon graphite fibre
reinforced PMMA and compared the flexural proper-
ties in wet and dry conditions to unreinforced PMMA.
Fracture stress and flexural modulus were higher for
the reinforced than for the unreinforced material. Wa-
ter absorption decreased the flexural properties of the
material possibly because of its effect on the adhesion
between the fibres and matrix.
Chow (1996) discussed the essential requirements
for obtaining carbon fibre reinforced polymers (CFRP)
with the desired mechanical properties. He proposed:
(i) good adhesion between matrix and the reinforce-
ment, a necessary condition for the external stresses to
be ultimately sustained by the reinforcement; (ii) good
wettability of the reinforcement by the matrix to
achieve maximum contact between the two phases at
188 D . C . J A G G E R et al.
molecular level. This will produce maximum adhe-
sion and eliminate voids which may create potential
areas for crack initiation and propagation; the rein-
forcement should be oriented to maximize its role at
the stress bearing phase; (iii) the concentration of re-
inforcement should be small enough to allow com-
plete coverage of the fibres by resin but not too small
that it acts as an area of stress concentration; the
positioning of reinforcing fibres across the thickness
of the composite should be carefully monitored. He
proposed an asymmetric/inhomogeneous distribution
of reinforcement across the thickness of the resin and
subsequent appliance could inadequately reinforce ar-
eas which are under high stress and result in failure.
The potential toxicity of carbon fibres was consid-
ered to be a possible problem although Manley, Bow-
man & Cook (1979) reported no long term toxicity
or carcogenicity in a study involving the implantation
of carbon in rats. However, Yazdanie & Mahood
(1985) experienced some problems with skin irrita-
tion on handling specimens.
There is little published data post-1980s on the use
of carbon as a method of reinforcing PMMA although
earlier studies had produced promising results. A fail-
ure to further investigate this method of reinforce-
ment could be due to problems associated with the
fibres, such as the difficult handling characteristics of
the fibres and their precise placement in the resin;
problems with polishing a denture base incorporating
fibres; poor aesthetics due to the black colour the
fibres impart on dentures which can be unacceptable
to some denture wearers; the potential toxicity of
carbon; and the development of alternative methods
of reinforcement.
Aramid fibres. An aramid is an organic compound
called polypara-phenylene terephthalamide synthetic
aramid polymer fibre and is marketed as Kevlar®*.
Kevlar® has a tensile strength more than twice that
of nylon and a modulus more than 20 times that of
nylon and twice that of E-glass. These properties
derive partly from the extremely fine nature of the
filaments which greatly reduces the occurrence of the
type of flaws and defects which weaken bulk materi-
* E I du Pont de Nemours and Co., Wilmington, DE, U.S.A.
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185–194
als. Kevlar® is used in industry, e.g. in the fabrication
of bullet-proof vests, automobile tyres, boat hulls and
aircraft. Polyaramid fibre has superior wettability
to carbon fibre and does not require treatment with
a coupling agent. The yellow colour is not acceptable
to some individuals and can limit their use in
aesthetic areas. Problems can arise with fibres
exposed at the surface of the resin which present
a rough surface that cannot be polished and can
be uncomfortable for the patient. Studies of aramid
fibres have found no evidence of toxicity (Lee, Kelly
& Kennedy, 1983; Dunnigan, Nadeau & Paradis,
1984).
Grave, Chandler & Wolfaardt (1985) compared the
transverse strength of samples of cross linked acrylic
resin with samples containing various percentages of
aramid fibres. All of the reinforced specimens were
significantly weaker. A possible explanation is the
failure of adhesion between the fibre and the matrix
resulting in the layers of fibre separating the matrix
into layers of narrow cross-section. Contrary to this
finding Berrong, Weed & Young (1990) reported a
significant improvement of impact strength with a
fibre content up to 2%. Mullarky (1985) also re-
ported an increase in the strength and fatigue resis-
tance of acrylic resin appliances reinforced with
unidirectional aramid fibre.
Glass fibres. Glass fibres have been used in different
forms to strengthen dental polymers, including wo-
ven, loose and continuous such as roving or fibre
bundles. Smith (1957) reported on glass reinforce-
ment of PMMA by simply mixing discrete fibres with
the dough or by lamination with glass cloth. The in-
corporation of glass was limited to 20% due to the
deleterious effects on the doughing properties above
this percentage. The addition of fibres did not give a
substantial improvement to the tensile strength. Ide-
ally, to strengthen polymer resins by including glass
fibres, there should be good adhesion between the
polymer matrix and the fibres. Untreated fibres act as
inclusion bodies in the acrylic resin mixture and in-
stead of strengthening, actually weaken the resin.
Various chemicals have been used to try to
strengthen the bond, for example silane compounds.
Solnit (1991) measured the transverse strength
of PMMA filled with either untreated or silane

treated glass fibres. Untreated fibre specimens were
weaker than unreinforced specimens suggesting that
the silane treated fibres were stronger but not signifi-
cantly so. The type of fibre whether in cloth form or
loose form affected the strength of the resin. Untreated
cloth form fibres had a strengthening effect whereas
untreated loose glass fibres had a weakening effect,
with opposite effects for the pre-treated fibres. Vallittu
(1993a) studied the effect of two different silane com-
pounds on the adhesion between different types of
fibres including glass fibres. The silanized glass fibres
used as reinforcement markedly increased the fracture
resistance.
The position of the glass fibres within the polymer
can affect the strength of the resin. Galan & Lynch
(1989) suggested placing the fibres normal to the load-
ing force for optimum strengthening. Similarly, the
concentration of fibres is important and Vallittu, Lassila
& Lappalainen (1994a) reported that the concentration
of fibres in the polymer matrix should be high for
optimum strengthening. Glass fibres are generally
added to the polymer by hand; however, problems can
arise with the lateral spreading of fibres in the polymer
matrix as acrylic resin is pressed in the mould causing
an inhomogenous distribution throughout. In addition
poor wetting of fibres within the acrylic resin and
polymerization shrinkage of the PMMA destroys the
layer of resin on the surface of the fibres and decreases
the bond between the fibres and the polymer.
Vallittu (1994) suggested the pre treatment of fibre
rovings with a PMMA – MMA mixture to minimize the
effect of polymerization shrinkage such that minimal
shrinkage of PMMA allowed the fibres to bond to each
other via an even layer of PMMA. The incorporation of
glass fibres produced an increase in the strength and a
decrease in fatigue weakening of PMMA. However, an
excess of methyl methacrylate monomer to ensure
better impregnation of fibres with PMMA would in-
crease the polymerization shrinkage and could cause
dimensional changes within the denture. Vallittu
(1996a) demonstrated that the polymerization shrink-
age of PMMA caused lower dimensional accuracy of
test specimens reinforced with glass fibre. He con-
cluded wetting of the fibres would cause minimal dis-
tortion of the end product.
Miettinen & Vallittu (1997) studied the release of
residual monomer into water from glass fibre/PMMA
composite used in dentures and confirmed that the use
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185 – 194
THE REINFORCEMENT OF DENTURES 189
of this type of reinforcement statistically increased the
release of residual MMA but questioned whether it
would be of clinical significance.
Yen, Collard & King (1991) studied the effects of
hollow glass microspheres on the density and impact
strength of denture base resins. The addition of
20 vol% and 40 vol% significantly reduced the density
and impact strength of the denture base resin com-
pared with resin without filler. The addition of the
microsphere filler decreased the denture base resin
density by 8 to 9% and the impact strength by 30%.
The loss in impact strength due to the incorporation of
the fillers outweighed the benefit of a reduction in
density of the acrylic resin.
Most studies investigate the reinforcement of PMMA
with a single type of fibre, however, Vallittu & Narva
(1997) looked at a hybrid fibre reinforcement, i.e. a
composite that consists of glass fibres and aramid fibres
embedded in a resin matrix. The addition of glass fibres
alone to autopolymerizing acrylic resin at a concentra-
tion of 12·4% weight increased the impact strength to
74·7 kJ/m2 compared with 7·8 kJ/m2 for unreinforced
resin. The additional fibres did not influence the impact
strength.
Vallittu (1997) discussed the concept of total fibre
reinforcement (TFR) and partial fibre reinforcement
(PFR). The entire denture base can be reinforced with
a fibre weave or a fibre reinforcement can be accu-
rately placed at the weak region of the denture. These
types of reinforcement can be defined as TFR and PFR
respectively. Vallittu, Lassila & Lappalainen (1994b)
and Vallittu (1996b) reported that unidirectional elec-
trical glass (E-glass) PFR considerably improved the
mechanical properties of removable complete and par-
tial dentures in vitro. In a clinical investigation Vallittu
(1997) studied the effect of PFR reinforcements intro-
duced at the time of repair after a period of 13 months
post-denture insertion for 12 complete and 10 partial
removable dentures. This study highlighted some of
the advantages of PFR over TFR. For instance for TFR
in the form of a weave or mat the fibres are multidirec-
tional, whereas the highest strength for fibre composite
can be obtained with fibres oriented in one direction.
Also, the problem of tissue irritation from protruding
fibres experienced with TFR can be minimized with the
use of PFR where fibres running in the direction of the
surface of the denture do not protrude.
190 D . C . J A G G E R et al.
Research into the use of glass fibres for the reinforce-
ment of PMMA continues to date.
Metal inserts. Metals can be added in the form of wires,
plates or fillers. Jennings & Wuebbenhorst (1960) re-
ported on the reinforcement of pedodontic prosthetic
appliances with stainless steel mesh, braided wire plate,
a stainless steel lingual bar and stainless steel wire. A
significant increase in transverse strength of acrylic
resin was produced by reinforcement with a stainless
steel lingual bar or stainless steel wire. However, rein-
forcement with mesh and a braided wire plate did not
produce a significant improvement. Berry & Funk
(1971) suggested the use of a vitallium strengthener
for a group of individuals who had experienced re-
peated fracture of a lower denture. Carrol & von
Fraunhofer (1984) determined the effect of reinforcing
autopolymerizing acrylic resin with flat braided two
strand brass wire and one of four diameters of or-
thodontic wire. Reinforcement with wire of 0·051 inch
diameter produced an increase in transverse strength
which was thought to be clinically significant.
The thickness and position of the strengthener
within the resin can affect its reinforcing properties.
Ruffino (1985) discussed the effect of steel strengthen-
ers on the fracture resistance of the acrylic resin com-
plete denture base and stressed the importance of the
position of the metal strengthener and its effect on the
strength. For maximum strengthening the metal
should be placed perpendicular to the anticipated line
of stress and fracture and not coincident with that line.
The resistance to deflection of a thick steel strength-
ener, as opposed to a thin strengthener, compensate
for the discontinuity the strengthener produced. Two
steel strengtheners several millimetres apart and per-
pendicular to the anticipated line of fracture produced
significant resistance to flexure and reduced the likeli-
hood of fracture of acrylic resin bases.
Sehajpal & Sood (1989) studied the effect of metal
fillers on some physical properties of acrylic resin. They
determined the effect on the thermal conductivity,
tensile strength, compressive strength, and radiopacity
of PMMA when adding varying amounts of powdered
silver, copper and aluminium. The compressive
strength of PMMA increased with the addition of these
fillers and the tensile strength decreased. Explanations
given for this reduction in strength included: a de-
crease in the cross-section of load bearing polymer
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185–194
matrix; stress concentration because of filler particles;
change in the modulus of elasticity of resin and mode
of crack propagation through it because of fillers; void
formation from entrapped air and moisture; and in-
complete wetting of the fillers by resin.
Many attempts, however, to strengthen acrylic resin
in this way failed because stress concentrations occur
around embedded materials and the net effect of em-
bedding fibres or metals is actually to weaken the
polymer. This is often due to poor adhesion between
the acrylic resin matrix and the fibre metal inserts.
Various approaches have been used to improve the
adhesion between the metal surface/acrylic resin such
as sandblasting, silanization and metal adhesive resins.
Modification of the surface by sandblasting has been
investigated by Vallittu & Lassila (1992) who studied
the effect of surface roughness of various metal wires
on the fracture resistance of acrylic resin. They investi-
gated the reinforcement of PMMA with metal
strengtheners divided into Remanium spring hard clasp
wire, semicircular wire and braided wire plate. The
investigation showed that the surface roughening of
the metal wires used to reinforce acrylic resin denture
base material increased the fracture resistance of the
test specimens. The best results were achieved by sand-
blasting which was thought to enhance retention be-
tween the strengthener and the resin by increasing the
surface area to promote adhesion.
The use of a metal adhesive resin (Meta Dent®†)
composed of a conventional powder liquid poly
(methyl methacrylate) and methyl methacrylate sys-
tem containing 5% 4-methacryloxyethyl trimellitate
anhydrite (4Meta) in the monomer has been reported
to improve the bond strength between metal and resin.
Improved bond strengths were reported for Meta
Dent®/flat cobalt chromium plates compared to high
impact resin / metal plates (Jacobsen et al., 1988).
Vallittu (1993b) showed an improved adhesion be-
tween metal and acrylic resin with a silanizing tech-
nique and produced a subsequent enhancement in
fracture resistance. Polyzois (1995) investigated the
fracture load and deflection of acrylic specimens with
different types of metal inserts. A metal adhesive resin
(Meta Dent®) and a conventional denture resin (Melio-
dent®‡) were used with round metal braided wires and
mesh as inserts. The results indicated that metal inserts
†
Sun Medical Co., Kyoto, Japan.
‡
Bayer Dental, Newbury, U.K.

enhance the fracture resistance of both denture resins.
There were no significant differences between the
metal adhesive and the conventional denture resin.
The inclusion of metals as a mean of reinforcement
of PMMA have limited value because often the areas of
stress concentration outweigh the benefits. For den-
tures which have a permanent resilient soft lining the
use of a metal strengthener in the form of a cobalt
chromium lingual plate is a reasonable option.
Ultra-high molecular weight polyethylene. Polyethylene, a
naturally crystalline polymer is drawn at temperatures
below its melting point, to produce a material of en-
hanced modulus in the axial direction. Polyethylene
fibres are ductile, neutral colour, low density and of
known biocompatibility. They can be drawn as monofi-
lament fibres and woven into fabrics. They can be
treated to enhance the adhesion between polyethylene
and acrylic resin with electrical plasma treatment,
which etches the surface so that it can bond mechani-
cally to the resin phase.
Braden et al. (1988) produced encouraging results
with the reinforcement of PMMA with ultra-high mod-
ulus polyethylene (UHMPE) and concluded that etch-
ing fibres with electric plasma promoted adhesion
between the fibre and the resin. The results for en-
hancement of flexural strength were disappointing but
there was a significant improvement in impact
strength. Gutteridge (1988) also demonstrated an im-
provement in impact strength with the incorporation
of fibres from 0·5 to 4% by weight of 6 mm length of
UHMPE. The addition of fibres at a percentage greater
than 3% made the dough unworkable and 1% was
sufficient to produce a satisfactory improvement in
strength. Gutteridge (1992) compared the transverse
bend strength and hardness of PMMA reinforced with
1– 2% by weight of untreated or plasma etched
UHMPE fibre and the impact strength of PMMA con-
taining 0·5 – 3% by weight of plasma etched UHMPE.
The Young’s modulus and transverse strength were
unaffected by the inclusion of fibre and hardness was
unaffected at the 1% level but reduced at the 2% level.
The impact strength of specimens containing 1 or 2%
by weight of plasma etched UHMPE was not signifi-
cantly different to that recorded in the previous study
of untreated fibre specimens.
Adding UHMPE fibres, however, can have an effect
on the dimensional accuracy of PMMA as investigated
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185 – 194
THE REINFORCEMENT OF DENTURES 191
by Cheng, Chow & Ladizesky (1993) and Chow, Cheng
& Ladizesky (1993). The latter study was concerned
with water uptake of polyethylene fibre reinforced
resin and the dimensional changes during water im-
mersion. Results showed a very significant reduction in
water sorption and a reduction in dimensional
changes. Possible reasons for this were the hydropho-
bic nature of the fibres compared to the hydrophillic
resin they replace coupled with the interface between
the fibre and the resin which would not permit the
ingress of water.
Ladizesky et al. (1993a) attempted to increase the
percentage of fibres in chopped form from those used
by Gutteridge (1988) to 4–30% by an incremental
mixing technique and pre-wetting of the fibres with
monomer to reduce clumping.
In an alternative form to loose fibres, Ladizesky et al.
(1993b) investigated the effect of the addition of three
layers of woven polyethylene to an acrylic resin den-
ture base and found that the impact strength was
substantially increased but no improvement in the
modulus or flexural strength. Ladizesky, Chow &
Cheng (1994) increased the woven layers to 10 and
discovered that this greatly improved the flexural
strength and largely removed the weakening effect of
notches.
Ladizesky & Chow (1992a) examined the effect of
interface adhesion, water immersion and anatomical
notches on the mechanical properties of resins rein-
forced with continuous high performance polyethylene
fibres. Water immersion generally had little effect on
the mechanical properties and interface strength.
Plasma etching improved adhesion between the fibres
and the resin and the presence of UHMPE reduced the
notch sensitivity. Kelly (1969) discussed the large
notch sensitivity of the acrylic resin denture base and
suggested modified procedures to eliminate abrupt
changes in surface contour such as frenal notches.
Ladizesky & Chow (1992a) suggested that UHMPE re-
inforced acrylic resins require no such precautions
providing a greater degree of freedom in the design of
the prosthesis.
The orientation of the polyethylene fibres within the
denture base can affect the strength of the acrylic resin.
Ladizesky & Chow (1992b) described a method for the
best placement and orientation of fibres within the
base and a method of making maxillary and mandibu-
lar complete denture bases reinforced with parallel
continuous high density linear polyethylene fibres.
192 D . C . J A G G E R et al.
Carlos & Harrison (1996) addressed the problem of
the need to add polyethylene fibres in a strategic fash-
ion for them to be of benefit, i.e. running parallel to
the surface of the denture. However, the addition of
fibres in this way can be labour intensive and time
consuming; when fibres are randomly mixed into
MMA powder some fibres can be orientated to produce
beneficial effects and others produce little or no effect.
Carlos & Harrison (1996) investigated an alternative
approach in the form of the effect of surface untreated
ultra-high molecular weight polyethylene ‘beads’ on
doughing, manipulation, setting, flexural strength, im-
pact strength and hardness of PMMA and Harrison,
Constantinidis & Vowles (1997) investigated surface
treated beads on a similar range of properties. These
investigations provided a simple and rapid method of
adding polyethylene to acrylic resin; however, the re-
sults were disappointing with no significant beneficial
effects.
The use of polyethylene to reinforce PMMA in the
form of provisional restorations has been discussed
(Ramos, Runyan & Christensen, 1996), as has the use
of immediate and indirect woven polyethylene ribbon
reinforced periodontal-prosthetic splints (Miller, Hald-
mzadeh & Rudo, 1995)
To date the reinforcement of acrylic resin with
polyethylene in the form of woven mat is a satisfactory
way of producing a resin with improved mechanical
properties. However, the fabrication of dentures by this
method is time consuming and prohibits its routine use
in the dental laboratory.
Self-reinforcement. The advantages of self-reinforced
composite materials are improved mechanical proper-
ties over the amorphous random polymer. Self-rein-
forced materials have been used in polyglycolic acid
resorbable screws and plates (Tormala et al., 1991) and
collagen forming materials (Wyler et al., 1992). This
concept of self-reinforcement of polymers has been
discussed (Gilbert, Ney & Lautenschlager, 1995). The
concept is based on the idea of a fibrous material which
is chemically identical to the matrix holding the fibres
in place. Gilbert and co-workers also described the
reinforcement of PMMA with PMMA fibres of im-
proved mechanical properties compared to the bulk
resin. The composite material consisted of high
strength, high ductility PMMA fibres embedded in a
matrix of PMMA. The fibres were processed to impart
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185–194
large amounts of molecular orientation by thermo-
molecular processing (e.g. fibre spinning or drawing).
The static mechanical properties of a unidirectional
continuous form of the composite were evaluated and
showed significantly greater tensile properties, flexural
ductility, fracture toughness and fatigue strength com-
pared with bulk PMMA and bone cement. This mate-
rial may be applicable for use in several medical and
dental applications.
Conclusions
Some of the materials from these developments have
an excellent balance of impact resistance and flexural
properties, however, most are not acceptable to the
dental technician because of their processing character-
istics. The most popular material at present for the
fabrication of dentures, which has a high impact
strength, is a rubber modified acrylic polymer whose
handling characteristics are more or less identical to
conventional poly (methyl methacrylate). The flexural
properties of these materials, however, are relatively
poor and long-term failure due to fatigue can be a
problem. Unfortunately the high cost of these materials
restricts their use in the NHS sector of the denture
market. A significant saving in NHS expenditure would
result if a cost effective material with enhanced fatigue
and impact resistance was readily available.
References
BATES, J.F., STAFFORD, G.D., HUGGETT, R. & HANDLEY, R.W. (1977)
Current status of pour type denture base resins. Journal of
Dentistry, 5, 177 – 189.
BERRONG, I.M., WEED, R.M. & YOUNG, J.M. (1990) Fracture
resistance of Kevlar-reinforced poly(methyl methacrylate)
resin: a preliminary study. International Journal of Prosthodontics,
3, 391 – 395.
BERRY, H.H. & FUNK, O.J. (1971) Vitallium strengthener to pre-
vent lower denture breakage. Journal of Prosthetic Dentistry, 137,
532 – 536.
BOWMAN, A.J. & MANLEY, T.R. (1984) The elimination of break-
ages in upper dentures by reinforcement with carbon fibre.
British Dental Journal, 156, 87 – 89.
BRADEN, M., DAVY, K.W.M., PARKER, S., LADIZESKY, N.H. & WARD,
I.M. (1988) Denture base poly (methyl methacrylate) rein-
forced with ultra-high modulus polyethylene fibres. British
Dental Journal, 164, 109 – 113.
BUCKNALL, C.B. (1977) Toughened Plastics. Applied Science Pub-
lishers, London.
 THE REINFORCEMENT OF DENTURES
CARLOS, B. & HARRISON, A. (1996) The effect of untreated
UHMWPE beads on some properties of acrylic resin denture
base material. Journal of Dentistry, 25, 59–64.
CARROL, C.E. & VON FRAUNHOFER, J.A. (1984) Wire reinforcement
of acrylic resin prostheses. Journal of Prosthetic Dentistry, 52,
639 – 641.
CHOW, T.W. (1996) A study of the reinforcement of dental polymers
with ultra high modulus polyethylene fibres. PhD thesis, University
of London.
CHENG, Y.Y., CHOW, T.W. & LADIZESKY, N.H. (1993) Denture base
resin reinforced with high-performance polyethylene fiber:
water sorption and dimensional changes during immersion.
Journal of Macromolecular Science and Physics, B32, 433 – 481.
CHOW, T.W., CHENG, Y.Y. & LADIZESKY, N.H. (1993) Polyethylene
fibre reinforced poly(methylmethacrylate) dimensional
changes during immersion. Journal of Dentistry, 21, 367 – 372.
DARBAR, U.R., HUGGETT, R. & HARRISON, A. (1994) Denture
fracture. A survey. British Dental Journal, 176, 342–345.
DEBOER, J., VERMILYEA, S.G. & BRADY, R.E. (1984) The effect of
carbon fiber orientation on the fatigue resistance and bending
properties of two denture resins. Journal of Prosthetic Dentistry,
51, 119 – 121.
DENTAL PRACTICE BOARD (1997) Dental Practice Board Annual Re-
port. Eastbourne, U.K.
DUNNIGAN, J., NADEAU, D. & PARADIS, D. (1984) Cytotoxic effects
of aramid fibres on rat pulmonary macrophages: comparison
with chrysotile asbestos. Toxicology Letters, 20, 277.
GALAN, D. & LYNCH, E. (1989) The effect of reinforcing fibres in
denture acrylics. Journal of the Irish Dental Association, 35, 109 –
113.
GILBERT, J.L., NEY, D.S. & LAUTENSCHLAGER, E.P. (1995) Self
reinforced composite poly (methyl methacrylate): static and
fatigue properties. Biomaterials, 16, 1043–1055.
GRAVE, A.M.H., CHANDLER, H.D. & WOLFAARDT, J.F. (1985) Den-
ture base acrylic reinforced with high modulus fibre. Dental
Materials, 1, 185 – 187.
GUTTERIDGE, D.L. (1988) The effect of including ultra-high-mod-
ulus polyethylene fibre on the impact strength of acrylic resin.
British Dental Journal, 164, 177–180.
GUTTERIDGE, D.L. (1992) Reinforcement of poly (methyl
methacrylate) with ultra-high-modulus polyethylene fibre.
Journal of Dentistry, 20, 50–54.
HARGREAVES, A.S. (1969) The prevalence of fractured dentures. A
survey. British Dental Journal, 126, 451–455.
HARRISON, A., CONSTANTINIDIS, V. & VOWLES, R. (1997) The effect
of surface treated UHMWPE beads on some properties of
acrylic denture base material. European Journal of Prosthodontics
and Restorative Dentistry, 5, 39–42.
HOLDEN, M.H. (1968) The radiolucent plastic foreign body. Dental
Practitioner and Dental Record, 18, 209–211.
JACOBSEN, J.E., CHAI CHANG, J., KERI, P.P. & WATANABE, L.G.
(1988) Bond strength of 4 Meta acrylic resin denture base to
cobalt chromium ally. Journal of Prosthetic Dentistry, 60, 570 –
576.
JAGGER, D.C. & HARRISON, A. (1998) The fractured denture-solv-
ing the problem. Journal of Primary Dental Care, 5, 159 – 162.
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185 – 194
193
JENNINGS, R.E. & WUEBBENHORST, A.M. (1960) The effect of metal
reinforcements on the transverse strength of acrylic resin.
Journal of Dentistry for Children, 27, 162 – 168.
KELLY, E. (1969) Fatigue failure in denture base polymers. Jour-
nal of Prosthetic Dentistry, 2, 257 – 266.
KYDD, W.L. (1956) Complete base deformation with varied oc-
clusal tooth form. Journal of Prosthetic Dentistry, 6, 714 –718.
LADIZESKY, N.H. & CHOW, T.W. (1992a) The effect of interface
adhesion, water immersion and anatomical notches on me-
chanical properties of denture base resins reinforced with con-
tinuous high performance polyethylene fibres. Australian Dental
Journal, 37, 277 – 289.
LADIZESKY, N.H. & CHOW, T.W. (1992b) Reinforcement of com-
plete denture bases with continuous high performance
polyethylene fibres. Journal of Prosthetic Dentistry, 68, 934–939.
LADIZESKY, N.H., CHEN, Y.Y., CHOW, T.W. & WARD, I.M. (1993a)
Acrylic reinforced with chopped high performance
polyethylene fibres-properties and denture construction. Dental
Materials, 9, 128 – 135.
LADIZESKY, N.H., PANG, M.K.M., CHOW, T.W. & WARD, I.M.
(1993b) Acrylic resin reinforced with woven highly drawn
linear polyethylene fibres. 3. Mechanical properties and further
aspects of denture construction. Australian Dental Journal, 38,
28 – 38.
LADIZESKY, N.H., CHOW, T.W. & CHENG, Y.Y. (1994) Denture base
reinforcement using woven polyethylene fiber. International
Journal of Prosthodontics, 7, 307 – 314.
LAMBRECHT, J.R. & KYDD, W.L. (1962) A functional stress analysis
of the maxillary complete denture base. Journal of Prosthetic
Dentistry, 12, 865 – 872.
LEE, K., KELLY, D. & KENNEDY, G. (1983) Pulmonary response to
inhaled kevlar aramid synthetic fibres in rats. Toxicology and
Applied Pharmacology, 71, 242.
MANLEY, T.R., BOWMAN, A.J. & COOK, M. (1979) Denture bases
reinforced with carbon fibres. British Dental Journal, 146, 25.
MIETTINEN, V. M. & VALLITTU, P. K. (1997) Release of residual
methyl methacrylate into water from glass – fibre poly (methyl
methacrylate) composite used in dentures. Biomaterials, 18,
181 – 185.
MILLER, T.E., HALDMZADEH, F. & RUDO, D.N. (1995) Immediate
and indirect woven polyethylene ribbon-reinforced periodon-
tal-prosthetic splint: a case report. Quintessence International, 26,
267 – 271.
MULLARKY, R.H. (1985) Aramid fiber reinforcement of acrylic
appliances. Journal of Clinical Orthodontics, 19, 655 – 658.
POLYZOIS, G.L. (1995) Reinforcement of denture acrylic resin. The
effect of metal inserts and denture resin type on fracture
resistance. European Journal of Prosthodontics and Restorative Den-
tistry, 3, 275 – 278.
RAMOS, V., RUNYAN, D.A. & CHRISTENSEN, L.C. (1996) The effect
of plasma treated polyethylene fiber on the fracture strength of
poly methylmethacrylate. Journal of Prosthetic Dentistry, 76, 94–
96.
RAWLS, H.R., STARR, J., KASTEN, F.H., MURRAY, M., SMID, J. &
CABASSO, I. (1990) Radiopaque acrylic resins containing mis-
cible heavy-metal compounds. Dental Materials, 6, 250 –255.
194 D . C . J A G G E R et al.
REES, J.S., HUGGETT, R. & HARRISON, A. (1990) Finite element
analysis of the stress concentrating effect of frenal notches in
complete dentures. International Journal of Prosthodontics, 3,
238 – 240.
RODFORD, R.A. (1986) The development and evaluation of high
impact strength denture base. materials. Journal of Dental Re-
search, 14, 214 – 217.
RODFORD, R.A. (1990) Further development and evaluation of
high-impact-strength denture base materials. Journal of Den-
tistry, 18, 151 – 157.
RUFFINO, A.R. (1985) Effect of stainless steel strengtheners on
fracture resistance of the acrylic resin complete denture base.
Journal of Prosthetic Dentistry, 54, 75–78.
RUYTER, I.E., EKSTRAND, K. & BJORK, N. (1986) Development of
carbon/graphite fibre reinforced poly(methyl methacrylate)
suitable for implant-fixed dental bridges. Dental Materials, 2,
6 – 9.
SAUNSBURY, P. (1964) Radio-opaque denture resins. Dental Practi-
tioner and Dental Record, 14, 243–244.
SCHREIBER, C.K. (1974) The clinical application of carbon fibre/
polymer denture bases. British Dental Journal, 137, 21.
SCHREIBER, C.K. (1971) Polymethylmethaerylate reinforced with
carbon fibres. British Dental Journal, 130, 29–30.
SEHAJPAL, S.B. & SOOD, V.K. (1989) Effect of fillers on some
physical properties of acrylic resin. Journal of Prosthetic Dentistry,
61, 746 – 751.
SKIRVIN, D.R., VERMILYEA, S.G. & BRADY, R.E. (1982) Polymethyl-
methacrylate reinforcement: effect on fatigue failure. Military
Medicine, 147, 1037–1040.
SMITH, D.C. (1957) The non-metallic denture base—recent de-
velopments. Dental Practitioner and Dental Record, 8, 73 – 80.
SOLNIT, G.S. (1991) The effect of methyl methacrylate reinforce-
ment with silane-treated and untreated glass fibers. Journal of
Prosthetic Dentistry, 66, 310–314.
STAFFORD, G.D., BATES, J.F., HUGGETT, R. & HANDLEY, R. (1980) A
review of the properties of some denture base polymers. Jour-
nal of Dentistry, 8, 292–306.
STAFFORD, G.D., HUGGETT, R., MACGREGOR, A.R. & GRAHAM, J.
(1986) The use of nylon as a denture base material. Journal of
Dentistry, 14, 18 – 22.
TORMALA, P., VASENIUS, J., VAINIONPAA, S., LAIHO, J., POHJONEN, T.
& ROKKANAN, P. (1991) Ultra-high strength absorbable self
reinforced polyglycolide (SR-PGA) composite rods for internal
fixation of bone fractures: in vitro and in vivo study. Journal of
Biomedical Material Research, 25, 1–22.
VALLITTU, P.K. (1993a) Comparison of two different silane com-
pounds used for improving adhesion between fibres and acrylic
denture base material. Journal of Oral Rehabilitation, 20, 533 –
539.
VALLITTU, P.K. (1993b) Effect of some properties of metal
strengtheners on the fracture resistance of acrylic denture base
material. Journal of Oral Rehabilitation, 20, 241–248.
© 1999 Blackwell Science Ltd, Journal of Oral Rehabilitation 26; 185–194
VALLITTU, P.K. (1994) Acrylic resin fibre composite. Part 11: The
effect of polymerisation shrinkage of poly methylmethacrylate
applied to fibre roving on transverse strength. Journal of Pros-
thetic Dentistry, 71, 613 – 617.
VALLITTU, P.K. (1996a) Comparison of in vitro fatigue resistance
of acrylic resin partial denture reinforced with continuous glass
fibres or metal wire. Journal of Prosthodontics, 5, 115 – 121.
VALLITTU, P.K. (1996b) Dimensional accuracy and stability of poly
methylmethacrylate reinforced with metal wire or with contin-
uous glass fiber. Journal of Prosthetic Dentistry, 75, 617 –621.
VALLITTU, P.K. (1997) Glass fiber reinforcement in repaired
acrylic resin removeable dentures: Preliminary results of a
clinical study. Quintessence International, 28, 39 – 44.
VALLITTU, P.K. & LASSILA, V.P. (1992) Effect of metal strengthen-
er’s surface roughness on fracture resistance of acrylic denture
base material. Journal of Oral Rehabilitation, 19, 385 – 391.
VALLITTU, P.K., LASSILA, V.P. & LAPPALAINEN, R. (1994a) Acrylic
resin fibre composite. Part 1: The effect of fibre concentration
on fracture resistance. Journal of Prosthetic Dentistry, 71, 607–
612.
VALLITTU, P.K., LASSILA, V.P. & LAPPALAINEN, R. (1994b) Trans-
verse strength and fatigue of denture acrylic glass fiber com-
posite. Dental Materials, 10, 116 – 121.
VALLITTU, P.K. & NARVA, K. (1997) Impact strength of a modified
continuous glass fiber poly methylmethacrylate. International
Journal of Prosthodontics, 10, 142 – 148.
WISKOTT, H.W.A., NICHOLLS, J.I. & BELSER, U.C. (1995) Stress
fatigue: basic principles and prosthodontic implications. Inter-
national Journal of Prosthodontics, 8, 105 – 116.
WYLEGALA, R.T. (1973) Reinforcing denture base material with
carbon fibres. Dental Technician, 26, 97 – 100.
WYLER, A., MARKUS, R.T., WAGNER, H.J. & DE CASTRO, B. (1992)
A new class of composite materials: matrix autoreinforced
organic materials — MARIOM. Journal of Material Research, 7,
1990 – 1992.
YAZDANIE, N. & MAHOOD, M. (1985) Carbon fiber acrylic resin
composite: an investigation of transverse strength. Journal of
Prosthetic Dentistry, 53, 543 – 547.
YUNUS, N., HARRISON, A. & HUGGETT, R. (1994) Effect of mi-
crowave irradiation on the flexural strength and residual
monomer levels on an acrylic repair material. Journal of Oral
Rehabilitation, 21, 641 – 648.
YEN, T.W., COLLARD, S.M. & KING, G.E. (1991) The effect of
hollow microsphere fillers on density and impact strength of
denture base resins. Journal of Prosthetic Dentistry, 65, 147–152.
Correspondence: Mr D. C. Jagger, Department of Oral and Dental
Science, Division of Restorative Dentistry (Prosthodontics), Bris-
tol Dental School and Hospital, Lower Maudlin Street, Bristol BSI
2LY, U.K. E-mail: d.c.jagger@bris.ac.uk