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Kim HT, Jo YH, Jee EB, Yoon HI, Yilmaz B. Effect of postpolymerization time and atmosphere on surface properties and biofilm formation in additively manufactured resins for definitive restorations. J Dent 2024; 147:105143. [PMID: 38906456 DOI: 10.1016/j.jdent.2024.105143] [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: 04/26/2024] [Revised: 06/03/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024] Open
Abstract
OBJECTIVES To investigate how postpolymerization time (PPT) and atmosphere (PPA) influence the surface properties, protein adsorption, and microbial adhesion of two types of additively manufactured (AM) resins used for definitive restorations. METHODS Two different types of commercially available AM resins for definitive restorations (UR and CR) were used to create disk-shaped specimens. These specimens were divided into eight groups based on resin type (UR and CR), PPT (standard or extended), and PPA (air or nitrogen). After postpolymerization, the surface roughness (Ra and Sa) and surface free energy (SFE) of all specimens were measured. The study also evaluated protein adsorption, microbial attachment, and cytotoxicity. A non-parametric factorial analysis of variance with post-hoc analyses was conducted, using a significance level (α) of 0.05. RESULTS The Ra and Sa values for CR were higher than those for UR, regardless of PPT or PPA (P < 0.05). For UR, SFE was higher with extended PPT compared to standard PPT. CR had higher SFE than UR under standard PPT. The interaction between PPT and PPA had a significant effect on protein adsorption (P < 0.05). When PPT was standard, nitrogen significantly increased protein adsorption compared to air. The interaction between resin type and PPA, and between resin type and PPT, significantly affected microbial adhesion (P < 0.05). The changes in PPT or PPA did not affect the cytotoxicity of either AM resin. CONCLUSION Surface properties, protein adsorption, and microbial attachment were influenced by the interactions among PPT, PPA, and resin type. These factors can have implications for resin-based definitive restorations. CLINICAL SIGNIFICANCES Clinicians should understand the impact of PPT and PPA on the surface properties of AM resins for definitive restorations, particularly regarding protein adsorption and microbial adhesion. Additionally, the type of AM resin (based on chemical composition) could affect its biological properties.
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Affiliation(s)
- Hyun-Tae Kim
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ye-Hyeon Jo
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Eun-Byeol Jee
- Dental Research Institute, Seoul National University School of Dentistry, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea; Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH, United States
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Kim HT, Çakmak G, Lee YH, Jo YH, Yoon HI, Yilmaz B. Mechanical properties, cytotoxicity, and protein adsorption of three-dimensionally printable hybrid resin containing zwitterionic polymer and silicate-based composites for dental restorations. J Dent 2024; 147:105134. [PMID: 38885733 DOI: 10.1016/j.jdent.2024.105134] [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: 01/29/2024] [Revised: 05/28/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
OBJECTIVE To evaluate the mechanical and biological properties of three-dimensionally (3D) printable resins filled with 2-methacryloyloxyethyl phosphorylcholine (MPC) and silicate-based composites and compare with those of a commercially available 3D-printable resin for definitive restorations. METHODS A group of 3D-printable hybrid resins (HRs) filled with 6 wt% MPC and three different compositions of silicate-based composites (barium silicate to zirconium silicate ratios: 1.50:1 for HR1, 0.67:1 for HR2, and 0.25:1 for HR3) were prepared. The HR groups were compared with the commercially available unfilled 3D-printable resin (CR) marketed for definitive restorations in terms of flexural strength and modulus, fracture toughness, surface roughness, Vickers hardness, light transmittance (all, n = 15), cytotoxicity, and protein adsorption (both, n = 3). All data were analyzed by using non-parametric Kruskal-Wallis and Dunn's tests (α=0.05). RESULTS The HR groups had significantly higher flexural strength, modulus, fracture toughness, and hardness values than the CR (P < 0.001). HR3 had the highest surface roughness and light transmittance among the groups (P ≤ 0.006). None of tested resins showed cytotoxicity. Both HR2 and HR3 showed significantly lower protein adsorption than the CR, with a difference of approximately 60% (P ≤ 0.026). CONCLUSION Both HR2 and HR3 exhibited superior mechanical properties (flexural strength, flexural modulus, fracture toughness, and Vickers hardness), light transmittance, and protein-repellent activity than the CR, with no impact on cytotoxicity. CLINICAL SIGNIFICANCE The MPC/silicate-based composite-filled resins may be a suitable alternative for definitive restorations, given their higher mechanical properties and promising biological properties to prevent microbial adhesion and subsequent biofilm formation, as well as their non-cytotoxic properties.
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Affiliation(s)
- Hyun-Tae Kim
- Department of Prosthodontics, Seoul National University Dental Hospital, Seoul, Republic of Korea
| | - Gülce Çakmak
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | | | - Ye-Hyeon Jo
- Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyung-In Yoon
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Prosthodontics, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Burak Yilmaz
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland; Department of Restorative, Preventive and Pediatric Dentistry, School of Dental Medicine, University of Bern, Bern, Switzerland; Division of Restorative and Prosthetic Dentistry, The Ohio State University, Columbus, OH, United States
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Zhu L, Han W, Xiang R, Xu H, Bai D, Wang P, Xue C. Does curve of Spee affect the precision of 3D-printed curvature-adaptive splints? J Dent 2024; 147:105108. [PMID: 38844153 DOI: 10.1016/j.jdent.2024.105108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/28/2024] [Accepted: 06/04/2024] [Indexed: 06/30/2024] Open
Abstract
OBJECTIVES This study aimed to propose a standardized protocol for the fabrication of three-dimensionally (3D)-printed curvature-adaptive splints (CASs) and assess the precision of CASs on dentitions with different depths of the curve of Spee (COS). METHODS 76 lower dental resin models, each exhibiting one of the four types of COS (0-, 2-, 4-, and 6-mm deep), were selected and digitally scanned. CASs were designed, 3D printed, and grouped into C0, C2, C4, and C6, corresponding to the four types of COS depths. To assess precision, the CASs occluded with the resin model were scanned as a whole and compared with the originally designed ones. RESULTS In terms of translational deviations observed in the CASs, the mean value of absolute sagittal deviation (0.136 mm) was significantly higher than those of vertical (0.091 mm) and transversal deviations (0.045 mm) (P < 0.01). Regarding rotational deviations of the CASs, the mean deviation in pitch (0.323°) was significantly higher than those in yaw (0.083°) and roll (0.110°) (P < 0.01). However, when comparing the accuracy of CASs across C0, C2, C4, and C6 groups, no statistically significant difference was found. Additionally, the translational deviations, rotational deviations, and RMSE of all groups were significantly lower than the clinically acceptable limits of 0.5 mm, 1°, and 0.25 mm, respectively (P < 0.01). CONCLUSIONS The depth of the COS has no significant impact on the precision of CASs, as evidenced by the absence of statistically significant differences in translational, rotational deviations, and RMSE among all groups (C0, C2, C4, and C6). Moreover, despite relatively high deviations in the sagittal dimension and pitch, all dimensional deviations and RMSE remained statistically significantly lower than the corresponding clinically acceptable limits (CALs) in all groups. CLINICAL SIGNIFICANCE This standardized protocol incorporating "curvature-adaptation" represents an optimized approach to fabricating diverse 3D-printed splints tailored to dentitions with different anatomical features in contemporary digital dentistry.
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Affiliation(s)
- Liwei Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Wenze Han
- School of Stomatology, Shanxi Medical University, Taiyuan 030001, Shanxi, China
| | - Runzhe Xiang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Hui Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Ding Bai
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China
| | - Peiqi Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
| | - Chaoran Xue
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, Sichuan, China.
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Saadat Sarmadi B, Schmidt F, Beuer F, Metin DS, Simeon P, Nicic R, Unkovskiy A. The Effect of Build Angle and Artificial Aging on the Accuracy of SLA- and DLP-Printed Occlusal Devices. Polymers (Basel) 2024; 16:1714. [PMID: 38932064 PMCID: PMC11207952 DOI: 10.3390/polym16121714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/22/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
The aim of this study is to investigate the influence of printing material, build angle, and artificial aging on the accuracy of SLA- and DLP-printed occlusal devices in comparison to each other and to subtractively manufactured devices. A total of 192 occlusal devices were manufactured by one SLA-printing and two DLP-printing methods in 5 different build angles as well as milling. The specimens were scanned and superimposed to their initial CAD data and each other to obtain trueness and precision data values. A second series of scans were performed after the specimens underwent an artificial aging simulation by thermocycling. Again, trueness and precision were investigated, and pre- and post-aging values were compared. A statistically significant influence was found for all main effects: manufacturing method, build angle, and thermocycling, confirmed by two-way ANOVA. Regarding trueness, overall tendency indicated that subtractively manufactured splints were more accurate than the 3D-printed, with mean deviation values around ±0.15 mm, followed by the DLP1 group, with ±0.25 mm at 0 degree build angle. Within the additive manufacturing methods, DLP splints had significantly higher trueness for all build angles compared to SLA, which had the highest mean deviation values, with ±0.32 mm being the truest to the original CAD file. Regarding precision, subtractive manufacturing showed better accuracy than additive manufacturing. The artificial aging demonstrated a significant influence on the dimensional accuracy of only SLA-printed splints.
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Affiliation(s)
- Bardia Saadat Sarmadi
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Franziska Schmidt
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Dilan Seda Metin
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Philipp Simeon
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Robert Nicic
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
| | - Alexey Unkovskiy
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité—Universitätsmedizin Berlin, Aßmannshauser Street 4-6, 14197 Berlin, Germany; (B.S.S.); (F.S.); (F.B.); (D.S.M.); (P.S.); (R.N.)
- Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19c1, Moscow 119146, Russia
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Revilla-León M, Cascos-Sánchez R, Zeitler JM, Barmak AB, Kois JC, Gómez-Polo M. Influence of print orientation and wet-dry storage time on the intaglio accuracy of additively manufactured occlusal devices. J Prosthet Dent 2024; 131:1226-1234. [PMID: 36635137 DOI: 10.1016/j.prosdent.2022.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 12/06/2022] [Accepted: 12/06/2022] [Indexed: 01/11/2023]
Abstract
STATEMENT OF PROBLEM Different factors can affect the manufacturing accuracy of additively manufactured dental devices; however, the influence of print orientation and wet-dry storage time on their intaglio accuracy remains uncertain. PURPOSE The purpose of this in vitro study was to assess the effect of print orientation (0, 45, 70, and 90 degrees) and wet-dry storage time (0, 30, 60, and 90 days) on the intaglio accuracy of additively manufactured occlusal devices. MATERIAL AND METHODS An occlusal device design was obtained in a standard tessellation language (STL) file format (control file) which was used to fabricate all the specimens by using a stereolithography printer (Form 3+) and a biocompatible resin material (Dental LT Clear Resin, V2). Four groups were created based on the print orientation used to manufacture the specimens: 0, 45, 70, and 90 degrees. Each group was divided into 4 subgroups depending on the time elapsed between manufacturing and accuracy evaluation: 0, 30, 60, and 90 days. For the subgroup 0, a desktop scanner (T710) was used to digitize all the specimens. The 30-day subgroup specimens were stored for 30 days with the following daily storage protocol: 16 hours inside a dry lightproof container, followed by 8 hours in artificial saliva (1700-0305 Artificial Saliva) inside the same lightproof container. The specimens were then digitized by following the same procedures used for subgroup 0. For the subgroups 60 and 90, the identical procedures described for subgroup 30 were completed but after 60 and 90 days of storage, respectively. The reference STL file was used to measure the intaglio discrepancy with the experimental scans obtained among the different subgroups by using the root mean square error calculation. Two-way ANOVA and post hoc Tukey pairwise comparison tests were used to analyze the data (α=.05). RESULTS Print orientation (P<.001) and usage time (P<.001) were significant predictors of the trueness value obtained. Additionally, the 0-degree print orientation at day 0 group demonstrated the best trueness value among all the groups tested (P<.05). No significant trueness discrepancies were found among the 45-, 70-, and 90-degree print orientation, or among the 30, 60, and 90 days of storage. A significant precision difference was found in the variance between print orientation groups across usage time subgroups. CONCLUSIONS The print orientation and wet-dry storage times tested influenced the trueness and precision of the intaglio surfaces of the occlusal devices manufactured with the 3D printer and material selected.
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Affiliation(s)
- Marta Revilla-León
- Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Faculty and Director of Research and Digital Dentistry, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Mass
| | - Rocío Cascos-Sánchez
- Postgraduate Advanced in Implant-Prosthodontics, Department of Conservative Dentistry and Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain
| | | | - Abdul B Barmak
- Assistant Professor Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, NY
| | - John C Kois
- Founder and Director, Kois Center, Seattle, Wash; Affiliate Professor, Graduate Prosthodontics, Department of Restorative Dentistry, University of Washington, Seattle, Wash; Private Practice, Seattle, Wash
| | - Miguel Gómez-Polo
- Associate Professor, Department of Conservative Dentistry and Prosthodontics, Director of postgraduate program of Advanced in Implant-Prosthodontics, School of Dentistry, Complutense University of Madrid, Madrid, Spain.
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Pecenek D, Gokcen-Rohlig B, Ongul D, Ayvalioglu DC. Evaluation of the clinical performance of different occlusal device materials. J Prosthet Dent 2024:S0022-3913(24)00295-6. [PMID: 38806342 DOI: 10.1016/j.prosdent.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/30/2024]
Abstract
STATEMENT OF PROBLEM Computer aided technologies have been used to fabricate occlusal devices. However, the clinical behavior of the newly developed materials developed for occlusal devices is unknown. PURPOSE The purpose of this prospective, double-blind study was to assess the clinical efficacy of recently introduced computer-aided design and computer-aided manufacturing (CAD-CAM) materials for the fabrication of occlusal devices. MATERIAL AND METHODS A total of 24 participants were divided randomly into 2 study groups; polyetheretherketone (PEEK) and polymethyl methacrylate (PMMA), and a control group (CG). Conventional impressions and gypsum casts were obtained from all participants. In the study groups, the casts were digitalized with an extraoral digital scanner, designed with a software program (Bite Occlusal Device Module; exocad GmbH) and milled from PEEK and PMMA blocks. Clear resin sheets were used for occlusal device fabrication in the CG. The baseline measurements were made during the initial appointments. After 6 months, the participants returned for follow-up evaluations. Clinical performance based on surface roughness, wear of the antagonist teeth, occlusal device fit and therapeutic effect, as well as participant satisfaction were compared using the 1-way ANOVA test between the main groups (α=.05). The post hoc and Kruskal Wallis-H tests were used to compare the nonparametric group. RESULTS The therapeutic effects of the occlusal devices did not differ. All participants showed improvement in palpation and mandibular movement scores, but no statistically significant differences were found among the groups (P>.05). PEEK and PMMA had statistically less surface wear than CG (P<.001) and led to less antagonist tooth wear. No significant participant satisfaction difference was seen among the groups (P>.05). The control group had the best fit (P<.001). CONCLUSIONS Recent CAD-CAM materials exhibit clinically acceptable outcomes, and their performance is comparable with that of traditional materials. CAD-CAM materials appear suitable in terms of accuracy, surface wear, and therapeutic efficacy.
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Affiliation(s)
- Duygucan Pecenek
- Graduate student, Department of Prosthodontics, Institute of Graduate Studies in Health Sciences, Istanbul University, Istanbul, Turkey
| | - Bilge Gokcen-Rohlig
- Professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Deger Ongul
- Associate Professor, Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Demet Cagıl Ayvalioglu
- Assistant Professor, Department of Prosthodontics, Faculty of Dentistry, Altınbas University, Istanbul, Turkey
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Simeon P, Unkovskiy A, Saadat Sarmadi B, Nicic R, Koch PJ, Beuer F, Schmidt F. Wear resistance and flexural properties of low force SLA- and DLP-printed splint materials in different printing orientations: An in vitro study. J Mech Behav Biomed Mater 2024; 152:106458. [PMID: 38364445 DOI: 10.1016/j.jmbbm.2024.106458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVES To investigate the influence of material and printing orientation on wear resistance and flexural properties of one low force SLA- and two DLP-printed splint materials and to compare these 3D-printed splints to a subtractively manufactured splint material. METHODS Two DLP-printed (V-Print splint, LuxaPrint Ortho Plus) and one low force SLA-printed (Dental LT Clear) material, where specimens were printed in three printing orientations (0°, 45°, 90°), were investigated. In addition, one milled splint material (Zirlux Splint Transparent) was examined. A total of 160 specimens were produced for both test series. The two-body wear test was performed in a chewing simulator (80'000 cycles at 50 N with 5-55 °C thermocycling). Steatite balls were used as antagonists. The wear pattern was analyzed with a 3D digital microscope in terms of maximum vertical intrusion depth (mm) and total volume loss (mm³). The flexural properties were investigated by three-point bending in accordance with ISO 20795-1: 2013 (denture base polymers). The flexural strength (MPa) and the flexural modulus (MPa) were measured. Two-way ANOVA was performed to investigate the effects of the two independent variables material and printing orientation for the three 3D-printed materials. The comparison of the printing orientations within one material was carried out with one-way ANOVA with post-hoc Tukey tests. RESULTS Two-way ANOVA revealed that wear and flexural properties are highly dependent on the 3D-printed material (p < 0.001). Across groups, a significant effect was observed for wear depth (p = 0.031) and wear volume (p = 0.044) with regard to printing orientation but this was not found for flexural strength (p = 0.080) and flexural modulus (p = 0.136). One-way ANOVA showed that both DLP-printed groups showed no significant differences within the printing orientations in terms of wear and flexural properties. Dental LT Clear showed that 90° oriented specimens had higher flexural strength than 0° oriented ones (p < 0.001) and 45° oriented specimens also showed higher values than 0° ones (p = 0.038). No significant differences were observed within the printing orientations for flexural modulus and wear behaviour within this group. T-tests showed that the milled splints exhibited statistically higher wear resistance and flexural properties compared to all three 3D-printed splint materials (p < 0.001) and that highly significant differences were found between the 3D-printed splint materials for both test series. CONCLUSION Within the limitations of this in vitro study, it can be stated that wear behaviour and flexural properties are highly dependent on the 3D-printed material itself. Currently, milled splints exhibit higher wear resistance and flexural properties compared to 3D-printed splint materials. The printing orientation has a minor influence on the properties investigated. Nevertheless, two-way ANOVA also showed a significant influence of printing orientation in the wear test across groups and one-way ANOVA detected significant effects for SLA material in terms of flexural strength, with printing in 90° showing the highest flexural strength. Therefore, anisotropy was found in SLA material, but it can be limited with the employed printing parameters. Both DLP-printed materials showed no significant difference within the printing orientation.
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Affiliation(s)
- Philipp Simeon
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Alexey Unkovskiy
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany; Department of Dental Surgery, Sechenov First Moscow State Medical University, Bolshaya Pirogovskaya Street, 19с1, Moscow, 119146, Russia
| | - Bardia Saadat Sarmadi
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Robert Nicic
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Petra Julia Koch
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Orthodontics and Orthofacial Orthopedics, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Florian Beuer
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Franziska Schmidt
- Charité - Universitätsmedizin Berlin, Center for Oral Health Sciences CC3, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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Sun X, Feng Y, Jiao Y, Liu W. Fully digital workflow for the fabrication of occlusal stabilization splints based on individual mandibular movement. J Dent 2024; 141:104826. [PMID: 38157975 DOI: 10.1016/j.jdent.2023.104826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 12/07/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024] Open
Abstract
OBJECTIVE This study was conducted to present a completely digital workflow for the fabrication of occlusal stabilization splints using CAD/CAM systems and a digital face bow based on optical sensor technology. METHODS Digital scans of the maxillary and mandibular arches of 20 volunteers were obtained using an intraoral scanner. Jaw relation and mandibular movements were recorded with a digital face bow via optical sensors. The virtual increase of the vertical dimension of occlusion (VDO) was then performed, after which computer-aided design (CAD) of the occlusal stabilization splints was carried out. The corresponding splints were then manufactured using digitally controlled technology. RESULTS A completely digital workflow for the manufacturing of occlusal stabilization splints was found to be clinically feasible. The corresponding data analysis revealed high congruence between virtual and physical occlusal contacts on the occlusal splint. Moreover, the appropriate guidance of the anterior teeth area was easily obtainable, and the time for adjusting the occlusion was less. CONCLUSIONS This study demonstrated that the fabrication of occlusal stabilization splints using a fully digital workflow is feasible. Compared to traditional impression-based manufacturing, several advantages of digital manufacturing include easy accessibility, time-efficient manufacturing, high-level accuracy in splint quality, and potential to manufacture duplicate splints. CLINICAL SIGNIFICANCE The proposed fully digital approach may help young dentists fabricating stable occlusal splints with beneficial curative effects. Meanwhile, it could also improve the production efficiency of stable occlusal splints, saving time for both doctors and patients while reducing labor costs.
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Affiliation(s)
- Xinrong Sun
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yue Feng
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Yi Jiao
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China
| | - Weicai Liu
- Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Department of Prosthodontics, Stomatological Hospital and Dental School of Tongji University, 399, Yanchang Middle Rd, Jing'an District, Shanghai 200072, China.
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Khanlar LN, Francis C, Basir Barmak A, Rios ALS, Ashtiani RE, Zandinejad A. Effect of a new support design on the marginal and internal gap of additively manufactured interim crowns using direct light deposition technology. J Prosthodont 2024; 33:188-194. [PMID: 36810925 DOI: 10.1111/jopr.13668] [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: 09/16/2022] [Revised: 02/06/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
PURPOSE To investigate the design and location of supporting structures on the marginal and internal gap of interim restorations. MATERIALS AND METHODS A mandibular right first molar resin tooth was prepared for a full coverage crown and scanned using a laboratory scanner (3Shape D900). The scanned data were converted into standard tessellation language (STL) format and an indirect prosthesis was designed using computer-aided design (CAD) software (exocad DentalCAD). The STL file was used to fabricate a total of 60 crowns with a 3D printer (EnvisionTEC Vida HD). The crowns were printed using E-Dent C&B MH resin and divided into 4 groups based on four different support structure designs, including supports on the occlusal (0° group), buccal and occlusal (45° group), buccal (90° group), and a new design consisting of horizontal bars placed on all surfaces and line angles (Bar) (n = 15). The silicone replica technique was used to determine the gap discrepancy. Fifty measurements were obtained for each specimen to examine the marginal and internal gaps by using a digital microscope (Olympus SZX16) at ×70 magnification. Additionally, the marginal discrepancy at different locations of the tested crowns, including buccal (B), lingual (L), mesial (M), and distal (D), as well as the maximum and minimum marginal gap intervals among groups, were analyzed. The collected data were analyzed using factorial ANOVA, followed by the Tukey HSD test for multiple comparisons (a = 0.05). RESULTS There was a significant difference in marginal and internal gaps among the groups (p < 0.001). The buccal placement supports (90° group) had the least marginal and internal discrepancies (p < 0.001). The new design group showed the highest marginal and internal gap. The marginal discrepancy in different locations of the tested crowns (B, L, M, D) was found to be significantly different among the groups (p < 0.001). The mesial margin of the Bar group had the largest marginal gap, whereas the buccal margin of the 90° group had the lowest marginal gap. The new design had a significantly smaller difference between the maximum and minimum marginal gap intervals than other groups (p < 0.001). CONCLUSION The location and design of the supporting structures affected the marginal and internal gaps of an interim crown. The buccal placement of supporting bars (90° printing orientation) showed the smallest mean internal and marginal discrepancies.
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Affiliation(s)
- Leila Nasiry Khanlar
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Claire Francis
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Abdul Basir Barmak
- Department of Comprehensive Dentistry, EIOH Medical Center, University of Rochester, Rochester, New York, USA
| | - Alma L Salazar Rios
- Department of Prosthodontics, College of Dentistry, Texas A&M University, Dallas, Texas, USA
| | - Reza Eftekhar Ashtiani
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirali Zandinejad
- Department of Comprehensive Dentistry, College of Dentistry, Texas A&M University, Dallas, Texas, USA
- Private Practice, Arlington, Texas, USA
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赵 一, 王 勇. [Current Status and Analysis of the Clinical Application of Digital Technology in Oral Medicine]. SICHUAN DA XUE XUE BAO. YI XUE BAN = JOURNAL OF SICHUAN UNIVERSITY. MEDICAL SCIENCE EDITION 2024; 55:101-110. [PMID: 38322515 PMCID: PMC10839490 DOI: 10.12182/20240160301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Indexed: 02/08/2024]
Abstract
With the increasing maturity and popularization of digital technology in oral medicine, its application has now expanded to various clinical subspecialties of oral medicine. Digitalization has become one of the important development directions of oral medicine. What is the current development status of digital technology in oral medicine? In what ways is digital technology applied across various clinical specialties of oral medicine? Dentists are particularly concerned about these issues in their clinical work and research. In this paper, all the digital technologies applied in oral medicine are organized and categorized from a technical perspective. In this paper, we focused on presenting three-dimensional data acquisition technology, dental computer-aided design technology, dental computer-aided processing technology, and oral surgery implementation technology. Their technical principles, technical characteristics, applications in oral medicine, a secondary discipline of medicine, and the development status of domestically-developed technology are described and reviewed in detail. The other technologies such as oral digital materials, oral virtual simulation teaching, and oral multi-source data management are briefly discussed. We intend to provide references for dentists to apply digital technology in clinical practice and research.
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Affiliation(s)
- 一姣 赵
- 北京大学口腔医学院·口腔医院,数字化研究中心 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔生物材料和数字诊疗装备国家工程研究中心 口腔数字医学北京市重点实验室 国家卫生健康委口腔数字医学重点实验室 (北京 100081)Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学医学部医学技术研究院 (北京 100191)Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
| | - 勇 王
- 北京大学口腔医学院·口腔医院,数字化研究中心 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔生物材料和数字诊疗装备国家工程研究中心 口腔数字医学北京市重点实验室 国家卫生健康委口腔数字医学重点实验室 (北京 100081)Center of Digital Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology, Beijing 100081, China
- 北京大学医学部医学技术研究院 (北京 100191)Institute of Medical Technology, Peking University Health Science Center, Beijing 100191, China
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Benli M, Al-Haj Husain N, Ozcan M. Mechanical and chemical characterization of contemporary occlusal splint materials fabricated with different methods: a systematic review. Clin Oral Investig 2023; 27:7115-7141. [PMID: 37910242 DOI: 10.1007/s00784-023-05360-0] [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: 03/25/2023] [Accepted: 10/22/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE To systematically review studies on various occlusal splint materials and describe their mechanical and chemical properties. METHODS MEDLINE (PubMed), Scopus, and Web of Science searches were conducted for in vitro studies focusing on occlusal splint materials. Two reviewers performed an assessment of the identified studies and data abstraction independently, and this was complimented by an additional hand search. The articles were limited to those in the English language that were published between January 1st, 2012, and December 1st, 2022. RESULTS The initial search yielded 405 search results of which 274 were selected for full-text review following abstract evaluation. 250 articles that did not meet the inclusion criteria were excluded, and the remaining 25 articles (with 1 article identified from the reference lists of included articles) providing mechanical and chemical values were used in this review. Poly methyl methacrylate (PMMA) -based occlusal splint materials showed the highest values in terms of hardness, wear resistance, flexural strength, flexural modulus, e-modulus, and fracture toughness. The material group with the highest water sorption and water solubility was 3D printed (PR) splint materials. In addition, the lowest degree of double bond conversion was also observed in this group of materials. CONCLUSIONS The outcome of this review suggests that mechanically and chemically acceptable properties can be attained with PMMA-based occlusal splint materials using both conventional and digital production methods. PR splint materials should not be considered as the primary choice for long-term treatments due to their low mechanical and chemical properties. CLINICAL RELEVANCE This review provides clinical recommendations for selecting the appropriate material and fabrication method for occlusal splints while taking the patients' needs and the materials´ mechanical and chemical properties into account.
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Affiliation(s)
- Merve Benli
- James B. Edwards College of Dental Medicine, Department of Oral Rehabilitation, Division of Removable Prosthodontics, MUSC, Charleston, USA.
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Nadin Al-Haj Husain
- Division of Dental Biomaterials, Clinic for Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
- Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, 3010, Bern, Switzerland
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032, Zurich, Switzerland
| | - Mutlu Ozcan
- Division of Dental Biomaterials, Center for Dental Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
- Clinic for Chewing Function Disturbances, Center for Dental Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Raffaini JC, Soares EJ, Oliveira RFDL, Vivanco RG, Amorim AA, Pereira ALC, Pires-de-Souza FCP. Effect of artificial aging on mechanical and physical properties of CAD-CAM PMMA resins for occlusal splints. J Adv Prosthodont 2023; 15:227-237. [PMID: 37936836 PMCID: PMC10625884 DOI: 10.4047/jap.2023.15.5.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE This study aimed to assess and compare the color stability, flexural strength (FS), and surface roughness of occlusal splints fabricated from heat-cured acrylic resin, milled polymethyl methacrylate (PMMA)-based resin, and 3D-printed (PMMA) based-resin. MATERIALS AND METHODS Samples of each type of resin were obtained, and baseline measurements of color and surface roughness were recorded. The specimens were divided into three groups (n = 10) and subjected to distinct aging protocols: thermomechanical cycling (TMC), simulated brushing (SB), and control (without aging). Final assessments of color and surface roughness and three-point bending test (ODM100; Odeme) were conducted, and data were statistically analyzed (2-way ANOVA, Tukey, P <.05). RESULTS Across all resin types, the most significant increase in surface roughness (Ra) was observed after TMC (P < .05), with the 3D-printed resin exhibiting the lowest Ra (P < .05). After brushing, milled resin displayed the highest Ra (P < .05) and greater color alteration (ΔE00) compared to 3D-printed resin. The most substantial ΔE00 was recorded after brushing for all resins, except for heat-cured resin subjected to TMC. Regardless of aging, milled resin exhibited the highest FS (P < .05), except when compared to 3D-printed resin subjected to TMC. Heat-cured resin exposed to TMC demonstrated the lowest FS, different (P < .05) from the control. Under control conditions, milled resin exhibited the highest FS, different (P < .05) from the brushed group. 3D-printed resin subjected to TMC displayed the highest FS (P < .05). CONCLUSION Among the tested resins, 3D-printed resin demonstrated superior longevity, characterized by minimal surface roughness and color alterations. Aging had a negligible impact on its mechanical properties.
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Affiliation(s)
- Júlia Correa Raffaini
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Eduardo Jose Soares
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Rebeca Franco de Lima Oliveira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Rocio Geng Vivanco
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Ayodele Alves Amorim
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
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Orgev A, Levon JA, Chu TMG, Morton D, Lin WS. The effects of manufacturing technologies on the surface accuracy of CAD-CAM occlusal splints. J Prosthodont 2023; 32:697-705. [PMID: 36227731 DOI: 10.1111/jopr.13610] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 10/01/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To investigate the effects of the manufacturing technologies on the surface (cameo and intaglio) accuracy (trueness and precision) of computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal splints. MATERIALS AND METHODS The digital design of the master occlusal splint was designed in a CAD software program. Six groups (n = 10) were tested in this study, including Group 1 - Milling (Wax), Group 2 - Heat-polymerizing, Group 3 - Milling (M series), Group 4 - Milling (DWX-51/52D), Group 5 - 3D-printing (Cares P30), and Group 6 - 3D-printing (M2). The study samples were placed in a scanning jig fabricated from putty silicone and Type III dental stone. The study samples were then scanned with a laboratory scanner at the intaglio and cameo surfaces, and the scanned files were exported in standard tessellation language (STL) file format. The master occlusal splint STL file, was used as a reference to compare with all scanned samples at the intaglio and cameo surfaces in a surface matching software program. Root mean square (RMS, measured in mm, absolute value) values were calculated by the software for accuracy comparisons. Group means were used as the representation of trueness, and the standard deviation for each group was calculated as a measure of precision. Color maps were recorded to visualize the areas of deviation between study samples and the master occlusal splint file. The data were normalized and transformed to rank scores, and one-way ANOVA was used to test for the differences between the groups. Pairwise comparisons were made between different groups. Fishers least square differences were used to account for the family-wise error rate. A 5% significance level was used for all the tests. RESULTS The null hypotheses were rejected. The manufacturing technologies significantly affected the trueness of occlusal splints at both intaglio and cameo surfaces (p < 0.001). At the cameo surfaces, Group 1 - Milling (Wax) (0.03 ± 0.02 mm), Group 3 - Milling (M series) (0.04 ± 0.01 mm), and Group 4 - Milling (DWX-51/52D) (0.04 ± 0.01 mm) had the smallest mean RMS values and highest trueness. Group 3 had the smallest standard deviation and highest precision among all groups (p < 0.001, except p = 0.005 when compared with Group 2). Group 5 had the largest standard deviation and lowest precision among all groups (p < 0.001). At the intaglio surfaces, Group 1 - Milling (Wax) (0.06 ± 0.01 mm) had the smallest RMS values and highest trueness among all groups (p < 0.001), and Group 2 - Heat-polymerizing (0.20 ± 0.03 mm) and Group 5 - 3D-printing (Cares P30) (0.15 ± 0.05 mm) had significantly larger mean RMS and standard deviation values than all other groups (p < 0.001), with lowest trueness and precision. In the color maps, Group 2 - Heat-polymerizing and Group 5 - 3D-printing (Cares P30) showed the most discrepancies with yellow and red (positive discrepancies) in most areas, and Group 1 - Milling (Wax) showed the best and most uniform surface matching with the most area in green. CONCLUSION The manufacturing technologies significantly affected the trueness and precision of occlusal splints at both intaglio and cameo surfaces. The 5-axis milling units and industrial-level CLIP 3D-printer could be considered to achieve surface accuracy of occlusal splints.
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Affiliation(s)
- Ahmet Orgev
- Department of Restorative Dentistry, University at Buffalo School of Dental Medicine, Buffalo, New York
| | - John A Levon
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Tien-Min G Chu
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Dean Morton
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
| | - Wei-Shao Lin
- Department of Prosthodontics, Indiana University School of Dentistry, Indianapolis, Indiana
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Peng T, Yang Z, Ma T, Zhang M, Ren G. Comparative evaluation of the volume of occlusal adjustment of repositioning occlusal devices designed by using an average value digital articulator and the jaw movement analyzer. J Prosthet Dent 2023:S0022-3913(23)00419-5. [PMID: 37537106 DOI: 10.1016/j.prosdent.2023.06.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 06/21/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023]
Abstract
STATEMENT OF PROBLEM The volume of occlusal adjustment of digital occlusal devices designed with different digital occlusal articulators is unknown. PURPOSE The purpose of this clinical study was to evaluate and compare the clinical efficacy and volume of occlusal adjustment of digital occlusal devices designed by using an average value digital articulator and the jaw movement analyzer (JMA). MATERIAL AND METHODS Thirty participants were randomly divided into 2 groups, an Average value group and a JMA group, with 15 participants in each group. The centric relation position of the participants was determined by an experienced investigator with the aid of a leaf gauge. An intraoral scanner (TRIOS 3) was used to obtain digital scans of the maxillary and mandibular dentition and the maxillomandibular relationship record in the centric relation position. Personalized articulator parameters of participants in the JMA group were obtained by using a JMA (JMAnalyser). Different articulator parameters were used to fabricate an occlusal device in a denture design software program (exocad DentalCAD). The surface of the occlusal device was coated with a dental optical spray and then scanned by using a laboratory scanner (Kavo LS3). The process was repeated after the occlusal device was adjusted. The files of the 2 scans were imported into a reverse engineering software program, and the root mean square (RMS) values were obtained by best-fit alignment and 3-dimensional comparison. The Shapiro-Wilk normality test and homogeneity of variance test were performed, and t tests were used to evaluate differences in the RMS values between the groups (α=.05). RESULTS The experimental data were generally normally distributed (P>.05). No statistically significant difference was found between the RMS values of the Average and the JMA groups (P>.05). CONCLUSIONS No significant difference in the volume of occlusal adjustment was found when using occlusal devices made by using the digital average articulator or the JMA, suggesting that either method can be used to program articulators for the fabrication of occlusal devices.
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Affiliation(s)
- Tiwu Peng
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Zhikang Yang
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Teng Ma
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Mindi Zhang
- Graduate student, Dental Technology, School of Stomatology, Binzhou Medical University, Yantai, Shandong, PR China
| | - Guanghui Ren
- Associate Professor, Center for Occlusion, Yantai Stomatological Hospital of Binzhou Medical University, Yantai, Shandong, PR China.
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Somogyi A, Végh D, Róth I, Hegedüs T, Schmidt P, Hermann P, Géczi Z. Therapy for Temporomandibular Disorders: 3D-Printed Splints from Planning to Evaluation. Dent J (Basel) 2023; 11:dj11050126. [PMID: 37232777 DOI: 10.3390/dj11050126] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/29/2023] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION This article describes the authors' digital workflow-based method for fabricating intraoral occlusal splints, from planning to the evaluation phase. MATERIALS AND METHODS In our protocol, first, we had a registration phase. This included taking digital impressions, determining the centric relation (CR) position with the deprogrammer Luci Jig, and using the digital facebow for measuring the individual values. The laboratory phase was next, which included planning and manufacturing with a 3D printer. The last phase was delivery, when we checked the stability of the splint and adjusted the occlusal part. RESULT The average cost is lower for a fully digital splint than for conventional methods. In terms of time, there was also a significant difference between the classic and digital routes. From a dental technical point of view, the execution was much more predictable. The printed material was very rigid and, therefore, fragile. Compared to the analog method, the retention was much weaker. CONCLUSION The presented method permits time-efficient laboratory production, and may also be performed chairside in a dental office. The technology is perfectly applicable to everyday life. In addition to its many beneficial properties, its negative properties must also be highlighted.
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Affiliation(s)
- Andrea Somogyi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
| | - Dániel Végh
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
| | - Ivett Róth
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
| | - Tamás Hegedüs
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
| | - Péter Schmidt
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
| | - Zoltán Géczi
- Department of Prosthodontics, Faculty of Dentistry, Semmelweis University, 1085 Budapest, Hungary
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Rezaie F, Farshbaf M, Dahri M, Masjedi M, Maleki R, Amini F, Wirth J, Moharamzadeh K, Weber FE, Tayebi L. 3D Printing of Dental Prostheses: Current and Emerging Applications. JOURNAL OF COMPOSITES SCIENCE 2023; 7:80. [PMID: 38645939 PMCID: PMC11031267 DOI: 10.3390/jcs7020080] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/23/2024]
Abstract
Revolutionary fabrication technologies such as three-dimensional (3D) printing to develop dental structures are expected to replace traditional methods due to their ability to establish constructs with the required mechanical properties and detailed structures. Three-dimensional printing, as an additive manufacturing approach, has the potential to rapidly fabricate complex dental prostheses by employing a bottom-up strategy in a layer-by-layer fashion. This new technology allows dentists to extend their degree of freedom in selecting, creating, and performing the required treatments. Three-dimensional printing has been narrowly employed in the fabrication of various kinds of prostheses and implants. There is still an on-demand production procedure that offers a reasonable method with superior efficiency to engineer multifaceted dental constructs. This review article aims to cover the most recent applications of 3D printing techniques in the manufacturing of dental prosthetics. More specifically, after describing various 3D printing techniques and their advantages/disadvantages, the applications of 3D printing in dental prostheses are elaborated in various examples in the literature. Different 3D printing techniques have the capability to use different materials, including thermoplastic polymers, ceramics, and metals with distinctive suitability for dental applications, which are discussed in this article. The relevant limitations and challenges that currently limit the efficacy of 3D printing in this field are also reviewed. This review article has employed five major scientific databases, including Google Scholar, PubMed, ScienceDirect, Web of Science, and Scopus, with appropriate keywords to find the most relevant literature in the subject of dental prostheses 3D printing.
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Affiliation(s)
- Fereshte Rezaie
- Department of Endodontic, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz P.O. Box 5163639888, Iran
| | - Masoud Farshbaf
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz P.O. Box 5163639888, Iran
| | - Mohammad Dahri
- Research Center for Pharmaceutical Nanotechnology, Biomedicine Institute, Tabriz University of Medical Sciences, Tabriz P.O. Box 5163639888, Iran
| | - Moein Masjedi
- Department of Pharmaceutics, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz P.O. Box 6468571468, Iran
| | - Reza Maleki
- Department of Chemical Technologies, Iranian Research Organization for Science and Technology (IROST), Tehran P.O. Box 33535111, Iran
| | - Fatemeh Amini
- School of Dentistry, Shahed University of Medical Sciences, Tehran P.O. Box 5163639888, Iran
| | - Jonathan Wirth
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
| | - Keyvan Moharamzadeh
- Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai P.O. Box 505055, United Arab Emirates
| | - Franz E. Weber
- Center for Dental Medicine/Cranio-Maxillofacial and Oral Surgery, Oral Biotechnology and Bioengineering, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland
| | - Lobat Tayebi
- School of Dentistry, Marquette University, Milwaukee, WI 53233, USA
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Implementation of a Full Digital Workflow by 3D Printing Intraoral Splints Used in Dental Education: An Exploratory Observational Study with Respect to Students' Experiences. Dent J (Basel) 2022; 11:dj11010005. [PMID: 36661542 PMCID: PMC9858622 DOI: 10.3390/dj11010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/11/2022] [Accepted: 12/16/2022] [Indexed: 12/28/2022] Open
Abstract
Fully digital workflows gained acceptance in dental practice and thereby are of interest for undergraduate education. An exploratory clinical observation was designed to track the implementation of such a workflow with novice digital users in order to describe its feasibility, time investment, and pitfalls. METHODS Students were invited to provide feedback for their experiences with a training module that consisted of the following: intraoral scanning, computer-aided design (CAD), manual finishing, and insertion of a 3D-printed bite splint for the lower jaw. RESULTS A total of 82 fourth-year students participated in the module. The average time required to perform an intraoral scan was 17 m 5 s, and all students were able to design a splint with an average time of 2 h 38 m. Students who indicated prior experience with CAD seem to outperform inexperienced students in both CAD task completion and intraoral scanning. The initial fit was reported as clinically acceptable by 68.5% of the participants, while 79% rated the workflow as very good to satisfactory and indicated that the training was helpful for dental practice. CONCLUSIONS The implementation of a digital workflow in undergraduate dental education is feasible and has acceptable clinical results. However, CAD is time-intensive, and the experience can be challenging.
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Alikhasi M, Jafarian Z. Additional Manufactured Interim Restorations: a Review on the Literature. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2022; 23:424-437. [PMID: 36718160 PMCID: PMC9883624 DOI: 10.30476/dentjods.2021.91503.1589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/13/2021] [Accepted: 11/16/2021] [Indexed: 02/01/2023]
Abstract
Interim restorations are essential in many clinical scenarios in which indirect restorations are administered. Additional manufacturing (AM) technology has recently been introduced and applied in different fields of dental practice. This study aimed to collect relevant information from published papers regarding different aspects of AM temporary restorations with a focus on the most relevant technical properties. An electronic search was performed on Medline/ PubMed/ Scopus databases up to April 2020 to find relevant, peer-reviewed articles about AM provisional restoration. Although promising results for AM temporary restorations were obtained, comprehensive application of this technology in making provisional restorations requires information to address the missing properties concerning the short time of application.
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Affiliation(s)
- Marzieh Alikhasi
- Dental Research Center and Dept. of Prosthodontics and Implant, Dentistry Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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19
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Effect of 3D Printer Type and Use of Protection Gas during Post-Curing on Some Physical Properties of Soft Occlusal Splint Material. Polymers (Basel) 2022; 14:polym14214618. [PMID: 36365611 PMCID: PMC9658356 DOI: 10.3390/polym14214618] [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: 10/14/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Despite the fact that three-dimensional (3D) printing is frequently used in the manufacturing of occlusal splints, the effects of the 3D printer type and post-curing methods are still unclear. The aim of this study was to investigate the effect of the printer type (digital light processing: DLP; and liquid crystal display: LCD) as well as the post-curing method with two different atmospheric conditions (air and nitrogen gas (N2)) on the mechanical and surface properties of 3D-printed soft-type occlusal splint material. The evaluated properties were flexural strength, flexural modulus, Vickers hardness (VHN), fracture toughness, degree of double bond conversion (DC%), water sorption, water solubility, and 3D microlayer structure. The printer type significantly affected all the evaluated properties. Flexural strength, flexural modulus, and fracture toughness were significantly higher when specimens were printed by a DLP printer, while VHN and DC% were significantly higher, and a smoother surface was noticeably obtained when printed by an LCD printer. The post-curing at an N2 atmosphere significantly enhanced all of the evaluated properties except water sorption, 3D microlayer structure, and fracture toughness. The current results suggested that the printer type and the post-curing methods would have an impact on the mechanical and surface properties of the evaluated material.
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20
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Inokoshi M, Soeda Y, Akiyama Y, Ueda K, Kubota K, Minakuchi S. Fully Digital Workflow for the Fabrication of Three-Dimensionally Printed Surgical Splints for Preventing Postoperative Bleeding: A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12773. [PMID: 36232073 PMCID: PMC9566380 DOI: 10.3390/ijerph191912773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 09/25/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
The management of postoperative bleeding is mandatory in patients receiving anticoagulants. In this case report, we introduce a fully digital workflow for surgical splint fabrication to prevent postoperative bleeding in patients receiving anticoagulants and/or at risk of inadvertent extraction of a mobile tooth during impression making. An 87-year-old woman using apixaban had a left mandibular canine that required extraction due to chronic apical periodontitis. A digital impression was obtained using an intraoral scanner. First, the tooth to be extracted was deleted using three-dimensional (3D) computer-aided design (CAD) software (Geomagic Freeform, 3D Systems) and a stereolithography (STL) file was exported. This modified STL file was imported into another CAD software (3Shape Dental System, 3Shape) and a surgical splint was designed. The splint was fabricated using a 3D printer (Form 3; Formlabs) and light-curable resin (Dental LT Clear, Formlabs) and was delivered after the tooth extraction. The patient was followed-up 2 days after the extraction; no postoperative bleeding was detected and the surgical splint was removed. The additively manufactured surgical splint fabricated using a fully digital workflow was efficacious for managing postoperative bleeding after a dental extraction.
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21
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Effect of Nitrogen Gas Post-Curing and Printer Type on the Mechanical Properties of 3D-Printed Hard Occlusal Splint Material. Polymers (Basel) 2022; 14:polym14193971. [PMID: 36235919 PMCID: PMC9571503 DOI: 10.3390/polym14193971] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 11/16/2022] Open
Abstract
Although three-dimensional (3D) printing is clinically convenient to fabricate occlusal splints, it is still unclear how the post-curing method and the printer type can affect 3D-printed splints. This study aimed to evaluate the effect of stroboscopic post-curing at a nitrogen gas (N2) atmosphere versus post-curing in an air atmosphere, as well as the printer type (liquid crystal display (LCD) and digital light processing (DLP)) on the mechanical properties of a 3D-printed hard-type occlusal splint material. Flexural strength, flexural modulus, Vickers hardness number (VHN), fracture toughness, degree of double bond conversion (DC), 3D microlayer structure, water sorption, and water solubility were evaluated. The post-curing method significantly affected all evaluated properties except fracture toughness and 3D microlayer structure, while the printer type significantly affected all evaluated properties except flexural strength and flexural modulus. VHN and DC were significantly higher, and the smoother surface was noticeably obtained when printed by LCD printer and post-cured at an N2 atmosphere. The current results suggested that the post-curing method and the printer type would play a role in the mechanical properties of the evaluated material and that the combination of post-curing at an N2 atmosphere and LCD printer could enhance its mechanical properties and surface smoothness.
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22
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Tigmeanu CV, Ardelean LC, Rusu LC, Negrutiu ML. Additive Manufactured Polymers in Dentistry, Current State-of-the-Art and Future Perspectives-A Review. Polymers (Basel) 2022; 14:polym14173658. [PMID: 36080732 PMCID: PMC9460687 DOI: 10.3390/polym14173658] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/21/2022] [Accepted: 09/01/2022] [Indexed: 11/16/2022] Open
Abstract
3D-printing application in dentistry not only enables the manufacture of patient-specific devices and tissue constructs, but also allows mass customization, as well as digital workflow, with predictable lower cost and rapid turnaround times. 4D printing also shows a good impact in dentistry, as it can produce dynamic and adaptable materials, which have proven effective in the oral environment, under its continuously changing thermal and humidity conditions. It is expected to further boost the research into producing a whole tooth, capable to harmoniously integrate with the surrounding periodontium, which represents the ultimate goal of tissue engineering in dentistry. Because of their high versatility associated with the wide variety of available materials, additive manufacturing in dentistry predominantly targets the production of polymeric constructs. The aim of this narrative review is to catch a glimpse of the current state-of-the-art of additive manufacturing in dentistry, and the future perspectives of this modern technology, focusing on the specific polymeric materials.
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Affiliation(s)
- Codruta Victoria Tigmeanu
- Department of Technology of Materials and Devices in Dental Medicine, Faculty of Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Lavinia Cosmina Ardelean
- Department of Technology of Materials and Devices in Dental Medicine, Faculty of Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Correspondence:
| | - Laura-Cristina Rusu
- Department of Oral Pathology, Faculty of Dental Medicine, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
| | - Meda-Lavinia Negrutiu
- Department of Prostheses Technology and Dental Materials, Faculty of Dental Medicine, Research Center in Dental Medicine Using Conventional and Alternative Technologies, “Victor Babes” University of Medicine and Pharmacy Timisoara, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
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Bürgers R, Schubert A, Müller J, Krohn S, Rödiger M, Leha A, Wassmann T. Cytotoxicity of 3D‐printed, milled, and conventional oral splint resins to L929 cells and human gingival fibroblasts. Clin Exp Dent Res 2022; 8:650-657. [PMID: 35570327 PMCID: PMC9209804 DOI: 10.1002/cre2.592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 05/01/2022] [Indexed: 11/22/2022] Open
Abstract
Objectives Evidence on the biocompatibility of three‐dimensional (3D)‐printed and milled resins for oral splints is limited. This in vitro study assessed the influence of the manufacturing method on the cytotoxicity of oral splint resins on L929 cells and human gingival fibroblasts (GF1). Materials and Methods Standardized specimens of four 3D‐printed, two‐milled, one‐thermoformed, and one‐pressed splint resin were incubated with L929 and GF1 cells for 24 h. Immunofluorescence and WST‐8 assay were performed to evaluate cytotoxic effects. One‐way analysis of variance and Tukey's multiple comparison test were applied with the variables “splint resin” and “manufacturing method” (p < .05). Results Immunofluorescence showed attachment of L929 and GF1 cells to the splint resins. Irrespective of the manufacturing method, the WST‐8 assay revealed significant differences between splint resins for the viability of L929 and GF1 cells. L929 cells generally showed lower viability rates than GF1 cells. The evaluation of cell viability by the manufacturing method showed no significant differences between 3D printing, milling, and conventional methods. Conclusions The cytotoxic effects of 3D‐printed, milled, and conventional oral splint resins were similar, indicating minor influence of the manufacturing method on biocompatibility. Cytotoxicity of the resins was below a critical threshold in GF1 cells. The chemical composition might be more crucial than the manufacturing method for the biocompatibility of splint resins.
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Affiliation(s)
- Ralf Bürgers
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Andrea Schubert
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Jonas Müller
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Sebastian Krohn
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Matthias Rödiger
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
| | - Andreas Leha
- Department of Medical StatisticsUniversity Medical Center GöttingenGöttingenGermany
| | - Torsten Wassmann
- Department of ProsthodonticsUniversity Medical Center GöttingenGöttingenGermany
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24
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Patzelt SBM, Krügel M, Wesemann C, Pieralli S, Nold J, Spies BC, Vach K, Kohal RJ. In Vitro Time Efficiency, Fit, and Wear of Conventionally- versus Digitally-Fabricated Occlusal Splints. MATERIALS (BASEL, SWITZERLAND) 2022; 15:1085. [PMID: 35161032 PMCID: PMC8837971 DOI: 10.3390/ma15031085] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/20/2022] [Accepted: 01/28/2022] [Indexed: 02/01/2023]
Abstract
The purpose of the study was to compare conventional to digital workflows of occlusal splint production regarding time efficiency, overall fit, and wear. Fifteen Michigan splints were fabricated with a conventional and digital method. The duration for the dentist's and the dental technician's workload was recorded. Subsequently, the overall fit was examined with a four-level score (1-4). Paired t-tests were used to compare the time results for the conventional and digital workflows and the sign test to compare the overall fit. The mean time (16 min 58 s) for computerized optical impressions was longer than for conventional impressions (6 min 59 s; p = 0.0001). However, the dental technician needed significantly less mean time for the digital splint production (47 min 52 s) than for the conventional (163 min 32 s; p = 0.001). The overall fit of the digitally-fabricated splints was significantly better compared to the conventionally-fabricated splints (p = 0.002). There was no impact of the different materials used in the conventional and digital workflow on the wear (p = 0.26). The results suggest that the digital workflow for the production of occlusal splints is more time efficient and leads to a better fit than the conventional workflow.
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Affiliation(s)
- Sebastian Berthold Maximilian Patzelt
- Private Dental Clinic, Am Dorfplatz 3, 78658 Zimmern ob Rottweil, Germany
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
| | - Marei Krügel
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
| | - Christian Wesemann
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
| | - Stefano Pieralli
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
| | - Julian Nold
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
| | - Benedikt Christopher Spies
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
| | - Kirstin Vach
- Medical Center—University of Freiburg, Institute of Medical Biometry and Statistics, Faculty of Medicine, University of Freiburg, Stefan-Meier-Str. 26, 79104 Freiburg, Germany;
| | - Ralf-Joachim Kohal
- Medical Center—University of Freiburg, Center for Dental Medicine, Department of Prosthetic Dentistry, Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106 Freiburg, Germany; (M.K.); (C.W.); (S.P.); (J.N.); (B.C.S.); (R.-J.K.)
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25
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A Novel Low-Shrinkage Resin for 3D Printing. J Dent 2022; 118:103957. [PMID: 35038476 DOI: 10.1016/j.jdent.2022.103957] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 01/08/2022] [Accepted: 01/12/2022] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To evaluate the shrinkage, accuracy, and mechanical properties of a newly developed photo-polymerizable resin material for 3D printing dental applications and compare it with three commercially available resins. METHODS An experimental novel proprietary resin material for 3D printing was formulated. This new resin, Die and Model Tan (SprintRay), Formlabs Grey (FormLabs), and LCD Grey (Roxel 3D) were evaluated and tested for volumetric shrinkage, accuracy, and flexural and tensile properties. Volumetric shrinkage was measured using the AcuVol video imaging method. The accuracy of the 3D printed objects through the DLP (digital light processing) printing system was determined by the 3D deviation between the scanned model and the original CAD digital model. Parallelepiped specimens (2 × 2 × 25 mm, n= 5) were printed for flexural strength, flexural modulus, and modulus of resilience and measured in accordance with ISO-4049. Dumbbell-shaped specimens (Type V, n = 5) were printed to investigate the tensile strength and tested according to ASTM-D638. Data were analyzed using one-way ANOVA and post-hoc Tukey tests (p≤0.05). RESULTS The experimental resin exhibited significantly lower volumetric shrinkage and significantly higher accuracy than the other commercially available resins (p < 0.001). The experimental resin showed flexural strength, flexural modulus, and tensile strength similar to Die and Model Tan resin (SprintRay) (p > 0.05), and these parameters were significantly higher than those of Formlabs Grey resin (Formlabs) and lower than those of LCD Gray resin (Roxel3D)(p <0.001). CONCLUSION The newly formulated 3D printing resin demonstrated lower volumetric shrinkage, high accuracy, and adequate mechanical properties compared to the commercially available resin materials. CLINICAL SIGNIFICANCE The new 3D printed objects exhibited higher accuracy, good stability over time, and adequate mechanical properties. The new 3D printing resin is a good candidate for modeling applications for restoration, orthodontics and implants.
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26
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GIBREEL M, PEREA-LOWERY L, VALLITTU PK, GAROUSHI S, LASSILA L. Two-body wear and surface hardness of occlusal splint materials. Dent Mater J 2022; 41:916-922. [DOI: 10.4012/dmj.2022-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mona GIBREEL
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | - Leila PEREA-LOWERY
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | | | - Sufyan GAROUSHI
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | - Lippo LASSILA
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
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27
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Crenn MJ, Rohman G, Fromentin O, Benoit A. Polylactic acid as a biocompatible polymer for three-dimensional printing of interim prosthesis: Mechanical characterization. Dent Mater J 2021; 41:110-116. [PMID: 34866117 DOI: 10.4012/dmj.2021-151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Mechanical properties of polylactic acid (PLA), which is a biopolymer obtained via 3D-printing, were compared with conventional resins for the realization of interim prosthesis. A PLA built by fused deposition modeling and traditional interim resins (Unifast®, Integrity®, Temporary CB®) were divided into 4 groups (n=10). Each group was investigated for Young modulus, flexural strength, microhardness and analysis of the fractured surface. Data were analyzed by Kruskal-Wallis and ANOVA (α=0.05). The porosity of the PLA was calculated from the crystallinity degree and density. PLA-group showed an elastic modulus and flexural strength in the same range than Integrity®-group, better than Unifast®-group and inferior to Temporary CB®-group (p<0.05). PLA-group microhardness was equivalent to Unifast®-group and inferior to Integrity® and Temporary CB® groups (p<0.05). Due to mechanical properties similar to conventional resins and the low porosity rate, this biocompatible 3D-printed polymer may be an interesting alternative to conventional polymer to build temporary prosthesis.
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Affiliation(s)
- Marie-Joséphine Crenn
- Innovative Dental Materials and Interfaces research Unit (URB2I, UR 4462), Faculty of Health, Paris University.,Departement of Odontology, Rothschild Hospital
| | - Géraldine Rohman
- Innovative Dental Materials and Interfaces research Unit (URB2I, UR 4462), Faculty of Health, Paris University.,Tissue Engineering and Proteomics (TIP) team, CSPBAT UMR CNRS 7244, Sorbonne Paris Nord
| | - Olivier Fromentin
- Innovative Dental Materials and Interfaces research Unit (URB2I, UR 4462), Faculty of Health, Paris University.,Departement of Odontology, Rothschild Hospital
| | - Aurélie Benoit
- Innovative Dental Materials and Interfaces research Unit (URB2I, UR 4462), Faculty of Health, Paris University
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Abstract
The purpose of this pilot study was to demonstrate the capabilities of the T-Scan Novus system in bruxism treatment by splints. Bruxism patients underwent treatment with a splint made by additive manufacturing. Intraoral scanning was performed using Trios Color (3Shape), and digital design was performed using 3Shape Dental system design - splint studio. The biocompatible material Dental LT Clear Resin was printed using a Formlabs Form 2 printer. The T-Scan Novus system with a software attached to it, version 9.1, was used for digital examination of the occlusion. A splint with an occlusal thickness of 2.5 mm was developed and software adapted with relief to antagonists. The digitally set occlusion with even contacts turned out to be clinically unbalanced. After adjusting with T-Scan Novus, a balanced occlusion was achieved in the right and left halves. The treatment of bruxism with splint therapy continues to be the main method. Its combination with digital technologies allows more precise constructions and more accurate balancing of occlusal relationships.
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Affiliation(s)
- Tanya Bozhkova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
| | - Dobromira Shopova
- Department of Prosthetic Dentistry, Faculty of Dental Medicine, Medical University, Plovdiv, Bulgaria
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29
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Lee EH, Ahn JS, Lim YJ, Kwon HB, Kim MJ. Effect of post-curing time on the color stability and related properties of a tooth-colored 3D-printed resin material. J Mech Behav Biomed Mater 2021; 126:104993. [PMID: 34871954 DOI: 10.1016/j.jmbbm.2021.104993] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/19/2021] [Accepted: 11/21/2021] [Indexed: 01/27/2023]
Abstract
This study investigated the effect of post-curing time on the color stability and related properties, such as degree of conversion (DC), surface roughness, water contact angle, water sorption (Wsp), and water solubility (Wsl) of 3D-printed resin for dental restorations. The 3D-printed specimens were divided into four groups according to the post-curing time (0, 5, 10, and 20 min). Color changes (ΔE00) of the specimens immersed in aging media were measured using a spectrophotometer at different aging times. The DC of the resin was measured using a FTIR. The surface roughness (Ra) of the resin immersed in coffee was measured at different aging times. Water contact angle was evaluated using the sessile drop method, and Wsp and Wsl were tested according to the ISO 4049:2019. The ΔE00 values of the specimens immersed in coffee and red wine decreased with increasing post-curing time. As the post-curing time increased up to 10 min, the DC increased and water contact angle decreased. The Ra value of the group without post-curing (0 min) increased gradually for 30 days, except between 7 and 15 days. However, when the post-curing time increased to greater than 10 min, no apparent change in Ra value was detected. The Wsp and Wsl of the group without post-curing were significantly lower and larger than that of the other groups, respectively. The longer the post-curing time of the tooth-colored 3D-printed resin, the better the color stability. The post-curing time of the 3D-printed resin affected the DC, surface roughness after aging in the staining media, water contact angle, water sorption, and water solubility.
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Affiliation(s)
- Eun-Hyuk Lee
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Jin-Soo Ahn
- Dental Research Institute and Department of Dental Biomaterials Science, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Young-Jun Lim
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Ho-Beom Kwon
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea
| | - Myung-Joo Kim
- Dental Research Institute and Department of Prosthodontics, School of Dentistry, Seoul National University, Seoul, 03080, Republic of Korea.
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30
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Khalaj R, Tabriz AG, Okereke MI, Douroumis D. 3D printing advances in the development of stents. Int J Pharm 2021; 609:121153. [PMID: 34624441 DOI: 10.1016/j.ijpharm.2021.121153] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/07/2023]
Abstract
3D printing technologies have found several applications within the biomedical sector including in the fabrication of medical devices, advanced visualization, diagnosis planning and simulation of surgical procedures. One of the areas in which of 3D printing is anticipated to revolutionised is the manufacturing of implantable bioresorbable drug-eluting scaffolds (stents). The ability to customize and create personalised tailor-made bioresorbable scaffolds has the potential to help solve many of the challenges associated with stenting, such as inappropriate stent sizing and design, abolish late stent thrombosis and help artery growth; 3D printing offers a rapid prototyping and effective method of producing stents making customization of designs feasible. This review provides an overview of the subjects and summarizes the latest research in the 3D printing technologies employed for the design and fabrication of bioresorbable stents including materials with the required printable and mechanical properties. Finally, we present a regulatory perspective on the development and engineering of 3D printed implantable stents.
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Affiliation(s)
- Roxanne Khalaj
- School of Science, University of Greenwich, Central Avenue, Chatham Maritime, Chatham, Kent ME4 4TB, UK; CIPER Centre for Innovation and Process Engineering Research, Kent ME4 4TB, UK
| | - Atabak Ghanizadeh Tabriz
- School of Science, University of Greenwich, Central Avenue, Chatham Maritime, Chatham, Kent ME4 4TB, UK; CIPER Centre for Innovation and Process Engineering Research, Kent ME4 4TB, UK
| | - Michael I Okereke
- Mathematical Modelling for Engineering Research Group, Department of Engineering Science, University of Greenwich, UK
| | - Dennis Douroumis
- School of Science, University of Greenwich, Central Avenue, Chatham Maritime, Chatham, Kent ME4 4TB, UK; CIPER Centre for Innovation and Process Engineering Research, Kent ME4 4TB, UK.
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Many Moving Pieces: Virtual Preoperative Surgical Planning for Traumatic Occlusal Splints. J Craniofac Surg 2021; 33:1037-1041. [PMID: 34690316 DOI: 10.1097/scs.0000000000008282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRO Achieving anatomic reduction and re-establishing premorbid occlusion in patients with complex maxillomandibular fractures is challenging even for seasoned surgeons. Historically, surgeons have utilized occlusal splints to help establish occlusal relationships before fracture reduction and fixation. These acrylic splints are fabricated from dental impressions and require manual repositioning of tooth bearing segments along the fracture line to reapproximate premorbid occlusion. The process is laborious, requires a dental lab, and is less efficacious in edentulous patients or those with significantly comminuted fractures; as such it has largely fallen out of practice. Recently, with advances in virtual 3D modeling and printing, we demonstrate that occlusal splints can be designed from computed tomography scans, manipulated virtually, and printed without obtaining impressions from the patient. METHODS/RESULTS In our series of 3 patients with complex maxillomandibular fractures, occlusal splints were created by 1) obtaining maxillofacial computed tomography scans, 2) reducing the fractures virtually, and 3) using orthognathic virtual surgery software to create the splint. The time between planning and delivery of the splint was 4 to 7 days. These splints were successfully utilized to help establish premorbid occlusion in conjunction with maxillomandibular fixation and aided in expeditious intraoperative fracture reduction and fixation. CONCLUSIONS In the treatment of complex facial fractures, occlusal splints can be a useful adjunct in the operative reduction and fixation of fractures. With the advent of virtual preoperative surgical planning via 3D modeling and 3D printing, these occlusal splints can be created of a sufficient fidelity to avoid the strict need for dental impressions.
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Effect of Printing Layer Thickness on the Trueness and Margin Quality of 3D-Printed Interim Dental Crowns. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11199246] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The information in the literature on the effect of printing layer thickness on interim 3D-printed crowns is limited. In the present study, the effect of layer thickness on the trueness and margin quality of 3D-printed composite resin crowns was investigated and compared with milled crowns. The crowns were printed in 3 different layer thicknesses (20, 50, and 100 μm) by using a hybrid resin based on acrylic esters with inorganic microfillers or milled from polymethylmethacrylate (PMMA) discs and digitized with an intraoral scanner (test scans). The compare tool of the 3D analysis software was used to superimpose the test scans and the computer-aided design file by using the manual alignment tool and to virtually separate the surfaces. Deviations at different surfaces on crowns were calculated by using root mean square (RMS). Margin quality of crowns was examined under a stereomicroscope and graded. The data were evaluated with one-way ANOVA and Tukey HSD tests. The layer thickness affected the trueness and margin quality of 3D-printed interim crowns. Milled crowns had higher trueness on intaglio and intaglio occlusal surfaces than 100 μm-layer thickness crowns. Milled crowns had the highest margin quality, while 20 μm and 100 μm layer thickness printed crowns had the lowest. The quality varied depending on the location of the margin.
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Nasiry Khanlar L, Revilla-León M, Barmak AB, Ikeda M, Alsandi Q, Tagami J, Zandinejad A. Surface roughness and shear bond strength to composite resin of additively manufactured interim restorative material with different printing orientations. J Prosthet Dent 2021; 129:788-795. [PMID: 34602276 DOI: 10.1016/j.prosdent.2021.08.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 08/08/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
STATEMENT OF PROBLEM Additive manufacturing (AM) is a technology that has been recently introduced into dentistry for fabricating dental devices, including interim restorations. Printing orientation is one of the important and influential factors in AM that affects the accuracy, surface roughness, and mechanical characteristics of printed objects. However, the optimal print orientation for best bond strength to 3D-printed interim restorations remains unclear. PURPOSE The purpose of this in vitro study was to evaluate the effect of printing orientation on the surface roughness, topography, and shear bond strength of AM interim restorations to composite resin. MATERIAL AND METHODS Disk-shaped specimens (Ø20×10 mm) were designed by a computer-aided design software program (Geomagic freeform), and a standard tessellation language (STL) file was obtained. The STL file was used for the AM of 60 disks in 3 different printing orientations (0, 45, and 90 degrees) by using E-Dent 400 C&B material. An autopolymerizing interim material (Protemp 4) was used as a control group (CNT), and specimens were fabricated by using the injecting mold technique (n=20). Surface roughness (Sa, Sz parameters) was measured by using a 3D-laser scanning confocal microscope (CLSM) at ×20 magnification. For shear bond testing, the specimens were embedded in polymethylmethacrylate autopolymerized resin (n=20). A flowable composite resin was bonded by using an adhesive system. The specimens were stored in distilled water at 37 °C for 1 day and thermocycled 5000 times. The shear bond strength (SBS) was measured at a crosshead speed of 1 mm/min. The data were analyzed by 1-way ANOVA, followed by the Tukey HSD test (α=.05). RESULTS The 45-degree angulation printing group reported the highest Sa, followed by the CNT and the 90-degree and 0-degree angulations with significant difference between them (P<.001). The CNT showed the highest Sz, followed by the 45-degree, 90-degree, and 0-degree angulations. The mean ±standard deviation SBS was 28.73 ±5.82 MPa for the 90-degree, 28.21 ±10.69 MPa for the 45-degree, 26.21 ±11.19 MPa for the 0-degree angulations and 25.39 ±4.67 MPa for the CNT. However, no statistically significant difference was found in the SBS among the groups (P=.475). CONCLUSIONS Printing orientation significantly impacted the surface roughness of 3D-printed resin for interim restorations. However, printing orientation did not significantly affect the bond strength with composite resin.
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Affiliation(s)
- Leila Nasiry Khanlar
- PhD Candidate, Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Marta Revilla-León
- Assistant Professor and Assistant Program Director AEGD Residency Program, College of Dentistry, Texas A&M University, Dallas, Texas; Affiliate Faculty Graduate Prosthodontics, School of Dentistry, University of Washington, Seattle, Wash; Researcher at Revilla Research Center, Madrid, Spain
| | - Abdul Basir Barmak
- Assistant Professor of Clinical Research and Biostatistics, EIOH Medical Center, University of Rochester, Rochester, NY
| | - Masaomi Ikeda
- Senior Lecturer, Oral Prosthetic Engineering, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Qutaiba Alsandi
- PhD Candidate, Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junji Tagami
- Professor, Department of Cariology and Operative Dentistry, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Amirali Zandinejad
- Associate Professor with Tenure and Program Director AEGD Residency Program, College of Dentistry, Texas A&M University, Dallas, Texas.
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Gibreel M, Perea-Lowery L, Vallittu PK, Lassila L. Characterization of occlusal splint materials: CAD-CAM versus conventional resins. J Mech Behav Biomed Mater 2021; 124:104813. [PMID: 34530298 DOI: 10.1016/j.jmbbm.2021.104813] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/16/2021] [Accepted: 09/03/2021] [Indexed: 11/15/2022]
Abstract
AIM The aim of this in vitro study was to assess the mechanical properties of five commercially available subtractive computer-aided design and computer-aided manufacturing (CAD-CAM) milled splint materials, as well as to compare them with conventional heat-polymerized and autopolymerizing resins used in the construction of conventional splints. MATERIAL AND METHODS Five CAD-CAM milled (ProArt CAD Splint, Therapon Transpa, Temp Premium Flexible Transpa, Cast, and Aqua), one autopolymerizing (Palapress), and one heat-polymerized (Paladon 65) resin materials were evaluated. Flexural strength, E-modulus, Vickers hardness, fracture toughness, fracture work, water sorption, and water solubility were measured. Samples were evaluated after dry and water storage for 30 days at 37 °C. Data were collected and statistically analyzed. RESULTS Under both storage circumstances, the flexural strength values of Paladon 65, Therapon Transpa, Temp Premium Flexible Transpa, and Aqua were statistically non-significant (P=0.055). The polycarbonate-based CAD-CAM material Temp Premium Flexible Transpa had the highest statistically significant values of the fracture toughness and fracture work (P<0.001). Moreover, it exhibited the lowest percentages of water sorption and water solubility among the investigated materials (P<0.001). All of the CAD-CAM materials exhibited dry elastic moduli greater than Palapress and lower than Paladon 65. One of the CAD-CAM materials, Cast, had the highest dry Vickers hardness value, which was non-significant when compared to Therapon Transpa (P=0.762). CONCLUSION CAD-CAM polycarbonate-based splint materials exhibit higher fracture toughness and fracture work as well as lower water sorption and solubility than polymethyl methacrylate-based ones. The mechanical characteristics of the assessed CAD-CAM milled splint materials were not typically superior to those of the conventional heat-polymerized resin. However, some of them outperformed the autopolymerizing acrylic resin in terms of flexural strength, surface microhardness, water sorption, and water solubility.
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Affiliation(s)
- Mona Gibreel
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland.
| | - Leila Perea-Lowery
- Department of Biomaterials Science, Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
| | - Pekka K Vallittu
- Professor and Chair of Biomaterials Science Department, University of Turku, Welfare Division, Turku, Finland
| | - Lippo Lassila
- Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku, Finland
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Kuscu E, Klink A, Spintzyk S, Kraemer Fernandez P, Huettig F. Bonding Interface and Repairability of 3D-Printed Intraoral Splints: Shear Bond Strength to Current Polymers, with and without Ageing. MATERIALS 2021; 14:ma14143935. [PMID: 34300854 PMCID: PMC8307865 DOI: 10.3390/ma14143935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 12/12/2022]
Abstract
This in-vitro study investigates the bonding interfaces reached by the conditioning of a splint material additively manufactured by digital light processing (AM base) as well as the shear bond strength (SBS) of resins bonded to these surfaces (repair material). Therefore, the AM base was either stored in dry for 12 h or wet environment for 14 days to simulate ageing by intraoral wear. The dry and wet group was bonded after physical and/or chemical conditioning to cylinders made from polymethylmethacrylate or four novel polymers allowing splint modifications. Blasted and methylmethacrylate (MMA)-conditioned Polymethylmethacrylate (PMMA) bonded to PMMA acted as the gold standard. The surface profiles revealed highest differences of Ra towards the gold standard in AM base conditioned with other than MMA after sandblasting. The adhesively bonded repair materials of the wet AM base were further aged in wet environment for 14 days. The SBS of the gold standard (25.2 MPa and 25.6 MPa) was only reached by PMMA bonded to blasted and MMA-conditioned AM base after dry (22.7 MPa) and non-conditioned after wet storage (23 MPa). Four repair materials failed to reach the threshold of 5 MPa after dry storage and three after wet storage, respectively. Non-conditioned AM base revealed the highest risk for adhesive fractures when using other resins than PMMA.
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Affiliation(s)
- Ebru Kuscu
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
- Correspondence:
| | - Andrea Klink
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
| | - Sebastian Spintzyk
- Section Medical Materials Science and Technology, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany;
| | - Pablo Kraemer Fernandez
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
| | - Fabian Huettig
- Department of Prosthodontics, University Clinic of Dentistry, Oral Medicine, and Maxillofacial Surgery with Dental School, Tuebingen University Hospital, Osianderstr. 2–8, 72076 Tübingen, Germany; (A.K.); (P.K.F.); (F.H.)
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Schubert A, Bürgers R, Baum F, Kurbad O, Wassmann T. Influence of the Manufacturing Method on the Adhesion of Candida albicans and Streptococcus mutans to Oral Splint Resins. Polymers (Basel) 2021; 13:polym13101534. [PMID: 34064561 PMCID: PMC8150722 DOI: 10.3390/polym13101534] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/05/2021] [Accepted: 05/06/2021] [Indexed: 02/07/2023] Open
Abstract
Microbial adhesion to oral splints may lead to oral diseases such as candidiasis, periodontitis or caries. The present in vitro study aimed to assess the effect of novel computer-aided design/computer-aided manufacturing (CAD/CAM) and conventional manufacturing on Candida albicans and Streptococcus mutans adhesion to oral splint resins. Standardized specimens of four 3D-printed, two milled, one thermoformed and one pressed splint resin were assessed for surface roughness by widefield confocal microscopy and for surface free energy by contact angle measurements. Specimens were incubated with C. albicans or S. mutans for two hours; a luminometric ATP assay was performed for the quantification of fungal and bacterial adhesion. Both one-way ANOVA with Tukey post hoc testing and Pearson correlation analysis were performed (p < 0.05) in order to relate manufacturing methods, surface roughness and surface free energy to microbial adhesion. Three-dimensional printing and milling were associated with increased adhesion of C. albicans compared to conventional thermoforming and pressing, while the S. mutans adhesion was not affected. Surface roughness and surface free energy showed no significant correlation with microbial adhesion. Increased fungal adhesion to oral splints manufactured by 3D printing or milling may be relevant for medically compromised patients with an enhanced risk for developing candidiasis.
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Gottsauner M, Reichert T, Koerdt S, Wieser S, Klingelhoeffer C, Kirschneck C, Hoffmann J, Ettl T, Ristow O. Comparison of additive manufactured models of the mandible in accuracy and quality using six different 3D printing systems. J Craniomaxillofac Surg 2021; 49:855-866. [PMID: 34120812 DOI: 10.1016/j.jcms.2021.04.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 03/13/2021] [Accepted: 04/11/2021] [Indexed: 02/06/2023] Open
Abstract
The aim of this study was to analyze and compare the accuracy and quality of six 3D printing systems available on the market. Data acquisition was performed with 12 scans of human mandibles using an industrial 3D scanner and saved in STL format. These STL files were printed using six different printing systems. Previously defined distances were measured with a sliding caliper on the 72 printed mandibles. The printed models were then scanned once again. Measurements of volumes and surfaces for the STL files and the printed models were compared. Accuracy and quality were evaluated using industrial software. An analysis of the punctual aberration between the template and the printed model, based on a heat map, was also carried out. Secondary factors, such as costs, production times and expendable materials, were also examined. All printing systems performed well in terms of accuracy and quality for clinical usage. The Formiga P110 and the Form 2 showed the best results for volume, with average aberrations of 0.13 ± 0.23 cm3 and 0.12 ± 0.17 cm3, respectively. Similar results were achieved for the heat map aberration, with values of 0.008 ± 0.11 mm (Formiga P110) and 0.004 ± 0.16 mm (Form 2). Both printers showed no significant difference from the optimal neutral line (Formiga P110, p = 0.15; Form 2, p = 0.60). The cheapest models were produced by the Ultimaker 2+, with an average of 5€ per model, making such desktop printers affordable for rapid prototyping. Meanwhile, advanced printing systems with sterilizable and biocompatible printing materials, such as the Formiga P110 and the Form 2, fulfill the high expectations for maxillofacial surgery.
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Affiliation(s)
- Maximilian Gottsauner
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany.
| | - Torsten Reichert
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany.
| | - Steffen Koerdt
- Department of Oral and Maxillofacial Surgery, Charité University Medicine Berlin, Charitéplatz 1, D-10117, Berlin, Germany.
| | - Stefan Wieser
- Technologie Centrum Westbayern, Emil-Eigner-Straße 1, D-86720, Noerdlingen, Germany
| | - Christoph Klingelhoeffer
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany.
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany.
| | - Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
| | - Tobias Ettl
- Department of Oral and Maxillofacial Surgery, University Hospital Regensburg, University of Regensburg, Franz-Josef-Strauß-Allee 11, D-93053, Regensburg, Germany.
| | - Oliver Ristow
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, University of Heidelberg, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
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Additive Manufacturing Processes in Medical Applications. MATERIALS 2021; 14:ma14010191. [PMID: 33401601 PMCID: PMC7796413 DOI: 10.3390/ma14010191] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 12/29/2022]
Abstract
Additive manufacturing (AM, 3D printing) is used in many fields and different industries. In the medical and dental field, every patient is unique and, therefore, AM has significant potential in personalized and customized solutions. This review explores what additive manufacturing processes and materials are utilized in medical and dental applications, especially focusing on processes that are less commonly used. The processes are categorized in ISO/ASTM process classes: powder bed fusion, material extrusion, VAT photopolymerization, material jetting, binder jetting, sheet lamination and directed energy deposition combined with classification of medical applications of AM. Based on the findings, it seems that directed energy deposition is utilized rarely only in implants and sheet lamination rarely for medical models or phantoms. Powder bed fusion, material extrusion and VAT photopolymerization are utilized in all categories. Material jetting is not used for implants and biomanufacturing, and binder jetting is not utilized for tools, instruments and parts for medical devices. The most common materials are thermoplastics, photopolymers and metals such as titanium alloys. If standard terminology of AM would be followed, this would allow a more systematic review of the utilization of different AM processes. Current development in binder jetting would allow more possibilities in the future.
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Tian Y, Chen C, Xu X, Wang J, Hou X, Li K, Lu X, Shi H, Lee ES, Jiang HB. A Review of 3D Printing in Dentistry: Technologies, Affecting Factors, and Applications. SCANNING 2021; 2021:9950131. [PMID: 34367410 PMCID: PMC8313360 DOI: 10.1155/2021/9950131] [Citation(s) in RCA: 131] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/20/2021] [Accepted: 06/24/2021] [Indexed: 05/14/2023]
Abstract
Three-dimensional (3D) printing technologies are advanced manufacturing technologies based on computer-aided design digital models to create personalized 3D objects automatically. They have been widely used in the industry, design, engineering, and manufacturing fields for nearly 30 years. Three-dimensional printing has many advantages in process engineering, with applications in dentistry ranging from the field of prosthodontics, oral and maxillofacial surgery, and oral implantology to orthodontics, endodontics, and periodontology. This review provides a practical and scientific overview of 3D printing technologies. First, it introduces current 3D printing technologies, including powder bed fusion, photopolymerization molding, and fused deposition modeling. Additionally, it introduces various factors affecting 3D printing metrics, such as mechanical properties and accuracy. The final section presents a summary of the clinical applications of 3D printing in dentistry, including manufacturing working models and main applications in the fields of prosthodontics, oral and maxillofacial surgery, and oral implantology. The 3D printing technologies have the advantages of high material utilization and the ability to manufacture a single complex geometry; nevertheless, they have the disadvantages of high cost and time-consuming postprocessing. The development of new materials and technologies will be the future trend of 3D printing in dentistry, and there is no denying that 3D printing will have a bright future.
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Affiliation(s)
- Yueyi Tian
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - ChunXu Chen
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xiaotong Xu
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Jiayin Wang
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xingyu Hou
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Kelun Li
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Xinyue Lu
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - HaoYu Shi
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
| | - Eui-Seok Lee
- Department of Oral and Maxillofacial Surgery, Graduate School of Clinical Dentistry, Korea University, Seoul 08308, Republic of Korea
| | - Heng Bo Jiang
- The Conversationalist Club, School of Stomatology, Shandong First Medical University & Shandong Academy of Medical Sciences, Tai'an, Shandong 271016, China
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Suzuki Y, Shimizu S, Waki T, Shimpo H, Ohkubo C. Laboratory efficiency of additive manufacturing for removable denture frameworks: A literature-based review. Dent Mater J 2020; 40:265-271. [PMID: 33361665 DOI: 10.4012/dmj.2020-206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this literature review was to verify the laboratory efficiency of additive manufacturing (AM) systems for removable partial denture (RPD) frameworks. All available relevant articles in English published from 1990 to 2020 were found by searching online databases and by hand research. A total of 17 articles dealt with the surface roughness, fitness accuracy, and retentive forces of AM frameworks. The surface roughness of AM was inferior to that of casting and milling. Whether conventional cast or AM RPD frameworks had superior fitness accuracy could not be clarified. As compared with casting and AM, milling enabled the fabrication of RPD clasps with comparable or better fitness accuracy. Over time, AM clasps had retentive force values of superior consistency as compared with those of conventional cast clasps. Clasps fabricated by repeated laser sintering and high-speed milling could obtain smoother surfaces and more suitable retention than those of AM clasps.
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Affiliation(s)
- Yasunori Suzuki
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Satoshi Shimizu
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Takuya Waki
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Hidemasa Shimpo
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
| | - Chikahiro Ohkubo
- Department of Removable Prosthodontics, Tsurumi University School of Dental Medicine
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Perea-Lowery L, Gibreel M, Vallittu PK, Lassila L. Evaluation of the mechanical properties and degree of conversion of 3D printed splint material. J Mech Behav Biomed Mater 2020; 115:104254. [PMID: 33333480 DOI: 10.1016/j.jmbbm.2020.104254] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 11/26/2020] [Accepted: 12/06/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the effect of post-curing method, printing layer thickness, and water storage on the mechanical properties and degree of conversion of a light-curing methacrylate based resin material (IMPRIMO® LC Splint), used for the fabrication of 3D printed occlusal splints and surgical guides. METHODS 96 bar-shaped specimens were 3D printed (Asiga MAX), half of them with a layer thickness of 100 μm (Group A), and half with 50 μm (Group B). Each group was divided in three subgroups based on the post-curing method used: post-curing with light emitting diode (LED) and nitrogen gas; post-curing with only LED; and non-post-curing. Half of the specimens from each subgroup were water-stored for 30 days while the other half was dry-stored (n = 8). Flexural strength and flexural modulus were evaluated. Additional specimens were prepared and divided in the same way for surface hardness (n = 96), fracture toughness, and work of fracture (n = 96). Five specimens were selected from each subgroup for evaluating the degree of conversion (DC). Data were collected and statistically analyzed with 1-way, 2-way ANOVA, and Tukey post-hoc analysis (α = 0.05). RESULTS The 2-way ANOVA showed that the post-curing method and water storage significantly affected the investigated mechanical properties (P < 0.001). The 1-way ANOVA revealed a statistically significant difference among the tested groups on the investigated properties (P < 0.001). After water storage, the 100 μm subgroup post-cured with only LED showed higher flexural strength (51 ± 9) than the 50 μm and 100 μm subgroups that were post-cured with LED in addition to nitrogen gas atmosphere (38 ± 5, 30 ± 3) (p < 0.05). The 50 μm subgroup post-cured with only LED showed the highest significant flexural modulus values (1.7 ± 0.08) (p < 0.05). However, the 50 μm subgroup post-cured with LED plus nitrogen showed significantly higher surface hardness values (p < 0.05) among the investigated groups. The non-post-cured subgroups showed the lowest values, which were significantly different from the other subgroups (p < 0.05). CONCLUSION The post-curing method, water storage, and printing layer thickness play a role in the mechanical properties of the investigated 3D Printed occlusal splints material. The combination of heat and light within the post-curing unit can enhance the mechanical properties and degree of conversion of 3D printed occlusal splints. Flexural strength and surface hardness can increase when decreasing printing layer thickness.
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Affiliation(s)
- Leila Perea-Lowery
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B (2nd Floor), FI-20520, Turku, Finland.
| | - Mona Gibreel
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B (2nd Floor), FI-20520, Turku, Finland
| | - Pekka K Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B (2nd Floor), FI-20520, Turku, Finland; City of Turku Welfare Division, Oral Health Care, Lemminkäisenkatu 2, FI-20520, Turku, Finland
| | - Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Itäinen Pitkäkatu 4B (2nd Floor), FI-20520, Turku, Finland
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Wang S, Li Z, Ye H, Zhao W, Liu Y, Zhou Y. Preliminary clinical evaluation of traditional and a new digital PEEK occlusal splints for the management of sleep bruxism. J Oral Rehabil 2020; 47:1530-1537. [PMID: 32841412 DOI: 10.1111/joor.13083] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/23/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare the manual time and preliminary clinical effects between the digital manufactured occlusal splints for sleep bruxism patients with those of traditional hard splints. METHODS Sixteen individuals (18 to 44 y/o) with clinically diagnosed sleep bruxism were selected based on the inclusion criteria. All patients were divided into two groups, and a random control method was applied. Digital splints (test group) were designed and milled using CAD/CAM. Hard splints (control group) were made of transparent acrylic resin in laboratory office. The manual time spent including impression obtaining, splint production and clinical occlusal adjustment was recorded. A visual analog scale was used to report the subjective evaluations. The maximum depth loss and volumetric loss of the occlusal surface of splints in posterior tooth were measured. SPSS software was used for statistical analysis (P = .05). RESULTS Comparing with control group, the manual time spent in test group was significantly less in all of three procedures (P < .001). The VAS scores for retention were not significantly different (P = .086), but the wearing comfort scores of test group were significantly higher (P < .001). Both maximum depth loss (P = .007) and volumetric loss in test group were significantly less than control group (P = .005). CONCLUSION In the current study, the digitally manufactured splints exhibit significantly improved comfort and time efficiency than traditional hard splints. Moreover, the new milling material (PEEK) has better wear resistance than acrylic resins.
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Affiliation(s)
- Shimin Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zheng Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hongqiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenyan Zhao
- Department of Implantology, Yinchuan Stomatology Hospital, Yinchuan, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Piedra-Cascón W, Sadeghpour M, Att W, Revilla-León M. A vat-polymerized 3-dimensionally printed dual-material occlusal device: A dental technique. J Prosthet Dent 2020; 126:271-275. [PMID: 32951868 DOI: 10.1016/j.prosdent.2020.07.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 12/23/2022]
Abstract
A technique to additively manufacture an occlusal device by using a completely digital workflow is described. Using a computer-aided design program, information captured with an intraoral scanner was used to additively manufacture a dual-material occlusal device by using a vat-polymerization printer. This technique allows for the combination of 2 different materials, resulting in an occlusal device with a resilient intaglio and a hard resin exterior surface. Advantages of the resulting occlusal device compared with a single-material device include improved patient acceptance and comfort, better fit, and minimal adjustments to ensure fit.
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Affiliation(s)
- Wenceslao Piedra-Cascón
- Affiliate Faculty, Esthetic Dentistry Program, Department of Restorative Dentistry, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain; Researcher at Revilla Research Center, Madrid, Spain
| | | | - Wael Att
- Professor and Chair, Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
| | - Marta Revilla-León
- Assistant Professor and Assistant Program Director, AEGD Residency, Comprehensive Dentistry Department, College of Dentistry, Texas A&M University, Dallas, Texas; Affiliate Faculty, Graduate Prosthodontics, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash; Researcher at Revilla Research Center, Madrid, Spain.
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Evaluation of the marginal fit of metal copings fabricated by using 3 different CAD-CAM techniques: Milling, stereolithography, and 3D wax printer. J Prosthet Dent 2020; 124:81-86. [DOI: 10.1016/j.prosdent.2019.09.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 08/15/2019] [Accepted: 09/04/2019] [Indexed: 12/13/2022]
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Marcel R, Reinhard H, Andreas K. Accuracy of CAD/CAM-fabricated bite splints: milling vs 3D printing. Clin Oral Investig 2020; 24:4607-4615. [PMID: 32436163 PMCID: PMC7666673 DOI: 10.1007/s00784-020-03329-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 05/07/2020] [Indexed: 11/30/2022]
Abstract
Objectives The aim of this study was to investigate the accuracy of CAD/CAM-fabricated bite splints in dependence of fabrication method (milling vs 3D printing), positioning (horizontal vs vertical), selection of material, and method of deviation measurement. Materials and methods Bite splints were 3D-printed in either horizontal or vertical position (n = 10) using four different resins (Dental LT, Ortho Clear, Freeprint Splint, V-Splint). As control, ten bite splints were fabricated by CNC milling (ProArt CAD Splint). The splints were scanned and deviations between the CAD-file (trueness) and between each other within one group (precision) were measured by two different software applications and methods (cloud-to-cloud vs cloud-to-mesh). Data were analyzed using univariate analysis, Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. Results The highest impact on accuracy was exerted by the selection of the material (trueness: ηP2 = 0.871, P < 0.001; precision: ηP2 = 0.715, P < 0.001). Milled splints showed the highest trueness (P < 0.01) but not the highest precision at the same time. Horizontally positioned 3D-printed bite splints showed the least deviations in terms of trueness while vertical positioning resulted in the highest precision. The cloud-to-cloud method showed higher measured deviations than the other methods (P < 0.001–P = 0.002). Conclusion Milled splints show higher trueness than 3D-printed ones, while the latter reveal higher reproducibility. The calculated deviations vary according to the measurement method used. Clinical relevance In terms of accuracy, milled and 3D-printed bite splints seem to be of equal quality.
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Affiliation(s)
- Reymus Marcel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - Hickel Reinhard
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Keßler Andreas
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
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Reymus M, Stawarczyk B. In vitro study on the influence of postpolymerization and aging on the Martens parameters of 3D-printed occlusal devices. J Prosthet Dent 2020; 125:817-823. [PMID: 32444206 DOI: 10.1016/j.prosdent.2019.12.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 11/15/2022]
Abstract
STATEMENT OF PROBLEM Additive manufacturing has been proposed for the fabrication of occlusal devices. However, information about the mechanical properties of additively manufactured devices is lacking. PURPOSE The purpose of this in vitro study was to evaluate the influence of the postpolymerization unit and artificial aging on the Martens hardness (HM) and indentation modulus (EIT) of different 3D-printed materials in comparison with a conventionally milled material. MATERIAL AND METHODS Thirty disks (20 mm in diameter and 5 mm in thickness) were additively manufactured (D20 II, Rapidshape & Form 2) for each 3D-printed material (NextDent Splint, Formlabs Dental LT Clear, and Freeprint Splint). As a control, 10 disks of the same thickness were cut from a conventionally milled material (Temp Premium). Each specimen was measured for HM and EIT (ZHU 0,2) after fabrication. The specimens were stored in water at 37 °C and measured again after 2 and 4 weeks. The data were analyzed statistically by using the Kruskal-Wallis, Mann-Whitney U, and Wilcoxon tests (adjusted by Bonferroni correction α=.05/27=.002). RESULTS The highest influence on HM parameters was shown by artificial aging (partial eta squared: HM: ηP2=0.840, EIT: ηP2=0.855, P<.001), followed by the material (HM: ηP2=0.690 EIT: ηP2=0.845, P<.001) and the postpolymerization unit (HM: ηP2=0.649, EIT: ηP2=0.778, P<.001). Initial HM values ranged from 147 ±8.11 N/mm2 for Formlabs postpolymerized in Otoflash to 89.5 ±8.55 N/mm2 for Detax postpolymerized in the Labolight unit. EIT values ranged from 3.92 ±0.061 kN/mm2 for Formlabs postpolymerized in Otoflash to 2.48 ±0.212 kN/mm2 for Detax postpolymerized in the Labolight unit. In general, HM and EIT values decreased after water storage, whereas the values remained unchanged for the control group. CONCLUSIONS HM parameters of additively manufactured occlusal devices depend on postpolymerization strategy. Otoflash and Printbox result in higher HM and EIT values. The 3D-printed materials are more prone to artificial aging than the control group, which brings into question their long-term service.
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Affiliation(s)
- Marcel Reymus
- Resident, Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany.
| | - Bogna Stawarczyk
- Professor, Department of Prosthetic Dentistry, University Hospital, LMU Munich, Munich, Germany
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Vasques MT, Mori M, Laganá DC. Three-dimensional printing of occlusal devices for temporomandibular disorders by using a free CAD software program: A technical report. J Prosthet Dent 2020; 123:232-235. [DOI: 10.1016/j.prosdent.2018.12.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 12/06/2018] [Accepted: 12/06/2018] [Indexed: 11/29/2022]
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Gholampour S, Gholampour H, Khanmohammadi H. Finite element analysis of occlusal splint therapy in patients with bruxism. BMC Oral Health 2019; 19:205. [PMID: 31484524 PMCID: PMC6727492 DOI: 10.1186/s12903-019-0897-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Accepted: 08/21/2019] [Indexed: 11/22/2022] Open
Abstract
Background Bruxism is among the habits considered generally as contributory factors for temporomandibular joint (TMJ) disorders and its etiology is still controversial. Methods Three-dimensional models of maxilla and mandible and teeth of 37 patients and 36 control subjects were created using in-vivo image data. The maximum values of stress and deformation were calculated in 21 patients six months after using a splint and compared with those in the initial conditions. Results The maximum stresses in the jaw bone and head of mandible were respectively 4.4 and 4.1 times higher in patients than in control subjects. Similar values for deformation were 5.8 and 4.9, respectively. The maximum stress in the jaw bone and head of mandible decreased six months after splint application by up to 71.0 and 72.8%, respectively. Similar values for the maximum deformation were 80.7 and 78.7%, respectively. Following the occlusal splint therapy, the approximation of maximum deformation to the relevant values in control subjects was about 2.6 times the approximation of maximum stress to the relevant values in control subjects. The maximum stress and maximum deformation occurred in all cases in the head of the mandible and the splint had the highest effectiveness in jaw bone adjacent to the molar teeth. Conclusions Splint acts as a stress relaxer and dissipates the extra stresses generated as well as the TMJ deformation and deviations due to bruxism. The splint also makes the bilateral and simultaneous loading possible and helps with the treatment of this disorder through regulation of bruxism by creating a biomechanical equilibrium between the physiological loading and the generated stress.
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Affiliation(s)
- Seifollah Gholampour
- Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran.
| | - Hanie Gholampour
- Department of Electrical and Computer Engineering, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Hamed Khanmohammadi
- Department of Biomedical Engineering, North Tehran Branch, Islamic Azad University, Tehran, Iran
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Fracture load of 3D-printed fixed dental prostheses compared with milled and conventionally fabricated ones: the impact of resin material, build direction, post-curing, and artificial aging-an in vitro study. Clin Oral Investig 2019; 24:701-710. [PMID: 31127429 DOI: 10.1007/s00784-019-02952-7] [Citation(s) in RCA: 113] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 05/06/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate the impact of 3D print material, build direction, post-curing, and artificial aging on fracture load of fixed dental prostheses (FDPs). MATERIALS AND METHODS Three-unit FDPs were 3D-printed using experimental resin (EXP), NextDent C&B (CB), Freeprint temp (FT), and 3Delta temp (DT). In the first part, the impacts of build direction and artificial aging were tested. FDPs were manufactured with their long-axis positioned either occlusal, buccal, or distal to the printer's platform. Fracture load was measured after artificial aging (H2O: 21 days, 37 °C). In the second part, the impact of post-curing was tested. FDPs were post-cured using Labolight DUO, Otoflash G171, and LC-3DPrint Box. While the positive control group was milled from TelioCAD (TC), the negative control group was fabricated from a conventional interim material Luxatemp (LT). The measured initial fracture loads were compared with those after artificial aging. Each subgroup contained 15 specimens. Data were analyzed using Kolmogorov-Smirnov test, one-way ANOVA followed by Scheffé post hoc test, t test, Kruskal-Wallis test, and Mann-Whitney U test (p < 0.05). The univariate ANOVA with partial eta squared (ηP2) was used to analyze the impact of test parameters on fracture load. RESULTS Specimens manufactured with their long-axis positioned distal to the printer's platform showed higher fracture load than occlusal ones (p = 0.049). The highest values were observed for CB, followed by DT (p < 0.001). EXP showed the lowest values, followed by FT (p < 0.001). After artificial aging, a decrease of fracture load for EXP (p < 0.001) and DT (p < 0.001) was observed. The highest impact on values was exerted by interactions between 3D print material and post-curing unit (ηP2 = 0.233, p < 0.001), followed by the 3D print material (ηP2 = 0.219, p < 0.001) and curing device (ηP2 = 0.108, p < 0.001). CONCLUSIONS Build direction, post-curing, artificial aging, and material have an impact on the mechanical stability of printed FDPs. CLINICAL RELEVANCE The correct post-curing strategy is mandatory to ensure mechanical stability of 3D-printed FDPs. Additively manufactured FDPs are more prone to artificial aging than conventionally fabricated ones.
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Wang SM, Li Z, Wang GB, Ye HQ, Liu YS, Tong D, Gao WH, Zhou YS. [Preliminary clinical application of complete digital workflow of design and manufacturing occlusal splint for sleep bruxism]. JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2019; 51:105-110. [PMID: 30773553 DOI: 10.19723/j.issn.1671-167x.2019.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To establish a complete workflow of digital design and manufacturing occlusal splint for sleep bruxism, which can be preliminarily applied in clinical use, thus observe the clinical efficacy. METHODS Twenty-four patients with sleep bruxism were recruited in the study and randomly divided into two groups by using random number tables. Digital-occlusal-splint (experimental group) treatment plan and traditional-occlusal-splint (control-group) treatment plan were carried out for each group, respectively. For experimental group, digital models of patients' both dental arches and the occlusion relationship after elevation were captured using an intraoral scanner. The occlusal splint was carried out by computer aided design/computer aided manufacturing (CAD/CAM), including splint designing and milling. For control group, the traditional soft occlusal splint was fabricated by vacuum laminator. The two kinds of occlusal splints were tried in the patients from each group, and the occlusal contacts were tested respectively by T-scan analysis system, which recorded the changes of occlusal indicators in the two groups. The retention, appearance and occlusal comfort degree were evaluated by the two groups of patients. Mann-Whitney test was performed with IBM SPSS 20.0 software, and bilateral test was performed. P<0.05 was considered to be statistically significant. RESULTS The complete workflow of digital design and manufacturing occlusal splint was successfully established. During the clinical use, there was no statistical difference in the retention evaluation of two kinds of occlusal splints between the two groups of patients (Z=-0.538, P=0.590). The appearance score (Z=2.038, P=0.042) and the occlusal comfort score (Z=-2.579, P=0.010) of the experimental group were higher than those of the control group, with statistically significant differences. The T-scan analysis results showed that only the second molar on both sides of the traditional occlusal splint had occlusal contact in intercupsal position, while the digital occlusal splint had stable and bilaterally balanced contact between the maxillary and mandibular teeth. Furthermore, the occlusal force was uniformly distributed in the experimental group. CONCLUSION The complete workflow of digital occlusal splint improves the occlusal design, greatly simplifies and optimizes the traditional process of making occlusal splint. This new method is resource-saving and environmental-friendly, and it is able to serve patients more conveniently and efficiently.
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Affiliation(s)
- S M Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Z Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - G B Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - H Q Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y S Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - D Tong
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.,Dental Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - W H Gao
- Dental Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
| | - Y S Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
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