In-vitro performance of subtractively and additively manufactured resin-based molar crowns

Purpose: To compare the in-vitro performance and wear behavior of additively or subtractively fabricated resin -based composite molar crowns for temporary and permanent application.Materials and methods: Identical molar crowns (n = 8 per group) were manufactured from materials for tem-porary or permanent application (3x temporary additive fabrication, 3x additive permanent fabrication, 1x temporary subtractive fabrication, 1x permanent subtractive fabrication). All crowns were adhesively bonded (Calibra Universal, Dentsply Sirona, USA) on standardized resin-based composite molars (FDI 46, P Pro tem-porary Crown & Bridge). Thermal cycling and mechanical loading (2 x 3000 x 5 degrees C/55 degrees C, 2min, H20 dist., 1.2 x 106 force 50N) were performed and fracture force was determined (v = 1 mm/min, Z010, Zwick, Germany). Mean wear, maximum wear, and roughness were investigated on polished (P1200) specimens (n = 8 per group, d = 8 mm) in a pin-on-block test (50N; 120000 cycles; 1.6Hz; H2O). Statistics were performed by using one-way ANOVA, Bonferroni post-hoc-tests, and Pearson-correlation (a = 0.05).Results: All crowns survived TCML without failures. Fracture forces ranged from 1362.4 +/- 182.4N to 2354.1 +/- 373.3N for the additive temporary crowns, from 1680.4.4 +/- 525.1N to 2601.6 +/- 403.7N for the additive per-manent crowns, and reached values of 2988.5 +/- 604.7N for subtractive temporary crowns and 3092.0 +/- 307.6 N for subtractive permanent crowns. Significant (p < 0.001) differences were identified between the various additively manufactured systems, but not for the subtractively fabricated systems (p = 0.673). Mean wear of the additive temporary crowns ranged between 114.5 +/- 25.8 mu m and 163.8 +/- 21.4 mu m without significant differ-ences (p = 0.061). Mean wear of the additive permanent crowns ranged between 120.0 +/- 27.5 mu m and 171.3 +/- 31.8 mu m with significant differences (p = 0.004). No statistically significant differences were identified between temporary and permanent subtractively manufactured specimens, with mean wear ranging between 140.5 +/- 51.1 mu m and 176.6 +/- 26.8 mu m (p = 0.673). Maximum wear of additive temporary specimens ranged between 221.4.5 +/- 53.3 mu m and 322.1 +/- 50.6 mu m; significant differences were identified between the groups (p = 0.016). Maximum wear of additive permanent specimens ranged between 246.3 +/- 47.3 mu m and 337.4 +/- 61.4 mu m, and significant differences were identified between the groups (p = 0.006). Mean wear of the subtractive group (permanent and temporary) showed no differences in maximum wear from 277.9 +/- 79.7.1 mu m to 316.4 +/- 58.1 mu m (p = 0.288). Ra roughness ranged from 0.7 +/- 0.2 mu m to 3.6 +/- 1.3 mu m with significant differences (p < 0.001) and Rz reference between 65.9 +/- 26.2 mu m and 16.8 +/- 6.3 mu m. Conclusion: Temporary and permanent molar crowns provided at least acceptable in-vitro performance and fracture force for clinical mid-term application. Laboratory wear stability of the resin-based materials appeared sufficient, but should be verified under clinical conditions.