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    Additive or subtractive manufacturing of crown patterns used for pressing or casting: A trueness analysis
    (Elsevier Science, 2022) Çakmak, Gülce; Dönmez, Mustafa Borga; Cuellar, Alfonso Rodrigues; Kahveci, Çiğdem; Schimmel, Martin; Yılmaz, Burak
    Objectives: To investigate the effect of subtractive and additive manufacturing techniques on the trueness of crown patterns used for pressing or casting. Material and Methods: A complete-coverage mandibular right first molar crown was designed in standard tessellation language (STL) format. This STL served as the control (C- STL) and was used to fabricate 30 crown patterns in 3D-printed resin (PR, ProArt Print Wax), millable wax suitable for casting (BW, ProArt CAD Wax Blue), and millable wax suitable for pressing (YW, ProArt CAD Wax Yellow) (n=10). Subtractively manufactured patterns were fabricated by using a 5-axis milling unit (PrograMill PM7), while 3D-printed patterns were fabricated by using a digital light processing-based 3D printer (PrograPrint PR5; Ivoclar Vivadent, Schaan, Liechtenstein). All fabricated patterns were digitized by using an intraoral scanner (CEREC Primescan SW 5.2) to generate test-STLs. C-STL and test-STLs were transferred into a 3D analysis software (Medit Link v 2.4.4). Trueness evaluation was performed at 4 different surfaces (external, intaglio with margin, marginal, and intaglio without margin) and for complete scan meshes (overall) by using the root mean square (RMS) method. Data were analyzed with Kruskal-Wallis and Mann-Whitney U tests (?=.05). Results: RMS values varied significantly at all surfaces (P<.001), except for marginal surface (P=.151). PR had the highest RMS values at external surface (P?.007), intaglio surfaces (with (P?.003) and without margin (P?.005)), and overall (P?.01). No significant differences were observed between YW and BW (P?.223). Conclusion: Patterns fabricated by using subtractive manufacturing exhibited high trueness. The deviation values, in general, were small, particularly at intaglio and marginal surfaces; thus, clinical difference in crown-fit may be negligible using additive or subtractive technique. Clinical Significance The fit of definitive crowns may be similar when tested crown patterns are additively or subtractively manufactured. However, crowns fabricated by using tested 3D-printed resin patterns may require more chairside adjustments compared with those fabricated by using subtractively manufactured wax patterns.
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    Cameo and intaglio surface stability and variability of additively, subtractively, and conventionally manufactured occlusal devices after long-term storage
    (Elsevier, 2024) Orgev, Ahmet; Dönmez, Mustafa Borga; Almogbel, Lolowh; Çakmak, Gülce; Marques, Vinicius Rizzo; Kahveci, Çiğdem; Yılmaz, Burak
    Statement of problem: Additive and subtractive manufacturing have become alternative technologies for fabricating occlusal devices. However, knowledge of the long-term stability of occlusal devices fabricated using these recent technologies is limited. Purpose: The purpose of this in vitro study was to evaluate the cameo and intaglio surface stability and variability of additively, subtractively, and conventionally manufactured occlusal devices after 18 months of storage. Material and methods: A standard tessellation language (STL) file of a dentate maxillary typodont was used to design a master occlusal device. The STL file of this design was used to fabricate occlusal devices additively either with a digital light processing (AM-1) or a continuous liquid interface production (AM-2) printer, subtractively with 2 different 5-axis milling units (SM-1 and SM-2), and conventionally (TM-HP) (n=10). STL files of each device's cameo and intaglio surfaces were generated using a laboratory scanner after fabrication and after 18 months of storage in a moist environment. These generated files were imported into an analysis software program (Geomagic Control X) to analyze the dimensional stability of tested devices by using the root mean square method. The average deviation values defined the variability of measured changes over time. Cameo and intaglio surface deviations were analyzed using the Kruskal-Wallis and Dunn tests, while the variability of measured deviations was analyzed with 1-way analysis of variance and the Tukey HSD tests (α=.05). Results: Significant differences were observed among tested devices when the intaglio surface deviations and the cameo surface variability were considered (P<.001). SM-2 had significantly higher intaglio surface deviations than AM-1, SM-1, and AM-2 (P≤.036). Among the test groups, AM-1 had the greatest cameo surface variability (P≤.004). Conclusions: SM-2 resulted in lower intaglio surface stability than the additive and the other subtractive manufacturing technologies, while AM-1 led to the highest cameo surface variability among the test groups.
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    Color and translucency of milled polymethyl methacrylate crowns on non-tooth-colored interim abutments with different surface treatments
    (2022) Çakmak, Gülce; Cuellar, Alfonso Rodriguez; Treviño Santos, Alejandro; Johnston, William M; Dönmez, Mustafa Borga; Yılmaz, Burak
    Statement of problem: The interim rehabilitation of implants has become a necessity, particularly for those placed in the esthetic regions. However, the optical properties of computer-aided design and computer-aided manufacturing (CAD-CAM) polymethyl methacrylate (PMMA) crowns on interim abutments with different surface treatments are unclear. Purpose: The purpose of this in vitro study was to investigate the color and translucency of CAD-CAM PMMA crowns when different surface treatments were used on titanium interim abutments. Material and methods: A maxillary dentate stone cast with a narrow-diameter implant analog at the left lateral incisor site was used. Three titanium interim abutments (blue) were divided into 3 groups according to the surface treatment they received: control (steam cleaning), opaqued (120-?m Al2O3 airborne-particle abrasion and opaque application), and airborne-particle abraded (120-?m Al2O3). Thirty PMMA crowns (A2 shade) were milled (n=10). The color coordinates of the crown-interim abutment pairs and a shade tab (A2) were measured by using a colorimeter. The color differences (?E00) between the crowns and the shade tab and the relative translucency parameter (RTP) values of the crowns were calculated by using the CIEDE2000 formula. One-way ANOVA was used to analyze the ?E00 and RTP values with subsequent Tukey honestly significant difference tests (?=.05). Results: The abutment surface treatment significantly affected the ?E00 of interim crowns from the shade tab (P<.001), but no significant effect was found on RTP (P=.26). The control group had the highest ?E00 from the shade tab (P?.011). No significant difference (P=.14) was found between the opaqued and the ?E00 of the airborne-particle abraded groups from the shade tab. Conclusions: The surface treatments of interim abutments affected the color of CAD-CAM PMMA crowns, which differed from that of the shade tab. The color of crowns on opaqued or airborne-particle abraded interim abutments was closer to the color of the shade tab. Abutment surface treatments did not affect the translucency of crown-interim abutment pairs.
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    Comparison of measured deviations in digital implant scans depending on software and operator
    (Elsevier, 2022) Çakmak, Gülce; Marques, Vinicius Rizzo; Dönmez, Mustafa Borga; Lu, Wei-En; Abou-Ayash, Samir; Yılmaz, Burak
    Objectives: To investigate the effect of 3-dimensional (3D) analysis software and operator on the measured deviations in implant scans. Material and Methods: A combined healing abutment-scan body (CHA-SB) system was digitized with an industrial scanner (ATOS Core 80) to generate a master standard tessellation language file (MRM-STL) and an intraoral scanner (TRIOS 3) to generate 9 test-scan STL files, which were transferred into metrology-grade (Geomagic Control X, GX and GOM Inspect, GM) and nonmetrology-grade (Medit Link, ML) software for deviation analysis. Test-scan STLs were superimposed over MRM-STL and 2 planes passing through the center of the SB were generated. Distance deviations at 8 points on these planes were analyzed by two different operators with similar level of experience. Data were analyzed with analysis of variance and F tests (?=.05). Results: Only model 1 (P=.049) analyzed by operator 2 showed significant differences among tested software, and the highest deviations were measured with GM (P?.037). However, the difference in values measured with GX and ML was nonsignificant (P=.91). Operator correlation was high (ICC?.712, P?.011), except for models 1 (GM, ICC=-.335, P=.813), 2 (GM, ICC=.025, P=.468 and ML, ICC=-.013, P=.507), 6 (GM, ICC=-.085, P=.583), and 8 (GM, ICC=-.386, P=.85). Conclusion: The measured deviations in implant scans in all models, except for one, were similar among the tested software, regardless of the operator. The inter-rater reliability of operators while using tested 3D analysis software was overall high. When observed, low inter-rater reliability was mostly with only one of the metrology grade software. Clinical Significance: Nonmetrology-grade 3D analysis software may be a suitable alternative to metrology-grade software to measure the deviations in digital implant scan body scans. When GOM metrology-software is used, measured deviations in implant scan body scans may vary more across operators. © 2022
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    Dimensional stability of additively manufactured dentate maxillary diagnostic casts in biobased model resin
    (MDPI, 2024) Demirel, Münir; Türksayar, Almira Ada Diken; Petersmann, Sandra; Spintzyk, Sebastian; Dönmez, Mustafa Borga
    This study aimed to evaluate the dimensional stability of maxillary diagnostic casts fabricated from a biobased model resin, which consists of 50% renewable raw materials for sustainable production, a model resin, and stone, over one month. A master maxillary stone cast was digitized with a laboratory scanner to generate a reference file. This master cast was also scanned with an intraoral scanner to additively manufacture casts with a biobased model resin (BAM) and a model resin (AM). Polyvinylsiloxane impressions of the master cast were also made and poured in type III stone (CV) (n = 8). The same laboratory scanner was used to digitize each model one day (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4) after fabrication. Deviations from the reference file were calculated with an analysis software and analyzed with generalized linear model analysis (alpha = 0.05). The interaction between the material and the time point affected measured deviations (p < 0.001). Regardless of the time point, CV had the lowest and AM had the highest deviations (p < 0.001). BAM mostly had lower deviations at T0 and mostly had higher deviations at T4 (p <= 0.011). AM had the highest deviations at T4 and then at T3, whereas it had the lowest deviations at T0 (p <= 0.002). The measured deviations of CV increased after each time point (p < 0.001). BAM casts had deviations within the previously reported clinically acceptable thresholds over one month and had acceptable dimensional stability. Therefore, tested biobased resin may be a viable alternative for the sustainable manufacturing of maxillary diagnostic casts that are to be used clinically.
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    Dimensional Stability of Additively Manufactured Diagnostic Maxillary Casts Fabricated with Different Model Resins
    (Quintessence Publishing Co. Inc., 2024) Dönmez, Mustafa Borga; Wepfer, Alena Bruna; Güven, Mehmet Esad; Çakmak, Gülce; Schimmel, Martin; Yılmaz, Burak
    Purpose: To evaluate the effect of model resin type and time interval on the dimensional stability of additively manufactured diagnostic casts. Materials and Methods: Ten irreversible hydrocolloid impressions and 10 impressions from an intraoral scanner were made from a reference maxillary stone cast, which was also digitized with a laboratory scanner. Conventional impressions were poured in type III stone (SC), while digital impressions were used to additively manufacture casts with a nanographene-reinforced model resin (GP) or a model resin (DM). All casts were digitized with the same laboratory scanner 1 day (T0), 1 week (T1), 2 weeks (T2), 3 weeks (T3), and 4 weeks (T4) after fabrication. Cast scans were superimposed over the reference cast scan to evaluate dimensional stability. Data were analyzed with Bonferroni-corrected repeated measures ANOVA (α =.05). Results: The interaction between the main factors (material type and time interval) affected anterior teeth deviations, while the individual main factors affected anterior teeth and entire-cast deviations (P ≤.008). Within anterior teeth, DM had the lowest deviations at T3, and GP mostly had lower values at T2 and lower deviations at T3 than at T0 (P ≤.041). SC had the highest pooled anterior teeth deviations, and GP had the highest pooled entire cast deviations (P <.001). T3 had lower pooled anterior teeth deviations than at T0, T1, and T4, and higher pooled entire cast deviations than T1 were demonstrated (P ≤.027). Conclusions: The trueness of nanographene-reinforced casts was either similar to or higher than that of other casts. Dimensional changes were acceptable during the course of 1 month. © 2024 by Quintessence Publishing Co Inc.
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    Effect of barium silicate on mechanical properties, transmittance, and protein adsorption of resin for additive manufacturing containing zwitterionic polymer
    (Elsevier Inc., 2024) Dönmez, Mustafa Borga; Kim, Hyun-Tae; Lee, Yun-Hee; Jo, Ye-Hyeon; Yoon, Hyung-In; Yılmaz, Burak
    Statement of problem: Studies on the effect of barium silicate on the material properties of additively manufactured (AM) resins containing 2-methacryloyloxyethyl phosphorylcholine (MPC) for dental applications are lacking. Purpose: The purpose of this in vitro study was to evaluate the mechanical properties, transmittance, and protein adsorption of MPC-containing AM resin incorporated with different barium silicate contents and to compare these findings with those of a commercially available unfilled AM resin marketed for definitive restorations. Material and methods: Resins incorporating 6 wt% MPC and 4 different concentrations of barium silicate (10 wt%, MB10; 20 wt%, MB20; 30 wt%, MB30; and 40 wt%, MB40) were prepared. An MPC-containing resin with no filler was also prepared (0 wt%, MBN). Surface roughness (n=15), Vickers hardness (n=15), flexural strength and modulus (n=15), fracture toughness (n=15), transmittance (n=15), and protein adsorption (n=3) of the filled resin specimens were measured and compared with those of commercially available unfilled resin specimens. All data were analyzed using the Kruskal–Wallis and Dunn tests (α=.05). Results: All experimental resins had higher surface roughness than the unfilled resin (P≤.048). MB40 had higher hardness, flexural strength, flexural modulus, and fracture toughness than most other groups (P≤.047). MB10 had higher transmittance than most other groups (P≤.012). All experimental resins had lower protein adsorption than the unfilled resin, regardless of the barium silicate content (P≤.023). Conclusions: The experimental resin containing 6 wt% MPC and 40 wt% barium silicate showed better mechanical properties and lower protein adsorption than the resin with no MPC or ceramic fillers. Transmittance decreased with the increase of barium silicate in the resins. © 2024 Editorial Council for The Journal of Prosthetic Dentistry
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    Effect of coffee thermal cycling on the surface properties and stainability of additively manufactured denture base resins in different layer thicknesses
    (John Wiley and Sons Inc, 2025) Çakmak, Gülce; Asadolahi, Nura Watson; Schimmel, Martin; Molinero-Mourelle, Pedro; Akay, Canan; Dönmez, Mustafa Borga; Yılmaz, Burak
    Purpose: To compare the effect of coffee thermal cycling on surface roughness (Ra), Vickers microhardness (MH), and stainability of denture base resins additively manufactured in different layer thicknesses with those of subtractively manufactured denture base materials. Materials and Methods: Eighty disk-shaped specimens (Ø10×2 mm) were fabricated from two subtractively (Merz M-PM [SM-M] and G-CAM [SM-G]) and three additively (NextDent 3D+ [50 µm, AM-N-50; 100 µm, AM-N-100], FREEPRINT Denture [50 µm, AM-F-50; 100 µm, AM-F-100], and Denturetec [50 µm, AM-S-50; 100 µm, AM-S-100]) manufactured denture base materials (n = 10). Ra measurements were performed before and after polishing by using a non-contact optical profilometer, while MH values and color coordinates were measured after polishing. Specimens were then subjected to 5000 cycles of coffee thermal cycling, all measurements were repeated, and color differences (ΔE00) were calculated. A linear mixed effect model was used to analyze Ra and MH data, while one-way analysis of variance was used to analyze ΔE00 data (α = 0.05). Ra values were further evaluated according to a clinically acceptable threshold of 0.2 µm, while ΔE00 values were evaluated according to perceptibility (1.72 units) and acceptability (4.08 units) thresholds. The interaction between the material type and the time interval affected both Ra and MH (p ≤ 0.001). Tested materials had their highest Ra before polishing (p ≤ 0.029). Before polishing, AM-F-100 had the highest, and SM-M and SM-G had the lowest Ra (p < 0.001). After polishing and after coffee thermal cycling, SM-G mostly had lower Ra than those of other materials (p ≤ 0.036). SM-G mostly had higher MH than that of other materials before and after coffee thermal cycling (p ≤ 0.025). Coffee thermal cycling reduced the MH of SM-M and increased that of AM-S-100 (p ≤ 0.024). AM-N-100 had higher ΔE00 than AM-F, AM-S-100, and SM-G (p ≤ 0.009), while AM-F and SM-G had lower ΔE00 than AM-S-50 and AM-N-50 (p ≤ 0.024). Conclusions: Polishing reduced the surface roughness of all materials, whereas the effect of coffee thermal cycling was nonsignificant. Most of the tested materials had acceptable surface roughness after polishing and after coffee thermal cycling according to the reported threshold. Layer thickness only affected the microhardness of tested additively manufactured resins, which was material-dependent. Subtractively manufactured specimens mostly had high microhardness and that of nonreinforced subtractively manufactured resin decreased after coffee thermal cycling. When reported color thresholds are considered, all materials had acceptable color stability. © 2023 The Authors. Journal of Prosthodontics published by Wiley Periodicals LLC on behalf of American College of Prosthodontists.
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    Effect of different surface treatments and thermomechanical aging on the ion elution of CAD-CAM materials
    (Elsevier Science, 2022) Sert, Murat; Gülce Subaşı, Meryem; Çakmak, Gülce; Dönmez, Mustafa Borga; Yılmaz, Burak
    Statement of problem. Dental ceramics have been reported to elute ions when subjected to nonneutral pH. However, the effect of surface treatments and thermomechanical aging on the ion elution of CAD-CAM ceramics is unclear. Purpose. The purpose of this in vitro study was to compare the effect of surface treatment (glazed or polished) and thermomechanical aging on the ion elution of CAD-CAM materials before and after 2-body wear simulation. Material and methods. Specimens were prepared from 6 CAD-CAM materialsdleucite (LC), feldspathic (FP), zirconia-reinforced lithium silicate (ZLS), lithium disilicate (LDS) glass-ceramics, polymer-infiltrated ceramic network (PICN), and zirconia (ZIR)dand divided into 2 groups according to the surface treatments (glazed or polished) (n=6). For baseline ion elution values, specimens were placed into polyethylene bottles containing deionized water (pH 7.4) that had been stored in an incubator for 168 hours at 37 C. The eluted ions in the immersion solution were measured by using inductively coupled plasma-optic emission spectrophotometry. The specimens were then subjected to thermomechanical aging by using human enamel as an antagonist. After aging, the ion elution of the specimens was remeasured. Ion elution data before and after 2-body wear were analyzed by using the Mann-Whitney U test, while the effect of 2-body wear was assessed by using the Wilcoxon signed rank test (a=.05). Results. The presence of some ions varied depending on the material-surface treatment pair before (Al, As, B, Ba, Ca, K, Li, Mg, Na, P, and Zn) and after (Al, B, Ba, Ca, Co, Li, Mg, and P) 2-body wear. Polished materials had higher ion elution than the glazed materials before 2-body wear (P .041), except for LC (P and Zn) and PICN (Ca, Cu, and K) (P .009). After 2-body wear, polished LC (B and Ba), FP (Al, B, and Mg), ZLS (Al, Ba, Ca, and Li), ZIR (B and Ba), glazed PICN (Ca, Mg, and P), ZLS (P), and ZIR (Co) presented higher ion elution than their counterparts (P .041). The effect of 2-body wear on the ion elution of polished LC (Al, K), FP (Na), ZLS (Li), LDS (K, Na), PICN (Al, Na), ZIR (Na, Y), glazed LC (Na), FP (Ba, Na), ZLS (B, Ba, Y), LDS (Na), PICN (Y), and ZIR (Na) was nonsignificant (P .075). However, the elution of remaining ions showed a significant difference before and after 2-body wear (P .046). Conclusions. The chemical stability of tested CAD-CAM materials was affected by the 2-body wear. Glazing led to a lower ion elution except for LDS and PICN. While polishing resulted in lower ion elution for PICN, both surface treatments resulted in similar ion elution for LDS. (J Prosthet Dent 2022;-:---)
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    Effect of different surface treatments on the surface roughness and orthodontic bond strength of partially-stabilized zirconia
    (GALENOS YAYINCILIK, 2022) Dönmez, Mustafa Borga; Demirel Ballı, Betül; Demirel, Münir; Gündoğdu, Yasemin; Kılıç, Hamdi Şükür
    Objective: To investigate the effect of different surface treatments on the surface roughness (Ra) and shear bond strength (SBS) of partially stabilized zirconia (Y-PSZ) with different yttrium content.Materials and Methods: Zirconia samples were milled from 5Y-PSZ and 4Y-PSZ disks and divided into 5 groups: Control (C), sandblasting (APA), single-step self -etch primer etching (MEP), Er:YAG laser (ER), and femtosecond laser (FS) irradiation (n=11). Surface Ra was measured and metallic mandibular incisor brackets were bonded. SBS test was performed after thermocycling. Data were analyzed using two-way ANOVA and Tamhane's T2 tests (alpha=0.05).Results: Only surface treatment affected Ra and SBS (p<0.001). FS groups had the highest (p<0.001), and C groups had the lowest values Ra (p <= 0.001). MEP groups had lower Ra than ER and APA (p <= 0.002). FS and APA groups resulted in the highest SBS (p<0.001), while MEP groups achieved significantly higher SBS than ER groups (p<0.001). The C group showed the lowest SBS (p<0.001).Conclusion: Within the limitations of this in vitro study, sandblasting and FS irradiation was found to be the most effective surface treatments for metallic bracket bonding to Y-PSZ.
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    Effect of femtosecond laser induced surface patterns on the flexural strength of monolithic zirconia
    (Wiley, 2024) Okutan, Yener; Gündoğdu, Yasemin; Dönmez, Mustafa Borga; Şeker, Hüseyin; Kılıç, Hamdi Şükür
    To investigate how patterns generated by femtosecond (fs) laser and femtosecond laser power affect the surface roughness (Ra) and biaxial flexural strength (BFS) of monolithic zirconia. Eighty disk-shaped zirconia specimens were divided into eight subgroups (n = 10): Control (C), airborne-particle abrasion (APA), 400 mW fs laser (spiral [SP(400)], square [SQ((400))], circular [CI(400)]), and 700 mW fs laser ([SP(700)], [SQ((700))], [CI(700)]). Ra values were calculated by using a surface profilometer. One additional specimen per group was analyzed with scanning electron microscopy and x-ray diffractometry. BFS values were obtained by using the piston-on-3-ball test. One-way ANOVA and either Tukey's HSD (BFS) or Tamhane's T2 (Ra) tests were used to evaluate data (alpha = 0.05). Regardless of the pattern and power, fs laser groups had higher Ra than C and APA, while SP groups had lower Ra than CI and SQ groups (p <= 0.004). For each pattern, Ra increased with higher laser power (p < 0.001), while the laser power did not affect the BFS (p >= 0.793). CI and SQ groups had lower BFS than the other groups (p <= 0.040), whereas SP groups had similar BFS to C and APA (p >= 0.430). Fs laser microstructuring with spiral surface pattern increased the Ra without jeopardizing the BFS of zirconia. Thus, this treatment might be an option to roughen tested zirconia.
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    Effect of firing cycle and aging on long-term chemical degradation of monolithic CAD-CAM ceramics
    (Elsevier Science, 2022) Sert, Murat; Gülce Subaşı, Meryem; Dönmez, Mustafa Borga; Çakmak, Gülce; Yiımaz, Burak
    Statement of problem. Previous studies have shown the susceptibility of dental ceramics to degradation when subjected to certain media. However, knowledge on the effect of repeated firings and thermocycling on the ion elution of computer-aided design and computer-aided manufacturing (CAD-CAM) ceramics is lacking. Purpose. The purpose of this in vitro study was to compare the effect of repeated firings on the ion elution of CAD-CAM materials before and after thermocycling. Material and methods. Bar-shaped specimens were prepared from 4 different CAD-CAM materials (monolithic zirconia [Z], zirconia- reinforced lithium silicate glass-ceramic [S], lithium disilicate glass-ceramic [EX], and leucite-reinforced glass-ceramic [E]) and divided into 3 groups according to the number of repeated glaze firings (1 firing [1F], 2 firings [2F], and 4 firings [4F]). Specimens were placed into deionized water (pH 7.4) and stored at 37 C for 168 hours. Inductively coupled plasma-optic emission spectrophotometry (ICP-OES) was used to measure the baseline values of the eluted ions in immersion. The specimens were then subjected to thermocycling. Then, surface roughness (Ra) and ion elution values were measured. The Kruskal-Wallis and Mann-Whitney U tests were used to analyze the ion elution data before and after thermocycling, and the effect of thermocycling on ion elution was assessed by the Wilcoxon signed rank test. Ra data were analyzed with 2-way analysis of variance (ANOVA) and the Tukey honestly significant difference tests (a=.05). Results. Elution of some ions varied depending on the material-firing pair before (Al, As, B, Ba, Cr, Cu, Li, Mg, Na, P, and Zn) and after (Al, As, B, Ba, Be, Ca, Cd, Co, Cr, Cu, K, Li, Mg, Na, P, Y, and Zn) thermocycling. Before thermocycling, all firing groups within each material showed a similar number of significantly higher eluted ions. After thermocycling, the number of significantly higher eluted ions decreased in all materials, except for EX. The effect of thermocycling on the ion elution of the 1F group of Z (Al, Be, Ca, Cd, Co, Cr, Cu, K, Li, P, Y, and Zn), S (As, Be, Cd, Co, Cr, K, P, and Y), EX (B, Cu, and P), and E (B and Ba); 2F group of Z (Al, Be, Ca, Co, Cr, Cu, K, Li, P, and Y), S (Be, Cd, Co, K, Li, and Y), EX (P), and E (P); 4F group of Z (Al, As, Ba, Be, Ca, Cd, Co, Cr, Cu, K, Li, P, and Y), S (Al, Be, Cd, Co, Cr, Li, Mg, and Y), EX (Be, Ca, Cd, Co, K, Y, and Zn), and E (Ca and P) was nonsignificant (P .051). The interaction between material and repeated firings (P<.001) had a significant effect on Ra. For 1F groups, E showed the highest Ra (P .003), while Z had higher Ra than S (P=.009). For 2F groups, Z had higher Ra than S (P=.01). The differences among 4F groups were nonsignificant (P .677). An increased number of repeated firings (2F and 4F) decreased the Ra of E (P<.001). Conclusions. The effect of repeated firings and thermocycling on the chemical stability of the tested CAD-CAM materials varied. No clear trend was observed on the elution of different ions within material-firing pairs before thermocycling. However, thermocycling increased the number of significantly higher eluted ions for EX. The effect of thermocycling on the ion elution of materials varied depending on ions. Repeated firings decreased the surface roughness of E. (J Prosthet Dent 2022;-:---)
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    Effect of intraoral scanner and fixed partial denture situation on the scan accuracy of multiple implants: an in vitro study
    (Wiley, 2023) Abou Ayash, Samir; Yılmaz, Burak; Mathey, Amber; Gaeumann, Fabio; Mathey, Ayşe; Dönmez, Mustafa Borga
    BackgroundAccuracy of intraoral implant scans may be affected by the region of the implant and the type of the intraoral scanner (IOSs). However, there is limited knowledge on the scan accuracy of multiple implants placed for an implant-supported fixed partial denture (FPD) in different partially edentulous situations when digitized by using different IOSs. PurposeTo investigate the effect of IOS and FPD situation on the scan accuracy of two implants when partial-arch scans were performed. Materials and MethodsTissue level implants were placed in 3 maxillary models with implant spaces either at right first premolar and right first molar sites (Model 1, 3-unit FPD), at right canine and right first molar sites (Model 2, 4-unit FPD), or at lateral incisor sites (Model 3, 4-unit FPD). Reference standard tessellation language (STL) files of the models were generated by using an optical scanner (ATOS Capsule 200MV120). Two IOSs (CEREC Primescan [CP] and TRIOS 3 [TR]) were used to perform partial-arch scans (test-scans) of each model (n = 14), which were exported in STL format. A metrology-grade analysis software (GOM Inspect 2018) was used to superimpose test-scan STLs over the reference STL to calculate 3D distance, inter-implant distance, and angular (mesiodistal and buccopalatal) deviations. Trueness and precision analyses were performed by using bootstrap analysis of variance followed by Welch tests with Holm correction (alpha = 0.05). ResultsTrueness of the scans was affected by IOS and FPD situation when 3D distance deviations were considered, while inter-implant distance, mesiodistal angular, and buccopalatal angular deviations were only affected by the FPD situation (p < 0.001). Scan precision was affected by the interaction between the IOSs and the FPD situation when 3D distance and buccopalatal angular deviations were concerned, while IOSs and FPD situation were effective when all deviations were concerned (p <= 0.001). When 3D distance deviations were considered, CP scans had higher accuracy TR scans in Models 1 and 3 (p <= 0.002), and the Model 1 scans had the highest accuracy (p < 0.001). When inter-implant distance deviations were considered, Model 1 scans had the highest accuracy with CP and higher accuracy than Model 2 when TR was used (p <= 0.030). When mesiodistal angular deviations were considered, Model 1 scans had the highest accuracy (p <= 0.040). When buccopalatal angular deviations were considered, Model 1 scans had the highest accuracy among models when CP was used (p <= 0.020). ConclusionsPosterior 3-unit fixed partial denture implant scans, CP scans, and combination of these two factors had accuracy either similar to or better than their tested counterparts.
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    Effect Of Intraoral Scanner On The Scan Accuracy Of Different Restoration Designs
    (Ankara Diş Hekimleri Odası, 26 Ocak 2024) Demirel, Münir; Türksayar, Almira Ada Diken; Dönmez, Mustafa Borga
    Objective: The aim of this in vitro study was to evaluate the effect of intraoral scanner used in different preparation geometries on trueness and precision. Materials and Methods: Three different dental models of inlay, onlay and full crown preparation designs were used in the study. Reference scans were performed with an industrial-grade scanner (ATOS Core 80, GOM), while each model was scanned 10 times with the following intraoral scanners, respectively: Trios 4 (3Shape), Trios 3 (3Shape), Primescan (Dentsplay Sirona), Omnicam (Dentsplay) Sirona), Planmeca Emerald (Planmeca), Medit i700 (Medit Corp). All scan data were converted to STL file and saved. Then, the data were recorded in the 3D image processing software (Geomagic Control X 2020.1) and the accuracy and precision values were calculated. Shapiro Wilk, two-way ANOVA and post hoc Tukey tests were performed for statistical analysis. Results: Both the geometry of the preparation and the intraoral scanner used were found to be effective in the accuracy analysis. The highest accuracy values were obtained in the full crown design and with the Medit i700. The precision values of the full crown preparation were found to be higher in all intraoral scanners except Trios 4, but there was no significant difference between the scanners. Conclusion: It should be considered that the accuracy and sensitivity of the preparations with complex geometries may decrease depending on the intraoral scanner used.
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    Effect of measurement techniques and operators on measured deviations in digital implant scans
    (ELSEVIER, 2022) Çakmak, Gülce; Dönmez, Mustafa Borga; Akay, Canan; De Silva, Marcella Paula; Mangano, F. G.; Abou-Ayash, S.; Yılmaz, Burak
    Objectives: To evaluate the effect of different measurement techniques and operators on measured deviations in in vitro implant scans. Methods: A 2-piece system that comprises a healing abutment (HA) and a scan body (SB) was mounted onto an implant at right first molar site of a polymethylmethacrylate mandibular dentate model. Model was digitized by using an industrial scanner (reference model scan, n=1) and an intraoral scanner (test scan, n=20). All standard tessellation language files were imported into a 3-dimensional analysis software and superimposed. Three operators with similar experience performed circle-based and point-based deviation analyses (n=20). Deviations measured with different techniques were compared with paired samples t-test within each operator, while the reliability of the operators was assessed by using F-tests for both technqiues (?=.05). Results: Point-based technique resulted in lower deviations than circle-based technique for all operators (P=.001) with to higher reliability among operators (ICC=.438, P=.001). The correlation among the operators was nonsignificant when circle-based technique was used (ICC=.114, P=.189). Conclusion: Lower deviations were detected with the point-based technique. In addition, different operators' measurements had higher correlation when point-based technique was used compared with circle-based technique. Clinical significance: Point-based technique may be preferred over circle-based technique for research studies on scan accuracy of implants, given its higher reliability. The accuracy of measured deviations may increase if the number of planes are increased, which can facilitate point generation at different surfaces of the scan body.
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    Effect of Polymerization Unit, Polishing, and Coffee Thermocycling on the Color and Translucency of Additively Manufactured Resins Used for Definitive Prostheses
    (Quintessence Publishing Co. Inc., 2024) Dönmez, Mustafa Borga; Çakmak, Gülce; Sabatini, Gabriela Panca; Kahveci, Çiğdem; Orğev, Ahmet; Yoon, Hyunğ-In; Yılmaz, Burak
    Purpose: To evaluate the effect of polymerization unit, polishing, and coffee thermocycling on the color and translucency of additively manufactured polyurethane-based resins with different viscosities. In addition, their color behavior was compared with the color of the shade tab throughout the fabrication steps and aging. Materials and Methods: Disk-shaped specimens (010 X 2 mm) were fabricated from polyurethane-based resins with different viscosities (Tera Harz TC-80DP and C&B permanent; n = 30 per material). Baseline color coordinates were measured after cleaning. The specimens in each resin group were divided into three subgroups (n = 10 per subgroup) to be polymerized with different polymerization units (Otoflash G171 [FLN], Wash and Cure 2.0 [CLED1], and P Cure [CLED2]), polished, and subjected to coffee thermocycling. Color coordinates were remeasured after each process. Color differences (ΔE00) and relative translucency parameter (RTP) values were calculated. Data were statistically analyzed (α =. 05). Results: Time points and polymerization units affected the ΔE00 for each material (P<. 049). ΔE00 of each polymerization unit pair had significant differences within and among different time points within each material (P <. 024). ΔE00 (when compared with the shade tab) and RTP were mostly affected by polymerization units and time points within both materials (P <. 042). Conclusions: Tested polymerization units, polishing, and coffee thermocycling affected the color difference and translucency of tested resins. Color differences ranged from moderately unacceptable to extremely unacceptable, and the differences in translucency values mostly ranged from perceptible to unacceptable, according to previous thresholds. In addition, tested resin-polymerization unit pairs had unacceptable color differences when compared to the shade tab. CLED1 may enable higher color stability for tested resins © (2024), (Quintessence Publishing Co. Inc.). All Rights Reserved.
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    Effect of potassium aluminum sulfate application on the viability of fibroblasts on a cad-cam feldspathic ceramic before and after thermocycling
    (PMID, 2022) Çakmak, Gülce; Akay, Canan; Dönmez, Mustafa Borga; Mumcu, Emre; Akan, Handan Sevim; Sasany, Rafat; Abou-Ayash, Samir; Yılmaz, Burak
    Abstract: Potassium aluminum sulfate (alum) is a known adjuvant, which has been used as a mordant in textile industry for color fixation. This material has potential to be incorporated into dentistry for color stability, yet its toxicity first needs to be evaluated. The present study aimed to evaluate the cytotoxic potential of potassium aluminum sulfate (alum) on fibroblasts when applied onto feldspathic ceramic before and after thermocycling. Forty-eight feldspathic ceramic specimens were divided into four groups (FC: no alum application or thermocycling; FCT: thermocycling without alum application; FA: alum application without thermocycling; FAT: alum application and thermocycling) (n = 12). Cell viability was assessed by using a tetrazolium salt 3-[4,5-dimethylthiazol2-yl]-2,5-diphnyltetrazolium bromide assay at 24 and 72 h, and cell cultures without any ceramic specimens served as control (C). One sample from each material group was further analyzed with energy dispersive X-ray spectroscopy (EDX). Cell viability at different time intervals within each group was analyzed with Friedman tests, while Kruskal–Wallis tests were used to compare the test groups within each time interval. Pairwise comparisons were further resolved by using Wilcoxon tests (a = 0.05). C had lower (p = 0.01) and FA had higher (p = 0.019) cell viability after 72 h. After 24 h, the highest cell viability was observed in C (p ? 0.036). After 72 h, the differences between C and FA, C and FAT, FC and FA, and FCT and FAT were nonsignificant (p > 0.05). Cell viability was not affected by alum application or thermocycling at any time interval (p ? 0.631). EDX analysis showed an increase in potassium concentration in FA and FAT when compared with FC and FCT. Regardless of the time interval, alum application onto feldspathic ceramic and thermocycling did not influence the cell viability.
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    Effect of printing layer thickness on the trueness and fit of additively manufactured removable dies
    (Elsevier, 2022) Yılmaz, Burak; Dönmez, Mustafa Borga; Kahveci, Çiğdem; Cuellar, Alfonso Rodrigues; de Paula, Marcella Silva; Schimmel, Martin; Abou-Ayash, Samirl; Çakmak, Gülce
    Statement of problem: Additive manufacturing is commonly used for the fabrication of definitive casts with removable dies. However, how the trueness and fit of removable dies are affected by printing layer thickness is lacking. Purpose: The purpose of this in vitro study was to investigate the trueness and fit of additively manufactured removable dies printed in different layer thicknesses. Material and methods: A mandibular cast with a prepared right first molar tooth was digitized (CEREC Primescan), and its standard tessellation language (STL) file was imported into a software program (DentalCAD 3.0). A removable die (D-STL) and a hollow cast with (M-STL) or without the die (SM-STL) were designed. D-STL and SM-STL were imported into a nesting software program (Composer), and 45 removable dies in 3 layer thicknesses (100 ?m, 50 ?m, and 50 to 100 ?m) (n=15) and 1 cast (100-?m) were additively manufactured. Each removable die (TD-STLs), the cast with each die (TM-STLs), and the cast without the die (TSM-STL) were digitized by using the same scanner. All STL files were imported into a software program (Medit Link v 2.4.4), and TD-STLs were superimposed over D-STL. The root mean square (RMS) method was used to analyze the trueness of the dies at 2 different areas (crown and root portion) and as a complete unit (overall). Overall RMS values of the cast with and without the die were also calculated after superimposing TM-STLs over M-STL. The fit of the dies in the cast was evaluated by using a triple-scan protocol to measure deviations at 5 different points (point M: most mesial point of the margin; point TM: tip of the mesial cusp; point O: deepest point of the occlusal fossa; point TD: tip of the distal cusp; point D: most distal point of the margin) on the crown portion. One-way ANOVA and Tukey honestly significant difference tests were used to evaluate data (?=.05). Results: The RMS values of removable dies showed significant differences at each area (P?.002). The 50- to 100-?m group had higher overall RMS values than the 100-?m group (P=.017). The 100-?m group had the highest RMS values for the crown portion (P?.019), while the 50-?m group had the highest RMS values for the root portion (P<.001). The 50-?m group had the lowest RMS values for the crown portion when the die was in the cast (P<.001). Except for point TM (P=.228), significant differences were observed among the test groups at all points (P<.001). The 50-?m group had the lowest distance deviations at points M, TD, and D (P?.005), while the 100-?m group had the highest distance deviations at points O and D (P?.010). Conclusions: Removable dies fabricated by using a 100-?m or 50- to 100-?m combined layer thickness had trueness that was either similar to or better than that of dies fabricated with a 50-?m layer thickness. When the die was on the cast, the 50-?m layer thickness resulted in the best crown portion trueness. However, because the deviation differences among groups were clinically small, the 100-?m layer thickness can be considered for the efficient fabrication of removable dies when the tested printer and resin are used. © 2022 Editorial Council for the Journal of Prosthetic Dentistry
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    Effect of printing layer thickness on the trueness of 3-unit interim fixed partial dentures
    (Elsevier Science, 2022) Çakmak, Gülce; Cuellar, Alfonso Rodriguez; Dönmez, Mustafa Borga; Abou-Ayash, Samir; Lu, Wei-En; Schimmel, Martin; Yılmaz, Burak
    Statement of problem. Three-dimensional printing has facilitated the fabrication processes in dentistry. However, knowledge on the effect of layer thickness on the trueness of 3D-printed fixed partial dentures (FPDs) is lacking. Purpose. The purpose of this in vitro study was to compare the effect of printing layer thickness on the trueness of 3-unit interim FPDs fabricated by using additive manufacturing with that of those fabricated by subtractive manufacturing. Material and methods. The right first premolar and first molar teeth of a dentate mandibular model were prepared for a 3-unit restoration and then digitized by using an intraoral scanner. A 3-unit interim FPD was designed to fabricate 40 restorations by using either the additive (NextDent C&B MFH) with layer thicknesses of 20 mm (n=10), 50 mm (n=10), and 100 mm (n=10) or subtractive manufacturing technique (Upcera) (milled, n=10). After fabrication, the interim FPDs were digitized by using the same intraoral scanner and were superimposed over the design data by using a 3D analysis software program. Root mean square (RMS) was used to analyze the trueness of the restorations at 4 different surfaces (external, intaglio, marginal area, and intaglio occlusal) and as a complete unit (overall). Data were analyzed with the Kruskal-Wallis and Wilcoxon tests with Bonferroni correction (a=.05). Results. The 100-mm-layer thickness interim FPDs showed the greatest overall (P .015), external (P .021), and intaglio occlusal (P .021) deviations, whereas the milled interim FPDs showed the lowest (P=.001). No significant differences were found among the test groups for marginal RMS (P .108). The differences between the 50-mm-layer thickness and 100-mm-layer thickness interim FPDs for the intaglio surface deviations (P=.064) and between the 20-mm-layer thickness and 50- mm-layer thickness interim FPDs for each surface tested were not statistically significant (P .108). Conclusions. The printing layer thickness had a significant effect on the trueness of the additively manufactured interim FPDs. However, subtractively manufactured interim FPDs presented higher trueness than those additively manufactured, regardless of the printing layer thickness. (J Pros- thet Dent 2022;-:---)
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    Effect of printing orientation on the fracture strength of additively manufactured 3-unit interim fixed dental prostheses after aging
    (Elsevier Science, 2022) Diken Türksayar, Almira Ada; Dönmez, Mustafa Borga; Olcay, Emin Orkun; Demirel, Münir; Demir, Esra
    Objectives: To evaluate the effect of printing orientation on the fracture strength of 3-unit interim fixed dental prostheses fabricated by using additive manufacturing and to compare with those fabricated by subtractive manufacturing after thermomechanical aging. Materials and Methods: A 3-unit fixed dental prosthesis was designed by using a dental design software (exocad DentalCAD 2.2 Valetta) in standard tessellation language (STL) format. This STL file was exported into a nesting software (PreForm) and 3-unit interim fixed dental prostheses with 5 different orientations (0°, 30°, 45°, 90°, and 150°) were printed by using a 3-dimensional (3D) printing interim resin (Temporary CB) (n=10). The same STL file was also used to mill polymethymethacrylate (DuoCAD) 3-unit interim fixed dental prostheses as the control group (n=10). All specimens were cemented onto cobalt-chromium test models representing a maxillary first premolar and first molar tooth with a long-term temporary cement (DentoTemp), and subjected to thermomechanical aging (120000 cycles, 1.6 Hz, 50 N, 5-55°C). Then, all specimens were loaded until fracture by using a universal tester. The data were analyzed with nonparametric 1-way analysis of variance (Kruskal- Wallis) and Dunn’s tests (? = 0.05). 3 Results: Additively manufactured specimens printed with 90° showed the lowest fracture strength values (P?.048). However, the difference between specimens printed with 45° and 90° was nonsignificant (P>.05). Milled 3-unit interim fixed dental prostheses withstood significantly higher loads than 3-unit interim fixed dental prostheses printed with 45° and 150° (P?.012). In addition, specimens printed with 0° showed higher fracture strength than the specimens printed with 45° (P=.01). Specimens printed with 0° and 30° presented similar fracture strength values with milled (P?.057) and 150° printed (P>.05) specimens. Conclusion: Printing orientation had a significant effect on the fracture strength of 3-unit interim fixed dental prostheses. Among the additively manufactured samples, those printed with 0° showed similar fracture strength values with the subtractively manufactured samples. Clinical Significance Three-unit interim fixed dental prostheses fabricated with 0° and 30° using the 3D printing interim resin tested may be alternatives to milled PMMA in terms of fracture strength