Laurino Fernando Antonio Reis, Cesar Paulo Francisco, Romano Marcelo Munhóes, Ritter André Vicente, Sadr Alireza
University of São Paulo, School of Dentistry, Department of Stomatology, São Paulo, Brazil; Department of Restorative Dentistry, University of Washington, 1959 NE Pacific St., Seattle, WA 98195, USA.
University of São Paulo, School of Dentistry, Department of Dental Materials, São Paulo, Brazil.
Dent Mater. 2025 Aug 1. doi: 10.1016/j.dental.2025.07.014.
This study assessed the wear resistance of 3D-printed CAD/CAM composites using optical coherence tomography (OCT). OCT is a non-destructive and clinically applicable imaging technique that enables real-time and precise measurement of wear volume and subsurface changes without radiation exposure. The 3D-printed composites C&B MFH, VarseoSmile CrownPlus, and Nanolab 3D were compared to the CAD/CAM composite milling block, Lava Ultimate, to determine whether their wear resistance was comparable to or exhibited significantly more significant material loss than the CAD/CAM block under cyclic loading in a chewing simulator.
Specimens of the three 3D-printed CAD/CAM composites-C&B MFH, VarseoSmile CrownPlus, and Nanolab 3D-were designed as disks, 3D-printed or milled, then cleaned and polished before undergoing cyclic loading in a chewing simulator for 600,000 cycles. OCT analysis was used to measure wear extent and subsurface crack score. Statistical analysis was performed using one-way ANOVA and Kruskal-Wallis tests with post-hoc Bonferroni comparisons.
Significant differences in wear resistance and crack development were observed among the composites. Lava Ultimate and C&B MFH exhibited the highest wear resistance (0.7 ± 0.4 mm³ and 0.7 ± 0.2 mm³), while Nanolab 3D had the lowest and significantly different wear resistance (1.7 ± 0.8 mm³, p = 0.004). VarseoSmile CrownPlus showed intermediate volume loss (1.0 ± 0.7 mm³) with no significant difference from Nanolab 3D (p = 0.2). For vertical wear extent, Lava Ultimate (215.6 ± 40 μm) and C&B MFH (310 ± 107 μm) had significantly lower wear than Nanolab 3D (546 ± 143 μm, p < 0.001), while VarseoSmile CrownPlus (396 ± 131 μm) was not significantly different from Nanolab 3D (p = 0.8). A similar pattern was observed for cracks, with Lava Ultimate showing significantly different from the 3D-printed composites (p < 0.001). Nanolab 3D exhibited the highest crack formation, showing a significant difference compared to all other materials (p < 0.001), while no significant difference was found between C&B MFH and VarseoSmile CrownPlus (p = 0.5).
In conclusion, the 3D-printed CAD/CAM composites demonstrated varying performance under cyclic loading, comparable or inferior to the CAD/CAM block, with OCT proving useful for evaluating composite wear resistance.
本研究使用光学相干断层扫描（OCT）评估3D打印的CAD/CAM复合材料的耐磨性。OCT是一种无损且临床适用的成像技术，能够在无辐射暴露的情况下实时精确测量磨损体积和表面下变化。将3D打印的复合材料C&B MFH、VarseoSmile CrownPlus和Nanolab 3D与CAD/CAM复合铣削块Lava Ultimate进行比较，以确定在咀嚼模拟器的循环加载下，它们的耐磨性是否与CAD/CAM块相当，或者是否表现出明显更多的材料损失。
将三种3D打印的CAD/CAM复合材料——C&B MFH、VarseoSmile CrownPlus和Nanolab 3D——的样本设计为圆盘，进行3D打印或铣削，然后在咀嚼模拟器中进行600,000次循环的循环加载之前进行清洁和抛光。使用OCT分析来测量磨损程度和表面下裂纹评分。使用单因素方差分析和Kruskal-Wallis检验以及事后Bonferroni比较进行统计分析。
在复合材料之间观察到耐磨性和裂纹发展的显著差异。Lava Ultimate和C&B MFH表现出最高的耐磨性（0.7±0.4mm³和0.7±0.2mm³），而Nanolab 3D的耐磨性最低且有显著差异（1.7±0.8mm³，p = 0.004）。VarseoSmile CrownPlus显示出中等体积损失（1.0±0.7mm³），与Nanolab 3D无显著差异（p = 0.2）。对于垂直磨损程度，Lava Ultimate（215.6±40μm）和C&B MFH（310±107μm）的磨损明显低于Nanolab 3D（546±143μm，p < 0.001），而VarseoSmile CrownPlus（396±131μm）与Nanolab 3D无显著差异（p = 0.8）。在裂纹方面观察到类似的模式，Lava Ultimate与3D打印的复合材料有显著差异（p < 0.001）。Nanolab 3D表现出最高的裂纹形成，与所有其他材料相比有显著差异（p < 0.001），而C&B MFH和VarseoSmile CrownPlus之间未发现显著差异（p = 0.5）。
总之，3D打印的CAD/CAM复合材料在循环加载下表现出不同的性能，与CAD/CAM块相当或较差，OCT被证明可用于评估复合材料的耐磨性。
