Fatigue resistance of 3D printed anatomic post-and-core after mastication simulation.

STATEMENT OF PROBLEM: Rigid post-and-core systems have traditionally been used in the restoration of endodontically treated teeth and are regarded by many as the standard treatment. Flexible materials, including nanoceramic resins, are being increasingly implemented as post-and-core systems, but data supporting their use are lacking. PURPOSE: The purpose of this in vitro study was to compare the fatigue resistance of conventional cast metal and nanoceramic 3-dimensionally (3D) printed resin post-and-core systems with teeth without posts. MATERIAL AND METHODS: Thirty freshly extracted human maxillary premolars were endodontically treated and divided into 3 subgroups (n=10) according to the restorative procedure: cast metal post-and-core (CM), nanoceramic 3D printed resin post-and-core (3DR), and without a post (0P). The CM post-and-core group was fabricated conventionally, while the 3DR group was printed using a 3D resin printing material. For the 0P group, the teeth were restored with a composite resin foundation after root canal obturation. Complete coverage 3-mol% monolithic zirconia restorations were cemented on all specimens. The specimens were exposed to simultaneous mastication simulation (1.2 million cycles) and thermocycling (10 000 cycles at 5 ºC to 55 ºC) and analyzed based on the failure of specimens. Data were analyzed using the Kruskal-Wallis survival analysis and the Wilcoxon rank sum test (α=.05). RESULTS: The Kruskal-Wallis test indicated statistically significant differences among the cycles needed to reach failure for each of the 3 groups (P<.001). At 1.2 million cycles, there were no CM failures. The 3DR group failed at a median value of 950 000 cycles, while the 0P group failed at a median value of 222 500 cycles (P<.001). CONCLUSIONS: All the endodontically treated teeth that received CM survived the 1 200 000 simulated mastication cycles. Both 3DR and 0P specimens fractured at the crown cervical third during mastication simulation.

Evaluation of surface roughness of differently manufactured denture base materials.

STATEMENT OF PROBLEM: The popularity of computer-aided design and computer-aided manufacturing (CAD-CAM) dentures has led to the introduction of new denture materials and resins. However, studies on the surface characteristics of these materials and how they compare to dentures fabricated by more traditional methods are lacking. PURPOSE: The purpose of this cross-sectional study was to determine whether the surface roughness (Ra) of denture base materials differed based on manufacturing technique. MATERIAL AND METHODS: Disks of Ø10×2-mm (n=10) were fabricated using 6 different manufacturing techniques, including compression molding (Lucitone 199), injection molding (Ivocap High Impact), Computer Numerical Control (CNC) milling (Ivotion Base), and additive manufacturing on the Carbon M2 (Lucitone Digital Print), the SprintRay Pro55 S (Dentca Denture Base II), and the Envision One (Flexcera Base) systems. An automatic, noncontact laser confocal microscope (VK-X1000 Series; KEYENCE) was used to analyze the Ra surface roughness of each specimen at ×5 magnification. The images were imported into a multifile analyzer, horizontal and vertical roughness profiles were inserted into each scan, and Ra values were calculated and averaged by following the International Organization for Standardization (ISO) 4287 standard. A 1-way analysis of variance (ANOVA) was performed to compare the effect of manufacturing technique on surface roughness, followed by the Tukey multiple comparisons test (α=.05). RESULTS: The additively manufactured Dentca Denture Base II (AM-DB) exhibited a statistically significantly higher Ra when compared with the other test groups (P<.001). The additively manufactured Flexcera Base (AM-FB) showed a higher Ra mean value when compared with injection molding (IM) (P=.036). No statistically significant difference in surface roughness was found among the other tested materials representing the different processing methods (P>.05). CONCLUSIONS: The manufacturing method influences the Ra of denture base materials with varying results. The injection molding method resulted in the smoothest surface compared with additively manufactured and CNC-milled denture base materials.

Effect of simulated toothbrushing on the surface roughness of LOCATOR abutments: An in vitro study.

STATEMENT OF PROBLEM: Studies evaluating the effect of toothbrushing and toothpaste abrasivity on the surface roughness of LOCATOR abutments are lacking. PURPOSE: The purpose of this in vitro study was to compare the surface roughness of LOCATOR abutments before and after simulated toothbrushing with different toothpastes to make recommendations for the home care of patients with LOCATOR abutments. MATERIAL AND METHODS: LOCATOR bone-level overdenture abutments (N=36) were analyzed with a confocal laser scanning microscope (Keyence VK-X1100) at ×5 magnification. Surface scans were made to determine the degree of surface roughness (Ra). Two toothpastes of different abrasivity (Colgate Total and Crest ProHealth) and deionized water were used as the brushing media (n=12). Each toothpaste was mixed with water in a 1:2 ratio. The abutments were brushed using soft nylon toothbrushes for 30 000 cycles in a ZM-3.12 toothbrushing simulator, which has been interpreted as 3 years of regular use. All specimens were then reanalyzed under the microscope. Changes in surface texture were compared by using a repeated measures analysis of variance (ANOVA) statistical test and a pairwise Sídák multiple comparisons test (α=.05). RESULTS: The mean surface roughness value of LOCATOR abutments at baseline ranged between 1.34 µm and 1.35 µm. After 30 000 cycles of toothbrushing simulation, the mean value increased to 1.62 µm (DI water, P=.001), 1.74 µm (Colgate Total, P<.001), and 2.03 µm (Crest ProHealth, P<.001). All brushing media resulted in a statistically significant increase in surface roughness (P<.001). CONCLUSIONS: LOCATOR abutments demonstrated significant increases in surface roughness after being subjected to toothbrushing, regardless of the brushing medium. Whitening toothpaste caused significantly more surface roughness than nonabrasive toothpaste and deionized water. Deionized water resulted in the lowest increase in surface roughness.

Performance and efficacy of a recently introduced diamond rotary instrument: Cutting, surface preparation, and cleanability.

STATEMENT OF PROBLEM: Evaluation of the cutting efficiency and effectiveness, surface roughness, and cleanability of a novel rotary instrument is lacking. PURPOSE: The purpose of this in vitro study was to compare the cutting efficiency and effectiveness of a recently introduced diamond rotary instrument containing corundum microspheres with conventional instruments by evaluating the heat generated, surface roughness, and cleanability of each instrument after tooth preparations. MATERIAL AND METHODS: Sound molars (n=225) were used to evaluate cutting efficiency and effectiveness by measuring the heat generated by 3 diamond dental rotary instruments: test instrument (TI), reference instrument (RI), and NTI instrument (NI). Thirty cavity preparations (27 mm3) were prepared, and the thermal change (ΔT) was determined from a thermocouple inserted in the pulp chamber. The surface roughness of the dentin substrate was determined after veneer preparations using scanning white-light interferometry and scanning electron microscope imaging. The cleanability of TI and RI was also determined by comparing the efficacy of 3 conventional disinfection protocols after contaminating the instrument with Gram-positive or Gram-negative oral pathogens. The mean and standard deviation values for thermal change, surface roughness, and colony forming units were calculated at a 95% confidence level, and 1-way ANOVA was used to determine statistical significance (α=.05). RESULTS: The NI instrument had the lowest mean ΔT (1.47 °C). The TI (1.77 °C) and RI (1.85 °C) groups showed statistically similar means (P>.05). The TI presented the lowest surface roughness (1.68 µm), followed by the RI (1.87 µm) (P<.001). The NI resulted in the highest surface roughness (2.17 µm) (P<.001). The disinfection protocols used were more effective on the TI group than on the RI group regardless of organisms and time exposed to the cleaning solution (P<.001). CONCLUSIONS: The novel diamond instrument demonstrated similar cutting efficiency and effectiveness when compared with conventional diamond instruments. However, the novel instrument produced smoother tooth preparations and was easier to clean than the conventional diamond rotary instruments.