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 • Shrinkage of 21% occurs during the polymerization of the pure

monomer.

• It is a hard resin with a Knoop hardness number of 18–20.

• Tensile strength is approximately 8500 pounds per square inch (600

kg/cm2

).

• Modulus of elasticity is approximately 350,000 pounds per square

inch.

• It is soluble in organic solvents such as chloroform and acetone.

• Water absorption: 0.3% absorption is observed after 24 h, which is

reversible, if the resin is dried.

• Heat polymerization is preferred compared to autopolymerization

because of colour stability and also because of the presence of free

toxic tertiary amines in the latter.

Advantages

• Durable

• Colour stable

• Cosmetic

• Can be relined or repaired

• Compatible with most adhesive system and can be easily cleaned

• Easy and quick to fabricate

Disadvantages

• It has higher rigidity.

• Duplicate prosthesis is not possible, because of mould destruction

during processing.

• Water sorption – increased weight 0.5% after 1 week.

• Its use is doubtful in the movable tissue bed.

• Because of relatively high thermal conductivity, the patient may

complain of discomfort in cold climatic conditions.

Acrylic copolymers (palamed, polyderm)

These are soft elastic but are not widely accepted because of the

following reasons:

• These have poor edge strength.

• These have poor durability.

• These are susceptible to degradation when exposed to sunlight.

• Processing and colouration is difficult.

• Completed restoration is often tacky and predisposing to dust

collection and staining.

• J.M. Antonucci and J.W. Stansburry reported the new generation of

acrylic monomers, oligomers and macromers.

• These are thermal, chemical and photoinitiated.

• These can eliminate the shortcomings of traditional acrylic

copolymers.

PVC and copolymers (realistic, mediplast)

• It consists of a combination of PVC and plasticizer.

• PVC is a clear, hard resin. It is tasteless and odourless.

• Copolymers of vinyl chloride and vinyl acetate are more flexible but

less chemically resistant than polymethyl chloride.

• It darkens when exposed to UV light and heat.

• It requires heat and light stabilization to prevent discolouration

during fabrication and use.

• Polyvinyl acetate is stable to light and heat but has an abnormally

low-softening point (35–40°C).

Realistic

• It is a PVC compound and solidifies into a flexible material when

heated.

Advantages

• It is easy to handle and is ideal for an inexperienced person using

maxillofacial materials.

• It is flexible and provides acceptable initial appearance.

• It is available in a wide variety of colours to match the patient’s skin

tone.

• Staining can be achieved both internally and externally. Ferrous

pigments incorporated into the mixture give the long life and the

best aesthetic results.

Disadvantages

• Migration of plasticizer leads to discolouration and hardening of

prosthesis.

• These can be stained easily when exposed to UV light, peroxides

and ozone.

• These lack lifelike translucency and tend to absorb sebaceous

secretions, cosmetics and solvent.

• Edges, if thin, tear easily and may be reinforced with nylon fabric.

• These require metal moulds, as they polymerize at high

temperatures.

Chlorinated polyethylene (CPE)

• D.H. Lewis and D.J. Castleberry tested and found this material to

be similar to PVC in both chemical composition and physical

properties.

• The processing procedure involves high-heat curing with

pigmented sheets in metal moulds.

• The system consists of the industrial CPE which is blended with

additives – low-density polyethylene, calcium stearate and soya

bean oil.

• The mechanical properties of formulated material are good.

• No chemical reaction is involved in fabrication.

• Material is relatively cheap.

• Disadvantage: Metal moulds are required for fabrication, as they

polymerize at high temperatures.

Polyurethane elastomers (Epithane-3)

• Polyurethane elastomers contain a urethane linkage.

• In the presence of catalyst, isocyanate combines with a hydroxyl

group.

• Varying amount of isocyanates will change the physical properties

of final products.

• These have excellent properties such as elasticity and ease of

colouration.

• Deficiencies are moisture sensitive leading to gas bubbles and cause

local irritation.

• Epithane-3 is a commercially available four-component system.

Advantages

• These can be made elastic without compromising the strength at the

margins.

• Their flexibility made them to be used on movable bed.

• These can be coloured extrinsically and intrinsically.

• Superior cosmetic results can be obtained.

• These are durable and resemble the living tissue.

Disadvantages

• These are difficult to process consistently.

• Isocyanate is moisture sensitive.

• Water contamination is difficult to control and leads to gas bubbles.

• These are not colour stable.

• These have poor compatibility with adhesive systems.

• Clinical usefulness is less than 6 months.

• Isocyanate is a toxic compound and can cause local irritation.

• Cleaning of adhesive from prosthesis can be difficult for the patient.

Silicone elastomers

The silicones were introduced in 1946 and are one of the most widely

used materials for facial restorations.

• They consist of alternate chains of sodium and oxygen which can be

modified by attaching various organic side groups to the silicone

atoms or by cross-linking the molecular chains.

• G.W. Barnhart (1960) was the first to use silicone elastomers for

extraoral prosthesis.

• These are a combination of organic and inorganic compounds.

• Chemically, polydimethyl siloxane (PDM) combines with water to

form a polymer.

• These polymers are translucent, watery and white fluids, whose

viscosity is determined by the length of polymer chain.

• PDM is commonly known as silicone.

• Additives are added to give colour and fillers provide strength.

• Antioxidants and vulcanizing agents are used to convert the raw

mass from plastic to a rubbery resin during processing.

• The process of cross-linking of polymers is referred as

vulcanization. It can occur with or without heat and is dependent

on the catalyst or the cross-linking agent used.

Classification

On the basis of vulcanization

(i) RTV

(ii) HTV

On the basis of their application

(i) Class I: Implant grade, which requires the material to undergo

extensive testing and must meet the FDA requirements.

(ii) Class II: Medical grade, which is approved for external use. This

material is used for the fabrication of maxillofacial prosthesis.

(iii) Class III: Industrial grade, which is commonly used for industrial

applications.

HTV (heat vulcanizing silicones)

• These involve the use of a diorganopolysiloxane (e.g. PDM).

• The vulcanizing agent is benzoyl peroxide.

• The filler added to the polymer is finely divided silica with particle

size of 30 microns.

• Amount of filler added to the polymer can be varied depending on

the requirement of strength, hardness and elongation.

• There is more intense mechanical milling of the solid HTV

elastomers compared with the soft putty RTV silicone.

Various types of HTV silicone

• Silastic 370, 372, 373, 4-4514, and 4-4515 are white, opaque materials,

with putty-like consistency.

• Catalyst or vulcanizing agent of HTV is dichlorobenzoyl peroxide or

platinum salt.

• These exhibit excellent thermal stability and are biologically inert

but lack elasticity.

• PDM may be added to reduce the stiffness and the hardness of the

prosthesis.

• Silastic S-6508 is in raw state which is similar to sticky modelling

clay. It must be vulcanized at high temperatures and is formed in

pressure moulds.

• Silastic 399 resembles white Vaseline in its raw state. It is easily

spatulated, but nonflowing.

Advantages

• Excellent thermal stability

• Colour stable

• Biologically inert

Disadvantages

• Not adequate elasticity in function

• Low edge strength

• Opaque, lifeless appearance

RTV (room temperature vulcanization silicones)

• These are composed of comparatively short-chain silicone polymers

which are partially end blocked with hydroxyl groups.

• Filler: Diatomaceous earth particles.

• Catalyst: Stannous octoate.

• Cross-linking agent: Orthoalkyl silicate.

• These are available as clear solutions that enable the fabrication of

translucent prosthesis.

• RTV silicone is blended with suitable earth pigments to produce the

patient’s basic skin colour.

Advantages

• These are colour stable.

• These are biologically inert.

• These retain physical and chemical properties at wide range of

temperatures.

• These are easier to process.

Disadvantages

• These have poor edge strength

• These are costly.

• Cosmetic appearance of the material is inferior to other materials.

Advantages of HTV over RTV

• Less chances of air bubble entrapment, because hand mixing of

catalyst with the elastomer is avoided.

• Increased tear strength, mechanical durability and chemical

resistance

• Increased biocompatibility

Silastics

It is a medical grade silicone rubber material.

• It is in the form of thick white liquid. When combined with

organometallic catalyst, it vulcanizes without the use of heat or

pressure.

• Dibutyltin dilaurate will prolong the vulcanization time and will

cause skin irritation unless prosthesis is washed thoroughly.

• Working time varies from 2 to 60 min by adjusting the catalyst.

Thinner is added to the catalyst to increase accuracy (thinner can be

added 10% of weight without noticeable changes in the prostheses).

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