Comparative Assessment of Flexural Strength in Heat-cured Polymethyl Methacrylate Resin Reinforced with Silver Nanoparticles, Siwak, and Fluconazole: An In-vitro Study

Introduction: For crafting complete dentures, Polymethylmethacrylate (PMMA) has long been the material of choice. Various reinforcements are being used to enhance the properties of PMMA and minimise denture fracture. Aim: The present in -vitro study compared the flexural strength of PMMA resin samples reinforced with Silver Nanoparticles (Ag NP), siwak, and fluconazole. Materials and Methods: The present in -vitro experiment was conducted from July to August 2017 at the Prosthodontics Department of a Dental College with technical support from the Centre for Scientific Research and Development (CSRD), affiliated with People's University in Bhopal, Madhya Pradesh, India. Flexural testing was conducted at the Central Institute of Plastic Engineering and Technology (CIPET), Bhopal. A total of 120 acrylic resin samples, each measuring 65 mm in length, 10 mm in width, and 2.5 mm in thickness, were fabricated in accordance with American Dental Association (ADA) Specification No. 12. These specimens were categorised into four distinct groups. The first group consisted of only PMMA resin (Group A), while the remaining three groups comprised PMMA resin enhanced with AgNP (Group B), Siwak (Group C), and Fluconazole (Group D), respectively, with each group containing 30 samples. Subsequently, these specimens underwent a flexural strength assessment through a 3 -point flexural test. The statistical analysis to assess and compare the mean flexural strength of the samples was conducted. The present analysis was performed first by applying an Analysis of Variance (ANOVA) test, followed by pairwise comparisons with Tukey's Post -hoc test. A p -value less than 0.05 was used to determine statistical significance. Results: The mean flexural strength (+/- Standard Deviation) in N/mm2 for PMMA; PMMA+AgNP; PMMA+Siwak and PMMA+ Fluconazole was 82.33 +/- 5.18; 80.55 +/- 5.67; 71.50 +/- 10.15; and 74.03 +/- 10.84, respectively. The mean flexural strengths of the PMMA and PMMA+AgNP groups were similar (p=0.842). However, the flexural strength of the Siwak+PMMA and Fluconazole+PMMA groups was significantly less than that of the other two groups. Conclusion: The flexural strength of PMMA is unaffected by the inclusion of AgNP at a concentration of 1%, and its incorporation would allow the benefit from its antibacterial qualities. It is not advised to add fluconazole or siwak because doing so reduces the flexural strength.