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Mohammed M Gad,1 Shaimaa M Fouda,1,2 Fahad A Al-Harbi,1 Ritva Näpänkangas,2,3 Aune Raustia2,3 1Department of Substitutive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia; 2Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland; 3Medical Research Center, Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland Abstract: This paper reviews acrylic denture base resin enhancement during the past few decades. Specific attention is given to the effect of fiber, filler, and nanofiller addition on poly(methyl methacrylate) (PMMA) properties. The review is based on scientific reviews, papers, and abstracts, as well as studies concerning the effect of additives, fibers, fillers, and reinforcement materials on PMMA, published between 1974 and 2016. Many studies have reported improvement of PMMA denture base material with the addition of fillers, fibers, nanofiller, and hybrid reinforcement. However, most of the studies were limited to in vitro investigations without bioactivity and clinical implications. Considering the findings of the review, there is no ideal denture base material, but the properties of PMMA could be improved with some modifications, especially with silanized nanoparticle addition and a hybrid reinforcement system. Keywords: denture base, PMMA, reinforcement, nanoparticles, fibers, fillers