Fracture Load of Veneered and Monolithic Single-Unit Fixed Dental Prostheses Made from the High-Performance Thermoplastic Polyphenylene Sulfone

PURPOSE: To investigate the fracture load of different veneers for monolithic single-unit fixed dental prostheses (FDPs) made of a novel potential framework material, polyphenylene sulfone (PPSU). MATERIALS AND METHODS: The fracture loads of four PPSU frameworks with different veneers (manual polymer veneer with Ceramage Body A3B; prefabricated polymer veneer with Novo.lign; digital polymer veneer with Telio CAD; digital ceramic veneer with IPS Empress CAD) and a monolithic control group (PPSU, Gehr) were examined initially and after 1,200,000 masticatory (50 N, 1.3 Hz) and 6,000 thermal cycles (5°C/55°C). Fracture analysis was performed using light microscope imaging. Fracture types were classified, and relative frequencies were determined. Univariate analysis of variance, post hoc Scheffé, partial eta squared, Kruskal-Wallis test, and Weibull moduli using the maximum likelihood estimation method were calculated. The defined level of significance was adjusted by Bonferroni correction (P < .005). RESULTS: Aging did not affect the fracture load values. Single-unit FDPs with a digital ceramic veneer showed lower values than monolithic and manual polymer-veneer specimens. Single-unit FDPs with a prefabricated and digital polymer veneer were in the same value range as specimens with a manual polymer and digital ceramic veneer. No differences were observed between manual polymer veneer and monolithic single-unit FDPs. All veneered specimens showed a fracture of the veneer. For monolithic single-unit FDPs, a plastic deformation was observed. CONCLUSION: Veneered and monolithic PPSU showed sufficient fracture load values to indicate successful clinical use in single-unit FDPs. The choice of veneering method and material may play a minor role.

Food Solutions and Cigarette Smoke-Dependent Changes in Color and Surface Texture of CAD/CAM Composite Resins-An In Vitro Study.

PURPOSE: To investigate the discoloration and surface properties of four CAD/CAM composite resins following storage in various food solutions and exposure to cigarette smoke. MATERIALS AND METHODS: A total of 74 specimens (N = 370) were prepared for five materials: Brilliant Crios (BC), Cerasmart (GC), Lava Ultimate (LU), Shofu Block HC (SH), and Sonic Fill 2 (SO). Discoloration (ΔE) was investigated with a spectrophotometer. Measurements were taken before immersion in storage media (carrot juice, curry, cigarette smoke, red wine, energy drink, and distilled water), after 2 weeks of immersion, and after manual polishing of the specimens following immersion. The average surface roughness (Ra) was measured with a profilometer. Qualitative surface observation was performed with scanning electron microscopy (SEM). Data were analyzed using Kolmogorov-Smirnov test, Mann-Whitney U test, and one-way ANOVA with Tukey post hoc test. RESULTS: The highest influence on ΔE after immersion was observed for storage medium (ηηP2 = 0.878, P < .001), followed by the interaction between storage medium and material (ηP2 = 0.770, P < .001) and material (ηP2 = 0.306, P < .001). For ΔE after polishing, the highest influence was indicated by the interaction between material and medium (ηP2 = 0.554, P < .001), followed by medium (ηP2 = 0.244, P < .001) and material (ηP2 = 0.196, P < .001). Immersion in carrot juice led to the highest color change (ΔE: 8.0 to 10.4), whereas the lowest values were recorded in distilled water (ΔE: 2.0 to 2.4). Carrot juice and the energy drink caused the highest Ra values (0.120 µm to 0.355 µm). SEM pictures indicated a loss of the organic matrix after manual polishing. CONCLUSION: The different materials reacted dissimilarly to the various storage media in terms of discoloration. Surface roughness increased after immersion or polishing. Neither discoloration nor surface roughness could be reset to default by manual polishing. Int J Prosthodont 2023;36:194-202. doi: 10.11607/ijp.6950.

Three-dimensionally printed and milled polyphenylene sulfone materials in dentistry: Tensile bond strength to veneering composite resin and surface properties after different pretreatments.

STATEMENT OF PROBLEM: Polyphenylene sulfone (PPSU) is a thermoplastic that can be processed using 3-dimensional printing. PPSU is new to dentistry, and scientific data on its properties are lacking. PURPOSE: The purpose of this in vitro study was to test the surface properties and the tensile bond strength (TBS) between PPSU and a veneering composite resin in comparison with a polyetheretherketone (PEEK). MATERIAL AND METHODS: Gehr PPSU (PPSU-B1), Radel R-5000 NT (PPSU-B2), and Juvora Dental Disc (PEEK-CG) substrates were cut from bulk material, while FIL-A-GEHR PPSU (PPSU-3D) was 3-dimensionally printed (N=504, n=126/material). TBS to veneering composite resin (CeramageUp) was tested initially and after 5000 and 10 000 thermocycles, and fracture types were analyzed. Surface free energy (SFE) and surface roughness (Ra) were determined after pretreatment with aluminum oxide (Al2O3) of different grain sizes (50 and 110 µm) applied with different pressures (0.1, 0.2, 0.4 MPa), silicon dioxide (SiO2)-coated Al2O3 (0.28 MPa), sulfuric acid, or polished. Qualitative surface characterization was performed by using a scanning electron microscope (SEM). One-way ANOVA, the Kruskal-Wallis, Mann-Whitney U, and the Spearman correlation tests were computed (α=.05). RESULTS: PPSU-3D and PEEK-CG presented higher TBS results than PPSU-B1 and PPSU-B2. Initial TBS values were higher than after 10 000 thermocycles. Adhesive fractures between substrate and veneering composite resin occurred most frequently. With a few exceptions, PEEK-CG presented higher SFE values than all other materials within a pretreatment group, while PPSU-3D and PEEK-CG showed consistently high Ra values. An increase in pressure and particle size increased SFE and Ra. CONCLUSIONS: FFF-printed PPSU-3D showed similar TBS values with the veneering composite resin to the more established PEEK. Pretreatment methods devised for PEEK represent valid strategies for increasing both the SFE and Ra of the high-performance polymer PPSU.

3D printing of dental restorations: Mechanical properties of thermoplastic polymer materials.

In the seminal field of 3D printing of dental restorations, the time and cost saving manufacturing of removable and fixed dental prostheses from thermoplastic polymer materials employing fused filament fabrication (FFF) is gaining momentum. As of today, the additive manufacturing of the established semi-crystalline polyetheretherketone (PEEK) requires extensive post-processing and lacks precision. In this context, the amorphous polyphenylene sulfone (PPSU) may provide a higher predictability and reliability of the results. The aim of this study was to investigate the mechanical properties of PPSU and PEEK processed by FFF (PPSU1-3D (PPSU Radel) and PPSU2-3D (Ultrason P 3010 NAT)) or extrusion (PPSU1-EX (Radel R-5000 NT) and PEEK-CG (PEEK Juvora)). Three-point flexural strength, two-body wear, and Martens hardness (HM) and indentation modulus (EIT) were tested after aging. One-way ANOVA, the Kruskal-Wallis and the Pearson's and Spearman's correlation tests were computed (α = 0.05). PPSU1-3D and PPSU2-3D showed lower flexural strength values than PPSU1-EX and PEEK-CG. PPSU1-3D showed the highest, and PEEK-CG and PPSU1-EX the lowest height loss. The highest HM and EIT results were observed for PEEK-CG and the lowest for PPSU1-3D. Correlations were observed between all parameters except for the application height. In conclusion, the manufacturing process affected the flexural strength of PPSU, with 3D printed specimens presenting lower values than specimens cut from prefabricated molded material. This finding indicates that the 3D printing parameters employed for the additive manufacturing of PPSU specimens in the present investigation require further optimization. For 3D printed specimens, the quality of the filament showed an impact on the mechanical properties, underlining the importance of adhering to high quality standards during filament fabrication. Extruded PPSU led to comparable results with PEEK for flexural strength and two-body wear, indicating this novel dental restorative material to be a suitable alternative to the established PEEK for the manufacturing of both removable and fixed dental prostheses.

Fracture load and chewing simulation of zirconia and stainless-steel crowns for primary molars.

Aesthetic alternatives to stainless-steel crowns for restoring primary molars attain growing interest. We studied the mechanical properties of prefabricated zirconia crowns and conventional crowns. Three brands of prefabricated zirconia crowns were compared with computer-aided design/computer-aided manufacturing (CAD/CAM) zirconia crowns, preveneered stainless-steel crowns, and conventional stainless-steel crowns regarding: (i) fracture load under each of three conditions [no pretreatment, artificial aging in saliva for 12 wk, and after chewing simulation/thermocycling (1.68 × 106 cycles/5-55°C)]; and (ii) survival rate during chewing simulation, considering decementation, fracture, chipping, fatigue cracks, and occlusal holes. Without pretreatment, the prefabricated zirconia crowns showed mean fracture load values between 893 N and 1,582 N, while the corresponding values for CAD/CAM zirconia crowns and preveneered stainless-steel crowns were 2,444 N and 6,251 N. Preveneered stainless-steel crowns showed significantly lower fracture loads after artificial aging (5,348 N after saliva aging; 3,778 N after chewing simulation) than without artificial aging, whereas the fracture load of zirconia crowns was not influenced negatively. The survival rate of the different groups of zirconia crowns and preveneered stainless-steel crowns during chewing simulation was 100%, but only 41.7% for the stainless-steel crowns. These in-vitro data suggest that prefabricated zirconia crowns are aesthetically and durable alternatives to stainless-steel crowns for primary molars.

Influence of residual bone thickness on primary stability of hybrid self-tapping and cylindric non-self-tapping implants in vitro.

PURPOSE: To assess the primary stability of a hybrid self-tapping implant and a cylindric non-self-tapping implant in an in vitro test model using polyurethane foam. MATERIALS AND METHODS: Eighty standardized blocks of cellular rigid polyurethane foam, 2 cm long and 1 cm wide, with different thicknesses of 2, 4, 6, and 9 mm (n = 10 per group) were cut. Two implant systems--a hybrid self-tapping (Tapered Effect [TE], Straumann) and a cylindric non-self-tapping (Standard Plus [SP] Wide Neck, Straumann) were placed in the block specimens. Subsequently, resonance frequency analysis (RFA) was performed. The RFA measurements were made in triplicate on four aspects of each implant (mesial, distal, buccal, and oral), and the mean RFA value was calculated. Subsequently, the tensile load of the implants was determined by pull-out tests. The data were analyzed using one-way and two-way analysis of variance followed by a post hoc Scheffe test and a t test (α = .05). Additionally, the simple linear correlation between the RFA and tensile load values was evaluated. RESULTS: No statistically significant differences were found between TE and SP in terms of RFA at different bone thicknesses. Starting from a bone thickness of 4 mm, TE implants showed significantly higher tensile load compared to SP implants (P = .016 to .040). A correlation was found between the RFA measurements and tensile load. CONCLUSIONS: Mechanically stable placement is possible with TE and SP implants in a trabecular bone model. RFA and tensile load increased with greater bone thickness.