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Statement of problem Polyphenylene sulfone (PPSU) is a thermoplastic that can be processed using 3-dimensional printing. PPSU is new to dentistry, and scientific data on its properties are lacking. Purpose The purpose of this in vitro study was to test the surface properties and the tensile bond strength (TBS) between PPSU and a veneering composite resin in comparison with a polyetheretherketone (PEEK). Material and methods Gehr PPSU (PPSU-B1), Radel R-5000 NT (PPSU-B2), and Juvora Dental Disc (PEEK-CG) substrates were cut from bulk material, while FIL-A-GEHR PPSU (PPSU-3D) was 3-dimensionally printed (N=504, n=126/material). TBS to veneering composite resin (CeramageUp) was tested initially and after 5000 and 10 000 thermocycles, and fracture types were analyzed. Surface free energy (SFE) and surface roughness (Ra) were determined after pretreatment with aluminum oxide (Al2O3) of different grain sizes (50 and 110 μm) applied with different pressures (0.1, 0.2, 0.4 MPa), silicon dioxide (SiO2)-coated Al2O3 (0.28 MPa), sulfuric acid, or polished. Qualitative surface characterization was performed by using a scanning electron microscope (SEM). One-way ANOVA, the Kruskal-Wallis, Mann-Whitney U, and the Spearman correlation tests were computed (α=.05). Results PPSU-3D and PEEK-CG presented higher TBS results than PPSU-B1 and PPSU-B2. Initial TBS values were higher than after 10 000 thermocycles. Adhesive fractures between substrate and veneering composite resin occurred most frequently. With a few exceptions, PEEK-CG presented higher SFE values than all other materials within a pretreatment group, while PPSU-3D and PEEK-CG showed consistently high Ra values. An increase in pressure and particle size increased SFE and Ra. Conclusions FFF-printed PPSU-3D showed similar TBS values with the veneering composite resin to the more established PEEK. Pretreatment methods devised for PEEK represent valid strategies for increasing both the SFE and Ra of the high-performance polymer PPSU.

Objective To investigate the degree of conversion (DC), Martens hardness (HM), elastic indentation modulus (EIT), and biaxial flexural strength (BFS) of six dual-polymerizing resin composite luting materials initially and after 2 and 7 days of aging. Materials and methods Specimens fabricated from Bifix QM (BIF; VOCO), Calibra Ceram (CAL; Dentsply Sirona), DuoCem (DUO; Coltène/Whaledent), G-CEM LinkForce (GCE; GC Europe), PANAVIA V5 (PAN; Kuraray Europe), and Variolink Esthetic DC (VAR; Ivoclar Vivadent) (n = 12 per material) were light-polymerized through 1 mm thick discs (Celtra Duo, Dentsply Sirona). DC, HM, and EIT were recorded directly after fabrication, and after 2 and 7 days of aging. As a final test, BFS was measured. Univariate ANOVAs, Kruskal–Wallis, Mann–Whitney U, Friedman, and Wilcoxon tests, and Weibull modulus were computed (p Results While CAL presented low DC, HM, EIT, and BFS values, DUO and BIF showed high results. Highest Weibull moduli were observed for VAR and DUO. DC and Martens parameters increased between the initial measurement and 2 days of aging, while aging for 7 days provided no further improvement. Conclusions The choice of dual-polymerizing resin composite luting material plays an important role regarding chemical and mechanical properties, especially with patients sensitive to toxicological issues. DUO may be recommended for bonding fixed dental prostheses, as it demonstrated significantly highest and reliable results regarding DC, HM, and BFS. As DC and HM showed an increase in the first 48 h, it may be assumed that the polymerization reaction is not completed directly after initial polymerization, which is of practical importance to dentists and patients. Clinical relevance The chemical and mechanical properties of dual-polymerizing resin composite luting materials influence the overall stability and long-term performance of the restoration.

To investigate the degree of conversion (DC), Martens hardness (HM), elastic indentation modulus (EIT), and flexural strength (FS) of veneering resin composites (SR Nexco Paste (NP), Ceramage Incisal (CI), Gradia Plus (GP); n=60/group) cured with different polymerization devices (bre.Lux Power Unit, Labolight DUO, Otoflash G171, LC-3DPrint Box, PCU LED; n=12/subgroup) after storage. Otoflash G171 and Labolight DUO showed increased DC/HM/EIT. CI presented the lowest DC and highest HM/EIT. NP showed the highest DC and lowest HM/EIT. Within Otoflash G171, Laboligth DUO and PCU LED, highest FS was observed for CI. Storage did not affect DC/HM/EIT for specimens cured with Otoflash G171 or Labolight DUO. With storage not showing an influence on the tested parameters for polymerization devices that otherwise presented superior results, increased storage time cannot be recommended. For the tested resin composites, this study observed a high/low degree of conversion to coincide with respectively low/high amounts of fillers/mechanical properties.

Objectives To examine the retention force of removable dental prosthesis (RDP) clasps made from polyetheretherketone (PEEK) and cobalt-chrome-molybdenum (CoCrMo, control group) after storage in water and artificial aging. Materials and methods For each material, 15 Bonwill clasps with retentive buccal and reciprocal lingual arms situated between the second pre- and first molar were manufactured by milling (Dentokeep [PEEKmilled1], NT digital implant technology; breCAM BioHPP Blank [PEEKmilled2], bredent), pressing (BioHPP Granulat for 2 press [PEEKpressed], bredent), or casting (remanium GM 800+ [CoCrMo], Dentaurum); N = 60, n = 15/subgroup. A total of 50 retention force measurements were performed for each specimen per aging level (initial; after storage [30 days, 37 °C] and 10,000 thermal cycles; after storage [60 days, 37 °C] and 20,000 thermal cycles) in a pull-off test. Data were statistically analyzed using one-way ANOVA, post hoc Scheffé and mixed models (p < 0.05). Results Initial, PEEKpressed (80.2 ± 35.2) and PEEKmilled1 (98.9 ± 40.3) presented the lowest results, while PEEKmilled2 (170.2 ± 51.8) showed the highest values. After artificial aging, the highest retention force was observed for the control group (131.4 ± 56.8). The influence of artificial aging was significantly higher for PEEK-based materials. While PEEKmilled2 and PEEKpressed showed an initial decline in retention force, all other groups presented no impact or an increase in retention force over a repetitive insertion and removal of the clasps. Conclusions Within the tested PEEK materials, PEEKmilled2 presented superior results than PEEKpressed. Although CoCrMo showed higher values after artificial aging, all materials exhibited sufficient retention to recommend usage under clinical conditions. Clinical relevance As RDPs are still employed for a wide range of indications, esthetic alternatives to conventional CoCrMo clasps are sought.

Objectives To investigate the retention force of polyetheretherketone (PEEK) removable dental prosthesis clasps in comparison with a cobalt-chrome-molybdenum control group after storage in artificial saliva. Materials and Methods Clasps were milled (Dentokeep (PEEKmilled1), NT digital implant technology; breCAM BioHPP Blank (PEEKmilled2), bredent), pressed (BioHPP Granulat for 2 press (PEEKpressed), bredent), or cast (remanium GM 800+ (cobalt-chrome-molybdenum), Dentaurum); N = 60, n = 15/subgroup. Retention force was examined 50 times/specimen in a pull-off test using the universal testing machine (Zwick 1445), where pull-off force was applied with a crosshead speed of 5 mm/minute until the maximum force dropped by 10%, at different aging levels: (1) initial, after storage in artificial saliva for (2) 90 and (3) 180 days. Statistical analysis was performed using one-way ANOVA followed by post hoc Scheffé-test and mixed models (p < 0.05). Results Cobalt-chrome-molybdenum presented the highest retention force. No differences were observed between polyetheretherketone materials. Cobalt-chrome-molybdenum showed a significant decrease of its values after artificial aging, while polyetheretherketone materials presented similar results over the course of aging. Regarding a repetitive insertion and removal, even though PEEKmilled2 and cobalt-chrome-molybdenum showed an initial increase, ultimately, a decrease in retention force was observed for all tested groups. Conclusions Although the control group showed significantly higher results, the retention force of polyetheretherketone materials indicate a potential clinical application. Neither the manufacturing process nor artificial aging showed an impact on the retention force of polyetheretherketone clasps. Clinical relevance Mechanical properties of novel removable dental prosthesis clasp materials devised to meet the growing esthetic demands of patients need to be investigated to ensure a successful long-term clinical application.

Purpose To investigate the impact of high-speed sintering and artificial aging on the fracture load of three-unit zirconia fixed dental prostheses (FDPs). Materials and methods Three-unit FDPs manufactured from 3Y-TZP (Ceramill Zolid, Amann Girrbach) and 4Y-TZP (Ceramill Zolid HT+, Amann Girrbach; N = 128, n = 64/group) were sintered at 1,580°C (high-speed sintering) or at 1,450°C (control group; n = 32/subgroup). Specimens were bonded to steel abutment models using Multilink Automix (Ivoclar Vivadent), and fracture load was examined without (n = 16/subgroup) and with artificial aging (6,000 thermocycles [5°C/55°C] and 1,200,000 chewing cycles [50 N]; n = 16/subgroup). Univariate analysis of variance, unpaired t test, and Weibull modulus were computed (P Results Sintering protocol (P = .944), artificial aging (P = .630), and zirconia material (P = .445) did not show an influence on the fracture load of three-unit FDPs. High-speed sintering led to superior Weibull modulus results for artificially aged 4Y-TZP specimens, while all other groups showed values in the same range. Conclusion The present study shows promising results for the novel high-speed sintering protocol, as it led to comparable fracture load and similar, or even superior, Weibull modulus results compared to the control group. The 4Y-TZP material presented fracture load results similar to the tried-and-tested 3Y-TZP. Artificial aging did not influence zirconia's resistance to fracture for either 3Y-TZP or 4Y-TZP.

In the seminal field of 3D printing of dental restorations, the time and cost saving manufacturing of removable and fixed dental prostheses from thermoplastic polymer materials employing fused filament fabrication (FFF) is gaining momentum. As of today, the additive manufacturing of the established semi-crystalline polyetheretherketone (PEEK) requires extensive post-processing and lacks precision. In this context, the amorphous polyphenylene sulfone (PPSU) may provide a higher predictability and reliability of the results. The aim of this study was to investigate the mechanical properties of PPSU and PEEK processed by FFF (PPSU1-3D (PPSU Radel) and PPSU2-3D (Ultrason P 3010 NAT)) or extrusion (PPSU1-EX (Radel R-5000 NT) and PEEK-CG (PEEK Juvora)). Three-point flexural strength, two-body wear, and Martens hardness (HM) and indentation modulus (EIT) were tested after aging. One-way ANOVA, the Kruskal-Wallis and the Pearson's and Spearman's correlation tests were computed (α = 0.05). PPSU1-3D and PPSU2-3D showed lower flexural strength values than PPSU1-EX and PEEK-CG. PPSU1-3D showed the highest, and PEEK-CG and PPSU1-EX the lowest height loss. The highest HM and EIT results were observed for PEEK-CG and the lowest for PPSU1-3D. Correlations were observed between all parameters except for the application height. In conclusion, the manufacturing process affected the flexural strength of PPSU, with 3D printed specimens presenting lower values than specimens cut from prefabricated molded material. This finding indicates that the 3D printing parameters employed for the additive manufacturing of PPSU specimens in the present investigation require further optimization. For 3D printed specimens, the quality of the filament showed an impact on the mechanical properties, underlining the importance of adhering to high quality standards during filament fabrication. Extruded PPSU led to comparable results with PEEK for flexural strength and two-body wear, indicating this novel dental restorative material to be a suitable alternative to the established PEEK for the manufacturing of both removable and fixed dental prostheses.

PURPOSE To investigate the fracture load of different veneers for monolithic single-unit fixed dental prostheses (FDPs) made of a novel potential framework material, polyphenylene sulfone (PPSU). MATERIALS AND METHODS The fracture loads of four PPSU frameworks with different veneers (manual polymer veneer with Ceramage Body A3B; prefabricated polymer veneer with Novo.lign; digital polymer veneer with Telio CAD; digital ceramic veneer with IPS Empress CAD) and a monolithic control group (PPSU, Gehr) were examined initially and after 1,200,000 masticatory (50 N, 1.3 Hz) and 6,000 thermal cycles (5°C/55°C). Fracture analysis was performed using light microscope imaging. Fracture types were classified, and relative frequencies were determined. Univariate analysis of variance, post hoc Scheffe, partial eta squared, Kruskal-Wallis test, and Weibull moduli using the maximum likelihood estimation method were calculated. The defined level of significance was adjusted by Bonferroni correction (P < .005). RESULTS Aging did not affect the fracture load values. Single-unit FDPs with a digital ceramic veneer showed lower values than monolithic and manual polymer-veneer specimens. Single-unit FDPs with a prefabricated and digital polymer veneer were in the same value range as specimens with a manual polymer and digital ceramic veneer. No differences were observed between manual polymer veneer and monolithic single-unit FDPs. All veneered specimens showed a fracture of the veneer. For monolithic single-unit FDPs, a plastic deformation was observed. CONCLUSION Veneered and monolithic PPSU showed sufficient fracture load values to indicate successful clinical use in single-unit FDPs. The choice of veneering method and material may play a minor role.

Objectives To investigate the edge chipping resistance (ECR) of six veneering composite resins after different treatment protocols. Materials and methods Rectangular bar specimens were manufactured from Ceramage Incisal (CER; Shofu), dialog Vario Occlusal (DIA; Schutz Dental), Gradia Plus Heavy Body Enamel (GRA; GC Europe), in:joy incisal (INJ; Dentsply Sirona Deutschland), SR Nexco Paste Incisal (SRN; Ivoclar Vivadent), and Signum composite enamel (SIG; Kulzer). ECR was determined after five treatment protocols: (1) no treatment, (2) after storage in distilled water at 37 °C for 7 days, (3) storage in distilled water with an additional 10 000 thermal cycles (5 °C/55 °C), and hydrothermal treatment at 134 °C at a water vapor pressure of 0.2 MPa for a duration of (4) 3.5 min or (5) 23.5 min. Force was applied with the universal testing machine ZHU 0.2 (Zwick Roell) mounted with a Vickers diamond indenter until the chip fractured off the specimen and ECR values were computed by dividing the applied maximum force by the distance to the center of the applied force. Fracture analysis was performed employing light microscope imaging. Univariate and one-way ANOVA, Scheffe and Tukey-B post hoc, and partial eta squared (ƞp2) were computed (p Results DIA presented consistently high ECR values, while CER showed low results. For some groups, seven days’ storage in water and hydrothermal treatment for 3.5 min led to higher ECR results than observed in the initial state, while an additional 10 000 thermal cycles and hydrothermal treatment for 23.5 min resulted in lower ECR values. Conclusions The examined veneering composite resins differed in regard to their mechanical properties, with DIA possessing the highest resistance to chipping. While post-processing can initially increase a material's edge chipping resistance, intensified treatment protocols reduced the mechanical properties of veneering composite resins.