Surface Quality of 3D-Printed Models as a Function of Various Printing Parameters

Comparing the Accuracy of Conventional Gypsum and 3D-Printed Dental Casts Using Three-Dimensional Analysis

INTRODUCTION

Dental impressions and casts play a critical role in dental care, facilitating diagnoses and the fabrication of prostheses. Traditional methods of fabrication involve elastomeric materials that are more prone to errors and patient discomfort. Digital advancements offer promising alternatives, yet their accuracy and applicability to military dentistry remain under-explored. This study evaluates the accuracy of digital casts produced with material available in the Military Health System compared to conventional methods.

MATERIALS AND METHODS

Using a digital (n = 10) and analog (n = 10) methodology casts were fabricated from a reference cast (n = 1). The reference and cast samples were scanned with a reference scanner to generate stereolithography files. These files were used to generate full arch, single crown, fixed dental prosthesis, and inlay digital casts which were then compared using a three-dimensional (3D) comparison software to evaluate accuracy. Root mean square values were obtained, giving a quantitative evaluation of the deviation of each sample from the reference cast. Statistical analysis consisted of a Shapiro-Wilk and Levene test to account for homogeneity of variances in each group. An ANOVA and Tukey post-hoc test were used to determine differences in accuracy among the full arch and a two-way ANOVA and Tukey post-hoc test evaluated differences in trueness among the casts of the individual preparations.

RESULTS

Analog full arch casts had an average root mean square of 106 ±19.18 µm when examining trueness and 12 ±2.58 µm for precision. Digital full arch casts had an average root mean square of 51.9 ±5.39 µm when examining trueness and 4.2 ±1.57 µm for precision. Overall digital casts surpassed analog counterparts in accuracy. Fixed dental prostheses were found to be the only group, which showed no statistically significant difference between digital and analog.

CONCLUSION

These findings validate the potential of digital workflows in enhancing the speed and accuracy of dental care in the Military Health System, while underscoring the need for further exploration and refinement in specific clinical contexts.

Impact of 3D resin and base designs on the accuracy of additively manufactured casts using a stereolithography technology

STATEMENT OF PROBLEM

Three-dimensional (3D) printed casts can be fabricated using a wide range of 3D polymer resins and designed with varying casts´ base configurations. Nevertheless, the influence of different base designs, in conjunction with various 3D printing resins, on the final dimensional accuracy of casts manufactured through SLA-LCD 3D printing technology remains unclear.

PURPOSE

This study assessed the impact of 3D printing resins and base designs on the dimensional accuracy of diagnostic casts fabricated using a SLA-LCD vat-polymerization 3D printer. Two resins (NextDent Model 2.0 and Aqua Gray 4K) and 5 different base configurations were evaluated for their effect on trueness and precision.

MATERIAL AND METHODS

A digital maxillary cast was modified into three base designs: solid (Group S), honeycomb (Group HC), and hollow (Group H). Honeycomb and hollow designs had subgroups with 1-mm (HC1, H1) and 2-mm (HC2, H2) wall thicknesses, resulting in 50 specimens (n=10 per subgroup). Eleven embedded precision cubes were used for accuracy assessment. A Sonic Mini 4K vat-polymerization printer was used for cast printing, and dimensional deviations were captured using a coordinate measuring device. Trueness was defined by the average dimensional discrepancy, and precision was indicated by the standard deviation. Statistical analysis included Kruskal-Wallis and Mann-Whitney U tests (α=.05).

RESULTS

NextDent resin showed trueness falling between 44.8 5 µm and 64.5 µm and precision values varying between 33.5 5 µm and 48.9 µm, while Aqua Gray 4K resin ranged from 24.1 5 µm to 81.1 µm for trueness and 19.8 5 µm to 65.9 µm for precision. Significant differences (P<.001) were observed in all axes (x-, y-, z-axes) and 3D deviations, influenced by resin and base design.

CONCLUSIONS

Resin type and base design significantly affect the dimensional accuracy of 3D printed casts. Aqua Gray 4K with a 2-mm hollow base provided the highest accuracy, particularly when matched with the printer manufacturer. All casts met clinical standards.

Impact of aging on the mechanical and structural properties of additively manufactured resin for occlusal devices

STATEMENT OF PROBLEM

Studies of the impact of aging on additively manufactured occlusal devices are lacking. Whether the materials meet clinical parameters and possess appropriate mechanical properties that are preserved over time remains unclear.

PURPOSE

The purpose of this in vitro study was to investigate the impact of aging on the structural and mechanical properties of additively manufactured resin used in the fabrication of occlusal devices.

MATERIAL AND METHODS

Specimens were manufactured using a 3-dimensional (3D) printer and divided into groups according to layer height: 25 µm (G25) and 50 µm (G50). Flexural strength, Vickers surface microhardness, modulus of elasticity, surface roughness, and dimensional accuracy were determined at baseline and at 30, 60, 90, and 180 days. The specimens were immersed in distilled water in a bacteriological oven at 37 ºC for aging. The results for surface microhardness, surface roughness, and dimensional accuracy were analyzed using repeated-measures 2-way ANOVA. For flexural strength and modulus of elasticity, 2-way ANOVA was performed. All analyses were followed by the Tukey multiple comparison test (α=.05).

RESULTS

G25 exhibited significant variations in several properties over time, including a reduction in flexural strength and surface microhardness and an increase in the modulus of elasticity. Conversely, G50 had higher microhardness and flexural strength but a significant reduction in roughness and modulus of elasticity after 180 days.

CONCLUSIONS

The findings indicate that, except for surface roughness, the mechanical properties of the 3D printed resins changed over time, with layer height significantly influencing these variations.

Influence of Polymers Surface Roughness on Noise Emissions in 3D-Printed UAV Propellers

Following the rising popularity of Unmanned Aerial Vehicles (UAVs) among large-scale users, in the form of domestic as well as professional drones, with applications in domains such as safety (e.g., surveillance drones), terrain mapping (using geo-scanning UAVs), videography drones, and high performance drones used in FPV (First Person View) drone competitions-as well as the rising wide accessibility of Fused Filament Fabrication (FFF)-especially considering the recent apparition and popularization of 3D printers capable of displaying exponential increases in performance metrics, the present work takes into consideration the practice of fabricating UAV propellers by means of FFF, focusing on the theoretical, as well as on the practical aspects of the roughness and quality observed at the level of the resulting surfaces. The paper proposes a set of propeller configurations obtained by combining popular propeller geometries, such as the Gemfan 51466-3 three-bladed propeller and the novel Toroidal propeller model, with a range of different fabrication materials, such as the Polyethylene Terephthalate Glycol (PETG) filament and the Polylactic Acid (PLA) filament. The main aim of the study is to reveal observations on the influence that the surface quality has on the performance metrics of a propeller. Based on the practical work, which aims to develop a comparative study between two drone propeller geometries manufactured by a nonconventional process, 3D printing, the practical applications in the study were carried out using low-cost equipment in order to evaluate the results obtained in a domestic setting. The study involves the identification of the noise values produced by the two geometries due to the roughness of the propeller surfaces.

Trueness of 3-dimensionally printed complete arch implant analog casts

STATEMENT OF PROBLEM

Although a completely digital workflow has numerous advantages, a physical definitive cast may be especially helpful for the accurate assembly of components of complex complete arch-fixed prostheses, the evaluation of esthetic and occlusion features, or prosthesis fabrication. Research on the accuracy of additive complete arch casts with implants positioned with a large anterior-posterior (A-P) spread is sparse.

PURPOSE

The purpose of this in vitro study was to evaluate the trueness of complete arch 4-implant analog casts with a large A-P distribution fabricated with different 3-dimensional (3D) printers.

MATERIAL AND METHODS

Ten systems were evaluated representing currently available printing technologies and materials for the additive fabrication of complete arch 4-implant analog casts and compared for deviations in the X-, Y-, and Z-axes from the master model scan (MMS), recorded in standard tessellation language (STL). The MMS was provided to the laboratory selected by the manufacturer, permitting them to create their specific cast with computer-aided design and computer-aided manufacture specific to a particular system, including analog receptacle offset settings. Laboratories fabricated N=10 casts and affixed analogs. A conventional splinted impression and stone cast (CON) was fabricated as a control. The casts were scanned with a precision laboratory scanner (D2000; 3Shape A/S), and files were imported into the Convince metrology software program (3Shape A/S) for comparison with the MMS for mean deviations in the X-, Y-, and Z- axes. A 2-way ANOVA and the Tukey HSD comparison tests were performed between system groups and the 4 implant locations (α=.05). Comparative color maps were used to determine dimensional changes of the edentulous ridges.

RESULTS

For 2-dimensional deviations from the MMS in each of the 3 axes, the printer type, implant location, and interaction between those 2 variables were found to be statistically significant (P<.05). Comparisons among printers showed the smallest deviations for Asiga Pro 4K (ASG) and Stratasys Origin One (ORI) printers in both the X- and Y-axes and for CON in the Z-axis. For 3D deviations, comparison among printers indicated that ORI, SprintRay Pro55 S (SPR), and Ackuretta SOL (ACK) had the largest deviations, whereas CON and ASG showed the smallest deviations. Comparison color mapping demonstrates a disparity between printed model dimensional changes and implant analog positioning since the color maps of the casts' ridge crests were not in concordance with the results of the implant analog deviations.

CONCLUSIONS

ASG, 3D Systems ProJet MJP 2500 Plus (MJP), 3D Systems NextDent 5100 (NEX), Stratasys J5 DentaJet (PJ5), Ivoclar PrograPrint PR5 (PR5), and Prodways ProMaker LD20 (PWY) were similar in terms of 3D deviations to the conventional stone cast control. Comparative color mapping showed the direction and quantity of the dimensional changes of the ridge crest frequently did not correlate with the 3D deviations of implant analog positioning. Implant analog insertion errors were predominantly responsible for analog position 3D deviations rather than the polymerization shrinkage of additive photopolymers.

Effects of support-structure design and postpolymerization protocols on dimensional changes in three-dimensionally printed complete dentures

STATEMENT OF PROBLEM

Additive manufacturing technologies have become popular for the fabrication of complete dentures; however, the effects of different support-structure designs and postpolymerization protocols on denture accuracy remain unknown.

PURPOSE

The purpose of this in vitro study was to evaluate the effects of different support-structure designs and postpolymerization protocols on the accuracy of 3-dimensionally (3D) printed complete dentures.

MATERIAL AND METHODS

Simulated complete maxillary complete dentures were 3D printed using 2 support-structure designs: conventional and tree-like. Both types of complete dentures were maintained at different temperatures (40 °C, 60 °C, and 80 °C) for 15 and 30 minutes after polymerization. All specimens were optically scanned in the same orientation using a light scanner with an accuracy of 10 µm and repeatability of 4 µm. The acquired data for the intaglio surfaces of all complete dentures were exported into a 3D analysis software program. Scan data (n=8) were superimposed on the standard tessellation language (STL) reference file to evaluate trueness. In addition, scan data (n=28) were superimposed onto a combination of STL files for each protocol by using the combination formula (8C2=28) to evaluate precision. Root mean square error (RMSE) values were used to analyze dimensional changes in the denture base during the postpolymerization process. Two-way analysis of variance (ANOVA) with interaction was used to analyze the accumulated data, and the Tukey post hoc test was used for multiple comparisons (α=.05).

RESULTS

Overall, RMSE values for both trueness and precision were lower with the tree-like support structure than with the conventional support structure, and precision was significantly different between the groups (F=24.482, P<.001). Moreover, significant differences according to the postpolymerization protocols were observed in both trueness (F=15.104, P<.001) and precision (F=13.244, P<.001). The lowest RMSE values for both trueness and precision were observed in the 30-minute, 60-°C group. Although the support-structure design and postpolymerization protocols did not affect trueness, they significantly affected precision (F=2.362, P=.040).

CONCLUSIONS

The tree-like support structure improved the dimensional accuracy of the intaglio surface when the complete denture was maintained at 60 °C for 30 minutes after polymerization. The findings suggest that the relationship between the support-structure design and postpolymerization protocol influences the accuracy of 3D printed complete dentures.

Influence of 3D printing angles on the accuracy of indirect adhesion transfer models: an in vitro study

The aim of this study was to evaluate the effect of different Angle printing on the model on the printing platform and whether it affects the later transfer accuracy. Ten bracket transfer models were printed on the platform of the 3D printer in four ways: 0° without support rod, 0°, 45° and 90° with support rod. Transfer guide plates for transfer brackets were made using PVS. The linear and angular discrepancies were determined digitally by measuring six different dimensions. The best performance was achieved at 90° with a support bar, with mesiogingival wing center point gap and diogingival wing center point gap of 0.169 and 0.176, respectively (P < 0.05). The linear deviation of groups A and B in the vertical direction was highest (0.285 (P < 0.001) and 0.283 (P < 0.001), respectively) when the transfer guide plate was made by PVS for the transfer bracket, followed by the proximal and distal direction. The best performance was achieved in the Orovestibular. The printing angle of the 3D indirect bonding slot transfer model on the printing platform significantly impacts the transfer accuracy, with the accuracy of the 45° and 90° bracket models having the least impact. A minimum transfer error of 90° since 90° 3D printed bracket transfer models with support rods have the best reliability.

Influence of different print orientations on properties and behavior of additively manufactured resin dental devices: A systematic review and meta-analysis

STATEMENT OF PROBLEM

Different factors affect 3-dimensionally (3D) printed resin products. However, evidence on the effect of the print orientation on resin dental devices is lacking.

PURPOSE

The purpose of this systematic review and meta-analysis was to assess the impact of print orientation on the properties and accuracy of 3D printed implant surgical guides, occlusal devices, clear orthodontic retainers, and aligners.

MATERIAL AND METHODS

The electronic databases PubMed (MEDLINE), Cochrane, and Scopus were comprehensively searched in July 2024. A modified Consolidated Standards of Reporting Trials (CONSORT) statement was used to judge the included studies, and the data were analyzed by the RevMan 5.4 software program of the Cochrane collaboration by applying an inverse variance analysis (α=.05).

RESULTS

Twenty-six records were included. Complete arch, solid surgical guides with horizontal printing orientation exhibited the highest accuracy (P≤.01). Short-span surgical guides printed vertically showed relatively high accuracy (P≤.05). Hollow or mesh devices might not be affected by orientations. Occlusal device accuracy favored horizontal orientation, but correlated with the technology and materials, while the accuracy of orthodontic aligners revealed controversial findings, assuming the limited impact of orientation on orthodontic aligners. The cytotoxicity of occlusal devices was a material-related biological characteristic and unaffected by orientation. Although flexural strength favors horizontal orientation, conflicting results were observed for physical and other mechanical properties due to several variables.

CONCLUSIONS

Horizontal orientation is recommended for printing complete arch surgical guides, while the accuracy of short surgical guides might favor vertical orientation. The physical mechanical properties depend on the printing orientation, technology, material, and printed parts, but horizontal orientation might produce parts with the best mechanical performance.

Properties and Behavior of Additively Manufactured Provisional Fixed Dental Prostheses: A Systematic Review on 3D Printing Orientations Relative to Applied Materials and Postprocessing

OBJECTIVES

This systematic review aimed to assess the influence of printing orientations alone and with other parameters, such as applied material and postprocessing, on the physical-mechanical properties and mechanical behavior of provisional fixed dental prostheses (FDPs).

MATERIALS AND METHODS

A comprehensive search of websites such as PubMed, Scopus, Web of Science, and Cochrane was conducted in July 2024. Adhering to PRISMA 2020 guidelines, the studies that investigated the impact of printing orientations on the physical and mechanical properties were included in this review. The modified CONSORT statement was utilized for the risk of bias assessment. A total of 24 records were included; the main build-up angles were horizontal, oblique, and vertical (0°, 45°, and 90°), and other angles such as 30° and 150° were also reported. The data focused on the impact of orientation on 3D-printed products from different materials, applying various postcuring times and artificial aging. Horizontally printed specimens exhibited significantly superior mechanical properties and behavior compared with other angles, while vertically printed specimens displayed the lowest results. Additionally, the material type, amount, and type of fillers and postcuring had the most substantial impacts; zirconia fillers showed more enhanced strength compared to silica fillers, and the mechanical behavior was enhanced with postcuring time of up to 120 min. Optical properties were more related to the materials and technology applied than to printing directions. Polishing of the products enhances surface quality and removes differences from various orientations. Resin specimens exhibited a high susceptibility to staining, irrespective of printing orientation. Furthermore, aging significantly influenced the mechanical properties, gloss, and surface quality of the specimens.

CONCLUSIONS

To achieve high-quality provisional FDPs, it is essential to select a horizontal orientation. Careful selection of materials is necessary, as well as adherence to optimal printing parameters. 3D-printed resin may not yet be suitable for permanent rehabilitation; however, it is appropriate for short- and long-term temporization.

CLINICAL SIGNIFICANCE

The production of dental parts is shifting to additive manufacturing; it is crucial to understand the impact of various parameters on the physical and mechanical behavior of dental parts, particularly provisional restorations, to ensure their durable clinical service.

Influence of build angle, printing layer thickness and aging on the flexural strength, precision, roughness and porosity analysis of a printed resin for provisional restorations

Evaluate the impact of printing parameters on flexural strength (σ), flexural modulus (E), precision, and surface topography characteristics of a resin used to produce provisional restorations. 450 bars for provisional restorations were printed using the SLA printing (25 × 2x2mm ISO-4049), and randomly divided into 30 groups (n = 15) according to the following factors: "printing layer thickness" (25 μm;50 μm;100 μm), "Build angle" (0°,30°,45°,60°,90°) and "thermocycling-TC" (with or without). Following printing, the samples underwent cleaning with isopropyl alcohol. Photopolymerization was performed for 15 min with an UV lamp. Subsequently, each bar was assessed using a digital caliper at 11 specific points in three dimensions for comparison with the STL file area for precision analysis. Half of the samples underwent thermocycling. All samples were submitted to the σ test. Data for σ (MPa), and (GPa) and precision (mm) were analyzed using 3 and 2-way ANOVA, respectively, and Tukey's post hoc test (5%). Micro-CT, 3D profilometry, and SEM were also performed and analyzed descriptively. The 90°/25μmTC (63.0 ± 4.5) showed the highest σ, being only statistically similar to the 45°/25μmTC (57.7 ± 3.1). For precision 0°/25 μm (-2.56 ± 0.04) expressed the greatest variation to the other experimental groups with a sample shrinkage of 25.6% compared to the STL file. The profilometry revealed that the 30º/25 μm group showed prominent peaks and valleys, presenting elevated roughness values with an average of Sa (28.25 μm). Moreover, it was observed that the groups with a 60° angle presented the lowest porosity values. A print layer thickness of 25 μm combined with a build angle of 90º and 45º resulted in higher σ and greater precision.

Color reproduction trueness of 3D-printed full-color dental casts with scans derived from an intraoral scanner

PURPOSE

To investigate the effects of shade tab color variations (tooth-colored vs. gingiva-colored) and surface treatment (application of mineral oil) on the trueness of color reproduction from dental shade tabs to 3D-printed full-color dental casts, using digital scans obtained from an intraoral scanner.

MATERIALS AND METHODS

Pristine tooth-colored (with 16 shade tabs) and gingiva-colored (with five shade tabs) shade guides were digitally scanned using an intraoral scanner, and subsequently, 3D-printed replicas were created using a full-color material jetting 3D printer. Three color measurements using a contact type digital spectrophotometer were recorded, including actual shade tabs (R0), dried 3D-printed study samples (RP1), and study samples with mineral oil application (RP2), in this study to calculate color differences between the actual shade tabs and 3D-printed ones. The CIEDE2000 formula was used to calculate the color differences (color reproduction trueness) between reference shade tabs and 3D-printed full-color study samples-without and with mineral oil, ∆E00(RP1), and ∆E00(RP2). ∆E00(RP1) and ∆E00(RP2) were compared with a 50:50% accessibility threshold (AT) and a 50:50% perceptibility threshold (PT). A grading system, based on the relative ranges of AT and PT, was employed. The percentage of samples falling into each color-matching category was then recorded. The data collected were subjected to statistical analysis, utilizing a mixed model ANOVA to evaluate the effects of shade tab color and mineral oil application on color differences, α = 0.05.

RESULTS

The application of mineral oil significantly affected the ∆E00 [F(1, 378) = 19.1, p = < 0.0001]. However, this effect was only significant for the gingiva-colored study samples; the mineral oil application significantly decreased color difference, showing ∆E00(RP1) of 8.71 ± 3.78 and ∆E00(RP2) of 6.55 ± 2.14 (p < 0.0001). For the tooth-colored groups, the mineral oil application did not yield any color difference, showing ∆E00(RP1) of 7.05 ± 2.35 and ∆E00(RP2) of 6.94 ± 2.35 (p = 0.497). In the absence of mineral oil, gingiva-colored samples revealed a significantly larger ∆E00(RP1) of 8.71 ± 3.78 compared to tooth-colored samples at 7.05 ± 2.35 (p = 0.017). Conversely, mineral oil application rendered comparable ∆E00(RP2) values between gingiva-colored (6.55 ± 2.14) and tooth-colored (6.94 ± 2.35) samples (p = 0.558). All 3D-printed full-color samples showed Grade 1 (extremely unacceptable mismatch) and Grade 2 (clearly unacceptable mismatch), regardless of the shades or the presence of mineral oil.

CONCLUSIONS

Utilizing an intraoral scanner to gather digital color data, along with an MJ 3D printer, offers the potential for producing 3D-printed full-color dental casts for prosthesis characterization in the dental laboratory. While mineral oil improves the color reproduction trueness of gingiva-colored objects, all 3D-printed full-color samples exhibited unacceptable mismatches when compared to their target objects. This underscores the need for future improvement in the digital color data acquisition process and color optimization protocols in 3D printing processes.

Impact of 3D printing orientation on accuracy, properties, cost, and time efficiency of additively manufactured dental models: a systematic review

BACKGROUND

The evidence on the effect of printing orientation on dimensional accuracy and properties of resinous dental models is unclear. This systematic review aimed to assess the impact of printing orientation on the accuracy and properties of additively manufactured resinous dental models, besides the cost, material consumption, and time efficiency at different orientations.

METHODS

A comprehensive web search (PubMed, Scopus, Cochrane) was performed in July 2024 without language restrictions. The included studies were assessed using the modified consort statement for laboratory studies on dental materials. The outcomes were accuracy and surface quality, besides the cost and time efficiency of additively manufactured dental models printed in different directions.

RESULTS

Following PRISMA guidelines, 14 records were included. Most records favored horizontally printed models with minor controversies regarding accuracy, material consumption, time, and cost efficiency. While orientation can influence surface quality, it is often more significantly affected by factors such as the printing technology used, the material properties, and the layer thickness.

CONCLUSIONS

Horizontal orientation has proven to be the most efficient for producing dental models, particularly for single-model manufacturing, due to its superior time and cost savings. However, large-scale and overnight massive production favors the vertical orientation since the platform accommodates twice to triple the models' numbers as horizontal orientation. The majority of studies favor horizontal orientation for its accuracy. Choosing the optimal orientation in additive manufacturing not only ensures precision of dental models, improving the fit of restorations and prostheses, but also leads to significant reductions in production time, material usage, and energy consumption, ultimately minimizing environmental impact.

TRIAL REGISTRATION

Not applicable.

3D Bioprinting in Limb Salvage Surgery

With the development of 3D bioprinting and the creation of innovative biocompatible materials, several new approaches have brought advantages to patients and surgical teams. Increasingly more bone defects are now treated using 3D-bioprinted prostheses and implementing new solutions relies on the ability of engineers and medical teams to identify methods of anchoring 3D-printed prostheses and to reveal the potential influence of bioactive materials on surrounding tissues. In this paper, we described why limb salvage surgery based on 3D bioprinting is a reliable and effective alternative to amputations, and why this approach is considered the new standard in modern medicine. The preliminary results of 3D bioprinting in one of the most challenging fields in surgery are promising for the future of machine-based medicine, but also for the possibility of replacing various parts from the human body with bioactive-based constructs. In addition, besides the materials and constructs that are already tested and applied in the human body, we also reviewed bioactive materials undergoing in vitro or in vivo testing with great potential for human applications in the near future. Also, we explored the recent advancements in clinically available 3D-bioprinted constructs and their relevance in this field.

Investigation of Stereolithography Additively Manufactured Components for Deviations in Dimensional and Geometrical Features

The rapid investment casting (RIC) process requires a 3D-printed pattern to create a ceramic mold. Stereolithography (SLA) is a commonly used 3D printing method for pattern creation due to its ability to print complex shapes with smooth surfaces. The printing parameters can significantly affect the dimensional accuracy of the pattern. This study examines how different build orientations (0°, 45°, and 90°) affect the dimensional accuracy of parts produced using SLA. The specimens were printed using castable wax resin. They were measured to investigate the dimensional deviations using 3D scanning technology to understand the correlation between orientation and accuracy better. It was found that the orientation of the print affects the overall accuracy significantly. Parts printed at a 45° angle generally showed the smallest deviations from their nominal dimensions, except for certain features. For instance, cylindrical features showed deviations improving from -7.28% at 0° to -4.81% at 90°, while spherical features had deviations decreasing from -5.01% at 0° to -2.46% at 90°. Simple features, such as holes, exhibited minimal deviation across orientations, with the smallest error observed at 45° (1.98%). These results demonstrate different features and build orientations can affect the accuracy of the printed part differently. To ensure better accuracy, parts printed in different build orientations will require varying amounts of compensation during the design stage. By managing build orientations and controlling the inherent limitations of SLA, users can improve the print's accuracy and meet quality standards more effectively. Research results can help industries optimize print settings and reduce dimensional errors.

A comparative study of strength and surface properties of permanent 3D-printed resins with CAD-CAM milled fixed dental prostheses

PURPOSE

To compare the strength, surface roughness, and hardness of newly introduced permanent three-dimensional (3D)-printed resin in comparison with computer-aided design and computer-aided manufacturing (CAD-CAM) milled materials.

MATERIALS AND METHODS

Three 3D-printed resins (NextDent C&B, Formlabs Permanent Crown, and VarseoSmile Crown plus) and two CAD-CAM milled (IPS e.max ZirCAD LT and VITA Enamic) resins were used to fabricate discs specimens. A total of 200 disc specimens were fabricated according to manufacturer recommendations. Within each group, half of the specimens were subjected to thermal cycling (5°C-55°C, the 30 s, 5000 cycles). Aged and nonaged specimens were evaluated for biaxial flexural strength (BFS), surface roughness, and hardness. Results were statistically analyzed using analysis of variance (ANOVA) and t-tests (α = 0.05).

RESULTS

Significant differences (p < 0.05) were observed in the BFS, surface roughness, and hardness between the 3D-printed and milled groups, before and after thermal aging. Overall, the CAD-CAM milled ceramic group had superior strength, surface roughness, and hardness when compared to all other groups (p < 0.001), except for surface roughness after thermal aging, which was similar in all groups (p = 0.063). Within each group, there was no significant difference (p > 0.05) in surface roughness after thermal aging. BFS values of 3D-printed materials were statistically similar. In terms of surface roughness, Formlabs specimens displayed the highest value before and after thermal cycling, when compared to other 3D-printed materials. Regarding hardness, the VarseoSmile Crown plus group demonstrated the highest values compared to other 3D-printed materials, before and after thermal cycling.

CONCLUSION

Permanent 3D-printed resins have lower strength than CAD-CAM milled materials. 3D-printed permanent resin materials exhibited high roughness and comparable hardness to CAD-CAM materials. Thermal aging negatively affected the properties of 3D-printed permanent crowns. Owing to the low strength of 3D-printed permanent resins, they may not be recommended for clinical practice until further improvements in flexural strength are made to meet clinical standards.

Accuracy of One-Piece vs. Segmented Three-Dimensional Printed Transfer Trays for Indirect Bracket Placement

OBJECTIVE

To assess the accuracy of three-dimensional (3D) printed one-piece vs. multiple segmented transfer trays for indirect bonding techniques in moderate and severe crowding cases.

METHODS

Eighty digital maxillary dental models were produced by an extraoral scanner. 3D-printed one-piece and segmented trays were virtually designed utilizing Maestro 3D Ortho Studio® v4 and printed using a NextDent printer. The sample was classified into two groups: Group 1 (moderate crowding) included 40 digital models with a space deficiency of 6-7 mm, and Group 2 (severe crowding) included 40 digital models with a space deficiency of 10 mm. Ortho classic brackets were then placed into the 3D printed models with the aid of the transfer trays, and the models with the final bracket positioning were scanned using iTero scanner. Four measurements were selected on each tooth to perform the analysis. Mann-Whitney and Kruskal-Wallis tests were used for comparisons. A p-value of ≤ 0.05 was considered statistically significant.

RESULTS

In the moderate crowding group, statistically significant differences were detected between the one-piece, segmented, and control groups for three measurements (p < 0.001), while the rest of the measurements showed no significant differences (p > 0.05). In the severe crowding group, no significant differences were detected for any of the measurements.

CONCLUSIONS

One-piece and segmented 3D-printed transfer trays are considered accurate tools for indirect bonding in moderate and severe malocclusion cases. The severity of crowding did not affect the accuracy of bracket transfer in indirect bonding.

Effect of 3D printing technology and print orientation on the trueness of additively manufactured definitive casts with different tooth preparations

OBJECTIVES

To evaluate the fabrication trueness of additively manufactured maxillary definitive casts with various tooth preparations fabricated with different 3-dimensional (3D) printers and print orientations.

METHODS

A maxillary typodont with tooth preparations for a posterior 3-unit fixed partial denture, lateral incisor crown, central incisor and canine veneers, first premolar and second molar inlays, and a first molar crown was digitized with an industrial scanner. This scan file was used to fabricate definitive casts with a digital light processing (DLP) or stereolithography (SLA) 3D printer in different orientations (0-degree, 30-degree, 45-degree, and 90-degree) (n = 7). All casts were digitized with the same scanner, and the deviations within each preparation site were evaluated. Generalized linear model analysis was used for statistical analysis (α = 0.05).

RESULTS

The interaction between the 3D printer and the print orientation affected measured deviations within all preparations (P ≤ 0.001) except for the lateral incisor crown and canine veneer (P ≥ 0.094), which were affected only by the main factors (P < 0.001). DLP-90 mostly led to the highest and DLP-0 mostly resulted in the lowest deviations within posterior tooth preparations (P ≤ 0.014). DLP-30 led to the lowest deviations within the first premolar inlay and DLP-45 led to the lowest deviations within the central incisor veneer preparation (P ≤ 0.045).

CONCLUSIONS

Posterior preparations of tested casts had the highest trueness with DLP-0 or DLP-30, while central incisor veneer preparations had the highest trueness with DLP-45. DLP-90 led to the lowest trueness for most of the tooth preparations.

CLINICAL SIGNIFICANCE

Definitive casts with tooth preparations fabricated with the tested DLP 3D printer and the print orientation adjusted on tooth preparation may enable well-fitting restorations. However, 90-degree print orientation should be avoided with this 3D printer, as it led to the lowest fabrication trueness.

Influence of base designs on the manufacturing accuracy of vat-polymerized diagnostic casts using two different technologies

STATEMENT OF PROBLEM

Diagnostic casts can incorporate different base designs and be manufactured using different vat-polymerization technologies. However, the influence of the interrelation between the base design and the 3D printing technology on the casts' final accuracy remains unclear.

PURPOSE

The purpose of this in vitro study was to assess the influence of different base designs of 3D printed casts on the accuracy of 2 vat-polymerization technologies.

MATERIAL AND METHODS

A digital maxillary cast was obtained and used to generate 3 different base designs: solid (S group), honeycombed (HC group), and hollow (H group). The HC and H groups were subdivided based on the wall thickness of the cast design, resulting in 2 subgroups with thicknesses of 1 mm (HC1 and H1) and 2 mm (HC2 and H2) (N=100, n=10). Eleven reference cubes were added to each specimen for subsequent measurements. Specimens were manufactured by using 2 vat-polymerization 3D printers: Nextdent 5100 (ND group) and Sonic Mini 4K (SM4K group) and a resin material suitable for both 3D printers (Nextdent Model 2.0). A coordinate measuring machine quantified the linear and 3-dimensional discrepancies between the digital cast and each reference specimen. Trueness was defined as the average absolute dimensional discrepancy between the virtual cast and the specimens produced through additive manufacturing (AM), while precision was delineated as the standard deviation in dimensional discrepancies between the digital cast and the AM specimens. The data were analyzed using the Kruskal-Wallis and Mann-Whitney U pairwise comparison tests (α=.05).

RESULTS

For the NextDent group the trueness ranged from 21.83 µm to 28.35 µm, and the precision ranged from 17.82 µm to 37.70 µm. For the Phrozen group, the trueness ranged from 45.15 µm to 64.51 µm, and the precision ranged from 33.51 µm to 48.92 µm. The Kruskal-Wallis test showed significant differences on the x-, y-, and z-axes and in the 3D discrepancy (all P<.001). On the x-axis, the Mann-Whitney U test showed significant differences for the Phrozen group between the H-2 and H-1 groups (P=.001), H-2 and S groups (P<.001), and HC-2 and S groups (P=.012). On the y-axis, significant differences were found in the Phrozen group between the H-2 and H-1 groups (P=.001), the H-2 and S, H-1 and HC-1, and HC-1 and S groups (P<.001), the H-1 and HC-2 groups (P=.007), and the HC-2 and S groups (P=.009). The NextDent group exhibited significant differences, particularly among the HC-1 and H-2 groups (P=.004), H-1 (P=.020), and HC-2 (P=.001) groups; and on the z-axis significant differences were found in the Phrozen group between the H-2 and H-1 and S groups and the HC-2 group and H-1 and S groups (both P<.001). In the NextDent group, significant differences were found between the H-2 and HC-2 (P=.047) and HC-1 (P=.028) groups. For the 3D discrepancy analysis, significant differences were found in the Phrozen group between the H-2 and H-1 and S groups (P<.001), the H-1 and HC-2 groups (P=.001), the S and HC-1 and HC-2 groups (P<.001), and the H-1 and HC-1 groups (P=.002). In the NextDent group, significant differences were observed between the H-2 and HC-1 groups (P=.012).

CONCLUSIONS

The accuracy of digital casts depends on the manufacturing trinomial and base design of the casts. The honeycomb and hollow based designs provided the highest accuracy in the NextDent and Phrozen groups respectively for the material polymer tested. All specimens fell in the clinically acceptable range.

The Evaluation of the Trueness of Dental Mastercasts Obtained through Different 3D Printing Technologies

In contemporary dentistry, several 3D printing techniques, including a stereolithography apparatus (SLA), digital light processing (DLP), liquid crystal display (LCD), and PolyJet 3D inkjet printing technology (PolyJet), are employed for model production. Despite their widespread use, there remains a paucity of the literature regarding the trueness and precision of these devices in dental applications. Existing studies comparing the accuracy of dental models manufactured by different printing technologies yield disparate conclusions regarding dental prosthesis manufacturing. This study aimed to test two null hypotheses: first, that the trueness of various new-generation 3D printers is equivalent, and second, that the trueness of printing by these printers is sufficient for achieving high-precision mastercasts in dental prosthodontics manufacturing. The research focuses on evaluating the trueness of five contemporary dental 3D printers: Anycubic Mono X 6Ks (Hongkong Anycubic Technology Co., Hongkong, China), Asiga Max (Asiga, Sydney, Australia), Creo C5 (Planmeca Oy, Helsinki, Finland), Form 3B (Formlabs, Boston, MA, USA), and J5 Dentajet (Stratasys Ltd., Eden Prairie, MN, USA). The methodology employed involved the creation of a digital test object using Blender software, adhering meticulously to the dimensions outlined in ISO standard 20896-1. These dimensions were chosen to be both relevant for this study and representative of clinical scenarios. Subsequently, the test object was printed and precise measurements were conducted utilizing a metrology-type Nikon XTH225 ST Reflection target in conjunction with VGStudio MAX analysis software. The results of our investigation revealed clinically negligible deviations in ball dimensions across all printers, with the maximum observed deviations ranging between 1.17% and 2.03% (notably observed in the Creo C5 printer). Transversal distortion exhibited variance based on the linear accuracy of each printer, with Stratasys21 and Formlabs 3B demonstrating superior accuracy among the evaluated printers. Distortions in the analyzed dimensions (specifically, anterior b-c, posterior a-d, and oblique a-c) were found to be uniform. In conclusion, while the first null hypothesis was rejected, indicating variations in trueness among the 3D printers assessed, our findings affirm the suitability of all five analyzed 3D printers for clinical applications. Consequently, these printers can be utilized for the fabrication of high-precision mastercasts in dental prosthodontics manufacturing.

Dimensional Accuracy of Different Three-Dimensional Printing Models as a Function of Varying the Printing Parameters

Even in digital workflows, models are required for fitting during the fabrication of dental prostheses. This study examined the influence of different parameters on the dimensional accuracy of three-dimensionally printed models. A stereolithographic data record was generated from a master model (SOLL). With digital light processing (DLP) and stereolithography (SLA) printing systems, 126 models were produced in several printing runs-SolFlex350 (S) (DLP, n = 24), CaraPrint 4.0 (C) (DLP, n = 48) and Form2 (F) (SLA, n = 54)-and their accuracy was compared with plaster and milled polyurethane models. In addition to the positioning on the build platform, a distinction was made between parallel and across arrangement of the models to the printer's front, solid and hollow models, and printing with and without support structures. For accuracy assessment, five measurement sections were defined on the model (A-E) and measured using a calibrated digital calliper and digital scans in combination with the GOM Inspect Professional software 2021. The mean deviation between the measurement methods for all distances was 79 µm. The mean deviation of the models from the digital SOLL model were 207.1 µm for the S series, 25.1 µm for the C series and 141.8 µm for the F series. While positioning did not have an influence, there were clinically relevant differences mainly regarding the choice of printer, but also individually in alignment, model structure and support structures.

Influence of print orientation and wet-dry storage time on the intaglio accuracy of additively manufactured occlusal devices

STATEMENT OF PROBLEM

Different factors can affect the manufacturing accuracy of additively manufactured dental devices; however, the influence of print orientation and wet-dry storage time on their intaglio accuracy remains uncertain.

PURPOSE

The purpose of this in vitro study was to assess the effect of print orientation (0, 45, 70, and 90 degrees) and wet-dry storage time (0, 30, 60, and 90 days) on the intaglio accuracy of additively manufactured occlusal devices.

MATERIAL AND METHODS

An occlusal device design was obtained in a standard tessellation language (STL) file format (control file) which was used to fabricate all the specimens by using a stereolithography printer (Form 3+) and a biocompatible resin material (Dental LT Clear Resin, V2). Four groups were created based on the print orientation used to manufacture the specimens: 0, 45, 70, and 90 degrees. Each group was divided into 4 subgroups depending on the time elapsed between manufacturing and accuracy evaluation: 0, 30, 60, and 90 days. For the subgroup 0, a desktop scanner (T710) was used to digitize all the specimens. The 30-day subgroup specimens were stored for 30 days with the following daily storage protocol: 16 hours inside a dry lightproof container, followed by 8 hours in artificial saliva (1700-0305 Artificial Saliva) inside the same lightproof container. The specimens were then digitized by following the same procedures used for subgroup 0. For the subgroups 60 and 90, the identical procedures described for subgroup 30 were completed but after 60 and 90 days of storage, respectively. The reference STL file was used to measure the intaglio discrepancy with the experimental scans obtained among the different subgroups by using the root mean square error calculation. Two-way ANOVA and post hoc Tukey pairwise comparison tests were used to analyze the data (α=.05).

RESULTS

Print orientation (P<.001) and usage time (P<.001) were significant predictors of the trueness value obtained. Additionally, the 0-degree print orientation at day 0 group demonstrated the best trueness value among all the groups tested (P<.05). No significant trueness discrepancies were found among the 45-, 70-, and 90-degree print orientation, or among the 30, 60, and 90 days of storage. A significant precision difference was found in the variance between print orientation groups across usage time subgroups.

CONCLUSIONS

The print orientation and wet-dry storage times tested influenced the trueness and precision of the intaglio surfaces of the occlusal devices manufactured with the 3D printer and material selected.

Influence of postprocessing rinsing solutions and duration on flexural strength of aged and nonaged additively manufactured interim dental material

STATEMENT OF PROBLEM

Additive manufacturing procedures for fabricating interim restorations include rinsing postprocessing procedures. However, the impact of different rinsing solutions and times on flexural strength is unknown.

PURPOSE

The purpose of this in vitro study was to assess the influence of the rinsing solutions and duration, as well as accelerated aging (thermocycling) procedures, on the flexural strength and Weibull characteristics of an additively manufactured interim dental material.

MATERIAL AND METHODS

A bar design (25×2×2 mm) file was used to fabricate all the specimens with 3D printing and an interim material (Nextdent C&B MFH). Five groups were created based on the rinsing solution used during the postprocessing procedures: 91% isopropyl alcohol (IPA) (control or IPA-91), 99% IPA (IPA-99 group), bio-ethyl alcohol 100% (BE group), tripropylene glycol monomethyl ether (TPM) 100% (TPM group), and water miscible formula (Resinaway) (RA group). Each group was divided into 4 subgroups depending on the total rinsing time: 5, 6, 7, and 8 minutes (5, 6, 7, and 8 subgroups). Additionally, each subgroup was distributed between nonaged and aged thermocycling procedures (n=10). Flexural strength measurements were made by using a universal testing machine. Two-parameter Weibull distribution values, including the Weibull modulus, scale (m), and shape (0), were calculated. Three-way ANOVA and pairwise multiple comparison Tukey tests were used to analyze the data (α=.05).

RESULTS

Three-way ANOVA showed that the rinsing solution (P<.001), rinsing time (P=.004), and thermocycling procedures (P<.001) were significant predictors of the flexural strength values obtained. The IPA-91 and IPA-99 groups obtained the highest flexural strength, while the RA, TPM, and BE groups obtained the lowest flexural strength. The 7- and 8-minute subgroups obtained the highest flexural strength, while the 5-minute subgroup obtained the lowest flexural strength. The nonaged specimens obtained significantly higher mean flexural strength values than the aged specimens.

CONCLUSIONS

The vat-polymerized additively manufactured interim dental material tested with differing rinsing solutions and times demonstrated significant differences in the flexural strength values measured. Accelerated artificial aging procedures significantly decreased the flexural strength of the vat-polymerized interim dental material tested.

Spatial Trueness Evaluation of 3D-Printed Dental Model Made of Photopolymer Resin: Use of Special Structurized Dental Model

(1) Background: Various 3D printers are available for dental practice; however, a comprehensive accuracy evaluation method to effectively guide practitioners is lacking. This in vitro study aimed to propose an optimized method to evaluate the spatial trueness of a 3D-printed dental model made of photopolymer resin based on a special structurized dental model, and provide the preliminary evaluation results of six 3D printers. (2) Methods: A structurized dental model comprising several geometrical configurations was designed based on dental crown and arch measurement data reported in previous studies. Ninety-six feature sizes can be directly measured on this original model with minimized manual measurement errors. Six types of photo-curing 3D printers, including Objet30 Pro using the Polyjet technique, Projet 3510 HD Plus using the Multijet technique, Perfactory DDP and DLP 800d using the DLP technique, Form2 and Form3 using the SLA technique, and each printer's respective 3D-printable dental model materials, were used to fabricate one set of physical models each. Regarding the feature sizes of the simulated dental crowns and dental arches, linear measurements were recorded. The scanned digital models were compared with the design data, and 3D form errors (including overall 3D deviation; flatness, parallelism, and perpendicularity errors) were measured. (3) Results: The lowest overall 3D deviation, flatness, parallelism, and perpendicularity errors were noted for the models printed using the Objet30 Pro (overall value: 45 μm), Form3 (0.061 ± 0.019 mm), Objet30 Pro (0.138 ± 0.068°), and Projet 3510 HD Plus (0.095 ± 0.070°), respectively. In color difference maps, different deformation patterns were observed in the printed models. The feature size proved most accurate for the Objet30 Pro fabricated models (occlusal plane error: 0.02 ± 0.36%, occlusogingival direction error: -0.06 ± 0.09%). (4) Conclusions: The authors investigated a novel evaluation approach for the spatial trueness of a 3D-printed dental model made of photopolymer resin based on a structurized dental model. This method can objectively and comprehensively evaluate the spatial trueness of 3D-printed dental models and has a good repeatability and generalizability.

Influence of printing orientation on mechanical properties of aged 3D-printed restorative resins

OBJECTIVE

To evaluate the influence of printing orientation on flexural strength (σf) and elastic modulus (E) of different 3D printing dental restorative resins.

METHODS

Bar-shaped specimens (n = 20) were fabricated from two SLA-printed resins (FT- Formlabs Temporary, and FP- Formlabs Permanent) and two DLP-printed resins (DFT- Detax Freeprint Temp, and GCT- GC Temporary) using two building orientations (0º and 90º). The 3D-printed structures were aged (14 d) before submitted to three-point bending in 37ºC distilled water at a crosshead speed of 1.0 ± 0.3 mm/min until fracture to calculate the σf and the E values. The fractured surfaces were evaluated using stereomicroscopy and scanning electron microscopy (SEM) following fractography principles. Data were statistically analyzed using two-way ANOVA and Tukey post-hoc (α = 0.001).

RESULTS

FP and FT showed significantly higher E values than DFT and GCT, irrespectively of printing orientation (p < 0.001). There was no statistical difference between the building orientations (0º and 90º) for the mean σf and E values for the resin materials evaluated. Fractographic characteristics were similar for the surface fracture from all the materials evaluated, showing typical brittle fracture behavior.

SIGNIFICANCE

Printing orientation did not influence of flexural strength and elastic modulus values for the 3D-printed resin structures evaluated. Surface topography was mostly governed by the 3D printer type.

Wear resistance and flexural properties of low force SLA- and DLP-printed splint materials in different printing orientations: An in vitro study

OBJECTIVES

To investigate the influence of material and printing orientation on wear resistance and flexural properties of one low force SLA- and two DLP-printed splint materials and to compare these 3D-printed splints to a subtractively manufactured splint material.

METHODS

Two DLP-printed (V-Print splint, LuxaPrint Ortho Plus) and one low force SLA-printed (Dental LT Clear) material, where specimens were printed in three printing orientations (0°, 45°, 90°), were investigated. In addition, one milled splint material (Zirlux Splint Transparent) was examined. A total of 160 specimens were produced for both test series. The two-body wear test was performed in a chewing simulator (80'000 cycles at 50 N with 5-55 °C thermocycling). Steatite balls were used as antagonists. The wear pattern was analyzed with a 3D digital microscope in terms of maximum vertical intrusion depth (mm) and total volume loss (mm³). The flexural properties were investigated by three-point bending in accordance with ISO 20795-1: 2013 (denture base polymers). The flexural strength (MPa) and the flexural modulus (MPa) were measured. Two-way ANOVA was performed to investigate the effects of the two independent variables material and printing orientation for the three 3D-printed materials. The comparison of the printing orientations within one material was carried out with one-way ANOVA with post-hoc Tukey tests.

RESULTS

Two-way ANOVA revealed that wear and flexural properties are highly dependent on the 3D-printed material (p < 0.001). Across groups, a significant effect was observed for wear depth (p = 0.031) and wear volume (p = 0.044) with regard to printing orientation but this was not found for flexural strength (p = 0.080) and flexural modulus (p = 0.136). One-way ANOVA showed that both DLP-printed groups showed no significant differences within the printing orientations in terms of wear and flexural properties. Dental LT Clear showed that 90° oriented specimens had higher flexural strength than 0° oriented ones (p < 0.001) and 45° oriented specimens also showed higher values than 0° ones (p = 0.038). No significant differences were observed within the printing orientations for flexural modulus and wear behaviour within this group. T-tests showed that the milled splints exhibited statistically higher wear resistance and flexural properties compared to all three 3D-printed splint materials (p < 0.001) and that highly significant differences were found between the 3D-printed splint materials for both test series.

CONCLUSION

Within the limitations of this in vitro study, it can be stated that wear behaviour and flexural properties are highly dependent on the 3D-printed material itself. Currently, milled splints exhibit higher wear resistance and flexural properties compared to 3D-printed splint materials. The printing orientation has a minor influence on the properties investigated. Nevertheless, two-way ANOVA also showed a significant influence of printing orientation in the wear test across groups and one-way ANOVA detected significant effects for SLA material in terms of flexural strength, with printing in 90° showing the highest flexural strength. Therefore, anisotropy was found in SLA material, but it can be limited with the employed printing parameters. Both DLP-printed materials showed no significant difference within the printing orientation.

Accuracy of 3D Printed Model Acquired from Different Types of Intra Oral Scanners and 3D Printers

Objective

The aim of this study was to verify the influence of different types of intraoral scanners and 3D printers on the accuracy of printed models in comparison to plaster models obtained from conventional impressions.

Material and Methods

A dental study model was used as the reference model and was molded with polyvinyl siloxane to produce the plaster models which were scanned by a reference scanner. Two types of intraoral scanners and digital files were printed by two types of 3D printers. To measure the accuracy (trueness and precision) amongst the groups, the datasets were superimposed via a best-fit alignment method utilizing a 3D analysis program (Geomagic Verify; 3D Systems). The trueness of the complete arch was evaluated by superimposing the STL file data of the reference model with STL file data obtained from other scanners. The precision of the complete arch was evaluated by superimposing the scan data within each group. The quantitative values were automatically calculated by the 3D analysis program based on the root mean square (RMS).

Results

It was observed that all the tested combinations of the scanner and 3D printer showed variation from reference which was nonsignificant. However, Trios 4 intraoral scanner and Formlabs 3D printer was the combination that showed the best trueness and precision values.

Conclusions

It was concluded that the accuracy of printed and plaster models was impaired due to the trueness of the models. The type of printer influenced the accuracy of the printed models, while the type of scanner did not. The standardization of the method of obtaining printed models must be carried out to provide the production of quality models. However, there will be differences between the technologies.

Trueness of vat-photopolymerization printing technology of interim fixed partial denture with different building orientation: A Microcomputed tomography study

Background

The aim was to assess the consequence of different printing orientation on the marginal misfit and internal gap of 3-unit interim fixed partial denture manufactured by two different additive manufacturing technologies compared to milling technique.

Material and Methods

Three-unit interim fixed partial denture (FPD) was designed by using exocad software (Dental CAD 3.0 Galway) in the format of standard tessellation language (STL) , which was transferred to a nesting software (PreForm) and printed by A Next Dent C&B resin liquid (NextDent; Soesterberg, Neitherland) by using two printing technologies; stereolithography (SLA, n=30) and digital light processing (DLP, n=30) with 3 different orientations (occlusal direction [0°] ,buccal direction [90°] & lingual direction [270°]) for each technology (n=10). Additionally, a control group was milled (CAD/Milling, n=10) from DC PMMA A1 Disc (White peaks dental solutions; Gmbh& co., Germany). A Microcomputed tomography was used to measure the marginal misfit and internal gap for each specimen in 12 different points. The average value of the marginal and internal gaps measurements was calculated, and one-way ANOVA was used for the comparison between groups.

Results

SLA printing technology showed a similar result to CAD/Milling with all different printing orientations tested. DLP printing technology showed the highest gap values within all the printing orientations with significant difference (p< 0.001) with the CAD/Milling and SLA.

Conclusions

Regarding the trueness of the interim FPDs, SLA was a promising technology for its superior adaptation. Marginal misfit and Internal gap for DLP printing technology limiting the use of that technology as it exceeded the acceptable clinical range. Key words:3D Printing, Microcomputed topography, Marginal Gap, Internal Misfit.

Trueness of five different 3D printing systems including budget- and professional-grade printers: An In vitro study

Problem

Several types of 3D printers with different techniques and prices are available on the market. However, results in the literature are inconsistent, and there is no comprehensive agreement on the accuracy of 3D printers of different price categories for dental applications.

Aim

This study aimed to investigate the accuracy of five different 3D printing systems, including a comparison of budget- and higher-end 3D printing systems, according to a standardized production and evaluation protocol.

Material and methods

A maxillary reference model with prepared teeth was created using 16 half-ball markers with a diameter of 1 mm to facilitate measurements. A reference file was fabricated using five different 3D printers. The printed models were scanned and superimposed onto the original standard tesselation language (.stl) file, and digital measurements were performed to assess the 3-dimensional and linear deviations between the reference and test models.

Results

After examining the entire surface of the models, we found that 3D printers using Fused filament fabrication (FFF) technology -120.2 (20.3) μm create models with high trueness but high distortion. Distortions along the z-axis were found to be the highest with the stereolithography (SLA)-type 3D printer at -153.7 (38.7) μm. For the 4-unit FPD, we found 201.9 (41.8) μm deviation with the digital light processing (DLP) printer. The largest deviation (-265.1 (55.4) μm) between the second molars was observed for the DLP printer. Between the incisor and the second molar, the best results were produced by the FFF printer with -30.5 (76.7) μm.

Conclusion

Budget-friendly 3D printers are comparable to professional-grade printers in terms of precision. In general, the cost of a printing system is not a reliable indicator of its level of accuracy.

The Impact of Technology Teaching in the Dental Predoctoral Curriculum on Students' Perception of Digital Dentistry

The goal was to assess dental students' perception of digital technologies after participating in a CAD/CAM exercise for scanning, designing, and manufacturing computer-aided provisional fixed dental restorations. A survey was conducted among second- (pre-D2 and post-D2), first- (D1, negative control), third-, and fourth-year dental students (D3 and D4, positive controls). Only OSU College of Dentistry students who completed the activity and completed the surveys were included. Seven questions were rated, which evaluated changes in knowledge, skill, interest, the importance of technology availability in an office, patients' perception of technology, the importance of having the technology, and the expected frequency of clinics utilizing the technology. Statistical analysis was performed with a significance level of 0.05. A total of 74 pre-D2 and 77 post-D2 questionnaires were completed. Additionally, 63 D1, 43 D3, and 39 D4 participants responded to the survey. Significant differences were found for "knowledge" and "skill" between the pre-D2 and post-D2 and pre-D2 and control groups (p < 0.001). There was a significant difference between the post-D2 participants and all the controls in terms of "interest" (p = 0.0127) and preference for in-practice technology availability (p < 0.05). There were significant results between the post-D2 participants and all the controls regarding the importance of technology availability in an office (p < 0.001) and the expected frequency of clinics utilizing the technology (p = 0.01). No significance was found for "value of technology to patients" and "the importance of having the technology". The presence of technology in practice and in educational academic environments significantly improved students' interest and perception of their knowledge and skill.

Effect of a new support design on the marginal and internal gap of additively manufactured interim crowns using direct light deposition technology

PURPOSE

To investigate the design and location of supporting structures on the marginal and internal gap of interim restorations.

MATERIALS AND METHODS

A mandibular right first molar resin tooth was prepared for a full coverage crown and scanned using a laboratory scanner (3Shape D900). The scanned data were converted into standard tessellation language (STL) format and an indirect prosthesis was designed using computer-aided design (CAD) software (exocad DentalCAD). The STL file was used to fabricate a total of 60 crowns with a 3D printer (EnvisionTEC Vida HD). The crowns were printed using E-Dent C&B MH resin and divided into 4 groups based on four different support structure designs, including supports on the occlusal (0° group), buccal and occlusal (45° group), buccal (90° group), and a new design consisting of horizontal bars placed on all surfaces and line angles (Bar) (n = 15). The silicone replica technique was used to determine the gap discrepancy. Fifty measurements were obtained for each specimen to examine the marginal and internal gaps by using a digital microscope (Olympus SZX16) at ×70 magnification. Additionally, the marginal discrepancy at different locations of the tested crowns, including buccal (B), lingual (L), mesial (M), and distal (D), as well as the maximum and minimum marginal gap intervals among groups, were analyzed. The collected data were analyzed using factorial ANOVA, followed by the Tukey HSD test for multiple comparisons (a = 0.05).

RESULTS

There was a significant difference in marginal and internal gaps among the groups (p < 0.001). The buccal placement supports (90° group) had the least marginal and internal discrepancies (p < 0.001). The new design group showed the highest marginal and internal gap. The marginal discrepancy in different locations of the tested crowns (B, L, M, D) was found to be significantly different among the groups (p < 0.001). The mesial margin of the Bar group had the largest marginal gap, whereas the buccal margin of the 90° group had the lowest marginal gap. The new design had a significantly smaller difference between the maximum and minimum marginal gap intervals than other groups (p < 0.001).

CONCLUSION

The location and design of the supporting structures affected the marginal and internal gaps of an interim crown. The buccal placement of supporting bars (90° printing orientation) showed the smallest mean internal and marginal discrepancies.

Comparison of surface roughness of additively manufactured implant-supported interim crowns fabricated with different print orientations

PURPOSE

To assess the influence of print orientation on the surface roughness of implant-supported interim crowns manufactured by using digital light processing (DLP) 3D printing procedures.

MATERIALS AND METHODS

An implant-supported maxillary right premolar full-contour crown was obtained. The interim restoration design was used to fabricate 30 specimens with 3 print orientations (0, 45, and 90 degrees) using an interim resin material (GC Temp PRINT) and a DLP printer (Asiga MAX UV) (n = 10). The specimens were manufactured, and each was cemented to an implant abutment with autopolymerizing composite resin cement (Multilink Hybrid Abutment). Surface roughness was assessed on the buccal surface of the premolar specimen by using an optical measurement system (InfiniteFocusG5 plus). The data were analyzed with a Shapiro-Wilk test, resulting in a normal distribution. One-way ANOVA and the Tukey HSD tests were selected (α = 0.05).

RESULTS

Statistically significant discrepancies were found in the surface roughness mean values among the groups tested (p < 0.001). The lowest mean ± standard deviation surface roughness was found with the 90-degree group (1.2 ± 0.36 μm), followed by the 0-degree orientation (2.23 ± 0.18 μm) and the 45-degree group (3.18 ± 0.31 μm).

CONCLUSIONS

Print orientation parameter significantly impacted the surface roughness of the implant-supported interim crowns manufactured by using the additive procedures tested.

Comparison of light transmittance and color changes between polyurethane and copolyester retainer materials after staining and destaining

BACKGROUND

Retainers are the only effective approach to prevent orthodontic relapse. The aim of this study was to compare the changes in color and light-transmittance of rough and smooth thermoformed polyurethane and copolymer retainer samples after staining in different solutions and destaining with different approaches.

METHODS

Four hundred copolyester (Essix® ACE) and 400 polyurethane (Zendura®) samples with different surface textures, smooth and rough, were stained in 4 different solutions (n = 100 per solution) over 28 days. Each of the four groups of 100 stained samples of each material was subdivided into 5 groups of 20 samples and subjected to different destaining solutions. Light transmittance and color changes were evaluated using a spectrometer and a spectrophotometer. Mean differences were compared using a two-way analysis of variance (ANOVA) and posthoc multiple comparison tests at P = 0.05.

RESULTS

No significant differences in light transmittance were found between both untreated materials. Both materials were stained in a similar fashion and showed no significant differences between two materials after staining. Coffee and tea stained both materials more significantly than wine, but there was a significant difference of changes of color and light transmittance between rough and smooth surfaces during the destaining in coffee- and tea-stained samples of copolyester material. All destaining solutions were effective at removing all stains on the samples. The surface roughness of the material plays a significant role in the ability of the materials to be destained, demonstrating a more significant greater effect on cleaning rough samples for improvements in light-transmittance and greater changes in color.

CONCLUSIONS

This study concluded that the surface of materials plays a significant role in the material destaining and staining. In addition, the different polymers used for retainer fabrication exhibited different responses during the destaining process depending on types of stains.

Effect of support structures on the trueness and precision of 3D printing dentures: An in vitro study

Purpose Additive manufacturing has revolutionized the fabrication of complete dentures. However, this process involves support structure, which is a construction part that holds the specimen during printing, and may prove to be disadvantageous. Therefore, this in vitro study compared the effect of support structure reduction on various volume and area distributions of a 3D-printed denture base to determine optimal parameters based on accuracy.Methods A complete maxillary denture base construction file was used as reference. Twenty denture bases were 3D printed under four conditions (total n=80): no support structure reduction (control), palatal support structure reduction (Condition P), border support structure reduction (Condition B), and palatal and border support structure reduction (Condition PB). Printing time and resin consumption were also recorded. The intaglio surface trueness and precision of all acquired data were exported to a 3D analysis software, and the dimensional changes to the denture base were analyzed using the root-mean-square estimate (RMSE) to assess geometric accuracy and generate color map patterns. Nonparametric Kruskal-Wallis and Steel-Dwass tests (α=0.05) analyzed the accumulated data.Results Control had the lowest RMSE values for trueness and precision. Nevertheless, it demonstrated a significantly lower RMSE than that of Condition B (P=0.02) in precision. Owing to negative deviation at the palatal region, Conditions P and PB had higher retention than Control and Condition B regarding the color map pattern.Conclusions Within the limitations of this study, the reduction of palatal and border support structures showed optimal accuracy with resource and cost savings.

Evaluation of the influence of different build angles on the surface characteristics, accuracy, and dimensional stability of the complete denture base printed by digital light processing

Purpose

This study aims to investigate the influence of the build angle on the surface characteristics, accuracy, and dimensional stability of digital light processing (DLP) printed resin bases.

Material and methods

Rectangular and complete denture base samples were fabricated at 0, 45, and 90-degree angles (n = 5 for rectangular samples; n = 10 for maxillary and mandibular denture base samples) using a DLP printer. Surface morphology and roughness were assessed using a profilometer, followed by measuring hydrophilicity with a contact angle meter. Accuracy (trueness and precision) and dimensional stability were evaluated at intervals of 1, 3, 7, 14, 28, and 42 days after base printing using best-fit-alignment and deviation analysis in 3D software. Statistical analysis was performed using one-way ANOVA for surface characteristics (α = 0.05), multi-way ANOVA for accuracy and dimensional stability data, and Tukey's test for post-hoc comparisons.

Results

The 0-degree group exhibited significantly lower mean roughness (1.27 ± 0.19 μm) and contact angle (80.50 ± 3.71°) (P < 0.001) compared to the 90-degree and 45-degree groups. The 0-degree build angle led to superior trueness (maxilla: 77.80 ± 9.35 μm, mandible: 61.67 ± 10.32 μm) and precision (maxilla: 27.51 ± 7.43 μm, mandible: 53.50 ± 15.16 μm) compared to other groups (P < 0.001). Maxillary base precision was superior to mandibular base precision (P < 0.001). The maxillary base exhibited less dimensional deviation than the mandibular base. The 90-degree group showed the highest deviation compared to the other two groups, and all groups' deviations increased over time (P < 0.001).

Conclusions

The build angle significantly influences the surface characteristics, accuracy, and dimensional stability of DLP-printed denture bases. A 0-degree build angle provides the most favorable performance. The maxillary base displayed superior precision and dimensional stability than the mandibular base.

Influence of pulse energy, tip design and insertion depth during Er:YAG-activated irrigation on cleaning efficacy in simulated severely curved complex root canal systems in vitro

AIM

To investigate the influence of pulse energy, tip geometry and tip position in simulated 3D-printed root canals with multiple side canals at different levels in all directions on the cleaning performance of laser-activated irrigation (LAI) compared to sonic activation (EDDY) and conventional needle irrigation (NI).

METHODOLOGY

3D-printed root canal models (25/.06, length 20 mm, curvature 60°, radius 5 mm) with side canals (diameter 0.2 mm) at 2, 5 and 8 mm from the apex were filled with coloured biofilm-mimicking hydrogel. LAI (Morita AdvErL Evo, Kyoto, Japan) was performed with six settings (n = 20; pulse-energy, pulses per second [PPS], tip position): LAI1 (50 mJ, 25 PPS, P400FL, canal entrance [CE]), LAI2 (same as LAI1, but insertion depth 9 mm before the apical endpoint [AE] [corresponding to 1 mm above the first lateral canals]), LAI3 (80 mJ, 25 PPS, P400FL, 9 mm before AE), LAI4 (same as LAI 3, but at CE) for 3 × 20 s each, LAI5 (50 mJ, 25 PPS, P400FL 2 × 20 s, CE & R200T (30 mJ, 25 PPS, 1 × 20 s, 9 mm before AE), LAI6 (30 mJ, 25 PPS, R200T, 9 mm before AE, 3 × 20 s). A continuous irrigation (3 mL/20 s) using distilled water accompanied the irrigation cycles. NI and EDDY (3 × 20 s each; 3 mL/20 s irrigation, insertion AE minus 1 mm, amplitude 4 mm) served as control groups. Biofilm-mimicking hydrogel removal (ImageJ, NIH) was assessed for the entire system, the central canal and the lateral canals using standardized photographs with a microscope (Expert DN, Müller-Optronic) and statistically analysed was performed using Kruskal-Wallis and Dunn tests (p = .05). Irrigant extrusion beyond the foramina was also recorded.

RESULTS

LAI2 (99.08%; interquartile range [IQR]: 96.85-100.00) and LAI3 (97.50%; 96.24-100.00) achieved the significantly best and LAI6 (80.08%; 73.41-84.69) the significantly worst removal of hydrogel from the entire root canal system amongst all LAI configurations (p < .05). There were no significant differences between LAI6, EDDY (72.89%; 67.49-76.22) and manual irrigation (54.39%; 51.01-56.94) (p > .05). R200T laser tip caused significantly more often irrigant extrusion than all other techniques (p < .05).

CONCLUSION

Tip design, energy settings, and the positioning of the laser tip below the canal entrance caused an improvement in cleaning performance of the LAI. However, the small R200T tip created significantly more procedural errors (irrigant extrusion) due to higher concentrated energy.

Fabrication of 3D-printed molds for polydimethylsiloxane-based microfluidic devices using a liquid crystal display-based vat photopolymerization process: printing quality, drug response and 3D invasion cell culture assays

Microfluidic platforms enable more precise control of biological stimuli and environment dimensionality than conventional macroscale cell-based assays; however, long fabrication times and high-cost specialized equipment limit the widespread adoption of microfluidic technologies. Recent improvements in vat photopolymerization three-dimensional (3D) printing technologies such as liquid crystal display (LCD) printing offer rapid prototyping and a cost-effective solution to microfluidic fabrication. Limited information is available about how 3D printing parameters and resin cytocompatibility impact the performance of 3D-printed molds for the fabrication of polydimethylsiloxane (PDMS)-based microfluidic platforms for cellular studies. Using a low-cost, commercially available LCD-based 3D printer, we assessed the cytocompatibility of several resins, optimized fabrication parameters, and characterized the minimum feature size. We evaluated the response to both cytotoxic chemotherapy and targeted kinase therapies in microfluidic devices fabricated using our 3D-printed molds and demonstrated the establishment of flow-based concentration gradients. Furthermore, we monitored real-time cancer cell and fibroblast migration in a 3D matrix environment that was dependent on environmental signals. These results demonstrate how vat photopolymerization LCD-based fabrication can accelerate the prototyping of microfluidic platforms with increased accessibility and resolution for PDMS-based cell culture assays.

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Optimization of Dimensional Accuracy and Surface Roughness of SLA Patterns and SLA-Based IC Components

Rapid investment casting is a casting process in which the sacrificial patterns are fabricated using additive manufacturing techniques, making the creation of advanced designs possible. One of the popular 3D printing methods applied in rapid investment casting is stereolithography because of its high dimensional precision and surface quality. Printing parameters of the used additive manufacturing method can influence the surface quality and accuracy of the rapid investment cast geometries. Hence, this study aims to investigate the effect of stereolithography printing parameters on the dimensional accuracy and surface roughness of printed patterns and investment cast parts. Castable wax material was used to print the sacrificial patterns for casting. A small-scale prosthetic biomedical implant for total hip replacement was selected to be the benchmark model due to its practical significance. The main results indicate that the most significant stereolithography printing parameter affecting surface roughness is build angle, followed by layer thickness. The optimum parameters that minimize the surface roughness are 0.025 mm layer thickness, 0° build angle, 1.0 support density index, and across the front base orientation. As for the dimensional accuracy, the optimum stereolithography parameters are 0.025 mm layer thickness, 30° build angle, 0.6 support density index, and diagonal to the front base orientation. The optimal printing parameters to obtain superior dimensional accuracy of the cast parts are 0.05 mm layer thickness, 45° build angle, 0.8 support density index, and diagonal to the front model base orientation. With respect to the surface roughness, lower values were obtained at 0.025 mm layer thickness, 0° build angle, 1.0 support density index, and parallel to the front base orientation.

Effect of build angle, resin layer thickness and viscosity on the surface properties and microbial adhesion of denture bases manufactured using digital light processing

OBJECTIVES

To investigate differences in the surface properties and microbial adhesion of denture base resins for digital light processing (DLP) with varying resin layer thicknesses (LT), build angles (BA), and resin viscosities.

METHODS

Two denture base resins for DLP with different viscosities (high and low) were used to prepare disk specimens applying two manufacturing parameters: 1) LT (50 or 100 μm) and 2) BA (0-, 45-, and 90-degree). Surface roughness and contact angle values were measured on the test surfaces (n=10 per group). Streptococcus oralis and Candida albicans absorbance was measured to assess microorganism attachment (n=6 per group). A three-way analysis of variance (ANOVA) was conducted, considering the main effects and their interactions (viscosity, LT, and BA). Post-hoc multiple pairwise comparisons were performed. All data were analyzed at a level of significance (P) of 0.05.

RESULTS

LT and BA significantly affected the surface roughness and contact angle of the specimens, depending on resin viscosity (P<.001). Absorbance measurement showed no significant interaction between the three factors (P>.05). However, significant interactions were observed between viscosity and BA (P<.05) and between LT and BA (P<.05).

CONCLUSIONS

Regardless of the viscosity and LT, discs with a 0-degree BA showed the least roughness. High-viscosity specimens fabricated with a 0-degree BA had the lowest contact angle. Regardless of the LT and viscosity, discs with a 0-degree BA showed the lowest S. oralis attachment. Attachment of C. albicans was the least on the disk with 50 μm LT, irrespective of the viscosity.

CLINICAL SIGNIFICANCE

Clinicians should consider the effects of LT and BA on surface roughness, contact angle, and microbial adhesion of DLP-generated dentures, which can differ depending on resin viscosity. A 50 μm LT and 0-degree BA can be used with a high-viscosity resin to fabricate denture bases with less microbial adhesion.

Transfer Accuracy of 3D-Printed Customized Devices in Digital Indirect Bonding: A Systematic Review and Meta-Analysis

Aim

To evaluate in vitro and in vivo the accuracy of 3D-printed customized transfer devices during indirect bonding technique (IBT).

Methods

A search for articles published in the English language until April 2022 was carried out using PubMed, Web of Science, Scopus, and Google Scholar databases and by applying a specific search strategy for each database to identify all potentially relevant in vivo or in vitro studies. After the removal of duplicate articles and data extraction according to the participants-intervention-comparison-outcome-study design schema scheme, the methodological quality of the included studies was assessed using the Swedish Council on Technology Assessment in Health Care Criteria for Grading Assessed Studies.

Results

The initial search identified 126 articles, 43 of which were selected by title and abstract. After full-text reading, 15 papers were selected for the qualitative analysis and seven studies for the quantitative analysis. The evidence quality for the selected studies was moderate.

Conclusions

Except for the bucco-lingual direction, the 3D-printed customized devices have a transfer accuracy within the clinically acceptable limits established by the American Board of Orthodontics. Therefore, 3D-printed transfer devices may be considered an accurate method for bonding position during IBT, both in vitro and in vivo. Additional randomized clinical studies in vivo should be suggested.

Fluidic shaping and in-situ measurement of liquid lenses in microgravity

In the absence of gravity, surface tension dominates over the behavior of liquids. While this often poses a challenge in adapting Earth-based technologies to space, it can also provide an opportunity for novel technologies that utilize its advantages. In particular, surface tension drives a liquid body to a constant-mean-curvature shape with extremely smooth surfaces, properties which are highly beneficial for optical components. We here present the design, implementation and analysis of parabolic flight experiments demonstrating the creation and in-situ measurement of optical lenses made entirely by shaping liquids in microgravity. We provide details of the two experimental systems designed to inject the precise amount of liquid within the short microgravity timeframe provided in a parabolic flight, while also measuring the resulting lens' characteristics in real-time using both resolution target-imaging and Shack-Hartmann wavefront sensing. We successfully created more than 20 liquid lenses during the flights. We also present video recordings of the process, from the lenses' creation during microgravity and up until their collapse upon return to gravity. The work thus demonstrates the feasibility of creating and utilizing liquid-based optics in space.

Excellent Characteristics of Environmentally Friendly 3D-Printed Nasopharyngeal Swabs for Medical Sample Collection

3D-printed nasopharyngeal swabs for medical sample collection have been manufactured via additive manufacturing (AM), evaluated, and characterized in the present study. A multi-part component of nasopharyngeal swabs was proposed, in which the swab and handle were manufactured separately to reach sustainable production and environmentally friendly products. The swab was investigated using tensile, flexural, surface roughness, dimensional accuracy, and sample collection testing. The influence of printing parameters and post-curing time treatment on the mechanical properties, surface roughness, and dimensional accuracy of 3D-printed nasopharyngeal swabs were also evaluated. The result showed that 3D-printed nasopharyngeal swab shows outstanding tensile strength compared to the commercial flock nasopharyngeal swab. Moreover, the swab neck flexibility test showed that both PLA and dental non-castable 3D-printed nasopharyngeal swabs were able to bend 180°. Subsequently, the surface roughness of 3D-printed nasopharyngeal swab was identic with the commercial flock nasopharyngeal swab. The proposed 3D-printed nasopharyngeal swab design could carry an artificial mucus sample of 141.6 mg at a viscosity of 9455.4 mPa.s. The cost to fabricate a 3D-printed nasopharyngeal swab was estimated at USD0.01-0.02 per swab. 3D-printed nasopharyngeal swab shows potential as a feasible option, greener, less medical waste, and more sustainable.

Clear guidance to select the most accurate technologies for 3D printing dental models - A network meta-analysis✰

OBJECTIVES

Thus far, the findings of numerous studies conducted on the accuracy of three-dimensional (3D) printed dental models are conflicting. Therefore, the aim of the network meta-analysis (NMA) is to determine the accuracy of 3D printed dental models compared with digital reference models.

DATA

Studies comparing the accuracy of 3D printed full-arch dental models manufactured using different printing techniques to initial STL files were included.

SOURCES

This study was registered in PROSPERO (CRD42021285863). An electronic search was performed across four databases in November 2021, and search was restricted to the English language.

STUDY SELECTION

A systematic search was conducted based on a prespecified search query. 16,303 articles were pooled after the removal of the duplicates. Following study selection and data extraction, 11 eligible studies were included in the NMA in 6 subgroups. The outcomes were specified as trueness and precision and expressed as root mean square (RMS) and absolute mean deviation values. Seven printing technologies were analyzed: stereolithography (SLA), digital light processing (DLP), fused deposition modeling/fused filament fabrication (FDM/FFF), MultiJet, PolyJet, continuous liquid interface production (CLIP), and LCD technology. The QUADAS-2 and GRADE were used to evaluate the risk of bias and certainty of evidence.

CONCLUSIONS

SLA, DLP, and PolyJet technologies were the most accurate in producing full-arch dental models.

CLINICAL SIGNIFICANCE

The findings of the NMA suggest that SLA, DLP, and PolyJet technologies are sufficiently accurate for full-arch dental model production for prosthodontic purposes. In contrast, FDM/FFF, CLIP, and LCD technologies are less suitable for manufacturing dental models.

Material extrusion of thermoplastic acrylic for intraoral devices: Technical feasibility and evaluation

With global demand for 3D printed medical devices on the rise, the search for safer, inexpensive, and sustainable methods is timely. Herein, we assessed the practicality of the material extrusion process for acrylic denture bases of which successful outcomes can be extended to implant surgical guides, orthodontic splints, impression trays, record bases and obturators for cleft palates or other maxillary defects. Representative materials comprising denture prototypes and test samples were designed and built with in-house polymethylmethacrylate filaments using varying print directions (PDs), layer heights (LHs) and reinforcements (RFs) with short glass fiber. The study undertook a comprehensive evaluation of the materials to determine their flexural, fracture, and thermal properties. Additional analyses for tensile and compressive properties, chemical composition, residual monomer, and surface roughness (Ra) were completed for parts with optimum parameters. Micrographic analysis of the acrylic composites revealed adequate fiber-matrix compatibility and predictably, their mechanical properties improved simultaneously with RFs and decreased LHs. Fiber reinforcement also improved the overall thermal conductivity of the materials. Ra, on the other hand, improved visibly with decreased RFs and LHs and the prototypes were effortlessly polished and characterized with veneering composites to mimic gingival tissues. In terms of chemical stability, the residual methyl methacrylate monomer contents are well below standards threshold for biological reactions. Notably, 5 vol% acrylic composites built with 0.05 mm LH in 0° on z-axis produced optimum properties that are superior to those of conventional acrylic, milled acrylic and 3D printed photopolymers. Finite element modeling successfully replicated the tensile properties of the prototypes. It may well be argued that the material extrusion process is cost-effective; however, the speed of manufacturing could be longer than that of established methods. Although the mean Ra is within an acceptable range, mandatory manual finishing and aesthetic pigmentation are required for long-term intraoral use. At a proof-of-concept level, it is evident that the material extrusion process can be applied to build inexpensive, safe, and robust thermoplastic acrylic devices. The broad outcomes of this novel study are equally worthy of academic reflection, and further translation to the clinic.

Is microbial adhesion affected by the build orientation of a 3-dimensionally printed denture base resin?

STATEMENT OF PROBLEM

How the build orientation of a 3-dimensionally (3D) printed denture affects microbial adhesion is unclear.

PURPOSE

The purpose of this in vitro study was to compare the adherence of Streptococcus spp. and Candida spp. on 3D-printed denture bases prepared at different build orientations with conventional heat-polymerized resin.

MATERIAL AND METHODS

Resin specimens (n=5) with standardized 28.3 mm² surface area were 3D printed at 0 and 60 degrees, and heat-polymerized (3DP-0, 3DP-60, and HP, respectively). The specimens were placed in a Nordini artificial mouth (NAM) model and exposed to 2 mL of clarified whole saliva to create a pellicle-coated substratum. Suspensions of Streptococcus mitis and Streptococcus sanguinis, Candida albicans and Candida glabrata, and a mixed species, each at 10⁸ cfu/mL were pumped separately into the model for 24 hours to promote microbial adhesion. The resin specimens were then removed, placed in fresh media, and sonicated to dislodge attached microbes. Each suspension (100 μL) was aliquoted and spread on agar plates for colony counting. The resin specimens were also examined under a scanning electron microscope. The interaction between types of specimen and groups of microbes was examined with 2-way ANOVA and then further analysis with Tukey honest significant test and Kruskal-Wallis post hoc tests (α=.05).

RESULTS

A significant interaction was observed between the 3DP-0, 3DP-60, and HP specimen types and the groups of microbes adhering to the corresponding denture resin specimens (P<.05). The difference was statistically significant among 3DP-0, 3DP-60, and HP specimens (P<.05). The adherence of candida was 3.98-times lower on the 3DP-0 than that of HP (P<.05). However, adherence of the mixed-species microbes and streptococci on the 3DP-60 were 1.75 times and 2-fold higher, respectively (P<.05). The scanning electron micrographs showed that 3DP-0 exhibited the lowest microbial adherence compared with HP and 3DP-60.

CONCLUSIONS

Adherence affinity of denture base resin is affected by the build orientation rather than by the group of different microbes. Three-dimensionally printed denture base resin fabricated at a 0-degree build orientation exhibited low affinity for microbial adhesion. Three-dimensionally printed dentures may reduce microbial adhesion when printed at a 0-degree build orientation.

Influence of Fabrication Technique on Adhesion and Biofilm Formation of Candida albicans to Conventional, Milled, and 3D-Printed Denture Base Resin Materials: A Comparative In Vitro Study

The aim of this study was to evaluate the adhesion and biofilm formation of Candida albicans (C. albicans) on conventionally fabricated, milled, and 3D-printed denture base resin materials in order to determine the susceptibility of denture contamination during clinical use. Specimens were incubated with C. albicans (ATCC 10231) for 1 and 24 h. Adhesion and biofilm formation of C. albicans were assessed using the field emission scanning electron microscopy (FESEM). The XTT (2,3-(2-methoxy-4-nitro-5-sulphophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazolium hydroxide) assay was used for the quantification of fungal adhesion and biofilm formation. The data were analyzed using GraphPad Prism 8.02 for windows. One-way ANOVA with Tukey's post hoc testing were performed with a statistical significance level set at α = 0.05. The quantitative XTT biofilm assay revealed significant differences in the biofilm formation of C. albicans between the three groups in the 24 h incubation period. The highest proportion of biofilm formation was observed in the 3D-printed group, followed by the conventional group, while the lowest candida biofilm formation was observed in the milled group. The difference in biofilm formation among the three tested dentures was statistically significant (p < 0.001). The manufacturing technique has an influence on the surface topography and microbiological properties of the fabricated denture base resin material. Additive 3D-printing technology results in increased candida adhesion and the roughest surface topography of maxillary resin denture base as compared to conventional flask compression and CAD/CAM milling techniques. In a clinical setting, patients wearing additively manufactured maxillary complete dentures are thus more susceptible to the development of candida-associated denture stomatitis and accordingly, strict oral hygiene measures and maintenance programs should be emphasized to patients.

Effect of various printing parameters on the accuracy (trueness and precision) of 3D-printed partial denture framework

OBJECTIVES

To measure and compare the accuracy of 3D-printed materials used for RPD production to improve workflow and eliminate errors in manufacturing.

METHODS

A partially edentulous maxilla (Kennedy Class III, modification 1) was prepared and designed with proximal plates, rest seats and clasps in one first premolar, one canine and two second molars. A total of 540 3D printed RPD frameworks were 3D printed with three different types of resin (DentaCAST (Asiga, Australia), SuperCAST (Asiga, Australia) and NextDent (3D Systems, Netherlands)). To evaluate the trueness of the printing materials, they were printed with three types of layer thickness: 50 μm, 75 μm and 100 μm, using two types of build angles: 0° and 45° and three types of plate locations: side, middle and corner. After production, all specimens were scanned and superimposed with a control sample that was digitally designed. Using the initial alignment and best-fit alignment method, the root mean square error (RMSE) was calculated. To capture region specific discrepancy, 10 points of XYZ internal discrepancy within RPDs were measured and Euclidean error was calculated. Data was statistically analysed using Shapiro-Wilk and Kruskal-Wallis tests, one-way ANOVA and T-test (SPSS Version 29) and MATLAB (R2022b).

RESULTS

Optimal results were found using 45°, middle of the build plate and layer thicknesses of 100 μm (115 ± 19 μm, DentaCAST), 75 μm (143 ± 14 μm, NextDent), 50 μm (98 ± 35 μm, SuperCAST), which were clinically acceptable. Results were statistically significant when comparing layer thickness in each testing group (p < 0.001). Layer thickness was a primary parameter in the determination of print accuracy among all materials (p < 0.001). Higher discrepancies and failures were observed in 0° prints. No statistically significant difference was found in material usage between build angles or layer thickness (p > 0.005).

CONCLUSIONS

All three 3D printing materials exhibited clinically acceptable RMSE results with a build angle of 45° with a printing layer thickness of 50 μm for SuperCAST, 75 μm NextDent and 100 μm for DentaCAST. The highest discrepancies were mostly found in posterior clasps, while the lowest discrepancy was found in palatal straps. Despite unoptimized spacing of prints, frameworks configured to print in the middle of the build plate result in the least printing failures.

3D Printing of Dental Prostheses: Current and Emerging Applications

Revolutionary fabrication technologies such as three-dimensional (3D) printing to develop dental structures are expected to replace traditional methods due to their ability to establish constructs with the required mechanical properties and detailed structures. Three-dimensional printing, as an additive manufacturing approach, has the potential to rapidly fabricate complex dental prostheses by employing a bottom-up strategy in a layer-by-layer fashion. This new technology allows dentists to extend their degree of freedom in selecting, creating, and performing the required treatments. Three-dimensional printing has been narrowly employed in the fabrication of various kinds of prostheses and implants. There is still an on-demand production procedure that offers a reasonable method with superior efficiency to engineer multifaceted dental constructs. This review article aims to cover the most recent applications of 3D printing techniques in the manufacturing of dental prosthetics. More specifically, after describing various 3D printing techniques and their advantages/disadvantages, the applications of 3D printing in dental prostheses are elaborated in various examples in the literature. Different 3D printing techniques have the capability to use different materials, including thermoplastic polymers, ceramics, and metals with distinctive suitability for dental applications, which are discussed in this article. The relevant limitations and challenges that currently limit the efficacy of 3D printing in this field are also reviewed. This review article has employed five major scientific databases, including Google Scholar, PubMed, ScienceDirect, Web of Science, and Scopus, with appropriate keywords to find the most relevant literature in the subject of dental prostheses 3D printing.

Accuracy of palatal orthodontic mini-implants placed by conventionally or CAD/CAM-based surgical guides: a comparative in vitro study

OBJECTIVES

To investigate and compare the transfer accuracy of five different surgical guides (SGs) for the insertion of orthodontic mini-implants (OMIs) in the anterior palate.

MATERIALS AND METHODS

Stereolithographic files of 10 maxillary patient models and their corresponding lateral cephalograms were virtually matched and used for planning the position of two parallel OMIs in the paramedian region of the anterior palate. For each patient model, three 3-dimensional (3D)-printed and two conventional SGs were manufactured from different materials, and a total of 96 OMIs were transferred to the anterior palates of the respective 50 molded resin models. The planned (T0) and the actual (T1) OMI positions were analyzed and compared after superimposition of the digitized models. The deviations between the OMI positions in T0 and T1 were described as the distance between the head and the tip, respectively, of each OMI in millimeters and the deviating angle between the OMI axes for each patient and SG.

RESULTS

The conventionally manufactured SGs of Pattern Resin LS (GC Europe N.V., Leuven, Belgium) showed the highest linear and angular transfer accuracy for the insertion of OMIs. The highest deviations were found with the SGs made of IMPRIMO LC Splint (3D-printed; Scheu-Dental, Iserlohn, Germany) and Memosil 2 (conventional SG; Kulzer, Hanau, Germany).

CONCLUSIONS

The 3D-printed SGs did not reach the accuracy of the conventional SGs made of Pattern Resin but may provide sufficient accuracy for palatal OMI placement.

The Effect of Stacking on the Accuracy of 3D-Printed Full-Arch Dental Models

The objective of this study was to assess the effect of stacking on the dimensional and full-arch accuracy of 3D-printed models, utilising a standardised assessment methodology. A previously validated methodology involving a standard tessellation language image (STL) reference model, comprising seven spheres on a horseshoe base resembling a dental arch, was used. Six 3D-designed STL models were prepared, optimised, and stacked horizontally using 3D Sprint software. The stacking file was transferred to the NextDent 5100 printer to build the physical models. To assess accuracy, a coordinate measuring machine (CMM) measured the diameter of the spheres n=210, and twenty-one vectors extended between the centres of each of the seven spheres (n = 630). When compared to the reference model, significant differences were observed for dimensional (p = 0.006) and full-arch accuracy (p = 0.006) for all stacked models. Additionally, significant differences were observed between the stacked models for the dimensional accuracy between the posterior (p = 0.015), left posterior (p = 0.005) and anteroposterior (p = 0.002). The maximum contraction was observed in the fourth stacked model, which demonstrated the highest median deviation and least precision within the full-arch (MD = 666 μm, IQR = 55 μm), left posterior (MD = 136 μm, IQR = 12 μm), posterior (MD = 177 μm, IQR = 14 μm) and anteroposterior (MD = 179 μm, IQR = 16 μm) arch segments. In general, the anterior and left posterior arch segments recorded the highest contractions with a median deviation of 34 μm and 29 μm, and precision of 32 μm and 22 μm, respectively. Statistically significant differences were observed between the stacked models in terms of dimensional accuracy that were within clinically acceptable thresholds. The greatest contraction was noted in the fourth model, displaying the least full-arch accuracy compared to the other models. Stacked, additively manufactured, full arch models are a viable alternative for diagnostic, orthodontic, and single-unit prosthodontic applications. In contrast, caution should be exercised when utilising stacked models for full arch high accuracy prosthodontic applications. Further research is needed to assess the impact of additional variables including different printers and resins.