Dimensional accuracy and simulation-based optimization of polyolefins and biocopolyesters for extrusion-based additive manufacturing and steam sterilization.

Polyolefins exhibit robust mechanical and chemical properties and can be applied in the medical field, e.g. for the manufacturing of dentures. Despite their wide range of applications, they are rarely used in extrusion-based printing due to their warpage tendency. The aim of this study was to investigate and reduce the warpage of polyolefins compared to commonly used filaments after additive manufacturing (AM) and sterilization using finite element simulation. Three types of filaments were investigated: a medical-grade polypropylene (PP), a glass-fiber reinforced polypropylene (PP-GF), and a biocopolyester (BE) filament, and they were compared to an acrylic resin (AR) for material jetting. Square specimens, standardized samples prone to warpage, and denture bases (n = 10 of each group), as clinically relevant and anatomically shaped reference, were digitized after AM and steam sterilization (134 °C). To determine warpage, the volume underneath the square specimens was calculated, while the deviations of the denture bases from the printing file were measured using root mean square (RMS) values. To reduce the warpage of the PP denture base, a simulation of the printing file based on thermomechanical calculations was performed. Statistical analysis was conducted using the Kruskal-Wallis test, followed by Dunn's test for multiple comparisons. The results showed that PP exhibited the greatest warpage of the square specimens after AM, while PP-GF, BE, and AR showed minimal warpage before sterilization. However, warpage increased for PP-GF, BE and AR during sterilization, whereas PP remained more stable. After AM, denture bases made of PP showed the highest warpage. Through simulation-based optimization, warpage of the PP denture base was successfully reduced by 25%. In contrast to the reference materials, PP demonstrated greater dimensional stability during sterilization, making it a potential alternative for medical applications. Nevertheless, reducing warpage during the cooling process after AM remains necessary, and simulation-based optimization holds promise in addressing this issue.

Influence of sterilization on the retention forces of lithium disilicate and polymer-infiltrated ceramic-network crowns bonded to titanium base abutments: An in-vitro study.

OBJECTIVES: The aim of this study was to evaluate the effect of sterilization on the retention forces of lithium disilicate (LD) and polymer-infiltrated ceramic network (PICN) crowns bonded to titanium base (Ti-base) abutments. MATERIALS AND METHODS: Forty LD and 40 PICN crowns were milled and then bonded to 80 Ti-bases with two resin composite cements: Multilink Hybrid Abutment (mh) and Panavia V5 (pv) for a total of 8 groups (n = 10). Half of the specimens (test) underwent an autoclaving protocol (pressure 1.1 bar, 121°C, 20.5 min) and the other half not (control). Restorations were screw-retained to implants, and retention forces (N) were measured with a pull-off testing machine. The surfaces of the Ti-bases and the crowns were inspected for the analysis of the integrity of the marginal bonding interface and failure mode. Student's t-test, chi-square test, and univariate linear regression model were performed to analyze the data (α = 0.05). RESULTS: The mean pull-off retention forces ranged from 487.7 ± 73.4 N to 742.2 ± 150.3 N. Sterilized groups showed statistically significant overall higher maximum retention forces (p < .05), except for one combination (LD + mh). Sterilization led to an increased presence of marginal gaps and deformities compared to no-sterilization (p < .001), while no statistically significant relationship was found between failure mode and sterilization (p > .05). CONCLUSIONS: Sterilization may have a beneficial effect on the retention forces of LD and PICN crowns bonded to titanium base abutments, although it may negatively influence the integrity of the marginal bonding interface.

Accuracy of additively manufactured and steam sterilized surgical guides by means of continuous liquid interface production, stereolithography, digital light processing, and fused filament fabrication.

Different printing technologies can be used for prosthetically oriented implant placement, however the influence of different printing orientations and steam sterilization remains unclear. In particular, no data is available for the novel technology Continuous Liquid Interface Production. The objective was to evaluate the dimensional accuracy of surgical guides manufactured with different printing techniques in vertical and horizontal printing orientation before and after steam sterilization. A total of 80 surgical guides were manufactured by means of continuous liquid interface production (CLIP; material: Keyguide, Keyprint), digital light processing (DLP; material: Luxaprint Ortho, DMG), stereolithography (SLA; Surgical guide, Formlabs), and fused filament fabrication (FFF; material: Clear Base Support, Arfona) in vertical and horizontal printing orientation (n = 10 per subgroup). Spheres were included in the design to determine the coordinates of 17 reference points. Each specimen was digitized with a laboratory scanner after additive manufacturing (AM) and after steam sterilization (134 °C). To determine the accuracy, root mean square values (RMS) were calculated and coordinates of the reference points were recorded. Based on the measured coordinates, deviations of the reference points and relevant distances were calculated. Paired t-tests and one-way ANOVA were applied for statistical analysis (significance p < 0.05). After AM, all printing technologies showed comparable high accuracy, with an increased deviation in z-axis when printed horizontally. After sterilization, FFF printed surgical guides showed distinct warpage. The other subgroups showed no significant differences regarding the RMS of the corpus after steam sterilization (p > 0.05). Regarding reference points and distances, CLIP showed larger deviations compared to SLA in both printing orientations after steam sterilization, while DLP manufactured guides were the most dimensionally stable. In conclusion, the different printing technologies and orientations had little effect on the manufacturing accuracy of the surgical guides before sterilization. However, after sterilization, FFF surgical guides exhibited significant deformation making their clinical use impossible. CLIP showed larger deformations due to steam sterilization than the other photopolymerizing techniques, however, discrepancies may be considered within the range of clinical acceptance. The influence on the implant position remains to be evaluated.