Mudhaffer Shaymaa, Silikas Nick, Satterthwaite Julian
PhD student, Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK.
Full Professor, Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK.
J Prosthet Dent. 2025 May 22. doi: 10.1016/j.prosdent.2025.04.040.
The long-term stability and clinical safety of 3 dimensional (3D) printed dental restorative resins in the oral cavity remains uncertain, despite their increased use.
The purpose of this in vitro study was to evaluate the impact of different printing orientations on the sorption, solubility, and monomer elution of various 3D printed definitive and interim dental restorative resins compared with that of milled resin materials.
Two 3D printed materials for definitive restoration, VarseoSmile Crownplus (VCP) and Crowntec (CT) and 3 for interim restorations, C&B MFH (ND), Dima C&B temp (DT), and GC temp print (GC), were additively manufactured in 3 orientations (0, 45, and 90 degrees). A digital light processing (DLP) 3D printer (ASIGA MAX UV) was used with postprocessing parameters as per the manufacturers' recommendations. Specimens for sorption and solubility (14×14×1 mm) were stored in artificial saliva at 37 °C and measured over a 90-day period (n=6). Specimens used for monomer elution (14×14×2 mm) were stored in a 75% ethanol and water (E/W) solution, and elution was assessed after 1 and 7 days using ultra-high performance liquid chromatography coupled with mass spectrometry (UHPLC/MS) (n=4). Milled materials, Lava Ultimate (LU) and Telio CAD (TC), were used as controls. Multiple way ANOVA, 1-way ANOVA, and Tukey HSD post hoc tests (α=.05) were used to analyze the data.
Printing orientation significantly influenced the sorption and solubility of 3D printed resins (P=.008) but did not influence their monomer elution (P=.774). All materials met the recommended International Organization for Standardization (ISO) 4049 standards for sorption and solubility, except ND, which exceeded the maximum recommended sorption value (57.1 μg/mm). The 3D printed interim materials ND, DT, and GC exhibited greater sorption (27.3-57.1 μg/mm), solubility (2.6-3.6 μg/mm), and monomer elution (53.2-87.4 μmol/L) compared with the definitive materials VCP (9.8-0.9 μg/mm, 50.5 μmol/L) and CT (9.4-0.02 μg/mm, 51.3 μmol/L). All 3D printed resins exhibited lower sorption (9.4-30.1 μg/mm) but significantly higher monomer elution (50.5-87.4 μmol/L) compared with LU (36.1 μg/mm, 7.6 μmol/L), except for ND, which had the highest sorption values (P<.001). TC exhibited sorption values (23.6 μg/mm) that were intermediate between those of the definitive and interim 3D printed materials. Filler weight correlated negatively with sorption (r=.739) and solubility (r=.896) (P<.001) but did not correlate with monomer elution.
Sorption, solubility, and monomer elution were more influenced by the type of material than the printing orientation. Definitive 3D printed materials demonstrated less sorption, solubility, and monomer elution compared with the interim 3D printed materials. All 3D printed resins had greater amounts of eluted residual monomers compared with the milled resin block LU. The 3D printed resins primarily eluted bisphenol A ethoxylate dimethacrylate (bis-EMA) and urethane dimethacrylate (UDMA) monomers, with all concentrations remaining below the cytotoxic levels established in previous studies.
尽管三维（3D）打印牙科修复树脂的使用越来越多，但其在口腔中的长期稳定性和临床安全性仍不确定。
本体外研究的目的是评估不同打印方向对各种3D打印的确定性和临时牙科修复树脂的吸附、溶解性和单体洗脱的影响，并与研磨树脂材料进行比较。
两种用于确定性修复的3D打印材料，VarseoSmile Crownplus（VCP）和Crowntec（CT），以及三种用于临时修复的材料，C&B MFH（ND）、Dima C&B temp（DT）和GC temp print（GC），以三种方向（0、45和90度）进行增材制造。使用数字光处理（DLP）3D打印机（ASIGA MAX UV），并根据制造商的建议设置后处理参数。用于吸附和溶解性测试的样本（14×14×1mm）在37°C的人工唾液中储存，并在90天内进行测量（n = 6）。用于单体洗脱测试的样本（14×14×2mm）储存在75%乙醇和水（E/W）溶液中，并在1天和7天后使用超高效液相色谱-质谱联用（UHPLC/MS）评估洗脱情况（n = 4）。研磨材料Lava Ultimate（LU）和Telio CAD（TC）用作对照。使用多因素方差分析、单因素方差分析和Tukey HSD事后检验（α = 0.05）分析数据。
打印方向显著影响3D打印树脂的吸附和溶解性（P = 0.008），但不影响其单体洗脱（P = 0.774）。除ND超过推荐的最大吸附值（57.1μg/mm）外，所有材料均符合国际标准化组织（ISO）4049关于吸附和溶解性的推荐标准。与确定性材料VCP（9.8 - 0.9μg/mm，50.5μmol/L）和CT（9.4 - 0.02μg/mm，51.3μmol/L）相比，3D打印的临时材料ND、DT和GC表现出更大的吸附（27.3 - 57.1μg/mm）、溶解性（2.6 - 3.6μg/mm）和单体洗脱（53.2 - 87.4μmol/L）。与LU（36.1μg/mm，7.6μmol/L）相比，所有3D打印树脂的吸附较低（9.4 - 30.1μg/mm），但单体洗脱显著更高（50.5 - 87.4μmol/L），除ND具有最高吸附值外（P < 0.001）。TC的吸附值（23.6μg/mm）介于确定性和临时3D打印材料之间。填料重量与吸附（r = 0.739）和溶解性（r = 0.896）呈负相关（P < 0.001），但与单体洗脱无关。
吸附、溶解性和单体洗脱受材料类型的影响大于打印方向。与临时3D打印材料相比，确定性3D打印材料的吸附、溶解性和单体洗脱较少。与研磨树脂块LU相比，所有3D打印树脂的洗脱残留单体量更多。3D打印树脂主要洗脱双酚A乙氧基二甲基丙烯酸酯（bis - EMA）和聚氨酯二甲基丙烯酸酯（UDMA）单体，所有浓度均低于先前研究确定的细胞毒性水平。
