In-Vitro Evaluation of the Mechanical Properties of Posterior Adhesive Restorations Fabricated Using Three Different Techniques

Project no. 32594 · Status: Kapanmış (Yayın bekleniyor) · 2025

Summary

<p><strong>Objective:&nbsp;</strong>The&nbsp;primary&nbsp;objective&nbsp;of&nbsp;this&nbsp;study&nbsp;is&nbsp;to&nbsp;evaluate&nbsp;the&nbsp;optical&nbsp;properties&nbsp;of&nbsp;adhesive&nbsp;restorations&nbsp;fabricated&nbsp;using&nbsp;different&nbsp;methods&nbsp;for&nbsp;the&nbsp;treatment&nbsp;of&nbsp;single&nbsp;tooth&nbsp;loss&nbsp;in&nbsp;the&nbsp;posterior&nbsp;region&nbsp;after&nbsp;an&nbsp;aging&nbsp;process&nbsp;and&nbsp;to&nbsp;assess&nbsp;their&nbsp;mechanical&nbsp;durability.&nbsp;The&nbsp;secondary&nbsp;objective&nbsp;is&nbsp;to&nbsp;investigate&nbsp;the&nbsp;effect&nbsp;of&nbsp;static&nbsp;and&nbsp;dynamic&nbsp;intraoral&nbsp;chewing&nbsp;forces&nbsp;on&nbsp;fracture&nbsp;resistance&nbsp;using&nbsp;the&nbsp;Finite&nbsp;Element&nbsp;Stress&nbsp;Analysis&nbsp;(FESA)&nbsp;method.</p><p><strong>Materials&nbsp;and&nbsp;Methods:&nbsp;</strong>This&nbsp;study&nbsp;utilized&nbsp;120&nbsp;extracted&nbsp;human&nbsp;teeth,&nbsp;consisting&nbsp;of&nbsp;30&nbsp;mandibular&nbsp;premolars&nbsp;and&nbsp;30&nbsp;mandibular&nbsp;molars&nbsp;for&nbsp;posterior&nbsp;restorations&nbsp;and&nbsp;also&nbsp;30&nbsp;maxillary&nbsp;canines&nbsp;and&nbsp;30&nbsp;maxillary&nbsp;central&nbsp;incisors&nbsp;for&nbsp;anterior&nbsp;restorations.&nbsp;The&nbsp;extracted&nbsp;teeth&nbsp;were&nbsp;grouped&nbsp;into&nbsp;pairs&nbsp;(one&nbsp;molar&nbsp;-&nbsp;blank&nbsp;-&nbsp;one&nbsp;premolar&nbsp;/&nbsp;one&nbsp;canine&nbsp;–&nbsp;blank&nbsp;–&nbsp;one&nbsp;central)&nbsp;according&nbsp;to&nbsp;their&nbsp;positions&nbsp;in&nbsp;the&nbsp;dental&nbsp;arch&nbsp;and&nbsp;embedded&nbsp;in&nbsp;acrylic&nbsp;blocks&nbsp;with&nbsp;their&nbsp;coronal&nbsp;parts&nbsp;exposed.&nbsp;To&nbsp;simulate&nbsp;periodontal&nbsp;tissues,&nbsp;a&nbsp;silicone&nbsp;impression&nbsp;material&nbsp;was&nbsp;used.&nbsp;The&nbsp;teeth&nbsp;were&nbsp;randomly&nbsp;assigned&nbsp;to&nbsp;one&nbsp;of&nbsp;three&nbsp;groups&nbsp;based&nbsp;on&nbsp;the&nbsp;fabrication&nbsp;technique&nbsp;used&nbsp;for&nbsp;restoration.</p><p>-&nbsp;Group&nbsp;1&nbsp;(3B):&nbsp;Restorations&nbsp;fabricated&nbsp;using&nbsp;a&nbsp;three-dimensional&nbsp;(3D)&nbsp;dental&nbsp;printer&nbsp;(n=10).&nbsp;The&nbsp;teeth&nbsp;were&nbsp;scanned&nbsp;using&nbsp;an&nbsp;intraoral&nbsp;scanner&nbsp;(Trios&nbsp;3,&nbsp;3Shape,&nbsp;Denmark)&nbsp;and&nbsp;digitally&nbsp;uploaded.&nbsp;The&nbsp;restorations&nbsp;were&nbsp;designed&nbsp;using&nbsp;a&nbsp;computer-aided&nbsp;design&nbsp;program&nbsp;(DWOS,&nbsp;DentalWings,&nbsp;Montreal&nbsp;QC,&nbsp;Canada)&nbsp;and&nbsp;then&nbsp;fabricated&nbsp;with&nbsp;a&nbsp;3D&nbsp;dental&nbsp;printer&nbsp;using&nbsp;a&nbsp;resin&nbsp;material&nbsp;(VarseoSmile&nbsp;Crown&nbsp;Plus;&nbsp;BEGO,&nbsp;Bremen,&nbsp;Germany).</p><p>-&nbsp;Group&nbsp;2&nbsp;(FO):&nbsp;Restorations&nbsp;fabricated&nbsp;using&nbsp;fiber&nbsp;mesh&nbsp;and&nbsp;direct&nbsp;composite&nbsp;(n=10).&nbsp;In&nbsp;this&nbsp;group,&nbsp;a&nbsp;fiber&nbsp;mesh&nbsp;scaffold&nbsp;(Interlig,&nbsp;Angelus,&nbsp;Brazil)&nbsp;was&nbsp;used,&nbsp;onto&nbsp;which&nbsp;a&nbsp;flowable&nbsp;composite&nbsp;(Charisma&nbsp;Flow,&nbsp;Heraeus&nbsp;Kulzer,&nbsp;Hanau,&nbsp;Germany)&nbsp;and&nbsp;adhesive&nbsp;(Gluma&nbsp;Universal&nbsp;Bond,&nbsp;Heraeus&nbsp;Kulzer,&nbsp;Hanau,&nbsp;Germany)&nbsp;were&nbsp;applied.&nbsp;The&nbsp;restorations&nbsp;were&nbsp;completed&nbsp;with&nbsp;a&nbsp;direct&nbsp;composite&nbsp;(Charisma&nbsp;Smart,&nbsp;Heraeus&nbsp;Kulzer,&nbsp;Hanau,&nbsp;Germany).</p><p>-&nbsp;Group&nbsp;3&nbsp;(IK):&nbsp;Restorations&nbsp;fabricated&nbsp;using&nbsp;the&nbsp;indirect&nbsp;composite&nbsp;technique&nbsp;(n=10).&nbsp;In&nbsp;this&nbsp;group,&nbsp;a&nbsp;freehand&nbsp;indirect&nbsp;composite&nbsp;technique&nbsp;was&nbsp;applied&nbsp;using&nbsp;Signum&nbsp;(Heraeus&nbsp;Kulzer,&nbsp;Hanau,&nbsp;Germany).</p><p>Following&nbsp;restoration,&nbsp;the&nbsp;L,&nbsp;a,&nbsp;b*&nbsp;values**&nbsp;of&nbsp;the&nbsp;samples&nbsp;were&nbsp;recorded&nbsp;before&nbsp;and&nbsp;after&nbsp;the&nbsp;aging&nbsp;process&nbsp;using&nbsp;a&nbsp;spectrophotometer&nbsp;(Vita&nbsp;Easyshade&nbsp;V,&nbsp;Vita&nbsp;Zahnfabrik,&nbsp;Bad&nbsp;Säckingen,&nbsp;Germany),&nbsp;in&nbsp;accordance&nbsp;with&nbsp;the&nbsp;CIEDE2000&nbsp;color&nbsp;formulation.&nbsp;Subsequently,&nbsp;the&nbsp;compressive&nbsp;strength&nbsp;test&nbsp;was&nbsp;conducted&nbsp;using&nbsp;a&nbsp;universal&nbsp;testing&nbsp;machine&nbsp;(Shimadzu&nbsp;AG-X,&nbsp;Kyoto,&nbsp;Japan)&nbsp;to&nbsp;evaluate&nbsp;the&nbsp;mechanical&nbsp;resistance&nbsp;of&nbsp;the&nbsp;restorations.&nbsp;Statistical&nbsp;analysis&nbsp;of&nbsp;the&nbsp;data&nbsp;was&nbsp;performed&nbsp;using&nbsp;one-way&nbsp;ANOVA&nbsp;variance&nbsp;analysis&nbsp;and&nbsp;post-hoc&nbsp;Tukey&nbsp;tests&nbsp;(p&lt;0.05).&nbsp;Finite&nbsp;element&nbsp;stress&nbsp;analysis&nbsp;was&nbsp;applied&nbsp;in&nbsp;order&nbsp;to&nbsp;determine&nbsp;the&nbsp;accuracy&nbsp;and&nbsp;consistency&nbsp;of&nbsp;the&nbsp;fracture&nbsp;strength&nbsp;(KIC)&nbsp;values&nbsp;​​measured&nbsp;in&nbsp;the&nbsp;study&nbsp;in&nbsp;a&nbsp;simulation&nbsp;environment&nbsp;that&nbsp;can&nbsp;mimic&nbsp;the&nbsp;conditions&nbsp;in&nbsp;the&nbsp;oral&nbsp;environment.</p><p><strong>Results:</strong>&nbsp;When&nbsp;examined&nbsp;in&nbsp;terms&nbsp;of&nbsp;fracture&nbsp;strength,&nbsp;the&nbsp;ANOVA&nbsp;test&nbsp;results&nbsp;for&nbsp;posterior&nbsp;restorations&nbsp;showed&nbsp;mean&nbsp;fracture&nbsp;strengths&nbsp;of&nbsp;396.34&nbsp;MPa&nbsp;for&nbsp;group&nbsp;3B,&nbsp;1057.9175&nbsp;MPa&nbsp;for&nbsp;group&nbsp;FO,&nbsp;and&nbsp;763.11&nbsp;MPa&nbsp;for&nbsp;group&nbsp;IK.&nbsp;A&nbsp;statistically&nbsp;significant&nbsp;difference&nbsp;was&nbsp;found&nbsp;between&nbsp;the&nbsp;mean&nbsp;fracture&nbsp;strengths&nbsp;of&nbsp;the&nbsp;three&nbsp;groups&nbsp;(p&nbsp;&lt;&nbsp;0.05).&nbsp;The&nbsp;post-hoc&nbsp;test&nbsp;also&nbsp;revealed&nbsp;a&nbsp;significant&nbsp;difference&nbsp;in&nbsp;fracture&nbsp;strength&nbsp;between&nbsp;groups&nbsp;3B&nbsp;and&nbsp;FO&nbsp;(p&nbsp;&lt;&nbsp;0.05).&nbsp;Regarding&nbsp;color&nbsp;change&nbsp;parameters,&nbsp;FO&nbsp;had&nbsp;the&nbsp;highest&nbsp;ΔE00&nbsp;values,&nbsp;showing&nbsp;significant&nbsp;differences&nbsp;with&nbsp;both&nbsp;groups&nbsp;3B&nbsp;and&nbsp;IK.&nbsp;Groups&nbsp;3B&nbsp;and&nbsp;IK&nbsp;were&nbsp;similar,&nbsp;with&nbsp;no&nbsp;significant&nbsp;difference&nbsp;between&nbsp;them.</p><p>In&nbsp;anterior&nbsp;restorations,&nbsp;the&nbsp;fracture&nbsp;strength&nbsp;values&nbsp;​​of&nbsp;group&nbsp;3B&nbsp;(536.88&nbsp;MPa)&nbsp;were&nbsp;statistically&nbsp;significantly&nbsp;higher&nbsp;than&nbsp;the&nbsp;other&nbsp;groups&nbsp;(p&nbsp;&lt;&nbsp;0.05).&nbsp;When&nbsp;color&nbsp;change&nbsp;values&nbsp;​​were&nbsp;examined,&nbsp;the&nbsp;FO-group&nbsp;had&nbsp;the&nbsp;highest&nbsp;ΔE00&nbsp;values,&nbsp;similar&nbsp;to&nbsp;posterior&nbsp;restorations,&nbsp;while&nbsp;a&nbsp;significant&nbsp;difference&nbsp;was&nbsp;found&nbsp;with&nbsp;the&nbsp;HR&nbsp;group&nbsp;and&nbsp;the&nbsp;3D&nbsp;group&nbsp;(p&nbsp;&lt;0.05).&nbsp;Mechanical&nbsp;test&nbsp;results&nbsp;were&nbsp;consistent&nbsp;with&nbsp;SESA&nbsp;simulation&nbsp;data&nbsp;for&nbsp;posterior&nbsp;restorations,&nbsp;but&nbsp;consistency&nbsp;was&nbsp;only&nbsp;found&nbsp;for&nbsp;the&nbsp;3D&nbsp;and&nbsp;HR&nbsp;groups&nbsp;in&nbsp;anterior&nbsp;restorations.</p><p><strong>Conclusion:</strong>&nbsp;The&nbsp;use&nbsp;of&nbsp;fiber&nbsp;mesh&nbsp;in&nbsp;the&nbsp;posterior&nbsp;region,&nbsp;where&nbsp;chewing&nbsp;forces&nbsp;are&nbsp;high,&nbsp;increases&nbsp;mechanical&nbsp;strength.&nbsp;Furthermore,&nbsp;improvements&nbsp;in&nbsp;the&nbsp;mechanical&nbsp;properties&nbsp;of&nbsp;materials&nbsp;are&nbsp;needed&nbsp;for&nbsp;the&nbsp;use&nbsp;of&nbsp;restorations&nbsp;produced&nbsp;with&nbsp;newer&nbsp;three-dimensional&nbsp;dental&nbsp;printers.&nbsp;However,&nbsp;in&nbsp;the&nbsp;anterior&nbsp;region,&nbsp;where&nbsp;chewing&nbsp;forces&nbsp;are&nbsp;lower,&nbsp;for&nbsp;single&nbsp;tooth&nbsp;loss,&nbsp;these&nbsp;materials&nbsp;are&nbsp;affected&nbsp;by&nbsp;cavity&nbsp;geometry&nbsp;and&nbsp;volume.&nbsp;Therefore,&nbsp;it&nbsp;was&nbsp;determined&nbsp;that&nbsp;one-piece&nbsp;3D-printed&nbsp;restorations&nbsp;are&nbsp;more&nbsp;successful&nbsp;in&nbsp;terms&nbsp;of&nbsp;both&nbsp;color&nbsp;change&nbsp;and&nbsp;fracture&nbsp;resistance.</p>

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