Titanium and its alloys are widely used for dental and medical biomaterials due to their excellent mechanical and biological advantages. After the introduction of direct laser metal sintering (DLMS) 3D printing technology and its use over conventional machine-cut processes, questions remain regarding whether 3D-printed titanium (alloy) devices have similar biological properties to machine-cut counterparts for dental applications. Thus, this work focuses on comparing the biological activities of machine-cut and 3D-printed specimens after optimizing the DLMS 3D-printing conditions in terms of the mechanophysical characteristics. The DLMS 3D-printing (as a function of the laser spacing from 30-100μm) and post-surface treatment (as-given or sand-blasted) conditions were optimized using medical-grade Ti-6Al-4V powders in terms of the inner pore amount, mechanical properties, roughness and hydrophilicity. Then, the initial cell adhesion of the optimized DLMS 3D-printed Ti-6Al-4V specimen was compared with that of the machine-cut Ti-6Al-4V specimen against human dermal fibroblasts (hDFs) and mesenchymal stem cells (hMSCs), which are representative of direct-contact cell types of orofacial mucosa and bone, respectively. hMSC differentiation on the specimens was conducted for up to 21 days to measure the osteogenic gene expression and biomineralization. Laser spacings of 30-40μm had fewer inner defects and consequently a higher three-point flexural strength and elastic modulus compared to other larger laser spacings. Depending on the span width (0.3-1mm) in the lattice architecture, the elastic modulus of the 3D-printed cuboid specimen can be further controlled (up to ∼30 times). The sand-blasted specimens after 3D printing revealed lower surface roughness and higher hydrophilicity compared to the as-3D printed specimen, which were considered optimal conditions for biological study. Initial hDF and hMSC adhesion for 12 hr and hMSC differentiation on the surface were comparable between the sand-blasted 3D-printed and machine-cut specimens in terms of adherent cell numbers, vinculin intensity, osteogenic gene expression and biomineralization. The optimized DLMS 3D-printed Ti-6Al-4V specimen had similar biological properties to those of the machine-cut counterpart, suggesting the potential usefulness of 3D printing technology for a wide range of dental applications.

Under some clinical conditions, the preparation of crowns of limited marginal thickness is inevitable. In such situations, it is questionable whether the same ideal preparation criteria can be applied equally. Since there are only a small number of studies focusing on the fracture resistance with respect to the marginal thickness, there is a need for a study evaluating whether zirconia crowns of limited marginal thickness are clinically acceptable. The purpose of this study is to evaluate the fracture resistance of monolithic zirconia crowns of limited marginal thickness in the posterior area. Methods: Abutments and CAD/CAM zirconia crowns with a marginal thickness of 1.0 mm were set as the control group, while experimental groups A, B, and C possessed reduced marginal thicknesses of 0.8 mm, 0.6 mm, and 0.4 mm, respectively (n = 10 per group). Resin-based abutment dies and monolithic zirconia crowns were fabricated using the CAD/CAM technique, and a universal testing machine was used to measure the fracture load value. Fractured specimens were examined with a scanning electron microscope. The data were analyzed using a one-way ANOVA and Bonferroni post hoc test (p < 0.05). Results: The means and standard deviations of the fracture load values of the control group and the three experimental groups were as follows: control group (1.0 mm): 3090.91 ± 527.77 N; group A (0.8 mm): 2645.39 ± 329.21 N; group B (0.6 mm): 2256.85 ± 454.15 N; group C (0.4 mm): 1957.8 ± 522.14 N. Conclusions: The crowns fabricated with a CAD/CAM zirconia block with limited marginal thicknesses of 0.6 mm and 0.4 mm showed significantly lower fracture resistance values compared to those with the recommended margin thickness of 1.0 mm.