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Santi MR, Khodor N, Sekula M, Donatelli D, De Souza GM. Effect of cleaning solution on surface properties of 3D-printed denture materials. J Prosthodont 2024. [PMID: 39233451 DOI: 10.1111/jopr.13936] [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: 10/09/2023] [Accepted: 08/17/2024] [Indexed: 09/06/2024] Open
Abstract
PURPOSE To evaluate the effect of cleaning solutions on surface properties of 3D-printed resins. MATERIALS AND METHODS Seven different resin materials for denture base and teeth were used in the form of 280 half-disks. Samples were randomly assigned to two cleaning groups (FD, FreshDent; PO, Polydent), with daily 2- or 3-min immersion followed by water storage, repeated for 30 days. Samples were then cleaned in an ultrasonic bath with water and analyzed for surface roughness (Keyence, VHX-7000N) and hardness (Shimadzu, HMV-2 series). The pH of cleaning solutions was analyzed over 5-min and the surface morphology of specimens was analyzed via scanning electron microscopy (SEM). Statistical analysis used two-way ANOVA (α = 0.05). RESULTS Surface roughness of base materials was significantly affected (p < 0.001), whereas roughness of teeth materials was not. As for hardness, there was a significant interaction between materials and cleaning solution for both, base (p < 0.001) and teeth (p < 0.001). For teeth materials, PO significantly increased Denture's (Dentca) hardness and decreased that of Rodin's (Pac Dent), while PO significantly increased Rodin's Base (Pac Dent) hardness. The hardness of Flexcera Ultra (Envision Tec), Glidewell (Glidewell), Lucitone (Dentsply Sirona), and NextDent (NextDent) teeth and base materials were not affected by the cleaning solution. Overall, the pH of FD averaged 7.3 and PO averaged 6.6. All the SEM images indicated surface irregularities after immersion in either FD or PO. CONCLUSIONS One-month of storage and cyclic cleaning of 3D- printed resins did not affect surface roughness but had a significant impact on hardness. The cleaning solutions' effect was not homogeneous among materials.
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Affiliation(s)
- Marina Rodrigues Santi
- Department of Restorative Dentistry, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil
| | - Nadima Khodor
- Department of Rehabilitative and Reconstructive Dentistry, University of Louisville, School of Dentistry, Louisville, Kentucky, USA
| | - Michael Sekula
- Department of Bioinformatics and Biostatistics, University of Louisville, School of Dentistry, University of Louisville, Louisville, Kentucky, USA
| | - David Donatelli
- Department of Rehabilitative and Reconstructive Dentistry, University of Louisville, School of Dentistry, Louisville, Kentucky, USA
| | - Grace Mendonça De Souza
- Department of Comprehensive Dentistry, University of Louisville, School of Dentistry, Louisville, Kentucky, USA
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Guttridge C, Shannon A, O'Sullivan A, O'Sullivan KJ, O'Sullivan LW. Effects of post-curing duration on the mechanical properties of complex 3D printed geometrical parts. J Mech Behav Biomed Mater 2024; 156:106585. [PMID: 38795405 DOI: 10.1016/j.jmbbm.2024.106585] [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: 01/26/2024] [Revised: 03/26/2024] [Accepted: 05/18/2024] [Indexed: 05/27/2024]
Abstract
This study aims to assess the efficacy of post-curing guidance supplied by 3D printing resin manufacturers. Current guidance applies generically to all geometries with the caveat that post-curing should be extended for 'large' or 'complex' geometries but specific guidance is not provided. Two vat-polymerisation 3D printers (Form3B, Figure 4 Standalone) were used to print test models in 6 biocompatible resins (Pro Black, Med White, Med Amber, Biomed Black, Biomed White, Biomed Amber). The test model is of a complex geometry whilst also housing ISO 527 test specimens in concentric layers. Two separate intervals of curing were applied (100%, 500% stated guidance) creating different curing treatments of the specimens throughout the model. Post processed test models were disassembled and pull testing performed on each of the specimens to assess the mechanical properties. The analysis showed that extending the curing duration had significant effects on the mechanical properties of some materials but not all. The layers of the model had a significant effect except for elongation at break for the Med Amber material. This research demonstrates that generic post-curing guidance regarding UV exposures is not sufficient to achieve homogenous material strength properties for complex geometries. Large variations in mechanical properties throughout the models suggest some material was not fully-cured. This raises a query if such materials as originally marketed as biocompatible are fully cured and therefore safe to use for medical applications involving complex geometries.
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Affiliation(s)
- Callum Guttridge
- Rapid Innovation Unit - School of Design and Confirm Smart Manufacturing Centre, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Alice Shannon
- Rapid Innovation Unit - School of Design and Confirm Smart Manufacturing Centre, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Aidan O'Sullivan
- Rapid Innovation Unit - School of Design and Confirm Smart Manufacturing Centre, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Kevin J O'Sullivan
- Rapid Innovation Unit - School of Design and Confirm Smart Manufacturing Centre, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland
| | - Leonard W O'Sullivan
- Rapid Innovation Unit - School of Design and Confirm Smart Manufacturing Centre, University of Limerick, Ireland; Health Research Institute, University of Limerick, Ireland.
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Haugli KH, Alkarra D, Samuelsen JT. Digital manufacturing techniques and the in vitro biocompatibility of acrylic-based occlusal device materials. Clin Oral Investig 2024; 28:312. [PMID: 38748326 PMCID: PMC11096251 DOI: 10.1007/s00784-024-05707-1] [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: 11/15/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Material chemistry and workflow variables associated with the fabrication of dental devices may affect the biocompatibility of the dental devices. The purpose of this study was to compare digital and conventional workflow procedures in the manufacturing of acrylic-based occlusal devices by assessing the cytotoxic potential of leakage products. METHODS Specimens were manufactured by 3D printing (stereolithography and digital light processing), milling, and autopolymerization. Print specimens were also subjected to different post-curing methods. To assess biocompatibility, a human tongue epithelial cell line was exposed to material-based extracts. Cell viability was measured by MTT assay while Western blot assessed the expression level of selected cytoprotective proteins. RESULTS Extracts from the Splint 2.0 material printed with DLP technology and post-cured with the Asiga Flash showed the clearest loss of cell viability. The milled and autopolymerized materials also showed a significant reduction in cell viability. However, by storing the autopolymerized material in dH2O for 12 h, no significant viability loss was observed. Increased levels of cytoprotective proteins were seen in cells exposed to extracts from the print materials and the autopolymerized material. Similarly to the effect on viability loss, storing the autopolymerized material in dH2O for 12 h reduced this effect. CONCLUSIONS/CLINICAL RELEVANCE Based on the biocompatibility assessments, clinical outcomes of acrylic-based occlusal device materials may be affected by the choice of manufacturing technique and workflow procedures.
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Affiliation(s)
- Ketil Hegerstrøm Haugli
- NIOM, Nordic Institute of Dental Materials, Oslo, Norway.
- Dental Technology Program, Faculty of Health Sciences, Oslo Metropolitan University (OsloMet), OsloMet Box 4, St. Olavs plass, Oslo, 0130, Norway.
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4
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Grutle LA, Holm HV, Kopperud HBM, Uhlig S. Validation of a human saliva model for the determination of leachable monomers and other chemicals from dental materials. J Chromatogr B Analyt Technol Biomed Life Sci 2024; 1236:124073. [PMID: 38452631 DOI: 10.1016/j.jchromb.2024.124073] [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: 01/09/2024] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/09/2024]
Abstract
This study aimed to prove the validity of a mixture of chemicals, including salts, small organic molecules, mucin, and α-amylase, as saliva surrogate ("artificial saliva") for assessing leakage of methacrylate monomers and other constituents from dental materials. To achieve this, we developed and validated a liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the quantification of 2-hydroxyethyl methacrylate (HEMA), triethylene glycol dimethacrylate (TEGDMA), diurethane dimethacrylate (UDMA), bisphenol A glycerolate dimethacrylate (BisGMA), diphenyl(2,4,6-trimethylbenzoyl)phosphine oxide (TPO), bisphenol A (BPA), and five homologues of ethoxylated bisphenol A dimethacrylate (BisEMA EO2-6) in unstimulated and artificial saliva, and compared their concentrations in the two saliva media following either spiking with a mixture of the compounds or incubation of test specimens of printed biomaterials. Test specimens were immersed in unstimulated/artificial saliva, incubated at 37 °C for 24 h, and saliva aliquots were extracted with methanol and subsequently analyzed by LC-MS/MS. The method was validated with regard to matrix effects, linearity, selectivity, lower limits of quantification (LLOQ), precision, bias and combined measurement uncertainty (u'). The performance characteristics of the method were comparable for unstimulated and artificial saliva samples. The combined u' for individual chemicals at a concentration of 10 × LLOQ were within the range of 5.3-14 % for unstimulated saliva and 6.9-16 % for artificial saliva, except for the BisEMA homologues. Combined u' for the latter were 27-74 % in unstimulated saliva, and 27-79 % in artificial saliva. There was no detectable release of BPA from the test specimens, and the TPO concentrations were mainly below the LLOQ. TEGDMA and UDMA were detected in the highest quantities, and at comparable concentrations in the unstimulated and artificial saliva. For all BisEMA homologues, the release was higher in unstimulated saliva than in artificial saliva. The study showed that the artificial saliva model can be a suitable replacement for native saliva, but might underestimate leakage of more lipophilic methacrylates.
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Affiliation(s)
- Lene A Grutle
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70A, 0855 Oslo, Norway
| | - Heidi V Holm
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70A, 0855 Oslo, Norway
| | - Hilde B M Kopperud
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70A, 0855 Oslo, Norway
| | - Silvio Uhlig
- Nordic Institute of Dental Materials (NIOM), Sognsveien 70A, 0855 Oslo, Norway.
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de Souza FA, Blois MC, Collares K, Dos Santos MBF. 3D-printed and conventional provisional single crown fabrication on anterior implants: A randomized clinical trial. Dent Mater 2024; 40:340-347. [PMID: 38103959 DOI: 10.1016/j.dental.2023.12.004] [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: 05/24/2023] [Revised: 11/28/2023] [Accepted: 12/08/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES The present study aims to compare provisional single crowns on anterior implants made using conventional PMMA and 3D-printed workflows. The study assessed the occurrence of failures, color variation, signs of early deterioration, operating time, and patients' satisfaction with the treatment through a randomized controlled trial. METHODS This study was conducted as a randomized controlled trial, following the SPIRIT and CONSORT guidelines. Patients were included in the study after meeting the eligibility criteria and were randomly assigned to one of two groups (conventional and 3D-printed). FDI criteria, visible plaque index (VPI), bleeding on probing (BOP), and color variation were considered as the primary outcomes. Operating time and patient satisfaction were also assessed as secondary outcomes. Fisher's exact test was performed to analyze the association between the primary and secondary outcomes and the study groups. Mann-Whitney test was used to compare the mean VAS satisfaction scores between the conventional PMMA and 3D-printed groups (STATA 14™, with an α = 0.05). RESULTS A total of 42 provisional single crowns (n = 21) were made for 33 patients. Only the fracture parameter (FDI) showed a statistically significant difference, with 3D-printed provisionals exhibiting higher rates of catastrophic failures compared to conventional ones (p = 0.05). Although the operating time for the 3D-printed group was shorter (p < 0.001), no statistical difference observed in patients' satisfaction regarding esthetics, phonetics, chewing, or comfort. SIGNIFICANCE 3D-printed and conventional PMMA provisional single crowns showed comparable clinical performance, except for the observed fracture types. Although 3D-printed provisional restorations showed a shorter operating time, overall patients' satisfaction was not affected.
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Affiliation(s)
- Fernanda Angeloni de Souza
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Program in Dentistry, Mercosur Dental Educational Institute, Brazil
| | - Matheus Coelho Blois
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil; Program in Dentistry, Mercosur Dental Educational Institute, Brazil
| | - Kaue Collares
- Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Fotovat F, Abbasi S, Nikanjam S, Alafchi B, Baghiat M. Effects of various disinfectants on surface roughness and color stability of thermoset and 3D-printed acrylic resin. Eur J Transl Myol 2024; 34:11701. [PMID: 38247390 PMCID: PMC11017172 DOI: 10.4081/ejtm.2024.11701] [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: 08/31/2023] [Accepted: 01/02/2024] [Indexed: 01/23/2024] Open
Abstract
Denture cleansers are extensively utilized to inhibit the colonization of various Candida species. Currently, additive technology in denture fabrication has become more prevalent. This study aims to assess the impact of disinfectants on the surface roughness and color stability of distinct denture bases. Disc-shaped samples (N=66) were exposed to three different disinfectants: 0.5% sodium hypochlorite, 1% hydrogen peroxide, and 2% chlorhexidine. The samples underwent evaluation via spectrophotometry and profilometry, respectively. Data analysis was conducted utilizing analysis of variance (ANOVA) (p < 0.05). Within the heat-cured group, sodium hypochlorite resulted in the most notable change in surface roughness (0.2 μm), while chlorhexidine exhibited the least impact (0.001 μm), showing a significant difference (p <0.008). The color change (ΔE) for 3D-printed samples immersed in all disinfectants was higher compared to heat-cured samples. Among the heat-cured samples, chlorhexidine induced the highest ΔE (2.76), while sodium hypochlorite resulted in the lowest (ΔE = 1.44), and this difference was statistically significant (p <0.008). Chlorhexidine caused the most significant color alteration among the solutions, while sodium hypochlorite induced the most considerable changes in surface roughness.
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Affiliation(s)
- Farnoush Fotovat
- Department of Prosthodontics, School of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan.
| | - Samaneh Abbasi
- Department of Prosthodontics, School of Dentistry, Hamadan University of Medical Sciences, Hamadan.
| | - Saeed Nikanjam
- Department of Prosthodontics, School of Dentistry, Dental Research Center, Hamadan University of Medical Sciences, Hamadan.
| | - Behnaz Alafchi
- Modeling of noncommunicable diseases research center, Hamadan University of Medical Sciences, Hamadan.
| | - Mandana Baghiat
- School of Dentistry, Hamadan University of Medical Sciences, Hamadan.
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Patel P, Dhal K, Gupta R, Tappa K, Rybicki FJ, Ravi P. Medical 3D Printing Using Desktop Inverted Vat Photopolymerization: Background, Clinical Applications, and Challenges. Bioengineering (Basel) 2023; 10:782. [PMID: 37508810 PMCID: PMC10376892 DOI: 10.3390/bioengineering10070782] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023] Open
Abstract
Medical 3D printing is a complex, highly interdisciplinary, and revolutionary technology that is positively transforming the care of patients. The technology is being increasingly adopted at the Point of Care (PoC) as a consequence of the strong value offered to medical practitioners. One of the key technologies within the medical 3D printing portfolio enabling this transition is desktop inverted Vat Photopolymerization (VP) owing to its accessibility, high quality, and versatility of materials. Several reports in the peer-reviewed literature have detailed the medical impact of 3D printing technologies as a whole. This review focuses on the multitude of clinical applications of desktop inverted VP 3D printing which have grown substantially in the last decade. The principles, advantages, and challenges of this technology are reviewed from a medical standpoint. This review serves as a primer for the continually growing exciting applications of desktop-inverted VP 3D printing in healthcare.
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Affiliation(s)
- Parimal Patel
- Department of Mechanical & Aerospace Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Kashish Dhal
- Department of Mechanical & Aerospace Engineering, University of Texas at Arlington, Arlington, TX 76019, USA
| | - Rajul Gupta
- Department of Orthopedic Surgery, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Karthik Tappa
- Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Frank J Rybicki
- Department of Radiology, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Prashanth Ravi
- Department of Radiology, University of Cincinnati, Cincinnati, OH 45219, USA
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Abdollahpour S, Estedlal T, Chiniforush N, Rafeie N, Nikparto N, Abbasi M, Ranjbar Omrani L. Effect of Different Bleaching Methods on Monomer Release from Aged Microhybrid and Nanohybrid Resin Composites. Int J Dent 2023; 2023:2773879. [PMID: 37216177 PMCID: PMC10198759 DOI: 10.1155/2023/2773879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 04/09/2023] [Accepted: 04/11/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Recently, the application of laser-assisted bleaching has increased in dental practice. This method might affect the physical and chemical properties of resin composite and its monomer release. This study aimed to evaluate the effect of in-office, at-home, and laser-assisted bleaching on the monomer release (bisphenol A diglycidyl dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), and urethane dimethacrylate (UDMA)) from aged nanohybrid (Grandio, Voco) and microhybrid (Clearfil AP-X Esthetics, Kuraray) resin composites. Methods Thirty-two samples of each composite were prepared. The samples underwent aging procedure with UV light at 65°C for 100 hr. The samples were divided into 4 groups: OB: conventional in-office bleaching with Opalescence Boost PF 40% gel; HB: home bleaching with Opalescence PF 15% gel; LB: bleaching with JW Power bleaching gel followed by diode laser application; and C: control group without bleaching. Then, the samples were immersed in a solution containing 75% ethanol + 25% distilled water. The medium was renewed after 8, 16, 24 hr, and 7 days and was analyzed using high-performance liquid chromatography method to evaluate the monomer release. The data were analyzed using Two-way ANOVA and Post hoc Tukey test. Results The bleaching method had no effect on TEGDMA and BisGMA release in both composites while it affected UDMA release in nanohybrid composite; UDMA release was significantly higher in LB compared to control and also higher in OB and LB compared to HB. No difference was observed in the microhybrid composite in this regard. Conclusion Laser-assisted bleaching did not affect monomer release from microhybrid composite while it increased UDMA release from nanohybrid composite. The bleaching method had no effect on TEGDMA and BisGMA release.
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Affiliation(s)
- Siavash Abdollahpour
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Tarane Estedlal
- Department of Operative Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Department of Surgical Science and Integrated Diagnosis, University of Genoa, Genoa, Italy
| | - Niyousha Rafeie
- Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nariman Nikparto
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Abbasi
- Restorative Dentistry Department, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ladan Ranjbar Omrani
- Restorative Dentistry Department, Dental Research Center, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Berghaus E, Klocke T, Maletz R, Petersen S. Degree of conversion and residual monomer elution of 3D-printed, milled and self-cured resin-based composite materials for temporary dental crowns and bridges. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2023; 34:23. [PMID: 37173418 PMCID: PMC10182118 DOI: 10.1007/s10856-023-06729-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
The aim of this work was to investigate the elution of residual monomers as a function of the manufacturing process, which are CAD/CAM manufacturing, self-curing and 3D printing. The experimental materials used consisted of the base monomers TEGDMA, Bis-GMA and Bis-EMA and 50 wt.% fillers. Additionally, a 3D printing resin without fillers was tested. The elution of the base monomers into the different media (water, ethanol and ethanol/water (75/25 vol. %)) at 37 °C over a period of up to 120 d as well as the degree of conversion (DC) by FTIR were investigated. No monomer elution could be detected in water. Most residual monomers in both other media were released from the self-curing material whereas the 3D printing composite released relatively little. The CAD/CAM blanks released hardly any quantitatively detectable amounts of monomers. Relative to the base composition, TEGDMA eluted less than Bis-GMA and Bis-EMA. DC did not correlate with residual monomer release; thus, leaching was determined not only by the amount of residual monomers present but by further factors as possibly network density and structure. The CAD/CAM blanks and the 3D printing composite showed similar high DC but lower residual monomer release from the CAD/CAM blank, likewise the self-curing composite and the 3D printing resin exhibited similar DC but different monomer elution. In terms of residual monomer elution and DC, the 3D printing composite seems promising as a new material class for the use as temporary dental crowns and bridges.
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Affiliation(s)
- Eva Berghaus
- Laboratory of Chemistry and Surface Modification, University of Applied Sciences Osnabrück, Osnabrück, Germany
| | - Thorsten Klocke
- Laboratory of Chemistry and Surface Modification, University of Applied Sciences Osnabrück, Osnabrück, Germany
| | - Reinhard Maletz
- Department of Material Science and Medical Engineering, Faculty of Mechanical Engineering and Marine Technology, University of Rostock, Rostock, Germany
| | - Svea Petersen
- Laboratory of Chemistry and Surface Modification, University of Applied Sciences Osnabrück, Osnabrück, Germany.
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Da Silva TM, Immich F, De Araujo TS, Lund RG, Da Silva AF, Piva E, Da Rosa WLDO. Photosensitive resins used in additive manufacturing for oral application in dentistry: A scoping review from lab to clinic. J Mech Behav Biomed Mater 2023; 141:105732. [PMID: 36898354 DOI: 10.1016/j.jmbbm.2023.105732] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 01/21/2023] [Accepted: 02/11/2023] [Indexed: 03/05/2023]
Affiliation(s)
| | - Felipe Immich
- School of Dentistry, Federal University of Pelotas, RS, Brazil.
| | | | - Rafael Guerra Lund
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Adriana Fernandes Da Silva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
| | - Evandro Piva
- Department of Restorative Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil.
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Burkhardt F, Schmidt VD, Wesemann C, Schirmeister CG, Rothlauf S, Pieralli S, Brandenburg LS, Kleinvogel L, Vach K, Spies BC. Tailoring the composition of biocopolyester blends for dimensionally accurate extrusion-based printing, annealing and steam sterilization. Sci Rep 2022; 12:20341. [PMID: 36434090 PMCID: PMC9700831 DOI: 10.1038/s41598-022-24991-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022] Open
Abstract
Fused filament fabrication (FFF) represents a straightforward additive manufacturing technique applied in the medical sector for personalized patient treatment. However, frequently processed biopolymers lack sufficient thermal stability to be used as auxiliary devices such as surgical guides. The aim of this study was to evaluate the dimensional accuracy of experimental biocopolyester blends with improved thermal characteristics after printing, annealing and sterilization. A total of 160 square specimens and 40 surgical guides for oral implant placement were printed. One subgroup of each material (n = 10) underwent thermal annealing before both subgroups were subjected to steam sterilization (134 °C; 5 min). Specimens were digitized and the deviation from the original file was calculated. The thermal behavior was analyzed using differential scanning calorimetry and thermogravimetric analysis. A one-way ANOVA and t-tests were applied for statistical analyses (p < 0.05). All biocopolyester blends showed warpage during steam sterilization. However, the material modification with mineral fillers (21-32 wt%) and nucleating agents in combination with thermal annealing showed a significantly reduced warpage of printed square specimens. Geometry of the printing object seemed to affect dimensional accuracy, as printed surgical guides showed less distortion between the groups. In summary, biocopolyesters did benefit from fillers and annealing to improve their dimensional stability.
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Affiliation(s)
- F Burkhardt
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
| | - V D Schmidt
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - C Wesemann
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - C G Schirmeister
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany
- Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt a.M, Germany
| | - S Rothlauf
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - S Pieralli
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - L S Brandenburg
- Department of Oral and Maxillofacial Surgery, Medical Center-University of Freiburg, Center for Dental Medicine, Hugstetterstr. 55, 79106, Freiburg, Germany
| | - L Kleinvogel
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - K Vach
- Medical Center-University of Freiburg, Institute for Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104, Freiburg, Germany
| | - B C Spies
- Department of Prosthetic Dentistry, Medical Center-University of Freiburg, Center for Dental Medicine, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
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Mechanical Properties and In Vitro Biocompatibility of Hybrid Polymer-HA/BAG Ceramic Dental Materials. Polymers (Basel) 2022; 14:polym14183774. [PMID: 36145918 PMCID: PMC9505225 DOI: 10.3390/polym14183774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/02/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study is to prepare hybrid polymer-ceramic dental materials for chairside computer-aided design/computer-aided manufacturing (CAD/CAM) applications. The hybrid polymer-ceramic materials were fabricated via infiltrating polymerizable monomer mixtures into sintered hydroxyapatite/bioactive glass (HA/BAG) ceramic blocks and thermo-curing. The microstructure was observed by scanning electron microscopy and an energy-dispersive spectrometer. The phase structure was analyzed by X-ray diffraction. The composition ratio was analyzed by a thermogravimetric analyzer. The hardness was measured by a Vickers hardness tester. The flexural strength, flexural modulus, and compressive strength were measured and calculated by a universal testing machine. The growth of human gingival fibroblasts was evaluated by a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) colorimetric assay and immunofluorescence staining. The results showed that the sintering temperature and BAG content affected the mechanical properties of the hybrid polymer-ceramic materials. The X-ray diffraction analysis showed that high-temperature sintering promoted the partial conversion of HA to β-tricalcium phosphate. The values of the hardness, flexural strength, flexural modulus, and compressive strength of all the hybrid polymer-ceramic materials were 0.89-3.51 GPa, 57.61-118.05 MPa, 20.26-39.77 GPa, and 60.36-390.46 MPa, respectively. The mechanical properties of the hybrid polymer-ceramic materials were similar to natural teeth. As a trade-off between flexural strength and hardness, hybrid polymer-ceramic material with 20 wt.% BAG sintered at 1000 °C was the best material. In vitro experiments confirmed the biocompatibility of the hybrid polymer-ceramic material. Therefore, the hybrid polymer-ceramic material is expected to become a new type of dental restoration material.
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Antonopoulou S, Cho SH, Kesterke M, Kontogiorgos E, Korentzelos D. Effect of different storage conditions on the fit of 3D-printed occlusal devices used to treat temporomandibular disorders. J Prosthet Dent 2022; 128:488.e1-488.e9. [PMID: 35970613 DOI: 10.1016/j.prosdent.2022.07.001] [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: 01/27/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/15/2022]
Abstract
STATEMENT OF PROBLEM Research-based storage guidelines for 3-dimensional (3D)-printed occlusal devices are lacking. PURPOSE The purpose of this in vitro study was to investigate the dimensional stability of the internal surface of 3D-printed occlusal devices under different storage conditions. MATERIAL AND METHODS Maxillary and mandibular dental casts were scanned and exported to a 3D printer to fabricate 30 occlusal devices. The specimens were stored under 3 different conditions (n=10): air dried and stored under natural light (group DL), stored in a dark container with water (group W), and air dried and stored in a dark container (group D). The intaglio surfaces of the occlusal devices were scanned by a laboratory scanner at 4 time points: immediately after polymerization (t0, control), after 1 day (t1), after 7 days (t2), and after 27 days (t3). The dimensional changes of the fitting surfaces between t0 and t1 (Δt1), t0 and t2 (Δt2), and t0 and t3 (Δt3) were measured by using best fit alignment in a surface analysis software program. In addition, comparisons were made between the posterior and anterior sections. Statistical analysis was completed with Kolmogorov-Smirnov, 1-way ANOVA, Friedman, Kruskal-Wallis, Mann-Whitney, and unpaired t tests. RESULTS The root mean square (RMS) of group DL between Δt1 and Δt2 (P=.002) and between Δt1 and Δt3 (P=.002) showed a statistically significant difference. The RMS of group W between Δt1 and Δt3 (P=.008) showed a statistically significant difference. When the groups were compared with each other at the different time points, the DL group showed a statistically significant difference compared with groups W and D at Δt1. The examination of different areas of the occlusal device (right molar, incisor, and left molar sites) indicated no statistically significant differences in RMS among all groups (P>.05). CONCLUSIONS The occlusal devices of group DL showed the least dimensional change of the fitting surface for Δt1 in comparison with group W and D, while no statistically significant differences were found among the groups for Δt2 and Δt3. In terms of the different locations, no statistically significant differences were found among the 3 locations for any given group after 27 days.
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Affiliation(s)
- Stavroula Antonopoulou
- Assistant Professor, Graduate Prosthodontics, Department of Prosthodontics, University of Pittsburgh, School of Dental Medicine, Pittsburgh, Pa
| | - Seok-Hwan Cho
- Associate Professor and Chairman, Department of Prosthodontics, University of Iowa College of Dentistry and Dental Clinics, Iowa City, Iowa.
| | - Matthew Kesterke
- Assistant Professor, Graduate Orthodontics, Department of Orthodontics, Texas A&M College of Dentistry, Dallas, Texas
| | - Elias Kontogiorgos
- Professor and Director, Implant Dentistry, Department of Comprehensive Dentistry, Texas A&M University College of Dentistry, Dallas, Texas
| | - Dimitrios Korentzelos
- AP/CP Resident at UPMC, Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pa
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14
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Frasheri I, Aumer K, Keßler A, Miosge N, Folwaczny M. Effects of resin materials dedicated for additive manufacturing of temporary dental restorations on human gingival keratinocytes. J ESTHET RESTOR DENT 2022; 34:1105-1112. [PMID: 35731110 DOI: 10.1111/jerd.12938] [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: 01/03/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study investigated the effect of eluates of conventional and 3D-printed resin materials for manufacturing temporary dental restorations on gingival keratinocytes. METHODS Three-dimensional (3D)-printed resin materials: 3Delta temp (Deltamed), NextDent MFH (Nextdent), Freeprint temp (Detax), GC temp (GC), were compared to Grandio disc (Voco) and Luxatemp (DMG). Human gingival keratinocytes (IHGKs) were exposed to eluates of the materials and XTT assays were performed at 24 h, 48 h, 72 h, or 144 h. For quantification of the proinflammatory response, the protein amount of IL-6 and 8 was determined in the supernatants using ELISA. One-way ANOVA with post hoc analysis was used to compare differences in cell viability and IL-6 and IL-8 levels between groups. RESULTS At 24 h, and more remarkably at 48 h, a significant decrease in cell viability occurred for the 3D-printed materials compared to the untreated IHGKs, but also compared to Grandio disc and Luxatemp. Except for the expression of IL-8 in presence of the eluate of Grandio disc at 24 and 48 h, all tested materials caused attenuation of IL-6 and 8 from IHGKs for any observation period. CONCLUSIONS The materials for additive manufacturing affect cell proliferation differently than the subtractive manufactured material Grandio disc and the conventional material Luxatemp. CLINICAL SIGNIFICANCE In comparison to conventional and subtractive manufactured restorations, 3D printed temporary restorations might induce more negative effects on the gingival and probably also on pulpal health since viability and the proinflammatory response of oral keratinocytes are more intensively affected by these materials.
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Affiliation(s)
- Iris Frasheri
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Aumer
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Andreas Keßler
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Nicolai Miosge
- Tissue Regeneration Work Group, Department of Prosthodontics, Medical Faculty, Georg-August-University, Göttingen, Germany
| | - Matthias Folwaczny
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
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15
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Soto-Montero J, de Castro EF, Romano BDC, Nima G, Shimokawa CAK, Giannini M. Color alterations, flexural strength, and microhardness of 3D printed resins for fixed provisional restoration using different post-curing times. Dent Mater 2022; 38:1271-1282. [PMID: 35717230 DOI: 10.1016/j.dental.2022.06.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the effect of post-curing times on the color change, flexural strength (FS), modulus (FM) and microhardness at different depths of four 3D printed resins. MATERIALS AND METHODS A characterization of the light emitted by 3D-resin post-curing unit (Wash and Cure 2.0, Anycubic) was performed. The tested 3D printed resins were Cosmos Temp3D (COS), SmartPrint BioTemp (SM) Resilab3D Temp (RES) and Prizma3D BioProv (PRI) were evaluated under five different post-curing conditions (no post-curing or 5-, 10-, 15, and 20 min of post-curing). For color change analysis, 10 mm diameter x 1 mm thick discs (n = 7) were printed, and the luminosity, color and translucency were measured before post-curing as control, and repeatedly after 5 min cycles of post-curing until a total of 20 min was reached for ΔE00 [CIED2000 (1:1:1)] calculation. For FS and FM, 25 × 2×2 mm (n = 10, for each post-curing time) 3D printed bars were subjected to a 3-point being test. Knoop microhardness (KHN) was measured transversally on 5 × 5×5 mm blocks (n = 10, for each post-curing time). Color results were analyzed by one-way repeated measures ANOVA (factor: color change). FS and FM were analyzed by two-way ANOVA (factors: Material*Post-Curing Time). KHN was analyzed individually for each material by two-way ANOVA (factors: Depth*Post-Curing Time). RESULTS The post-curing time significantly influenced the ΔE00, FS, FM and KHN of all the evaluated materials. COS and SMA presented ΔE00 values above the acceptability threshold after 5 and 10 min of post-curing, respectively. The FS of RES reached a plateau after 5 min of post-curing, and for PRI and SMA, the FS stabilized after 10 min of post-curing. The post-curing process improved the KHN of the tested materials, and longer exposure periods were associated to higher KHN values at all the evaluated depths. SIGNIFICANCE A fine adjustment of the post-curing time is crucial to produce adequate mechanical properties in 3D-printed restorative resins, while minimizing the color alterations on the restorations. For the evaluated resins, 5-10 min of post-curing will result in adequate mechanical properties, without affecting the acceptability in the color of the material. However, the results are material-dependent, and evaluation of each specific resin is advised.
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Affiliation(s)
- Jorge Soto-Montero
- Department of Restorative Dentistry, School of Dentistry, Universidad de Costa Rica, Montes de Oca, SJ, Costa Rica.
| | - Eduardo F de Castro
- Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Beatriz de C Romano
- Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Gabriel Nima
- School of Dentistry, Universidad Científica del Sur, Lima, Perú
| | - Carlos A K Shimokawa
- Department of Restorative Dentistry, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcelo Giannini
- Department of Restorative Dentistry, Operative Dentistry Division, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
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Burkhardt F, Spies BC, Wesemann C, Schirmeister CG, Licht EH, Beuer F, Steinberg T, Pieralli S. Cytotoxicity of polymers intended for the extrusion-based additive manufacturing of surgical guides. Sci Rep 2022; 12:7391. [PMID: 35513701 PMCID: PMC9072356 DOI: 10.1038/s41598-022-11426-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 04/19/2022] [Indexed: 11/09/2022] Open
Abstract
Extrusion-based printing enables simplified and economic manufacturing of surgical guides for oral implant placement. Therefore, the cytotoxicity of a biocopolyester (BE) and a polypropylene (PP), intended for the fused filament fabrication of surgical guides was evaluated. For comparison, a medically certified resin based on methacrylic esters (ME) was printed by stereolithography (n = 18 each group). Human gingival keratinocytes (HGK) were exposed to eluates of the tested materials and an impedance measurement and a tetrazolium assay (MTT) were performed. Modulations in gene expression were analyzed by quantitative PCR. One-way ANOVA with post-hoc Tukey tests were applied. None of the materials exceeded the threshold for cytotoxicity (< 70% viability in MTT) according to ISO 10993-5:2009. The impedance-based cell indices for PP and BE, reflecting cell proliferation, showed little deviations from the control, while ME caused a reduction of up to 45% after 72 h. PCR analysis after 72 h revealed only marginal modulations caused by BE while PP induced a down-regulation of genes encoding for inflammation and apoptosis (p < 0.05). In contrast, the 72 h ME eluate caused an up-regulation of these genes (p < 0.01). All evaluated materials can be considered biocompatible in vitro for short-term application. However, long-term contact to ME might induce (pro-)apoptotic/(pro-)inflammatory responses in HGK.
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Affiliation(s)
- Felix Burkhardt
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.
| | - Benedikt C Spies
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Christian Wesemann
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany.,Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Assmanshauser Str. 4-6, 14197, Berlin, Germany
| | - Carl G Schirmeister
- Freiburg Materials Research Center FMF and Institute for Macromolecular Chemistry, Albert-Ludwigs-University Freiburg, Stefan-Meier-Str. 21, 79104, Freiburg, Germany.,Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt, Germany
| | - Erik H Licht
- Basell Sales & Marketing B.V., LyondellBasell Industries, Industriepark Höchst, 65926, Frankfurt, Germany
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité -Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin and Berlin Institute of Health, Assmanshauser Str. 4-6, 14197, Berlin, Germany
| | - Thorsten Steinberg
- Division of Oral Biotechnology, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Stefano Pieralli
- Department of Prosthetic Dentistry, Faculty of Medicine, Medical Center, Center for Dental Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
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17
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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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18
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Hampe T, Wiessner A, Frauendorf H, Alhussein M, Karlovsky P, Bürgers R, Krohn S. Monomer Release from Dental Resins: The Current Status on Study Setup, Detection and Quantification for In Vitro Testing. Polymers (Basel) 2022; 14:polym14091790. [PMID: 35566958 PMCID: PMC9100225 DOI: 10.3390/polym14091790] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/23/2022] [Accepted: 04/25/2022] [Indexed: 02/04/2023] Open
Abstract
Improvements in mechanical properties and a shift of focus towards esthetic dentistry led to the application of dental resins in various areas of dentistry. However, dental resins are not inert in the oral environment and may release monomers and other substances such as Bisphenol-A (BPA) due to incomplete polymerization and intraoral degradation. Current research shows that various monomers present cytotoxic, genotoxic, proinflammatory, and even mutagenic effects. Of these eluting substances, the elution of BPA in the oral environment is of particular interest due to its role as an endocrine disruptor. For this reason, the release of residual monomers and especially BPA from dental resins has been a cause for public concern. The assessment of patient exposure and potential health risks of dental monomers require a reliable experimental and analytical setup. However, the heterogeneous study design applied in current research hinders biocompatibility testing by impeding comparative analysis of different studies and transfer to the clinical situation. Therefore, this review aims to provide information on each step of a robust experimental and analytical in vitro setup that allows the collection of clinically relevant data and future meta-analytical evaluations.
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Affiliation(s)
- Tristan Hampe
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.W.); (R.B.); (S.K.)
- Correspondence:
| | - Andreas Wiessner
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.W.); (R.B.); (S.K.)
| | - Holm Frauendorf
- Institute for Organic and Biomolecular Chemistry, University of Göttingen, 37077 Göttingen, Germany;
| | - Mohammad Alhussein
- Molecular Phytopathology and Mycotoxin Research, University of Göttingen, 37077 Göttingen, Germany; (M.A.); (P.K.)
| | - Petr Karlovsky
- Molecular Phytopathology and Mycotoxin Research, University of Göttingen, 37077 Göttingen, Germany; (M.A.); (P.K.)
| | - Ralf Bürgers
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.W.); (R.B.); (S.K.)
| | - Sebastian Krohn
- Department of Prosthodontics, University Medical Center Göttingen, 37075 Göttingen, Germany; (A.W.); (R.B.); (S.K.)
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19
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Zoabi A, Redenski I, Oren D, Kasem A, Zigron A, Daoud S, Moskovich L, Kablan F, Srouji S. 3D Printing and Virtual Surgical Planning in Oral and Maxillofacial Surgery. J Clin Med 2022; 11:jcm11092385. [PMID: 35566511 PMCID: PMC9104292 DOI: 10.3390/jcm11092385] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023] Open
Abstract
Compared to traditional manufacturing methods, additive manufacturing and 3D printing stand out in their ability to rapidly fabricate complex structures and precise geometries. The growing need for products with different designs, purposes and materials led to the development of 3D printing, serving as a driving force for the 4th industrial revolution and digitization of manufacturing. 3D printing has had a global impact on healthcare, with patient-customized implants now replacing generic implantable medical devices. This revolution has had a particularly significant impact on oral and maxillofacial surgery, where surgeons rely on precision medicine in everyday practice. Trauma, orthognathic surgery and total joint replacement therapy represent several examples of treatments improved by 3D technologies. The widespread and rapid implementation of 3D technologies in clinical settings has led to the development of point-of-care treatment facilities with in-house infrastructure, enabling surgical teams to participate in the 3D design and manufacturing of devices. 3D technologies have had a tremendous impact on clinical outcomes and on the way clinicians approach treatment planning. The current review offers our perspective on the implementation of 3D-based technologies in the field of oral and maxillofacial surgery, while indicating major clinical applications. Moreover, the current report outlines the 3D printing point-of-care concept in the field of oral and maxillofacial surgery.
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Affiliation(s)
- Adeeb Zoabi
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Idan Redenski
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Daniel Oren
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Adi Kasem
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Asaf Zigron
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Shadi Daoud
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Liad Moskovich
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Fares Kablan
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
| | - Samer Srouji
- Department of Oral and Maxillofacial Surgery, Galilee College of Dental Sciences, Galilee Medical Center, Nahariya 2210001, Israel; (A.Z.); (I.R.); (D.O.); (A.K.); (A.Z.); (S.D.); (L.M.); (F.K.)
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed 1311502, Israel
- Correspondence:
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20
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Francisco I, Paula AB, Ribeiro M, Marques F, Travassos R, Nunes C, Pereira F, Marto CM, Carrilho E, Vale F. The Biological Effects of 3D Resins Used in Orthodontics: A Systematic Review. Bioengineering (Basel) 2022; 9:bioengineering9010015. [PMID: 35049724 PMCID: PMC8773237 DOI: 10.3390/bioengineering9010015] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/27/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022] Open
Abstract
Three-dimensional (3D) resin medical-dental devices have been increasingly used in recent years after the emergence of digital technologies. In Orthodontics, therapies with aligners have gained popularity, mainly due to the aggressive promotion policies developed by the industry. However, their systemic effects are largely unknown, with few studies evaluating the systemic toxicity of these materials. The release of bisphenol A and other residual monomers have cytotoxic, genotoxic, and estrogenic effects. This systematic review aims to analyze the release of toxic substances from 3D resins used in Orthodontics and their toxic systemic effects systematically. The PICO question asked was, "Does the use of 3D resins in orthodontic devices induce cytotoxic effects or changes in estrogen levels?". The search was carried out in several databases and according to PRISMA guidelines. In vitro, in vivo, and clinical studies were included. The in vitro studies' risk of bias was assessed using the guidelines for the reporting of pre-clinical studies on dental materials by Faggion Jr. For the in vivo studies, the SYRCLE risk of bias tool was used, and for the clinical studies, the Cochrane tool. A total of 400 articles retrieved from the databases were initially scrutinized. Fourteen articles were included for qualitative analysis. The risk of bias was considered medium to high. Cytotoxic effects or estrogen levels cannot be confirmed based on the limited preliminary evidence given by in vitro studies. Evidence of the release of bisphenol A and other monomers from 3D resin devices, either in vitro or clinical studies, remains ambiguous. The few robust results in the current literature demonstrate the absolute need for further studies, especially given the possible implications for the young patient's fertility, which constitutes one of the largest groups of patients using these orthodontic devices.
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Affiliation(s)
- Inês Francisco
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
- Correspondence:
| | - Anabela Baptista Paula
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, 3004-531 Coimbra, Portugal; (C.M.M.); (E.C.)
- Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal
| | - Madalena Ribeiro
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Filipa Marques
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Raquel Travassos
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Catarina Nunes
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Flávia Pereira
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
| | - Carlos Miguel Marto
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, 3004-531 Coimbra, Portugal; (C.M.M.); (E.C.)
- Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal
- Faculty of Medicine, Institute of Experimental Pathology, University of Coimbra, 3004-531 Coimbra, Portugal
| | - Eunice Carrilho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, 3004-531 Coimbra, Portugal; (C.M.M.); (E.C.)
- Faculty of Medicine, Area of Environment Genetics and Oncobiology (CIMAGO), Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, 3004-531 Coimbra, Portugal
- Centre for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3004-531 Coimbra, Portugal
- Clinical Academic Center of Coimbra (CACC), 3004-531 Coimbra, Portugal
| | - Francisco Vale
- Faculty of Medicine, Institute of Orthodontics, University of Coimbra, 3004-531 Coimbra, Portugal; (A.B.P.); (M.R.); (F.M.); (R.T.); (C.N.); (F.P.); (F.V.)
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21
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Wegmüller L, Halbeisen F, Sharma N, Kühl S, Thieringer FM. Consumer vs. High-End 3D Printers for Guided Implant Surgery-An In Vitro Accuracy Assessment Study of Different 3D Printing Technologies. J Clin Med 2021; 10:jcm10214894. [PMID: 34768413 PMCID: PMC8584299 DOI: 10.3390/jcm10214894] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/10/2021] [Accepted: 10/23/2021] [Indexed: 01/10/2023] Open
Abstract
This study evaluates the accuracy of drill guides fabricated in medical-grade, biocompatible materials for static, computer-aided implant surgery (sCAIS). The virtually planned drill guides of ten completed patient cases were printed (n = 40) using professional (Material Jetting (MJ)) and consumer-level three-dimensional (3D) printing technologies, namely, Stereolithography (SLA), Fused Filament Fabrication (FFF), and Digital Light Processing (DLP). After printing and post-processing, the drill guides were digitized using an optical scanner. Subsequently, the drill guide's original (reference) data and the surface scans of the digitized 3D-printed drill guide were superimposed to evaluate their incongruencies. The accuracy of the 3D-printed drill guides was calculated by determining the root mean square (RMS) values. Additionally, cast models of the planned cases were used to check that the drill guides fitted manually. The RMS (mean ± SD) values for the accuracy of 3D-printed drill guides were-MJ (0.09 ± 0.01 mm), SLA (0.12 ± 0.02 mm), FFF (0.18 ± 0.04 mm), and DLP (0.25 ± 0.05 mm). Upon a subjective assessment, all drill guides could be mounted on the cast models without hindrance. The results revealed statistically significant differences (p < 0.01) in all except the MJ- and SLA-printed drill guides. Although the measured differences in accuracy were statistically significant, the deviations were negligible from a clinical point of view. Within the limits of this study, we conclude that consumer-level 3D printers can produce surgical guides with a similar accuracy to a high-end, professional 3D printer with reduced costs.
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Affiliation(s)
- Lukas Wegmüller
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland; (L.W.); (N.S.)
| | - Florian Halbeisen
- Basel Institute for Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, University of Basel, 4031 Basel, Switzerland;
| | - Neha Sharma
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland; (L.W.); (N.S.)
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, 4058 Basel, Switzerland;
| | - Florian M. Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, 4123 Allschwil, Switzerland; (L.W.); (N.S.)
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, 4031 Basel, Switzerland
- Correspondence:
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22
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Bieger V, Thieringer FM, Fischer J, Rohr N. Fibroblast behavior on conventionally processed, milled, and printed occlusal device materials with different surface treatments. J Prosthet Dent 2021:S0022-3913(21)00461-3. [PMID: 34598769 DOI: 10.1016/j.prosdent.2021.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022]
Abstract
STATEMENT OF PROBLEM Occlusal devices can be either conventionally processed, milled, or printed. However, little is known about the biocompatibility of 3D printing resin materials. PURPOSE The purpose of this in vitro study was to compare the viability and morphology of human gingival fibroblast cells (HFG-1) after cultivation on conventionally processed, milled, and printed occlusal device materials with different surface treatments. MATERIAL AND METHODS Disks of a conventionally processed (PalaXpress Clear [pP]), milled (Yamahachi PMMA Clear [sY]), and 2 different printed materials (Dental LT Clear Resin [aD]; Freeprint splint [aF]) were prepared. The surfaces of the specimens were finished by using 2 different treatments (unpolished and polished with P1200-grit silicon carbide paper). HGF-1 cells were cultivated on the specimens for 24 hours, and a viability assay was performed by using polystyrene disks as a control (n=9 disks per group). Cell morphology and the topography of the specimens were examined with scanning electron microscopy (n=3 disks per group). Two-way analysis of variance was applied to determine the effect of material and surface treatment followed by the post hoc Fisher least significant difference test (α=.05). RESULTS Overall, material (P<.001) and surface treatment (P<.001) significantly influenced the viability of HGF-1 cells. The viability of cells on all specimens displayed mean values between 0.85 and 1.01 compared with the control except for unpolished aD (0.00 ±0.07) and aF (0.02 ±0.05) that had only a few cells with a round shape. CONCLUSIONS The behavior of HGF-1 cells on conventionally processed and milled specimens was similar and not dependent on the surface treatment. Unpolished printed specimens had a cytotoxic effect. However, after polishing, cell behavior was similar to that of the conventionally processed and milled specimens.
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Affiliation(s)
- Vivien Bieger
- Postgraduate student, Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, Basel, Switzerland
| | - Florian M Thieringer
- Assistant Professor, Senior consultant Oral and Cranio-Maxillofacial Surgery / Co-director 3D Print Lab, University Hospital Basel, Basel, Switzerland; and Head of Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland
| | - Jens Fischer
- Professor emeritus, Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, Basel, Switzerland
| | - Nadja Rohr
- Assistant Professor, Head of Biomaterials and Technology, Department of Reconstructive Dentistry, University Center for Dental Medicine Basel, Basel, Switzerland.
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23
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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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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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Elution behavior of a 3D-printed, milled and conventional resin-based occlusal splint material. Dent Mater 2021; 37:701-710. [PMID: 33648744 DOI: 10.1016/j.dental.2021.01.024] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 12/12/2020] [Accepted: 01/20/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The elution of unpolymerized (co-)monomers and additives from methacrylic resin-based materials like polymethyl methacrylate (PMMA) can cause adverse side effects, such as mutagenicity, teratogenicity, genotoxicity, cytotoxicity and estrogenic activity. The aim of this study was to quantify the release and the cytotoxicity of residual (co-)monomers and additives from PMMA-based splint materials under consideration of real splint sizes. Three different materials used for additive (3D printing), subtractive (milling) and conventional (powder and liquid) manufacturing were examined. METHODS The splint materials SHERAprint-ortho plus (additive), SHERAeco-disc PM20 (subtractive) and SHERAORTHOMER (conventional) were analysed. 16 (n = 4) sample discs of each material (6 mm diameter and 2 mm height) were polished on the circular and one cross-section area and then eluted in both distilled water and methanol. The discs were incubated at 37 °C for 24 h or 72 h and subsequently analysed by gas chromatography/mass spectrometry (GC/MS) for specifying and quantifying released compounds. XTT-based cell viability assays with human gingival fibroblasts (HGFs) were performed for Tetrahydrofurfuryl methacrylate (THFMA), 1,4-Butylene glycol dimethacrylate (BDDMA) and Tripropylenglycol diacrylate (TPGDA). In order to project the disc size to actual splint sizes in a worst-case scenario, lower and upper jaw occlusal splints were designed and volumes and surfaces were measured. RESULTS For SHERAeco-disc PM20 and for SHERAORTHOMER no elution was determined in water. SHERAprint-ortho plus eluted the highest THFMA concentration of 7.47 μmol/l ±2,77 μmol/l after 72 h in water. Six (co-)monomers and five additives were detected in the methanol eluates of all three materials tested. The XTT-based cell viability assays resulted in a EC50 of 3006 ± 408 μmol/l for THFMA, 2569.5 ± 308 μmol/l for BDDMA and 596.7 ± 88 μmol/l for TPGDA. SIGNIFICANCE With the solvent methanol, released components from the investigated splint materials exceeded cytotoxic concentrations in HGFs calculated for a worst-case scenario in splint size. In the water eluates only the methacrylate THFMA could be determined from SHERAprint-ortho plus in concentrations below cytotoxic levels in HGFs.
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