Alfouzan AF, et al. J Adv Prosthodont. 2021 Jun;13(3):160-171. https://doi.org/10.4047/jap.2021.13.3.160

This study assessed the efficacy of five denture cleansers on the microbial adherence and surface topography of conventional and CAD/CAM denture base resins. Acrylic resin discs were fabricated using conventional, milling, and 3D printing methods (N = 180). The discs were contaminated with dual species of Candida albicans and Streptococcus mutans biofilm for 72 h and then disinfected with either of the denture cleansers (Fittydent cleansing tablets, 2% Chlorhexidine gluconate, 0.2% Chlorhexidine gluconate, 0.5% sodium hypochlorite, and 1% sodium hypochlorite (n = 10). Distilled water served as the control group. The colony-forming units of the microorganisms were calculated, followed by post-treatment surface roughness. Data were statistically analyzed using one-way ANOVA, paired t-test, and post hoc Tukey HSD test (α = 0.05). Among the denture cleansers, 2% Chlorhexidine gluconate, 0.5% sodium hypochlorite, and 1% sodium hypochlorite had the best cleansing effect on the resin discs and demonstrated zero growth of colonies for both the species. Comparing the material groups, the 3D-processed discs showed higher colony-forming units followed by the conventional and CAD/CAM milled group. The highest surface roughness was demonstrated by the 3D-printed discs (0.690 ± 0.08 μm), followed by the conventional (0.493 ± 0.11 μm) and the milled groups (0.301 ± 0.08 μm). The tested chemical denture cleansers affected the Candida albicans and Streptococcus mutans adhesion compared to control discs immersed in distilled water. The clinician may recommend to their patient to use 2% chlorhexidine gluconate for the disinfection of CAD/CAM PMMA denture base materials.

The purpose of this in vitro study is to compare the roughness and gloss of four resin-modified CAD/CAM ceramics after different surface treatments. Forty-eight specimens (1.20 × 12 mm²) were prepared from Lava Ultimate (LU), Vita Enamic (VE), Cerasmart (CS), and Crystal Ultra (CU) CAD/CAM ceramics. The prepared specimens were polished with silicon carbide paper before being roughened with a 30 µm grit diamond bur. Each material was allocated into four groups: control (no treatment), Luster Meisinger polishing (MP), Optiglaze (OG), or Meisinger polishing, followed by a final polishing with Shofu Direct Dia Paste (MP+PP). The roughness and gloss were measured after the surface treatment using a profilometer and gloss meter, respectively. Scanning electron microscopy micrographs were obtained to analyze the surface characteristics. Statistical analysis was performed using a multivariate analysis of variance (MANOVA), one-way ANOVA, and Dunnett’s post hoc test (α = 0.05). The surface treatments significantly affected the surface roughness and gloss of the tested materials (p < 0.05). All the tested resin-modified CAD/CAM ceramics demonstrated a lower surface roughness and higher gloss after glazing using OG, followed by MP+PP and MP. The highest and lowest Ra were presented by the control VE (0.63 ± 0.23 µm) and glazed LU specimens (0.04 ± 0.01 µm), respectively. The highest and lowest GU were presented by the glazed LU (90.48 ± 4.69 GU) and the control VE specimens (23.32 ± 2.41 GU), respectively. After clinical adjustment, finishing, and polishing, the restoration is essential to obtain a restorative surface with lower roughness and the highest gloss. Surface glazing using Optiglaze exhibited the smoothest and glossiest surface of all the tested resin-modified ceramics.

This study aimed to evaluate the airborne-particle abrasion surface treatment effects on the tensile bond strength (TBS) between resilient denture liner and CAD/CAM or conventional heat polymerized poly (methyl methacrylate) (PMMA) acrylic denture resins. A total of 48 dumbbell-shaped specimens (70 mm in total length, and 12 mm and 7 mm in diameter at the thickest and thinnest section, respectively) were prepared from CAD/CAM and conventional acrylic resins. Before relining with denture liner, 12 specimens from each material were surface-treated by 110 µm Al₂O₃ airborne-particle abrasion, and the remaining specimens served as control (no treatment). Following relining, all the specimens were aged by thermal cycling (1000 cycles, 5–55 °C). The TBS of denture liner to acrylic denture resins was tested in a universal testing apparatus at a 5 mm/min crosshead speed. The debonded surfaces were visually examined for the failure modes. ANOVA and multiple comparisons posthoc analysis tests were applied to determine the significant difference in TBS between the study groups (α = 0.05). A significant difference in TBS was observed between the control and surface treated groups (p < 0.001) for both acrylic resins materials. However, there was no statistically significant difference in bond strength between the acrylic resins materials (p = 0.739). Surface treatment with airborne-particle abrasion demonstrated increased TBS of the soft denture liners to acrylic resins. The TBS of conventional and CAD/CAM acrylic resins to soft denture liners were not considerably different.

Objectives: This systematic review compares computer-aided design and computer-aided manufacturing (CAD/CAM) 3D-printed complete dentures (CDs) with conventional ones in terms of patient satisfaction. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) reporting criteria for systematic reviews were followed in conducting this systematic review. The study question was “What are the patient satisfaction outcomes of 3D-printed versus conventional CDs in edentulous patients?” according to the population, intervention, comparison, and outcome (PICO) framework. A comprehensive electronic search was conducted across three databases (PubMed/Medline, Web of Science core collection, and Scopus; last update: 18 August 2024) to obtain clinical trials that compared traditional and 3D-printed CDs. The retrieved articles were screened, their data were extracted, and their quality was evaluated. Results: The initial search retrieved 803 publications; 12 were chosen for a thorough review, and 5 of them—4 randomized cross-over studies and 1 randomized three-parallel arm study—met the requirements for this systematic review. One study showed significant differences in five of nine patient denture satisfaction domains, positively favoring the conventional CDs. Two studies showed non-significant differences in satisfaction domains between the conventional and 3D-printed groups, except for aesthetics and pronunciation. On the contrary, the satisfaction scores in two other studies showed no significant difference between the conventional and 3D-printed denture groups. Conclusions: The analysis of the included studies and evidence gathered demonstrates that CAD/CAM 3D-printed CDs seem to be comparable with conventional CDs in terms of overall patient satisfaction; however, 3D-printed CDs generate some concerns related to aesthetics and speech.

This study aimed to compare the effect of thickness and background on the color changes of CAD/CAM materials (zirconia-reinforced lithium silicate (Suprinity), lithium disilicate (IPS E-max CAD), and hybrid ceramic (Enamic)). Twelve specimens for each thickness (0.4 mm, 0.5 mm, 1 mm, 1.5 mm, and 2 mm) were obtained by sectioning three CAD/CAM materials. A spectrophotometer was used to measure the color change of the specimens against different backgrounds (A2 enamel, A4 dentin, gray, and metal) using the CIELab color space system. Analysis of variance, sample t-test, and posthoc multiple comparison tests were used to evaluate and compare the color changes for different material types, thicknesses, and background colors, with a significance level of P ≤ 0.05. The result demonstrated that material type, the thickness of the material, and the color of the background had a significant effect on ΔE (P = 0.000). Regardless of the material thickness, Suprinity had the highest mean ΔE values (5.4 ± 1.9), and E-max had the lowest mean ΔE values (1.1 ± 0.6). At 2 mm thickness, Enamic presented the lowest ∆E values (0.5 ± 0.5) against the A2 background. The 0.5 and 1 mm specimens corresponded to the highest ΔE values, whereas the 1.5 and 2 mm thickness specimens predominantly gave the lowest ΔE values. All the independent factors, including the type and thickness of the material, and color of the background, contributed significantly to ΔE of the tested materials (P ≤ 0.05). The study confirms the high masking ability of the lithium disilicate (E-max) material. In clinical situations where the color of the core needs to be masked, it is recommended to use lithium disilicate (E-max).