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Öğe 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, AnneStatement 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)Öğe Comparison of trueness and margin quality of additively and subtractively manufactured definitive resin-based laminate veneers(Mosby-Elsevier, 2025) Yilmaz, Deniz; Cakmak, Gulce; Gueven, Mehmet Esad; Yoon, Hyung-In; Schimmel, Martin; Yilmaz, BurakStatement of problem: Currently available 3-dimensional (3D) additively manufactured (AM) resins used for definitive restorations have different chemical compositions and viscosities. The fabrication trueness and margin quality of laminate veneers additively manufactured with different resins have not been extensively studied. Purpose: The purpose of this in vitro study was to evaluate the fabrication trueness and margin quality of AM and subtractively manufactured (SM) definitive resin-based laminate veneers. Material and methods: A laminate veneer restoration for a maxillary right central incisor with a 25-mu m cement space was designed to generate a reference laminate veneer standard tessellation language (STL) file (RLV-STL). This RLV-STL was used to fabricate resin-based laminate veneers (N=60) for definitive use, either using AM (a low-viscosity, urethane acrylate-based resin (C&B Permanent, AM-LV), a high-viscosity, urethane acrylate-based resin (Tera Harz TC-80DP, AM-HV), and a glass-reinforced composite resin (Crowntec, AM-S) or SM (glass-filler reinforced composite resin blocks (Tetric CAD, SM) technologies. All laminate veneers were digitized with an intraoral scanner (CEREC Primescan SW 5.2) to generate their test STL files (TLV-STLs). RLV-STL and TLV-STLs were transferred into a 3D analysis software program (Geomagic Control X), and a trueness (external, intaglio, and marginal surface) analysis was performed by using the root mean square (RMS) method. The margin quality of laminate veneers was examined visually under a stereomicroscope and graded. The Kruskal-Wallis and Dunn tests were performed to analyze the data (alpha=.05). Results: External, intaglio, and marginal RMS values showed statistically significant differences among test groups (P<.001). The SM group had the highest RMS values for the external surface (P<.001), whereas the AM-LV group had the lowest RMS values. The AM-HV group had the highest RMS values for the intaglio surface (P<.001). No significant difference was found between the SM and AM-HV groups for marginal RMS values, which were higher than for the other groups (P=.830). All average values for the axial mesial, axial distal, and incisal edge margin quality of laminate veneers were found to be similar and Grade 3 (smooth edge) in all groups. Conclusions: Regardless of the evaluated surface, the fabrication technique affected the trueness of laminate veneers. The low-viscosity AM laminate veneers and AM laminate veneers reinforced with glass fillers had higher trueness than the SM laminate veneers at all surfaces. The low-viscosity AM laminate veneers had the highest trueness on external and marginal surfaces among the test groups and had higher trueness than the high-viscosity AM laminate veneers.Öğe Effect of Hydrothermal Aging on the Flexural Strength and Microhardness of Materials Used for Additive or Subtractive Manufacturing of Definitive Restorations(Quintessence Publishing Co Inc, 2024) Yilmaz, Deniz; Cakmak, Gulce; Guven, Mehmet Esad; Pieralli, Stefano; Yoon, Hyung-In; Revilla-Leon, Marta; Yilmaz, BurakPurpose: To evaluate the flexural strength (FS) and microhardness of various CAD/CAM restorative materials intended for definitive use. The effect of hydrothermal aging on the mechanical properties of these materials was also investigated. Materials and Methods: A total of 210 bar-shaped specimens (17 x 4 x 1.5 mm +/- 0.02 mm) were fabricated via either subtractive manufacturing (SM) methods-reinforced composite resin (SM-CR), polymer-infiltrated ceramic network (SM-PICN), fine-structured feldspathic ceramic (SM-FC), nanographene-reinforced polymethyl methacrylate (PMMA; SM-GPMMA), PMMA-based resin (SM-PMMA)-or additive manufacturing (AM) methods with urethane acrylate-based resins (AM-UA1 and AM-UA2). Specimens were then divided into two subgroups (nonaged or hydrothermal aging; n = 15). A three-point flexural strength test was performed, and five specimens from the nonaged group were submitted to microhardness testing. Specimens were subjected to 10,000 thermal cycles, and the measurements were repeated. Results: Regardless of aging, SM-CR had the highest FS (P <.001), followed by SM-GPMMA (P =.042). In nonaged groups, AM-UA2 had a lower FS than all other materials except SM-FC (P = 1.000). In hydrothermal aging groups, AM specimens had lower FS values than other materials, except SM-PMMA. With regard to microhardness, there was no significant difference found between any of the tested materials (P =.945) in the nonaged and hydrothermal aging groups. Conclusions: The effect of hydrothermal aging on FS varied depending on the type of restorative material. Regardless of aging condition, SM-CR showed the highest FS values, whereas SM- FC had the highest microhardness. Hydrothermal aging had no significant influence on the microhardness of the tested materials.Öğe Fabrication Trueness, Intaglio Surface Adaptation, and Marginal Integrity of Resin- Based Onlay Restorations Fabricated by Additive and Subtractive Manufacturing(Quintessence Publishing Co Inc, 2024) Cakmak, Gulce; Steigmeier, David; Guven, Mehmet Esad; Yilmaz, Deniz; Schimmel, Martin; Yoon, Hyung-In; Yilmaz, BurakPurpose: To evaluate the fabrication trueness, intaglio surface adaptation, and marginal integrity of resin- based onlay restorations made via additive manufacturing (AM) or subtractive manufacturing (SM). Materials and Methods: An onlay restoration was designed (DentalCAD Galway 3.0) and saved as an STL file to generate a design STL file (DO-STL). Using this design, 45 onlays were fabricated either with AM (3D-printed resin for definitive [AM-D; Tera Harz TC- 80DP] and interim [AM- I; Freeprint temp] restorations) or SM (composite resin, Tetric CAD) technologies. Onlays were scanned with an intraoral scanner (CEREC Primescan SW 5.2), and the scans were saved as test STL files (TO-STLs). For trueness evaluation, TO-STLs were superimposed over the DO-STL, and root mean square (RMS) values of overall and intaglio surfaces were measured (Geomagic Control X). For the intaglio surface adaptation and marginal integrity, a triple-scan protocol was performed. Kolmogorov-Smirnov, one- way ANOVA, and post-hoc Tukey honestly significant difference tests were used to analyze data (alpha =.05). Results: RMS values of intaglio and overall surfaces, intaglio adaptation, and marginal integrity varied among test groups (P <.001). AM- D had the greatest overall surface RMS (P <.001), while SM had the greatest intaglio surface RMS (P <.001). SM had the highest average distance deviations for intaglio surface adaptation and marginal integrity, whereas AM-D had the lowest (P <.001). Conclusions: AM-D onlays showed lower overall trueness than AM-I onlays and SM definitive onlays. However, AM-D onlays presented high intaglio surface trueness, intaglio surface adaptation, and marginal integrity.Öğe 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, BurakObjectives: 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.
