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Lee CKJ, Yong CW, Tan SL, Seah JA, Chew MT, Ren Y. Accuracy and clinical fit of milled versus rapid prototyped orthognathic surgical splints. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:102069. [PMID: 39260569 DOI: 10.1016/j.jormas.2024.102069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2024] [Accepted: 09/07/2024] [Indexed: 09/13/2024]
Abstract
Three-dimensional (3D) printing has slowly become an integral part of orthognathic surgery. However, there is a lack of studies evaluating accuracy of orthognathic surgical splints fabricated from subtractive milling versus additive 3D printing. The primary aim of this in vitro study was to compare the differences in trueness between milled and 3D-printed splints, while the secondary aim was to compare the differences in clinical fit of these splints. A sample of eight patients was selected, and STL files of the final orthognathic surgical splint were used to fabricate three splints for each of the eight cases. The first splint was fabricated by subtractive milling (SM), whereas the second and third splints were 3D printed with Digital Light Processing (DLP) and Laser Stereolithography (SLA), respectively. Paired superimposition of scans was performed using a reference model. The clinical fit of the splints to the printed models was also assessed. The mean root mean square (RMS) deviations for the SM, SLA, and DLP were 0.11 ± 0.02, 0.16 ± 0.02 and 0.14 ± 0.02 respectively. The post-hoc analysis showed that the SM splints had the highest accuracy (p<0.01). However, DLP splints showed the best clinical fit, followed by SM and SLA. In conclusion, splints fabricated by SM were more accurate than those fabricated by 3D printing, although this difference may not be clinically significant. The site, rather than the magnitude of the errors, may have a greater effect on the clinical usability of splints. In general, SM and DLP splints demonstrated a good clinical fit and were suitable for the fabrication of surgical splints.
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Affiliation(s)
- Cheryl Ker Jia Lee
- NATIONAL DENTAL CENTRE, Department of Orthodontics, Level 8, Academic Clinical Program (ACP) Office 5 Second Hospital Ave, Singapore 168938.
| | - Chee Weng Yong
- FACULTY OF DENTISTRY, NATIONAL UNIVERSITY SINGAPORE, Discipline of Oral & Maxillofacial Surgery Level 10, Dean's Office, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085
| | - Suat Li Tan
- NATIONAL DENTAL CENTRE, Digital Dentistry Unit, Level 8, Academic Clinical Program (ACP) Office, 5 Second Hospital Ave, Singapore 168938
| | - Ji An Seah
- NATIONAL DENTAL CENTRE, Digital Dentistry Unit, Level 8, Academic Clinical Program (ACP) Office, 5 Second Hospital Ave, Singapore 168938
| | - Ming Tak Chew
- NATIONAL DENTAL CENTRE, Department of Orthodontics, Level 8, Academic Clinical Program (ACP) Office 5 Second Hospital Ave, Singapore 168938
| | - Yijin Ren
- UNIVERSITY MEDICAL CENTER GRONINGEN, UNIVERSITY OF GRONINGEN, 9712 CP Groningen, Netherlands
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Altarazi A, Jadaan L, McBain AJ, Haider J, Kushnerev E, Yates JM, Alhotan A, Silikas N, Devlin H. 3D-printed nanocomposite denture base resin: The effect of incorporating TiO 2 nanoparticles on the growth of Candida albicans. J Prosthodont 2024; 33:25-34. [PMID: 37837403 DOI: 10.1111/jopr.13784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/23/2023] [Accepted: 10/06/2023] [Indexed: 10/16/2023] Open
Abstract
PURPOSE To develop a biocompatible denture base resin/TiO2 nanocomposite material with antifungal characteristics that is suitable for 3D-printing denture bases. MATERIALS AND METHODS TiO2 nanoparticles (NPs) with a 0.10, 0.25, 0.50, and 0.75 weight percent (wt.%) were incorporated into a commercially available 3D-printed resin material. The resulting nanocomposite material was analyzed using Lactate dehydrogenase (LDH) and AlamarBlue (AB) assays for biocompatibility testing with human gingival fibroblasts (HGF). The composite material was also tested for its antifungal efficacy against Candida albicans. Fourier transform infrared (FTIR) and Energy Dispersive X-ray Spectroscopy (EDX) mapping were conducted to assess the surface coating and the dispersion of the NPs. RESULTS LDH and AB assays confirmed the biocompatibility of the material showing cell proliferation at a rate of nearly 100% at day 10, with a cytotoxicity of less than 13% of the cells at day 10. The concentrations of 0.10, 0.25, and 0.50 wt.% caused a significant reduction (p < 0.05) in the number of candida cells attached to the surface of the specimens (p < 0.05), while 0.75 wt.% did not show any significant difference compared to the control (no TiO2 NPs) (p > 0.05). FTIR and EDX analysis confirmed the presence of TiO2 NPs within the nanocomposite material with a homogenous dispersion for 0.10 and 0.25 wt.% groups and an aggregation of the NPs within the material at higher concentrations. CONCLUSION The addition of TiO2 NPs into 3D-printed denture base resin proved to have an antifungal effect against Candida albicans. The resultant nanocomposite material was a biocompatible material with HGFs and was successfully used for 3D printing.
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Affiliation(s)
- Ahmed Altarazi
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
- Restorative Dental Science, College of Dentistry, Taibah University, Madinah, Saudi Arabia
| | - Layali Jadaan
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Andrew J McBain
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Julfikar Haider
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
- Department of Engineering, Manchester Metropolitan University, Manchester, UK
| | - Evgeny Kushnerev
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Manchester, Manchester, UK
| | - Julian M Yates
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Manchester, Manchester, UK
| | - Abdulaziz Alhotan
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Nick Silikas
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Hugh Devlin
- Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
- School of Dentistry, University of Jordan, Jordan
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Refaie A, Bourauel C, Elshazly T, Evers-Dietze B, Alhotan A, Aldesoki M. Trueness and precision of digital light processing fabricated 3D printed monolithic zirconia crowns. J Dent 2024; 148:105151. [PMID: 38909644 DOI: 10.1016/j.jdent.2024.105151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 06/25/2024] Open
Abstract
OBJECTIVES The present study aimed to evaluate the trueness and precision of monolithic zirconia crowns (MZCs) fabricated by 3D printing and milling techniques. METHODS A premolar crown was designed after scanning a prepared typodont. Twenty MZCs were fabricated using milling and 3D-printing techniques (n = 10). All the specimens were scanned with an industrial scanner, and the scanned data were analyzed using 3D measurement software to evaluate the trueness and precision of each group. Root mean square (RMS) deviations were measured and statistically analyzed (One-way ANOVA, Tukey's, p ≤ 0.05). RESULTS The trueness of the printed MZC group (140 ± 14 μm) showed a significantly higher RMS value compared to the milled MZCs (96 ± 27 μm,p < 0.001). At the same time, the precision of the milled MZCs (61 ± 17 μm) showed a significantly higher RMS value compared to that of the printed MZCs (31 ± 5 μm,p < 0.001). CONCLUSIONS The Fabrication techniques had a significant impact on the accuracy of the MZCs. Milled MZCs showed the highest trueness, while printed MZCs showed the highest precision. All the results were within the clinically acceptable error values. CLINICAL SIGNIFICANCE Although the trueness of the milled MZCs is higher, the manufacturing accuracy of the 3D-printed MZCs showed clinically acceptable results in terms of trueness and precision. However, additional clinical studies are recommended. Furthermore, the volumetric changes of the material should be considered.
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Affiliation(s)
- Ashraf Refaie
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Fixed Prosthodontics, Faculty of Dentistry, Fayoum University, Egypt.
| | | | - Tarek Elshazly
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
| | - Bernd Evers-Dietze
- Department of Electrical Engineering, Mechanical Engineering and Technical Journalism (EMT), Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | - Abdulaziz Alhotan
- Department of Dental Health, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Mostafa Aldesoki
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
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Orgev A, Donmez MB, Almogbel L, Cakmak G, Marques VR, Kahveci C, Yilmaz B. Cameo and intaglio surface stability and variability of additively, subtractively, and conventionally manufactured occlusal devices after long-term storage. J Prosthet Dent 2024; 132:604.e1-604.e7. [PMID: 38955603 DOI: 10.1016/j.prosdent.2024.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 07/04/2024]
Abstract
STATEMENT OF PROBLEM Additive and subtractive manufacturing have become alternative technologies for fabricating occlusal devices. However, knowledge of the long-term stability of occlusal devices fabricated using these recent technologies is limited. PURPOSE The purpose of this in vitro study was to evaluate the cameo and intaglio surface stability and variability of additively, subtractively, and conventionally manufactured occlusal devices after 18 months of storage. MATERIAL AND METHODS A standard tessellation language (STL) file of a dentate maxillary typodont was used to design a master occlusal device. The STL file of this design was used to fabricate occlusal devices additively either with a digital light processing (AM-1) or a continuous liquid interface production (AM-2) printer, subtractively with 2 different 5-axis milling units (SM-1 and SM-2), and conventionally (TM-HP) (n=10). STL files of each device's cameo and intaglio surfaces were generated using a laboratory scanner after fabrication and after 18 months of storage in a moist environment. These generated files were imported into an analysis software program (Geomagic Control X) to analyze the dimensional stability of tested devices by using the root mean square method. The average deviation values defined the variability of measured changes over time. Cameo and intaglio surface deviations were analyzed using the Kruskal-Wallis and Dunn tests, while the variability of measured deviations was analyzed with 1-way analysis of variance and the Tukey HSD tests (α=.05). RESULTS Significant differences were observed among tested devices when the intaglio surface deviations and the cameo surface variability were considered (P<.001). SM-2 had significantly higher intaglio surface deviations than AM-1, SM-1, and AM-2 (P≤.036). Among the test groups, AM-1 had the greatest cameo surface variability (P≤.004). CONCLUSIONS SM-2 resulted in lower intaglio surface stability than the additive and the other subtractive manufacturing technologies, while AM-1 led to the highest cameo surface variability among the test groups.
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Affiliation(s)
- Ahmet Orgev
- Clinical Associate Professor, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, Buffalo, NY.
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey; and ITI Scholar, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Lolowh Almogbel
- Fellow, Advanced Education Program in Implant Dentistry, Loma Linda University School of Dentistry, Loma Linda, Calif.; Restorative and Prosthetic Dental Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Gulce Cakmak
- Senior Research Associate, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Vinicius Rizzo Marques
- Digital Implant Fellow, Department of Restorative Dentistry, School of Dental Medicine, University at Buffalo, Buffalo, NY
| | - Cigdem Kahveci
- Assistant Professor, Department of Prosthodontics, Giresun University Faculty of Dentistry, Giresun, Turkey
| | - Burak Yilmaz
- Associate Professor, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Associate Professor, Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; and Adjunct Professor, Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, Ohio
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Hampe T, Liersch J, Wiechens B, Bürgers R, Krohn S. Bisphenol A release from CAD/CAM splint materials. Eur J Oral Sci 2024; 132:e12993. [PMID: 38778467 DOI: 10.1111/eos.12993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 04/26/2024] [Indexed: 05/25/2024]
Abstract
This study aimed to investigate the bisphenol A (BPA) release from four CAD/CAM splint materials: three polycarbonate-based (DD BioSplint C, Splint Plus Biostar, Temp Premium Flexible) and one polymethylmethacrylate-based (Temp Basic) material. From each material, ten cylindrical samples (n = 40) were immersed in high-performance liquid chromatography (HPLC) grade water following ISO 10993-12 and incubated for 24 h in an incubation shaker at 37°C and 112 rpm. Following BPA derivatization, analysis was performed by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). After 24 h of incubation, all investigated materials released significant amounts of BPA compared to water blanks. The material-dependent elution increased in the following order: DD BioSplint C < Splint Plus Biostar < Temp Basic < Temp Premium Flexible. Subtracting extraneous BPA, the concentrations ranged between 2.27 ng/mL and 12.65 ng/mL. After extrapolating the concentrations in relation to the average surface area of occlusal splints, the amount of BPA per mL exceeded the Tolerable Daily Intake (TDI) set by the European Union for a person weighing 70 kg by 1.32-6.16 times. Contrary to the release from previously investigated materials, BPA elution from CAD/CAM splint materials was highly elevated. Considering the increasing adaptation of CAD/CAM techniques, elution from them may represent a relevant BPA source in daily dental practice.
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Affiliation(s)
- Tristan Hampe
- Department of Prosthodontics, University Medical Center Göttingen, Göttingen, Germany
| | - Julia Liersch
- Department of Prosthodontics, University Medical Center Göttingen, Göttingen, Germany
| | - Bernhard Wiechens
- Department of Prosthodontics, University Medical Center Göttingen, Göttingen, Germany
- Department of Orthodontics, University Medical Center Göttingen, Göttingen, Germany
| | - Ralf Bürgers
- Department of Prosthodontics, University Medical Center Göttingen, Göttingen, Germany
| | - Sebastian Krohn
- Department of Prosthodontics, University Medical Center Göttingen, Göttingen, Germany
- Department of Orthodontics, University Hospital Regensburg, Regensburg, Germany
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Zhu L, Han W, Xiang R, Xu H, Bai D, Wang P, Xue C. Does curve of Spee affect the precision of 3D-printed curvature-adaptive splints? J Dent 2024; 147:105108. [PMID: 38844153 DOI: 10.1016/j.jdent.2024.105108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES This study aimed to propose a standardized protocol for the fabrication of three-dimensionally (3D)-printed curvature-adaptive splints (CASs) and assess the precision of CASs on dentitions with different depths of the curve of Spee (COS). METHODS 76 lower dental resin models, each exhibiting one of the four types of COS (0-, 2-, 4-, and 6-mm deep), were selected and digitally scanned. CASs were designed, 3D printed, and grouped into C0, C2, C4, and C6, corresponding to the four types of COS depths. To assess precision, the CASs occluded with the resin model were scanned as a whole and compared with the originally designed ones. RESULTS In terms of translational deviations observed in the CASs, the mean value of absolute sagittal deviation (0.136 mm) was significantly higher than those of vertical (0.091 mm) and transversal deviations (0.045 mm) (P < 0.01). Regarding rotational deviations of the CASs, the mean deviation in pitch (0.323°) was significantly higher than those in yaw (0.083°) and roll (0.110°) (P < 0.01). However, when comparing the accuracy of CASs across C0, C2, C4, and C6 groups, no statistically significant difference was found. Additionally, the translational deviations, rotational deviations, and RMSE of all groups were significantly lower than the clinically acceptable limits of 0.5 mm, 1°, and 0.25 mm, respectively (P < 0.01). CONCLUSIONS The depth of the COS has no significant impact on the precision of CASs, as evidenced by the absence of statistically significant differences in translational, rotational deviations, and RMSE among all groups (C0, C2, C4, and C6). Moreover, despite relatively high deviations in the sagittal dimension and pitch, all dimensional deviations and RMSE remained statistically significantly lower than the corresponding clinically acceptable limits (CALs) in all groups. CLINICAL SIGNIFICANCE This standardized protocol incorporating "curvature-adaptation" represents an optimized approach to fabricating diverse 3D-printed splints tailored to dentitions with different anatomical features in contemporary digital dentistry.
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Affiliation(s)
- Liwei Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Wenze Han
- School of Stomatology, Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Runzhe Xiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Hui Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Peiqi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Chaoran Xue
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Valenti C, Federici MI, Coniglio M, Betti P, Pancrazi GP, Tulli O, Masciotti F, Nanussi A, Pagano S. Mechanical and biological properties of polymer materials for oral appliances produced with additive 3D printing and subtractive CAD-CAM techniques compared to conventional methods: a systematic review and meta-analysis. Clin Oral Investig 2024; 28:396. [PMID: 38916682 DOI: 10.1007/s00784-024-05772-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/11/2024] [Indexed: 06/26/2024]
Abstract
OBJECTIVES The aim of this review was to analyze mechanical and biological properties of resin materials used with subtractive or additive techniques for oral appliances fabrication and compare them to those conventionally manufactured. MATERIALS AND METHODS The protocol was registered online at Open Science Framework (OSF) registries ( https://osf.io/h5es3 ) and the study was based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). An electronic search was conducted on MEDLINE (via PubMed), Scopus, and Web of Science from 1 February 2022 to 1 May 2022. INCLUSION CRITERIA in vitro and in vivo studies published in the last 10 years, with CAD-CAM or 3D printed resins for occlusal splints. Data considered homogenous were subjected to meta-analysis (95% confidence interval [CI]; α = 0.05) with Stata17 statistical software. Since all variables were continuous, the Hedge g measure was calculated. A fixed-effects model was used for I2 = 0%, while statistical analysis was conducted using a random-effects model with I2 > 0%. RESULTS 13 studies were included after full-text reading. The mechanical properties most studied were wear, flexural strength, surface hardness and surface roughness, while only 1 study investigated biological properties, performing the XTT viability assay. For the meta-analysis, only surface roughness, volume loss, and flexural strength were selected. Considering surface roughness, the subtractive specimen had a lower average value compared to traditional ones (Hedge's g with 95% CI = -1.25[ -1.84, - 0.66]). No significant difference was detected in terms of volume loss (P > 0.05) between the groups (Hedge's g with 95% CI = -0.01 [-2.71, - 2.68]). While flexural strength was higher in the control group (Hedge's g with 95% CI = 2.32 [0.10-4.53]). CONCLUSION 3D printed materials showed properties comparable to conventional resins, while milled splint materials have not shown better mechanical performance compared with conventional heat-cured acrylic resin. Polyetheretherketone (PEEK) have great potential and needs to be further investigated. Biological tests on oral cell populations are needed to confirm the long-term biocompatibility of these materials. CLINICAL RELEVANCE The use of "mixed splints" combining different materials needs to be improved and evaluated in future research to take full advantage of different characteristics and properties.
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Affiliation(s)
- Chiara Valenti
- CISAS "Giuseppe Colombo", University of Padua, Via Venezia, 15, Padua, 35131, Italy
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
| | - Maria Isabella Federici
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
| | - Maddalena Coniglio
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy.
- Strada vicinale Via delle Corse, S. Andrea delle Fratte, Perugia, 06132, Italy.
| | - Paolo Betti
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
| | - Gian Piero Pancrazi
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
| | - Ornella Tulli
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
| | - Francesca Masciotti
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
| | | | - Stefano Pagano
- Department of Medicine and Surgery, Faculty of Dentistry, University of Perugia, S. Andrea delle Fratte, Perugia, 06156, Italy
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Saadat Sarmadi B, Schmidt F, Beuer F, Metin DS, Simeon P, Nicic R, Unkovskiy A. The Effect of Build Angle and Artificial Aging on the Accuracy of SLA- and DLP-Printed Occlusal Devices. Polymers (Basel) 2024; 16:1714. [PMID: 38932064 PMCID: PMC11207952 DOI: 10.3390/polym16121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
The aim of this study is to investigate the influence of printing material, build angle, and artificial aging on the accuracy of SLA- and DLP-printed occlusal devices in comparison to each other and to subtractively manufactured devices. A total of 192 occlusal devices were manufactured by one SLA-printing and two DLP-printing methods in 5 different build angles as well as milling. The specimens were scanned and superimposed to their initial CAD data and each other to obtain trueness and precision data values. A second series of scans were performed after the specimens underwent an artificial aging simulation by thermocycling. Again, trueness and precision were investigated, and pre- and post-aging values were compared. A statistically significant influence was found for all main effects: manufacturing method, build angle, and thermocycling, confirmed by two-way ANOVA. Regarding trueness, overall tendency indicated that subtractively manufactured splints were more accurate than the 3D-printed, with mean deviation values around ±0.15 mm, followed by the DLP1 group, with ±0.25 mm at 0 degree build angle. Within the additive manufacturing methods, DLP splints had significantly higher trueness for all build angles compared to SLA, which had the highest mean deviation values, with ±0.32 mm being the truest to the original CAD file. Regarding precision, subtractive manufacturing showed better accuracy than additive manufacturing. The artificial aging demonstrated a significant influence on the dimensional accuracy of only SLA-printed splints.
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Affiliation(s)
- Bardia Saadat Sarmadi
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Dilan Seda Metin
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Philipp Simeon
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Robert Nicic
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow 119146, Russia
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Ateş G, Demirel M, Donmez MB, Dayan SÇ, Sülün T. Effect of material and antagonist type on the wear of occlusal devices with different compositions fabricated by using conventional, additive, and subtractive manufacturing. J Prosthet Dent 2024; 131:1235.e1-1235.e8. [PMID: 38594086 DOI: 10.1016/j.prosdent.2024.03.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024]
Abstract
STATEMENT OF PROBLEM Additive (AM) and subtractive (SM) manufacturing have become popular for fabricating occlusal devices with materials of different chemical compositions. However, knowledge on the effect of material and antagonist type on the wear characteristics of occlusal devices fabricated by using different methods is limited. PURPOSE The purpose of this in vitro study was to evaluate the effect of material and antagonist type on the wear of occlusal devices fabricated by using conventional manufacturing, AM, and SM. MATERIAL AND METHODS Two-hundred and forty Ø10×2-mm disk-shaped specimens were fabricated by using heat-polymerized polymethylmethacrylate (control, CM), AM clear device resin fabricated in 3 different orientations (horizontal [AMH], diagonal [AMD], and vertical [AMV]), SM polymethylmethacrylate (SMP), and SM ceramic-reinforced polyetheretherketone (SMB) (n=40). Specimens were then divided into 4 groups based on the antagonists: steatite ceramic (SC); multilayered zirconia (ZR); lithium disilicate (EX); and zirconia-reinforced lithium silicate (ZLS) used for thermomechanical aging (n=10). After aging, the volume loss (mm3) and maximum wear depth (μm) were digitally evaluated. Data were analyzed with 2-way analysis of variance and Tukey honestly significant difference tests (α=.05). RESULTS The interaction between the device material and the antagonist affected volume loss and maximum depth of wear (P<.001). AMH had volume loss and depth of wear that was either similar to or higher than those of other materials (P≤.044). When SC was used, CM had higher volume loss and depth of wear than AMV, and, when EX was used, AMD had higher volume loss and depth of wear than SMP (P≤.013). SC and ZR led to higher volume loss of CM and AMH than EX and led to the highest depth of wear for these materials, while ZR also led to the highest volume loss and depth of wear of AMD and AMV (P≤.019). EX led to the lowest volume loss and depth of wear of AMV and SMP and to the lowest depth of wear of AMH (P≤.021). Regardless of the antagonist, SMB had the lowest volume loss and depth of wear (P≤.005). CONCLUSIONS AMH mostly had higher volume loss and depth of wear, while SMB had the lowest volume loss, and its depth of wear was not affected by the tested antagonists. ZR mostly led to higher volume loss and maximum depth of wear, while EX mostly led to lower volume loss and maximum depth of wear of the tested occlusal device materials.
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Affiliation(s)
- Gökçen Ateş
- Postdoctoral Research Associate, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey; and ITI Scholar, Department of Prosthodontics, University of São Paulo (USP), São Paulo, Brazil
| | - Münir Demirel
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Biruni University, Istanbul, Turkey
| | - Mustafa Borga Donmez
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istinye Univeristy, İstanbul, Turkey; and ITI Scholar, Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Süleyman Çağatay Dayan
- Associate Professor, Program of Dental Technicians, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tonguç Sülün
- Professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
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Kollmuss M, Edelhoff D, Schwendicke F, Wuersching SN. In Vitro Cytotoxic and Inflammatory Response of Gingival Fibroblasts and Oral Mucosal Keratinocytes to 3D Printed Oral Devices. Polymers (Basel) 2024; 16:1336. [PMID: 38794529 PMCID: PMC11125196 DOI: 10.3390/polym16101336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 04/29/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The purpose of this study was to examine the biocompatibility of 3D printed materials used for additive manufacturing of rigid and flexible oral devices. Oral splints were produced and finished from six printable resins (pairs of rigid/flexible materials: KeySplint Hard [KR], KeySplint Soft [KF], V-Print Splint [VR], V-Print Splint Comfort [VF], NextDent Ortho Rigid [NR], NextDent Ortho Flex [NF]), and two types of PMMA blocks for subtractive manufacturing (Tizian Blank PMMA [TR], Tizian Flex Splint Comfort [TF]) as controls. The specimens were eluted in a cell culture medium for 7d. Human gingival fibroblasts (hGF-1) and human oral mucosal keratinocytes (hOK) were exposed to the eluates for 24 h. Cell viability, glutathione levels, apoptosis, necrosis, the cellular inflammatory response (IL-6 and PGE2 secretion), and cell morphology were assessed. All eluates led to a slight reduction of hGF-1 viability and intracellular glutathione levels. The strongest cytotoxic response of hGF-1 was observed with KF, NF, and NR eluates (p < 0.05 compared to unexposed cells). Viability, caspase-3/7 activity, necrosis levels, and IL-6/PGE2 secretion of hOK were barely affected by the materials. All materials showed an overall acceptable biocompatibility. hOK appeared to be more resilient to noxious agents than hGF-1 in vitro. There is insufficient evidence to generalize that flexible materials are more cytotoxic than rigid materials. From a biological point of view, 3D printing seems to be a viable alternative to milling for producing oral devices.
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Affiliation(s)
- Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; (F.S.); (S.N.W.)
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany;
| | - Falk Schwendicke
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; (F.S.); (S.N.W.)
| | - Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336 Munich, Germany; (F.S.); (S.N.W.)
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11
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Simeon P, Unkovskiy A, Saadat Sarmadi B, Nicic R, Koch PJ, Beuer F, Schmidt F. Wear resistance and flexural properties of low force SLA- and DLP-printed splint materials in different printing orientations: An in vitro study. J Mech Behav Biomed Mater 2024; 152:106458. [PMID: 38364445 DOI: 10.1016/j.jmbbm.2024.106458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To investigate the influence of material and printing orientation on wear resistance and flexural properties of one low force SLA- and two DLP-printed splint materials and to compare these 3D-printed splints to a subtractively manufactured splint material. METHODS Two DLP-printed (V-Print splint, LuxaPrint Ortho Plus) and one low force SLA-printed (Dental LT Clear) material, where specimens were printed in three printing orientations (0°, 45°, 90°), were investigated. In addition, one milled splint material (Zirlux Splint Transparent) was examined. A total of 160 specimens were produced for both test series. The two-body wear test was performed in a chewing simulator (80'000 cycles at 50 N with 5-55 °C thermocycling). Steatite balls were used as antagonists. The wear pattern was analyzed with a 3D digital microscope in terms of maximum vertical intrusion depth (mm) and total volume loss (mm³). The flexural properties were investigated by three-point bending in accordance with ISO 20795-1: 2013 (denture base polymers). The flexural strength (MPa) and the flexural modulus (MPa) were measured. Two-way ANOVA was performed to investigate the effects of the two independent variables material and printing orientation for the three 3D-printed materials. The comparison of the printing orientations within one material was carried out with one-way ANOVA with post-hoc Tukey tests. RESULTS Two-way ANOVA revealed that wear and flexural properties are highly dependent on the 3D-printed material (p < 0.001). Across groups, a significant effect was observed for wear depth (p = 0.031) and wear volume (p = 0.044) with regard to printing orientation but this was not found for flexural strength (p = 0.080) and flexural modulus (p = 0.136). One-way ANOVA showed that both DLP-printed groups showed no significant differences within the printing orientations in terms of wear and flexural properties. Dental LT Clear showed that 90° oriented specimens had higher flexural strength than 0° oriented ones (p < 0.001) and 45° oriented specimens also showed higher values than 0° ones (p = 0.038). No significant differences were observed within the printing orientations for flexural modulus and wear behaviour within this group. T-tests showed that the milled splints exhibited statistically higher wear resistance and flexural properties compared to all three 3D-printed splint materials (p < 0.001) and that highly significant differences were found between the 3D-printed splint materials for both test series. CONCLUSION Within the limitations of this in vitro study, it can be stated that wear behaviour and flexural properties are highly dependent on the 3D-printed material itself. Currently, milled splints exhibit higher wear resistance and flexural properties compared to 3D-printed splint materials. The printing orientation has a minor influence on the properties investigated. Nevertheless, two-way ANOVA also showed a significant influence of printing orientation in the wear test across groups and one-way ANOVA detected significant effects for SLA material in terms of flexural strength, with printing in 90° showing the highest flexural strength. Therefore, anisotropy was found in SLA material, but it can be limited with the employed printing parameters. Both DLP-printed materials showed no significant difference within the printing orientation.
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Affiliation(s)
- Philipp Simeon
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow, 119146, Russia
| | - Bardia Saadat Sarmadi
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Robert Nicic
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Petra Julia Koch
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Orthodontics and Orthofacial Orthopedics, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Franziska Schmidt
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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12
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Oday R, Abid M, Dziedzic A. The accuracy and retention of presurgical infant orthopaedics constructed from different polymer materials: A comparative study. J Taibah Univ Med Sci 2024; 19:379-389. [PMID: 38370166 PMCID: PMC10874750 DOI: 10.1016/j.jtumed.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/19/2023] [Accepted: 01/23/2024] [Indexed: 02/20/2024] Open
Abstract
Objectives This laboratory-based study aimed to evaluate and compare the accuracy and retention of moulding plates when used as pre-surgical orthopaedic appliances (PSIOs) for infants with cleft lip and/or palate (CL/P). Methods Ten moulding plates were fabricated from three different materials (total sample size: 30), including polymethyl methacrylate (PMMA), a hard clear aligner (PET-G polymer), and a dual-layered hard and soft clear aligner (mixed PET-G/EVA) on ten three-dimensional (3D) printed working models. Accuracy was evaluated by measuring the virtual gap between the data acquired from the moulding plate and the working model after the optical scanning at each of the designated 36 points for each plate. Exocad software was used to facilitate all virtual alignments and measurements. Retention was measured using a digital gauge that quantified the traction force required to separate the plates from the retention test cast (a soft resin printed cast). Results PET-G plates exhibited the best fit with the working cast, with overall adaptations of 0.146 ± 0.012 for PET-G, 0.250 ± 0.073 for PET-G/EVA, and 0.294 ± 0.113 for PMMA. For region-specific misfit, PET-G plates exhibited superior accuracy across all regions, with mean discrepancies of 0.16 ± 0.08 mm, 0.15 ± 0.061 mm, and 0.12 ± 0.128 mm in the anterior, middle, and posterior regions, respectively. Retention for PET-G was significantly higher than the other materials, with a mean of 3.34 N ± 0.487, as opposed to 1.65 N ± 0.331for PMMA and 1.27 N ± 0.239 for PET-G/EVA (P < 0.05). Conclusions Moulding plates constructed from PET-G exhibited a better fit and higher retention than those made from PET-G/EVA and PMMA. Clinical significance Collectively, our findings suggest that the selection of PET-G for PSIO appliances could have clinical significance by potentially improving treatment outcomes in infants with CL/P.
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Affiliation(s)
- Raghad Oday
- Department of Orthodontic, College of Dentistry, University of Baghdad, 01110, Iraq
| | - Mushriq Abid
- Department of Orthodontic, College of Dentistry, University of Baghdad, 01110, Iraq
| | - Arkadiusz Dziedzic
- Department of Conservative Dentistry with Endodontics, Medical University of Silesia, Katowice, Poland
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13
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Wulff J, Rauch A, Schmidt MB, Rosentritt M. Biaxial Flexural Strength of Printed Splint Materials. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1112. [PMID: 38473585 PMCID: PMC10934272 DOI: 10.3390/ma17051112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/14/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
One therapeutical alternative in the treatment of functional disorders is the use of printed oral splints. The mechanical properties of these materials are highly essential to their clinical effectiveness, and their performance may vary depending on factors such as cleaning, post-polymerization, or their orientation during construction. The objective of this in vitro investigation is to evaluate the effectiveness of the selected materials in terms of their biaxial flexural strength in relation to the criteria listed above. Splint materials were used in the printing of 720 discs. The printing process was carried out in different orientations in relation to the building platform. Either an automatic or manual cleaning process was performed on the samples. For post-polymerization, either an LED or Xenon light was utilized. A piston-on-three-ball test was used to measure the biaxial flexural strength (BFS) of the materials after they were stored in water for either 24 h or 60 days. The homogeneity of the data was controlled by employing the Levene method, and the differences between the groups were analyzed using the ANOVA and Bonferroni methods. After being stored for twenty-four hours, the mean BFS ranged anywhere from 79 MPa to 157 MPa. Following a period of sixty hours, the BFS exhibited a substantial drop and revealed values that ranged from 72 to 127 MPa. There was no significant difference that could be identified between the materials or between the various cleaning processes. The results of post-polymerization showed that the LED light produced higher means than the Xenon light did. In terms of position, the mean values varied greatly, with 0°'s mean value being 101 MPa, 45°'s mean value being 102 MPa, and 90°'s mean value being 115 MPa. The use of a build orientation of 90° and post-polymerization with LED light resulted in significantly increased biaxial flexural strength. According to this study, this design should be implemented in order to ensure that splint materials have the highest possible strength.
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Affiliation(s)
| | | | | | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany; (J.W.); (A.R.); (M.B.S.)
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Sun X, Feng Y, Jiao Y, Liu W. Fully digital workflow for the fabrication of occlusal stabilization splints based on individual mandibular movement. J Dent 2024; 141:104826. [PMID: 38157975 DOI: 10.1016/j.jdent.2023.104826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE This study was conducted to present a completely digital workflow for the fabrication of occlusal stabilization splints using CAD/CAM systems and a digital face bow based on optical sensor technology. METHODS Digital scans of the maxillary and mandibular arches of 20 volunteers were obtained using an intraoral scanner. Jaw relation and mandibular movements were recorded with a digital face bow via optical sensors. The virtual increase of the vertical dimension of occlusion (VDO) was then performed, after which computer-aided design (CAD) of the occlusal stabilization splints was carried out. The corresponding splints were then manufactured using digitally controlled technology. RESULTS A completely digital workflow for the manufacturing of occlusal stabilization splints was found to be clinically feasible. The corresponding data analysis revealed high congruence between virtual and physical occlusal contacts on the occlusal splint. Moreover, the appropriate guidance of the anterior teeth area was easily obtainable, and the time for adjusting the occlusion was less. CONCLUSIONS This study demonstrated that the fabrication of occlusal stabilization splints using a fully digital workflow is feasible. Compared to traditional impression-based manufacturing, several advantages of digital manufacturing include easy accessibility, time-efficient manufacturing, high-level accuracy in splint quality, and potential to manufacture duplicate splints. CLINICAL SIGNIFICANCE The proposed fully digital approach may help young dentists fabricating stable occlusal splints with beneficial curative effects. Meanwhile, it could also improve the production efficiency of stable occlusal splints, saving time for both doctors and patients while reducing labor costs.
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Affiliation(s)
- Xinrong Sun
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yue Feng
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yi Jiao
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Weicai Liu
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China.
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15
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Bargellini A, Mannari E, Cugliari G, Deregibus A, Castroflorio T, Es Sebar L, Serino G, Roggia A, Scotti N. Short-Term Effects of 3D-Printed Occlusal Splints and Conventional Splints on Sleep Bruxism Activity: EMG-ECG Night Recordings of a Sample of Young Adults. J Clin Med 2024; 13:776. [PMID: 38337469 PMCID: PMC10856225 DOI: 10.3390/jcm13030776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
(1) Background: This study aims to compare the effects of 3D-printed splints and conventional manufactured splints on sleep bruxism (SB) EMG activity. (2) Methods: Twenty-six patients (19 M, 7 F, 25.8 ± 2.6 years) were randomly allocated to a study group (3D splints) and a control group (conventional manufactured splints) and followed for a period of three months with night EMG-ECG recordings. Samples of the involved materials were analyzed for nanoindentation. The outcomes of interest considered were the overall SB index, the total amount of surface masseter muscle activity (sMMA), and general and SB-related phasic and tonic contractions. A statistical evaluation was performed with a confidence interval (CI) between 2.5% and 97.5%. (3) Results: Differences between groups with OAs were observed for general tonic contraction (p = 0.0009), while differences between recording times were observed for general phasic contractions (p = 0.002) and general tonic contractions (p = 0.00001). Differences between recording times were observed for the total amount of sMMA (p = 0.01), for general phasic contractions (p = 0.0001), and for general tonic contractions (p = 0.000009) during night recordings without OAs. (4) Conclusions: Three-dimensional splints seem to have a higher impact on SB-related electromyographic activity but not on the overall sleep bruxism index. The more regular surfaces offered by 3D splints could be related to phasic contraction stabilization.
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Affiliation(s)
- Andrea Bargellini
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, 10126 Torino, Italy; (A.B.); (A.D.); (T.C.)
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, 10126 Torino, Italy
| | - Elena Mannari
- Department of Surgical Sciences, Dental School, University of Torino, 10126 Torino, Italy; (E.M.); (A.R.)
| | - Giovanni Cugliari
- Department of Medical Sciences, University of Torino, 10126 Torino, Italy;
| | - Andrea Deregibus
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, 10126 Torino, Italy; (A.B.); (A.D.); (T.C.)
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, 10126 Torino, Italy
| | - Tommaso Castroflorio
- Department of Surgical Sciences, Specialization School of Orthodontics, Dental School, University of Torino, 10126 Torino, Italy; (A.B.); (A.D.); (T.C.)
- Department of Surgical Sciences, Gnathology Unit, Dental School, University of Torino, 10126 Torino, Italy
| | - Leila Es Sebar
- Department of Applied Science and Technology, Politecnico di Torino, 10129 Turin, Italy;
| | - Gianpaolo Serino
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, 10129 Turin, Italy;
- PolitoBioMedLab, Politecnico di Torino, 10129 Turin, Italy
| | - Andrea Roggia
- Department of Surgical Sciences, Dental School, University of Torino, 10126 Torino, Italy; (E.M.); (A.R.)
| | - Nicola Scotti
- Department of Surgical Sciences, Restorative Dentistry Unit, Dental School, University of Torino, 10126 Torino, Italy
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Rosentritt M, Hickl V, Rauch A, Schmidt M. Effects of storage and toothbrush simulation on Martens hardness of CAD/CAM, hand-cast, thermoforming, and 3D-printed splint materials. Clin Oral Investig 2023; 27:7859-7869. [PMID: 37957307 PMCID: PMC10713707 DOI: 10.1007/s00784-023-05378-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/05/2023] [Indexed: 11/15/2023]
Abstract
OBJECTIVES To investigate Martens hardness parameters of splint materials after storage in liquids and toothbrush simulation. MATERIALS AND METHODS Ten specimens per material and group were fabricated (hand-cast CAST, thermoformed TF, CAD/CAM-milled CAM, 3D-printed PS, PL, PK, PV), stored in air, water, coffee, red wine, and cleaning tablets and investigated after fabrication, 24 h, 2- and 4-week storage or toothbrushing. Martens hardness (HM), indentation hardness (HIT), indentation modulus (EIT), the elastic part of indentation work (ηIT), and indentation creep (CIT) were calculated (ISO 14577-1). STATISTICS ANOVA, Bonferroni post hoc test, between-subjects effects, Pearson correlation (α = 0.05). RESULTS HM varied between 30.8 N/mm2 for PS (water 4 weeks) and 164.0 N/mm2 for CAM (toothbrush). HIT values between 34.9 N/mm2 for PS (water 4 weeks) and 238.9 N/mm2 for CAM (toothbrush) were found. EIT varied between 4.3 kN/mm2 for CAM (toothbrush) and 1.8 kN/mm2 for PK (water 2 weeks). ηIT was found to vary between 16.9% for PS (water 4 weeks) and 42.8% for PL (toothbrush). CIT varied between 2.5% for PL (toothbrush) and 11.4% for PS (water 4 weeks). The highest impact was identified for the material (p ≤ 0.001). CONCLUSIONS Storage and toothbrushing influenced Martens parameters. The properties of splints can be influenced by the choice of materials, based on different elastic and viscoelastic parameters. High HM and EIT and low CIT might be beneficial for splint applications. CLINICAL RELEVANCE Martens parameters HM, EIT, and CIT might help to evaluate clinically relevant splint properties such as hardness, elasticity, and creep.
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Affiliation(s)
- Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany.
| | - Verena Hickl
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Angelika Rauch
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
| | - Michael Schmidt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042, Regensburg, Germany
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17
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Rosello Jimenez JR, Fuchs F, Schmohl L, Schulz-Siegmund M, Koenig A. Aging Processes and Their Influence on the Mechanical Properties of Printable Occlusal Splint Materials. Polymers (Basel) 2023; 15:4574. [PMID: 38232021 PMCID: PMC10707959 DOI: 10.3390/polym15234574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/17/2023] [Accepted: 11/21/2023] [Indexed: 01/19/2024] Open
Abstract
Three-dimensional (3D)-printed occlusal splints are becoming more prevalent in the treatment of tooth substance loss due to their fast and cost-effective production. The purpose of this in vitro study was to investigate whether the mechanical properties (tensile strength-TS, modulus of elasticity in tension-ME, and Vickers hardness-HV) vary between the materials (printed dimethacrylate-based resins: Keyprint KeySplint soft-KEY, Luxaprint Ortho Plus-LUX, V-Print splint-VPR, printed methacrylate-based resins Freeprint splint 2.0-FRE, and milled methacrylate-based material, CLEAR splint-CLE), and the influence of aging processes (extraoral storage conditions and nightly or daily use) was examined. The printed methacrylate-based resins (FRE, LUX, and VPR) had much higher TS (43.7-48.5 MPa compared to 12.3-13.3 MPa), higher ME (2.01-2.37 GPa compared to 0.43-0.72 GPa), and higher HV (11.8-15.0 HV compared to 3.3-3.5 HV) than both of the methacrylate-based resins (KEY and CLE) after the production process. Although the TS, ME, and HV of the printed dimethacrylate resins (FRE, LUX, and VPR) decreased significantly under humid conditions with possibly elevated temperatures (thermocycling as well as 37 °C), these mechanical properties were significantly higher than both methacrylate-based resins (KEY and CLE). Therefore, printed dimethacrylate resins should be used rather than methacrylate-based resins for high expected masticatory forces, low wall thicknesses, or very long wearing times (≥6 months).
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Affiliation(s)
- Jan Raffael Rosello Jimenez
- Department of Prosthodontics and Material Sciences, Leipzig University, 04103 Leipzig, Germany
- Private Practice, Zahnarztpraxis Jan Rosello, 04654 Frohburg, Germany
| | - Florian Fuchs
- Department of Prosthodontics and Material Sciences, Leipzig University, 04103 Leipzig, Germany
| | - Leonie Schmohl
- Department of Prosthodontics and Material Sciences, Leipzig University, 04103 Leipzig, Germany
| | | | - Andreas Koenig
- Department of Prosthodontics and Material Sciences, Leipzig University, 04103 Leipzig, Germany
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Raffaini JC, Soares EJ, Oliveira RFDL, Vivanco RG, Amorim AA, Pereira ALC, Pires-de-Souza FCP. Effect of artificial aging on mechanical and physical properties of CAD-CAM PMMA resins for occlusal splints. J Adv Prosthodont 2023; 15:227-237. [PMID: 37936836 PMCID: PMC10625884 DOI: 10.4047/jap.2023.15.5.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE This study aimed to assess and compare the color stability, flexural strength (FS), and surface roughness of occlusal splints fabricated from heat-cured acrylic resin, milled polymethyl methacrylate (PMMA)-based resin, and 3D-printed (PMMA) based-resin. MATERIALS AND METHODS Samples of each type of resin were obtained, and baseline measurements of color and surface roughness were recorded. The specimens were divided into three groups (n = 10) and subjected to distinct aging protocols: thermomechanical cycling (TMC), simulated brushing (SB), and control (without aging). Final assessments of color and surface roughness and three-point bending test (ODM100; Odeme) were conducted, and data were statistically analyzed (2-way ANOVA, Tukey, P <.05). RESULTS Across all resin types, the most significant increase in surface roughness (Ra) was observed after TMC (P < .05), with the 3D-printed resin exhibiting the lowest Ra (P < .05). After brushing, milled resin displayed the highest Ra (P < .05) and greater color alteration (ΔE00) compared to 3D-printed resin. The most substantial ΔE00 was recorded after brushing for all resins, except for heat-cured resin subjected to TMC. Regardless of aging, milled resin exhibited the highest FS (P < .05), except when compared to 3D-printed resin subjected to TMC. Heat-cured resin exposed to TMC demonstrated the lowest FS, different (P < .05) from the control. Under control conditions, milled resin exhibited the highest FS, different (P < .05) from the brushed group. 3D-printed resin subjected to TMC displayed the highest FS (P < .05). CONCLUSION Among the tested resins, 3D-printed resin demonstrated superior longevity, characterized by minimal surface roughness and color alterations. Aging had a negligible impact on its mechanical properties.
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Affiliation(s)
- Júlia Correa Raffaini
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Eduardo Jose Soares
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Rebeca Franco de Lima Oliveira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Rocio Geng Vivanco
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Ayodele Alves Amorim
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
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19
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Orgev A, Levon JA, Chu TMG, Morton D, Lin WS. The effects of manufacturing technologies on the surface accuracy of CAD-CAM occlusal splints. J Prosthodont 2023; 32:697-705. [PMID: 36227731 DOI: 10.1111/jopr.13610] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/01/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the effects of the manufacturing technologies on the surface (cameo and intaglio) accuracy (trueness and precision) of computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal splints. MATERIALS AND METHODS The digital design of the master occlusal splint was designed in a CAD software program. Six groups (n = 10) were tested in this study, including Group 1 - Milling (Wax), Group 2 - Heat-polymerizing, Group 3 - Milling (M series), Group 4 - Milling (DWX-51/52D), Group 5 - 3D-printing (Cares P30), and Group 6 - 3D-printing (M2). The study samples were placed in a scanning jig fabricated from putty silicone and Type III dental stone. The study samples were then scanned with a laboratory scanner at the intaglio and cameo surfaces, and the scanned files were exported in standard tessellation language (STL) file format. The master occlusal splint STL file, was used as a reference to compare with all scanned samples at the intaglio and cameo surfaces in a surface matching software program. Root mean square (RMS, measured in mm, absolute value) values were calculated by the software for accuracy comparisons. Group means were used as the representation of trueness, and the standard deviation for each group was calculated as a measure of precision. Color maps were recorded to visualize the areas of deviation between study samples and the master occlusal splint file. The data were normalized and transformed to rank scores, and one-way ANOVA was used to test for the differences between the groups. Pairwise comparisons were made between different groups. Fishers least square differences were used to account for the family-wise error rate. A 5% significance level was used for all the tests. RESULTS The null hypotheses were rejected. The manufacturing technologies significantly affected the trueness of occlusal splints at both intaglio and cameo surfaces (p < 0.001). At the cameo surfaces, Group 1 - Milling (Wax) (0.03 ± 0.02 mm), Group 3 - Milling (M series) (0.04 ± 0.01 mm), and Group 4 - Milling (DWX-51/52D) (0.04 ± 0.01 mm) had the smallest mean RMS values and highest trueness. Group 3 had the smallest standard deviation and highest precision among all groups (p < 0.001, except p = 0.005 when compared with Group 2). Group 5 had the largest standard deviation and lowest precision among all groups (p < 0.001). At the intaglio surfaces, Group 1 - Milling (Wax) (0.06 ± 0.01 mm) had the smallest RMS values and highest trueness among all groups (p < 0.001), and Group 2 - Heat-polymerizing (0.20 ± 0.03 mm) and Group 5 - 3D-printing (Cares P30) (0.15 ± 0.05 mm) had significantly larger mean RMS and standard deviation values than all other groups (p < 0.001), with lowest trueness and precision. In the color maps, Group 2 - Heat-polymerizing and Group 5 - 3D-printing (Cares P30) showed the most discrepancies with yellow and red (positive discrepancies) in most areas, and Group 1 - Milling (Wax) showed the best and most uniform surface matching with the most area in green. CONCLUSION The manufacturing technologies significantly affected the trueness and precision of occlusal splints at both intaglio and cameo surfaces. The 5-axis milling units and industrial-level CLIP 3D-printer could be considered to achieve surface accuracy of occlusal splints.
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Affiliation(s)
- Ahmet Orgev
- Department of Restorative Dentistry, University at Buffalo School of Dental Medicine, Buffalo, New York
| | - John A Levon
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Tien-Min G Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
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20
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Wang P, Wang Y, Xu H, Huang Y, Shi Y, Chen S, Bai D, Xue C. Effect of offset on the precision of 3D-printed orthognathic surgical splints. Clin Oral Investig 2023; 27:5141-5151. [PMID: 37415046 DOI: 10.1007/s00784-023-05134-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/26/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE This study evaluated the effect of offset on the precision of three-dimensional (3D)-printed splints, proposing to optimize the splint design to compensate for systematic errors. MATERIALS AND METHODS 14 resin model sets were scanned and offset as a whole by given distances (0.05, 0.10, 0.15, 0.20, 0.25, 0.30, 0.35, and 0.40 mm). Intermediate splints (ISs) and final splints (FSs) were generated from the non-offset and offset models and grouped correspondingly, named as splint type-offset value, IS-0.05, for instance. Dentitions occluded with the splint were scanned. Translational and rotational deviations of the lower dentition relative to the upper dentition were 3D measured. RESULTS Deviations of ISs and FSs were more evident in the vertical and pitch dimensions, and were mostly acceptable in other dimensions. ISs with offset ≥ 0.05 mm showed vertical deviations significantly below 1 mm (P < 0.05) while ISs with 0.10- to 0.30-mm offsets had pitch rotations significantly lower than 1° (P < 0.05). The Pitch of IS-0.35 was significantly larger than ISs with 0.15- to 0.30-mm offsets (P < 0.05). Meanwhile, FSs fit better as the offset increased and FSs with offsets ≥ 0.15 mm all had deviations significantly lower than 1 mm (for translation) or 1° (for rotation) (P < 0.05). CONCLUSIONS Offset affects the precision of 3D-printed splints. Moderate offset values of 0.10 to 0.30 mm are recommendable for ISs. Offset values ≥ 0.15 mm are recommended for FSs in cases with stable final occlusion. CLINICAL RELEVANCE This study found the optimal offset ranges for 3D-printed ISs and FSs via a standardized protocol.
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Affiliation(s)
- Peiqi Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Yipeng Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Hui Xu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Yixi Huang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Yu Shi
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Siqi Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China
| | - Chaoran Xue
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin Nan Road, Chengdu, 610041, China.
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21
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Peng T, Yang Z, Ma T, Zhang M, Ren G. Comparative evaluation of the volume of occlusal adjustment of repositioning occlusal devices designed by using an average value digital articulator and the jaw movement analyzer. J Prosthet Dent 2023:S0022-3913(23)00419-5. [PMID: 37537106 DOI: 10.1016/j.prosdent.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023]
Abstract
STATEMENT OF PROBLEM The volume of occlusal adjustment of digital occlusal devices designed with different digital occlusal articulators is unknown. PURPOSE The purpose of this clinical study was to evaluate and compare the clinical efficacy and volume of occlusal adjustment of digital occlusal devices designed by using an average value digital articulator and the jaw movement analyzer (JMA). MATERIAL AND METHODS Thirty participants were randomly divided into 2 groups, an Average value group and a JMA group, with 15 participants in each group. The centric relation position of the participants was determined by an experienced investigator with the aid of a leaf gauge. An intraoral scanner (TRIOS 3) was used to obtain digital scans of the maxillary and mandibular dentition and the maxillomandibular relationship record in the centric relation position. Personalized articulator parameters of participants in the JMA group were obtained by using a JMA (JMAnalyser). Different articulator parameters were used to fabricate an occlusal device in a denture design software program (exocad DentalCAD). The surface of the occlusal device was coated with a dental optical spray and then scanned by using a laboratory scanner (Kavo LS3). The process was repeated after the occlusal device was adjusted. The files of the 2 scans were imported into a reverse engineering software program, and the root mean square (RMS) values were obtained by best-fit alignment and 3-dimensional comparison. The Shapiro-Wilk normality test and homogeneity of variance test were performed, and t tests were used to evaluate differences in the RMS values between the groups (α=.05). RESULTS The experimental data were generally normally distributed (P>.05). No statistically significant difference was found between the RMS values of the Average and the JMA groups (P>.05). CONCLUSIONS No significant difference in the volume of occlusal adjustment was found when using occlusal devices made by using the digital average articulator or the JMA, suggesting that either method can be used to program articulators for the fabrication of occlusal devices.
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Affiliation(s)
- Tiwu Peng
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Zhikang Yang
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Teng Ma
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Mindi Zhang
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Guanghui Ren
- Associate Professor, Center for Occlusion, Yantai Stomatological Hospital of Binzhou Medical University, Yantai, Shandong, PR China.
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22
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Christopher H, Kykal J, Rues S, Schwindling FS, Rammelsberg P, Eberhard L. Thermo-flexible resin for the 3D printing of occlusal splints: a randomized pilot trial. J Dent 2023; 133:104514. [PMID: 37031885 DOI: 10.1016/j.jdent.2023.104514] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 04/11/2023] Open
Abstract
OBJECTIVES To compare the clinical performance of occlusal splints printed from thermo-flexible resin with milled splints. METHODS A parallel two-arm pilot trial was initiated. Forty-seven patients (n women=38) were recruited from a tertiary care center and randomized using an online tool (sealed envelope). Inclusion criterion was an indication for treatment with a centric relation occlusal splint due to bruxism or any form of painful temporomandibular disorder. Patients were excluded if they were younger than 18 years, unable to attend follow-up appointments, or required another type of splint therapy. Patients received either, a 3D-printed (intervention group, V-print splint comfort, VOCO) or a milled splint (control group, ProArt CAD splint, Ivoclar). Construction software Ceramill M-splint (AmannGirrbach), 3D-printer MAX UV 385 (Asiga) and milling unit PrograMill PM7 (Ivoclar) were used. Follow-up assessments were conducted after 2 weeks and 3 months. Outcome measures were survival, adherence, technical complications, patient satisfaction on a 10-point Likert scale, and maximum wear using superimposition of optical scans. RESULTS After 3 months, 20/23 intervention group and 18/24 control group participants were assessed. All splints survived. Minor complications were small crack formations on 6 printed and 4 milled splints. Mean patient satisfaction was 8 (SD 1.7) for printed, and 8.1 (SD 2.3) for milled splints (r= .1, p=.52). Median maximum wear was highly dispersed with 153 (IQR 140) in posterior and 195 (IQR 537) in frontal segments of printed, and 96 (IQR 78) respectively 123 (IQR 155) of milled splints, (both: r= .31, p=.084). CONCLUSIONS Within the limitations of a pilot trial, 3D-printed and milled splints performed similarly in terms of patient satisfaction, complication rates and wear behavior. CLINICAL SIGNIFICANCE Thermo-flexible material was proposed for 3D printing of occlusal splints to overcome mechanical weaknesses of previously available resins. This randomized pilot study provides evidence that this material is a viable alternative to milled splints for at least three months of clinical use. Further evidence on long-term use should be obtained.
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Affiliation(s)
- Herpel Christopher
- Heidelberg University Hospital, Department of Prosthodontics, Heidelberg, Germany.
| | - Jana Kykal
- Heidelberg University Hospital, Department of Prosthodontics, Heidelberg, Germany
| | - Stefan Rues
- Heidelberg University Hospital, Department of Prosthodontics, Heidelberg, Germany
| | | | - Peter Rammelsberg
- Heidelberg University Hospital, Department of Prosthodontics, Heidelberg, Germany
| | - Lydia Eberhard
- Heidelberg University Hospital, Department of Prosthodontics, Heidelberg, Germany
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23
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Piangsuk T, Dawson DV, El-Kerdani T, Lindquist TJ. The Accuracy of Post and Core Fabricated with Digital Technology. J Prosthodont 2023; 32:221-226. [PMID: 35413146 DOI: 10.1111/jopr.13522] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 03/31/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE To compare the accuracy of post and cores created with three different fabricating techniques: direct conventional, machine milling, and three-dimensional (3D) printing. MATERIALS AND METHODS Thirteen extracted single root central incisors were selected. Root canal treatment and tooth preparation for crown were performed on all teeth. Post space preparation of 11 mm was created using prefabricated fiber post drill to standardize post space width and length. Root canal impressions were performed on all teeth using polyvinyl siloxane impression material. Each impression was then three dimensionally scanned using an extraoral lab scanner. The scanned impressions were used to design digital files of post and cores with 3Shape CAD software. The digitally designed post and cores were used to fabricate 3D printed and milled post and core resin patterns. The same teeth were used to fabricate post and core with conventional technique (direct duplication of root canal with resin pattern). All posts were then scanned before being invested and then cast using base metal educational alloy. The metal post and cores were tried in with sample teeth and manually adjusted until found to be clinically acceptable. The post and cores were scanned in different stages to perform digital volume measurement using Geomagic Control software to determine accuracy. Pairwise comparisons were accomplished using exact version of the sign test (α = 0.05). RESULTS These three techniques of post and core fabrication showed different results in the various stages of fabrication. The accuracy of 3D printed resin pattern (26.89 ±11.09 mm3 ) was found to be inferior compare to milled resin pattern (28.20 ±11.41 mm3 , p = 0.0002). However, dimensional stability of the 3D printed resin pattern before and after casting (0.56 ±0.95 mm3 ) was found to be superior to milled resin pattern (0.79 ±0.89 mm3 ) and direct resin pattern (2.51 ±1.38 mm3 , p = 0.00002). All three techniques showed significant volume reduction after adjustment (p = 0.0002). In the final stage, the adjusted metal post and core fabricated with three different techniques showed no statistical different in accuracy (p = 0.15). CONCLUSION Digitally fabricated post and cores have the same degree of accuracy as those fabricated using the gold standard direct conventional post and core technique.
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Affiliation(s)
- Tarin Piangsuk
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Deborah V Dawson
- Iowa Institute for Oral Health Research, The University of Iowa College of Dentistry & Dental Clinics, Iowa City, IA
| | - Tarek El-Kerdani
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
| | - Terry J Lindquist
- Department of Prosthodontics, University of Iowa College of Dentistry, Iowa City, IA
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Aldesoki M, Keilig L, Dörsam I, Evers-Dietze B, Elshazly TM, Bourauel C. Trueness and precision of milled and 3D printed root-analogue implants: A comparative in vitro study. J Dent 2023; 130:104425. [PMID: 36646269 DOI: 10.1016/j.jdent.2023.104425] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/03/2022] [Accepted: 01/10/2023] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVES The present study aimed to evaluate the accuracy (trueness and precision) of titanium and zirconia multi-rooted root analogue implants (RAIs) manufactured by milling and 3D-printing. METHODS A multi-rooted RAI was designed based on a mandibular second molar segmented from cone-beam computed tomography (CBCT). The manufactured RAIs were divided into four groups: 3D-printed titanium (PT) and 3D-printed zirconia (PZ) (n=10 each), as well as milled titanium (MT) and milled zirconia (MZ) (n=5 each). The specimens were scanned with a high-precision scanner, and the scanned data were imported into 3D-measurement software to evaluate the precision and trueness of each group. Root mean square (RMS) deviations were measured and statistically analysed (One-way ANOVA, Tukey's, p≤0.05). RESULTS PZ showed the highest precision with RMS value of 21±6 µm. Nevertheless, there was no statistically significant difference in precision among the other groups. Regarding trueness, MZ showed the highest trueness with RMS value of 66±3 µm, whereas MT showed the lowest trueness result. Inspection sections showed that MT had significantly high RMS deviation in the furcation area (612±64 µm), whereas PZ showed significantly high RMS deviation at the apical area (197±17 µm). CONCLUSIONS The manufacturing process significantly influenced the RAI accuracy. PZ exhibited the highest precision, whereas MZ exhibited the highest trueness, followed by PT. Finally, our results suggest that 3D-printing can reproduce concave surfaces and less accessible areas better than milling. CLINICAL SIGNIFICANCE Milled and 3D-printed RAIs showed promising results in terms of precision and trueness. However, further clinical research is needed to advocate their use as immediate implants. Additionally, the inherent volumetric changes of the various materials during manufacturing should be considered.
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Affiliation(s)
- Mostafa Aldesoki
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany
| | - Istabrak Dörsam
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Prosthodontics, Dental School, University Hospital Bonn, Bonn, Germany
| | - Bernd Evers-Dietze
- Department of Electrical Engineering, Mechanical Engineering and Technical Journalism (EMT), Bonn-Rhein-Sieg University of Applied Sciences, Sankt Augustin, Germany
| | - Tarek M Elshazly
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany
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Dai J, Li P, Spintzyk S, Liu C, Xu S. Influence of additive manufacturing method and build angle on the accuracy of 3D-printed palatal plates. J Dent 2023; 132:104449. [PMID: 36773740 DOI: 10.1016/j.jdent.2023.104449] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 01/16/2023] [Accepted: 02/08/2023] [Indexed: 02/11/2023] Open
Abstract
OBJECTIVES In this in vitro study, the effects of additive manufacturing (AM) methods and build angles on the trueness and precision of 3D-printed palatal plate orthodontic appliances for newborns and infants were examined. METHODS Specimens were fabricated by different representative AM methods, including digital light processing (DLP), fused filament fabrication (FFF), and MultiJet printing (MJP). Three build angles (0°, 45°, and 90°) were used. After scanning, all specimens were analyzed using the 3D inspection software. The root mean square values were measured for trueness and precision. Color maps were created to detect deviations in samples. The data were statistically analyzed with a two-way ANOVA. RESULTS The trueness and precision were statistically influenced by both AM methods and build angles (p < 0.05). Moreover, the root mean square values of the 45° DLP (0.0221 ± 0.0017 μm) and the 0° MJP (0.0217 ± 0.0014 μm) were significantly lower compared to those in other groups (p < 0.001). CONCLUSIONS AM methods (DLP, FFF, and MJP) and build angles (0°, 45°, and 90°) significantly impacted the dimensional accuracy of additively manufactured palatal plate orthodontic appliances. Also, the 45° DLP and the 0° MJP were associated with the highest trueness and precision. CLINICAL SIGNIFICANCE All tested AM methods with different build angles yielded clinically acceptable outcomes (within an acceptance range of ±300 μm for trueness), achieving the highest accuracy with a technology-specific suitable build angle.
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Affiliation(s)
- Jingtao Dai
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China
| | - Ping Li
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China
| | - Sebastian Spintzyk
- ADMiRE Reseach Center - Additive Manufacturing, intelligent Robotics, Sensors and Engineering, School of Engineering and IT, Carinthia University of Applied Sciences, Europastraße 4, Villach 9524, Austria
| | - Chufeng Liu
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China.
| | - Shulan Xu
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, South Jiangnan Road No. 366, Guangzhou 510280, China.
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Bürgers R, Schubert A, Müller J, Krohn S, Rödiger M, Leha A, Wassmann T. Cytotoxicity of 3D‐printed, milled, and conventional oral splint resins to L929 cells and human gingival fibroblasts. Clin Exp Dent Res 2022; 8:650-657. [PMID: 35570327 PMCID: PMC9209804 DOI: 10.1002/cre2.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives Evidence on the biocompatibility of three‐dimensional (3D)‐printed and milled resins for oral splints is limited. This in vitro study assessed the influence of the manufacturing method on the cytotoxicity of oral splint resins on L929 cells and human gingival fibroblasts (GF1). Materials and Methods Standardized specimens of four 3D‐printed, two‐milled, one‐thermoformed, and one‐pressed splint resin were incubated with L929 and GF1 cells for 24 h. Immunofluorescence and WST‐8 assay were performed to evaluate cytotoxic effects. One‐way analysis of variance and Tukey's multiple comparison test were applied with the variables “splint resin” and “manufacturing method” (p < .05). Results Immunofluorescence showed attachment of L929 and GF1 cells to the splint resins. Irrespective of the manufacturing method, the WST‐8 assay revealed significant differences between splint resins for the viability of L929 and GF1 cells. L929 cells generally showed lower viability rates than GF1 cells. The evaluation of cell viability by the manufacturing method showed no significant differences between 3D printing, milling, and conventional methods. Conclusions The cytotoxic effects of 3D‐printed, milled, and conventional oral splint resins were similar, indicating minor influence of the manufacturing method on biocompatibility. Cytotoxicity of the resins was below a critical threshold in GF1 cells. The chemical composition might be more crucial than the manufacturing method for the biocompatibility of splint resins.
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Affiliation(s)
- Ralf Bürgers
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Andrea Schubert
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Jonas Müller
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Sebastian Krohn
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Matthias Rödiger
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Andreas Leha
- Department of Medical StatisticsUniversity Medical Center GöttingenGöttingenGermany
| | - Torsten Wassmann
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
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Digital Technologies: From Scientific to Clinical Applications in Orthodontic and Dental Communities. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12104977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
The significant progress made in our sector since the introduction of digital technologies has now made it possible to easily obtain all the information necessary to diagnose, design and perform interdisciplinary and complex therapies in a simpler and more reproducible way [...]
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Guerrero-Gironés J, López-García S, Pecci-Lloret MR, Pecci-Lloret MP, Lozano FJR, García-Bernal D. In vitro biocompatibility testing of 3D printing and conventional resins for occlusal devices. J Dent 2022; 123:104163. [DOI: 10.1016/j.jdent.2022.104163] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 04/22/2022] [Accepted: 05/12/2022] [Indexed: 10/18/2022] Open
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Accuracy of Additively Manufactured Dental Casts Compared with That of Virtual Scan Data Obtained with an Intraoral Scanner: An In Vitro Study. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12094348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
The study aimed to evaluate the time-related accuracy of additively manufactured dental casts and to compare it with scan data obtained with an intraoral scanner in vitro. Twenty-eight markers were attached to a set of dentiforms as reference model, and the distances between the markers were measured using a digital caliper. An intraoral scanner was used to obtain the virtual scan data of the reference model with a total of 30 scans per arch. The distances between markers were measured using a three-dimensional inspection software for all scans (group IOS). Scan data were additively manufactured using a 3D printer, and the distances between markers were measured as in the reference model immediately after post-polymerization (group PPIA), 1 day (group PP1D), 7 days (group PP7D), and 30 days after post-polymerization (group PP30D). The linear deviation in group IOS was 199.74 ± 11.14 μm, PPIA was 242.88 ± 49 μm, PP1D was 259.9 ± 42.59 μm, PP7D was 289.82 ± 39.74 μm, and PP30D was 315.8 ± 33.28 μm, in comparison with the reference model, with significant differences among all groups (all p < 0.05). When additively manufacturing casts from scan data to verify the quality of dental prostheses designed virtually, the prostheses should be adapted to casts manufactured within one week.
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Leonardi RM. 3D Imaging Advancements and New Technologies in Clinical and Scientific Dental and Orthodontic Fields. J Clin Med 2022; 11:jcm11082200. [PMID: 35456293 PMCID: PMC9031999 DOI: 10.3390/jcm11082200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 02/01/2023] Open
Affiliation(s)
- Rosalia Maria Leonardi
- Department of Medical-Surgical Specialties-Section of Orthodontics, School of Dentistry, University of Catania, Policlinico Universitario "G. Rodolico- San Marco", Via Santa Sofia 78, 95123 Catania, Italy
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Sidhom M, Zaghloul H, Mosleh IES, Eldwakhly E. Effect of Different CAD/CAM Milling and 3D Printing Digital Fabrication Techniques on the Accuracy of PMMA Working Models and Vertical Marginal Fit of PMMA Provisional Dental Prosthesis: An In Vitro Study. Polymers (Basel) 2022; 14:polym14071285. [PMID: 35406159 PMCID: PMC9003362 DOI: 10.3390/polym14071285] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/13/2022] [Accepted: 03/15/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Minimal evidence exists on the efficacy of different digital manufacturing techniques in the fabrication of precise dental working models and provisional prosthesis. Aim of study: The objective was to evaluate the effect of two digital fabrication techniques (CAD/CAM milling and 3D printing) on the accuracy of PMMA working models and marginal fit of PMMA provisional prosthesis. Materials and methods: Two abutment teeth of modified typodont were prepared. A reference stone model was fabricated, and an optical impression was performed to obtain a CAD reference model. Four CAM milled working models and four printed working models were fabricated. CAD software was used to design the provisional prostheses. Group A tested four milled provisional prosthesis, and group B tested four 3D printed prosthesis. The 3D accuracy of working models was assessed by superimposition of the control reference working model on the CAD test working model. A stereo-optical microscope was used to assess vertical marginal fit of the provisional dental prosthesis. Student’s t and Mann–Whitney U tests were utilized to compare the two groups. Results: Results showed no statistically significant difference between the two tested groups. Conclusion: The two digital working model fabrication techniques recorded comparable accuracy. Similarly, 3D printed provisional prosthesis showed comparable marginal fit to the CAD/CAM milled ones.
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Affiliation(s)
- Marina Sidhom
- Fixed Prosthodontics Department, Faculty of Oral and Dental Medicine, Misr International University, Cairo 12677, Egypt;
| | - Hanaa Zaghloul
- Conservative Dentistry, Faculty of Oral & Dental Medicine, Misr International University, Cairo 12677, Egypt;
| | - Ihab El-Sayed Mosleh
- Fixed Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah 22252, Saudi Arabia;
- Fixed Prosthodontics, Faculty of Dentistry, Cairo University, Cairo 11553, Egypt
| | - Elzahraa Eldwakhly
- Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia
- Correspondence:
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Jeon S, Jo YH, Yoon HI, Han JS. Antifungal effect, surface roughness, and cytotoxicity of three-dimensionally printed denture base with phytoncide-filled microcapsules: an in-vitro study. J Dent 2022; 120:104098. [DOI: 10.1016/j.jdent.2022.104098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/16/2022] [Accepted: 03/19/2022] [Indexed: 12/20/2022] Open
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Effects of storage and toothbrush simulation on color, gloss, and roughness of CAD/CAM, hand-cast, thermoforming, and 3D-printed splint materials. Clin Oral Investig 2022; 26:4183-4194. [PMID: 35119536 PMCID: PMC9072518 DOI: 10.1007/s00784-022-04391-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 01/23/2022] [Indexed: 11/08/2022]
Abstract
Objectives The aim was to investigate color, gloss, or roughness of splint materials after storage in liquids and toothbrush simulation. Materials and methods A total of 58 × 8 (n = 10 per material and group) specimens were fabricated (hand-cast, thermoforming, CAD/CAM-milled, 3D-printed materials); stored in air, water, coffee, red wine, and cleaning tablets; and investigated after fabrication, 24 h, two-, and four-week storage or toothbrushing. Color values (L*, a*, b*; ISO 11664–4:2008; CM–3500d, Konica-Minolta), gloss (ISO 2813:2014), and roughness values were determined (3D laser-scanning-microscope, KJ 3D, Keyence) before and after simulation or storage. Statistics: Levene-test, one-way ANOVA, Bonferroni post hoc test, between-subjects effects, Pearson correlation (α = 0.05). Results Color, gloss, and roughness altered due to contact with staining solutions/toothbrush simulation. Highest impact on color, gloss, and roughness presented the material followed by storage time (ΔE material (η2 = 0.239/p < 0.001), storage time (η2 = 0.179/p < 0.001); gloss (η2 = 0.751/p < 0.001) (η2 = 0.401/p < 0.001); Ra/Rz (η2 ≥ 0.801/p < 0.001) (η2 ≥ 0.416/p < 0.001)). Correlations were found between Rz and Ra (Pearson 0.887/p ≤ 0.001) or Rz and ΔE (0.517/p ≤ 0.001) or Ra and ΔE (0.460/p ≤ 0.001). Conclusions Storage and toothbrushing were accompanied by a change in color, gloss, and roughness. Almost all materials showed visible discoloration after 4 weeks of storage. Gloss values decreased as storage time increased. The initial roughness and polishability were better with harder materials. Clinical relevance. Milled and 3D printed splints show good color, gloss, and roughness resistance after 4-week storage or toothbrush application.
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Alabdullah SA, Hannam AG, Wyatt CC, McCullagh AP, Aleksejuniene J, Mostafa NZ. Comparison of digital and conventional methods of fit evaluation of partial removable dental prosthesis frameworks fabricated by selective laser melting. J Prosthet Dent 2022; 127:478.e1-478.e10. [DOI: 10.1016/j.prosdent.2021.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 09/25/2021] [Accepted: 09/27/2021] [Indexed: 11/30/2022]
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Accuracy of 3D-Printed Occlusal Devices of Different Volumes Using a Digital Light Processing Printer. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12031576] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
(1) Background: This in-vitro study was designed to investigate the accuracy of CAD/CAM fabricated occlusal devices with different heights and volumes. (2) Methods: Based on an intraoral scan, an occlusal device with a vertical bite elevation of 2.5 mm and 4.5 mm was digitally designed and 3D printed 10 times. The fabricated occlusal devices were digitized by an industrial structured light scanner (ILS) and provided in stl-format as test objects. The test objects were superimposed with the design dataset as reference to evaluate the accuracy of complete surfaces ([2.5_TOTAL] and [4.5_TOTAL]) with respect to their internal surfaces ([2.5_INTERNAL] and [4.5_INTERNAL]). The mean trueness and precision were calculated based on absolute mean deviation. Absolute and relative volume differences between reference and test were computed. Statistical significances were analyzed performing the Wilcoxon test (α = 0.05). (3) Results: As absolute mean deviation trueness values were obtained: 59 ± 5 µm for [2.5_INTERNAL], 98 ± 9 µm for [4.5_INTERNAL], 68 ± 1 µm for [2.5_TOTAL] and 90 ± 10 µm for [4.5_TOTAL]. The precision applying absolute mean deviation was 14 ± 8 µm for [2.5_INTERNAL], 22 ± 11 µm for [4.5_INTERNAL], 19 ± 10 µm for [2.5_TOTAL] and 26 ± 13 µm for [4.5_TOTAL]. The mean trueness and precision values differed significantly. Volume differences of 2.11% for [4.5_TOTAL] and of 2.35% for [2.5_TOTAL] in comparison to their reference file were evaluated. (4) Conclusions: Printed occlusal devices with minor height and volume were more accurate. Both types of devices exhibited results that were comparable to the literature.
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A Novel Low-Shrinkage Resin for 3D Printing. J Dent 2022; 118:103957. [PMID: 35038476 DOI: 10.1016/j.jdent.2022.103957] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To evaluate the shrinkage, accuracy, and mechanical properties of a newly developed photo-polymerizable resin material for 3D printing dental applications and compare it with three commercially available resins. METHODS An experimental novel proprietary resin material for 3D printing was formulated. This new resin, Die and Model Tan (SprintRay), Formlabs Grey (FormLabs), and LCD Grey (Roxel 3D) were evaluated and tested for volumetric shrinkage, accuracy, and flexural and tensile properties. Volumetric shrinkage was measured using the AcuVol video imaging method. The accuracy of the 3D printed objects through the DLP (digital light processing) printing system was determined by the 3D deviation between the scanned model and the original CAD digital model. Parallelepiped specimens (2 × 2 × 25 mm, n= 5) were printed for flexural strength, flexural modulus, and modulus of resilience and measured in accordance with ISO-4049. Dumbbell-shaped specimens (Type V, n = 5) were printed to investigate the tensile strength and tested according to ASTM-D638. Data were analyzed using one-way ANOVA and post-hoc Tukey tests (p≤0.05). RESULTS The experimental resin exhibited significantly lower volumetric shrinkage and significantly higher accuracy than the other commercially available resins (p < 0.001). The experimental resin showed flexural strength, flexural modulus, and tensile strength similar to Die and Model Tan resin (SprintRay) (p > 0.05), and these parameters were significantly higher than those of Formlabs Grey resin (Formlabs) and lower than those of LCD Gray resin (Roxel3D)(p <0.001). CONCLUSION The newly formulated 3D printing resin demonstrated lower volumetric shrinkage, high accuracy, and adequate mechanical properties compared to the commercially available resin materials. CLINICAL SIGNIFICANCE The new 3D printed objects exhibited higher accuracy, good stability over time, and adequate mechanical properties. The new 3D printing resin is a good candidate for modeling applications for restoration, orthodontics and implants.
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Lo Giudice A, Ronsivalle V, Rustico L, Aboulazm K, Isola G, Palazzo G. Evaluation of the accuracy of orthodontic models prototyped with entry-level LCD-based 3D printers: a study using surface-based superimposition and deviation analysis. Clin Oral Investig 2022; 26:303-312. [PMID: 34100158 DOI: 10.1007/s00784-021-03999-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 05/19/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the accuracy of dental models prototyped via entry-level liquid crystal display (LCD) 3D printers. MATERIALS AND METHODS Identical prototyped models were generated from a master digital file testing two entry-level LCD-based 3D printers and using one professional-grade 3D printer as gold standard (GS), with 50-µm and 100-µm layer thickness. Each 3D-printed model was scanned, and a specific 3D technology was used to perform surface-based superimposition and deviation analysis to evaluate trueness and precision. The distances between surface points of two superimposed models were converted to root mean square (RMS) and statistically analyzed. RESULTS The RMS values detected were significantly higher in dental models prototyped with entry-level compared to the SLA printer (p < 0.001), in terms of trueness (50 µm: GS 0.075 mm, LCD1 0.192 mm, LCD2 0.179 mm; 100 µm: GS 0.066 mm, LCD1 0.209 mm, LCD2 0.199 mm) and precision (50 µm: GS 0.028 mm, LCD1 0.075 mm, LCD2 0.085 mm; 100 µm: GS 0.039 mm, LCD1 0.096 mm, LCD2 0.101 mm). No significant differences were found between the values of RMS of both entry-level 3D printers (p > 0.05). Layer thickness did not affect either the trueness or precision of the 3D-printed models (p > 0.05). CONCLUSION Entry-level LCD-based 3D printers are not as accurate as professional-grade 3D printer, but still close to orthodontics clinical threshold values. CLINICAL RELEVANCE Clinicians should evaluate the intended application of 3D-printed orthodontic models before using entry-level 3D printers.
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Affiliation(s)
- Antonino Lo Giudice
- Department of Orthodontics, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Vittorio Emanuele, " Via Santa Sofia 78 95123, Catania, Italy
| | - Vincenzo Ronsivalle
- Department of Orthodontics, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Vittorio Emanuele, " Via Santa Sofia 78 95123, Catania, Italy
| | - Lorenzo Rustico
- Department of Orthodontics, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Vittorio Emanuele, " Via Santa Sofia 78 95123, Catania, Italy.
| | - Kaled Aboulazm
- Department of Orthodontics, School of Dentistry, Pharos University, Canal El Mahmoudia Street, Alexandria, Egypt
| | - Gaetano Isola
- Department of Orthodontics, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Vittorio Emanuele, " Via Santa Sofia 78 95123, Catania, Italy
| | - Giuseppe Palazzo
- Department of Orthodontics, School of Dentistry, Unit of Orthodontics, University of Catania, Policlinico Universitario "Vittorio Emanuele, " Via Santa Sofia 78 95123, Catania, Italy
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GIBREEL M, PEREA-LOWERY L, VALLITTU PK, GAROUSHI S, LASSILA L. Two-body wear and surface hardness of occlusal splint materials. Dent Mater J 2022; 41:916-922. [DOI: 10.4012/dmj.2022-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mona GIBREEL
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | - Leila PEREA-LOWERY
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | | | - Sufyan GAROUSHI
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | - Lippo LASSILA
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
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Wulff J, Schmid A, Huber C, Rosentritt M. Dynamic fatigue of 3D-printed splint materials. J Mech Behav Biomed Mater 2021; 124:104885. [PMID: 34628189 DOI: 10.1016/j.jmbbm.2021.104885] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Printed splints may be an alternative treatment for functional disorders. In addition to the selection of materials, the influence of cleaning or polymerisation can affect the dynamic behaviour and fatigue limit of printed materials. MATERIAL AND METHODS 96 discs (n = 6 per group, 16mmx2mm) were printed (P30+ DLP-printer, Straumann, CH; 100 μm layer) from splint materials (M1: Luxaprint OrthoPlus, DMG, G; M2: V-Print Splint, Voco, G). Specimens were either automatically cleaned (C1: Straumann P Wash, Straumann, CH) or manually cleaned (C2: Voco Pre-/Main-Clean protocol, Voco, G). Post polymerisation was performed with LED (P1: Cure, Straumann, CH) or Xenon light (P2: Otoflash N171, Ernst Hinrichs Dental, G). The flexural fatigue limit was determined under cyclic loading in terms of a staircase approach with a piston-on-3-ball-test according to ISO 6872 after 24 h or 60 days water storage (37 °C). Specimens were preloaded with 50N and dynamic force was applied for 105 loadings per step (f = 3Hz; steps 1: 50N-100N, 2: 50N-150N, 3: 50N-200N, 4: 50N-250N; F1000, Prematec, G; water at 37 °C). STATISTICS Kaplan Maier Log Rank (Mantel-Cox) test, ANOVA, Pearson correlations, Levene-test (α = 0.05, SPSS 26.0, IBM, Armonk, NY, USA)). RESULTS Mean survival cycles after 24 h of storage varied between 40388 (M1C2P2) and 195140 (M2C2P1) cycles and after 60 d decreased to 14022 (M1C2P2) and 173237 (M2C1P1). Kaplan Maier Log Rank test revealed significant differences between the material combinations. For M1 cleaning (Pearson: 0.346, p = 0.016) and for M2 polymerisation (Pearson: 0.616, p = 0.000) significantly influenced the number of loading cycles. Intermediate effects were found for material (p = 0.026), cleaning (p = 0.024) and polymerisation (p = 0.000) as well as the combination of material and polymerisation (p = 0.008). CONCLUSIONS The results show that the number of possible loading cycles of additively manufactured splint specimens depends on the type of material, their cleaning and post-polymerisation. CLINICAL SIGNIFICANCE Materials, cleaning and post-polymerisation of additive manufacturing processes should be matched to improve dynamic loading performance of splint materials.
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Affiliation(s)
- Johann Wulff
- DS, Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Alois Schmid
- DDS, Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Christina Huber
- DDS, Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany
| | - Martin Rosentritt
- Department of Prosthetic Dentistry, UKR University Hospital Regensburg, 93042 Regensburg, Germany.
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Son K, Lee WS, Lee KB. Effect of Different Software Programs on the Accuracy of Dental Scanner Using Three-Dimensional Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168449. [PMID: 34444195 PMCID: PMC8392431 DOI: 10.3390/ijerph18168449] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/06/2021] [Accepted: 08/06/2021] [Indexed: 12/20/2022]
Abstract
This in vitro study aimed to evaluate the 3D analysis for complete arch, half arch, and tooth preparation region by using four analysis software programs. The CAD reference model (CRM; N = 1 per region) and CAD test models (CTMs; N = 20 per software) of complete arch, half arch, and tooth preparation were obtained by using scanners. For both CRM and CTMs, mesh data other than the same area were deleted. For 3D analysis, four analysis software programs (Geomagic control X, GOM Inspect, Cloudcompare, and Materialise 3-matic) were used in the alignment of CRM and CTMs as well as in the 3D comparison. Root mean square (RMS) was regarded as the result of the 3D comparison. One-way analysis of variance and Tukey honestly significant difference tests were performed for statistical comparison of four analysis software programs (α = 0.05). In half-arch and tooth preparation region, the four analysis software programs showed a significant difference in RMS values (p < 0.001), but in complete-arch region, no significant difference was found among the four software programs (p = 0.139). As the area of the virtual cast for 3D analysis becomes smaller, variable results are obtained depending on the software program used, and the difference in results among software programs are not considered in the 3D analysis for complete-arch region.
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Affiliation(s)
- Keunbada Son
- Department of Dental Science, Graduate School, Kyungpook National University, Daegu 41940, Korea;
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
| | - Wan-Sun Lee
- Department of Dental Technology, Busan Institute of Science and Technology, 88 Srang-ro, 132 Beon-gil, Buk-gu, Busan 616-737, Korea;
| | - Kyu-Bok Lee
- Advanced Dental Device Development Institute (A3DI), Kyungpook National University, Daegu 41940, Korea
- Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu 41940, Korea
- Correspondence: ; Tel.: +82-053-600-7674
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Aretxabaleta M, Unkovskiy A, Koos B, Spintzyk S, Xepapadeas AB. Accuracy Evaluation of Additively and Subtractively Fabricated Palatal Plate Orthodontic Appliances for Newborns and Infants-An In Vitro Study. MATERIALS (BASEL, SWITZERLAND) 2021; 14:4103. [PMID: 34361299 PMCID: PMC8347028 DOI: 10.3390/ma14154103] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/02/2022]
Abstract
Different approaches for digital workflows have already been presented for their use in palatal plates for newborns and infants. However, there is no evidence on the accuracy of CAD/CAM manufactured orthodontic appliances for this kind of application. This study evaluates trueness and precision provided by different CAM technologies and materials for these appliances. Samples of a standard palatal stimulation plate were manufactured using stereolithography (SLA), direct light processing (DLP) and subtractive manufacturing (SM). The effect of material (for SM) and layer thickness (for DLP) were also investigated. Specimens were digitized with a laboratory scanner (D2000, 3Shape) and analyzed with a 3D inspection software (Geomagic Control X, 3D systems). For quantitative analysis, differences between 3D datasets were measured using root mean square (RMS) error values for trueness and precision. For qualitative analysis, color maps were generated to detect locations of deviations within each sample. SM showed higher trueness and precision than AM technologies. Reducing layer thickness in DLP did not significantly increase accuracy, but prolonged manufacturing time. All materials and technologies met the clinically acceptable range and are appropriate for their use. DLP with 100 µm layer thickness showed the highest efficiency, obtaining high trueness and precision within the lowest manufacturing time.
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Affiliation(s)
- Maite Aretxabaleta
- Department of Orthodontics in the University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery within the University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany; (B.K.); (A.B.X.)
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Aßmannshauser Str. 4-6, 14197 Berlin, Germany;
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, 119146 Moscow, Russia
| | - Bernd Koos
- Department of Orthodontics in the University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery within the University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany; (B.K.); (A.B.X.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany;
| | - Alexander B. Xepapadeas
- Department of Orthodontics in the University Centre of Dentistry, Oral Medicine and Maxillofacial Surgery within the University Hospital Tübingen, Osianderstr. 2-8, 72076 Tübingen, Germany; (B.K.); (A.B.X.)
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Kuscu E, Klink A, Spintzyk S, Kraemer Fernandez P, Huettig F. Bonding Interface and Repairability of 3D-Printed Intraoral Splints: Shear Bond Strength to Current Polymers, with and without Ageing. MATERIALS 2021; 14:ma14143935. [PMID: 34300854 PMCID: PMC8307865 DOI: 10.3390/ma14143935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022]
Abstract
This in-vitro study investigates the bonding interfaces reached by the conditioning of a splint material additively manufactured by digital light processing (AM base) as well as the shear bond strength (SBS) of resins bonded to these surfaces (repair material). Therefore, the AM base was either stored in dry for 12 h or wet environment for 14 days to simulate ageing by intraoral wear. The dry and wet group was bonded after physical and/or chemical conditioning to cylinders made from polymethylmethacrylate or four novel polymers allowing splint modifications. Blasted and methylmethacrylate (MMA)-conditioned Polymethylmethacrylate (PMMA) bonded to PMMA acted as the gold standard. The surface profiles revealed highest differences of Ra towards the gold standard in AM base conditioned with other than MMA after sandblasting. The adhesively bonded repair materials of the wet AM base were further aged in wet environment for 14 days. The SBS of the gold standard (25.2 MPa and 25.6 MPa) was only reached by PMMA bonded to blasted and MMA-conditioned AM base after dry (22.7 MPa) and non-conditioned after wet storage (23 MPa). Four repair materials failed to reach the threshold of 5 MPa after dry storage and three after wet storage, respectively. Non-conditioned AM base revealed the highest risk for adhesive fractures when using other resins than PMMA.
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Affiliation(s)
- Ebru Kuscu
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
- Correspondence:
| | - Andrea Klink
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany;
| | - Pablo Kraemer Fernandez
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
| | - Fabian Huettig
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
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Schubert A, Bürgers R, Baum F, Kurbad O, Wassmann T. Influence of the Manufacturing Method on the Adhesion of Candida albicans and Streptococcus mutans to Oral Splint Resins. Polymers (Basel) 2021; 13:polym13101534. [PMID: 34064561 PMCID: PMC8150722 DOI: 10.3390/polym13101534] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023] Open
Abstract
Microbial adhesion to oral splints may lead to oral diseases such as candidiasis, periodontitis or caries. The present in vitro study aimed to assess the effect of novel computer-aided design/computer-aided manufacturing (CAD/CAM) and conventional manufacturing on Candida albicans and Streptococcus mutans adhesion to oral splint resins. Standardized specimens of four 3D-printed, two milled, one thermoformed and one pressed splint resin were assessed for surface roughness by widefield confocal microscopy and for surface free energy by contact angle measurements. Specimens were incubated with C. albicans or S. mutans for two hours; a luminometric ATP assay was performed for the quantification of fungal and bacterial adhesion. Both one-way ANOVA with Tukey post hoc testing and Pearson correlation analysis were performed (p < 0.05) in order to relate manufacturing methods, surface roughness and surface free energy to microbial adhesion. Three-dimensional printing and milling were associated with increased adhesion of C. albicans compared to conventional thermoforming and pressing, while the S. mutans adhesion was not affected. Surface roughness and surface free energy showed no significant correlation with microbial adhesion. Increased fungal adhesion to oral splints manufactured by 3D printing or milling may be relevant for medically compromised patients with an enhanced risk for developing candidiasis.
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Schweiger J, Edelhoff D, Güth JF. 3D Printing in Digital Prosthetic Dentistry: An Overview of Recent Developments in Additive Manufacturing. J Clin Med 2021; 10:2010. [PMID: 34067212 PMCID: PMC8125828 DOI: 10.3390/jcm10092010] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/30/2021] [Accepted: 04/30/2021] [Indexed: 11/16/2022] Open
Abstract
Popular media now often present 3D printing as a widely employed technology for the production of dental prostheses. This article aims to show, based on factual information, to what extent 3D printing can be used in dental laboratories and dental practices at present. It attempts to present a rational evaluation of todays´ applications of 3D printing technology in the context of dental restorations. In addition, the article discusses future perspectives and examines the ongoing viability of traditional dental laboratory services and manufacturing processes. It also shows which expertise is needed for the digital additive manufacturing of dental restorations.
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Affiliation(s)
- Josef Schweiger
- Department of Prosthetic Dentistry, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, Ludwig-Maximilians University Munich, 80336 Munich, Germany;
| | - Jan-Frederik Güth
- Poliklinik für Zahnärztliche Prothetik, Center for Dentistry and Oral Medicine (Carolinum), Goethe-University, 60596 Frankfurt am Main, Germany
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Effects of Postcuring Temperature on the Mechanical Properties and Biocompatibility of Three-Dimensional Printed Dental Resin Material. Polymers (Basel) 2021; 13:polym13081180. [PMID: 33916899 PMCID: PMC8067535 DOI: 10.3390/polym13081180] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 04/03/2021] [Accepted: 04/04/2021] [Indexed: 11/16/2022] Open
Abstract
Three-dimensional (3D) printing is an attractive technology in dentistry. Acrylic-based 3D printed resin parts have to undergo postcuring processes to enhance their mechanical and biological properties, such as UV-light and thermal polymerization. However, no previous studies have revealed how the postcuring temperature influences the biocompatibility of the produced parts. Therefore, we postprocessed 3D printed denture teeth resin under different postcuring temperatures (40, 60 and 80 °C) for different periods (15, 30, 60, 90 and 120 min), and evaluated their flexural properties, Vickers hardness, cell cytotoxicity, cell viability, and protein adsorption. In addition, confocal laser scanning was used to assess the condition of human gingival fibroblasts. It was found that increasing the postcuring temperature significantly improved the flexural strength and cell viability. The flexural strength and cell viability were 147.48 ± 5.82 MPa (mean ± standard deviation) and 89.51 ± 7.09%, respectively, in the group cured at 80 °C for 120 min, which were higher than the values in the 40 and 60 °C groups. The cell cytotoxicity increased in the 40 °C groups and for longer cultivation time. Confocal laser scanning revealed identifiable differences in the morphology of fibroblasts. This study has confirmed that the postcuring temperature influences the final mechanical and biological properties of 3D printed resin.
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Keßler A, Dosch M, Reymus M, Folwaczny M. Influence of 3D- printing method, resin material, and sterilization on the accuracy of virtually designed surgical implant guides. J Prosthet Dent 2021; 128:196-204. [PMID: 33573833 DOI: 10.1016/j.prosdent.2020.08.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/12/2020] [Accepted: 08/12/2020] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Three-dimensional printing has introduced new manufacturing methods. However, information on the influence of the specific printing technology, material, sterilization, and the comparison between printing and milling on the accuracy of surgical guides is lacking. PURPOSE The purpose of this in vitro study was to evaluate the influence of the manufacturing method (printing and milling), printing technology stereolithography (SLA) and digital light processing (DLP), material, and sterilization on the accuracy of digitally designed surgical implant guides. MATERIAL AND METHODS Resin patient replicas with a single edentulous space were used to place 132 implants with digitally designed surgical guides. The accuracy of postoperative implant position was analyzed for the manufacturing method (printing and milling), resin materials, and preoperative autoclaving. To determine 3D accuracy, angular displacement, mean horizontal crestal, apical displacement, and the linear vertical displacement at the apex were calculated separately for each group (n=12). In addition, the surgical guides were qualitatively analyzed by using field emission scanning electron micrograph. RESULTS The postoperative angular deviation ranged from 0.76 ±0.52 degrees (Rapidshape D20II with NextDent SG) to 2.43 ±0.64 degrees (Form2 with NextDent SG) (P<.001). Linear horizontal displacement at the crest was smallest for Rapidshape D20II with 3Delta Guide (0.27 ±0.08 mm) and highest for Form2 with NextDent SG (0.54 ±0.10 mm) (P<.001). Linear horizontal displacement at the apex ranged from 0.36 ±0.10 mm (SolFlex 350 with V-Print SG) to 0.89 ±0.32 mm (Form2 with NextDent SG) (P<.001). Considering the vertical position displacement was no more than 0.43 ±0.07 mm (Form2 with NextDent SG) short of the apex, none of the implant tips were displaced apically. Preoperative autoclaving differentially impaired the accuracy of surgical guides. CONCLUSIONS The specific manufacturing technique, the 3D printing device, the resin material, and the application of preoperative sterilization all affected the accuracy of the postoperative implant position. Irrespective of the manufacturing method, all implants were placed within the commonly accepted safety distance.
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Affiliation(s)
- Andreas Keßler
- Assistant Professor, Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany.
| | - Maximilian Dosch
- Graduate student, Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Marcel Reymus
- Assistant Professor, Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Matthias Folwaczny
- Professor, Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
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Tian Y, Chen C, Xu X, Wang J, Hou X, Li K, Lu X, Shi H, Lee ES, Jiang HB. A Review of 3D Printing in Dentistry: Technologies, Affecting Factors, and Applications. SCANNING 2021; 2021:9950131. [PMID: 34367410 PMCID: PMC8313360 DOI: 10.1155/2021/9950131] [Citation(s) in RCA: 136] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/20/2021] [Accepted: 06/24/2021] [Indexed: 05/14/2023]
Abstract
Three-dimensional (3D) printing technologies are advanced manufacturing technologies based on computer-aided design digital models to create personalized 3D objects automatically. They have been widely used in the industry, design, engineering, and manufacturing fields for nearly 30 years. Three-dimensional printing has many advantages in process engineering, with applications in dentistry ranging from the field of prosthodontics, oral and maxillofacial surgery, and oral implantology to orthodontics, endodontics, and periodontology. This review provides a practical and scientific overview of 3D printing technologies. First, it introduces current 3D printing technologies, including powder bed fusion, photopolymerization molding, and fused deposition modeling. Additionally, it introduces various factors affecting 3D printing metrics, such as mechanical properties and accuracy. The final section presents a summary of the clinical applications of 3D printing in dentistry, including manufacturing working models and main applications in the fields of prosthodontics, oral and maxillofacial surgery, and oral implantology. The 3D printing technologies have the advantages of high material utilization and the ability to manufacture a single complex geometry; nevertheless, they have the disadvantages of high cost and time-consuming postprocessing. The development of new materials and technologies will be the future trend of 3D printing in dentistry, and there is no denying that 3D printing will have a bright future.
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Affiliation(s)
- Yueyi Tian
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - ChunXu Chen
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xiaotong Xu
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Jiayin Wang
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xingyu Hou
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Kelun Li
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xinyue Lu
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - HaoYu Shi
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Korea University, Seoul 08308, Republic of Korea
| | - Heng Bo Jiang
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
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Llaquet Pujol M, Vidal C, Mercadé M, Muñoz M, Ortolani-Seltenerich S. Guided Endodontics for Managing Severely Calcified Canals. J Endod 2020; 47:315-321. [PMID: 33278454 DOI: 10.1016/j.joen.2020.11.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/19/2020] [Accepted: 11/24/2020] [Indexed: 11/16/2022]
Abstract
Endodontic treatment of teeth with pulp canal obliteration presents a challenge given the high likelihood of procedural errors and complications during treatment. These drawbacks can be avoided by using a personalized 3-dimensional (3D) guide designed by overlaying a cone-beam computed tomographic scan with an intraoral scan of the patient. This 3D guide enables the clinician to obtain a straight access to the obliterated root canal.This article described guided endodontics in managing 7 severely obliterated teeth using both virtually designed 3D guides and a customized 1-mm-diameter cylindrical bur. This treatment approach was demonstrated to be safe and fast and can be considered as a predictable technique for the location of calcified canals, thus minimizing complications.
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Affiliation(s)
- Marc Llaquet Pujol
- Department of Restorative Dentistry and Endodontics, Universitat Internacional de Catalunya, Barcelona, Spain.
| | | | - Montse Mercadé
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain; Institut d'Investigació Biomèdica de Bellvitge Institute, Barcelona, Spain
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