Evaluation of wear behaviour of various occlusal splint materials and manufacturing processes

Objectives: To investigate the volumetric and vertical loss of occlusal splints manufactured by conventional (heat-cure), subtractive (CAD/CAM) and additive (3D-printing) methods. Methods: Six occlusal splint materials were investigated (n = 126), using three manufacturing methods: heat-cured, CAD/CAM and 3D-printed built-in three different printing angles (0 degrees, 45 degrees and 90 degrees). Block-on-ring wear testing was performed with extracted human molars as the antagonist. All samples were tested with an applied force of 49N at 1 Hz and 60RPM in artificial saliva at 37 degrees C for six and 12 months. Scanning electron microscopy images were analysed to evaluate the wear on the tooth enamel and in the splint material. Volumetric and vertical wear loss were statistically analysed. Results: The lowest volumetric and vertical loss was observed in CAD-CAM materials (6.44 +/- 1.77 mm(3) and 48.3 +/- 7.14 mu m) with no statistical significance to the heat-cured material (17.22 +/- 9.23 mm(3) and 148 +/- 121.1 mu m) after 12 months (p < 0.172). The mean volumetric loss of 3D printed materials ranged from 0.25 +/- 0.15 mm(3) to 0.29 +/- 0.1 4mm(3) with no statistical difference, whereas, the differences in vertical loss from 131.63 +/- 44.1 mu m to 493 +/- 79.19 mu m were statistically significant (p < 0.001). The highest vertical loss was observed in the KeySplint Soft 3D printed at 90 degrees (385.35 +/- 82.37 mu m), whereas FreePrint Splint 2.0 with a build angle of 0 degrees had the highest volumetric loss (204.59 +/- 25.67 mm(3)). Conclusion: CAD-CAM material had the highest wear resistance followed by heat-cured material.KeySplint Soft and FreePrint Splint 2.0 3D printed materials would be preferred for patients that do not have severe bruxing episodes. No significant wear of human enamel after six and 12 months was observed under SEM for any tested materials.

Automated summary

This study investigated the volumetric and vertical loss of occlusal splints manufactured by conventional (heat-cure), subtractive (CAD/CAM) and additive (3D-printing) methods. The results showed that CAD-CAM material had the highest wear resistance, followed by heat-cured material. KeySplint Soft and FreePrint Splint 2.0 3D printed materials would be preferred for patients without severe bruxing episodes. No significant wear of human enamel was observed for any tested materials.