Ceramic Printing— Comparative Study of the Flexural Strength of 3D-Printed and Milled Zirconia

Bergler, Michael; Korostoff, Jonathan; Torrecillas-Martínez, Laura; Mante, Francis K.

doi:10.11607/ijp.6749

Cited by 22 publications

(24 citation statements)

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“…In general, specimens in which the building and tensile loading direction are parallel (Figure 1a) have an inferior flexural strength than specimens which are loaded perpendicularly to the building direction (Figure 1b) [9]. Our results were in line with a previous study reported by Bergler et al (2021), which showed comparable flexural strength for both additively and subtractively manufactured zirconia [27]. On the other hand, Lu et al and Revilla-Leon et al reported that additive manufactured zirconia had a lower flexural strength than subtractive manufactured zirconia [17,28].…”

Section: Discussionsupporting

confidence: 92%

Additively Manufactured Zirconia for Dental Applications

et al. 2021

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We aimed to assess the crystallography, microstructure and flexural strength of zirconia-based ceramics made by stereolithography (SLA). Two additively manufactured 3 mol% yttria-stabilized tetragonal zirconia polycrystals (3Y-TZP: LithaCon 3Y 230, Lithoz; 3D Mix zirconia, 3DCeram Sinto) and one alumina-toughened zirconia (ATZ: 3D Mix ATZ, 3DCeram Sinto) were compared to subtractively manufactured 3Y-TZP (control: LAVA Plus, 3M Oral Care). Crystallographic analysis was conducted by X-ray diffraction. Top surfaces and cross-sections of the subsurface microstructure were characterized using scanning electron microscopy (SEM). Biaxial flexural strength was statistically compared using Weibull analysis. The additively and subtractively manufactured zirconia grades revealed a similar phase composition. The residual porosity of the SLA 3Y-TZPs and ATZ was comparable to that of subtractively manufactured 3Y-TZP. Weibull analysis revealed that the additively manufactured LithaCon 3Y 230 (Lithoz) had a significantly lower biaxial flexural strength than 3D Mix ATZ (3D Ceram Sinto). The biaxial flexural strength of the subtractively manufactured LAVA Plus (3M Oral Care) was in between those of the additively manufactured 3Y-TZPs, with the additively manufactured ATZ significantly outperforming the subtractively manufactured 3Y-TZP. Additively manufactured 3Y-TZP showed comparable crystallography, microstructure and flexural strength as the subtractively manufactured zirconia, thus potentially being a good option for dental implants.

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Section: Discussionsupporting

confidence: 92%

Additively Manufactured Zirconia for Dental Applications

et al. 2021

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“…Li et al reported a flexural strength of 812 ± 128 MPa for additively manufactured zirconia which is close to the findings in this study (755.1 ± 147.1 MPa). The findings in this study indicate that AM zirconia has adequate strength to be used for fabricating dental crowns and fixed dental prosthesis (ISO 6872) 42,50,52 …”

Section: Discussionmentioning

confidence: 79%

“…The findings in this study indicate that AM zirconia has adequate strength to be used for fabricating dental crowns and fixed dental prosthesis (ISO 6872). 42,50,52 Fabricating bio-inspired dental restorations with functionally graded structures emulating the mechanical properties of human enamel and dentin with dental ceramics is a challenge. However, fabricating ceramic structures with different porosities can impart functional grading.…”

Section: Discussionmentioning

confidence: 99%

The Flexural Strength and Flexural Modulus of Stereolithography Additively Manufactured Zirconia with Different Porosities

Zandinejad

Das

Barmak

et al. 2021

Journal of Prosthodontics

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Purpose: Additive manufacturing (AM) technologies are capable of fabricating complex geometries with different porosities. However, the effect of such porosities on mechanical properties of stereolithography (SLA) AM zirconia with different porosities is unclear. The purpose of this in vitro study was to investigate the mechanical properties namely flexural strength, and flexural modulus of AM zirconia with different porosities. Materials and Methods: A bar (25 × 4 × 3 mm) for flexural strength test (ISO standard 6872/2015) was designed by CAD software program and standard tessellation language (STL) file was obtained. The STL file was used to fabricate a total of 80 bars in four groups. Three experimental groups each containing 20 samples were manufactured using an SLA ceramic printer (CeraMaker 900; 3DCeram Co) and zirconia material (3DMix ZrO 2 paste; 3DCeram Co) with different sintering post processing to achieve different porosities including 0%-porosity (AMZ0), 20%-porosity (AMZ20), and 40%-porosity (AMZ40). The same STL file was used for subtractive manufacturing or milling of 20 zirconia bars as control group (CNCZ) with the same dimensions using a commercial zirconia. Three-point bending tests were performed for all groups following ISO standard 6872/2015 specification using a universal testing machine. Outcomes measured included load at fracture, mean flexural strength, and flexural modulus and they were compared across the experimental groups using a one-way ANOVA. Post hoc pair wise comparison between each pair of the groups were performed using Tukey test. Results: There was a significant difference between the four groups, in terms of fracture load, flexural strength and flexural modulus using one-way ANOVA. AM zirconia with 0% porosity (AMZ0) showed the highest value for fracture load (1132.7 ± 220.6 N), flexural strength (755.1 ± 147.1 MPa) and flexural modulus (41,273 ± 2193 MPa) and AM zirconia with 40% porosity (AMZ40) showed the lowest fracture load (72.13 ± 13.42 N), flexural strength (48.09 ± 8.95 MPa) and flexural modulus (7177 ± 506 MPa). Tukey's pairwise comparisons detected a significant difference between all the possible pairs for all variables except flexural modulus between AMZ0 and CNCZ. The Weibull moduli presented the lowest value for AMZ20 (4.4) followed by AMZ40 (6.1), AMZ0 (6.1), and the highest value was for CNCZ (8.1). Conclusion: AM zirconia with 0% porosity showed significantly higher flexural strength and flexural modulus when compared to milled and AM zirconia with 20% and 40% porosities.

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“…A total of 16 in vitro studies were included in the qualitative analysis 35,42‐45,47,58‐67 43,45,58–61,66,67 alumina (3 studies)], 35,42,62 hardness [zirconia (2 studies), 58,64 alumina (2 studies)], 35,62 fracture toughness [zirconia (1 study), 64 alumina (2 studies)], 35,62 morphology [zirconia (2 studies), 58,64 alumina (1 study)], 62 roughness [zirconia, (2 studies)], 58,64 Weibull distribution [zirconia (2 studies), 59,61 alumina (2 studies)], 62,42 density [zirconia (2 studies)], 61,64 sintering shrinkage [zirconia (2 studies)], 61,42 structure [zirconia (4 studies)], 44,61,64,67 fracture resistance [zirconia (2 studies)], 47,65 load bearing capacity [zirconia (1 study)], 63 wettability [zirconia (1 study)], 64 biocompatibility [zirconia (1 study)], 64 elastic modulus [zirconia (1 study)], 44 and chemical composition [zirconia (2 studies)] 61,43 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Color match, accuracy, and physical and mechanical properties are important factors for the clinical success and longevity of indirect restorations 31–40 . Several studies have investigated the AM of ceramics for dental restorations 12,22,30,41–47 . The authors are unaware of a systematic review on the effect of using AM for dental ceramic fabrications.…”

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confidence: 99%

Additive Manufacturing of Dental Ceramics: A Systematic Review and Meta‐Analysis

Hamad

Al-Rashdan

Ayyad

et al. 2022

Journal of Prosthodontics

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The purpose of this systematic review and meta-analysis was to evaluate the effect of using additive manufacturing (AM) for dental ceramic fabrication in comparison with subtractive manufacturing (SM), and to evaluate the effect of the type of AM technology on dental ceramic fabrication. Materials and methods: A search was conducted electronically in MEDLINE (via PubMed), EBSCOhost, Scopus, and Cochran Library databases, and also by other methods (table of contents screening, backward and forward citations, and grey literature search) up to February 12, 2022, to identify records evaluating additive manufacturing of ceramics for dental purposes in comparison with subtractive manufacturing. A minimum of 2 review authors conducted tstudy selection, quality assessment, and data extraction. Quality assessment was performed with Joanna Briggs Institute tool, and the quantitative synthesis was performed with the Comprehensive Meta-Analysis program (CMA, Biostat Inc). Hedges's g for effect size was calculated, with 0.2 as small, 0.5 as medium, and 0.8 as large. Heterogeneity was assessed with I 2 and prediction interval (PI) statistics. Publication bias was investigated with funnel plots and grey literature search. Certainty of evidence was assessed with the Grading of Recommendations: Assessment, Development, and Evaluation (GRADE) tool. Results: A total of 28 studies were included for the qualitative and quantitative synthesis; 11 in vitro studies on accuracy, 1 in vivo study on color, and 16 in vitro studies on physical and mechanical properties. Meta-analysis showed overall higher accuracy for SM compared with AM, with medium effect size (0.679, CI: 0.173 to 1.185, p = 0.009) and also for marginal (g = 1.05, CI: 0.344 to 1.760, p = 0.004), occlusal (g = 2.24, CI: 0.718 to 3.766, p = 0.004), and total (g = 4.544, CI: -0.234 to 9.323, p = 0.062) with large effect size; whereas AM had higher accuracy than SM with small effect size for the external (g = -0.238, CI: -1.215 to 0.739), p = 0.633), and internal (g = -0.403, CI: -1.273 to 0.467, p = 0.364) surfaces. For technology, self-glazed zirconia protocol had the smallest effect size (g = -0.049, CI: -0.878 to 0.78, p = 0.907), followed by stereolithography (g = 0.305, CI: -0.289 to 0.9, p = 0.314), and digital light processing (g = 1.819, CI: 0.662 to 2.976, p = 0.002) technologies. Flexural strength was higher for ceramics made by SM in comparison to AM with large effect size (g = -2.868, CI: -4.371 to -1.365, p < 0.001). Only 1 study reported on color, favoring ceramics made through combined AM and SM. Conclusions: Subtractive manufacturing had better overall accuracy, particularly for the marginal and occlusal areas, higher flexural strength, and more favorable hardness, fracture toughness, porosity, fatigue, and volumetric shrinkage; whereas AM had

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Ceramic Printing— Comparative Study of the Flexural Strength of 3D-Printed and Milled Zirconia

Cited by 22 publications

References 0 publications

Additively Manufactured Zirconia for Dental Applications

Additively Manufactured Zirconia for Dental Applications

The Flexural Strength and Flexural Modulus of Stereolithography Additively Manufactured Zirconia with Different Porosities

Additive Manufacturing of Dental Ceramics: A Systematic Review and Meta‐Analysis

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