REVIEW
Acetal Resin - A Quantum Leap in Aesthetic Restorative
Dentistry
Smitha Annie Thomas,1 V. Vidyashree Nandini 2
ABOUT THE AUTHORS
1. Dr. Smitha Annie Thomas
Senior Lecturer
Department of Prosthodontics
Dr. Syamala Reddy Dental
College Hospital and Research
Centre
Marathahalli, Bangalore.
2. Dr. V.Vidyashree Nandini,
M.D.S, D.N.B
Professor
Department of Prosthodontics
SRM Kattankulathur Dental
College
Tamil Nadu
EMAIL
drvidya_99@rediffmail.com
Corresponding Author:
Dr. Smitha Annie Thomas
Senior Lecturer
Dept. of Prosthodontics
Dr. Syamala Reddy Dental
College Hospital and
Research Centre
111/1 SGR Main Road,
Munnekolala
Marathahalli,
Bangalore - 560037
EMAIL -
dr.smitha.jacob@gmail.com
Contact No - 09620075265
Abstract
Changes in dental patient’s attitudes and awareness have been apparent in all aspects of
dentistry, especially aesthetics. This has increased the demand for not just improved functional
care, but aesthetically functional care. In removable partial denture fabrication, unsightly facial
clasps have always been a cosmetic problem with traditional options, either expensive or
technically difficult. This article describes the advent of a new material as an alternative for
anterior retention that maintains excellent aesthetics.
KEYWORDS: Acetal Resin, Polyoxymethylene, aesthetics, removable partial dentures
Introduction
Patients requiring extensive replacement of teeth with removable prostheses are
indeed aesthetic orphans in many contemporary dental practices. Although the advent
of successful osseointegration has dramatically reduced the need for removable
prostheses, there are still many patients who for health, anatomic, psychological, or
financial reasons are not candidates for implants. These patients deserve the same
level of aesthetic restorative dentistry as those who are restored with fixed prostheses.
For partially edentulous patients, the major problem is designing a removable partial
denture that avoids the unsightly display associated with conventional clasp
[1]
assemblies . In such aesthetically demanding situations, various methods to
overcome this aesthetic dilemma have included a conventional clasp type partial
[2,3,4] [5]
denture that incorporates a rotational path of insertion , Twin Flex Clasp , use of
[6] [7,8]
extra-coronal adhesive attachments , painting of clasps with tooth- colored resin ,
use of lingually positioned clasps, engagement of mesial rather than distal
[7,8,9] [9,10]
undercuts , use of precision attachments , use of gingivally rather than occlusally
[8,9,10]
approaching clasps .
Research in polymer science has provided us with an alternative material called “Acetal
resin”. Also known as Polyoxymethylene (POM), acetal resin is formed by the
polymerization of formaldehyde and is a thermoplastic technopolymer with a
[11]
monomer-free crystalline structure . The homopolymer, Polyoxymethylene (POM) is
a chain of alternating methyl groups linked by an oxygen molecule. This material has
been shown to have good biocompatibility and this has fostered its use in total hip
[11]
replacement and as artificial valve occluders . It has been used to form a stress
[12]
absorbing component in a dental implant system (IMZ) .
[13]
The possible use of acetal resins as denture base materials was considered by Smith .
These injection molded resins has been used as alternative denture base and denture
clasp material since 1986. It was marketed as a clasp material by Dental D (QuattroTi
Divisione Technopolimeri Biomedicali, Misano A., Italy), primarily on the basis of
IJCDS • aesthetics
superior NOVEMBER,[14], which allowed the clasp to better match the color of
2011 • 2(4) © 2011 Int. Journal of Clinical Dental Science the
56
These injection molded resins has been used as
alternative denture base and denture clasp material since
1986. It was marketed as a clasp material by Dental D
(QuattroTi Divisione Technopolimeri Biomedicali, Misano
[14]
A., Italy), primarily on the basis of superior aesthetics ,
which allowed the clasp to better match the color of the
abutment tooth. Acetal resin is available in 20 different
colour shades,17 of which are comparable with the “Vita”
colour scale (Vitapan; VITA Zahnfabrik, Bad Sackingen,
Germany) and 3 pink (Figure 1).
Acetal resins are fast emerging as a successful denture
base material, as tooth- colored clasps and in various
other dental applications, proving to be the “Gen- X
material in aesthetic restorative dentistry”.
CLINICAL USES
1. As direct retainers attached to a cobalt-chromium
removable partial denture framework, as well as the
supportive components of removable partial
[11]
dentures (Figure 2).
2. Removable partial prostheses (Figure 3).
3. Post-surgery space maintainers (Figure 4).
4. Gingival masks (Figure 5).
5. Provisional restorations (Figure 6).
6. Splints.
7. Positioning stents for patients due to have radiation
therapy.
8. Used as a framework material for patients with
allergic reactions to cobalt- chromium removable
partial denture framework.
good substitute for acrylic resins and metals in many
prosthetic applications. The above-mentioned features
remain stable under different operational conditions
such as: exposure to a 4 - 9 pH range, chemicals,
[17, 18]
humidity, cyclically repeated stresses, etc. .
LAB PROCEDURES FOR AESTHETIC CLASP
[19, 20]
FABRICATION
The processing procedure involves using special
equipment, which in turn may guarantee a constant
check of the melting temperature for the material, of
softening times, injection and the ensuing cooling under
[19, 20]
constant pressure .
First, the assembly (refractory cast with the wax pattern)
is placed at a distance of approximately 2.5 cm from the
injection opening of the special flask (Muffle Type 100;
Pressing Dental Srl). The flask is then closed and Type IV
dental stone is poured into the flask through the
opening of the special flask cover. The melted flask is
then removed. One acetal resin cylinder of the selected
colour is then placed into the injection tube and the tube
is placed with a special tweezer into the injection
channels of the injection machine J-100 (Pressing Dental
San Marino, Italy). The flask is then placed into the
injection machine that is programmed as follows;
melting temperature: 220°C, pre-injection time with the
material kept at the appropriate temperature: 20
minutes, post-injection time with the temperature
maintained at the desired level: 3 minutes, injection
pressure: 4 Bar.

PROPERTIES At the end of the programme, the flask is removed from

its initial position and the clasp assembly is deflasked.
1. Superior aesthetics. This is followed by smoothening the clasp with 600 grit
2. High resistance to abrasion. silicone carbide papers (Struers waterproof silicone
3. Excellent tensile and shock strength. carbide, Struers Scientific, Denmark). Polishing is done
4. High proportional limit with little viscous flow using rubber points (Pressing Dental Srl), followed by
(enabling it to behave elastically over a large enough using non-aggressive polishing paste (Universal Polish;
range to be used as a material for clasp Pressing Dental Srl).
[11]
fabrication)
5. High impact strength (69-122 J/m at 23°C) LIMITATIONS
2
6. Low modulus of elasticity (2.9 to 3.5 kN/mm ) which
allow for its use in larger retentive undercuts than 1. The retentive force for an acetal resin clasp may not
recommended for Cobalt- Chromium alloys (Elastic be sufficient for removable partial dentures due to
2 [11,12]
modulus; 22.43 kN/mm ) . This may be the significantly low retentive force required for
advantageous in clinical situations in which removal due to its low modulus of elasticity,
[15].
aesthetics and/or periodontal health are priorities suggesting that acetal resin clasps may be suitable
7. High elastic memory. for removable partial dentures where aesthetics or
[15]
8. Low thermal conductance. periodontal health is a primary concern .
9. Rigid.
10. Resistance to organic solvents, oils, alkalis, hot and 2. Pink acetal resin is more resistant to stress than the
cold water. white variety. This is because in colouring it, acrylic
11. Non allergenic, non-toxic fibres are added to the rough material and they
12. Clinically acceptable color changes after 300 hours amalgamate with the matrix, hence, decreasing the
[16]
of thermocycling . resistance of the white acetal resin as compared to
[21]
the pink variety .
These features, coupled with remarkable aesthetic
performance, make these injection moulded resins a

57 IJCDS • NOVEMBER, 2011 • 2(4) © 2011 Int. Journal of Clinical Dental Science
Figure 1: Acetal resin – Shade guide. Figure 2: Acetal resin aesthetic clasps

Figure 3: Acetal resin removable partial Figure 4: Acetal resin space maintainer
denture prosthesis.

Figure 5: Acetal resin gingival mask Figure 6: Acetal resin provisional restorations

IJCDS • NOVEMBER, 2011 • 2(4) © 2011 Int. Journal of Clinical Dental Science 58
 3. Due to the greater flexibility of acetal resin, when
compared with the Cobalt- Chromium and gold
alloys, a more bulky design would be required if the
[11]
same degree of retention is sought . E.g : To have
stiffness similar to a cast Cobalt- Chromium clasp
15 mm long and 1 mm in diameter, a suitable acetal
resin clasp must be shorter (approximately 5 mm)
with greater cross sectional diameter
[13
(approximately 1.4 mm) . It could be argued that a
larger bulkier design would be detrimental to oral
health by contributing to plaque accumulation.
[22]
However, according to Bergman B , if plaque
control is established and the patient presents with
regular visits, no evidence exists that any harm will
result.
CONCLUSION
In addition to the demand for aesthetics, shortcomings
of acrylic resins such as mechanical failure, dimensional
changes, color instability and allergic reactions have
caused the need for better improvised materials such as
Acetal resin to replace them. However, further research
on the clinical efficacy of acetal resin as aesthetic clasps,
removable partial denture prostheses is recommended
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