Repairability of a 3D printed denture base polymer: Effects of surface treatment and artificial aging on the shear bond strength

Shear bond strength of orthodontic brackets bonded with primer-incorporated orthodontic adhesives and unpolymerized 3-dimensional printing materials on 3-dimensional-printed crowns

INTRODUCTION

The use of 3-dimensional (3D) printing techniques in fabricating crowns has increased the demand for bracket bonding onto these surfaces. The objective was to evaluate the shear bond strength (SBS) of orthodontic brackets bonded onto 3D-printed crowns using primer-incorporated orthodontic adhesives and 3D printing materials as orthodontic adhesives.

METHODS

A total of 160 crowns were printed with two 3D printing materials, DentaTOOTH (Asiga, Sydney, Australia) (group A) and NextDent C&B Micro Filled Hybrid (3D Systems, Soesterberg, Netherlands) (group N). Each group was randomly divided into 4 adhesive subgroups (n = 20): Transbond XT (for groups A [ATX] and N [NTX]; 3M Unitek, Monrovia, Calif), Ortho Connect (for groups A [AOC] and N [NOC]; GC Corporation., Tokyo, Japan), Orthomite LC (for groups A [AOM] and N [NOM]; Sun Medical, Co Ltd, Moriyama, Shiga, Japan), and unpolymerized liquid state of 3D printing resin (for groups A [AA] and N [NN]). SBS was measured with a universal testing machine at a crosshead speed of 0.5 mm/min. The adhesive remnant index and the mode of failure were analyzed under the microscope. Statistical analysis was performed at a significance level of α = 0.05.

RESULTS

When used as adhesives (AA and NN), 3D printing materials showed no statistically significant difference in SBS compared with Transbond XT (ATX and NTX, respectively). In group N, NN showed a significantly higher SBS than primer-incorporated orthodontic adhesives (NOC and NOM; P <0.001). Adhesive failures were only observed in primer-incorporated orthodontic adhesives (AOC, NOC, AOM, and NOM).

CONCLUSIONS

Primer-incorporated orthodontic adhesives, as well as unpolymerized 3D printing materials employed as orthodontic adhesives on 3D-printed crowns, exhibited comparable bonding strength to Transbond XT without surface modification. Despite variations in adhesive-related factors, all measurements stayed within clinically acceptable ranges, highlighting the potential of these materials for orthodontic bonding on 3D-printed crowns, simplifying clinical procedures without compromising bond strength.

Shear bond strength of ultraviolet-polymerized resin to 3D-printed denture materials: Effects of post-polymerization, surface treatments, and thermocycling

PURPOSE

The purpose of this study is to compare the shear bond strength of ultraviolet (UV)-polymerized resin to 3D-printed denture materials, both with and without post-polymerization. Moreover, the effects of surface treatment and thermocycling on shear bond strength after post-polymerization were investigated.

METHODS

Cylindrical 3D-printed denture bases and teeth specimens were prepared. The specimens are subjected to two tests. For Test 1, the specimens were bonded without any surface treatment or thermal stress for comparison with and without post-polymerization. In Test 2, specimens underwent five surface treatments: untreated (CON), ethyl acetate (EA), airborne particle abrasion (APA) with 50 μm (50-APA) and 110 μm alumina (110-APA), and tribochemical silica coating (TSC). A UV-polymerized resin was used for bonding. Half of the Test 2 specimens were thermocycled for 10,000 cycles. Shear bond strength was measured and analyzed using Kruskal-Wallis and Steel-Dwass tests (n = 8).

RESULTS

In Test 1, post-polymerization significantly reduced shear bond strength of both 3D-printed denture materials (P < 0.05). No notable difference was observed between the denture teeth and the bases (P > 0.05). In Test 2, before thermocycling, the CON and EA groups exhibited low bond strengths, while the 50-APA, 110-APA, and TSC groups exhibited higher bond strengths. Thermocycling did not reduce bond strength in the latter groups, but significantly reduced bond strength in the EA group (P < 0.001).

CONCLUSIONS

Post-polymerization can significantly reduce the shear bond strength of 3D-printed denture materials. Surface treatments, particularly APA and TSC, maintained bond strength even after thermocycling.

Effect of various surface treatments on relining bond strength of CAD-CAM denture base materials

PURPOSE

The aim of this study was to analyze the impact of various surface treatments and production methods on the shear bond strength (SBS) between reline material and denture base resins.

MATERIALS AND METHODS

One-hundred-twenty specimens were produced using conventional heat-polymerization, subtractive, and additive techniques. Each group consisted of 40 specimens. The specimens were divided into four subgroups, each with 10 samples, for surface treatments. These subgroups were: (1) Control-only monomer application, (2) 50 μm airborne-particle abrasion, (3) 110 μm airborne-particle abrasion, and (4) Roughening with tungsten carbide bur. Representative specimens from each subgroup were examined under SEM. Then, auto-polymerized resin was condensed in the center of the specimens. Specimens were subjected to thermal aging (5000 cycles at 5-55°C). The SBS test was conducted and failure loads were recorded. The data were evaluated by two-way ANOVA and Tukey pairwise multiple comparisons method (p < 0.05).

RESULTS

The additively produced group showed significantly lower SBS than conventional and subtractive groups (p < 0.001), with no significant differences between the subtractive and conventional groups. Specimens that underwent monomer application only showed the lowest SBS among surface treatments, while 50 μm airborne-particle abrasion showed the highest SBS. Based on the partial eta-squared analysis results, the surface treatment mainly impacted SBS.

CONCLUSIONS

Among the surface treatment methods, treating denture bases with 50 μm airborne-particle abrasion is more effective for maintaining adhesion, especially in the additive technique.

Effect of repair and surface treatments on the strength of digitally fabricated resin-based dental prostheses: A systematic review of in vitro studies

OBJECTIVE

This review investigated the current literature pertaining to the repairability of computer-aided design-computer-aided manufacturing (CAD-CAM) milled and three-dimensional (3D) printed resin-based dental prostheses (RBDPs) as well as the appropriate surface treatment for each repair material that will produce adequate repair bond strength.

DATA/SOURCES

PubMed, Web of Science, and Scopus databases were searched for published articles involving repair of CAD-CAM RBDPs between January 2010 and June 2023. Data were collected and analyzed to reveal the surface treatment effects, suggested repair materials, and strength of repaired RBDPs.

STUDY SELECTION

Out of 164 retrieved titles, 11 studies were included, of which five investigated the repair of 3D-printed RBDPs, three investigated the repair of CAD-CAM milled resins, and three investigated both materials. Additionally, of the included studies, seven investigated denture base resins, three studied provisional restoration resins, and one evaluated 3D-printed intraoral splints. Various surface treatments were suggested, with air-abrasive methods being the most commonly used. Different materials for resin repair were proposed and used, including auto-polymerized, reline, and composite resins. For 3D-printed resins, repair with Bis-acrylic/Bis-GMA composites improved repair strength.

CONCLUSION

Surface treatments positively affected the repair strength of conventional and milled RBDPs. However, challenges remain relevant to the repair of 3D-printed resins owing to composition mismatches and fabrication techniques. Therefore, further investigation is required to develop new 3D-printed resins.

CLINICAL SIGNIFICANCE

CAD-CAM milled resins have satisfactory repair strength, which increases with surface treatment. The repair of 3D-printed resins has proven challenging even with surface treatments. However, composite resins are the materials of choice.

Fracture toughness, work of fracture, flexural strength and elastic modulus of 3D-printed denture base resins in two measurement environments after artificial aging

OBJECTIVES

To investigate the fracture toughness (KIC), work of fracture (WOF), flexural strength (FS) and elastic modulus (E) of four additively manufactured denture base resins in two different measurement environments after artificial aging.

METHODS

Rectangular specimens in two different dimensions (n = 480) were 3D-printed with four denture base resins: Denture 3D+ (DEN; NextDent), Fotodent Denture (FOT; Dreve ProDiMed), Freeprint Denture (FRE; Detax), V-Print dentbase (VPR; VOCO)). KIC, WOF, FS and E were measured after (1) water-storage (37 °C; KIC = 7 d; FS = 50 h); (2) water-storage + hydrothermal-aging (20 min, 0.2 MPa, 134 °C); (3) water storage + thermocycling (10,000 cycles, 5/55 °C) in two measurement environments (i) air-23 °C and (ii) water-37 °C. For FS, fracture types were classified, and relative frequencies determined. Univariate ANOVA, Kruskal-Wallis, Mann-Whitney U, and Spearman's correlation were calculated (p < 0.05, SPSS V.27.0). Weibull modulus (m) was calculated using the maximum likelihood estimation method.

RESULTS

DEN showed the highest KIC (5/6 groups), WOF and highest corresponding m (1/6 groups), while FRE presented the highest FS (2/6 groups) and E values. Hydrothermal-aging and thermocycling reduced KIC and WOF, FS and E, and the number of FS fracture pieces. For 6/8 groups, hydrothermal aging resulted in lower FS than thermocycling. Measurement in air-23 °C led to higher FS for 7/12 groups and a more brittle fracture behavior. A positive correlation between KIC and FS was observed.

SIGNIFICANCE

With measurements in air-23 °C resulting in higher FS than reported in water-37 °C, the measurement environment should be adapted to the clinical situation to allow valid predictions on the mechanical behavior of denture base resins when in situ.

Influence of hydrothermal aging on the shear bond strength of 3D printed denture-base resin to different relining materials

OBJECTIVES

This study evaluated the repairability of three-dimensional printed (3DP) denture bases based on different conventional relining materials and aging.

MATERIAL AND METHODS

The groups for surface characterization (surface-roughness and contact-angle measurements) were divided based on the denture base and surface treatment. Shear bond strength test and failure-mode analysis were conducted by a combination of three variables: denture base, relining materials, and hydrothermal aging (HA). The initial characterization involved quantifying the surface roughness (n = 10) and contact angle (n = 10) of denture base specimens with and without sandblasting (SB) treatment. Four relining materials (Kooliner [K], Vertex Self-Curing [V], Tokuyama Rebase II (Normal) [T], and Ufi Gel Hard [U]) were applied to 3DP, heat-cured (HC), and self-cured (SC) denture-base resin specimens. Shear bond strength (n = 15) and failure-mode analyses (n = 15) were performed before and after HA, along with evaluations of the fractured surfaces (n = 4). Statistical analyses were performed using a two-way analysis of variance (ANOVA) for surface characterization, and a three-way ANOVA was conducted for shear bond strength.

RESULTS

The surface roughness peaked in HC groups and increased after SB. The 3DP group displayed significantly lower contact angles, which increased after treatment, similar to the surface roughness. The shear bond strength was significantly lower for 3DP and HC denture bases than for SC denture bases, and peaked for U at 10.65 ± 1.88 MPa (mean ± SD). HA decreased the shear bond strength relative to untreated samples. Furthermore, 3DP, HC, and SC mainly showed mixed or cohesive failures with V, T, and U. K, on the other hand, trended toward adhesive failures when bonded with HC and SC.

CONCLUSION

This study has validated the repairability of 3DP dentures through relining them with common materials used in clinical practice. The repairability of the 3DP denture base was on par with that of conventional materials, but it decreased after aging. Notably, U, which had a postadhesive application, proved to be the most effective material for repairing 3DP dentures.

The effect of various surface treatments on the repair bond strength of denture bases produced by digital and conventional methods

There is limited information on the repairability of prostheses produced with digital technology. This study aims to evaluate various surface treatments on flexural bond strength of repaired dentured base resins produced by digital and conventional methods. A total of 360 samples were prepared from one heat-polymerized, one CAD/CAM milled and one 3D printed denture base materials. All of the test samples were subjected to thermocycling (5-55 °C, 5000 cycles) before and after repair with auto-polymerizing acrylic resin. The test samples were divided into five subgroups according to the surface treatment: grinding with silicon carbide (SC), sandblasting with Al2O3 (SB), Er:YAG laser (L), plasma (P) and negative control (NC) group (no treatment). In addition, the positive control (PC) group consisted of intact samples for the flexural strength test. Surface roughness measurements were performed with a profilometer. After repairing the test samples, a universal test device determined the flexural strength values. Both the surface topography and the fractured surfaces of samples were examined by SEM analysis. The elemental composition of the tested samples was analyzed by EDS. Kruskal-Wallis and Mann-Whitney U tests were performed for statistical analysis of data. SB and L surface treatments statistically significantly increased the surface roughness values of all three materials compared to NC subgroups (p < 0.001). The flexural strength values of the PC groups in all three test materials were significantly higher than those of the other groups (p < 0.001). The repair flexural strength values were statistically different between the SC-SB, L-SB, and NC-SB subgroups for the CAD/CAM groups, and the L-SC and L-NC subgroups for the 3D groups (p < 0.001). The surface treatments applied to the CAD/CAM and heat-polymerized groups did not result in a statistically significant difference in the repair flexural strength values compared to the NC groups (p > 0.05). Laser surface treatment has been the most powerful repair method for 3D printing technique. Surface treatments led to similar repair flexural strengths to untreated groups for CAD/CAM milled and heat-polymerized test samples.

Three-dimensionally printed denture base resins modified by nanoglass particles and carbon nanotubes

STATEMENT OF PROBLEM

Three-dimensionally (3D) printed denture base resins exhibit inferior mechanical properties compared with conventional and milled ones, a problem affecting their long-term clinical use. Improved 3D printed resins are required.

PURPOSE

The purpose of this in vitro study was to determine whether a 3D printed denture base resin with nanoglass particles and multiwalled carbon nanotubes (MWCNTs) would exhibit enhanced mechanical properties.

MATERIAL AND METHODS

The nanoglass particles and MWCNTs were silane coated and added to the resin to obtain the following groups: Control, resin modified with nanoglass particles with 2 percentages, 0.25 wt%, and 0.5 wt%; resin modified with MWCNTs with 2 percentages, 0.25 wt%, and 0.5 wt%; and a combination group with 0.25 wt% of each filler type. The printed specimens (N=330) were tested before and after thermocycling (600 cycles) for flexural strength (FS) and elastic modulus (n=22) by using a universal testing machine and for impact strength (IS) (n=22) by using a Charpy impact tester. The fractured impact specimens were then evaluated by using scanning electron microscopy (SEM). The surface roughness (Ra) (n=11) was assessed by using a profilometer. For data analysis, the 2-way ANOVA test was used for the analysis of FS, elastic modulus, and IS, and the 3-way ANOVA test was used for Ra with a subsequent Tukey post hoc test. Percentage change was compared among groups by using the Kruskal-Wallis test, followed by the Dunn post hoc test with Bonferroni correction (α=.05).

RESULTS

The filler content and thermocycling revealed a significant main interaction effect (P<.001) on FS, elastic modulus, and IS, with the 0.5% nanoglass group displaying the highest percentage decrease after thermocycling. The SEM images of fractured impact specimens revealed a brittle failure in the control and nanoglass groups. In contrast, the groups containing MWCNTs and the combination group displayed intermediate to ductile failure. Moreover, a significant inclusive interaction effect (P<.001) was found between the filler content, thermocycling, and polishing on surface roughness, with the 0.5% nanoglass group revealing the highest percentage increase in Ra of the polished surface after aging.

CONCLUSIONS

The addition of nanoglass and MWCNTs led to a significant improvement in the FS, elastic modulus, and IS of the 3D printed resin. The combination group displayed the least percentage change among all groups regarding the FS and IS, displaying intermediate to ductile failure. The control revealed the least percentage change in elastic modulus after thermocycling but with lower peak values compared with all other groups.

Effects of layer thickness and build angle on the microbial adhesion of denture base polymers manufactured by digital light processing

PURPOSE

To investigate the effects of printing-layer thickness and build angle on the surface characteristics and microbial adhesion of denture base polymers manufactured by digital light processing (DLP).

METHODS

Specimens were additively manufactured using DLP. The specimens were printed with different printing-layer thicknesses (25, 50, and 100 μm) and build angles (0°, 45°, and 90°). Scanning electron microscopy was used to observe the surface topography, and the arithmetical mean heights (Sa) were measured. Moreover, the initial Candida albicans (C. albicans) adhesion to the specimens was evaluated using an adhesion test. Finally, two-way ANOVA and Tukey's multiple comparison tests were conducted.

RESULTS

The results regarding the Sa values exhibited a statistically significant interaction (F (4, 45) = 90.77, P < 0.0001). The build angle has a significant impact on the surface topography. Furthermore, quantitative results revealed that the printing-layer thickness significantly affected C. albicans adhesion (F (2, 99) = 6.96, P = 0.0015).

CONCLUSIONS

The surface roughness was significantly affected by the printing-layer thickness and the build angle. Additionally, the surface topography was mainly determined by the build angle. Furthermore, the adhesion of C. albicans to the DLP-printed denture surfaces was significantly affected by the printing-layer thickness but not by the build angle. Consequently, it is critical to decrease the thickness of the printing layer to produce digital dentures with optimal material properties.

Effect of different surface treatments on the retention force of additively manufactured interim implant-supported crowns

PURPOSE

To compare the effect of different pre-cementation surface treatments and bonding protocols on the retention force of additively manufactured (AM) implant-supported interim crowns.

MATERIAL AND METHODS

A total of 50 AM interim crowns (Temporary CB resin) were cemented on implant abutments. Five groups (n = 10) were established based on the different surface pre-treatments performed in the intaglio surface of the specimens: no surface pre-treatment (Group C or control), air-abraded with 50-μm aluminium oxide particles (Group AP), air-abraded with 50-μm aluminium oxide particles followed by the application of silane (Group AMP), silane (Group MP), and air-abraded with 30 μm silica-coated aluminum oxide particles followed by the application of silane (Group CMP). Each specimen was cemented into an implant abutment using a composite resin cement (Rely X Unicem2). Afterward, the specimens underwent retention testing with a Universal Instron machine. Pull-off forces (N) and modes of failure were registered. Statistical analysis was performed using Mann-Whitney U tests with Bonferroni corrections for multiple tests (α = 0.05).

RESULTS

The median retention force values were 233.27 ±79.28 N for Group Control, 398.59 ±68.59 N for Group MP, 303.21 ±116.80 N for Group AMP, 349.31 ±167.73 N for Group CMP, and 219.85 ± 55.88 N for Group AP. The pull-off forces were significantly greater for Group MP, while the differences between the remaining groups were not statistically significant (P > 0.05). Group AP showed the lowest retention force values among all the groups. Failure modes after the pull-off testing were predominantly adhesive and substrate failure of the AM interim material.

CONCLUSIONS

The surface treatment of the intaglio AM crown tested significantly influenced the retention force values measured. Pre-treatment with an MDP-containing silane improved the retentive force values computed, whereas pre-treatment with 50-μm Al2 O3 air-particle abrasion alone is not recommended prior to cementation on a titanium-based implant abutment.

Influence of additive manufacturing method and build angle on the accuracy of 3D-printed palatal plates

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.

Water sorption, water solubility, degree of conversion, elastic indentation modulus, edge chipping resistance and flexural strength of 3D-printed denture base resins

OBJECTIVES

To investigate the water sorption (w_sp), water solubility (w_sl), degree of conversion (DC), elastic indentation modulus (E_IT), edge chipping resistance (ECR) and flexural strength (FS) of 3D-printed, milled and conventionally polymerized denture base resin materials.

METHODS

Specimens (N = 540) were 3D-printed (NextDent Denture 3D+ (DEN), Fotodent Denture (FOT), Freeprint Denture (FRE), V-Print dentbase (VPR)), cut (Ivotion Base (IVO)) and molded (PalaXpress (PAL)) in three geometries. W_sp,w_sl,DC, E_IT, ECR and FS were tested initially (24 h, 37 °C, H20) and after additional aging (5000 thermal cycles, 5/55 °C). Data were analyzed with Kolmogorov-Smirnov, univariate ANOVA, Kruskal-Wallis, Mann-Whitney U test and Spearman's correlation (p < 0.05) RESULTS: Most 3D-printed denture base resins showed higher w_sp (25.31-37.94 μg/mm³) and w_sl (0.08-8.27 μg/mm³), but also higher E_IT (3.11-4.09 GPa) and FS (60.81-99.57N/mm²) values than the control groups. DEN and VPR showed high DC (89.36-93.53%), E_IT (3.77-4.09 GPa) and FS (79.65-99.57N/mm²), while FOT showed low w_sp (25.31-27.35 μg/mm³) and w_sl (1.01-3.87 μg/mm³) values. In all materials, the examined parameters were affected by aging.

SIGNIFICANCE

Although 3D-printed denture base resins showed promising results with regard to the observed DC and FS, only FOT and FRE surpassed the threshold values defined by the ISO norms.

Repair Bond Strength of Conventionally and Digitally Fabricated Denture Base Resins to Auto-Polymerized Acrylic Resin: Surface Treatment Effects In Vitro

Denture base fracture is one of the most annoying problems for both prosthodontists and patients. Denture repair is considered to be an appropriate solution rather than fabricating a new denture. Digital denture fabrication is widely spreading nowadays. However, the repair strength of CAD-CAM milled and 3D-printed resins is lacking. This study aimed to evaluate the effect of surface treatment on the shear bond strength (SBS) of conventionally and digitally fabricated denture base resins. One l heat-polymerized (Major base20), two milled (IvoCad, AvaDent), and three 3D-printed (ASIGA, NextDent, FormLabs) denture base resins were used to fabricate 10 × 10 × 3.3 acrylic specimens (N = 180, 30/resin, n = 10). Specimens were divided into three groups according to surface treatment; no treatment (control), monomer application (MMA), or sandblasting (SB) surface treatments were performed. Repair resin was bonded to the resin surface followed by thermocycling (5000 cycles). SBS was tested using a universal testing machine where a load was applied at the resin interface (0.5 mm/min). Data were collected and analyzed using ANOVA and a post hoc Tukey test (α = 0.05). SEM was used for failure type and topography of fractured surfaces analysis. The heat-polymerized and CAD-CAM milled groups showed close SBS values without significance (p > 0.05), while the 3D-printed resin groups showed a significant decrease in SBS (p < 0.0001). SBS increased significantly with monomer application (p < 0.0001) except for the ASIGA and NextDent groups, which showed no significant difference compared to the control groups (p > 0.05). All materials with SB surface treatment showed a significant increase in SBS when compared with the controls and MMA application (p < 0.0001). Adhesive failure type was observed in the control groups, which dramatically changed to cohesive or mixed in groups with surface treatment. The SBS of 3D-printed resin was decreased when compared with the conventional and CAD-CAM milled resin. Regardless of the material type, SB and MMA applications increased the SBS of the repaired resin and SB showed high performance.

Adhesive Property of 3D-Printed PEEK Abutments: Effects of Surface Treatment and Temporary Crown Material on Shear Bond Strength

Three-dimensionally printed polyetheretherketone (PEEK) materials are promising for fabricating customized dental abutments. This study aimed to investigate the adhesive property of a 3D-printed PEEK material. The effects of surface treatment and temporary crown materials on shear bond strength were evaluated. A total of 108 PEEK discs were 3D printed by fused-filament fabrication. Surface treatments, including sandblasting, abrasive paper grinding, and CO2 laser ablation, were applied to the PEEK discs, with the untreated specimens set as the control. Afterward, the surface topographies of each group were investigated by scanning electron microscopy (SEM, n = 1) and roughness measurements (n = 7). After preparing the bonding specimens with three temporary crown materials (Artificial teeth resin (ATR), 3M™ Filtek™ Supreme Flowable Restorative (FR), and Cool Temp NATURAL (CTN)), the shear bond strength was measured (n = 6), and the failure modes were analyzed by microscopy and SEM. The results showed that ATR exhibited a significantly higher shear bond strength compared to FR and CTN (p < 0.01), and the PEEK surfaces treated by sandblasting and abrasive paper grinding showed a statistically higher shear bond strength compared to the control (p < 0.05). For clinical application, the ATR material and subtractive surface treatments are recommended for 3D-printed PEEK abutments.

Mechanical Properties Evaluation of Three Different Materials for Implant Supported Overdenture: An In-Vitro Study

Aim: the aim of this study was to compare the flexural strength and elastic modulus of three-dimensionally (3D) printed, conventional heat-cured, and high-impact implant-supported overdenture materials specimens. Materials and Methods: Thirty implant-supported overdenture materials specimens (bar-shaped, 65.0 × 10.2 × 5.1 ± 0.2 mm3) with one central hole were fabricated using 3D-printed, heat-cured conventional, and high-impact denture base resins (n = 10/group). Autopolymerizing acrylic resin was used to attach titanium matrix housings to the central holes of the specimens. A three-point bending test was conducted using a universal testing machine and a model analog with a crosshead speed of 5 mm/min. The indicative flexural strength and elastic modulus were recorded. Data were statistically analyzed using analysis of variance (ANOVA) and the Tukey tests at α = 0.05. Results: One-way ANOVA revealed a significant effect of denture base material on the flexural strength (p < 0.001) but not on the elastic modulus (p = 0.451) of the evaluated materials. The flexural strength of the 3D-printed specimens (95.99 ± 9.87 MPa) was significantly higher than the conventional (77.18 ± 9.69 MPa; p < 0.001) and high-impact ones (82.74 ± 7.73 MPa; p = 0.002). Conclusions: The maximum flexural strength was observed in the 3D-printed implant-supported overdenture material specimens, which might indicate their suitability as an alternative to the conventionally fabricated ones. Flexural strength and elastic modulus of conventional and high-impact heat-cured implant-supported overdenture materials specimens were comparable.

Effect of repair methods and materials on the flexural strength of 3D-printed denture base resin

PURPOSE

The aim of this study was to evaluate the flexural strength of a 3D-printed denture base resin (Cosmos Denture), after different immediate repair techniques with surface treatments and thermocycling.

MATERIALS AND METHODS

Rectangular 3D-printed denture base resin (Cosmos Denture) specimens (N = 130) were thermocycled (5,000 cycles, 5℃ and 55℃) before and after the different repair techniques (n = 10 per group) using an autopolymerized acrylic resin (Jet, J) or a hard relining resin (Soft Confort, SC), and different surface treatments: Jet resin monomer for 180 s (MMA), blasting with aluminum oxide (JAT) or erbium: yttrium-aluminum-garnet laser (L). The control group were intact specimens. A three-point flexural strength test was performed, and data (MPa) were analyzed by ANOVA and Games-Howell post hoc test (α = 0.05). Each failure was observed and classified through stereomicroscope images and the surface treatments were viewed by scanning electron microscope (SEM).

RESULTS

Control group showed the highest mean of flexural strength, statistically different from the other groups (P < .001), followed by MMA+J group. The groups with L treatment were statistically similar to the MMA groups (P > .05). The JAT+J group was better than the SC and JAT+SC groups (P < .05), but similar to the other groups (P > .05). Adhesive failures were most observed in JAT groups, especially when repaired with SC. The SEM images showed surface changes for all treatments, except JAT alone.

CONCLUSION

Denture bases fabricated with 3D-printed resin should be preferably repaired with MMA+J. SC and JAT+SC showed the worst results. Blasting impaired the adhesion of the SC resin.

Mechanical properties of 3D-printed prosthetic materials compared with milled and conventional processing: A systematic review and meta-analysis of in vitro studies

STATEMENT OF PROBLEM

Three-dimensional (3D) additive manufacturing (AM) is an evolving technology in dentistry, proposed as an alternative to subtractive milling manufacture (MM) or conventional processing. However, a systematic review of the use of AM technology instead of milling or conventional processing is lacking.

PURPOSE

The purpose of this systematic review and meta-analysis was to evaluate the mechanical properties of 3D-printed prosthetic materials compared with MM and conventional techniques.

MATERIAL AND METHODS

An electronic search of the literature was conducted on the MEDLINE (via PubMed), Scopus, and Web of Science databases. The inclusion criteria were in vitro studies published in the last 5 years, in English or Italian, and with 3D AM printed dental prosthetic materials. Data extraction was focused on dental prosthetic materials (ceramics, polymers, and metals) and their mechanical properties: flexural strength, fracture load, hardness, roughness, removable partial denture (RPD) fit accuracy, trueness, marginal discrepancy, and internal fit. Data considered homogenous were subjected to meta-analysis using the Stata17 statistical software program (95% confidence interval [CI]; α=.05). Since all variables were continuous, the Hedge g measure was calculated. A fixed-effects model was used for I2=0%, while the statistical analysis was conducted using a random-effects model with I2>0%.

RESULTS

From a total of 3624 articles, 2855 studies were selected, and 76 studies included after full-text reading. The roughness of AM-printed ceramics generally increased compared with that of conventional processing while the marginal discrepancy was comparable both for ceramics and polymers. The flexural strength, hardness, and fracture load of AM-printed polymers were statistically lower than those of the conventional group (P<.05). No significant difference was detected in terms of hardness, roughness, marginal discrepancy, fracture load, trueness, or internal fit between the AM and MM techniques (P>.05). Milling techniques showed significantly higher values of flexural strength (Hedge g=-3.88; 95% CI, -7.20 to -0.58; P=.02), also after aging (Hedge g=-3.29; 95% CI, -6.41 to -0.17; P=.04), compared with AM printing.

CONCLUSIONS

AM is comparable with MM in terms of mechanical properties, in particular with polymeric materials. The flexural strength of AM-printed prostheses is lower than with conventional and MM techniques, as are the parameters of hardness and fracture load, while the marginal discrepancy is similar to that of MM and conventional techniques. AM prostheses are commonly used for interim crowns and fixed partial dentures, as their rigidity and fracture resistance cannot support mastication forces for extended periods. More comparative studies are needed.

Effect of surface treatment on shear bond strength of relining material and 3D-printed denture base

PURPOSE

This study aimed to analyze the shear bond strength between the 3D-printed denture base and the chairside relining material, according to the surface treatment.

MATERIALS AND METHODS

Cylindrical specimens were prepared using DENTCA Denture Base II. The experimental groups were divided into 6 (n = 10): no surface treatment (C), Tokuyama Rebase II Normal adhesive (A), sandblasting (P), sandblasting and adhesive (PA), sandblasting and silane (PS), and the Rocatec system (PPS). After bonding the chairside relining material to the center of the specimens in a cylindrical shape, they were stored in distilled water for 24 hours. Shear bond strength was measured using a universal testing machine, and failure mode was analyzed with a scanning electron microscope. Shear bond strength values were analyzed using one-way analysis of variance, and Tukey’s honest significant difference test was used for post-hoc analysis (P < .05).

RESULTS

Group PPS exhibited significantly higher shear bond strength than all other groups. Groups P and PA displayed significantly higher bond strengths than the control group. There were no significant differences between groups PS and A compared to the control group. Regarding the failure mode, adhesive failure occurred primarily in groups C and A, and mixed failure mainly in groups P, PA, PS, and PPS.

CONCLUSION

The shear bond strength between the 3D-printed denture base and the chairside relining material exhibited significant differences according to the surface treatment methods. It is believed that excellent adhesive strength will be obtained when the Rocatec system is applied to 3D-printed dentures in clinical practice.

Rinsing postprocessing procedure of a 3D-printed orthodontic appliance material: Impact of alternative post-rinsing solutions on the roughness, flexural strength and cytotoxicity

OBJECTIVE

The present study evaluated the effect of different rinsing postprocessing solutions on surface characteristics, flexural strength, and cytotoxicity of an additive manufactured polymer for orthodontic appliances. These solutions have been deemed an alternative to the standard isopropanol which is a flammable liquid, known to have toxic effects.

METHODS

Tested specimens were manufactured using direct light processing of an orthodontic appliance polymer (FREEPRINT® splint 2.0, Detax) and post-processed with different post-rinsing solutions, including isopropanol (IPA), ethanol (EtOH), EASY 3D Cleaner (EYC), Yellow Magic7 (YM7), and RESINAWAY (RAY), respectively. All groups were post-cured following the manufacturer's instructions. Surface topography and roughness (Ra and Rv) were evaluated. In addition, flexural strength was measured by a three-point bending test. An extract test was performed to evaluate cytotoxicity. The data were analyzed by the Kruskal-Wallis test with Dunn's multiple comparisons test (p < 0.05).

RESULTS

Various post-rinsing solutions did not significantly affect the roughness values (Ra and Rv). Specimens post-processed with EtOH (98.1 ± 12.4 MPa) and EYC (101.1 ± 6.3 MPa) exhibited significantly lower flexural strength compared to the groups of IPA (110.7 ± 5.3 MPa), RAY (112.1 ± 5.6 MPa) and YM7 (117.3 ± 5.9 MPa), respectively. Finally, there were no cytotoxic effects of parts cleaned with different post-rinsing solutions.

SIGNIFICANCE

Considering the use of 3D-printed orthodontic appliance materials, different rinsing postprocessing procedures did not affect surface characteristics. However, the flexural strength was significantly influenced, which could be attributed to the chemical ingredients of the post-rinsing solutions. Various post-rinsing treatments had no alternation concerning cytocompatibility.

Effect of additive manufacturing method and build angle on surface characteristics and Candida albicans adhesion to 3D printed denture base polymers

OBJECTIVES

To investigate the influence of additive manufacturing method and build angle on surface characteristics and Candida albicans (C. albicans) adhesion to 3D printed denture base polymers.

METHODS

Specimens of 3D printing denture base polymers were prepared by two printers, namely, stereolithography (SLA, Form 3B) and digital light processing technology (DLP, Solflex 350 plus). Three build angles were used: 0°, 45°, and 90°. Surface topography was examined by scanning electron microscopy. Also, arithmetical mean height (S_a) values were calculated. An adhesion test was performed to observe initial C. albicans adhesion to the specimens. The data were statistically analyzed using the two-way analysis of variance and Tukey's multiple comparison test.

RESULTS

The data of S_a values had statistically significant differences, which were mainly determined by the main factor of build angle (p < 0.05). Moreover, the quantitative results of C. albicans adhesion exhibited no significant differences: printing techniques (p = 0.7794) and build angle (p = 0.0589), respectively.

CONCLUSIONS

Surface roughness was significantly influenced by the build angle rather than by the AM method. Whereas, AM method (SLA and DLP) and build angle (0°, 45°, and 90º) had no impacts on the C. albicans adhesion to the 3D printed denture bases.

CLINICAL SIGNIFICANCE

Build angle dominates the surface roughness and topography of the 3D printed denture polymers. Our results indicate that C. albicans' adhesion might not be influenced by AM method and build angle.

Postpolymerization of a 3D-printed denture base polymer: Impact of post-curing methods on surface characteristics, flexural strength, and cytotoxicity

OBJECTIVE

This study investigated the influence of postpolymerization of a three-dimensional (3D) printed denture base polymer. The effect of post-curing methods on surface characteristics, flexural strength, and cytotoxicity was evaluated.

METHODS

A total of 172 specimens were additively manufactured using one denture base material (V-Print dentbase, VOCO) and further post-cured by different light-curing devices, including Otoflash G171 (OF), Labolight DUO (LL), PCU LED (PCU), and LC-3DPrintbox (PB), respectively. Polymethyl methacrylate resin (PalaExpress Ultra) was used as a reference (REF). Afterward, surface topography was observed using scanning electron microscopy, and surface roughness was measured (n = 6). Furthermore, flexural strength was tested (n = 20). Cytotoxicity was evaluated by the extract and direct contact tests. The data were analyzed using the Kolmogorov-Smirnov test and one-way ANOVA followed by Tukey's multiple comparisons and Kruskal-Wallis tests (p < 0.05).

RESULTS

The different post-curing methods applied did not significantly influence surface topography and roughness (Ra). Meanwhile, specimens post-cured by PCU (162.3 ± 44.16 MPa) and PB (171.2 ± 34.41 MPa) showed significantly higher flexural strength than those post-cured by OF (131.3 ± 32.87 MPa) and REF (131.2 ± 19.19 MPa), respectively. Additionally, various post-curing methods effectively decreased the cytotoxic effects of 3D-printed denture base polymer.

CONCLUSIONS

Different post-curing methods did not significantly alter the Ra values of the 3D-printed denture base material. However, flexural strength was significantly affected by the postpolymerization methods, which might be attributed to the different wavelengths of post-curing devices. In addition, various postpolymerization methods reduced the cytotoxic effects of the 3D-printed denture base polymer.

CLINICAL SIGNIFICANCE

Flexural strength of additively manufactured denture bases depends on the postpolymerization strategy. Therefore, an appropriate post-curing method is required to optimize the flexural strength of 3D-printed denture materials.

Evaluation of Dimensional Changes According to Aging Period and Postcuring Time of 3D-Printed Denture Base Prostheses: An In Vitro Study

During the three-dimensional (3D) printing process of a dental prosthesis, using photopolymer resin, partially polymerized resin is further cured through the postcuring process that proceeds after the printing, which improves the stability of the printed product. The mechanical properties of the end product are known to be poor if the postcuring time is insufficient. Therefore, this study evaluated the effect of the postcuring time of the 3D-printed denture base on its dimensional stability, according to the aging period. The 3D prints were processed after designing maxillary and mandibular denture bases, and after the following postcuring times were applied: no postcuring, and 5, 15, 30, and 60 min. The dimensional stability change of the denture base was evaluated and analyzed for 28 days after the postcuring process. The trueness analysis indicated that the mandibular denture base had lower output accuracy than the maxillary denture base, and the dimensional stability change increased as postcuring progressed. In the no postcuring group for the mandible, the error value was 201.1 ± 5.5 µm (mean ± standard deviation) after 28 days, whereas it was 125.7 ± 13.0 µm in the 60 min postcuring group. For both the maxilla and the mandible, shorter postcuring times induced larger dimensional stability changes during the aging process. These findings indicate that in order to manufacture a denture base with dimensional stability, a sufficient postcuring process is required during the processing stage.

CAD-CAM removable complete dentures: A systematic review and meta-analysis of trueness of fit, biocompatibility, mechanical properties, surface characteristics, color stability, time-cost analysis, clinical and patient-reported outcomes

OBJECTIVES

This review compared Computer-aided designand Computer-aided manufactured (CAD-CAM) and conventionally constructed removable complete dentures (CDs).

DATA

Seventy-three studies reporting on CAD-CAM (milled/3D-printed) CDs were included in this review. The most recent literature search was performed on 15/03/2021.

SOURCES

Two investigators searched electronic databases [PubMed (MEDLINE), Embase, CENTRAL], online search engines (Google) and research portals. Hand searches were performed to identify literature not available online.

STUDY SELECTION

Studies on CAD-CAM CDs were included if they reported on trueness of fit, biocompatibility, mechanical, surface, chemical, color , microbiological properties, time-cost analysis, and clinical outcomes. Inter-investigator reliability was assessed using kappa scores. Meta-analyses were performed on the extracted data .

RESULTS

The kappa score ranged between 0.897-1.000. Meta-analyses revealed that 3D-printed CDs were more true than conventional CDs (p = 0.039). Milled CDs had a higher flexural-strength than conventional and 3D-printed CDs (p < 0.0001). Milled CDs had a higher flexural-modulus than 3D-printed CDs (p < 0.0001). Milled CDs had a higher yield-strength than injection-molded (p = 0.004), and 3D-printed CDs (p = 0.001). Milled CDs had superior toughness (p < 0.0001) and surface roughness characteristics (p < 0.0001) than other CDs . Rapidly-prototyped CDs displayed poor color-stability compared to other CDs (p = 0.029). CAD-CAM CDs d displayed better retention than conventional CDs (p = 0.015). Conventional CDs had a higher strain at yield point than milled CDs (p < 0.0001), and had superior esthetics than 3D-printed (p < 0.0001). Fabrication of CAD-CAM CDs required less chairside time (p = 0.037) and lower overall costs (p < 0.0001) than conventional CDs.

CONCLUSIONS

This systematic review concludes that CAD-CAM CDs offer a number of improved mechanical/surface properties and are not inferior when compared to conventional CDs.

CLINICAL SIGNIFICANCE

CAD-CAM CDs should be considered for completely edentulous patients whenever possible, since this technique offers numerous advantages including better retention, mechanical and surface properties but most importantly preserves a digital record. This can be a great advantage for older adults with limited access to dental care.

Bonding Interface and Repairability of 3D-Printed Intraoral Splints: Shear Bond Strength to Current Polymers, with and without Ageing

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.

Effect of thermocycling on the surface properties of CAD-CAM denture base materials after different surface treatments

PURPOSE

To evaluate the effect of thermocycling on the water contact angle (WCA), surface roughness (SR), and microhardness (MH) of different CAD-CAM PMMA denture base materials after different surface treatments (conventional laboratory polishing, polishing kit, or surface sealant).

MATERIALS AND METHODS

Disk-shaped specimens (10 × 2 mm) of 3 different CAD-CAM PMMAs, AvaDent (AV); Merz M-PM (M-PM); Polident (Poli), and a conventional heat-polymerized PMMA (Vynacron) (CV) (n=21) were divided into 3 different surface treatment groups (n=7): conventional laboratory polishing (CLP), polishing with acrylic resin polisher kit (PK), and a surface sealant (Palaseal) (SSC). Stereomicroscopic images were taken both before and after thermocycling. WCA, SR, and MH of all specimens were measured before and after thermocycling and compared by using a 2-way ANOVA (α=0.05).

RESULTS

After thermocycling, WCA significantly increased for CLP- or PK -applied (P<.001) specimens of all materials and SSC-applied M-PM (P=.002), SR significantly increased for CLP-applied M-PM (P=.027) and PK-applied Poli (P=.041), and MH significantly decreased for CLP- or PK-applied AV (P = .001, P < .001, respectively), CV (P=.033, P=.023, respectively), and M-PM (P=.003, P=.001, respectively), SSC-applied M-PM (P<.001), and CLP-applied Poli (P<.001). Stereomicroscopic images revealed rougher surfaces for PK-applied specimens.

CONCLUSIONS

After thermocycling, surface treatment had a significant effect on water contact angle and surface roughness. CLP or PK application resulted in hydrophobic surfaces compared with before thermocycling. CLP or SSC application on CAD-CAM PMMAs resulted in smoother surfaces. Thermocycling lowered the microhardness of all PMMAs, and the decrease was significant in CLP- or PK-applied PMMAs, except for PK-applied Poli.

Bond strength of conventional, subtractive, and additive manufactured denture bases to soft and hard relining materials

OBJECTIVE

To investigate the tensile and flexural strength of poured, subtractive, and additive manufactured denture base methacrylates bonded to soft and hard relining materials after hydrothermal cycling and microwave irradiation.

METHODS

This study included a conventional (CB), subtractive (SB), and additive (AB) base material as well as a soft (SCR) and hard (HCR) chairside and one hard laboratory-side (HLR) relining material. Reference bodies of the base materials and bonded specimens to the relining materials were produced with a rectangular cross-section. The specimens were either pre-treated by water storage (50 h, 37 °C), hydrothermal cycling (5000 cycles, 5 °C and 55 °C, 30 s each), or microwave irradiation (6 cycles, 640 W, 3 min, wet). A tensile and four-point bending test were performed for a total of 504 specimens. Data were analysed using multivariate analysis of variance (MANOVA) with post-hoc Tukey tests (α = 0.05).

RESULTS

In comparison with the other reference groups SB showed marginally higher tensile and flexural strength (p < 0.047). Bond strength to SCR was affected neither by the base material nor by the pre-treatment (p > 0.085). HCR demonstrated twice the bond strength to AB compared with SB and CB (p ≤ 0.001). HLR showed the highest bond strength to CB (p ≤ 0.001). There was no difference between the specimens after hydrothermally cycling and microwave irradiation (p > 0.318).

SIGNIFICANCE

The bond strength of hard relining materials to subtractive and additive manufactured denture bases differ compared with conventional pouring.