Wear and Fracture Resistance of 3D-Printed Denture Teeth: An In Vitro Comparative Study

Effect of Post-Printing Conditions on the Mechanical and Optical Properties of 3D-Printed Dental Resin

This study aimed to evaluate the flexural strength (FS), surface wear, and optical properties of 3D-printed dental resins subjected to different post-printing conditions. A total of 240 specimens (2 × 2 × 25 mm³) were 3D-printed using resin materials for permanent (VaresoSmile Crown Plus) VSC and temporary (VaresoSmile Temp) VST restorations. Specimens underwent five post-printing conditions: no post-printing cure; post-cured in a Form Cure curing unit; Visio Beta Vacuum; Ivoclar Targis; or heat-cured (150 °C) for 30 min. Each group of specimens (n = 24) was tested either directly after post-curing, after 24 h of dry storage, or following hydrothermal accelerated aging in boiling water for 16 h. The three-point bending test was used to evaluate the FS. The two-body wear test was performed on 50 disc-shaped specimens (n = 5/group). Surface gloss and translucency were measured for permanent VSC specimens (n = 5/group). SEM/EDS and statistical analyses were performed. The Form Cure device yielded the highest FS and lowest wear depth (p < 0.05). Hydrothermal aging significantly reduced FS. There were no statistical differences in FS and wear values between materials subjected to same post-printing conditions. VSC groups exhibited similar optical properties across different post-printing treatments. Post-printing treatment conditions had a significant impact on the FS and wear of the 3D-printed resin, while optical properties remained unaffected.

Surface hardness and wear resistance of prefabricated and CAD-CAM milled artificial teeth: A cross-over clinical study

PURPOSE

To clinically evaluate the surface roughness and wear resistance of prefabricated and CAD-CAM milled acrylic resin teeth for complete dentures.

MATERIALS AND METHODS

In a cross-over study design, 10 completely edentulous patients were randomly included in this study and given two complete dentures. The first complete denture was made using prefabricated teeth, while the second was constructed using CAD-CAM milled teeth. Following insertion (T0), 3 months (T3), and 6 months (T6), the complete dentures were scanned. Utilizing 3D surface super-imposition techniques, the vertical (2D wear), and volumetric (3D wear) material loss were measured. The hardness of the teeth was evaluated at the time of denture insertion (T0) and then after 6 months (T6) of denture insertion by digital Vickers hardness tester. Statistical analysis was done using SPSS software. Paired groups were compared by paired t-test. Also, a repeated measure test was used. The significant difference was considered if p ≤ 0.05.

RESULTS

The time of denture function was linearly correlated with the wear of the prefabricated and CAD-CAM milled denture tooth. Prefabricated acrylic teeth had significantly more vertical and volumetric wear after 3 and 6 months, compared to CAD-CAM milled denture teeth where p-values were 0.01, 0.009, 0.003, and 0.024, respectively. Additionally, CAD-CAM milled teeth displayed significantly higher hardness values than prefabricated teeth both before and after 6 months of use where p-values were 0.001. After 6 months, all studied teeth showed a decrease in their hardness.

CONCLUSIONS

In terms of wear resistance and surface hardness, CAD-CAM milled acrylic resin teeth were superior to prefabricated acrylic resin artificial teeth once the complete denture functions.

Denture relining using digital replication method: A dental technique

The aim of this report was to digitize traditional denture relining using a digital duplication method, in addition to assessing the wear resistance of three-dimensional (3D) printed denture teeth. A complete denture was relined using light body impression. The denture with impression was scanned yielding a standard tessellation language file that was designed to print the denture base and teeth. The printed teeth were fitted into the sockets of the printed denture base and then bonded using auto-polymerized acrylic resins, followed by finishing and polishing. Dentures were inserted and fit and occlusion were adjusted as needed, and the patient was scheduled for follow-up appointments at one week, three months, and six months. At each follow-up visit, dentures were scanned using a 3Shape E3 desktop scanner and scans were superimposed. The occlusal wear was assessed in reference to the first scan after the denture insertion visit. The accuracy of the intaglio surface of dentures was within clinically acceptable limits. The clinical evaluation of inserted dentures in terms of retention, occlusion, esthetic, and patient satisfaction was encouraging. Using digital duplication, conventional dentures could be relined. The advantages of digital records include eliminating polymerization dimensional changes, and reducing cost and clinical time by minimizing the number of visits, which is particularly helpful with geriatric patients.

Mechanical and fatigue resistance of restorations supported by welded-framework and realized using computer-aided designed prosthetic shells: In vitro pilot study

Resin coating in implants rehabilitation cannot always be aesthetic, durable and comfortable for the patient mainly due to the limited dimensions of the final structure. Intraoral welding technique and computer-aided designed prosthetic shells may be a solution. This in vitro study evaluates the capacity of load and the weakest point of implant-supported provisional prosthesis using welded titanium framework. Twelve samples were produced to simulate an implant supported fixed prosthetic bridge. Two implants (Ankylos; Dentsply Sirona Implants; Germany) were inserted inside blocks of nanoceramic material produced with a stereolithographic 3D printer. A polymethylmethacrylate (PMMA) resin shell was performed with CAD/CAM and relined on welded framework. Six samples were produced with the same procedure reducing resin thickness. The samples were subjected to fatigue test (6,500,000 cycles) using ElectroForce 3310 fatigue machine (t1); subsequently a mechanical compression test using a universal Shimadzu AGS-X 10 machine (t2). The samples were analyzed with a photographic and radiographic documentation at t0, t1 and t2. The samples survived mechanical fatigue test without evidence of failure. The radiographic and photographic evaluation revealed the fracture of resin coating after the mechanical compression test. The samples with minimal resin thickness fractured first. Adequate assessment of the resin thickness is mandatory to improve the longevity of these rehabilitations. CAD-CAM digital prosthetic design allows us to optimize the thicknesses and the prosthetic shapes, allowing us to obtain good degrees of resistance even in the presence of reduced prosthetic spaces.

Artificial teeth obtained by additive manufacturing: Wear resistance aspects. A systematic review of in vitro studies

Wear resistance is one of the properties that must be considered for maintaining the long-term functionality of artificial teeth in dental prostheses. This property can be altered by the method of tooth fabrication, the material, the chewing force, and the relationship to the antagonist tooth. This systematic review evaluated the wear resistance of artificial teeth obtained by the additive manufacturing method and aims to answer the question, "Do artificial teeth for dental prostheses obtained by additive manufacturing show wear resistance similar to prefabricated ones?" The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist guidelines were followed with a customized search in Scopus, PubMed/Medline, Embase, Science Direct, and Google Scholar databases on August 30, 2023. The inclusion criteria were artificial teeth for dental prostheses in acrylic resin by additive manufacturing and comparing the wear resistance with conventional prefabricated teeth, in vitro and English studies, without time restriction. And excluded if 1) do not make artificial teeth by additive manufacturing or that were metal or ceramic teeth; 2) clinical trials, animal studies, review articles, case reports, letters to the editor, short communication, book chapters; 3) another language that is not English. The selection was in two steps, reading the titles and abstracts, followed by reading the selected studies in full. The risk of bias analysis was performed with the adaptation of the quasi-experimental studies tool by Joanna Briggs Institute. Four hundred and twelve articles were found in the databases, after the selection steps and application of eligibility criteria, 6 articles were included for qualitative data analysis and presented low risk of bias. For teeth obtained by additive manufacturing, 2 studies reported lower wear resistance, 2 studies had higher resistance, and 2 similar compared to prefabricated ones. Additive manufactured teeth compared to prefabricated teeth show influences on wear resistance due to differences in material composition, relationship to the antagonist's tooth, applied force, chewing cycles, and processing methods.

Bond strength of CAD/CAM denture teeth to a denture base resin in a milled monolithic unit

Purpose Herein, the bond strength (BS) of denture teeth to a denture base resin in a milled monolithic unit was investigated and compared with those of 3D printed teeth to a 3D printed denture base and prefabricated teeth to a heat-cured acrylic resin before and after thermocycling.Methods Sixty specimens of a denture tooth attached to a cylindrical denture base were fabricated following ISO Standard 19736. Three fabrication techniques-3D printing, conventional compression molding, and milling using monolithic technology-were employed to mill teeth and denture base parts as a single unit. The BS was investigated before and after thermocycling. Data were statistically analyzed using the Kruskal-Wallis test with Bonferroni correction (α = 0.05).Results Before thermocycling, the mean BS of the milled group was significantly higher than that of the conventional group (P = 0.002). The 3D printed group showed no statistically significant difference from the milled (P = 0.051) and conventional (P = 0.824) groups. After thermocycling, although the mean BS values of the milled (P = 0.00) and 3D printed 
(P = 0.01) groups were significantly higher than that of the conventional group, there was no significant difference between them (P = 0.226). Only the BS of the conventional group was significantly reduced by thermocycling (P = 0.00).Conclusions The milled monolithic fabrication technique, which eliminates the need for a bonding step, offered a promising combination of high-precision digital fabrication and a significantly high BS. The BS of the conventional group significantly decreased after thermocycling.

Strength and Wear Behavior of Three-Dimensional Printed and Prefabricated Denture Teeth: An In Vitro Comparative Analysis

OBJECTIVES

 With advanced technology for complete denture fabrication, there is a lack of knowledge on the mechanical behavior of three-dimensional (3D) printed teeth despite the development of complete denture fabrication technologies. This study aimed to compare different types of 3D-printed teeth in terms of wear and fracture resistance in comparison to control prefabricated denture teeth.

MATERIALS AND METHODS

 One prefabricated tooth was selected and fixed in a resin holder and half of the tooth remained in anatomic form, while the other half was flattened for the wear test. One from each type was scanned and then printed with different resins; Asiga (DentaTOOTH, Asiga, Alexandria 2015,NSW, Australia), FormLabs (Denture Base LP, FormLabs, Berlin, Germany), and NextDent (NextDent C&B MFH, NextDent B.V., Soesterberg, the Netherlands) according to manufacturer recommendations. A total of 60 specimens (20/resin, n = 10) were thermo cycled (5,000 cycles) and wear test samples were further subjected to cyclic loading (1,70,000 cycles) in a chewing simulator machine CS-4.2 (SD Mechatronik GmbH, Germany). The fracture strength of anatomic teeth was measured using a universal testing machine (Instron model 5965, Massachusetts, United States), while Geomagic Control X software was used to assess the amount of wear of flattened teeth. Statistical analyses were performed with one-way analysis of variance with Tukey's post hoc test at significance level of α = 0.05.

RESULTS

 NextDent specimens showed the greatest volume loss, whereas FormLabs specimens showed the least volume loss. Comparing NextDent specimens to FromLabs specimens, FromLabs showed statistically significantly less volume loss (p < 0.001). No other group pairs differed significantly from one another in terms of volume loss (p > 0.06).

CONCLUSION

 3D-printed denture teeth showed comparable strength and wear resistance with the prefabricated denture teeth and were suitable for long-term clinical usage except for NextDent that significantly showed the lowest fracture resistance.

The effect of aging on the mechanical properties of 3-dimensional printed biocompatible resin materials used in dental applications: An in vitro study

INTRODUCTION

The mechanical properties of biocompatible printable resin materials in an intraoral environment is still being investigated. This study aimed to assess the effect of the aging process on the mechanical properties of resin samples produced by stereolithography appearance (SLA) and digital light processing (DLP) 3-dimensional printer systems.

METHODS

The cylindrical sample (4.00 × 20.00 mm) was designed by software, and the data were transformed into digital format. A DLP printer (n = 40) and an SLA printer (n = 40) carried out the printing process. The aging procedure was applied to 20 samples from each group using a thermocycling device. After the aging procedure, the samples were placed in the universal testing device for the 3-point bending test.

RESULTS

This study showed that the aging procedure decreased maximum load, bending stress, and Young's modulus values and increased maximum deflection values of the DLP group (P <0.01). However, no statistical difference was detected in the parameters compared with the SLA group except for the maximum deflection values. Furthermore, statistically significant differences were found between maximum deflection and Young's module values of SLA and DLP control and study groups (P <0.05).

CONCLUSIONS

This in vitro study revealed that the biocompatible printable resin materials produced by DLP and SLA printers had the mechanical strength to resist the values resembling the physiological occlusal forces even after the aging procedure and could produce intraoral appliances.

Effect of phytochemical-filled microcapsules with antifungal activity on material properties and dimensional accuracy of denture base resin for three-dimensional printing

BACKGROUND

Studies on the material properties and dimensional accuracy of three-dimensionally (3D) printed denture base containing microcapsules with antifungal phytochemicals are lacking.

METHODS

Two types of phytochemicals (phytoncide A and B) with antifungal activity were microencapsulated. The 3D-printed denture base specimens with minimum and maximum effective concentrations of microcapsules (6 and 8 wt% for phytoncide A; 15 and 25 wt% for phytoncide B) were prepared. The morphological changes of C. albicans on 3D-printed denture base with microcapsules was microscopically observed. The degree of conversion of 3D-printed denture base with microcapsules investigated. The microhardness and flexural strength values were also measured to evaluate the mechanical properties of 3D-printed denture bases. The dimensional accuracy (trueness) of the specimens with microcapsules was measured as root-mean-square values (RMS) for the whole, upper, and side surfaces of the specimens as well as their total height. For the degree of conversion, microhardness, and flexural strength values, the Kruskal-Wallis analysis and a post-hoc comparison using Mann-Whitney U test was performed. For the analysis of trueness (RMS), the one-way analysis of variance and a post-hoc comparison using Tukey's method was conducted (α = 0.05).

RESULTS

At both maximum and minimum effective concentrations of microcapsules, cell surface disruption or membrane breakdown of fungal cells were observed in the specimens. The groups with microcapsules (both phytoncide A- and B-filled) showed significantly lower microhardness and elastic modulus values than the control group (all, P = 0.001). For the trueness, all the RMS values of the whole, upper, and side surfaces of the specimens with microcapsules were less than 100 µm, although significantly higher than those without (all, P = 0.001). The mean flexural strength values of the groups with phytoncide A-filled microcapsule were higher than 65 MPa, not statistically different from that of the control group (all, P > 0.05). However, the groups with phytoncide B-filled microcapsules showed significantly lower values than the control (all, P = 0.001).

CONCLUSIONS

Within the limitations of this in-vitro study, the 3D-printed denture base containing 6 wt% of phytoncide A-filled microcapsules was clinically acceptable in terms of antifungal activity, dimensional accuracy, and flexural strength.