Adaptation of 3D Printed and Milled Titanium Custom Post and Core
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Abstract
Purpose: Restoration of endodontically treated teeth with substantial loss of tooth structure often requires custom post to provide sufficient retention for core material. Cement film thickness and its uniformity are important factors that can affect the success of custom post and core (CPC). A minimum and uniform cement layer will result in a post that is well adapted to the canal. Application of titanium (Ti) alloy has been successful in multiple aspects in dentistry, with very promising clinical outcomes. The purpose of this in vitro study was to evaluate and compare internal adaptation and cement film thickness of cast gold CPC, 3D printed Ti CPC, and milled Ti CPC.
Materials and Methods: 48 resin models, simulating a tooth prepared to receive a CPC, were fabricated. Models were randomly assigned to one of three groups (n=16 per group): (A) cast gold CPC (control group), (B) 3D printed Ti CPC, and (C) milled Ti CPC. Following manufacturing of CPCs, each CPC was cemented using dual-cure polymerizing resin cement. Then, each model/post and core assembly was sectioned at three specific levels representing coronal, middle, and apical thirds of the post. Each section was photographed using a microscope in a standardized setting. The pixels count for cement surface area was calculated for each image using Adobe Photoshop. Descriptive statistics of the mean and standard deviation of the cement film thickness around posts were calculated. Kruskal-Wallis test was used to compare the three groups. Dwass-Steel-Critchlow-Fligner test was used for pairwise comparison.
Results: For the coronal section, there was a statistically significant difference (P <.001) between group A and B and B and C. For the middle section, there was a statistically significant difference (P <.001) between groups A and B only. For the apical section, there was a statistically significant difference (P <.001) between all groups.
Conclusions: Within the limitation of this study and based on the findings, cast gold CPC showed a more consistent and reduced cement film thickness and thus superior internal adaptation than 3D printed and milled Ti CPCs.