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    Bond strength of additively manufactured composite resins to dentin and titanium when bonded with dual-polymerizing resin cements
    (Mosby-Elsevier, 2024) Donmez, Mustafa Borga; Cakmak, Gulce; Yilmaz, Deniz; Schimmel, Martin; Abou-Ayash, Samir; Yilmaz, Burak; Peutzfeldt, Anne
    Statement of problem. Additively manufactured composite resins for definitive restorations have been recently introduced. The bond strength between these composite resins and different substrates has not been extensively studied. Purpose. The purpose of this in vitro study was to measure the shear bond strength (SBS) between additively manufactured composite resins and dentin and titanium substrates and compare those with the SBS between subtractively manufactured polymer-infiltrated ceramic and the same substrates (dentin and titanium), when different dual-polymerizing resin cements were used. Material and methods. One hundred and eighty cylinder-shaped specimens (& Oslash;5x5 mm) were prepared from 3 materials recommended for definitive restorations: an additively manufactured composite resin (Crowntec [CT]); an additively manufactured hybrid composite resin (VarseoSmile Crown Plus [VS]); and a subtractively manufactured polymer-infiltrated ceramic (Enamic [EN]) (n=60). Specimens were randomly divided into six subgroups to be cemented to the two substrates (dentin and titanium; n=30) with 1 of 3 resin cements (RelyX Universal, Panavia V5, and Variolink Esthetic DC) (n=10). The restoration surface to be bonded was treated according to the respective manufacturer's recommendations. Dentin surfaces were treated according to the resin cement (Scotchbond Universal Plus Adhesive for RelyX Universal, Panavia V5 Tooth Primer for Panavia V5, and Adhese Universal for Variolink Esthetic DC), while titanium surfaces were airborne-particle abraded, and only the specimens paired with Panavia V5 were treated with a ceramic primer (Clearfil Ceramic Primer Plus). SBS was measured in a universal testing machine at a crosshead speed of 1 mm/min. Failure modes were analyzed under a microscope at x12 magnification. Data were analyzed by using 2-way analysis of variance and Tukey honestly significant difference tests (a=.05). Results. When SBS to dentin was considered, only restorative material, as a main factor, had a significant effect (P<.001); EN had the highest SBS (P<.001), while the difference in SBS values of CT and VS was not significant (P=.145). As for SBS to titanium, the factors restorative material and resin cement and their interaction had a significant effect (P<.001). Within each resin cement, EN had the highest SBS to titanium (P<.001), and within each restorative material, Variolink resulted in the lowest SBS (P<.010). Overall, EN and RelyX were associated with the highest SBS to titanium (P<.013). Mixed failures were predominant in most groups. Conclusions. Regardless of the substrate or the resin cement used, the subtractively manufactured polymer-infiltrated ceramic had higher shear bond strength than the additively manufactured composite resins. The SBS of the additively manufactured composite resins, whether bonded to dentin or titanium, were not significantly different from each other. Regardless of the restorative material, Variolink DC resulted in the lowest SBS for titanium surfaces. (J Prosthet Dent 2024;132:1067.e1-e8)
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    Fabrication trueness and marginal quality of additively manufactured resin-based definitive laminate veneers with different restoration thicknesses
    (Elsevier Sci Ltd, 2024) Cakmak, Guelce; Donmez, Mustafa Borga; Yilmaz, Deniz; Yoon, Hyung-In; Kahveci, Cig dem; Abou-Ayash, Samir; Yilmaz, Burak
    Objectives: To evaluate how restoration thickness (0.5 mm and 0.7 mm) affects the fabrication trueness of additively manufactured definitive resin-based laminate veneers, and to analyze the effect of restoration thickness and margin location on margin quality. Methods: Two maxillary central incisors were prepared either for a 0.5 mm- or 0.7 mm-thick laminate veneer. After acquiring the partial-arch scans of each preparation, laminate veneers were designed and stored as reference data. By using these reference data, a total of 30 resin-based laminate veneers were additively manufactured (n = 15 per thickness). All veneers were digitized and stored as test data. The reference and test data were superimposed to calculate the root mean square values at overall, external, intaglio, and marginal surfaces. The margin quality at labial, incisal, mesial, and distal surfaces was evaluated. Fabrication trueness at each surface was analyzed with independent t-tests, while 2-way analysis of variance was used to analyze the effect of thickness and margin location on margin quality (alpha = 0.05). Results: Regardless of the evaluated surface, 0.7 mm-thick veneers had lower deviations (P < 0.001). Only the margin location (P < 0.001) affected the margin quality as labial margins had the lowest quality (P < 0.001). Conclusion: Restoration thickness affected the fabrication trueness of resin-based laminate veneers as 0.7 mmthick veneers had significantly higher trueness. However, restoration thickness did not affect the margin quality and labial margins had the lowest quality. Clinical significance: Laminate veneers fabricated by using tested urethane-based acrylic resin may require less adjustment when fabricated in 0.7 mm thickness. However, marginal integrity issues may be encountered at the labial surface.
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    Trueness and precision of combined healing abutment scan body system scans at different sites of maxilla after multiple repositioning of the scan body
    (Elsevier Sci Ltd, 2023) Donmez, Mustafa Borga; Guven, Mehmet Esad; Yilmaz, Deniz; Abou-Ayash, Samir; Cakmak, Gulce; Yilmaz, Burak
    Objectives: To evaluate the accuracy of the scans of the combined healing abutment-scan body (CHA-SB) system located at different sites of the maxilla when SBs are replaced in between each scan.Methods: Three SBs were seated into HAs located at the central incisor, first premolar, and first molar sites of a maxillary model inside a phantom head, and the model was scanned extraorally (CEREC Primescan SW 5.2). This procedure was repeated with new SBs until a total of 10 scans were performed. Standard tessellation language files of CHA-SBs at each implant location were isolated, transferred into analysis software (Geomagic Control X), and superimposed over the proprietary library files to analyze surface (root mean square), linear, and angular deviations. Trueness and precision were evaluated with one-way analysis of variance and Tukey tests. The correlation between surface and angular deviations was analyzed with Pearson's correlation (alpha=0.05).Results: Molar implant scans had the highest surface and angular deviations (P <=.006), while central incisor implant scans had higher precision (surface deviations) than premolar implant scans (P=.041). Premolar implant scans had higher accuracy than central incisor implant scans on the y-axis (P <=.029). Central incisor implant scans had the highest accuracy on the z-axis (P <=.018). A strong positive correlation was observed between surface and angular deviations (r = 0.864, P<.001).Conclusion: Central incisor implant scans mostly had high accuracy and molar implant scans mostly had lower trueness. SBs were mostly positioned apically; however, the effect of SB replacement can be considered small as measured deviations were similar to those in previous studies and the precision of scans was high.Clinical Significance: Repositioning of scan bodies into healing abutments would be expected to result in similar single crown positioning regardless of the location of the implant, considering high scan precision with the healing abutment-scan body system. The duration of the chairside adjustments of crowns in the posterior maxilla may be longer than those in the anterior region.