Could the Old Poly(methylmethacrylate) Face Arrising Challanges of New Advanced Technologies for Dental Prosthesis Manufacturing?

Advancements in Digital Workflows for 3D-Printed Maxillofacial Soft Prostheses: Exploring Design and Materials in Direct Additive Manufacturing: A Scoping Review

The treatment of maxillofacial defects presents significant challenges due to the complexity of facial anatomy and the diversity of affected tissues. Traditional workflows are labor-intensive, costly, and limited in customization. Recent advancements in fully digital workflows and direct 3D printing technologies offer new possibilities for improving the fit, aesthetics, and efficiency of prosthetic manufacturing. This scoping review aims to evaluate the current state of direct 3D printing for maxillofacial soft prostheses, assess material properties and biocompatibility, and identify challenges and future directions in this field. Methods: A comprehensive search of PubMed and Scopus databases, along with a manual search of relevant journals, was conducted to identify studies published up to December 2024. Articles focusing on direct 3D printing of maxillofacial soft prostheses were included, while studies involving traditional or mold-based workflows, ocular prostheses, and literature reviews were excluded. Data on materials, manufacturing techniques, and clinical outcomes were extracted and analyzed. Results: Out of 898 articles screened, 11 were included, 5 of which were in vivo studies (case reports). The additive manufacturing methods used in these case reports were Drop-on-Demand (DoD) silicone printing and PolyJet technology. Conclusions: Fully digital workflows and direct 3D printing technologies show promise for advancing maxillofacial prosthesis manufacturing. However, the absence of dedicated software, biocompatible materials, and medium- to long-term clinical evaluations highlight significant research gaps. Future research should focus on material development, workflow optimization, and clinical validation to enable widespread clinical adoption.

A Review on the Biocompatibility of PMMA-Based Dental Materials for Interim Prosthetic Restorations with a Glimpse into their Modern Manufacturing Techniques

This paper's primary aim is to outline relevant aspects regarding the biocompatibility of PMMA (poly(methyl methacrylate))-based materials used for obtaining interim prosthetic restorations, such as the interaction with oral epithelial cells, fibroblasts or dental pulp cells, the salivary oxidative stress response, and monomer release. Additionally, the oral environment's biochemical response to modern interim dental materials containing PMMA (obtained via subtractive or additive methods) is highlighted in this review. The studies included in this paper confirmed that PMMA-based materials interact in a complex way with the oral environment, and therefore, different concerns about the possible adverse oral effects caused by these materials were analyzed. Adjacent to these aspects, the present work describes several advantages of PMMA-based dental materials. Moreover, the paper underlines that recent scientific studies ascertain that the modern techniques used for obtaining interim prosthetic materials, milled PMMA, and 3D (three-dimensional) printed resins, have distinctive advantages compared to the conventional ones. However, considering the limited number of studies focusing on the chemical composition and biocompatibility of these modern interim prosthetic materials, especially for the 3D printed ones, more aspects regarding their interaction with the oral environment need to be further investigated.

Eighteen Months Follow-Up with Patient-Centered Outcomes Assessment of Complete Dentures Manufactured Using a Hybrid Nanocomposite and Additive CAD/CAM Protocol

Abstract: The present study aimed to assess the eighteen month follow-up patient-centered outcomes of a simple and predictable protocol for 3D-printed functional complete dentures manufactured using an improved poly(methyl methacrylate) (PMMA)-nanoTiO2. A detailed morphological and structural characterization of the PMMA-TiO2 nanocomposite, using SEM, EDX, XRD, and AFM, after 3D-printing procedure and post-wearing micro-CT, was also performed.

METHODS

A total of 35 fully edentulous patients were enrolled in this prospective study. A 0.4% TiO2-nanoparticle-reinforced PMMA composite with improved mechanical strength, morphologically and structurally characterized, was used according to an additive computer-aided design and computer-aided manufacturing (CAD/CAM) protocol for complete denture fabrication. The protocol proposed involved a three-step appointment process. Before denture insertion, 1 week, 12 month, and 18-month follow up patients were evaluated via the Visual Analogue Scale (VAS, 0-10) and Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT), with a higher score meaning poor quality of life.

RESULTS

A total of 45 complete denture sets were inserted. OHIP-EDENT scored significantly better after 18 months of denture wearing, 20.43 (±4.42) compared to 52.57 (±8.16) before treatment; mean VAS was improved for all parameters assessed.

CONCLUSIONS

Within the limitations of this study, we can state that the proposed workflow with the improved material used is a viable treatment option for patients diagnosed with complete edentulism.

A photo-crosslinked hybrid interpenetrating polymer network (IPN) for antibacterial coatings on denture base materials

An interpenetrating polymer network (IPN) structured antibacterial layer was prepared on dental base materials using a one-step photo-crosslinking method.