The Influence of Thickness on the Mechanical Behaviors of 3D Printing Resins for Orthodontic Retainers

This study aimed to evaluate the mechanical behaviors of thermoformed and 3D-printed retainers with different thicknesses. Thermoformed retainers (Duran) and 3D-printed retainers (Dental LT Clear V2 and NextDent Ortho Flex) were fabricated at thicknesses of 0.5, 0.75, and 1 mm. Five samples of each material were subjected to compression, tensile, and flexural testing with the universal testing machine (Instron Ltd., Buckinghamshire, England). The results revealed that the mechanical behaviors were significantly influenced by thickness in each type of material. The increased thickness tended to increase strength and modulus in all three tests. However, Dental LT Clear V2 and Duran showed that flexural strength and modulus were inversely related to thickness. The compressive test revealed significantly greater compressive resistance in 3D-printed groups, except for the NextDent Ortho Flex at 0.5 mm. The tensile test showed that Dental LT Clear V2 at all thicknesses demonstrated significantly higher tensile strength and modulus, while NextDent Ortho Flex was significantly lowest at any thickness in tensile and flexural properties. In conclusion, the thickness significantly influenced the mechanical behaviors of the 3D-printed retainers. The 0.75 mm thickness of Dental LT Clear V2 could be considered as an alternative to fabricated retainers due to its similar mechanical properties compared with the thermoformed material.

Effect of wall thickness of 3D-printed models on resisting deformation from thermal forming in-office aligners

BACKGROUND

Fabricating clear aligners by thermoforming three-dimensional printed dental models requires a high degree of accuracy. It is unknown whether model thickness affects the accuracy when used to thermoform aligners.

PURPOSE

This research utilizes three-dimensional printed models made with differing wall thicknesses to determine its effect on their ability to withstand deformation during aligner fabrication.

METHODS

A total of 50 models of different wall thickness (10 each of 0.5, 1.0, 1.5, 2.0 mm, and solid) were printed using model resin (Model V2, Formlabs) on a low-force stereolithography printer (Form 3B, Formlabs). Aligners were then fabricated using a thermal pressure forming machine (Biostar V, Great Lakes Dental Technologies) utilizing 25 s cycles to adapt 0.030″ acrylic sheets (Invisacryl, Great Lakes Dental Technologies), then removed from the models and sprayed with a contrast powder (Optispray, Dentsply Sirona) to aid in scanning with an intraoral scanner (CEREC Primescan, Dentsply Sirona). Each aligner's data was then compared to the original file used for printing with 3D comparison software (Geomagic Control X, 3D Systems).

RESULTS

The results show model thickness greater than or equal to 2.0 mm produced clinically acceptable results within the margin of error (0.3 mm). A total of 0.5 mm thickness failed to withstand thermal forming in 4 of the 10 trials. A total of 0.5 mm produced 27.56% of results in tolerance, 1.0 mm produced 75.66% of results in tolerance, 1.5 mm had 80.38% of results in tolerance, 86.82% of 2 mm models were in tolerance, and solid had 96.45% of results in tolerance.

CONCLUSION

Hollow models of thicknesses 2.0 mm and solid models produced clinically acceptable aligners while utilizing less resin per unit compared to solid models, thus being more cost effective, time efficient and eco-friendly. Therefore, a recommendation can be made to print hollow models with a shell thickness of greater than 2.0 mm for aligner fabrication.

Mechanical properties of materials for 3D printed orthodontic retainers

AIM

The purpose of this study was to compare the mechanical properties of materials used for orthodontic retainers made by direct 3D printing and thermoforming.

The effect of crowding on the accuracy of 3-dimensional printing

INTRODUCTION

The purpose of this study was to evaluate the accuracy of 3-dimensional (3D) printed aligners compared to conventional vacuum-formed thermoplastic aligners with varying levels of dental crowding.

METHODS

Digital intraoral scans of 10 cases were assigned to their respective groups (n = 10, each, 30 total) as follows: no crowding (control), moderate crowding, and severe crowding. Digital images of these models were created in standard tessellation language (STL) file format using 3Shape software and randomly 3D printed. The STL files of each case were also sent to a dental laboratory to fabricate vacuum-formed samples, the current technology used for manufacturing aligners. The intaglio surfaces of fabricated aligners in both groups were scanned using cone beam computed tomography to create STL files, which were then compared to the original STL files of the cases using Geomagic Control X software. Absolute deviations from the original file and root mean square values were recorded. A Kruskal-Wallis test was conducted to analyze the difference in average deviation, and a t-test was repeated for the RMS measure. The significance level was set at 0.05.

RESULTS

The crowding did not affect the trueness of aligners manufactured using 3D printing or conventional vacuum-forming techniques (P = 0.79). 3D-printed aligners showed less deviation than the vacuum-formed samples (0.1125 mm vs 0.1312 mm; P <0.01). Aligners manufactured with the vacuum-forming technique had significantly higher variation than those with the 3D printing process (P = 0.04).

CONCLUSIONS

3D aligners printed directly from an STL file exhibited better precision and trueness than those fabricated using the conventional vacuum-forming technique. Since accuracy is defined as a combination of precision and trueness, it is concluded that direct printing from an STL file can be used to manufacture aligners.

Coffee Staining and Simulated Brushing Induced Color Changes and Surface Roughness of 3D-Printed Orthodontic Retainer Material

This in vitro study evaluated the influence of combined coffee staining and simulated brushing-induced color changes and surface roughness on 3D-printed orthodontic retainers. Specimens measuring 10 × 10 × 0.75 mm³ were obtained either by conventional vacuum forming or 3D printing at four print angulations (0°, 15°, 30°, and 45°) (n = 10). The prepared specimens were immersed in a coffee beverage and then mechanically brushed using a simulating device. The specimen's color difference (ΔE) and surface roughness (Ra) were quantified using a spectrophotometer and a non-contact profilometer, respectively. The highest and lowest mean ΔE values were recorded for the 3D-printed-45° (4.68 ± 2.07) and conventional (2.18 ± 0.87) groups, respectively. The overall mean comparison of ΔE between the conventional and 3D-printed groups was statistically significant (p < 0.01). After simulated brushing, all groups showed a statistically significant increase in the Ra values (p < 0.01). The highest Ra was in the 3D-printed-45° (1.009 ± 0.13 µm) and conventional (0.743 ± 0.12 µm) groups, respectively. The overall ΔE of 3D-printed orthodontic retainers was not comparable to conventional VFRs. Among the different angulations used to print the retainers, 15° angulations were the most efficient in terms of color changes and surface roughness and were comparable to conventional VFRs.

Degree of conversion of 3D printing resins used for splints and orthodontic appliances under different postpolymerization conditions

OBJECTIVES

To measure the degree of conversion (DC) of different 3D printing resins used for splints or orthodontic appliances under different postpolymerization conditions.

MATERIALS AND METHODS

Five 3D-printed photopolymer resins were studied. Each resin was analyzed in liquid form (n = 15), and then cylindrical specimens (n = 135) were additively manufactured and postcured with Form Cure (Formlabs) at different times (10, 60, and 90 min) and temperatures (20 °C, 60 °C, and 80 °C). The DC of each specimen was measured with Fourier transform infrared spectroscopy (FTIR). The data were statistically analyzed using a 3-way ANOVA followed by Tukey's post hoc test.

RESULTS

The time and temperature of postpolymerization significantly influenced the DC of each resin: when time and/or temperature increased, the DC increased. For all resins tested, the lowest DC was obtained with a postcuring protocol at 10 min and 20 °C, and the highest DC was obtained at 90 min and 80 °C. However, at 80 °C, the samples showed a yellowish color.

CONCLUSIONS

With the Form Cure device, the time and temperature of postcuring could have an impact on the DC of the 3D printing resins studied. The DC of the 3D printing resins could be optimized by adjusting the postpolymerization protocol.

CLINICAL RELEVANCE

Regardless of the resin used, when using the Form Cure device, postcuring at 60 min and 60 °C would be the minimal time and temperature conditions for achieving proper polymerization. Beyond that, it would be preferable to increase the postcuring time to boost the DC.

Comparison of 3-dimensional printing technologies on the precision, trueness, and accuracy of printed retainers

INTRODUCTION

This study aimed to evaluate the differences in the precision, trueness, and accuracy of 3-dimensional (3D) printed clear orthodontic retainers fabricated using printer systems with different printing technologies.

METHODS

Retainers (n = 15) were 3D printed using 4 different printers: stereolithography (SLA), digital light processing (DLP), continuous DLP, and polyjet photopolymer (PPP) printers. Printed retainers were transformed into a digital image through a cone-beam computed tomography scan and compared with the original image using 3D superimposition analysis software. At previously chosen landmarks (R6, L6, R3, L3, R1, and L1), intaglio surfaces of the retainers were compared to that of the reference model. The intercanine and the intermolar width measurements were also assessed. A discrepancy of up to 0.25 mm between the printed retainer and the reference retainer intaglio surfaces indicated accuracy and clinical acceptability. Precision and trueness were also determined. Root mean square and percent of points within the tolerance level were calculated for precision and trueness for each retainer. Statistical significance was set at P <0.05.

RESULTS

Interrater correlation coefficient indicated good agreement. Statistically significant differences were found between printer types among the 6 landmarks and the arch width measurements. When evaluating tolerance level and root mean square, statistically significant differences in median precision and trueness among each printer type were found.

CONCLUSION

Retainers fabricated by SLA, DLP, continuous DLP, and PPP technologies were shown to be clinically acceptable and accurate compared to the standard reference file. Based on both high precision and trueness, SLA and PPP printers yielded the most accurate retainers.

Effect of print angulation on the accuracy and precision of 3D-printed orthodontic retainers

INTRODUCTION

The study aimed to (1) compare the accuracy and precision of 3-dimensional (3D) printed retainers at various angulations and (2) evaluate the effect of angulation on printing time and the amount of resin consumed.

METHODS

Using a stereolithography 3D printer, 60 clear retainers were printed at 5 angulations (n = 12, each): 15°, 30°, 45°, 60°, and 90°. Samples for each group were randomly printed in a batch of 6 retainers at all print angulations as print 1 and print 2 cycles. Digital images of the original and printed samples were superimposed. Discrepancies on 8 landmarks were measured by 2 independent examiners, and 0.25 mm was set as the clinically acceptable threshold to determine the accuracy of the retainers.

RESULTS

Deviations ranged from 0.074 mm to 0.225 mm from the reference retainer at the cusp tips and incisal edges at all angulations, falling within the threshold of clinical acceptance. However, smooth surface measurements with deviations up to 0.480 mm were deemed clinically not acceptable. Three-dimensional printing at 15° was estimated to be the most time-efficient, whereas 3D printing at 45° was shown to be the most cost-effective setting.

CONCLUSIONS

Three-dimensional printed retainers, using a stereolithography printer, were found to be accurate within 0.25 mm at all print angulations at the cusp tips and incisal edges compared with the digital reference file. Smooth facial surfaces did not meet clinical acceptability. Print angulations were shown to affect the cost and amount of resin used.

Evaluation of the dimensional accuracy of thermoformed appliances taken from 3D printed models with varied shell thicknesses: An in vitro study

OBJECTIVE

Clinicians make numerous decisions when 3D printing models for fabrication of thermoformed appliances, including printing solid or hollow models. While hollow models can reduce resin use, models intended for thermoformed appliance fabrication must be printed with sufficient thickness to withstand thermoforming. The aim of the study was to determine for hollow 3D printed orthodontic models if there is an effect of shell thickness on the dimensional accuracy of retainers thermoformed upon them as compared with solid models and, if so, to identify the minimum shell thickness that ensures dimensional accuracy of the thermoformed retainer under the conditions investigated.

MATERIAL AND METHODS

Thermoformed appliances were fabricated on 3D printed models of six shell thicknesses: 1.0mm, 1.5mm, 2.0mm, 2.5mm, 3.0mm, and solid (n=10/group). The models were scanned before and after thermoforming. Thermoformed appliances were captured by two methods: scanning a polyvinylsiloxane casting of the appliance and scanning the appliance interior surface (intaglio surface). Each model-appliance pair was compared using superimposition software. A generalized linear model and post-hoc Tukey contrasts (α=0.05) were applied to compare each thickness.

RESULTS

Model thickness has a statistically significant effect on dimensional accuracy of thermoformed appliances. Appliances fabricated on 1.0mm and 1.5mm models displayed poor accuracy, with a statistically significantly lower percentage of data points within tolerance (±0.250mm) than appliances fabricated on models printed at 2.0mm thickness and greater.

CONCLUSIONS

3D printed model thickness affects the dimensional accuracy of a thermoformed retainer. To ensure minimal deformation and promote clinical utility of the thermoformed appliance, models should be printed with a minimum shell thickness of 2.0mm for the materials investigated.

3D printing technology as innovative solutions for biomedical applications

3D printing was once predicted to be the third industrial revolution. Today, the use of 3D printing is found across almost all industries. This article discusses the latest 3D printing applications in the biomedical industry.