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FUNDAMENTAL

RESEARCH
Influence of Different Postpolymerization
Strategies and Artificial Aging on
Hardness of 3D-Printed Resin Materials:
An In Vitro Study
Marcel Reymus, Dr Med Dent
Department of Conservative Dentistry and Periodontology, University Hospital,
Ludwig Maximilian University of Munich, Munich, Germany.

Bogna Stawarczyk, Prof Dr Rer Biol Hum, Dipl-Ing (FH), MSc


Department of Prosthetic Dentistry, University Hospital,
Ludwig Maximilian University of Munich, Munich, Germany.

Purpose: To investigate the influence of different postpolymerization strategies and artificial aging
periods on the Martens hardness parameters of 3D-printed resin materials indicated for temporary use.
Materials and Methods: Disks made of four 3D-printed resin materials (n = 30 each) were additively
manufactured and postpolymerized with three different postpolymerization devices (n = 10 specimens of
each material per device). Disks cut from a prefabricated milling material served as a control. The Martens
parameters (ie, Martens hardness [HM] and indentation modulus [EIT]) were measured initially and after
14- and 28-day storage periods in 37°C distilled water. The data were statistically analyzed using univariate
analysis, Kolmogorov Smirnov test, and nonparametric tests, including Kruskal-Wallis, Mann-Whitney
U, and Wilcoxon tests (α = .05). Results: The highest impact on the Martens parameters was exerted
by material (HM: ηP2 = 0.957, EIT: ηp2 = 0.967, P < .001), followed by postpolymerization device (HM:
ηP2 = 0.557, EIT: ηP2 = 0.496, P < .001) and duration of water storage (HM: ηP2= 0.068, EIT: ηP2= 0.038,
P < .001). The values for HM ranged between 108 and 282 N/mm2, and for EIT between 2.89 and
7.73 kN/mm2. The materials 3Delta Etemp and Temp PRINT showed the highest HM and EIT values regardless
of the postpolymerization device and water storage duration (P < .001). In contrast, NextDent C&B, followed
by Freeprint Temp, showed the lowest HM and EIT values (P < .001). The milled control group Telio CAD
ranged between the two lower groups. Conclusion: Postpolymerization strategy has a high impact on the
mechanical properties of 3D-printed resin materials. Materials with a higher filler content showed better
results regarding the Martens parameters. Such materials might be an alternative to conventional materials
for the milling procedure. Int J Prosthodont 2020;33:634–640. doi: 10.11607/ijp.6634

E
specially in the last decade, new materials and treatment options—including com-
puter-aided design/computer-assisted manufacturing (CAD/CAM)—have dra-
matically changed traditional workflows.1 CAD/CAM technology is widely used
by dentists and dental technicians since it ensures dental services of high quality.2,3
Correspondence to:
Dr Marcel Reymus The CAM process is currently mostly performed as a subtractive method by which
Department of Conservative the designed object is milled from prefabricated blocks. Those industrially fabricated,
Dentistry and Periodontology
standardized materials ensure high biocompatibility and consistent quality.4 However,
University Hospital
LMU Munich, Goethestrasse 70 this process wastes as much as 90% of the material.5 Recently, three-dimensional
80336 Munich, Germany (3D) printing, or additive manufacturing (AM), has been increasingly promoted for its
Fax: +49 89 4400 59302
use in dentistry. The term “3D printing” encompasses a variety of different technolo-
Email: mreymus@
dent.med.uni-muenchen.de gies, ranging from metal and ceramic sintering to resin-processing systems.6 However,
they are all additive methods, meaning the object is built up layer by layer, which
Submitted July 16, 2019;
reduces the amount of wasted material. Several dental applications for AM have been
accepted September 14, 2019.
©2020 by Quintessence presented recently, including dental casts,7 surgical or endodontic guides,8,9 occlu-
Publishing Co Inc. sal devices,10 and educational models.11,12 The most widespread AM technology in

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Reymus/Stawarczyk

the dental field is currently stereolithography. For this The null hypothesis of this study was that no differ-
method, liquid resin is selectively polymerized by either a ence would be found among the different materials,
single laser spot (SLA) or by a light beam (DLP) in order the different postpolymerization devices, or the time of
to finally create the desired object. Several materials are water storage regarding HM and EIT.
available for stereolithography, including materials for
the applications mentioned and also materials for long- MATERIALS AND METHODS
term interim fixed dental prostheses (FDPs), which are
used, for example, to test a new occlusal relationship The 3D-printed materials tested and the CAD/CAM
in patients requiring extensive prosthetic treatment.13 control (N = 130) are presented in Table 1. For each ma-
Such AM restorations might represent an alternative to terial, 30 disks (20 mm in diameter and 5 mm in thick-
manually fabricated or milled restorations by reducing ness) were additively manufactured by using a digital
the amount of time a dental technician has to spend on light processing (DLP) printer (D20II, Rapid Shape). For
fabrication. Information about the mechanical proper- all materials, the layer thickness was set to 50 µm, as
ties of 3D-printed restorations is scarce. Consequently, specified by the manufacturers. For the control group,
the purpose of this in vitro study was to evaluate the in- 10 disks of the same thickness were manually cut from
fluence of postpolymerization strategy and artificial ag- prefabricated blocks. The additively manufactured
ing on the Martens parameters—ie, Martens hardness specimens were cleaned according to the manufac-
(HM) and indentation modulus (EIT)—of different 3D- turers’ specifications: NextDent C&B (NDT), Freeprint
printed resin materials indicated for long-term interim Temp (FPT), and Temp PRINT (GCT) were cleaned for
use as FDPs. 5 minutes in an ultrasonic activated bath (RK 102 H,
Since these are photosensitive resins, the correct post- SONOREX SUPER, Bandelin) with 96% ethanol (Otto
polymerization strategy is essential to ensure adequate Fischar); and 3Delta Etemp (3DT) was exposed to cen-
mechanical properties and biocompatibility.14 The post- trifugal force (Allegra X-15R, Beckmann Coulter) for
polymerization devices proposed for stereolithography 3 minutes at 1,800 rounds per minute. Subsequently,
differ in their light-emitting technologies and include the specimens were postpolymerized using the devices
light-emitting diodes (LEDs), ultraviolet light (UV), and stated in Table 2 (n = 10 specimens per device). After
flashlights. Depending on their emitted wavelength, postprocessing, the disks were embedded in autopo-
different postpolymerization strategies might result in lymerizing acrylic resin (ScandiQuick A and B, ScanDia)
different Martens parameters. and grounded half automatically (Tegramin-20, Struers)
Dental restorations are exposed to a wet environment using consecutive silicon carbide papers up to P2000
during their service in the oral cavity, which strongly in- under constant water cooling.
fluences polymeric networks,15 altering their mechani- The Martens parameters were recorded longitudinally
cal properties because of water uptake or elution of initially and after storage for 14 or 28 days in a bath of
ingredients.16 When a material’s mechanical proper- distilled water at a temperature of 37°C using an incuba-
ties are investigated, its behavior under artificial aging tor (Heracell 150, Kulzer). For each measurement, every
should be evaluated.17,18 specimen was investigated at three different locations.
The measurement of Martens hardness is appropri- HM and EIT were determined by using a Martens
ate for characterizing the elastic-plastic behavior of hardness machine (ZHU 0.2, ZwickRoell). The specimens
polymeric materials and is suitable for disclosing sur- were loaded with a Vickers diamond indenter (α = 136
face degradations induced by prolonged water stor- degrees) with increasing forces of up to a maximum of
age.19 Furthermore, hardness values may be correlated 9.807 N, which was held for 10 seconds. The minimum
with the degree of conversion and the filler content indenter depth was always greater than 5 µm. HM and
of polymeric materials.20–24 However, the indentation EIT values were calculated (TestXpert V12.3 Master;
modulus is a suitable measurement for evaluating the ZwickRoell) using the following equations:
morphology and deformation behavior of materials.25
The recorded load-displacement curves give further in- F = F
HM =
formation on the mechanical behavior of the material. As(h) 26.43 × h2
The plateau of the curve demonstrates the material’s
creep characteristic, which can be correlated with clini- 2√Ap(hc) (1 – ν2i) –1
cal performance.26 A high creep characteristic tends to EIT = (1 – ν2s) = ( – )
√πS Ei
disturb the bonding interface between the tooth struc-
ture and the restoration27 and may lead to the uncoil-
ing of polymer chains.28 A higher filler content is said HM was measured in N/mm2; F (test force) in N;
to positively influence the creep characteristic of resin- (surface area of the indenter at distance h from the
based materials.29,30 trip) in mm2; h (indentation depth under applied test force)

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Fundamental Research

Table 1   Summary of Materials, Compositions, Manufacturers, and Lot Numbers


Brands 3D printer Matrix Filler Manufacturer Lot no.
3D-printed NextDent C&B D20II, Methacrylic oligomers > 90%, None NextDent XK044N01
materials Rapid Shape phosphine oxides < 3%
Freeprint Temp D20II, Methacrylatesa Not stateda Detax 200703
Rapid Shape
3Delta Etemp D20II, Methacrylatesa Siliciumdioxid, Deltamed 0124
Rapid Shape dental glass (50 wt%)b
Temp PRINT D20II, Urethane dimethacrylate 50 –< 75%, Quartz 10 –< 25wt% GC Europe 1803021
Rapid Shape 2,2'-ethylenedioxydiethyl
dimethacrylate 10 < 25%
Control Telio CAD Polymethylmethacrylates > 98% None Ivoclar Vivadent WW7588
group
aNo further information available from manufacturer.
bAs stated by the manufacturer.

Table 2   Summary of Postpolymerization Devices: Technology, Duration, Wavelength, and Manufacturer
Brand Technology Duration Wavelength Manufacturer
LC-3DPrint Box Ultraviolet light 30 min Range 315–550 nm, peaks at NextDent
approximately 360 and 435 nm
Otoflash G171 Flashlight, nitrogen atmosphere 2 processes of 2,000 flashes Range 300–700 nm, peaks at NK-Optik
approximately 480 and 530 nm
Labolight DUO Light-emitting diode 2 processes of 3 min Range 380–510 nm, peaks at GC Europe
approximately 395 and 475 nm

Initial
in mm; EIT in kN/mm2; Ei (elastic mod-
10
14 d
ulus of indenter) in N/mm2; Ap(hc)
8 28 d
(projected contact area under load)
6 in N/mm2; vs and vi Poisson ratio with
vs = 0.35 and vi = 0.3; and S (contact
EIT

4
* stiffness evaluated from the force re-
2 moval curve). The load displacement
0 curve of each measurement was re-
a NDT FPT 3DT EXT TC
corded. Additionally, the correspond-
ing load-displacement curve was
Initial recorded for each measurement.
10
14 d The data were statistically ana-
8
* 28 d lyzed using univariate analysis,
6 * Kolmogorov-Smirnov test, and non-
EIT

4 * * parametric tests including Kruskal-


2 Wallis, Mann-Whitney U, and
Wilcoxon tests (IBM SPSS Statistics
0
b NDT FPT 3DT EXT TC v. 25; adjusted by Bonferroni correc-
tion, α = .05/78 = .0006).
Initial
10 RESULTS
* 14 d
8 28 d
The descriptive statistics are sum-
6
marized in Table 3, and the corre-
EIT

* *
4 *
sponding box plots are presented
2 in Figs 1 and 2. According to the
0 univariate analysis, the highest in-
NDT FPT 3DT EXT TC
c fluence on HM and EIT was shown
Fig 1   Box plots of EIT values (in kN/mm2)
for the different tested materials, aging levels, and by material (partial eta squared:
postpolymerization devices. (a) Printbox. (b) Otoflash. (c) Labolight. HM: ηP² = 0.957, EIT: ηP² = 0.967,

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Reymus/Stawarczyk

P < .001), followed by postpolymer- Initial


ization device (HM: ηP² = 0.557, EIT: 400 14 d
ηP² = 0.496, P < .001) and duration 28 d
300
of water storage (HM: ηP² = 0.068,
EIT: ηP² = 0.038, P < .001). The in-

HM
200
teraction effect of the binary and *
100
trinary combinations of the three
independent parameters (mate- 0
NDT FPT 3DT EXT TC
rial, postpolymerization device, a
and duration of water storage) was
also significant (HM: ηP² = 0.014 to Initial
0.180, EIT: ηP² = 0.029 to 0.138, P 400 14 d
= .015 to P < .001). Kolmogorov- 28 d
Smirnov test indicated evidence of 300
the violation of normality assump- HM
200
tion regarding the distribution of * * *
*
the data (P < .05). Therefore, the 100
data were analyzed separately ac- 0
cording to the hypothesis using NDT FPT 3DT EXT TC
b
nonparametric statistical tests.
3DT followed by GCT showed the
Initial
highest HM and EIT values regardless
400 * 14 d
of postpolymerization device and
28 d
water storage duration (P < .001). 300
In contrast, NDT followed by FPT *
HM

200
showed the lowest HM and EIT values *
(P < .001). The milled control group 100
(Telio CAD [TC]) ranged between the
0
latter two homogenous groups. c
NDT FPT 3DT EXT TC
Initially and after 28 days of wa-
ter storage, specimens postpo- Fig 2   Box plots of HM values (in N/mm2) for the different tested materials, aging levels, and
postpolymerization devices. (a) Printbox. (b) Otoflash. (c) Labolight.
lymerized with the Labolight device
showed lower Martens parameters
than those postpolymerized with
the Otoflash or Printbox devices, For NTD and FPT, the lowest Mar- 3DT postpolymerized with Labo-
regardless of material (P < .001). tens parameters were observed af- light, higher Martens parameters
The same significant differences ter 14 days of water storage, and were measured after 28 days of
were observed for the FPT group the highest Martens parameters water storage than for nonstored
after 14 days of water storage (P were observed for nonstored speci- specimens (P = .022). In the control
< .001). Specimens postpolymer- mens (P < .001) when using the group, the lowest Martens param-
ized with Labolight and stored for Printbox or Otoflash. For NTD and eters were observed after 14-day
14 days showed higher EIT values GCT, which were postpolymerized storage, and the highest for non-
for NDT (P = .045) and higher HM with Labolight, the initial Martens stored specimens (P < .001).
values for 3DT (P = .023) than those parameters were lower than those
postpolymerized with Printbox. of the stored ones (P < .001). For DISCUSSION
In the GCT group after 14 days of FPT postpolymerized with Labo-
water storage, specimens postpo- light, specimens stored for 28 days An elastic-plastic behavior could be
lymerized with Labolight, followed showed higher values than non- recorded for all materials. However,
by Printbox, showed lower Martens stored ones and those stored for 14 as significant differences regarding
parameters than specimens postpo- days (P = .001). For 3DT and GCT the Martens parameters among the
lymerized with Otoflash (P < .001). postpolymerized with Printbox or different materials were found in
In the groups stored for 14 days, no Otoflash, higher Martens parame- this study, the null hypothesis was
impact of postpolymerization device ters were observed after 14 days of rejected. In general, 3DT and GCT
was observed for 3DT on EIT values water storage than initially or after showed the highest HM and EIT val-
(P = .084) or HM values (P = .701). storage for 28 days (P < .001). For ues, and FPT and NDT the lowest.

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Fundamental Research

Table 3   Mean ± Standard Deviation Martens Parameters for the Materials in Each Subgroup (HM in N/mm2,
EIT in kN/mm2)
Material/Martens parameter

Water NDT FPT 3DT


storage HM EIT HM EIT HM EIT
Postpolymerization device: Printbox
 Initial *134 ± 2.8a,2,C *3.37 ± 0.06a,2,C 156 ± 4.8b,2,C *3.87 ± 0.10b,2,C *179 ± 13.6d,2,B 7.70 ± 0.33d,2,B
  14 d *126 ± 2.5a,1,A *3.28 ± 0.06a,2,A *148 ± 4.6b,2,A *3.72 ± 0.13b,2,A *265 ± 11.7c,2,A *7.35 ± 0.40d,1,A
  28 d *130 ± 2.3a,2,B *3.33 ± 0.08a,2,B *152 ± 6.5b,2,B *3.79 ± 0.11b,2,AB *273 ± 5.8e,2,B *7.61 ± 0.16d,2,B
Postpolymerization device: Otoflash
 Initial *132 ± 2.7a,2,C *3.35 ± 0.08a,2,AB *157 ± 2.7b,2,C *3.88 ± 0.06b,2,C 282 ± 6.6d,2,B *7.71 ± 0.41d,2,B
  14 d *125 ± 3.2a,1,A *3.24 ± 0.12a,1,2,A *149 ± 4.0b,2,A *3.75 ± 0.08b,2,A *257 ± 22.3d,1,2,A *7.20 ± 0.72d,1,A
  28 d *129 ± 2.5a,2,B *3.39 ± 0.29a,2,B *151 ± 2.0b,2,B *3.80 ± 0.06b,2,B 276 ± 5.5d,2,B *7.73 ± 0.13d,2,B
Postpolymerization device: Labolight
 Initial *112 ± 6.6a,1,A *2.93 ± 0.16a,1,A *114 ± 7.9a,1,A *2.98 ± 0.18a,1,A *232 ± 22.3b,1,A *6.58 ± 0.62c,1,A
  14 d *124 ± 19.7 a,1,B *3.16 ± 0.29a,1,B 108 ± 8.9a,b,1,A *2.89 ± 0.18b,1,A *247 ± 36.1c,1,AB *6.94 ± 0.90c,1,A,B
  28 d *123 ± 3.4a,1,B *3.19 ± 0.10a,1,B *120 ± 9.5a,1,B *3.06 ± 0.16a,1,B *249 ± 12.5c,1,A *7.15 ± 0.34c,1,A
NDT = NextDent C&B; FPT = Freeprint Temp; 3DT = 3Delta Etemp; GCT = Temp PRINT; TC = Telio CAD; HM = Martens hardness; EIT = indentation modulus.
Values marked with the same superscript letter or number are not significantly different from each other.
a,b,c,d,eSignificant differences between the materials within aging level and polymerization device.
1,2,3Significant differences between the postpolymerization devices within aging level and material.
A,B,CSignificant differences between aging duration within polymerization device and 3D material.

*Not normally distributed groups.

The milled control group ranged between the two low- Significant differences between the tested postpo-
er groups. This result might be explained by the filler lymerization devices in terms of Martens parameters
content integrated into 3DT and GCT. According to were detected. Postpolymerization in the LED device re-
the manufacturers, these resins are the only materials sulted in the lowest values, regardless of the duration of
with filler particles. A material’s hardness is one factor water storage. The impact of the different postpolymer-
in its ability to resist stress, such as from an antagonist ization devices becomes clear from the load displace-
contact. Regarding the load displacement curves of the ment curves (Fig 3b). The creep characteristics of the
tested materials (Fig 3a), different mechanical charac- materials were higher after using the LED device than
teristics can be recorded between the materials. The after other postpolymerization devices. The control
curve peaks’ plateau indicates a material’s creep behav- material, however, showed a creep tendency compa-
ior under indentation load. A higher creep might lead rable to the LED-postpolymerized specimens. The fairly
to lasting deformation of a material due to long-term strong correlation between the degree of conversion
mechanical stress from tooth clenching and grinding. and the hardness might indicate that the LED device
A lower creep tendency for 3DT than the other mate- was less able to create a higher degree of conversion
rials was recorded in this study. Again, this might be than the flashlight or the UV light device. Nevertheless,
explained by the filler content of this material. Taking the working time of the UV light device was the high-
into account these results, filled resins for 3D printing est at 30 minutes. This long postpolymerization period
seem to be more favorable for long-term service than might have positively influenced the polymerization of
not-filled ones. All tested materials are indicated as tem- the tested specimens. However, whether a comparable
poraries, though the manufacturers do not state a spe- working time would have contributed to the results
cific duration of potential service time. The measured provided by the LED device in the same way is unclear.
Martens hardness is by far inferior to that of a CAD/ Besides the operating time, the postpolymerization de-
CAM resin composite.31 Nevertheless, the values ex- vices differ greatly in their emitting wavelength spec-
ceed those of the PMMA control material. So, the ques- tra. The flashlight operating device demonstrates the
tion arises: For what indications might such 3D-printed broadest spectrum, thus stimulating a larger selection
temporary restorations be used? From a financial and of photoinitiators. This might explain why this device
practical point of view, they do not seem to be an al- resulted in results comparable to the UV light device,
ternative to a provisional restoration for 1 or 2 weeks though its working time was much less.
or until the final restoration is fabricated by a dental Objects printed using 3D printing are manufactured
technician. Rather, they seem to be suitable as long- layer by layer. As for all resin-based materials, the adhe-
term temporary restorations for testing new occlusal sion and polymerization between the layers are decisive
situations. for their mechanical properties. DLP printers polymerize

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12
a b cd e
10
GCT TC
HM EIT HM EIT 8

Force (N)
6
174 ± 8.2c,2,C *4.87 ± 0.16c,2,C 157 ± 4.9 *4.27 ± 0.13
*150 ± 10.1b,A *4.46 ± 0.20c,A 140 ± 4.5 *3.91 ± 0.11 4
*157 ± 7.1d,2,B *4.62 ± 0.16c,2,B 144 ± 2.8 *3.97 ± 0.07
2

*179 ± 11.8c,2,C *4.92 ± 0.30c,2,C 0


0 20 40 60
166 ± 8.9c,1,A *4.76 ± 0.20c,1,A
Indentation (µm)
*167 ± 8.9c,2,A *4.76 ± 0.27c,2,AB a

*121 ± 10.5a,1,A *3.41 ± 0.23b,1,A 12


*139 ± 15.3b,2,B *4.07 ± 0.45b,2,B
a bc d
*146 ± 13.3b,1,B *4.33 ± 0.25b,1,C 10

Force (N)
6

each layer on the bottom of the printer’s vat, which is 2


filled with resin. Consequently, the polymerization takes
place without the presence of oxygen, and thus no oxy- 0
0 20 40 60
gen inhibition layer could interfere with the adhesion b Indentation (µm)
between the two layers. So, directly after the printing
process, additively manufactured objects demonstrate Fig 3  Load displacement curves. (a) Postpolymerization device
Otoflash: a = 3DT; b = GCT; c = FPT; d = TC; e = NDT. (b) 3D-printed
a high degree of conversion, which is even increased resin material NextDent C&B: a = TC; b = Otoflash; c = Printbox;
after the use of postpolymerization devices.32 The d = Labolight.
adhesion between the layers is quite high, as demon-
strated by a study that investigated the fracture load of
a 3D-printed three-unit partial denture depending on parameters decreased after 14 days of water storage.
the building direction.33 Objects that are 3D printed are This phenomenon might be explained by an initial water
anisotropic—this means that the mechanical properties uptake and degradation of the resin matrix. The increase
of such an object are dependent on the building direc- of the Martens parameters after another 14 days of wa-
tion with which it is manufactured.34 A force exerted ter storage, however, is quite interesting. Such behavior
on the object can have different impacts if it acts either has been reported for direct resin materials before.37 For
perpendicular or parallel to the layers. In this study, the this study, one could suppose that a subsequent post-
force was applied perpendicular to the layers, as this is polymerization process provoked by the warm storage
supposed to yield the highest mechanical properties, as medium would have taken place. This would mean that
stated by previous studies.35,36 The print layer thickness the postpolymerization devices were unable to lead to
was set to 50 µm, as specified by the manufacturers. the highest polymerization rate possible. However, it re-
However, a recent study discovered that such pre-set- mains unclear how the values would change after a lon-
tings for an SLA printer would not automatically match ger period of artificial aging. One might suppose that
the measured layer thickness as recorded under a scan- the values would decline again, as demonstrated by the
ning electron microscope after the printing process.35 study for the direct resin materials.37 Another study in-
The question of such a discrepancy would also be true vestigating a longer period of storage is needed. These
for a DLP printer such as the one used in this study, and null hypotheses were also rejected.
this should be investigated in further studies. The measured Martens parameters give an overview of
FDPs are exposed to 100% humidity during their time the important mechanical properties of resin-based mate-
in service. According to the results of this study, wa- rials, such as the elastic-plastic behavior, surface degrada-
ter storage seems to affect the mechanical properties tion induced by artificial aging, and deformation behavior
of the tested materials negatively. In general, Martens under force. Nevertheless, further parameters have to be

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Fundamental Research

investigated urgently for a more concrete comprehension 13. Güth JF, Edelhoff D, Ihloff H, Mast G. Complete mouth rehabilitation
of the properties of 3D-printed resins. This study focused after transposition osteotomy based on intraoral scanning: An experi-
mental approach. J Prosthet Dent 2014;112:89–93.
especially on the influence of different postpolymeriza- 14. Stansbury J, Idacavage M. 3D printing with polymers: Challenges among
tion strategies on the Martens parameters. expanding options and opportunities. Dent Mater 2016;32:54–64.
The influence of a longer artificial aging method on 15. Münchow EA, Ferreira AC, Machado RM, Ramos TS, Rodrigues-Junior
SA, Zanchi CH. Effect of acidic solutions on the surface degradation of a
elastic modulus and tensile strength is essential for a micro-hybrid composite resin. Braz Dent J 2014;25:321–326.
better understanding of this new class of materials and 16. Borges MA, Matos IC, Mendes LC, Gomes AS, Miranda MS. Degradation
should be the subject of future studies. of polymeric restorative materials subjected to a high caries challenge.
Dent Mater 2011;27:244–252.
17. Lohbauer U, Belli R, Ferracane JL. Factors involved in mechanical fatigue
CONCLUSIONS degradation of dental resin composites. J Dent Res 2013;92:584–591.
18. Wendler M, Belli R, Valladares D, Petschelt A, Lohbauer U. Chairside
CAD/CAM materials. Part 3: Cyclic fatigue parameters and lifetime
Based on the findings of this in vitro study, the follow- predictions. Dent Mater 2018;34:910–921.
ing conclusions were drawn: 19. Shahdad SA, McCabe JF, Bull S, Rusby S, Wassell RW. Hardness mea-
sured with traditional Vickers and Martens hardness methods. Dent
Mater 2007;23:1079–1085.
• The tested resins for additive manufacturing show 20. Ferracane JL. Correlation between hardness and degree of conversion
Martens parameters comparable with those of the during the setting reaction of unfilled dental restorative resins. Dent
milled control group, with filled resins having better Mater 1985;1:11–14.
21. Bouschlicher M, Rueggeberg FA, Wilson BM. Correlation of bottom-to-
results. top surface microhardness and conversion ratios for a variety of resin
• The 3D-printed resins and the control group reacted composite compositions. Oper Dent 2004;29:698–704.
to water storage in a comparable way. 22. ISO 4049:2009. Dentistry—Polymer-based restorative materials. Ge-
neva, Switzerland: International Organization for Standardization. 2019.
• Considering HM and EIT as the essential factors for 23. Li Y, Swartz M, Phillips R, Moore B, Roberts TA. Effect of filler content
assessing the mechanical properties of materials, and size on properties of composites. J Dent Res 1985;64:1396–1401.
3D-printed resins should offer an alternative to 24. Kim KH, Ong JL, Okuno O. The effect of filler loading and morphology
on the mechanical properties of contemporary composites. J Prosthet
conventional materials for interim service. Dent 2002;87:642–649.
25. Bürgin S, Rohr N, Fischer J. Assessing degradation of composite resin
ACKNOWLEDGMENTS cements during artificial aging by Martens hardness. Head Face Med
2017;13:9.
26. Baroudi K, Silikas N, Watts DC. Time‐dependent visco‐elastic creep and
The authors report no conflicts of interest. recovery of flowable composites. Eur J Oral Sci 2007;115:517–521.
27. Watts DC. Elastic moduli and visco-elastic relaxation. J Dent 1994;22:
154–158.
REFERENCES 28. Argon AS. A theory for the low-temperature plastic deformation of
glassy polymers. The Philosophical Magazine: A Journal of Theoretical
  1. Lambert H, Durand JC, Jacquot B, Fages M. Dental biomaterials for chair- Experimental and Applied Physics 1973;28:839–865.
side CAD/CAM: State of the art. J Adv Prosthodont 2017;9:486–495. 29. El-Safty S, Silikas N, Watts DC. Creep deformation of restorative resin-
  2. Beuer F, Schweiger J, Edelhoff D. Digital dentistry: An overview of composites intended for bulk-fill placement. Dent Mater 2012;28:
recent developments for CAD/CAM generated restorations. Br Dent J 928–935.
2008;204:505–511. 30. Bapna MS, Mueller HJ, Knoeppel R. Compressive creep of dental com-
  3. Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of posites. J Dent Res 1985;64:1179–1184.
crown and bridge restorations. Aust Dent J 2011;56(suppl 1):s97–s106. 31. Hampe R, Lümkemann N, Sener B, Stawarczyk B. The effect of artificial
  4. Nguyen JF, Migonney V, Ruse ND, Sadoun M. Resin composite blocks via aging on Martens hardness and indentation modulus of different dental
high-pressure high-temperature polymerization. Dent Mater 2012; CAD/CAM restorative materials. J Mech Behav Biomed Mater 2018;86:
28:529–534. 191–198.
  5. Strub JR, Rekow ED, Witkowski S. Computer-aided design and fabrica- 32. Reymus M, Lümkemann N, Stawarczyk B. 3D-printed material for
tion of dental restorations: Current systems and future possibilities. temporary restorations: Impact of print layer thickness and post-curing
J Amer Dent Assoc 2006;137:1289–1296. method on degree of conversion. Int J Comput Dent 2019;22:231–237.
  6. Kessler A, Hickel R, Reymus M. 3D printing in dentistry—State of the art. 33. Reymus M, Fabritius R, Kessler A, Hickel R, Edelhoff D, Stawarczyk B.
Oper Dent 2019. Epub ahead of print June 7. Fracture load of 3D-printed fixed dental prostheses compared with
  7. Hazeveld A, Huddleston Slater JJ, Ren Y. Accuracy and reproducibility milled and conventionally fabricated ones: The impact of resin material,
of dental replica models reconstructed by different rapid prototyping build direction, post-curing, and artificial aging—An in vitro study.
techniques. Am J Orthod Dentofacial Orthop 2014;145:108–115. Clin Oral Investig 2019. Epub ahead of print May 24.
  8. Reyes A, Turkyilmaz I, Prihoda TJ. Accuracy of surgical guides made from 34. Väyrynen VO, Tanner J, Vallittu PK. The anisotropicity of the flexural
conventional and a combination of digital scanning and rapid prototyp- properties of an occlusal device material processed by stereolithography.
ing techniques. J Prosthet Dent 2015;113:295–303. J Prosthet Dent 2016;116:811–817.
  9. Krastl G, Zehnder MS, Connert T, Weiger R, Kühl S. Guided endodontics: 35. Alaqeel SM, Ramakrishnaiah R, Basavaraju RM, Kotha SB. Effect of 3D
A novel treatment approach for teeth with pulp canal calcification and printing direction and water storage on nano-mechanical properties
apical pathology. Dent Traumatol 2016;32:240–246. of 3D printed and auto-polymerized polymer with special emphasis on
10. Salmi M, Paloheimo KS, Tuomi J, Ingman T, Mäkitie A. A digital process printing layer interface. Mater Express 2019;9:351–357.
for additive manufacturing of occlusal splints: A clinical pilot study. J R 36. Unkovskiy A, Bui PHB, Schille C, Geis-Gerstorfer J, Huettig F, Spintzyk S.
Soc Interface 2013;10:20130203. Objects build orientation, positioning, and curing influence dimensional
11. Reymus M, Fotiadou C, Kessler A, Heck K, Hickel R, Diegritz C. 3D accuracy and flexural properties of stereolithographically printed resin.
printed replicas for endodontic education. Int Endod J 2019;52:123–130. Dent Mater 2018;34:324–333.
12. Reymus M, Fotiadou C, Hickel R, Diegritz C. 3D‐printed model 37. Hahnel S, Henrich A, Bürgers R, Handel G, Rosentritt M. Investigation of
for hands‐on training in dental traumatology. Int Endod J mechanical properties of modern dental composites after artificial aging
2018;51:1313–1319. for one year. Oper Dent 2010;35:412–419.

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