Biomechanical Behavior of a 3D-Printed Denture Base Material.

PURPOSE: To evaluate relevant material properties (flexural strength [σf], elastic modulus [E], water sorption [Wsp] and solubility [Wsl], and biocompatibility) of an additive manufacturing (AM) polymer vs a heat-curing acrylic resin (AR; control) for the manufacture of complete dentures, testing the hypothesis that fabrications from both materials would present acceptable material properties for clinical use. MATERIALS AND METHODS: The σf, E, Wsp, and Wsl were evaluated according to the ISO 20795-1:2013 standard, and the biocompatibility was evaluated using MTT and SRB assays. Disk-shaped specimens were fabricated and used for Wsp (n = 5), Wsl (n = 5), and biocompatibility (n = 3) testing. For assessment of σf and E, bar-shaped specimens (n = 30) were fabricated and stored in 37°C distilled water for 48 hours or 6 months before flexural testing in a universal testing machine with a constant displacement rate (5 ± 1 mm/minute). Data from σf, E, Wsp, Wsl, and biocompatibility tests were statistically analyzed using Student t test (α = .05). Weibull analysis was also used for σf and E data. RESULTS: Significant differences between the two materials were found for the evaluated material properties. Water storage for 6 months did not affect the flexural strength of the AM polymer, but this material showed inadequate σf and Wsl values. CONCLUSIONS: Despite adequate biocompatibility and strength stability after 6 months of water storage, the AM polymer recommended for complete dentures needs further development to improve the material properties evaluated in this study.

Biomechanical behavior of a 3D-printed denture base material.

PURPOSE: To evaluate relevant material properties (flexural strength (σf), elastic modulus (E), water sorption (Wsp) and solubility (Wsl), and biocompatibility) of a 3D-printed resin (3D) and a heat cured acrylic resin (AR-control) used for complete denture manufacturing, testing the hypothesis that constructs from both materials would present acceptable material properties for clinical use. MATERIALS AND METHODS: The σf, E, Wsp and Wsl were evaluated according to the ISO 20795-1:2013 standard, and the biocompatibility was evaluated using 3-4,5-dimethyl-thiazol-2-yl-2.5-diphenyltetrazolium bromide (MTT) and sulforhodamine B (SRB) assays. Disk-shaped specimens were fabricated and used for Wsp (n = 5), Wsl (n = 5), and biocompatibility (n = 3). Bar-shaped specimens (n = 30) were fabricated and stored in 37° C distilled water for 48 hours and 6 months before flexural testing in a universal testing machine with constant displacement rate (5 ± 1 mm/min) until fracture. Data from σf, E, Wsp, Wsl and biocompatibility were statistically analyzed using Student t test (α= 0.05), Weibull analysis was also used for σf and E data. RESULTS: Significant differences between the two polymers were found for the evaluated material properties. Water storage for 6 months did not affect the flexural strength of 3D. Yet, the additive manufactured polymer showed inadequate flexural strength and water solubility values. CONCLUSION: Despite adequate biocompatibility and strength stability after 6 months of water storage, the additive manufactured polymer recommended for complete denture needs further development to improve the remaining material properties evaluated in this study.

Biomechanical properties of a 3D printing polymer for provisional restorations and artificial teeth.

OBJECTIVES: To characterize a resin-based polymer used for 3D printing (3D) provisional restorations and artificial teeth by evaluating relevant material's properties (flexural strength (σf), elastic modulus (E), water sorption (Wsp) and solubility (Wsl)) and biocompatibility, and comparing to a bis-acryl composite resin (BA) and a heat-cured acrylic resin (AR). METHODS: Structures were fabricated from 3D, BA and AR. Bar-shaped specimens (n = 30) were submitted to three-point flexure (in 37ºC water and constant displacement rate: 1 ± 0.3 mm/min) until fracture to calculate σf and E. Additional specimens (n = 30) were aged in 37ºC distilled water for six months before testing for σf. Disc-shaped specimens (n = 5) were dried in desiccators and oven until weight stability was reached, then they were immersed in distilled water for seven days, weighed and submitted to the drying process to obtain Wsp and Wsl. SRB and MTT assays were used to evaluate biocompatibility. Data were statistically analyzed using Kruskal Wallis, Student-Newman-Keuls (α = .05), and Weibull distribution. ANOVA and Tukey (α = .05) were used to evaluate the biocompatibility data. RESULTS: 3D structures showed higher σf than AR after aging. The BA showed the lowest values for σf and E, at baseline and after aging. All materials showed Wsp and Wsl values within the recommended standard values. AR structures showed lower cell viability (71.9%) than 3D (92.9%) and BA (90.8%) when using the SRB test. No difference was found when using MTT (p > .05). SIGNIFICANCE: The evaluated polymer-based 3D printing material showed adequate biomechanical behavior for using as a provisional restoration and artificial teeth.

3D printing restorative materials using a stereolithographic technique: a systematic review.

OBJECTIVE: To present through a systematic review a qualitative analysis of studies published on stereolithography-based 3D printing of restorative materials and their clinical applicability. METHODS: The literature search was conducted based on the question: "What is the state-of-the-art of available restorative materials for 3D printing based on stereolithography?" Online search was conducted in three databases (MEDLINE/PubMed, Scopus and Web of Science) with no restriction for year of publication. Data are reported based on PRISMA, including publication details such as authors and their countries, year and journal of publication, and study design. The synthesis is focused on describing the dental restorative materials and properties evaluated, applied methods, 3D printers used and clinical applicability. RESULTS: Studies that fit the inclusion criteria were performed in Asia (21), Europe (16) and USA (10), mostly using polymer-based restorative materials (38) for 3D printing constructs. Stereolithographic-printed ceramic-based restorative structures were evaluated by 9 studies. Many studies reported on dimensional accuracy (14), strength (11) and surface morphology (9) of the printed structures. Antibacterial response, cytotoxicity, internal and marginal fit, fracture and wear resistance, density, viscosity, elastic modulus, hardness, structural shrinkage and reliability, degree of conversion, layer cure depth, fatigue, and color were also evaluated by the included studies. Many of them (11) published a proof of concept as an attempt to demonstrate the clinical feasibility and applicability of the technology to print restorative materials, but only 5 studies actually applied the 3D printed restorative structures in patients, which highlights an increasing interest but limited early-stage translation. SIGNIFICANCE: The fast expansion of stereolithographic-based 3D printing has been impressive and represents a great technological progress with significant disruptive potential. Dentistry has demonstrated an incredible willingness to adapt materials, methods and workflows to this promising digital technology. However, esthetic appearance, wear resistance, wet strength and dimensional accuracy are the main current clinical limitations restricting the progression to functional part production with 3D printing, which may explain the absence of clinical trials and reports on permanent/definitive dental restorative materials and structures.