Additive Manufacturing Group Research Articles

Shear bond strength of porcelain to milled and stereolithography additively manufactured zirconia with and without surface treatment: An in vitro study

Statement of problemDelamination of veneering ceramic is one of the most common challenges relating to veneered zirconia restorations. Additive manufacturing (AM) is a fast-expanding technology that has gained widespread acceptance in dentistry and is increasingly being used to produce dental restorations. However, information about bonding of porcelain to AM zirconia is lacking. PurposeThe purpose of this in vitro study was to investigate the shear bond strength (SBS) of porcelain to milled and additively manufactured zirconia, and the effect of surface treatment on bond strength. Material and methodsA Ø12×5-mm disk was designed virtually to fabricate all specimens, which were divided into 2 groups according to the manufacturing technique: additively manufactured or milled zirconia. The effect of airborne-particle abrasion and a zirconia liner before porcelain application was investigated in both groups. Veneering porcelain was fired into an alumina ring mold on the zirconia surface. SBS was measured by using a universal testing machine at a crosshead speed of 1 mm/min before and after aging (n=10). SBS data were analyzed with 3-way ANOVA (α=.05) ResultsA significant difference was found between milled and AM zirconia. The SBS of porcelain to milled zirconia was significantly higher (1.38 MPa) than to AM zirconia (0.68 MPa) (P<.001). The surface treatment of zirconia had no significant effect on porcelain SBS in either group (P=.254), whereas thermocycling significantly reduced the SBS of porcelain to zirconia in both milled and AM groups (P=.001). ConclusionsPorcelain bonding to milled zirconia was better than to AM zirconia. Pretreating the zirconia substrate before porcelain application did not improve the porcelain bond.

Investigating contingent adoption of additive manufacturing in supply chains

PurposeThe purpose of this research is to investigate the contingent adoption of Additive Manufacturing (AM) and propose a typology to evaluate its adoption viability within a firm's supply chain.Design/methodology/approachBy conducting semi-structured interviews of practitioners with deep knowledge of AM and supply chains from diverse industries, this research explores the contingent factors influencing AM adoption and their interaction.FindingsWhile the AM literature is growing, there is a lack of research investigating how contingent factors influence AM adoption. By reviewing the extant literature on the benefits and barriers of AM, we explain the underlying contingencies that enact them. Further, we use an exploratory approach to validate and uncover underexplored contingent factors that influence AM adoption and group them into technological, organizational and strategic factors. By anchoring to a selected set of contingent factors, a typological framework is developed to explain when and how AM is a viable option.Research limitations/implicationsThis study focuses on specific industries such as automotive, machine manufacturing, aerospace and defense. Scholars are encouraged to explore the contextual factors affecting AM adoption in particular industries to expand our findings. The authors also acknowledge that the robustness of their framework can be enhanced by integrating the remaining contingent factors.Practical implicationsThe developed typological framework provides a pathway for practitioners to see how and when AM can be useful in their supply chains.Originality/valueThis is the first paper in the supply chain management literature to synthesize contingent factors and identify some overlooked factors for AM adoption. The research is also unique in explaining the interaction among selected factors to provide a typological framework for AM adoption. This research provides novel insights for managers to understand when and where to adopt AM and the key contingent factors involved in AM adoption.

Accuracy of Additively Manufactured and Milled Interim 3-Unit Fixed Dental Prostheses.

PurposeTo investigate the accuracy of additive manufacturing (AM) by means of internal fit of fixed dental prostheses (FDPs) fabricated with two AM technologies using different resins and printing modes (validated vs nonvalidated) compared to milling and direct manual methods.Material and methodsSixty 3‐unit interim FDPs replacing the first mandibular molar were divided into 6 groups (n = 10): manual (Protemp 4), milled (Telio‐CAD), and AM groups were subdivided based on AM technology (direct light processing (Rapidshape P30 [RS]) and stereolithography (FormLabs 2 [FL])) and the polymer type (P‐Pro‐C&B [St] and SHERAprint‐cb [Sh]) (RS‐St, RS‐Sh, FL‐St, FL‐Sh). Validated (RS‐Sh and RS‐St) or nonvalidated (FL‐St and FL‐Sh) modes were adopted for AM. The specimens were scanned to 3D align (GOM inspect) according to the triple scan method. The internal space between the FDPs and preparation surfaces in four sites (marginal, axial, occlusal, and total) was measured using equidistant surface points (GOM Inspect). Statistical analysis was done using Kruskal Wallis and Dunn post‐hoc tests. (α = 0.05).ResultsOne AM group (FL‐Sh) and milling exhibited better adaptation compared to manual and RS‐St at molar site (p < 0.05). FDPs with St resin (FL‐St and RS‐St) displayed bigger marginal space than milled, FL‐Sh, and RS‐Sh. The nonvalidated printing mode showed better mean space results (p < 0.05) with higher predictability and repeatability (p < 0.001).ConclusionsThe AM interim FDPs tested provided valid alternatives to the milled ones in regard to their accuracy results. The printing mode, resin, and the AM technology used significantly influenced the manufacturing accuracy of interim FDPs, particularly at the marginal area. The nonvalidated printing mode with lower‐cost 3D printers is a promising solution for clinical applications.

Marginal and internal fit of crowns based on additive or subtractive manufacturing

Objective To assess the marginal and internal fit of crowns manufactured by additive and subtractive manufacturing technique. Materials and Methods Twenty extracted teeth prepared for complete coverage crowns were scanned with an intra-oral scanner (Omnicam, DentsplySirona). For the subtractive manufacturing (SM) group, ten crowns were manufactured in a hybrid resin block (Vita Enamic, Vita Zahnfabrik). For the additive manufacturing (AM) group, the crowns were manufactured in a hybrid resin material (NextDent C&B, 3D systems). The design parameters were identical for the two groups. The marginal and internal fit (determined at the axial wall, the cusp tip and occlusally) was assessed before cementation with the replica technique and after cementation under stereomicroscope after sectioning of the crowned teeth. Results For the SM group, the marginal fit was 91 µm (±28 µm) before cementation and 85 µm (±18 µm) after cementation. In the AM group, the marginal fit was 75 µm (±29 µm) before cementation and 71 µm (±18 µm) after cementation. The differences were not statistically significant. As regards the internal fit, the fit at the axial wall was statistically significantly better in the SM group than in the AM group (p=.009 before cementation and .03 after cementation). Occlusally the fit in the AM group was significantly better than in the SM group after cementation (p<.001). Conclusion Within the limitations of the current study, the marginal fit of additively manufactured crowns is comparable to crowns manufactured with chair-side subtractive technique and within the clinically acceptable range. As regards the internal fit no one technique was consistently superior.

Chemical composition, surface roughness, and ceramic bond strength of additively manufactured cobalt-chromium dental alloys

Statement of problemSelective laser melting (SLM) additive manufacturing (AM) technology is a current option to fabricate cobalt-chromium (Co-Cr) metal frameworks for dental prostheses. However, the Co-Cr alloy composition, surface roughness, and ceramic bond strength values that SLM metals can obtain are not well-defined. PurposeThe purpose of this in vitro study was to compare the chemical composition, surface roughness, and ceramic shear bond strength of the milled and SLM Co-Cr dental alloys. Material and methodsA total of 50 disks of 5 mm in diameter and 1 mm in thickness were fabricated by using subtractive (control group) and AM with each of following SLM providers: SLM-1 (EOS), SLM-2 (3D systems), and SLM-3 (Concept Laser). The milled disks were airborne-particle abraded with 100-μm aluminum oxide particles. All the specimens were cleaned before surface roughness (Ra), weight (Wt%), and atomic (At%) percentages were analyzed. Three-dimensional profilometry was used to analyze the topographical properties of the surface parameters Ra (mean surface roughness). The chemical composition of Co-Cr alloy specimens was determined by using energy dispersive X-ray (EDAX) elemental analysis in a scanning electron microscope (SEM). Thereafter, the specimens were bonded to a ceramic (Dentine A3 and Enamel S-59; Creation CC) interface. Specimens were stored for 24 hours at 23 °C. The bond strength of the SLM-ceramic interface was measured by using the macroshear test (SBT) method (n=10). Adhesion tests were performed in a universal testing machine (1 mm/min). The Shapiro-Wilk test revealed that the chemical composition data were not normally distributed. Therefore, the atomic (At%) and weight percentages (Wt%) were analyzed by using the Kruskal-Wallis test, followed by pairwise Mann-Whitney U tests between the control and AM groups (AM-1 to AM-4). However, the Shapiro-Wilk test revealed that the surface roughness (Ra) and ceramic bond strength data were normally distributed. Therefore, data were analyzed by using 1-way ANOVA, followed by the post hoc Sidak test (α=.05). ResultsSignificant differences were obtained in Wt%, At%, and Ra values among the Co-Cr alloys evaluated (P<.05). Furthermore, the control group revealed significantly lower mean ±standard deviation Ra values (0.79 ±0.11 μm), followed by AM-3 (1.57 ±0.15 μm), AM-2 (1.80 ±0.43 μm), AM-1 (2.43 ±0.34 μm), and AM-4 (2.84 ±0.27 μm). However, no significant differences were obtained in the metal-ceramic shear bond strength among the different groups evaluated, ranging from mean ±standard deviation 75.77 ±11.92 MPa to 83.65 ±12.21 MPa. ConclusionsCo-Cr dental alloys demonstrated a significant difference in their chemical compositions. Subtractive and additive manufacturing procedures demonstrated a significant influence on the surface roughness of the Co-Cr alloy specimens. However, the metal-ceramic shear bond strength of Co-Cr alloys was found to be independent of the manufacturing process.

Discrepancy at the implant abutment-prosthesis interface of complete-arch cobalt-chromium implant frameworks fabricated by additive and subtractive technologies before and after ceramic veneering

Statement of problemSelective laser melting additive manufacturing (AM) technologies can be used to fabricate complete-arch cobalt-chromium (Co-Cr) implant-supported prostheses. However, the discrepancy at the implant-prosthesis interface with these fabrication techniques and after ceramic veneering remains unclear. PurposeThe purpose of the present in vitro investigation was to measure the discrepancy at the implant abutment-prosthesis interface before and after the ceramic veneering of frameworks fabricated by using subtractive and selective laser melting AM technologies. Material and methodsA completely edentulous cast with 6 implant abutment replicas (Multi-unit Abutment RP Replicas; Nobel Biocare Services AG) was prepared. A total of 20 Co-Cr frameworks were fabricated using subtractive or computer numerical control milling (CNC group) and additive (AM group) technologies (n=10). A coordinate measurement machine was used to measure the linear and angular discrepancy at the implant abutment-prosthesis interface. Subsequently, a ceramic veneer was applied to each framework following the same standardized protocol. A bonding layer (Chromium-Cobalt Bonding; Bredent), 2 opaquer layers (Powder opaque and liquid UF; Creation CC), a layer of dentin ceramic (Dentine A3; Creation CC), a layer of enamel ceramic (Enamel S-59; Creation CC), and a glaze layer (Glaze paste and Liquid GL; Creation CC) were applied following the manufacturer’s firing protocol. Coordinate measurement machine assessment was repeated to measure the linear and angular discrepancies after ceramic veneering procedures. Data were analyzed by using the Wilcoxon signedrank and Mann-Whitney U tests (α=.05). ResultsNo statistically significant differences (P>.05) were demonstrated in assessing the discrepancies at the implant abutment-prosthesis interface between the groups except for the XZ angle of the CNC group (P<.05). Ceramic techniques produced significantly higher linear and angular discrepancies in both groups (P<.001) with a mean ±standard deviation increase in the 3-dimensional gap of 36.9 ±15.6 μm in the CNC group and 38.9 ±16.6 μm in the AM group. The AM group presented significantly higher discrepancy in the x-axis than the CNC group (P<.001). ConclusionsManufacturing procedures did not significantly influence the discrepancy at the implant abutment-prosthesis interface, which was significantly increased after ceramic veneering, except for the XZ angle of the CNC group. The differences between the discrepancies at the implant abutment-prosthesis interface before and after ceramic application revealed no significant discrepancies among the groups, except in the AM group that presented a significantly higher discrepancy on the x-axis compared with the CNC group.

Flexural strength and Weibull characteristics of stereolithography additive manufactured versus milled zirconia

Statement of problemZirconia restorations can be processed by using stereolithography additive manufacturing (AM) technologies. However, whether additive manufactured zirconia could achieve flexural strength values comparable with those of milled zirconia is unclear. PurposeThe purpose of this in vitro study was to compare the flexural strength and Weibull characteristics of milled and additive manufactured zirconia. Material and methodsA total of 40 zirconia bars (25×4×1.2 mm) were obtained by using 2 manufacturing procedures, subtractive (CNC group) (IPS e.max ZirCAD; Ivoclar Vivadent AG) and additive manufacturing (AM group) (3DMix ZrO2; 3DCeram) technologies and assigned to 2 subgroups according to accelerating artificial aging procedures (mastication simulation): nonaged and aged (n=10). Flexural strength was measured in all specimens by using 3-point bend tests according to ISO/CD 6872.2 with a universal testing machine (Instron Model 8501; Instron Corp). Two-parameter Weibull distribution values, including the Weibull modulus, scale (m), and shape (0) were calculated. Flexural strength values were analyzed by using 2-way ANOVA and Student t statistical tests (α=.05). ResultsThe manufacturing procedure (P<.001), the mastication simulating aging procedure (P<.001), and the interaction between them (P<.001) significantly affected flexural strength values. The CNC group exhibited statistically higher flexural strength values than those in the AM group when the specimens were tested before performing an aging procedure (P<.001) and after mastication simulation (P<.001). Moreover, mastication simulation produced a significant reduction in flexural strength for both the CNC group (P<.039) and the AM group (P<.001). ConclusionsThe manufacturing process reported a significant effect on the flexural strength of the zirconia material tested. Mastication simulation as a means of accelerating artificial aging resulted in the significantly decreased flexural strength values of milled and additively manufactured zirconia material, with the Weibull moduli being significantly higher for the milled groups versus the milled specimens.

Accuracy of the Implant Replica Positions on the Complete Edentulous Additive Manufactured Cast.

To compare the implant replica position accuracy on a duplicated complete edentulous maxillary implant definitive cast made either using conventional procedures or material jetting additive manufacturing (AM) technology using a coordinate measuring machine (CMM). A complete edentulous maxillary cast with 6 implant replicas was prepared. The definitive cast was duplicated using two manufacturing procedures namely conventional (CNV group) and additive manufacturing procedures (AM group). On the CNV, an AM Co-Cr framework and a custom AM custom tray with a polyether impression material were used to obtain an impression of the definitive cast at room temperature (23°C). On the AM group, the definitive cast was digitized using a laboratory scanner. The standard tessellation language (STL) file was exported and used to manufacture the polymeric AM specimens using a multijet printer following manufacturer´s recommendations. A new digital implant replica was located on each corresponding housing of each AM specimen. A total of 10 specimens per group was obtained. A CMM was selected to measure the position of each implant replica on the definitive cast, CNV, and AM specimens. Linear and angular discrepancies were computed for each specimen. Thus, the Mann Whitney U test was used to analyze the data (p = 0.05). There was no significant difference in x-, y-, and z- linear and XZ angular discrepancy between both groups. However, the AM group revealed a significantly higher median YZ angular discrepancy than the CNV group (p = 0.007). Material jetting AM technology demonstrated no significant difference in trueness and precision values of the linear and angular implant replica positions when compared to the conventional technique.

Internal and marginal discrepancies associated with stereolithography (SLA) additively manufactured zirconia crowns

Statement of problemStereolithography (SLA) additive manufacturing (AM) technologies can be selected to fabricate zirconia crowns; however, the internal and marginal discrepancies associated with these new technologies remain unclear. PurposeThe purpose of this in vitro study was to measure and compare the marginal and internal discrepancies of milled and AM zirconia crowns by using the silicone replica technique. Material and methodsAn implant custom abutment was manufactured and scanned by using a laboratory scanner (CARES Software; Institut Straumann AG). An anatomic contour crown was digitally designed, and the standard tessellation language (STLC) file was obtained. The STLC file was splinted into 2 pieces, simulating the parts of the crown that would replace the enamel (STLG1 file) and dentin (STLG2 file) structures. Three groups were determined: anatomic contour zirconia milled (CNC group), AM anatomic contour zirconia (AM group), and AM splinted zirconia (SAM group). For the CNC group, the STLC file was used to manufacture milled (CARES zirconium-dioxide crown; Institut Straumann AG) zirconia specimens. For the AM group, the STLC file was used to additively fabricate (CERAMAKER 900; 3DCeram Co) the zirconia (3DMix ZrO2 paste; 3DCeram Co) specimens. For the SAM group, the STLG2 file was selected to AM (CERAMAKER 900; 3DCeram Co) the zirconia (3DMix ZrO2 paste; 3DCeram Co) specimens. Ten specimens per group were manufactured. The silicone replica technique was used to measure the marginal and internal discrepancies. The cement gap was measured on images captured by using a digital microscope at ×100 magnification. For the internal gap, 50 measurements were made for each specimen, and for the marginal gap, 25 measurements were made for each specimen. The normality test, Shapiro-Wilk test, was conducted. The results indicated that the distributions were not normal; therefore, nonparametric Kruskal-Wallis H and pairwise Mann-Whitney U-tests were used to analyze the data. The Spearman correlation coefficient was used to determine the correlation between marginal and internal discrepancies in all 3 groups. ResultsSignificant differences were found in marginal and internal discrepancies among the groups. The CNC group had the least marginal and internal discrepancies compared with the AM and SAM groups. The SAM group had significantly lower values for marginal and internal discrepancies than the AM group. The AM group showed the highest marginal and internal discrepancies. The CNC group had a weak correlation coefficient of 0.13 (P=.046), the AM group had a moderate correlation coefficient of 0.32 (P<.001), and the SAM group had a nonsignificant correlation coefficient of 0.12 (P=.051). ConclusionsCNC and SAM groups had clinically acceptable marginal and internal discrepancies, while the AM group had a clinically unacceptable marginal and internal crown discrepancies. Furthermore, a weak correlation was encountered between the marginal and internal discrepancies measured in all groups.

Color dimensions of additive manufactured interim restorative dental material

Statement of problemInterim dental restorations can be fabricated by using additive manufacturing (AM) technologies. Although dental restoration contours can be easily and accurately fabricated by using computer-aided design (CAD) procedures, protocols for creating predictable color dimensions of AM interim restorations are lacking. PurposeThe purpose of this in vitro study was to measure and compare color dimensions of different AM and conventional interim restorative materials. Material and methodsDisks (N=420) were fabricated by using either conventionally (CNV group) or additively manufactured (AM group) materials. The CNV group was further divided into the subgroups CNV-1 (Protemp 4; 3M ESPE) and CNV-2 (Anaxdent new outline dentin; Anaxdent). AM subgroups included AM-1 (FreePrint temp; Detax), AM-2 (E-Dent 400; Envisiontec), AM-3 (NextDent C&B; NextDent), AM-4 (NextDent C&B MFH; NextDent), and AM-5 (Med620 VEROGlaze; Stratasys). Color measurements in the CIELab coordinates were made by using a spectrophotometer (VITA EasyShade Advance 4.0; VITA) with a standardized photography gray card as a background under room light conditions (1003 lux). Color difference (ΔE*) values were calculated by using the CIE76 and CIEDE2000 formulas. The data were analyzed by using the Kruskal-Wallis test with nonparametric pairwise comparisons. ResultsOwing to a software error, the spectrophotometer was unable to measure the color of any specimens in the AM-5 subgroup, which was consequently excluded from further analysis. Significant differences (P=.001) between 2 manufacturing groups were found based on the L* variable. All subgroups were significantly different from each other for all 3 variables (P<.001). Pairwise comparisons revealed that all groups were significantly different from each other, except for the AM-1 and AM-2 subgroups, compared with the CNV-1 subgroup for the L* color dimension. The ΔE* values calculated by using the CIE76 formula varied from 6.63 to 23.1 and by using the CIEDE2000 formula from 3.43 to 10.21, suggesting a perceptible and unacceptable color mismatch between the CNV and AM groups. ConclusionsNone of the additively manufactured interim materials tested matched the conventional interim materials in all 3 CIELab color dimensions.

Evaluation of marginal and internal gap of three-unit metal framework according to subtractive manufacturing and additive manufacturing of CAD/CAM systems

PURPOSETo evaluate the fit of a three-unit metal framework of fixed dental prostheses made by subtractive and additive manufacturing.MATERIALS AND METHODSOne master model of metal was fabricated. Twenty silicone impressions were made on the master die, working die of 10 poured with Type 4 stone, and working die of 10 made of scannable stone. Ten three-unit wax frameworks were fabricated by wax-up from Type IV working die. Stereolithography files of 10 three-unit frameworks were obtained using a model scanner and three-dimensional design software on a scannable working die. The three-unit wax framework was fabricated using subtractive manufacturing (SM) by applying the prepared stereolithography file, and the resin framework was fabricated by additive manufacturing (AM); both used metal alloy castings for metal frameworks. Marginal and internal gap were measured using silicone replica technique and digital microscope. Measurement data were analyzed by Kruskal-Wallis H test and Mann-Whitney U-test (α=.05).RESULTSThe lowest and highest gaps between premolar and molar margins were in the SM group and the AM group, respectively. There was a statistically significant difference in the marginal gap among the 3 groups (P<.001). In the marginal area where pontic was present, the largest gap was 149.39 ± 42.30 µm in the AM group, and the lowest gap was 24.40 ± 11.92 µm in the SM group.CONCLUSIONThree-unit metal frameworks made by subtractive manufacturing are clinically applicable. However, additive manufacturing requires more research to be applied clinically.