The flexural strength of 3D-printed provisional restorations fabricated with different resins: a systematic review and meta-analysis.

BACKGROUND: Three-dimensional (3D) printing technology has revolutionized dentistry, particularly in fabricating provisional restorations. This systematic review and meta-analysis aimed to thoroughly evaluate the flexural strength of provisional restorations produced using 3D printing while considering the impact of different resin materials. METHODS: A systematic search was conducted across major databases (ScienceDirect, PubMed, Web of Sciences, Google Scholar, and Scopus) to identify relevant studies published to date. The inclusion criteria included studies evaluating the flexural strength of 3D-printed provisional restorations using different resins. Data extraction and quality assessment were performed using the CONSORT scale, and a meta-analysis was conducted using RevMan 5.4 to pool results. RESULTS: Of the 1914 initially identified research articles, only 13, published between January 2016 and November 2023, were included after screening. Notably, Digital Light Processing (DLP) has emerged as the predominant 3D printing technique, while stereolithography (SLA), Fused Deposition Modeling (FDM), and mono-liquid crystal displays (LCD) have also been recognized. Various printed resins have been utilized in different techniques, including acrylic, composite resins, and methacrylate oligomer-based materials. Regarding flexural strength, polymerization played a pivotal role for resins used in 3D or conventional/milled resins, revealing significant variations in the study. For instance, SLA-3D and DLP Acrylate photopolymers displayed distinct strengths, along with DLP bisacrylic, milled PMMA, and conventional PMMA. The subsequent meta-analysis indicated a significant difference in flexure strength, with a pooled Mean Difference (MD) of - 1.25 (95% CI - 16.98 - 14.47; P < 0.00001) and a high I2 value of 99%, highlighting substantial heterogeneity among the studies. CONCLUSIONS: This study provides a comprehensive overview of the flexural strength of 3D-printed provisional restorations fabricated using different resins. However, further research is recommended to explore additional factors influencing flexural strength and refine the recommendations for enhancing the performance of 3D-printed provisional restorations in clinical applications.

Influence of Light-Curing Glaze and Chlorhexidine Gluconate in the Acrylic Resin Properties: An in situ Study.

This in-situ study aimed to evaluate the chromatic stability, microhardness, and surfacefree energy of chemically activated acrylic resin (CAAR) samples. Eighty CAAR samples were made and each volunteer (n = 20) received two palatal plates with two sides of groups (without and with glaze application). The samples were exposed to two conditions: the control condition (sucrose 30%) and the test condition (sucrose 30% and 0.12% chlorhexidine). The volunteers used the first palatal device (control condition) for seven days and the second palatal device (test condition) for another seven days, with a seven-day break between them. Then, the ΔΕ00, microhardness, and surface-free energy tests were performed. Analysis of Variance and the Tukey test were used (α = 0.05). The control group with glaze showed higher ΔΕ00 compared to the group without the glaze. The test group with glaze had less ΔΕ00 than their respective controls. In both periods, when the glaze was applied, higher microhardness values were found for all groups. Groups with glaze showed lower roughness and higher surface-free energy than groups without the glaze. The values obtained in this study were satisfactory, showing the clinical efficacy of glaze and the use of 0.12% CH for maintaining the physical and mechanical properties of CAAR.

Effect of glaze and chlorhexidine on physical and mechanical properties of bis-acryl resin: An in situ study.

BACKGROUND: Temporary prosthesis protects the oral tissues, in addition to providing aesthetic look and masticatory function until a definitive prosthesis is manufactured. OBJECTIVES: To evaluate the effect of glaze and 0.12% chlorhexidine (CHX) on the physical and mechanical properties of bis-acryl, and to evaluate the antimicrobial efficacy of CHX. MATERIAL AND METHODS: Eighty specimens of bis-acryl resin were made. Over 40 of them the glaze was applied. One specimen with and 1 specimen without glaze were placed in niches of an appliance manufactured for each patient. Each of the 20 volunteers received 2 devices. Initially, the volunteers used one device and treated it with sucrose for 7 days (control), and later they used the other device and treated it with sucrose and CHX for 7 days (test). Color, microhardness, roughness, surface energy, and insoluble extracellular polysaccharides (EPS) tests were performed. All results were submitted to the Tukey's test, with the exception of the EPS results, which were submitted to the Student's t test. RESULTS: The ΔE00 of the unglazed control group was significantly higher than that of the unglazed test group. In all groups, a significant decrease in microhardness occurred over time. At both times, the glaze significantly increased the microhardness of the specimens (in all the glazed groups). At the final time, the test glaze group showed significantly higher microhardness compared with the control glaze group. Roughness in the groups without glaze increased significantly with CHX treatment over time. At both times, the glaze generated a significant reduction in roughness in the control and test groups. There was a significant reduction in surface energy over time in all groups. In most comparisons, the glazed groups showed significantly higher surface energy values compared with the unglazed control group. At the final time point, the unglazed test group showed a significantly higher surface energy value than the unglazed control group; and the glazed test group showed a significantly higher surface energy value compared with the glazed control group. The resins that received CHX had a significantly lower amount of biofilm. CONCLUSIONS: Color values were clinically acceptable in all tested groups. At both time points, the roughness values were clinically acceptable only in the glazed groups. Glaze increased the microhardness of the specimens. Microhardness and surface energy were reduced over time in all groups. Chlorhexidine can help prevent microhardness degradation. Glaze and CHX can increase surface energy. Chlorhexidine reduced the amount of bacterial biofilm.

Comparative Evaluation of Mechanical Properties and Color Stability of Dental Resin Composites for Chairside Provisional Restorations.

Resin composites have become the preferred choice for chairside provisional dental restorations. However, these materials may undergo discoloration, changes in surface roughness, and mechanical properties with aging in the oral cavity, compromising the aesthetics, functionality, and success of dental restorations. To investigate the color and mechanical stability of chairside provisional composite resins, this study evaluated the optical, surface, and mechanical properties of four temporary restoration resin materials before and after aging, stimulated by thermal cycling in double-distilled water. Measurements, including CIE LAB color analysis, three-point bending test, nanoindentation, scanning electron microscopy (SEM), and atomic force microscopy (AFM), were conducted (n = 15). Results showed significant differences among the materials in terms of optical, surface, and mechanical properties. Revotek LC (urethane dimethacrylate) demonstrated excellent color stability (ΔE00 = 0.53-Black/0.32-White), while Artificial Teeth Resin (polymethyl methacrylate) exhibited increased mechanical strength with aging (p < 0.05, FS = 68.40 MPa-non aging/87.21 MPa-aging). Structur 2 SC (Bis-acrylic) and Luxatemp automix plus (methyl methacrylate bis-acrylate) demonstrated moderate stability in optical and mechanical properties (Structur 2 SC: ΔE00 = 1.97-Black/1.38-White FS = 63.20 MPa-non aging/50.07 MPa-aging) (Luxatemp automix plus: ΔE00 = 2.49-Black/1.77-White FS = 87.72 MPa-non aging/83.93 MPa-aging). These results provide important practical guidance for clinical practitioners, as well as significant theoretical and experimental bases for the selection of restorative composite resins.

Comparison of marginal and internal adaptation of provisional polymethyl methacrylate restorations fabricated by two three-dimensional printers: An in vitro study.

Background: Chairside fabrication of provisional restorations using three-dimensional (3D) printers is rising in digital dentistry. The purpose of this research was to compare the marginal and internal adaptation of provisional polymethyl methacrylate (PMMA) restorations fabricated by two different 3D printers. Materials and Methods: In this in vitro investigation, an intact maxillary 1st molar acrylic model was first digitalized by a laboratory scanner. It was then prepared for an all-ceramic restoration and scanned again by the same scanner. The final restoration was designed in Exocad according to the scan files with a 50 µm cement gap. PMMA restorations were printed by two 3D printers; Group 1: Asiga (n = 10) and Group 2: Digident (n = 10). The replica technique was used to assess the marginal and internal fit of the restorations, and one-way ANOVA was used to analyze the data. P <0.05 was regarded as statistically significant. Results: The mean marginal gap of crowns in Group 1 was significantly lower than that of Group 2 (75 vs. 195 µm, P = 0.001). Regarding internal adaptation, no significant difference was found between the axial gap values in both groups (P > 0.05). The mean occluso-axial gap (90 vs. 140 µm, P = 0.026) and the mean occlusal gap (116 vs. 300 µm, P = 0.001) of crowns in Group 1 were significantly smaller compared to the equivalent values in Group 2. Conclusion: Provisional PMMA crowns fabricated by the Asiga printer showed significantly higher marginal and internal adaptation than those manufactured by Digident at all points except for the axial surface.

Marginal and internal fit and fracture resistance of three-unit provisional restorations fabricated by additive, subtractive, and conventional methods.

OBJECTIVES: To compare the marginal and internal fit and fracture resistance of three-unit provisional fixed dental prostheses (FDPs) fabricated by additive, subtractive, and conventional methods. MATERIAL AND METHODS: Eighty 3-unit FDPs were fabricated on metal dies of the maxillary right second premolar and second molar by four different techniques (n = 20): The direct method by using autopolymerizing polymethyl methacrylate (PMMA), indirect method by the compression molding technique, subtractive manufacturing by using PMMA blocks, and additive manufacturing by using digital light processing technology. The adaptation of restorations at the marginal, axial, cuspal, and fossa areas was assessed by using the silicone replica technique. After thermocycling and cyclic loading, the fracture resistance was measured by a universal testing machine. Data were analyzed by a two-way analysis of variance (ANOVA), ANOVA, and Tukey test (α = .05). RESULTS: The mean gap measured in the additive group was lower than that in all other groups at all points (p < .05); however, the difference in the marginal gap with the subtractive group was not significant (p = .995). The mean marginal and axial gaps in the subtractive group were significantly lower than the corresponding values in both conventional groups (p < .05). A significant difference existed between all groups regarding the mean cuspal and fossa gaps (p < .05). The mean fracture resistance of the additive group was significantly higher than that of indirect (p = .018) and direct (p < .001) groups, and the fracture resistance of the subtractive group was significantly higher than that of the direct group (p = .020). CONCLUSION: The digitally fabricated provisional FDPs showed superior marginal and internal fit and higher fracture resistance than the conventionally fabricated FDPs. Between the digital methods, the additive technique yielded superior internal fit.

Assessment of Coronal Leakage with Two Intracanal Medicaments After Exposure to Human Saliva-An In Vitro Study.

INTRODUCTION: One among the various reasons for root canal failure in endodontics is the leakage of an intracanal medicament due to improper coronal sealing. AIM: To assess the coronal leakage of two intracanal medicaments sealed with two different temporary filling materials. MATERIALS AND METHODS: An in-vitro study was done on 55 teeth where they were divided into three groups with two root canal medicaments namely calcium hydroxide + 0.2% chlorhexidine solution, triple antibiotic paste, and a control group. These three groups were restored temporarily with MD Temp and IRM, and these samples were checked for coronal leakage after 30 days. RESULTS: The group, triple antibiotic paste with IRM stayed for more number of days without leakage with the mean of 24.5 days, followed by group triple antibiotic paste with MD Temp. The least coronal leakage was seen in group MD Temp without Intracanal medicament with the mean of eight and half days followed by group IRM without Intracanal medicament. When comparing the two temporary filling materials without any medicament, there was no significant difference between the same. When comparing within MD Temp group, the least microleakage was seen with Triple antibiotic paste with MD Temp. In the IRM group, the least microleakage was seen with Triple antibiotic paste with IRM. CONCLUSION: Triple antibiotic paste was found to be the most promising intracanal medicament with an appropriate seal. CLINICAL SIGNIFICANCE: The best intracanal medicament, which is triple antibiotic paste in the present study could prevent microorganism leakage and inhibit bacterial growth.How to cite this article: Balaji S, Kumar K, Venkatesan R, Krishnamoorthy S, Manoharan V, Marimuthu S. Assessment of Coronal Leakage with Two Intracanal Medicaments After Exposure to Human Saliva-An In Vitro Study. Int J Clin Pediatr Dent., 2018;11(5):406-411.