Accuracy of CAD/CAM-fabricated bite splints: milling vs 3D printing.

OBJECTIVES: The aim of this study was to investigate the accuracy of CAD/CAM-fabricated bite splints in dependence of fabrication method (milling vs 3D printing), positioning (horizontal vs vertical), selection of material, and method of deviation measurement. MATERIALS AND METHODS: Bite splints were 3D-printed in either horizontal or vertical position (n = 10) using four different resins (Dental LT, Ortho Clear, Freeprint Splint, V-Splint). As control, ten bite splints were fabricated by CNC milling (ProArt CAD Splint). The splints were scanned and deviations between the CAD-file (trueness) and between each other within one group (precision) were measured by two different software applications and methods (cloud-to-cloud vs cloud-to-mesh). Data were analyzed using univariate analysis, Kolmogorov-Smirnov, Kruskal-Wallis, and Mann-Whitney U tests. RESULTS: The highest impact on accuracy was exerted by the selection of the material (trueness: ηP2 = 0.871, P < 0.001; precision: ηP2 = 0.715, P < 0.001). Milled splints showed the highest trueness (P < 0.01) but not the highest precision at the same time. Horizontally positioned 3D-printed bite splints showed the least deviations in terms of trueness while vertical positioning resulted in the highest precision. The cloud-to-cloud method showed higher measured deviations than the other methods (P < 0.001-P = 0.002). CONCLUSION: Milled splints show higher trueness than 3D-printed ones, while the latter reveal higher reproducibility. The calculated deviations vary according to the measurement method used. CLINICAL RELEVANCE: In terms of accuracy, milled and 3D-printed bite splints seem to be of equal quality.

Synergistic effects of H2O2 with components of dental restorative materials on gluconeogenesis in rat kidney tubules.

No data are available about (toxic) effects of dental materials administered in combination with H(2)O(2) from dental bleaching compounds. The effect of dental composite components triethyleneglycoldimethacrylate (TEGDMA) and hydroxyethylmethacrylate (HEMA) as well as mercuric chloride (HgCl(2)) and methylmercury chloride (MeHgCl), each in combination with H(2)O(2), was investigated on gluconeogenesis in kidney cells. From rats kidney tubules were prepared. Every 10 min up to 60 min 1-ml samples were drawn from the cell suspension for quantitating the glucose content. Glucose formation in controls was 3.5+/-0.3 nmol/mg.per min (mean+/-SEM, n=21). Relative rates of glucose formation were obtained by expressing individual rates as percentage of the corresponding control. X-Y concentration curves (effective concentration, EC) of the substances were calculated by fitting a four-parametric sigmoid function to the relative rates of the glucose formation at various test concentrations. At the end of the incubation period cell viability was assessed by trypan blue exclusion. Cell viability decreased within the 60 min interval from 90% to approx. 80% (controls), <25 (HEMA), <20 (TEGDMA), <20 (H(2)O(2)) <10 (MeHgCl), and <10 (HgCl(2)). Values of 50% effective concentration (EC(50)) were calculated from fitted curves. EC(50) values were (mmol/l; mean+/-SEM; n=4): HEMA, 17.2+/-2.8; TEGDMA, 1.9+/-0.2; H(2)O(2) 0.22+/-0.03, MeHgCl, 0.016+/-0.0005; and HgCl(2), 0.0017+/-0.0005. No significant decrease of the EC(50) values was found when kidney cells were exposed to HEMA, HgCl(2), or MeHgCl in addition with H(2)O(2) (1-100 microM), compared to those EC(50) values of each compound without H(2)O(2) addition. A significant decrease of the TEGDMA EC(50) values to about 0.25 or 0.04 (mmol/l) was found when cells were exposed to TEGDMA in combination with H(2)O(2) (75 or 100 microM), compared to that TEGDMA EC(50) value without H(2)O(2) addition. The addition of H(2)O(2) (75 and 100 microM) resulted in a synergistic toxic effect of TEGDMA.