journal of the mechanical behavior of biomedical materials 119 (2021) 104544

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Journal of the Mechanical Behavior of Biomedical Materials

journal homepage: http://www.elsevier.com/locate/jmbbm

3D printing of dental restorations: Mechanical properties of thermoplastic

polymer materials
Lisa Marie Schönhoff a, Felicitas Mayinger a, *, Marlis Eichberger a, Elena Reznikova b,
Bogna Stawarczyk a
a
Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
b
Apium Additive Technologies GmbH, Siemensallee 84, 76187, Karlsruhe, Germany

A R T I C L E I N F O A B S T R A C T

Keywords: In the seminal field of 3D printing of dental restorations, the time and cost saving manufacturing of removable
Thermoplastic polymer materials and fixed dental prostheses from thermoplastic polymer materials employing fused filament fabrication (FFF) is
Polyphenylene sulfone gaining momentum. As of today, the additive manufacturing of the established semi-crystalline poly­
Polyetheretherketone
etheretherketone (PEEK) requires extensive post-processing and lacks precision. In this context, the amorphous
3D printing
polyphenylene sulfone (PPSU) may provide a higher predictability and reliability of the results. The aim of this
Mechanical properties
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.

1. Introduction prepared by milling from prefabricated blanks (Miyazaki et al., 2009),

The ever-increasing demand for highly esthetic prosthetic restora­
tions (Samorodnitzky-Naveh et al., 2007) has invigorated research ac­
tivities in the field of tooth-shaded materials for both removable and
fixed dental prostheses. The success of new material compositions is,
however, not only measured by the clinical long-term performance of
the fabricated restorations, but the ease and reliability of their
manufacturing process.
While silicate and zirconia ceramics are nowadays routinely
the manufacturing process of 3D-printing is gaining importance as a
potential material and time saving option (Kessler et al., 2020; Ngo
et al., 2018). As of today, orthodontic splints and tooth models are
increasingly manufactured from low-viscosity resins employing an ad­
ditive work-flow. Unreacted monomers on the surface of the print
structures, do, however, require extensive post-processing and can limit
the application of this material group in the oral cavity due to their high
residual monomer content (Kurzmann et al., 2017). Against this back­
drop, high-performance thermoplastics present a favorable alternative,

* Corresponding author.
E-mail address: felicitas.mayinger@med.uni-muenchen.de (F. Mayinger).

https://doi.org/10.1016/j.jmbbm.2021.104544
Received 25 January 2021; Received in revised form 14 April 2021; Accepted 16 April 2021
Available online 21 April 2021
1751-6161/© 2021 Elsevier Ltd. All rights reserved.
L.M. Schönhoff et al.
as these inert materials possess a high biocompatibility (Wenz et al.,
1990). For fused filament fabrication (FFF), a thermoplastic filament is
melted in a nozzle, which moves to create a 3D-structure on a fixed
building platform layer by layer. In this context, the melting point of the
3D print material plays a key role. The high-performance polymer pol­
yetheretherketone (PEEK), which has been successfully employed in the
additive manufacturing of implants and inlays (Prechtel et al., 2020b;
Sharma et al., 2020), has a melting temperature of 343 ◦ C (Zanjanijam
et al., 2020), which has to be reached in the extrusion process of FFF. As
a lower melting temperature renders the printing process more practi­
cable and cheaper, the thermoplastic polyphenylene sulfone (PPSU)
might represent a suitable alternative. In contrast to PEEK, which un­
dergoes a phase transformation during cooling and occurs in a
semi-crystalline state after complete solidification, with the
crystalline-amorphous phase fraction being highly dependent on the
challenging adjustment of the cooling parameters, as rapid cooling
prevents the formation of crystalline structures, PPSU only exists in an
amorphous solid state (Dorf et al., 2018). This could entail a higher
consistency on the part of printed PPSU restorations compared to PEEK,
where the crystallinity exerts a strong impact on material properties,
with a high percentage of crystalline phase increasing a restoration’s
mechanical properties, while an increase in amorphous phase content
can improve its optical properties, such as translucency (Wang et al.,
2019; Yang et al., 2017; Zanjanijam et al., 2020). As PPSU possesses a
tensile strength of 55.0–76.9 MPa (in comparison: PEEK: 90.0–100.0
MPa) and a modulus of elasticity of 2.14 GPa (in comparison: PEEK:
3.5–20 GPa), as well as a high resistance to hydrolysis and different
sterilization methods (Dizon et al., 2018; Evans et al., 2016; Lee et al.,
2017), this material meets the requirements for a potentially successful
use in the additive manufacturing of dental restorations. The indication
spectrum of PPSU could include single and multi-unit fixed dental
prostheses, clasps and frameworks for removable dental prostheses and
implant structures. A recent publication has reported promising results
for the tensile bond strength between PPSU and a veneering composite
resin, hereby providing proof of principle for the feasible esthetic
veneering of this material group (Schönhoff et al., 2021).
Fig. 1. Study design.
2
Journal of the Mechanical Behavior of Biomedical Materials 119 (2021) 104544
To evaluate the mechanical properties of the thermoplastic polymer
PPSU in comparison with the established PEEK, three-point flexural
strength, two-body wear and Martens parameters were tested initially
and after artificial aging. The following null hypotheses were investi­
gated: (1) neither the material nor (2) aging show an influence on the
flexural strength, (3) the material shows no influence on the two-body
wear, and (4) neither the material nor (5) the aging level show an in­
fluence on the Martens parameters (HM and EIT).
2. Material and methods
In total, 368 specimens were fabricated from two different PPSU
materials (PPSU1, n = 184; PPSU2, n = 92) and PEEK (n = 92) (Fig. 1,
Table 1).
The following properties were tested, and compared: i. flexural
strength (N = 240, n = 20), ii. two-body wear (N = 48, n = 12), and iii.
Martens parameters, namely Martens hardness (HM) and indentation
modulus (EIT) (N = 80, n = 20).
2.1. Specimen preparation
Specimens with dimensions of 10 × 10 × 4 mm (cubic geometry, n =
128) for two-body wear and Martens parameters measurements and 2 ×
3 × 15 mm (bar geometry, n = 80) for flexural strength testing were
prepared using different manufacturing techniques.
3D-printed specimens (PPSU1-3D and PPSU2-3D, n = 184) were
printed (P115, Apium Additive Technologies) from the two different
filaments PPSU1 and PPSU2 with a 0.4 mm nozzle, tempered to 410 ◦ C,
in a controlled ambient temperature resulting from the 110 ◦ C printing
bed temperature and the 150 ◦ C adaptive heating system (Apium Ada­
pative Heating System; Apium Additive Technologies) at a speed of 400
mm/min and layer thickness of 0.15 mm. Layers (XY-plane: 10 × 10
mm) were printed with a Z building height of 4 mm. The force applied
during testing was perpendicular to the layer orientation.
Extruded specimens (PPSU1-EX and PEEK-CG, n = 184) were cut
from molded material with a diamond saw (Secotom-50, Struers) under
L.M. Schönhoff et al. Journal of the Mechanical Behavior of Biomedical Materials 119 (2021) 104544

Table 1
Abbreviations, materials, manufacturers, compositions, geometry, color and lot numbers used.
Abbreviation Material Manufacturer Composition Geometry Color Lot No.

PPSU1-EX Radel R-5000 NT Solvay PPSU 170 × 20 × 4 mm plate Translucent n.a.

PPSU1-3D (Fil-A-Gehr PPSU) PPSU Radel Gehr PPSU filament n.a.
PPSU2-3D Ultrason P 3010 NAT BASF PPSU n.a.
PEEK-CG PEEK Juvora Juvora PEEK 98 × 22 mm circular blank Opaque (grey) WO000042IDML

water-cooling by using a diamond disc (M1D13, Struers). The edges of
the bar specimens were broken by pulling them over SiC-Foil P1200
(Struers).
Cubic specimens were embedded in acrylic embedding resin (Scan­
DiQuick A, and B, ScanDia), and polished up to grain P2000 (SiC-Foil, Ø
200 mm, Struers) under water cooling with an automatic grinding and
polishing device (Tegramin 20, Struers), and cleaned in distilled water
for 5 min using an ultrasonic unit (Sonorex, Bandelin).
2.2. Flexural strength
The definitive dimensions of the bar specimens (n = 300) were
determined with a digital micrometer (Mitutoyo IP65, Mitutoyo Cor­
poration) with an accuracy of ±0.05 mm. Specimens were tested
initially (n = 20), as well as after 5000 (n = 20), and 10,000 thermo­
cycles (TC) between 5 ◦ C and 55 ◦ C with 20 s dwelling time. Aging with
5000 and 10,000 TC was aimed to mimic clinical conditions after
approximately 6 months or 1 year in vivo (Gale and Darvell, 1999).
Three-point flexural strength was tested in a universal testing machine
(Zwick/Roell 1445 RetroLine, ZwickRoell) with a crosshead speed of 1
mm/min. Flexural strength was calculated using the following formula:
3Pl
σ=
2wb2
with σ: Flexural strength (MPa), P: Fracture load (N), l: the test span
(mm), w: Specimen width (mm), b: Specimen thickness (mm).
2.3. Two-body wear
Embedded cubic specimens (n = 48) were subjected to 400,000
chewing- and 2000 thermocycles between 5 ◦ C, and 55 ◦ C (duration of
60 s for each thermocycle) in a chewing simulator (Chewing Simulator
CS-4, SD Mechatronik) with a vertical load of 50 N, and a sliding
movement of 0.7 mm employing steel antagonists. This aging procedure
is supposed to correlate with in vivo conditions after 3 years (Leinfelder
and Suzuki, 1999). Afterwards, specimens were cleaned in an ultrasonic
unit for 5 min (Sonorex, Bandelin) with distilled water. For two-body
wear analysis, the surface of each specimen was digitized with a trian­
gulation sensor (Las 20, SD Mechatronik) after chewing simulation. The
dataset was loaded in a software for digital image correlation (GOM
Correlate, GOM) and a plane was created to simulate the surface before
chewing simulation, which was superimposed with the scanning data
using a 3D matching procedure. The loss (removal) and application of
material was displayed graphically and computed numerically (Fig. 2).

Fig. 2. Graphic display of the height loss for a PPSU1-EX specimen.

3
L.M. Schönhoff et al. Journal of the Mechanical Behavior of Biomedical Materials 119 (2021) 104544

2.4. Martens parameters
On cubic embedded specimens (N = 80), HM (N/mm2), and EIT (kN/
mm2) were assessed (n = 20) using a universal hardness testing machine
(ZHU 0.2/Z2.5, ZwickRoell) by pressing a Vickers diamond indenter (α
= 136◦ ) with a maximum load of 9.807 N for 20 s vertically into the
specimen’s surface.
HM, and EIT were calculated, and force-displacement diagrams
recorded (testX-pert V12.3 Master, ZwickRoell). All specimens were
tested longitudinally after aging by thermocycling between 5 ◦ C, and
55 ◦ C with 20 s dwelling time after 5000 TC, 10,000 TC, 10,000 TC plus
36 days dry storage, and 20,000 TC. These aging conditions were aimed
to mimic clinical conditions after approximately 6 months, 1 year, 1 year
and 1 month, and 2 years in vivo (Gale and Darvell, 1999).
2.5. Statistical analysis
The statistical evaluation of the results was carried out with a
descriptive analysis, followed by the Kolmogorov-Smirnov test to verify
compliance with the normal distribution. Correlation coefficients were
determined using Pearson’s and Spearman’s correlation. One-way
ANOVA, Scheffé-post-hoc and Kruskal-Wallis test were performed to
analyze significant differences between the tested groups (IBM Statistics
SPSS 26.0, International Business Machines Corporation) (α = 0.05).
3. Results
For flexural strength, 3 out of 12 tested groups showed a violation of
the assumption of normality (Table 2).
Thus, non-parametric tests were performed. The material showed the
highest influence on flexural strength (partial eta-squared ((η2p) = 0.770,
p < 0.001) followed by the interaction of material and aging level (η2p =
0.191, p < 0.001) and the aging level (η2p = 0.079, p < 0.001). Regarding
the different materials, no differences between PPSU1-3D and PPSU2-
3D (p > 0.052) and between PPSU1-EX and PEEK-CG (p > 0.097)
were observed initially and after 10,000 TC, as PPSU1-3D and PPSU2-3D
showed lower flexural strength values than PPSU1-EX and PEEK-CG (p
< 0.001). After 5000 TC, PPSU1-EX and PEEK-CG showed the highest
flexural strength values, while the lowest values were observed for
PPSU2-3D (p < 0.001) (Fig. 3).
For PPSU1-EX, initial flexural strength results were the highest, fol­
lowed by values at 5000 TC and 10,000 TC (p < 0.008). In PPSU1-3D, no
differences were observed between initial flexural strength results and
values after 5000 TC (p = 0.116), and between 5000 TC and 10,000 TC
(p = 0.222), while values at 10,000 TC were higher than initial flexural
strength results (p = 0.009). For the materials PPSU2-3D and PEEK-CG,
no differences in flexural strength were observed regarding the different
aging levels (p > 0.252).
For two-body wear, none of the removal or application groups
showed a violation of the assumption of normality (Table 3).
Thus, parametric tests were performed. As the Pearson coefficient
indicated a correlation between volume and height values (R = 0.966, p
Table 2
Descriptive statistics (Min/median/max) of flexural strength values (N/mm2) of
the different materials after aging.
PPSU1-EX PPSU1-3D PPSU2-3D PEEK-CG
Initial 149.2/158.1/ 49.5/83.0/ 55.3/78.8/ 84.7/139.1/
169.4Bc 94.1*Aa 99.0Aa 222.9Ba
5000 TC 127.0/148.4/ 80.3/84.5/ 61.0/72.4/ 97.2/141.4/
162.2Cb 92.24Bab 87.0Aa 194.7Ca
10,000 97.4/112.8/ 80.0/87.6/ 62.2/74.6/ 106.6/130.1/
TC 157.9*Ba 92.03Ab 88.5*Aa 198.0Ba
* indicates deviations from the normal distribution.
ABC
indicate differences between materials within one aging level.
abc
indicate differences between aging levels within one material.
< 0.001), the parameter height was displayed and discussed to allow a
greater comparability to the current literature. The material showed an
influence on the height loss (η2p = 0.824, p < 0.001). PPSU1-3D showed
the highest height loss (p < 0.001), while PEEK-CG and PPSU1-EX
showed the lowest height loss (p < 0.001). No differences in the
height application were found between materials (p > 0.790).
As 11 out of 15 HM groups and all EIT groups showed a violation of
the assumption of normality (Table 4), non-parametric tests were
performed.
The material showed an influence on HM and EIT (η2p>0.938, p <
0.001). The highest HM and EIT values were found for PEEK-CG (p <
0.001) and the lowest for PPSU1-3D (p < 0.001). For both HM and EIT,
no differences were found between aging levels (p > 0.098).
Correlations were observed between all parameters (R > 0.617, p <
0.001) except for the application height (R > − 0.013–0.057, p > 0.351).
4. Discussion
The aim of this study was to evaluate the mechanical properties of
the high-performance polymer PPSU in comparison with the established
PEEK. As the choice of material showed an influence on flexural
strength, two-body wear and Martens parameters, the null hypotheses
(1), (3) and (4) were rejected. The second null hypothesis was partially
rejected since differences in flexural strength were observed for PPSU1-
EX and PPSU1-3D with respect to the different aging levels. For the
Martens parameters, aging showed no influence on either HM or EIT. The
fifth null hypothesis was thus accepted.
Since PPSU1-3D and PPSU1-EX specimens were manufactured from
the same core material, but PPSU1-EX showed superior flexural strength
results, the manufacturing process seems to play an essential role. While
PPSU1-EX specimens were cut from a prefabricated PPSU bar, that had
been produced from PPSU granulate by injection molding, PPSU1-3D
specimens were processed in an FFF printer from a filament, that had
been extruded from PPSU granulate in a preceding step. For PPSU1-3D,
one of the processing steps seems to have weakened the material. Prior
to filament extrusion, the material must be carefully dried and exact
temperatures have been maintained in the extrusion process itself to
ensure high quality standards. In the printing process, additional factors
to the necessary renewed pre-drying of the filament have been observed
to show an impact on the mechanical properties of the printed objects,
namely the printing parameters (printing speed, degree of infill and
printing strategy) and the employed printing temperatures (temperature
of the nozzle, printing bed and printing chamber) (Li and Lou, 2020;
Prechtel et al., 2020a; Wang et al., 2019). While additive manufacturing
promises a time efficient and material saving manufacturing process
(Kessler et al., 2020), it is yet to be determined in how far individually
printed layers fuse together to form a homogenous structure that
matches material properties obtained by injection molding (Wickra­
masinghe et al., 2020). The benefit of this standardized process, that
employs pressure and heat to ensure consistent material compositions,
has been described for denture bases made from poly­
methylmethacrylate (Keenan et al., 2003). It has yet to be determined
whether the lack of this manufacturing step is causal for the observed
impaired mechanical properties, or whether the printing process itself
that requires an additional heating of the filament during additive
manufacturing shows a negative effect. Future studies are needed to
investigate whether a reduction of the printing layer thickness below
0.15 mm and an adaption of the printing temperature may improve
PPSU properties to match those of injection molded counterparts, a feat
recently reported for 3D printed PEEK (Li and Lou, 2020).
After artificial aging with 5000 TC, PSSU1-3D showed higher flex­
ural strength results than PPSU2-3D. For HM, EIT and two-body wear,
the performance of the two materials was, however, reversed, with
PPSU2-3D showing higher Martens parameters and a higher resistance
to wear than PPSU1-3D. According to the manufacturers’ specifications,
both PPSU1-3D and PPSU2-3D filaments are manufactured from unfilled

4
L.M. Schönhoff et al. Journal of the Mechanical Behavior of Biomedical Materials 119 (2021) 104544

Fig. 3. Box plot of the flexural strength values of the different materials after different aging procedures.

Table 3
Descriptive statistics (Mean ± SD; 95% CI) of height loss and application (mm) of the different materials after 400,000 chewing cycles.
PPSU1-EX PPSU1-3D PPSU2-3D PEEK-CG

Mean ± SD 95% CI Mean ± SD 95% CI Mean ± SD 95% CI Mean ± SD 95% CI

Height loss − 0.285 ± [− 0.318; − 0.717 ± [− 0.786; − 0.389 ± [− 0.446; − 0.218 ± [− 0.291;
0.050AB − 0.253] 0.106C − 0.649] 0.088B − 0.332] 0.113A − 0.146]
Height 0.050 ± 0.023A [0.034; 0.065] 0.054 ± 0.027A [0.035; 0.072] 0.043 ± 0.031A [0.023; 0.063] 0.048 ± 0.023A [0.032; 0.063]
application

CI, confidence interval; SD, standard deviation.

ABC
indicate differences between materials.

homogeneity. In the extrusion process, the employed pressure influences

Table 4
the continuity of the filament diameter and the surface quality. The
Descriptive statistics (Min/median/max) for HM (N/mm2) and EIT (kN/mm2) of
pressure is in turn controlled by the extrusion speed in conjunction with
the different materials after aging.
the die diameter. The filament quality thus exerts an important influence
PPSU1-EX PPSU1-3D PPSU2- PEEK-CG on the print result (Wang et al., 2020). Noteworthy, PPSU2-3D was the
3D
only material besides the PEEK control group where no differences in
Initial HM 115/121/ 102/111/ 90/113/ 204/207/ flexural strength were observed for the different aging levels. This un­
124* 113* 149* 209
derlines the strong performance of this additively manufactured group
EIT 2.9/2.9/ 2.5/2.6/ 2.2/2.6/ 4.6/4.8/
3.1* 2.7* 3.6* 4.9* already seen for the Martens parameters and two-body wear, just as
5000 TC HM 106/115/ 99/109/ 85/108/ 193/206/ PPSU1-3D was affected by aging, with its flexural strength values at 10,
118* 111* 145* 209* 000 TC being higher than initial results. This might be caused by an
EIT 2.7/2.8/ 2.5/2.6/ 2.2/2.6/ 4.4/4.8/ ongoing post-polymerization process induced by the high temperature
3.0* 2.6* 3.6* 4.8*
10,000 TC HM 98/116/ 97/108/ 84/109/ 197/204/
water bath employed for thermocycling. As the constant performance of
119* 110* 146* 208 PEEK during aging is seen as one of its strongest features (Liebermann
EIT 2.6/2.8/ 2.5/2.6/ 2.3/2.6/ 4.6/4.7/ et al., 2016; Micovic et al., 2020; Taufall et al., 2016), follow-up studies
3.3* 2.6* 3.6* 4.8* are warranted to examine this promising novel material composition in
10,000 TC + 36 HM 108/116/ 97/108/ 65/112/ 197/206/
the field of dentistry with regard to its resistance to aging more closely.
days dry storage 127* 114 148* 210*
EIT 2.7/2.9/ 2.4/2.6/ 2.2/2.7/ 4.4/4.8/ The puzzling observation that the two additively manufactured mate­
3.4* 2.7* 3.6* 4.9* rials differed in their performance regarding flexural strength on the one
20,000 TC HM 99/116/ 88/105/ 99/110/ 199/203/ side, and Martens parameters and wear resistance on the other side, will
126* 109* 146* 205 have to be investigated further.
EIT 2.7/2.8/ 2.3/2.6/ 2.4/2.6/ 4.6/4.8/
3.6* 2.6* 3.6* 4.9*
As PSSU1-EX showed comparable properties to the tried-and-tested
control group (Schwitalla et al., 2015; Wimmer et al., 2016) for both
* indicates deviations from the normal distribution. flexural strength and height loss during two-body wear, this is a prom­
ising finding for the future application of PPSU materials. At the same
PPSU. As the two core materials were processed with the same printing time, PPSU1-EX was the only material that showed a negative impact of
parameters, a possible difference can therefore only be found in the artificial aging. Although a hydrophobic material, PPSU may be weak­
fabrication of the filament. During this process, contaminations (e.g., ened by water absorption during the thermocycling process. As the
dental wax) can be incorporated into the filament and impair its flexural strength of the additively manufactured group PPSU2-3D was,

5
L.M. Schönhoff et al.
however, not affected by aging and none of the tested groups showed an
impact of aging on the surface properties HM and EIT, this property
needs to be examined in follow-up studies.
Interestingly, correlations were observed between all parameters
except for the height application. Furthermore, no differences in the
height application were found between materials. Although this
parameter may provide valuable information about a thermoplastic’s
mechanical performance, as this material group has been observed to
undergo plastic deformation during force application (El-Qoubaa and
Othman, 2015), this parameter may be of negligible importance for the
tested materials.
One limitation of the present investigation is the potentially uneven
distribution of flaws in the test specimens distorting the observed three-
point flexural strength values. Future investigations should thus include
the computation and analysis of Weibull characteristic strength and
Weibull modulus. Furthermore, the present study only investigated one
printing and testing modality. As previous investigations have reported
a vertical printing strategy to yield lower results than observed for
specimens manufactured in a horizontal printing direction, with a
delamination taking place between layers during force application, a
horizontal printing strategy and perpendicular application of force was
used in the present study (Kessler et al., 2021; Prechtel et al., 2020a;
Unkovskiy et al., 2018). While this strategy should be employed in a
clinical setting to ensure the best outcome for the patient, with a hori­
zontal printing and perpendicular testing set-up providing the highest
reliability (Kessler et al., 2021), it could embellish the obtained in vitro
results, as both vertical and horizontal forces occur during masticatory
function. Future studies should thus focus on test set-ups, where the
employed force is applied in the same direction as the horizontal print
layers.
Based on the present findings, the choice of material and
manufacturing process seems to play an important role, which is
underlined by the parameter material showing the highest influence on
both flexural strength and Martens parameters. While this study in­
dicates a potentially successful long-term clinical use of PPSU in the field
of both removable and fixed dental prostheses with regard to its me­
chanical properties, it has yet to be determined whether an optimization
in the production of the printing filament and the additive
manufacturing process itself will allow comparable values to conven­
tionally fabricated specimens.
5. Conclusions
Based on the findings of this in vitro study, the following conclusions
were drawn:
1. The manufacturing process affected the flexural strength of the
thermoplastic polymer PPSU, with 3D printed specimens presenting
lower values than specimens cut from prefabricated molded mate­
rial. This finding indicates that the 3D printing parameters employed
for the additive manufacturing of PPSU specimens in the present
investigation require further optimization.
2. The quality of the filament processed in 3D printing showed an
impact on the mechanical properties of PPSU, underlining the
importance of adhering to high quality standards during filament
fabrication.
3. The flexural strength and height loss during two-body wear of
extruded PPSU was comparable to PEEK. PPSU, a novel material for
dental restorations, could thus represent a suitable alternative to the
established PEEK for the manufacturing of both removable and fixed
dental prostheses.
Funding
This work was supported by research program ZF4052006AW8 (AiF
Projekt GmbH, Berlin, Germany, ZIM-Kooperationsprojekte,
6
Journal of the Mechanical Behavior of Biomedical Materials 119 (2021) 104544
Projektträger des BMWi).
Ethical approval
This article does not contain any studies with human participants or
animals performed by any of the authors.
Informed consent
For this type of study, formal consent was not required.
CRediT authorship contribution statement
Lisa Marie Schönhoff: Investigation, Formal analysis, Writing –
original draft. Felicitas Mayinger: Formal analysis, Writing – original
draft, Writing – review & editing. Marlis Eichberger: Investigation.
Elena Reznikova: Investigation. Bogna Stawarczyk: Conceptualiza­
tion, Methodology, Formal analysis, Writing – review & editing,
Supervision.
Declaration of competing interest
The authors declare that they have no known competing financial
interests or personal relationships that could have appeared to influence
the work reported in this paper.
Acknowledgements
The authors would like to thank Gehr GmbH and BASF SE for
providing material for this study, as well as Apium Additive Technolo­
gies GmbH for providing material and printing specimens.
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