Assessing the physical and mechanical properties of 3D printed acrylic material for denture base application

Evaluation of mechanical properties and color stability of 3D-printed denture base materials following two surface treatments

BACKGROUND

Comprehending the synergistic of surface treatments and oral environmental factors is paramount for optimizing the performance of 3D-printed dentures. This study evaluates flexural strength, hardness, roughness, and color stability of 3D-printed resins after two surface treatments and coffee thermocycling, to establish alternative polishing efficacy.

MATERIALS AND METHODS

Rectangular test specimens (64 × 10 × 3.3 ± 0.2 mm) were fabricated from a conventional heat-cured denture base material (Probase HC, n = 20) and four 3D-printed denture base materials (Nextdent; ND, Formlabs; FL, Senertek; ST, Powerresin; PR, n = 40 per group), resulting in a total sample size of N = 180. Specimens were randomly assigned to undergo either mechanical polishing or glazing, followed by 5000 cycles of coffee thermocycling (CTC). Color change (ΔE00) and surface roughness (Ra) were assessed both prior to and subsequent to CTC. Subsequently, the specimens were subjected to a 3-point bending test and a Vickers microhardness (VH) test. Statistical analysis of the data was performed using descriptive and analytical methods, with a significance level set at α = 0.05.

RESULTS

The application of Vita Akzent® LC (VA) as a glaze material, while conferring supplementary protection against surface degradation during coffee thermocycling (CTC), resulted in a statistically significant increase in the initial surface roughness (Ra) values across all experimental 3D-printed groups (p < 0.05). It reduced the ΔE value of the FL group (p = 0.036) but did not have a statistically significant impact on the ΔE00 of other 3D-printed groups (p˃0.05). Additionally, VA enhanced the VH of most 3D-printed groups (p < 0.05). It improved the flexural strength of the PR and ST groups but decreased it for the FL group and had no significant effect on the ND group (p = 0.088). The mechanically polished specimens demonstrated acceptable Ra, ΔE00, and flexural strength values. However, they showed a lower VH than the glazed specimens.

CONCLUSION

Glaze application resulted in improved mechanical strength and hardness for the majority of 3D-printed groups; however, its capacity to effectively reduce surface roughness and discoloration was consistently limited. Conversely, mechanical polishing maintained its beneficial effects, demonstrating clinically acceptable values across all assessed parameters. Therefore, comprehensive additional investigations are necessitated to fully elucidate the performance characteristics of glaze materials and their interactions with 3D-printed denture base materials.

Edge strength of definitive 3D-printed restorative resin materials

STATEMENT OF THE PROBLEM

With the advent of digital technology in dentistry, manual methods for creating dental restorations are being replaced by digital CAD/CAM processes involving three-dimensional (3D) printing and milling. Marginal degradation and chipping are common issues, yet the literature on the edge strength of 3D-printed restorative materials remains limited. Uncertainties remain regarding the impact of print orientation on edge strength, necessitating further investigation to ensure clinical efficacy.

PURPOSE

The purpose of this study was to evaluate the influence of print orientation on the edge strength of 3D-printed dental restorative resins indicated for definitive and interim use and compare them with milled materials.

MATERIALS AND METHODS

Specimens (14 ×14 ×2 mm) were additively manufactured in three orientations (0, 45, and 90 degrees) using five 3D printed resins: VarseoSmile Crownplus (VCP), Crowntec (CT), Nextdent C&B MFH (ND), Dima C&B temp (DT), and GC temp print (GC). A DLP 3D printer (ASIGA MAX UV) was used, with post-processing parameters set according to manufacturer recommendations. Edge strength was measured at 0.5 mm and 1 mm distance from the edge using a CK 10 testing machine. Specimens were tested in dry conditions (0.5 mm) and after 48 hours of storage in artificial saliva at 37°C (0.5 mm and 1 mm). Failure modes were analysed visually and using optical and scanning electron microscopy. Filler content was assessed using the Ash method, and statistical analysis was conducted using ANOVA. Pearson correlation was used to assess the relationship between filler weight and edge strength.

RESULTS

Due to severe deformation before chipping under load at both distances, data for the 3D-printed and milled interim materials were excluded. The 90-degree printing orientation of definitive materials demonstrated significantly higher edge strength after 48 hours in artificial saliva compared to the 0- and 45-degree orientations (P < 0.001). Significant differences were observed between the 3D printed and milled materials at 0.5 (P < 0.001) mm but not at 1 mm (P ≥ 0.804). Failure modes were predominantly surface indentation without visible cracking (58 %), followed by surface indentation with visible cracking (17 %), edge chipping (0.2 %), and specimen fracture (13 %). A non-significant negative correlation was observed between filler weight and edge strength (r = 0.161, P < 0.680).

CONCLUSIONS

Based on the current findings, 3D printing definitive resin materials at a 90-degree orientation provided increased edge strength. 3D-printed materials can better resist crack propagation compared to milled composites.

CLINICAL IMPLICATIONS

Optimizing the print orientation to 90-degree can improve the edge strength of definitive 3D printed materials.

Effect of oxygen inhibition on 3D printed dental resins: A systematic review

STATEMENT OF PROBLEM

Polymerization under oxygen inhibition increases polymerization crosslinking by inhibiting the formation of peroxy radicals. A systematic review to understand the effects of this polymerization strategy on the properties of polymethyl methacrylate (PMMA) -based resins for additive manufacturing is lacking.

PURPOSE

The purpose of this systematic review was to determine whether oxygen inhibition during the postpolymerization process influences the physical-mechanical properties of PMMA-based resins for 3D printing.

MATERIAL AND METHODS

The systematic review was prepared in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines and was registered with the Open Science Framework (osf.io/y3u7g). The population, intervention, comparison, outcome, and study design (PICOS) were PMMA-based resins for additive manufacturing, oxygen inhibition polymerization, oxygen atmosphere polymerization, physical-mechanical properties, and in vitro studies. Two reviewers independently assessed the articles in 2 phases based on the eligibility criteria.

RESULTS

Initially, 1221 articles were found, of which 319 were excluded because of duplication. After reading the titles and abstracts based on the application of the eligibility criteria, 15 articles were selected for reading in full, and 11 were included in the systematic review. Most of the articles reported a significant improvement in the degree of conversion and in the physical and mechanical properties of PMMA-based resins for additive manufacturing.

CONCLUSIONS

Oxygen inhibition favors postpolymerization by increasing the availability of free radicals for polymer conversion, which may be a suitable polymerization strategy in clinical practice. The higher degree of conversion achieved by polymerization under oxygen inhibition improves physical-mechanical properties and surface characteristics.

Treatment of the Completely Edentulous Patient with Removable Prosthesis

Edentulism is a significant global health issue affecting over 350 million people. Tooth replacement with complete dentures can help mitigate the negative health and social impacts of edentulism. To meet this ongoing demand, efficient complete denture workflows are needed in dental education and practice. Advances in materials and technologies can improve predictability and reduce treatment time. Today, clinicians have the opportunity to combine digital and conventional workflows to find the best solutions for patients seeking removable complete and implant overdentures.

Milling has superior mechanical properties to other fabrication methods for PMMA denture bases: A systematic review and network meta-analysis

OBJECTIVES

This systematic review and network meta-analysis aimed to compare different PMMA (polymethyl methacrylate) complete denture base manufacturing techniques by evaluating their mechanical properties. The objective was to determine which method-compression molding, injection molding, milling, or 3D printing-offers the best performance.

DATA

In vitro studies investigating mechanical properties of PMMA denture base resins.

SOURCES

Four electronic databases such as PubMed, Embase, Web of Science, and the Cochrane Library were screened for English language articles. Two independent researchers selected studies, extracted data, assessed risk of bias, and evaluated evidence certainty.

RESULTS

A total of 17152 articles were found by electronic databases. Finally, 63 studies were analyzed, using random-effects model for network meta-analysis. The outcomes investigated were flexural strength, flexural modulus, surface roughness, impact strength, and Vickers hardness. Milling consistently ranked first or second across outcomes, excelling in flexural strength, modulus, and surface roughness. In contrast, 3D-printed denture bases demonstrated the lowest mechanical performance, highlighting the limitations of this technique at present.

CONCLUSION

Milling is generally recommended for PMMA denture bases due to its superior mechanical properties across most outcomes, supporting its use in clinical settings. However, while promising, 3D-printed PMMA denture bases require further improvement to meet clinical performance standards.

Effects of DLP printing orientation and postprocessing regimes on the properties of 3D printed denture bases

STATEMENT OF PROBLEM

The variety of recommended postprocessing techniques and printing parameters makes it challenging to determine the best approach to 3-dimensionally (3D) printed dentures.

PURPOSE

The purpose of this in vitro study was to assess the effect of printing orientations (0, 45, and 90 degrees) and postprocessing treatments (ultraviolet [UV], heat, or combination) on the mechanical and surface properties of 3D printed denture base resin.

MATERIAL AND METHODS

Three-dimensionally printed denture base resin specimens were fabricated at 0-, 45-, and 90-degree printing orientations, followed by 4 postprocessing techniques (UV, Heat, UV+Heat, and control). Microhardness was assessed using a Vickers microhardness tester. Additionally, the flexural strength (FS) and modulus of elasticity (MoE) were analyzed using a 3-point bend test. Wettability was measured according to the sessile drop test. The fractured surfaces were observed under scanning electron microscopy (SEM).

RESULTS

FS was significantly greater (P<.001) at a print orientation of 90 degrees (73.7 MPa) compared with 0 and 45 degrees (55.2 and 61.8 MPa). No significant difference in FS was found among postprocessing treatments (all complied with the International Organization for Standardization [ISO] requirements). The UV group had the highest MoE (up to 2061 MPa), followed by the heat-treated groups (up to 1412 MPa). The 45-degree print orientation showed the highest contact angle (CA) in almost all groups (CA=117.6±11.7), and UV led to higher hydrophilicity (CA=33.9±12.0). The effect of build orientation on the microhardness depended on the postprocessing technique with the highest value (23.4 ±1.3) achieved by UV postprocessing in combination with the 90-degree orientation.

CONCLUSIONS

The optimal FS of 3D printed denture base resin is achieved when it is printed in a vertical orientation (90 degrees relative to the platform base). Thermal annealing as a postprocessing technique combined with UV can effectively enhance FS, induce favorable wettability, and reduce stiffness.

Trueness of maxillary complete dentures duplicated by using conventional and 3D printing techniques: A comparative in vitro study

STATEMENT OF PROBLEM

Duplicating complete dentures and achieving accurately fitting prostheses poses a challenge. Conventional methods are often time-consuming and susceptible to human error. Advancements in digital technology for denture fabrication offer a promising alternative to conventional duplication techniques, but studies comparing the methods are lacking.

PURPOSE

The purpose of this in vitro study was to compare the trueness of duplicated complete dentures using 3-dimensional (3D) printing technology with that of dentures duplicated using the conventional method.

MATERIAL AND METHODS

A typodont was used to construct a maxillary complete denture using the conventional method. The denture was scanned using a desktop scanner, and the standard tessellation language (STL) file was considered the reference file. Each denture was duplicated using 3 techniques (10 in each group). In the first group, the denture was duplicated using the conventional technique; in the second group, the denture was printed as a single unit (monolithic) from a tooth-colored resin, and the denture flange was then veneered with pink resin; in the third group, the denture base was printed separately from the pink resin, and the teeth were printed as a single unit using tooth-colored resin. The denture base and the teeth were co-related using a positioning device. The duplicate dentures in the 3 groups were scanned, and the STL files were imported into a surface-matching software program to evaluate their trueness. Statistical analysis was done using 1-way ANOVA followed by the Tukey post hoc test (α=.05).

RESULTS

A significant difference (P<.001) was found in the trueness of the 3 duplication techniques, with the highest overall deviation recorded in the conventional denture group (0.73 ±0.06 mm) and the least deviation recorded in the monolithic denture group (0.21 ±0.04 mm). Deviations in the canine, first molar, and maxillary tuberosities were the lowest in the monolithic denture group (0.13 ±0.01 mm), (0.11 ±0.03 mm), (0.27 ±0.05 mm), respectively.

CONCLUSIONS

Using 3D printing technology for complete denture duplication has a promising outcome with the highest trueness reported with the monolithic denture. Comparative clinical studies are needed.

Mechanical properties of 3D printed denture base polymers

STATEMENT OF PROBLEM

Studies on the mechanical properties of 3-dimensionally (3D) printed denture base polymers with appropriate test methods are lacking.

PURPOSE

The purpose of this in vitro study was to determine the flexural strength (σf), elastic modulus (E), fracture toughness (KIC), work of fracture (ωe), and Martens hardness (HM) of 3D printed denture base polymers and to compare them with an injection molded material.

MATERIAL AND METHODS

Three resins for additive (Lucitone Digital Print, LDP; Flexcera Base, FCB and an experimental material, EXP) and 1 for injection molding (IvoBase Hybrid, IBH) fabrication were analyzed. Standardized specimens were fabricated, polished, tempered, and thermal cycled (5 °C to 55 °C) before testing for σf, E, KIC, ωe, and HM. The results were explored by global analysis (α=.05). The Kolmogorov-Smirnov test was used to test for data distribution. Parametric and nonparametric tests followed by pairwise comparison were applied to test for differences between groups.

RESULTS

The σf, E, and HM of 3D printed polymers were significantly lower than those of the injection molded, both for the tempered and aged groups. The σf was lowest for FCB and highest for IBH in the tempered state. The KIC and ωe of the tempered EXP and IBH groups were lower compared with those of FCB and LDP. After aging, EXP, FCB, and IBH presented KIC in the same range, but it was lower than for LDP. Compared with the printable polymers, the control group IBH was not affected by artificial aging.

CONCLUSIONS

The σf, E, and HM of printable polymers were lower than those of the control group, and specimens did not fracture in bend testing. In contrast, KIC and ωe were the highest for a printable polymer. Therefore, tension tests should be considered when testing ductile materials.

Effect of uniaxial bending methods on the flexural strength and Weibull analysis of heat-polymerized, CAD/CAM milled, and 3D-printed denture base resins

OBJECTIVES

To compare the flexural strength and modulus of denture base resins manufactured by conventional methods, 3-dimensional (3D) printing, and computer-aided design and computer-aided manufacturing (CAD/CAM) milling using 3-point bending (3PB) and 4-point bending (4PB) methods after simulated aging.

METHODS

Ninety bars (64 ×10 ×3.3 mm) were prepared from heat-polymerized (Lucitone-199), CAD/CAM milled (G-CAM), and 3D-printed (Denturetec) denture base resins (n = 30 per material). After 10,000 thermal cycles, specimens were subjected to either 3-point bending (3PB) or 4-point bending (4PB) (n = 15 per method) to measure the flexural strength (σ3PB and σ4PB) and elastic modulus (E3PB and E4PB) using a universal testing machine. Weibull analysis was performed to evaluate the reliability (m) and characteristic strength (σ0) as a function of 3PB and 4PB. Fractographic analysis was conducted using scanning electron microscopy (SEM). Data were analysed using 2-way ANOVA followed by Tukey post hoc and Student t-tests (α=.05).

RESULTS

Significant effects of material type and uniaxial bending method on flexural strength and modulus were found (P < .001). Irrespective of the flexural strength measurement approach, CAD/CAM milled resins exhibited significantly higher flexural strength in both methods (σ3PB=125.6 ± 5.2 MPa, σ4PB=110.5 ± 4.5 MPa) and elastic modulus (E3PB=2400 ± 120 MPa and E4PB=2800 ± 150 MPa) compared to 3D-printed and heat-polymerized resins. Irrespective of the denture base resin manufacturing method, σ3PB was significantly higher than σ4PB whereas E4PB was significantly higher than E3PB (P < .001). Weibull analysis exhibited highest reliability for CAD/CAM resins (m=25.24 - 43.83). Considerable microscopic differences were detected.

SIGNIFICANCE

CAD/CAM milled denture base resins exhibited superior flexural properties compared with 3D-printed and heat-polymerized resins.

Flexural Strength and Surface Properties of 3D-Printed Denture Base Resins-Effect of Build Angle, Layer Thickness and Aging

A variety of printable resins for denture bases are available, without detailed instructions on print parameters. This study aimed to evaluate the effect of the printing build angle and the layer thickness of 3D-printed denture base resins before and after thermocyclic aging on flexural strength values and surface properties. The flexural strength, surface roughness (Ra, Rz) and hardness (HM, HV2) of two 3D-printed denture base resins (Formlabs (FL) and V-print dentbase, VOCO, (VC)) were therefore compared to a conventionally pressed cold-curing control material (PalaXpress (PP)). The specimens were printed at a 0°, 45° or 90° build angle and the layer thickness was varied for FL at 50 and 100 µm and evaluated before and after thermocyclic aging (N = 200; n = 10). Differences in flexural strength values were analyzed using multifactorial ANOVAs (α = 0.05). The build angle and aging significantly affected the flexural strength of the 3D-printed denture base resins (p < 0.05), while the layer thickness showed no effect for FL (p = 0.461). The required threshold value of 65 MPa defined by ISO 20795-1 was exceeded by PP (70.5 MPa ± 5.5 MPa), by FL when printed at 90° (69.3 MPa ± 7.7 MPa) and by VC at 0° (69.0 MPa ± 4.6 MPa). The choice of an appropriate build angle for each material and printing technology is crucial for the flexural strength and consequently the clinical longevity of a printed denture base.

Aging and post-polymerization effects on conversion degree and properties of additive splint materials

The study objective was to analyze dimensional change, flexural strength, surface hardness, wear profile, and conversion degree of different additive splint materials under various post-polymerization conditions of time and artificial aging. Two additive manufacturing systems (Cara Print 4.0, Dima Print Ortho, Kulzer; SprintRay Pro, SprintRay Splint, SprintRay), and a thermally activated resin control (Clássico) were evaluated in artificial aging (deionized water or saliva; 28 or 84 days at 37°C), with recommended or doubled post-polymerization cycles. Dimensional change (surface metrology), flexural strength (ISO 20795-1:2013), fractography (SEM), Knoop hardness, two-body wear profilometry (150,000 cycles; 3mmØ; 20N; 2.1Hz), and conversion degree (FTIR spectroscopy) were assessed. Two-way ANOVA and post-hoc Tukey tests were used for parametric data, and Kruskal-Wallis and post-hoc Dunn tests, for non-parametric data (α = 0.05). Results indicated no statistically significant differences in dimensional change or flexural strength among the materials. Recommended post-polymerization cycles resulted in lower hardness for additive resins than the thermally activated control. Doubling post-polymerization time significantly increased flexural strength and hardness of Dima Print Ortho, but decreased flexural strength of SprintRay Splint, and did not affect wear resistance. Dima Print Ortho demonstrated the highest wear resistance. Artificial aging did not affect flexural strength, surface wear, or dimensional change, but negatively impacted the hardness of all materials except Dima Print Ortho. The conversion degree was unaffected by post-polymerization time, and no significant differences were found among the materials. Overall, additive materials exhibited mechanical and dimensional properties comparable to thermally activated resin, with doubling post-polymerization time positively influencing the properties.

An In-Vitro Evaluation of Strength, Hardness, and Color Stability of Heat-Polymerized and 3D-Printed Denture Base Polymers After Aging

This study evaluated the strength, hardness, and color stability of 3D-printed denture base resins and compared the outcome with conventional heat-cured denture base resins after aging by thermocycling. A total of 72 specimens from conventional and 3D-printed materials were fabricated in different shapes and dimensions based on the mechanical and color tests performed. The specimens were divided into five groups: flexural, tensile, and compressive strengths (n = 20), hardness, and color stability (n = 6). In all these groups, half of the specimens were stored in a distilled water bath at 37 °C for 24 h, and the remaining half of the specimens were subjected to aging by thermocycling. The 3D-printed specimens demonstrated the highest means of tensile strength (32.20 ± 3.8 MPa), compressive strength (106.31 ± 4.07 MPa), and Vickers hardness number (24.51 ± 0.36), and the lowest means of flexural strength (54.29 ± 13.17 MPa) and color difference (ΔE = 2.18 ± 1.09). Conventional heat-cured specimens demonstrated the highest means of flexural strength (59.96 ± 8.39 MPa) and color difference (ΔE = 4.74 ± 2.37) and the lowest means of tensile strength (32.17 ± 9.06 MPa), compressive strength (46.05 ± 4.98 MPa), and Vickers hardness number (10.42 ± 1.05). Aging significantly reduced the flexural strength (-27%), tensile strength (-44%), and hardness (-7%) of 3D-printed resins in contrast to the conventional resin's compressive strength (-15%) and color stability (p < 0.05). The 3D-printed resin had comparable flexural and tensile strength and significantly superior compressive strength, hardness, and color stability compared with conventional resins. Aging significantly and negatively affected the flexural strength, tensile strength, and hardness of 3D-printed resin.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

The science of printing and polishing 3D printed dentures

Objective

To analyze the effectiveness of various techniques available for printing, finishing and polishing of 3D printed prosthesis.

Methods

The articles were selected from electronic databases including PubMed and Scopus. Recently, lot of advancements have been observed in the field of 3D printing in dentistry.

Results

Numerous studies were found explaining the factors affecting the surface roughness such as printing speed, direction, layer thickness, post curing, etc., and the significance in achieving a smooth surface finish of a 3D printed prosthesis. The methods employed to achieve this range, similar to conventional and chairside polishing, are to use advanced coating materials such as light cured glazes to nanoparticles.

Conclusion

3D printing is being used in day-to-day practice and the prosthesis must be aesthetic looking to satisfy the patients' expectations. There is a lack of data supporting any one polishing method for the prosthesis. There is a need for further research on the existing techniques and newer advancements yielding aesthetic prostheses with an optimal surface finish.

Development of 3-dimensionally printed denture base material utilizing hybrid polymer: A preliminary investigation

STATEMENT OF PROBLEM

Current 3-dimensionally (3D) printed denture bases have inadequate strength and durability for long-term use, and milled denture bases generate excessive waste. Addressing these limitations is crucial to advancing prosthetic dentistry, ensuring improved patient outcomes and promoting environmental responsibility.

PURPOSE

The purpose of this in vitro study was to incorporate microparticles into a commercially available 3D printed denture base resin and compare its mechanical and biological properties with the conventional polymethyl methacrylate (PMMA) denture base material.

MATERIAL AND METHODS

Microparticles were collected from milled zirconia blanks and were blended with a 3D printing denture base resin (NextDent Denture 3D+). The optimal zirconia microparticle content (2%) for blending and printed was determined by using a liquid-crystal display (LCD) 3D printer. The printed specimens were then postrinsed and postpolymerized based on the manufacturer's instructions. Mechanical and biological characterization were carried out in terms of flexural strength, fracture toughness, and fungal adhesion. One-way ANOVA was carried out to analyze the results statistically.

RESULTS

The incorporation of microparticles in the 3D printed denture demonstrated higher mechanical strength (104.77 ±7.60 MPa) compared with conventional heat-polymerized denture base resin (75.15 ±24.41 MPa) (P<.001), but the mechanical strength deteriorated when compared with the unmodified 3D printing resin (122.17 ±11.58 MPa) (P<.001). However, the modified 3D printed denture showed greater antibacterial activity (1184.00 ±243.25 CFU/mL) than the unmodified resin (1486.50 ±103.94 CFU/mL) (P=.045).

CONCLUSIONS

The incorporation of microparticles into the 3D printed denture base resin demonstrated the potential to enhance the mechanical and biological properties of the denture base when compared with conventional techniques. However, when compared with the unmodified 3D printed denture base resin, the mechanical properties deteriorated while the biological properties improved.

Synthesis and evaluation of novel urethane macromonomers for the formulation of fracture tough 3D printable dental materials

3D printing of materials which combine fracture toughness, high modulus and high strength is quite challenging. Most commercially available 3D printing resins contain a mixture of multifunctional (meth)acrylates. The resulting 3D printed materials are therefore brittle and not adapted for the preparation of denture bases. For this reason, this article focuses on toughening by incorporation of triblock copolymers in methacrylate-based materials. In a first step, three urethane dimethacrylates with various alkyl spacer length were synthesized in a one-pot two-step synthesis. Each monomer was combined with 2-phenoxyethyl methacrylate as a monofunctional monomer and a polycaprolactone-polydimethylsiloxane-polycaprolactone triblock copolymer was added as toughener. The formation of nanostructures via self-assembly was proven by small angle X-ray scattering (SAXS) and transmission electron microscopy (TEM). The addition of the triblock copolymer resulted in a strong increase in fracture toughness for all mixtures. The nature of the urethane dimethacrylate had a significant impact on fracture toughness and flexural strength and modulus of the cured materials. Most promising systems were also investigated via dynamic fatigue propagation da/dN measurements, confirming that the toughening also works under dynamic load. By carefully selecting the length of the urethane dimethacrylate spacer and the amount of block copolymer, materials with the desired physical properties could be efficiently formulated. Especially the formulation containing the medium alkyl spacer length (DMA2/PEMA) and 5 wt% BCP1 (block copolymer), exhibits excellent mechanical properties and high fracture toughness.

Comparative Study of the Fracture Resistance of 3D-Printed and Prefabricated Artificial Teeth for Removable Dentures

The integration of three-dimensional (3D) printed resin denture teeth represents a significant advancement in digital dentistry. This study aims to assess the ability of 3D-printed denture teeth to withstand chipping and indirect tensile fractures, comparing them with conventionally manufactured resin denture teeth. Four groups, each comprising 30 specimens, were examined: Group 1 featured 3D-printed denture teeth (NextDent, 3D Systems, Soesterberg, The Netherlands), while the others included commercially obtained Ivostar Shade, SpofaDent Plus, and Major Super Lux teeth. Stereolithography 3D printing was utilized to produce methacrylate-based photopolymerized resin teeth models for Group 1, while the remaining groups were commercially sourced. Chipping and indirect tensile fracture tests were performed at a rate of 0.8 mm/min until material failure, offering valuable insights into the mechanical properties of the tested denture teeth. Statistical analysis was carried out using one-way analysis of variance (ANOVA), coupled with Tukey's honestly significant difference test to compare multiple groups, with a significance threshold of p < 0.05. The findings showed that 3D-printed resin denture teeth exhibited greater indirect tensile fracture resistance than Major Super Lux and Ivostar Shade, though they were surpassed by SpofaDent Plus. In the chipping test, the 3D-printed teeth experienced buccal chipping without distortion, indicating their structural stability under localized force. Fractures during the indirect tensile test originated near the loading point and extended cervically along the inner slopes of both cusps, displaying consistent fracture patterns. These results demonstrate that 3D-printed denture teeth made from resin materials provide adequate fracture resistance for clinical use, although further refinement of materials could enhance their performance relative to conventional alternatives.

Assessing the Current Landscape and Future Directions of Digital Denture Technology

Digital dentures are removable dental prostheses fabricated using computer-aided design/computer-aided manufacturing (CAD/CAM) technology. This study aimed to explore the trends in digital dentures. A comprehensive four-phase search and selection strategy was framed.

Dimensions and Lens.org databases were used. Boolean operators were used to combine keywords.

The most significant growth occurred by 2021, with 71 publications and 984 citations. Egypt had the highest publication rankings, with 46 total publications (TP) and 45 total citations (TC). The University of Geneva played a significant role in contributing to 16 TP and 491 TC. Egyptian Dental Journal ranked at the top. The group with four authors had an even higher number of authorships, with a total of 60. The top four keywords were CAD/CAM, 3D printing, CAD-CAM, complete denture, and digital dentistry. The Glossary of Prosthodontic Terms, Ninth Edition, was referenced 614 times and had the highest average number of citations (75.2). The top three writers had strong relationships with the three sources and preferred to publish using four keywords. The 11-author group, cluster 6, had the highest level of network cooperation.

In conclusion, research on digital dentures has grown in terms of number of articles and citations.

Three-Dimensionally-Printed Polymer and Composite Materials for Dental Applications with Focus on Orthodontics

Three-dimensional printing has transformed dentistry by enabling the production of customized dental restorations, aligners, surgical guides, and implants. A variety of polymers and composites are used, each with distinct properties. This review explores materials used in 3D printing for dental applications, focusing on trends identified through a literature search in PubMed, Scopus, and the Web of Science. The most studied areas include 3D-printed crowns, bridges, removable prostheses, surgical guides, and aligners. The development of new materials is still ongoing and also holds great promise in terms of environmentally friendly technologies. Modern manufacturing technologies have a promising future in all areas of dentistry: prosthetics, periodontology, dental and oral surgery, implantology, orthodontics, and regenerative dentistry. However, further studies are needed to safely introduce the latest materials, such as nanodiamond-reinforced PMMA, PLA reinforced with nanohydroxyapatite or magnesium, PLGA composites with tricalcium phosphate and magnesium, and PEEK reinforced with hydroxyapatite or titanium into clinical practice.

Oral health-related quality of life and patient satisfaction using three-dimensional printed dentures: A crossover randomized controlled trial

OBJECTIVES

This crossover randomized controlled clinical trial (RCT) aimed to evaluate the clinical applicability of three-dimensional printed dentures (CAD-3DPs) by comparing two fabricated complete dentures, CAD-3DPs and conventional complete dentures (CCDs), and assess the non-inferiority of CAD-3DPs. The hypothesis was that CAD-3DPs would be inferior to CCDs in terms of the oral health-related quality of life (OHRQoL) and patient satisfaction.

METHODS

This single-blind RCT was conducted at two university hospitals. The participants included adult patients with edentulous maxillary and mandibular arches, who had existing complete dentures and were willing to use new complete dentures. Eighteen participants were assigned to two groups: CCD-CAD-3DP and CAD-3DP-CCD, based on the order of denture delivery. Both sets of maxillary and mandibular CCDs and CAD-3DPs were delivered to all the participants. The OHRQoL using Oral Health Impact Profile for Edentulous Patients (OHIP-EDENT-J) was considered the primary outcome. General satisfaction using a 100-mm visual analog scale was also evaluated as a suboutcome.

RESULTS

Based on the non-inferior test on the total score of the OHIP-EDENT and each score of the seven conceptual subdomains, the lower limit of the 95 % confidence interval was < 2.65 in seven domains. Therefore, CAD-3DP was judged to be non-inferior to CCD. Patient satisfaction was not significantly different between the CCD and CAD-3DP groups (p > 0.05).

CONCLUSIONS

This RCT revealed that CAD-3DP is comparable to CCD based on the OHIP-JDENT scores and patient satisfaction.

CLINICAL SIGNIFICANCE

CAD-3DP is clinically applicable and comparable to CCD in terms of patient-reported outcomes.

The influence of the addition of titanium oxide nanotubes on the properties of 3D printed denture base materials

INTRODUCTION

In this study, the effects of adding titanium dioxide nanotubes (TiO2) to 3D-printed denture base resin on the mechanical and physical properties of denture bases were examined for the first time.

METHODS

The specimens were digitally created using 3D builder software from Microsoft Corporation through computer-aided design. In accordance with the test specifications for transverse strength, impact strength, hardness, surface roughness, and color stability, specimens were designed and printed with certain dimensions following relevant standards. TiO2 nanotubes (diameter: 15-30 nm and length: 2-3 μm) were added to the 3D-printed denture base resin (DentaBase, Asiga, Australia) at 1.0% and 1.5% by weight. Flexural strength, impact strength (Charpy impact), hardness, surface roughness, and color stability were evaluated, and the collected data were analyzed with ANOVA followed by Tukey's post hoc test (α = 0.05). Field emission scanning electron microscopy (FESEM) and energy dispersive x-ray spectroscopy (EDX) mapping were used to evaluate the dispersion of the nanotubes.

RESULTS

Compared with those of the control group (0.0 wt.% TiO2 nanotubes), the average flexural, impact, and hardness values of the 1.0 and 1.5 wt.% TiO2 nanotube reinforcement groups increased significantly. Both nanocomposite groups showed significant color changes compared to that of the pure resin, and there was a considerable reduction in the surface roughness of the nanocomposites compared to that of the control group.

CONCLUSION

Adding TiO2 nanotubes to 3D-printed denture base materials at 1.0 and 1.5 wt.% could enhance the mechanical and physical properties of the material, leading to better clinical performance.

CLINICAL SIGNIFICANCE

In terms of clinical applications, 3D-printed denture base material has been shown to be a viable substitute for traditional heat-cured materials. By combining this with nanotechnology, existing dentures could be significantly enhanced, promoting extended service life and patient satisfaction while addressing the shortcomings of the current standard materials.

Effects of print orientation and artificial aging on the flexural strength and flexural modulus of 3D printed restorative resin materials

STATEMENT OF PROBLEM

The integration of computer-aided design and computer-aided manufacture (CAD-CAM) technology has revolutionized restorative dentistry, offering both additive and subtractive manufacturing methods. Despite extensive research on 3-dimensionally (3D) printed materials, uncertainties remain regarding the impact of print orientation on their mechanical properties, especially for definitive resin materials, necessitating further investigation to ensure clinical efficacy.

PURPOSE

The purpose of this in vitro study was to investigate the influence of print orientation and artificial aging on the flexural strength (FS) and flexural modulus (FM) of 3D printed resin materials indicated for definitive and interim restorations.

MATERIAL AND METHODS

Specimens (2×2×25 mm) were additively manufactured in 3 orientations (0, 45, and 90 degrees) using five 3D printed resins: VarseoSmile Crownplus (VCP), Crowntec (CT), Nextdent C&B MFH (ND), Dima C&B temp (DT), and GC temp print (GC). A DLP 3D printer (ASIGA MAX UV) was used with postprocessing parameters as per the manufacturer recommendations. FS and FM were tested after storage in distilled water (DW) and artificial saliva (AS) for 24 hours, 1 month, and 3 months at 37 °C. Additional 2×2×16-mm specimens printed at 90 degrees were compared with the milled materials Lava Ultimate (LU) and Telio CAD (TC) after 24 hours of storage in AS at 37 °C (n=10). Measurements were conducted using a universal testing machine (Z020; Zwick/Roell) following the International Organization for Standardization (ISO) 4049 standard. Multiple way ANOVA, 1-way ANOVA, and Tukey HSD post hoc tests (α=.05) were used to analyze the data.

RESULTS

Print orientation significantly influenced the FS and FM of 3D printed resin materials, with the 90-degree orientation exhibiting superior mechanical properties (P<.05). Definitive resins (CT and VCP) exhibited higher FS and FM compared with interim resins (ND, DT, GC) at all time points (P<.001). LU had significantly higher FS and FM compared with other resins (P<.001), while TC had similar FS to definitive 3D printed resins. Aging time and media influenced FS and FM, with varying effects observed across different materials and time points. Strong positive correlations were found between filler weight and both FS (r=.83, P=.019) and FM. All materials met the minimum FS requirement of 80 MPa (ISO 4049) when printed at 90 degrees.

CONCLUSIONS

The 90-degree orientation produced specimens with higher FS than 0- and 45-degree orientations. CT recommended for definitive restorations displayed higher FS compared with VCP and those intended for interim use after 3 months of aging. LU exhibited higher FS and FM than 3D printed resins, while TC had similar FS and FM to the latter. Aging effects on 3D printed resins were minimal and were material specific.

Reinforcement of 3D-printed resins for denture base by adding aramid fibers: Effect on mechanical, surface, and optical properties

PURPOSE

The present study evaluated the mechanical, surface, and optical properties of 3D-printed resins for removable prostheses reinforced by the addition of aramid fibers.

MATERIALS AND METHODS

According to ISO 20795-1:2013 standards, specimens were printed using a digital light processing 3D printer and divided into two groups (n = 06/group): 3D-printed resin for denture base as the control group, and a group with the same 3D-printed resin in addition of 5% aramid fibers as the experimental group. Red aramid fibers were chosen for aesthetic characterization. The specimens were evaluated for their mechanical properties, such as elastic modulus (GPa), flexural strength (MPa), and superficial properties by their surface microhardness (KHN), surface roughness (μm), and surface free energy (mJ/m2). Optical properties were evaluated by the color difference (∆E00) between groups. The statistical test chosen after the exploratory analysis of the data was One-way ANOVA followed by Tukey's HSD (α = 0.05).

RESULTS

The results showed statistical differences in elastic modulus (p < 0.0001), flexural strength (p < 0.0001), surface free energy polar variable (p = 0.0322), total surface free energy (p = 0.0344), with higher values for the experimental. Surface hardness and surface roughness showed no statistical difference (p ≥ 0.05). The color difference (∆E00) obtained through the CIEDE2000 calculus was below the perceptibility threshold (≤1.1).

CONCLUSION

Adding aramid fibers to 3D-printed resin for denture bases resulted in better mechanical properties, without major alterations in surface properties. In addition, it is an easy-to-apply choice for mechanical reinforcement and aesthetic characterization, with the expression of small blood vessels in the 3D-printed resin for removable denture bases.

Effects of post-curing light intensity on the trueness, compressive strength, and resin polymerization characteristics of 3D-printed 3-unit fixed dental prostheses

PURPOSE

To investigate the effect of different post-curing light intensities on the trueness, compressive strength, and resin polymerization of 3D-printed 3-unit fixed dental prostheses (FPD).

MATERIALS AND METHODS

A total of 60 specimens were prepared to support a 3-unit FDP with a deep chamfer marginal design, utilizing computer-aided design and computer-aided manufacturing (CAD-CAM) technology. Light-polymerizing FDP resin with varying light intensities (105, 210, 420, and 840 mW/cm2) was employed for 10 min. Subsequently, trueness assessment, fracture load testing, scanning electron microscopy (SEM) surface examination, and Fourier-Transform Infrared (FTIR) analysis were conducted. A one-way analysis of variance (ANOVA) was performed to ascertain the differences between the experimental groups (p < 0.05).

RESULTS

The group exposed to 210 mW/cm2 showed the highest trueness (57.6 ± 2.1 µm), while the 840 mW/cm2 group had the highest deviation (79.3 ± 2.7 µm) (p < 0.001). Significant differences in fracture resistance were found between groups (p < 0.001), with mean fracture strengths of 1149.77 ± 67.81 N, 1264.92 ± 39.06 N, 1331.34 ± 53.62 N, and 1439.93 ± 34.58 N for light intensities of 105, 210, 420, and 840 mW/cm2, respectively (p < 0.001). The resin polymerization analysis shows a peak intensity surge at 3579 cm-1 for O-H and C-H stretching vibrations, except in samples exposed to 105 mw/cm2 light, with the lowest peak at 2890 cm-1. The performance of resin polymerization is most significant under the condition of 840 mW/cm2.

CONCLUSION

The light intensity of 210 mW/cm2 exhibited the highest trueness, while the 840 mW/cm2 group showed the highest deviation. However, the light intensity of 840 mW/cm2 demonstrated the highest compressive strength. Furthermore, polymerization occurred at all post-treatment light intensities except 105 mW/cm2. These findings indicate that while low-intensity usage offers greater trueness, high-intensity usage provides better compressive strength and polymerization. Therefore, 210 mW/cm2 could be the recommended solution for post-curing.

Biological, Antifungal, and Physical Efficacy of a Denture Cleanser Formulated with Cnidium officinale Extracts

BACKGROUND/OBJECTIVES

We aimed to assess the antifungal efficacy and impact of a denture cleanser containing Cnidium officinale extract on the surface characteristics of denture base materials, as well as its physical and biological properties.

METHODS

The experimental denture cleansers were formulated with C. officinale at concentrations of 100 and 150 μg/mL, combined with 1% cocamidopropyl betaine as a natural surfactant. Antifungal efficacy was evaluated using zone-of-inhibition assays against Candida albicans, revealing inhibition zones of 20 ± 1.8 mm for the 100 μg/mL concentration and 23.6 ± 1.6 mm for the 150 μg/mL concentration. Surface property assessments-including hardness, roughness, color stability, and solubility measurements-demonstrated no significant differences compared to the control group. Biological evaluations included the quantification of polyphenol and flavonoid content.

RESULTS

The C. officinale-based cleanser showed significant antifungal activity without affecting the hardness, roughness, color stability, or solubility of denture base materials. Biological tests revealed no cytotoxicity and minimal mucosal irritation. Polyphenol and flavonoid contents were quantitatively measured, revealing higher concentrations in the experimental groups, which were correlated with significant antifungal activity. These compounds are known for their roles in disrupting microbial processes and enhancing antimicrobial effects. These findings suggest that the C. officinale-based denture cleanser effectively inhibits C. albicans while preserving the physical properties of denture base materials.

CONCLUSIONS

This study highlights the potential of C. officinale in denture cleanser formulations, promoting denture hygiene and oral health. Future research should prioritize long-term clinical evaluations and formulation optimization.

Effect of artificial aging on fracture toughness and hardness of 3D-printed and milled 3Y-TZP zirconia

PURPOSE

This study aimed to evaluate the impact of artificial aging on the fracture toughness and hardness of three-dimensional (3D)-printed and computer-aided design and computer-aided manufacturing (CAD-CAM) milled 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP).

MATERIALS AND METHODS

Forty bar-shaped specimens (45 × 4 × 3 mm) were prepared using two manufacturing technologies: 3D printing (LithaCon 3Y 210, Lithoz GmbH, Vienna, Austria; n = 20) and milling (Initial Zirconia ST, GC, Japan; n = 20) of 3Y-TZP. The chevron-notch beam method was used to assess the fracture toughness according to ISO 24370. Specimens from each 3Y-TZP group were divided into two subgroups (n = 10) based on the artificial aging process (autoclaving): nonaged and aged. Nonaged specimens were stored at room temperature, while aged specimens underwent autoclave aging at 134°C under 2 bar-pressure for 5 h. Subsequently, the specimens were immersed in absolute 99% ethanol using an ultrasonic cleaner for 5 min. Each specimen was preloaded by subjecting it to a 4-point loading test, with a force of up to 200 N applied for three cycles. Further 4-point loading was conducted at a rate of 0.5 mm/min under controlled temperature and humidity conditions until fracture occurred. The maximum force (Fmax) was recorded and the chevron notch was examined at 30 × magnification under an optical microscope for measurements before the fracture toughness (KIc) was calculated. Microhardness testing was also performed to measure the Vickers hardness number (VHN). A scanning electron microscope (SEM) coupled with an energy dispersive X-ray unit (EDX) was used to examine surface topography and chemical composition. X-ray diffraction (XRD) was conducted to identify crystalline structure. Data were statistically analyzed using two-way ANOVA and Student's t-test with a significance level of 0.05.

RESULTS

The nonaged 3D-printed 3Y-TZP group exhibited a significantly higher fracture toughness value (6.07 MPa m1/2) than the milled 3Y-TZP groups (p < 0.001). After autoclave aging, the 3D-printed 3Y-TZP group maintained significantly higher fracture toughness (p < 0.001) compared to the milled 3Y-TZP group. However, no significant differences in hardness values (p = 0.096) were observed between the aged and nonaged groups within each manufacturing process (3D-printed and milled) independently.

CONCLUSION

The findings revealed that the new 3D-printed 3Y-TZP produced by the lithography-based ceramic manufacturing (LCM) technology exhibited superior fracture toughness after autoclave aging compared to the milled 3Y-TZP. While no significant differences in hardness were observed between the aged groups, the 3D-printed material demonstrated greater resistance to fracture, indicating enhanced mechanical stability.

Influence of different printing orientations and post-polymerization time on the translucency of three-dimensional (3D) printed denture base resins

PURPOSE

To evaluate the effect of different printing orientations and post-polymerization time with thermal cycling on the translucency of 3D-printed denture base resins.

METHODS

Heat-polymerized (HP) acrylic resin specimens were fabricated and 3D-printed denture base materials (NextDent, ASIGA, FormLabs) were printed with different printing orientations (0, 45, 90 degrees) and subjected to different post-polymerization times (15-, 30-, 60-, and 90-min). All specimens were polished and immersed in distilled water for 1 day at 37°C. CIEDE2000 was used to measure the translucency parameters (TP00) before and after thermal cycling (5000 cycles) recording the color parameters (L*, a*, b*) against a black and white background using a spectrophotometer. k-factors ANOVA followed by post hoc Tukey's test (α = .05) was performed for statistical analysis.

RESULTS

The k-factors ANOVA test showed a significant effect of resin material, post-polymerization time, and printing orientation on translucency (p < 0.001). In comparison to HP, all 3D-printed resins showed lower translucency with all post-polymerization times and printing orientation (p < 0.001) except FormLabs resin (p > 0.05). For all 3D-printed resins, the translucency increased, with increasing the post-polymerization time (p < 0.001) and 60- and 90-min showed the highest translucency. For printing orientation, 90 and 45 degrees significantly showed high translucency in comparison to 0 degrees (p < 0.001). FormLabs showed significantly higher translucency when compared with NextDent and ASIGA per respective printing orientation and post-polymerization time. The translucency significantly decreased after thermal cycling for all tested resins (p < 0.001).

CONCLUSION

The findings of this study demonstrated that the translucency of 3D-printed resins is influenced by the printing orientation, post-polymerization time, and resin type. As a result, choosing a resin type, and printing orientation, with a longer post-polymerization time should be considered since it may improve the esthetic appearance of the 3D-printed resins.

Effect of thermocycling on tensile bond strength of autopolymerized, heat-polymerized, milled, and 3D printed denture base materials bonded to 4 different denture liners: an in vitro study

BACKGROUND

Digitally fabricated dentures may require relining due to continual alveolar ridge resorption. However, studies evaluating the tensile bond strength (TBS) of digitally fabricated dentures bonded to denture liners are lacking. This study aimed to evaluate the TBS of autopolymerized, heat-polymerized, milled, and 3D printed denture base materials bonded to 2 acrylic-based and 2 silicone-based denture liners, both before and after thermocycling. Additionally, the impact of thermocycling on the TBS were also evaluated.

METHODS

The TBS of 4 different denture base materials (Palapress (PL), Vertex Rapid Simplified (VR), Smile CAM total prosthesis (SC), and NextDent denture 3D+ (ND)) bonded to 2 acrylic-based (GC Soft-Liner (GC) and Tokuyama Rebase II (RB)) and 2 silicone-based (Ufi Gel P (UP) and Sofreliner Tough M (ST)) denture liners were tested. Specimens (n = 8) were divided into non-thermocycling and thermocycling groups. Non-thermocycling specimens were tested after 24-hours water immersion, while thermocycling specimens were underwent 5000 cycle and were immediately tested. Mode of failure was examined under a stereomicroscope. Data were analyzed using 2-way ANOVA and Tukey HSD tests (α = 0.05), and independent samples t test (α = 0.05) for TBS between non-thermocycling and thermocycling groups.

RESULTS

For the non-thermocycling groups, within the same denture liner material, no significant differences were found between denture base materials, except the ND + RB group, which had significantly lower TBS. For the thermocycling groups, within the same denture liner material, the TBS in the PL group exhibited the highest and the ND group exhibited the lowest. Within the same denture base material, in both non-thermocycling and thermocycling groups, the TBS in the ST group exhibited the highest; in contrast, that in the GC group exhibited the lowest. No significant differences were observed in TBS between non-thermocycling and thermocycling groups, except for denture base materials bonded to the ST group, SC + UP, and ND + UP groups.

CONCLUSIONS

Milled denture base can be relined with acrylic-based or silicone-based denture liner. However, cautions should be exercised when relining 3D printed denture base. Thermocycling did not affect TBS between acrylic-based denture liners and denture bases. In contrast, it affected the bond between silicone-based denture liner and denture base.

Post-processing of a 3D-printed denture base polymer: Impact of a centrifugation method on the surface characteristics, flexural properties, and cytotoxicity

OBJECTIVES

To investigate the impact of a centrifugation method on the surface characteristics, flexural properties, and cytotoxicity of an additively manufactured denture base polymer.

METHODS

The tested specimens were prepared by digital light processing (DLP). A centrifugation method (CENT) was used to remove the residual uncured resin. In addition, the specimens were post-processed with different post-rinsing solutions: isopropanol (IPA), ethanol (EtOH), and tripropylene glycol monomethyl ether (TPM), respectively. A commercial heat-polymerized polymethyl methacrylate was used as a reference (REF). First, the values of surface topography, arithmetical mean height (Sa), and root mean square height (Sq) were measured. Next, flexural strength (FS) and modulus were evaluated. Finally, cytotoxicity was assessed using an extract test. The data were statistically analyzed using a one-way analysis of variance, followed by Tukey's multiple comparison test for post-hoc analysis.

RESULTS

The Sa value in the CENT group was lower than in the IPA, EtOH, TPM, and REF groups (p < 0.001). Moreover, the CENT group had lower Sq values than other groups (p < 0.001). The centrifugation method showed a higher FS value (80.92 ± 8.65 MPa) than the EtOH (61.71 ± 12.25 MPa, p < 0.001) and TPM (67.01 ± 9.751 MPa, p = 0.027), while affecting IPA (72.26 ± 8.80 MPa, p = 0.268) and REF (71.39 ± 10.44 MPa, p = 0.231). Also, the centrifugation method showed no evident cytotoxic effects.

CONCLUSIONS

The surfaces treated with a centrifugation method were relatively smooth. Simultaneously, the flexural strength of denture base polymers was enhanced through centrifugation. Finally, no evident cytotoxic effects could be observed from different post-processing procedures.

CLINICAL SIGNIFICANCE

The centrifugation method could optimize surface quality and flexural strength of DLP-printed denture base polymers without compromising cytocompatibility, offering an alternative to conventional rinsing post-processing.

Impact of Printing Orientation on the Accuracy of Additively Fabricated Denture Base Materials: A Systematic Review

Printing orientation is one of the printing parameters that affect the properties of three-dimensional (3D)-printed resins. Different printing orientations and directions have been suggested; however, no clear and specific orientations are recommended in the literature in terms of the printing orientation effect on the accuracy and fit of 3D-printed removable dental prostheses. This review aimed to evaluate the effect of printing orientation on the fit and accuracy of 3D-printed removable dental prostheses. The PubMed, Scopus, and Web of Science databases were searched for published articles that investigated the effect of printing orientations on the accuracy and fit of the 3D-printed denture base. Full-length English published articles were searched between January 2010 and December 2023, which examined topics related to printing orientations, building angles, 3D printing, printing technology, accuracy, dimensional changes, internal fit, marginal integrity, marginal discrepancies, trueness, precision, and adaptation. Of the ten included studies, one investigated maxillary and mandibular denture bases, seven assessed maxillary denture bases, and two evaluated mandibular bases. Different printing orientations, ranging from 0° to 315°, were explored, with a higher prevalence of 0°, 45°, and 90°. The included studies utilized stereolithography and digital light processing printing technologies. High accuracy was observed at 45°, followed by 90. Additional struts and bars on the cameo surface increased the accuracy of the 3D-printed denture base. These results shows that printing orientation has a significant effect on the accuracy of 3D-printed resin, with 45° exhibiting the highest accuracy. In addition to the support structure, the density and position can impact the accuracy.

Effects of printing orientation and artificial ageing on martens hardness and indentation modulus of 3D printed restorative resin materials

BACKGROUND

Three-dimensional (3D) printing is increasingly used to fabricate dental restorations due to its enhanced precision, consistency and time and cost-saving advantages. The properties of 3D-printed resin materials can be influenced by the chosen printing orientation which can impact the mechanical characteristics of the final products.

PURPOSE

The objective of this study was to evaluate the influence of printing orientation and artificial ageing on the Martens hardness (HM) and indentation modulus (EIT) of 3D-printed definitive and temporary dental restorative resins.

METHODS

Disk specimens (20 mm diameter × 2 mm height) were additively manufactured in three printing orientations (0°, 45°, 90°) using five 3D-printable resins: VarseoSmile Crownplus (VCP), Crowntec (CT), Nextdent C&B MFH (ND), Dima C&B temp (DT), and GC temp print (GC). The specimens were printed using a DLP 3D-printer (ASIGA MAX UV), while LavaTM Ultimate (LU) and Telio CAD (TC) served as milled control materials. Martens hardness (HM) and indentation modulus (EIT) were tested both before and after storage in distilled water and artificial saliva for 1, 30, and 90 days at 37 °C.

RESULTS

90° printed specimens exhibited higher HM than the other orientations at certain time points, but no significant differences were observed in HM and EIT between orientations for all 3D-printed materials after 90 days of ageing in both aging media. LU milled control material exhibited the highest HM and EIT among the tested materials, while TC, the other milled control, showed similar values to the 3D printed resins. CT and VCP (definitive resins) and ND displayed higher Martens parameters compared to DT and GC (temporary resins). The hardness of the 3D-printed materials was significantly impacted by artificial ageing compared to the controls, with ND having the least hardness reduction percentage amongst all 3D-printed materials. The hardness reduction percentage in distilled water and artificial saliva was similar for all materials except for TC, where higher reduction was noted in artificial saliva.

SIGNIFICANCE

The used 3D printed resins cannot yet be considered viable alternatives to milled materials intended for definitive restorations but are preferable for use as temporary restorations.

Impact of Artificial Aging on the Physical and Mechanical Characteristics of Denture Base Materials Fabricated via 3D Printing

Three-dimensional (3D) printing is becoming more prevalent in the dental sector due to its potential to save time for dental practitioners, streamline fabrication processes, enhance precision and consistency in fabricating prosthetic models, and offer cost-effective solutions. However, the effect of aging in artificial saliva of this type of material has not been explored. To assess the physical and mechanical properties of the two types of 3D-printed materials before and after being subjected to artificial saliva, a total of 219 acrylic resin specimens were produced. These specimens were made with two types of 3D-printed materials, namely, NextDent (ND) and Formlabs (FLs), and a Schottlander heat-cured (HC) resin material that was used as a control. Water sorption and solubility specimens (n = 5) were tested after three months of storage in artificial saliva. Moreover, the Vickers hardness, Martens hardness, flexural strength/modulus, and impact strength were evaluated both under dry conditions and after three months of storage in artificial saliva. The degree of conversion (DC), elemental analysis, and filler content were also investigated. The ANOVA showed that 3D-printed resins had significantly greater sorption than the control group (p < 0.05). However, the flexural strength values of the 3D-printed materials were significantly greater (p < 0.05) than those of the heat-cured material. The DC of the 3D-printed resins was lower than that of the control group, but the difference was not significant (p > 0.05). The 3D-printed materials contained significantly more filler than the control (p < 0.05). Moreover, the artificial saliva had a significant effect on the Vickers hardness for all tested groups and on the Martens hardness for the control group only (p < 0.05). Compared with conventional heat-cured materials, 3D-printed denture base materials demonstrated relatively poorer performance in terms of sorption, solubility, and DC but exhibited either comparable or superior mechanical properties. The aging process also influenced the Vickers and Martens' hardness. The strength of the 3D-printed materials was in compliance with ISO recommendations, and the materials could be used alongside conventional heat-cured materials.

Effect of post-curing conditions on surface characteristics, physico-mechanical properties, and cytotoxicity of a 3D-printed denture base polymer

OBJECTIVE

This study aims to investigate the influence of post-polymerization (post-curing) conditions on surface characteristics, flexural properties, water sorption and solubility, and cytotoxicity of additively manufactured denture base materials.

METHODS

The tested specimens were additively manufactured using digital light processing and classified into different post-curing condition groups: submerged in water (WAT), submerged in glycerin (GLY), and air exposure (AIR). An uncured specimen (UNC) was used as a control. The surface topography and roughness were observed. The flexural strength and modulus were determined via a three-point bending test. The water sorption and solubility were subsequently tested. Finally, an extract test was performed to assess cytotoxicity.

RESULTS

Different post-curing conditions had no significant effects on the surface topography and roughness (Sa value). Various post-curing conditions also had no significant effects on the flexural strength. Notably, the flexural modulus of the WAT group (2671.80 ± 139.42 MPa) was significantly higher than the AIR group (2197.47 ± 197.93 MPa, p = 0.0103). After different post-curing conditions, the water sorption and solubility of the specimens met the ISO standards. Finally, all post-curing conditions effectively reduced cytotoxic effects.

SIGNIFICANCES

Post-curing with different oxygen levels improved flexural properties, and flexural modulus significantly increased after the specimens were submerged in water. In addition, water sorption and solubility, and cytocompatibility were optimized by post-curing, irrespective of the post-curing conditions. Therefore, the water-submerged conditions optimized the flexural modulus of the 3D-printed denture base materials.

A 3D-simulation study of the deformation, tension, and stress of 3D-printed and conventional denture base materials after immersion in artificial saliva

INTRODUCTION

The worldwide application of digital technology has presented dentistry with transformative opportunities. The concept of digital dentures, incorporating computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques, holds the promise of improved precision, customization, and overall patient satisfaction. However, the shift from traditional dentures to their digital counterparts should not be taken lightly, as the intricate interplay between oral physiology, patient comfort, and long-term durability requires thorough examination.

The Influence of Contemporary Denture Base Fabrication Methods on Residual Monomer Content, Flexural Strength and Microhardness

(1) Background: Digital technologies are available for denture base fabrication, but there is a lack of scientific data on the mechanical and chemical properties of the materials produced in this way. Therefore, the aim of this study was to investigate the residual monomer content, flexural strength and microhardness of denture base materials as well as correlations between investigated parameters. (2) Methods: Seven denture base materials were used: one conventional heat cured polymethyl methacrylate, one polyamide, three subtractive manufactured materials and two additive manufactured materials. High-performance liquid chromatography was used to determine residual monomer content and the test was carried out in accordance with the specification ISO No. 20795-1:2013. Flexural strength was also determined according to the specification ISO No. 20795-1:2013. The Vickers method was used to investigate microhardness. A one-way ANOVA with a Bonferroni post-hoc test was used for the statistical analysis. The Pearson correlation test was used for the correlation analysis. (3) Results: There was a statistically significant difference between the values of residual monomer content of the different denture base materials (p < 0.05). Anaxdent pink blank showed the highest value of 3.2% mass fraction, while Polident pink CAD-CAM showed the lowest value of 0.05% mass fraction. The difference between the flexural strength values of the different denture base materials was statistically significant (p < 0.05), with values ranging from 62.57 megapascals (MPa) to 103.33 MPa. The difference between the microhardness values for the different denture base materials was statistically significant (p < 0.05), and the values obtained ranged from 10.61 to 22.86 Vickers hardness number (VHN). A correlation was found between some results for the material properties investigated (p < 0.05). (4) Conclusions: The selection of contemporary digital denture base manufacturing techniques may affect residual monomer content, flexural strength and microhardness but is not the only criterion for achieving favourable properties.

Effect of thermocycling on surface topography and fracture toughness of milled and additively manufactured denture base materials: an in-vitro study

BACKGROUND

Studies investigating thermocycling effect on surface topography and fracture toughness of resins used in digitally manufactured denture bases are few. The study aimed to assess the impact of thermocycling on surface topography and fracture toughness of materials used for digitally manufactured denture bases.

METHODS

Water sorption, solubility, hardness, surface roughness, and fracture toughness of both three-dimensional (3D)-printed and computer-aided design, computer-aided manufacturing (CAD-CAM) milled specimens (n = 50) were assessed both prior to and following 2000 thermocycles, simulating 2 years of clinical aging. Surface hardness (n = 10) was measured using a Vickers hardness testing machine, surface roughness (n = 10) was determined by a contact profilometer, and fracture toughness (n = 20) was measured using the 3-point bend test, then studying the fractured surfaces was done via a scanning electron microscope (SEM). Prior to and following thermocycling, water sorption and solubility (n = 10) were assessed. Normally distributed data was tested using two-way repeated ANOVA and two-way ANOVA, while Mann Whitney U test and the Wilcoxon signed ranks test were used to analyze data that was not normally distributed (α < 0.05).

RESULTS

Following thermocycling, Vickers hardness and fracture toughness of both groups declined, with a significant reduction in values of the 3D-printed resin (P < .001). The 3D-printed denture base resins had a rougher surface following thermocycling with a significant difference (P < .001). The sorption and solubility of water of both materials were not affected by thermocycling.

CONCLUSIONS

Before and after thermocycling, milled specimens had lower surface roughness and a greater degree of hardness and fracture toughness than 3D-printed specimens. Thermocycling lowered hardness and fracture toughness, and increased surface roughness in both groups, but had no effect on water sorption and solubility.

Microbiological, physicomechanical, and surface evaluation of an experimental self-curing acrylic resin containing halloysite nanotubes doped with chlorhexidine

OBJECTIVE

The objective was to synthesize halloysite nanotubes loaded with chlorhexidine (HNT/CHX) and evaluate the antimicrobial activity, microhardness, color change, and surface characteristics of an experimental self-curing acrylic resin containing varying concentrations of the synthesized nanomaterial.

METHODS

The characterization of HNT/CHX was carried out by calculating incorporation efficiency, morphological and compositional, chemical and thermal evaluations. SAR disks were made containing 0 %, 3 %, 5 %, and 10 % of HNT/CHX. Specimens (n = 3) were immersed in distilled water and spectral measurements were carried out using UV/Vis spectroscopy to evaluate the release of CHX for up to 50 days. The antimicrobial activity of the composite against Candida albicans and Streptococcus mutans was evaluated by disk-diffusion test. Microhardness, color analyses (ΔE), and surface roughness (Ra) (n = 9) were performed before and after 30 days of immersion. Data were analyzed using ANOVA/Bonferroni. {Results.} The incorporation efficiency of CHX into HNT was of 8.15 %. All test groups showed controlled and cumulative CHX release up to 30 or 50 days. Significant antimicrobial activity was verified against both microorganisms (p < 0.001). After the 30-day immersion period, the 10 % HNT/CHX group showed a significant increase in hardness (p < 0.05) and a progressive color change (p < 0.001). At T0, the 5 % and 10 % groups exhibited Ra values similar to the control group (p > 0.05), while at T30, all groups showed similar roughness values (p > 0.05). {Significance.} The modification of a SAR with HNT/CHX provides antimicrobial effect and controlled release of CHX, however, the immediate surface roughness in the 3 % group was compromised when compared to the control group.

The flexural strength of 3D-printed provisional restorations fabricated with different resins: a systematic review and meta-analysis

BACKGROUND

Three-dimensional (3D) printing technology has revolutionized dentistry, particularly in fabricating provisional restorations. This systematic review and meta-analysis aimed to thoroughly evaluate the flexural strength of provisional restorations produced using 3D printing while considering the impact of different resin materials.

METHODS

A systematic search was conducted across major databases (ScienceDirect, PubMed, Web of Sciences, Google Scholar, and Scopus) to identify relevant studies published to date. The inclusion criteria included studies evaluating the flexural strength of 3D-printed provisional restorations using different resins. Data extraction and quality assessment were performed using the CONSORT scale, and a meta-analysis was conducted using RevMan 5.4 to pool results.

RESULTS

Of the 1914 initially identified research articles, only 13, published between January 2016 and November 2023, were included after screening. Notably, Digital Light Processing (DLP) has emerged as the predominant 3D printing technique, while stereolithography (SLA), Fused Deposition Modeling (FDM), and mono-liquid crystal displays (LCD) have also been recognized. Various printed resins have been utilized in different techniques, including acrylic, composite resins, and methacrylate oligomer-based materials. Regarding flexural strength, polymerization played a pivotal role for resins used in 3D or conventional/milled resins, revealing significant variations in the study. For instance, SLA-3D and DLP Acrylate photopolymers displayed distinct strengths, along with DLP bisacrylic, milled PMMA, and conventional PMMA. The subsequent meta-analysis indicated a significant difference in flexure strength, with a pooled Mean Difference (MD) of - 1.25 (95% CI - 16.98 - 14.47; P < 0.00001) and a high I2 value of 99%, highlighting substantial heterogeneity among the studies.

CONCLUSIONS

This study provides a comprehensive overview of the flexural strength of 3D-printed provisional restorations fabricated using different resins. However, further research is recommended to explore additional factors influencing flexural strength and refine the recommendations for enhancing the performance of 3D-printed provisional restorations in clinical applications.

Comparison of cytotoxicity between 3D printable resins and heat-cure PMMA

Aim

The aim of this study was to evaluate and compare the cytotoxicity of polyurethane and polyoxymethylene printable resins with conventional heat cure polymethyl methacrylate denture base resins.

Methods

The study followed ISO-10993-5 guidelines. It comprised of three groups. Fifteen cuboidal samples measuring 10x10 × 10mm dimension were prepared for each group. The polymethylmethacrylate samples were fabricated using conventional denture processing techniques, while the polyoxymethylene samples were printed using fused deposition modeling and the polyurethane samples using stereolithography technique. Post fabrication the samples were evaluated for cytotoxicity using the MTT assay with the VERO cell line. The percentage of cell viability was calculated to determine the cytotoxic effects.

Results

Statistical analysis revealed a significant difference in the cell viability of the experimental groups (p ≤ 0.0001). The polyoxymethylene group showed the highest % cell viability (62.78 %), followed by the polymethylmethacrylate group (52.43 %), and the least was observed in the polyurethane-based resin group (46.47 %). The findings indicate polyoxymethylene group displayed least cytotoxicity, followed by polymethylmethacrylate, and polyurethane-based resin.

Conclusion

Polyoxymethylene resin exhibited the minimum cytotoxic properties among the tested materials, followed by polymethylmethacrylate and polyurethane resin.

Microbiological evaluation of conjunctival anopthalmic flora after using digital 3D-printed ocular prosthesis compared to conventional one: a randomized clinical trial

BACKGROUND

This study aims to assess the influence of using 3D-printed acrylic resin versus conventional Poly-methyl methacrylate (PMMA) for fabricating ocular prostheses on the biofilm and microbial flora of anophthalmic socket.

METHODS

A randomized controlled trial was designed as a parallel group study. Participants were allocated randomly into two groups: the control group, which received conventionally fabricated ocular prostheses (CG, n = 11), and the test group, which received digitally 3D-printed ocular prostheses (DG, n = 11). Microbiological analysis was conducted before prosthesis insertion and three months after using the ocular prosthesis. Swab samples were inoculated on blood agar, MacConkey's agar, and Sabouraud's dextrose agar (SDA) for isolating Gram-positive, Gram-negative, and fungal organisms, respectively. Subsequently, the plates were incubated at 37 degrees Celsius for 48 h. Additionally, a validated questionnaire was used for subjective clinical evaluation, including parameters such as comfort level, socket discharge, lacrimation, and frequency of lubrication for each ocular prosthesis patient in both groups.

RESULTS

Test group (DG, n = 11) exhibited a positive, though statistically insignificant, difference (p > 0.001) in microbial growth when compared to the control group (CG, n = 11). A statistically significant difference was observed in comfort levels between the two groups, with more comfort level within group II (test group) patients. While parameters such as discharge amount, discharge location, lacrimation and lubrication frequency displayed statistically insignificant differences between the two groups, all parameters showed improved results after three months of prosthesis use.

CONCLUSIONS

The choice of ocular prosthesis fabrication technique did not yield a statistically significant difference in anophthalmic flora. However, the 3D-printed acrylic resin, as an artificial eye material, displayed potential advantages in reducing the colonization of opportunistic pathogens. All subjective clinical evaluation parameters exhibited enhanced outcomes after three months of prosthesis use, emphasizing the need for an adaptation period during which patients complains are alleviated. In comparison with PMMA, 3D-printed acrylic resin showcased a certain degree of anti-colonization ability against pathogenic bacteria, along with a significant level of patient comfort, suggesting its potential as a promising material for ocular prostheses.

TRIAL REGISTRATION

This parallel double-blinded RCT has been registered at ClinicalTrials.gov with identification number: NCT05584865, 18/10/2022.

3D printed denture base material: The effect of incorporating TiO2 nanoparticles and artificial ageing on the physical and mechanical properties

OBJECTIVES

To evaluate the physical and mechanical properties of three-dimensional (3D) printed denture base resin incorporating TiO2 nanoparticles (NPs), subjected to a physical ageing process.

METHODS

Acrylic denture base samples were prepared by a Stereolithography (SLA) 3D printing technique reinforced with different concentrations (0.10, 0.25, 0.50, and 0.75) of silanated TiO2 NPs. The resulting nanocomposite materials were characterized in terms of degree of conversion (DC), and sorption/solubility flexural strength, impact strength, Vickers hardness and Martens hardness and compared with unmodified resin and conventional heat-cured (HC) material. The nanocomposites were reassessed after subjecting them to ageing in artificial saliva. A fractured surface was studied under a scanning electron microscope (SEM).

RESULTS

The addition of TiO2 NPs into 3D-printed resin significantly improved flexural strength/modulus, impact strength, Vickers hardness, and DC, while also slightly enhancing Martens hardness compared to the unmodified resin. Sorption values did not show any improvements, while solubility was reduced significantly. The addition of 0.10 wt% NPs provided the highest performance amongst the other concentrations, and 0.75 wt% NPs showed the lowest. Although ageing degraded the materials' performance to a certain extent, the trends remained the same. SEM images showed a homogenous distribution of the NPs at lower concentrations (0.10 and 0.25 wt%) but revealed agglomeration of the NPs with the higher concentrations (0.50 and 0.75 wt%).

SIGNIFICANCE

The outcomes of this study suggested that the incorporation of TiO2 NPs (0.10 wt%) into 3D-printed denture base material showed superior performance compared to the unmodified 3D-printed resin even after ageing in artificial saliva. The nanocomposite has the potential to extend service life of denture bases in future clinical use.

Comparative Evaluation of TiO2 Nanoparticle Addition and Postcuring Time on the Flexural Properties and Hardness of Additively Fabricated Denture Base Resins

Three-dimensionally (3D)-printed fabricated denture bases have shown inferior strength to conventional and subtractively fabricated ones. Several factors could significantly improve the strength of 3D-printed denture base resin, including the addition of nanoparticles and post-curing factors. This study evaluated the effect of TiO2 nanoparticle (TNP) addition and the post-curing time (PCT) on the flexural properties and hardness of three-dimensionally (3D)-printed denture base resins. A total of 360 specimens were fabricated, with 180 specimens from each type of resin. For evaluating the flexural properties, bar-shaped specimens measuring 64 × 10 × 3.3 mm were used, while, for the hardness testing, disc-shaped specimens measuring 15 × 2 mm were employed. The two 3D-printed resins utilized in this study were Asiga (DentaBASE) and NextDent (Vertex Dental B.V). Each resin was modified by adding TNPs at 1% and 2% concentrations, forming two groups and an additional unmodified group. Each group was divided into three subgroups according to the PCT (15, 60, and 90 min). All the specimens were subjected to artificial aging (5000 cycles), followed by testing of the flexural strength and elastic modulus using a universal testing machine, and the hardness using the Vickers hardness test. A three-way ANOVA was used for the data analysis, and a post hoc Tukey's test was used for the pairwise comparisons (α = 0.05). Scanning electron microscopy (SEM) was used for the fracture surface analysis. The addition of the TNPs increased the flexural strength in comparison to the unmodified groups (p < 0.001), while there was no significant difference in the elastic modulus and hardness with the 1% TNP concentration. Among the TNP groups, the 2% TNP concentration significantly decreased the elastic modulus and hardness (p < 0.001). The SEM showed a homogenous distribution of the TNPs, and the more irregular fracture surface displayed ductile fractures. The PCT significantly increased the flexural strength, elastic modulus, and hardness (p < 0.001), and this increase was time-dependent. The three-way ANOVA results revealed a significant difference between the material types, TNP concentrations, and PCT interactions (p < 0.001). Both concentrations of the TNPs increased the flexural strength, while the 2% TNP concentration decreased the elastic modulus and hardness of the 3D-printed nanocomposites. The flexural strength and hardness increased as the PCT increased. The material type, TNP concentration, and PCT are important factors that affect the strength of 3D-printed nanocomposites and could improve their mechanical performance.

Flexural Strength Analysis of Different Complete Denture Resin-Based Materials Obtained by Conventional and Digital Manufacturing

PMMA (Polymethylmethacrylate) is the material of choice to fabricate denture bases. Recently, with the introduction of CAD-CAM and 3D printers in dentistry, new materials have been proposed for complete denture manufacturing.

AIM

This study compared the flexural strength of different resins fabricated using different technologies (conventional, CAD-CAM-milled, and 3D-printed) and polymerization techniques.

METHODS

A total of 11 different resins were tested: six PMMA conventional (Acrypol R, Acrypol LL, Acrypol HI, Acrypol Fast, Acryself and Acryslef P), two milled obtained from UDMA PMMA disks (Ivotion disk and Aadva disk, control groups), two 3D-printed PMMA resins (NextDent Denture 3D+, and SprintRayEU Denture Base), and one 3D-printed composite resin (GC Temp Print). Flexural strength was measured using a universal testing machine. One-way ANOVA and Bonferroni post hoc tests were performed; the p-value was set at 0.05 to consider statistically significant differences among the groups. Spearman test was used to evaluate the correlation between polymerization technique and the flexural strength of 3D-printed resins.

RESULTS

CAD-CAM-milled specimens showed the highest flexural strength (107.87 MPa for UDMA) followed by 3D-printed composite resins (102.96 MPa). Furthermore, 3D-printed resins polymerized for 40 min with the BB cure unit showed no statistically significant differences with conventional resin groups. Moreover, in all the 3D-printed specimens, a high correlation between polymerization technique and flexural strength was found.

CONCLUSIONS

In terms of flexural strength, the polymerization technique is a determinant for both acrylic and composite resins. Temp Print can be a potential alternative to fabricating removable dentures and showed promising results when used in combination with pink color resin powder.

Microbial adhesion and biofilm formation by Candida albicans on 3D-printed denture base resins

This study evaluated surface properties and adhesion/biofilm formation by Candida albicans on 3D printed denture base resins used in 3D printing. Disc-shaped specimens (15 mm x 3 mm) of two 3D-printed resins (NextDent Denture 3D+, NE, n = 64; and Cosmos Denture, CO, n = 64) and a heat-polymerized resin (Lucitone 550, LU, control, n = 64) were analyzed for surface roughness (Ra μm) and surface free energy (erg cm-2). Microbiologic assays (90-min adhesion and 48-h biofilm formation by C. albicans) were performed five times in triplicate, with the evaluation of the specimens' surface for: (i) colony forming units count (CFU/mL), (ii) cellular metabolism (XTT assay), and (iii) fluorescence and thickness of biofilm layers (confocal laser scanning microscopy). Data were analyzed using parametric and nonparametric tests (α = 0.05). LU presented higher surface roughness Ra (0.329±0.076 μm) than NE (0.295±0.056 μm) (p = 0.024), but both were similar to CO (0.315±0.058 μm) (p = 1.000 and p = 0.129, respectively). LU showed lower surface free energy (47.47±2.01 erg cm-2) than CO (49.61±1.88 erg cm-2) and NE (49.23±2.16 erg cm-2) (p<0.001 for both). The CO and NE resins showed greater cellular metabolism (p<0.001) and CO only, showed greater colonization (p = 0.015) by C. albicans than LU in the 90-min and 48-hour periods. It can be concluded that both 3D-printed denture base resins are more prone to colonization by C. albicans, and that their surface free energy may be more likely associated with that colonization than their surface roughness.

Effect of layer thickness, build angle, and viscosity on the mechanical properties and manufacturing trueness of denture base resin for digital light processing

OBJECTIVES

To investigate effects of layer thickness, build angle, and viscosity on the mechanical properties and trueness of denture base resins used for digital light processing (DLP).

METHODS

Two denture base resins for DLP in different viscosity (high and low) were tested by using two manufacturing parameters:1) layer thickness (LT) (50- or 100-μm) and 2) build angle (BA) (0-, 45-, and 90-degree). disk- and bar-shaped specimens were used to evaluate hardness and flexural strength, respectively. Denture base specimens were used to examine trueness, and the deviation was calculated as the root mean square. Three-way analysis of variance (ANOVA) was conducted to determine the interaction among the three factors (viscosity, LT, and BA). Statistical significance was set at P < .05.

RESULTS

Effects of LT and BA on hardness differed according to viscosity, with significant interactions among three factors (P=.027). Regardless of LT or BA, the low-viscosity group had higher hardness than the high-viscosity group (P<.001). In terms of flexural strength, no significant interaction was detected between the factors (P=.212), however, the effects of LT and BA were significant (P=.003 and P<.001, respectively). Regarding trueness, a significant interaction was observed between viscosity and BA (P=.001). Low-viscosity group had higher trueness than high-viscosity group when the 45- and 90-degree BA were applied (P<.001).

CONCLUSIONS

LT and BA significantly affected the mechanical properties and trueness of the 3DP denture base, depending on the viscosity. For hardness and trueness, using low-viscosity resin and manufacturing with 50-μm LT and 45-degree BA are recommended.

CLINICAL SIGNIFICANCE

Resin viscosity affects the influence of LT and BA on the hardness, flexural strength, and trueness of DLP-generated denture bases. A 50-μm LT and 45-degree BA can be used with a low-viscosity resin to fabricate denture bases with higher hardness and trueness.

Physical and mechanical properties of four 3D-printed resins at two different thick layers: An in vitro comparative study

OBJECTIVES

This in vitro comparative study aimed to evaluate the physical and mechanical properties of four 3D-printed resins with two different thickness layers.

METHODS

Four printed resins (VarseoSmile Crown Plus, VSC; NexDent C&B MFH, MFH; Nanolab 3D, NNL; and Resilab 3D Temp, RSL) were printed with 50 µm and 100 µm layer thickness, resulting in 80 bars measuring 25 × 2×2 mm. The specimens underwent a Raman spectroscopy for degree of conversion, confocal laser scanning microscopy for surface roughness (Sa), three-point bending test for flexural strength and elastic modulus, and a Vickers hardness test (VHN). Data was tested for normality using the Shapiro-Wilk, two-way ANOVA, and Tukey test (α = 0.05) for statistical analysis.

RESULTS

The layer thickness affected all performed tests, but the elastic modulus (p < 0.001). Specimens with 100 µm showed, in general, worse results outcomes than those with 50 µm (p < 0.001). However, within the limitations of this comparative in vitro study, it could be concluded that the tested resins and layer thicknesses directly influenced physical and mechanical properties.

SIGNIFICANCE

The physical and mechanical properties of three-dimensional printed restorations can be affected by the layer thickness, which can interfere with the choice of the 3D printing resin for a desired clinical outcome.

Statistical Comparison of the Mechanical Properties of 3D-Printed Resin through Triple-Jetting Technology and Conventional PMMA in Orthodontic Occlusal Splint Manufacturing

Dental 3D-printing technologies, including stereolithography (SLA), polyjet (triple-jetting technology), and fusion deposition modeling, have revolutionized the field of orthodontic occlusal splint manufacturing. Three-dimensional printing is now currently used in many dental fields, such as restorative dentistry, prosthodontics, implantology, and orthodontics. This study aimed to assess the mechanical properties of 3D-printed materials and compare them with the conventional polymethylmethacrylate (PMMA). Compression, flexural, and tensile properties were evaluated and compared between PMMA samples (n = 20) created using the "salt and pepper" technique and digitally designed 3D-printed samples (n = 20). The samples were subjected to scanning electron microscope analysis. Statistical analysis revealed that the control material (PMMA) exhibited a significantly higher Young's modulus of compression and tensile strength (p < 0.05). In the flexural tests, the control samples demonstrated superior load at break results (p < 0.05). However, the 3D-printed samples exhibited significantly higher maximum bending stress at maximum load (MPa) (p < 0.05). Young's modulus of tensile testing (MPa) was statistically significant higher for the control samples, while the 3D-printed samples demonstrated significantly higher values for elongation at break (p < 0.05). These findings indicate that 3D-printed materials are a promising alternative that can be effectively utilized in clinical practice, potentially replacing traditional heat-cured resin in various applications.

Bacterial Adhesion on Dental Polymers as a Function of Manufacturing Techniques

The microbiological behavior of dental polymer materials is crucial to secure the clinical success of dental restorations. Here, the manufacturing process and the machining can play a decisive role. This study investigated the bacterial adhesion on dental polymers as a function of manufacturing techniques (additive/subtractive) and different polishing protocols. Specimens were made from polyaryletherketone (PEEK, PEKK, and AKP), resin-based CAD/CAM materials (composite and PMMA), and printed methacrylate (MA)-based materials. Surface roughness (R_z; R_a) was determined using a laser scanning microscope, and SFE/contact angles were measured using the sessile drop method. After salivary pellicle formation, in vitro biofilm formation was initiated by exposing the specimens to suspensions of Streptococcus mutans (S. mutans) and Streptococcus sanguinis (S. sanguinis). Adherent bacteria were quantified using a fluorometric assay. One-way ANOVA analysis found significant influences (p < 0.001) for the individual parameters (treatment and material) and their combinations for both types of bacteria. Stronger polishing led to significantly (p < 0.001) less adhesion of S. sanguinis (Pearson correlation PC = -0.240) and S. mutans (PC = -0.206). A highly significant (p = 0.010, PC = 0.135) correlation between S. sanguinis adhesion and R_z was identified. Post hoc analysis revealed significant higher bacterial adhesion for vertically printed MA specimens compared to horizontally printed specimens. Furthermore, significant higher adhesion of S. sanguinis on pressed PEEK was revealed comparing to the other manufacturing methods (milling, injection molding, and 3D printing). The milled PAEK samples showed similar bacterial adhesion. In general, the resin-based materials, composites, and PAEKs showed different bacterial adhesion. Fabrication methods were shown to play a critical role; the pressed PEEK showed the highest initial accumulations. Horizontal DLP fabrication reduced bacterial adhesion. Roughness < 10 µm or polishing appear to be essential for reducing bacterial adhesion.

Effect of Different Vat Polymerization Techniques on Mechanical and Biological Properties of 3D-Printed Denture Base

Three-dimensional printing is increasingly applied in dentistry to fabricate denture bases. Several 3D-printing technologies and materials are available to fabricate denture bases, but there is data scarcity on the effect of printability, mechanical, and biological properties of the 3D-printed denture base upon fabricating with different vat polymerization techniques. In this study, the NextDent denture base resin was printed with the stereolithography (SLA), digital light processing (DLP), and light-crystal display (LCD) technique and underwent the same post-processing procedure. The mechanical and biological properties of the denture bases were characterized in terms of flexural strength and modulus, fracture toughness, water sorption and solubility, and fungal adhesion. One-way ANOVA and Tukey’s post hoc were used to statistically analyze the data. The results showed that the greatest flexural strength was exhibited by the SLA (150.8±7.93 MPa), followed by the DLP and LCD. Water sorption and solubility of the DLP are significantly higher than other groups (31.51±0.92 μgmm3) and 5.32±0.61 μgmm3, respectively. Subsequently, the most fungal adhesion was found in SLA (221.94±65.80 CFU/mL). This study confirmed that the NextDent denture base resin designed for DLP can be printed with different vat polymerization techniques. All of the tested groups met the ISO requirement aside from the water solubility, and the SLA exhibited the greatest mechanical strength.

The influence of printing angle on color and translucency of 3D printed resins for dental restorations

OBJECTIVES

To evaluate the influence of printing orientation on color and translucency of 3D printing restorative resins.

METHODS

Four 3D printing resin systems in the available shades (DFT-Detax Freeprint Temp- A1, A2,A3; FP-Formlabs Permanent Crown- A2,A3,B1,C2; FT- Formlabs Temporary CB- A2,A3,B1,C2; GCT-GC Temporary- Light, Medium) were evaluated. Three samples (10×10×1.2 mm) from each material were printed at two different printing orientations (0° and 90°) and polished to 1.00 ± 0,01 mm of thickness. Spectral reflectance was measured against black background using a calibrated spectroradiometer, CIE D65 standard illuminant and the 45°/0°geometry. Color and translucency differences were evaluated using CIEDE2000 metric (ΔE₀₀) and 50:50% perceptibility (PT₀₀ and TPT₀₀) and acceptability (AT₀₀ and TAT₀₀) thresholds.

RESULTS

In general, color changes due to printing orientation at (0° and 90°) were mainly produced by ΔL* or ΔC* . ΔE₀₀ were above PT₀₀ for all DFT shades, FP-B1, FP-C2, FT-A2 and FT-B1. Only for DFT-1, ΔE₀₀ was above AT₀₀. ΔRTP₀₀ values were above TPT₀₀ for DFT-A1, DFT-A3, FP-B1 and FT-B1, but lower than TAT₀₀. The direction of the changes in translucency (ΔRTP₀₀) depends on the material and shade.

SIGNIFICANCE

The selection of building orientation (0° and 90°) for the 3D printed resins influence the visual color and translucency and therefore their esthetic appearance. These aspects should be considered when printing dental restorations using the evaluated materials.