Impact of varnishing, coating, and polishing on the chemical and mechanical properties of a 3D printed resin and two veneering composite resins.

STATEMENT OF PROBLEM: Three-dimensional (3D) printing enables the fast fabrication of definitive fixed dental prostheses (FDPs). However, data on the effects of surface treatments on their chemical and mechanical properties are lacking. PURPOSE: The purpose of this in vitro study was to examine the influence of different surface treatments on a 3D printed resin in comparison with 2 veneering composite resins. MATERIAL AND METHODS: A total of 288 specimens were manufactured from a 3D printed resin (VarseoSmile Crownplus) or veneering composite resins (GRADIA PLUS; VITA VM LC flow). Surfaces underwent varnishing, coating, polishing or remain untreated. Conversion rate (DC), surface roughness (SR), Martens parameter, flexural strength (FS), and 3-body wear (3BW) were determined (n=12). Statistical analysis was performed using Mann-Whitney-U, Kruskal-Wallis, and Spearman correlation tests (α=.05). RESULTS: After polishing, the 3D printed resin showed higher DC, SR, and 3BW but lower Martens parameters compared with veneering composite resins (P<.007). After goat hair brushing, the 3D printed resin showed lower FS than VITA-VCR (P=.043). For the 3D printed resin, goat hair brushing or GC-Varnish reduced SR, while VITA-Varnish showed the lowest 3BW (P<.045). For both veneering composite resins, goat hair brushing led to low SR and 3BW and high EIT and FS (P<.043). Silicone polishing led to low EIT of the 3D printed resin and low EIT and FS of GC-VCR (P<.009). Coating resulted in a lower EIT than the untreated surface and higher 3BW than GC-Varnish (P<.030). CONCLUSIONS: The 3D printed resin showed higher DC, SR, 3BW and lower HM, EIT, and FS values than the veneering composite resins. Polishing with a goat hair brush can be recommended for all tested materials. For the 3D printed resin, varnishing presents a promising alternative with regard to SR and 3BW. Silicone polishing and coating cannot be recommended.

Impact of material combinations and removal and insertion cycles on the retention force of telescopic systems.

OBJECTIVES: A variety of dental materials are available for the fabrication of telescopic crowns. The aim was to investigate the impact of material combinations and removal and insertion cycles on their retention forces. MATERIALS AND METHODS: CAD/CAM-fabricated cobalt-chromium-molybdenum (CoCr) and zirconia (ZrO2) primary crowns were combined with polyetheretherketone (PEEK), polyetherketoneketone (PEKK), CoCr, and ZrO2 secondary crowns (four combinations included PEEK/PEKK secondary crowns in a thickness of 0.5 mm bonded to the CoCr tertiary construction), resulting in 12 different material combinations: CoCr-PEEK; CoCr-PEKK; CoCr-ZrO2; CoCr-CoCr; CoCr-PEEK 0.5; CoCr-PEKK 0.5; ZrO2-PEEK; ZrO2-PEKK; ZrO2-ZrO2, ZrO2-CoCr; ZrO2-PEEK 0.5; and ZrO2-PEKK 0.5 (n = 15 pairings per material combination). Pull-off tests were performed with a universal testing machine initially and after 500, 5000, and 10,000 removal and insertion cycles in a mastication simulator. Descriptive statistics with the Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests were computed (α = 0.05). RESULTS: The tested parameters, material combination, and removal and insertion cycles had significant impact on the retention force values (p < 0.001). An increase in removal and insertion cycles was associated with a decrease in retention forces within CoCr and ZrO2 secondary crowns, regardless of the primary crown material. In contrast, PEEK and PEKK secondary crowns presented higher retention load values after 10,000 cycles than initially. CONCLUSION: Different material combinations behaved differently after simulated removal and insertion regimens. This difference should be considered during treatment planning. CLINICAL RELEVANCE: Telescopic crown systems should be made of materials with predictable retention forces that do not deteriorate with time. The implementation of new materials and technologies facilitates reproducibility and time-saving fabrication.

Digital versus conventional veneering of zirconia and cobalt chromium crowns: Fracture load before and after thermomechanical aging.

STATEMENT OF PROBLEM: To complement the digital workflow for manufacturing fixed dental prostheses, both high-strength frameworks and esthetic veneers should be designed and fabricated digitally. However, how the fracture load of digitally veneered restorations compares with conventionally fabricated restorations is unclear. PURPOSE: The purpose of this in vitro study was to examine the fracture load of digitally and conventionally veneered zirconia and cobalt chromium crowns initially and after thermomechanical aging. MATERIAL AND METHODS: Milled zirconia and cobalt chromium copings for a maxillary canine were fabricated (N=96). Digital veneers were milled and connected to the copings with a sintered ceramic slurry. The conventional veneers were fabricated by using a master mold, and the crowns were bonded to the cobalt chromium abutments. Half the specimens were subjected to 6000 thermal (5 °C to 55 °C, 60 seconds) and 1 200 000 mechanical (50 N, 1.5 Hz, 0.7 mm lateral movement) cycles opposed by steatite antagonists, and the fracture load was determined. Fracture types were categorized, and scanning electron microscopy performed. The data were analyzed with a 3-way global univariate analysis of variance, t test, the Pearson chi-squared test, and the Weibull modulus (α=.05). RESULTS: Unlike the framework material (P=.316) and artificial aging (P=.064), the veneering protocol affected the fracture load (P=.007). Digital veneers (range: 2242 to 2929 N) led to lower values than conventional veneers (range: 2825 to 3166 N), which was significant for aged cobalt chromium copings (P=.024; 2242 versus 3107 N). Conventionally veneered crowns showed lower Weibull moduli after thermomechanical aging (range: 3.2 to 3.5) than initially (range: 7.8 to 11.4). The copings of all the zirconia specimens fractured, while chipping occurred with the cobalt chromium specimens. CONCLUSIONS: The high fracture load values of the veneered crowns, even after simulated 5-year aging, indicated sufficient mechanical properties (nearly 4-fold the average occlusal force of 600 N) for the successful clinical application of digitally veneered zirconia and cobalt chromium copings.

Two-body wear of novel monolithic lithium-silicate ceramic materials and their corresponding different antagonists.

OBJECTIVES: Evaluation of the two-body wear of lithium-silicate ceramics against different antagonists compared to a direct resin composite and human teeth. METHODS: Initial LiSi Block [LISI], IPS e.max CAD [EMA], and CEREC Tessera [TESE] were investigated and compared with direct resin composite [FILL] and human teeth [tooth]. As antagonists were used: steatite, ceramic, and human enamel. The control group tooth was only tested with enamel antagonist. The combinations underwent thermomechanical aging using a chewing simulator. Material losses were calculated using GOM-analysis software. Kolmogorov-Smirnov test, Kruskal-Wallis H, Mann-Whitney-U-test with Bonferroni correction and Spearman-rho correlation were calculated. A fractographic analysis was performed. RESULTS: Within TESE, enamel antagonists led to lower restoration losses than steatite and ceramic antagonists. Within FILL, enamel and steatite antagonists caused lower material losses compared to ceramic antagonists. Against steatite antagonists, LISI showed lowest material losses. Against ceramic antagonists, the use of LISI led to lower material losses compared to FILL. Against tooth antagonists, TESE showed lower material losses than tooth and FILL and LISI lower than FILL. Within LISI, steatite antagonists showed lower material losses on the antagonist than ceramic. Within EMA, steatite antagonists showed higher material losses than ceramic ones. Within ceramic antagonists, LISI restoration material showed lower material losses than FILL and EMA. CONCLUSIONS: Regardless of the antagonist material, the material losses of LISI and EMA were comparable. However, the abrasion resistance of LISI tended to be higher than EMA. CLINICAL SIGNIFICANCE: LISI is a fully crystallized lithium-silicate ceramic and no longer needs to be processed after milling. In addition, the abrasion resistance is very good, regardless of the antagonist material chosen.

Mechanical Properties of High- and Low-Fusing Zirconia Veneering Ceramics Fired on Different Trays and Substrates.

This study aimed to evaluate the effect of ceramic type, firing tray, and firing substrate on the density, shrinkage, biaxial flexural strength, Martens' hardness, and elastic indentation modulus of zirconia veneering ceramics. Disk-shaped specimens were fabricated from a high-fusing (HFZ) and a low-fusing (STR) zirconia veneering ceramic. These specimens were then divided into 10 groups according to firing trays (round, small honeycomb-shaped, cordierite [RSC]; round, large honeycomb-shaped, aluminum oxide [RLA]; rectangular, plane, silicon nitride [RCPS]; round, plane, silicon nitride [RPS]; and rectangular, plane, calcium silicate [RCPC]) and firing substrates (firing cotton and platinum foil) used (n = 12). The density, shrinkage, biaxial flexural strength, Martens' hardness, and indentation modulus were measured, and analyzed with generalized linear model analysis (α = 0.05). The interaction between the ceramic type and firing substrate affected density (p < 0.001), and the other outcomes were affected by the interaction among all main factors (p ≤ 0.045). Higher density was observed with HFZ or platinum foil (p ≤ 0.007). RSC and RLA led to a higher density than RCPS within HFZ and led to the lowest density within STR (p ≤ 0.046). STR had a higher shrinkage (p < 0.001). RSC mostly led to a lower shrinkage of HFZ (p ≤ 0.045). The effect of ceramic type and firing substrates on the biaxial flexural strength, Martens' hardness, and indentation modulus was minimal while there was no clear trend on the effect of firing tray on these properties. Ceramic type, firing tray, and firing substrate affected the mechanical properties of the tested zirconia veneering ceramics. Firing the tested zirconia veneering ceramics over a round and small honeycomb-shaped cordierite firing tray with firing cotton mostly led to improved mechanical properties.

Mechanical and physical properties of splint materials for oral appliances produced by additive, subtractive and conventional manufacturing.

OBJECTIVES: To investigate the flexural strength (FS), elastic modulus (E), Martens hardness (HM), water sorption (wsp), water solubility (wsl) and degree of conversion (DC) of 3D-printed, milled and injection molded splint materials. METHODS: Specimens (N = 1140) were fabricated from five 3D-printed (GR-22 flex, GR-10 guide, ProArt Print Splint clear, V-Print Splint, V-Print Splint comfort), five milled (BioniCut, EldyPlus, ProArt CAD Splint clear, Temp Premium Flexible, Thermeo) and two injection molded (PalaXPress clear, Pro Base Cold) materials. FS, E, HM, wsp, wsl and DC were tested initially (24 h, 37 °C, H2O), after water storage (90 d, 37 °C, H2O) as well as after thermal cycling (5000 thermal cycles, 5/55 °C). Data were analyzed with Kolmogorov-Smirnov, Kruskal- Wallis, Mann-Whitney U test and Spearman's correlation (p < 0.05). RESULTS: Initially, the mean flexural strength values ranged from 1.9 to 90.7 MPa for printed, 3.8 to 107 MPa for milled and 99.7 to 102 MPa for injection molded materials. The initial mean elastic modulus values were 0.0 to 2.4 GPa for printed, 0.1 to 2.7 GPa for milled and 2.8 GPa for injection molded materials. The initial mean Martens hardness values were 14.5 to 126 N/mm2 for printed, 50.2 to 171 N/mm2 for milled and 143 to 151 N/mm2 for injection molded materials. Initially, the mean water sorption values ranged from 23.1 to 41.2 µg/mm3 for printed, 4.5 to 23.5 µg/mm3 for milled and from 22.5 to 23.3 µg/ mm3 for injection molded materials. The initial mean water solubility values ranged from 2.2 to 7.1 µg/mm3 for printed, 0.0 to 0.5 µg/mm3 for milled and 0.1 to 0.3 µg/mm3 for injection molded materials. After water storage and thermal cycling most of the values decreased and some increased. The mean DC values ranged initially from 72.3 to 94.5 %, after water storage from 74.2 to 96.8 % and after thermal cycling from 75.6 to 95.4 % for the printed materials. SIGNIFICANCE: The mechanical and physical properties of printed, milled and injection molded materials for occlusal devices vary and are influenced by aging processes. For clinical applications, materials need to be chosen according to the specific indications.

Dimensional Stability and Reproducibility of Varying FFF Models for Aligners in Comparison to Plaster Models.

To test the impact of FFF filaments, printing parameters, thermoforming foils, repeated thermoforming cycles, and type of jaw on the dimensional stability of FFF models for aligners and to compare them with plaster models, FFF models (maxilla, n = 48; mandible, n = 48) from two filaments (SIMPLEX aligner and Renfert PLA HT, both Renfert GmbH) were fabricated using four printing parameters (one, two, or three loops; four loops acted as the default) and conventional plaster models (n = 12) based on a young, female dentition. All models were thermoformed under pressure three times in total using two different thermoforming foils, namely 0.75 mm × 125 mm Ø aligner foil (CA Pro+ Clear Aligner, Scheu Dental) and 1.0 mm × 125 mm Ø Duran foil (Duran+, Scheu Dental). Aligner foil was heated at 220 °C for 25 s and Duran foil at 220 °C for 30 s. All models were scanned after fabrication as well as after each thermoforming cycle. The obtained STL datasets were analyzed using the local best-fit method (GOM Inspect Pro, Carl Zeiss Metrology GmbH). Data were analyzed using a Kolmogorov-Smirnov-test, a one-way ANOVA with post-hoc Scheffé, and a t-test (p < 0.05). The dimensional stability of the models was most strongly affected by the printing parameters (number of loops; ηp2 = 0.768, p < 0.001) followed by the thermoforming foil used (ηp2 = 0.663, p < 0.001) as well as the type of model (ηp2 = 0.588, p < 0.001). In addition, various interactions showed an influence on the dimensional stability (ηp2 = 0.041-0.386, p < 0.035). SIMPLEX maxillary models (default; four loops), thermoformed using aligner foil, showed higher deformation stability than did plaster models. These initial FFF models provide comparable precision to plaster models, but the dimensional stability of the FFF models, in contrast to that of plaster models, decreases with increasing numbers of thermoforming cycles.