Safety of 3D-Printed Acrylic Resins for Prosthodontic Appliances: A Comprehensive Cytotoxicity Review
Source abstract
Abstract
Additive manufacturing resins used in dental prosthetics may retain uncured monomers post-polymerization, posing potential long-term patient exposure risks. Understanding the biological safety of these materials is crucial, particularly for 3D-printed acrylic-based prosthodontic devices such as occlusal nightguards, complete and partial dentures, and temporary fixed prostheses. This paper reviews the literature evaluating the cytotoxicity of such materials. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we conducted a scoping review using the MESH keywords related to population (P), intervention (I), comparison (C), and outcome (O) across databases, including OVID Medline, EMBASE, and SCOPUS. Our search, limited to peer-reviewed English language articles from 2015 to 2023, resulted in 22 papers. These studies, utilizing digital light processing (DLP) or stereolithography (SLA) printing methods, varied in examining different 3D-printed materials, as well as washing and post-curing protocols. The primary experimental cells used were human gingival fibroblasts (HGF) and mouse fibroblasts (L929). There are no statistical differences in biocompatibility regarding different commercially available resins, washing solutions, or methods. Improvements in cell viability were related to an increase in washing time, as well as post-curing time. After the polishing procedure, 3D resin-based printed occlusal devices perform similarly to milled and conventionally processed ones. Our findings underline the importance of appropriate washing and post-curing protocols in minimizing the cytotoxic risks associated with these 3D-printed resin-based devices.
Source: crossref · Quality: baseline
Research context
OpenAlex topics: Additive Manufacturing and 3D Printing Technologies · Dental materials and restorations · 3D Printing in Biomedical Research
SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.
Affiliations
Department of Comprehensive Dentistry, University of Maryland School of Dentistry, 650 W Baltimore Street, Baltimore, MD 21201, USA
University of Maryland School of Dentistry, 650 W Baltimore Street, Baltimore, MD 21201, USA
School of Dentistry, Feevale University, 2755 ERS-239, Novo Hamburgo 93700, RS, Brazil
References (34)
Show source-provided references
1. Huang, G., Wu, L., Hu, J., Zhou, X., He, F., Wan, L., and Pan, S.-T. (2022). Main Applications and Recent Research Progresses of Additive Manufacturing in Dentistry. BioMed Res. Int., 2022.10.1155/2022/5530188 ↗
2. Digital dentistry: The new state of the art—Is it disruptive or destructive?10.1016/j.dental.2019.08.103 ↗
3. The Current State of Chairside Digital Dentistry and Materials10.1016/j.cden.2018.11.002 ↗
4. Elution behavior of a 3D-printed, milled and conventional resin-based occlusal splint material10.1016/j.dental.2021.01.024 ↗
5. Da Silva, T.M., Immich, F., De Araujo, T.S., Lund, R.G., Da Silva, A.F., Piva, E., and Da Rosa, W.L.D.O. (2023). Photosensitive resins used in additive manufacturing for oral application in dentistry: A scoping review from lab to clinic. J. Mech. Behav. Biomed. Mater., 141.10.1016/j.jmbbm.2023.105732 ↗
6. Jain, S., Sayed, M.E., Shetty, M., Alqahtani, S.M., Al Wadei, M.H.D., Gupta, S.G., Othman, A.A.A., Alshehri, A.H., Alqarni, H., and Mobarki, A.H. (2022). Physical and Mechanical Properties of 3D-Printed Provisional Crowns and Fixed Dental Prosthesis Resins Compared to CAD/CAM Milled and Conventional Provisional Resins: A Systematic Review and Meta-Analysis. Polymers, 14.10.3390/polym14132691 ↗
7. Initial biocompatibility of novel resins for 3D printed fixed dental prostheses10.1016/j.dental.2022.08.001 ↗
8. Pituru, S.M., Greabu, M., Totan, A., Imre, M., Pantea, M., Spinu, T., Tancu, A.M.C., Popoviciu, N.O., Stanescu, I.-I., and Ionescu, E. (2020). A Review on the Biocompatibility of PMMA-Based Dental Materials for Interim Prosthetic Restorations with a Glimpse into Their Modern Manufacturing Techniques. Materials, 13.10.3390/ma13132894 ↗
9. Effect of post-curing light exposure time on the physico–mechanical properties and cytotoxicity of 3D-printed denture base material10.1016/j.dental.2021.10.011 ↗
10. An organotypic model of oral mucosa cells for the biological assessment of 3D-printed resins for interim restorations10.1016/j.prosdent.2022.04.017 ↗
11. 3D-printed resins for provisional dental restorations: Comparison of mechanical and biological properties10.1111/jerd.12888 ↗
12. Bayarsaikhan, E., Gu, H., Hwangbo, N.-K., Lim, J.-H., Shim, J.-S., Lee, K.-W., and Kim, J.-E. (2022). Influence of different postcuring parameters on mechanical properties and biocompatibility of 3D printed crown and bridge resin for temporary restorations. J. Mech. Behav. Biomed. Mater., 128.10.1016/j.jmbbm.2022.105127 ↗
13. Bayarsaikhan, E., Lim, J.-H., Shin, S.-H., Park, K.-H., Park, Y.-B., Lee, J.-H., and Kim, J.-E. (2021). Effects of Postcuring Temperature on the Mechanical Properties and Biocompatibility of Three-Dimensional Printed Dental Resin Material. Polymers, 13.10.3390/polym13081180 ↗
14. Fibroblast behavior on conventionally processed, milled, and printed occlusal device materials with different surface treatments10.1016/j.prosdent.2021.08.015 ↗
15. Biomechanical properties of a 3D printing polymer for provisional restorations and artificial teeth10.1016/j.dental.2022.11.004 ↗
16. Cytotoxicity of 3D-printed, milled, and conventional oral splint resins to L929 cells and human gingival fibroblasts10.1002/cre2.592 ↗
17. Comparison of flexural properties and cytotoxicity of interim materials printed from mono-LCD and DLP 3D printers10.1016/j.prosdent.2020.09.003 ↗
18. Post-processing of DLP-printed denture base polymer: Impact of a protective coating on the surface characteristics, flexural properties, cytotoxicity, and microbial adhesion10.1016/j.dental.2022.11.008 ↗
19. In vitro biocompatibility testing of 3D printing and conventional resins for occlusal devices10.1016/j.jdent.2022.104163 ↗
20. Hwangbo, N.-K., Nam, N.-E., Choi, J.-H., and Kim, J.-E. (2021). Effects of the Washing Time and Washing Solution on the Biocompatibility and Mechanical Properties of 3D Printed Dental Resin Materials. Polymers, 13.10.3390/polym13244410 ↗
21. Influence of postwashing process on the elution of residual monomers, degree of conversion, and mechanical properties of a 3D printed crown and bridge materials10.1016/j.dental.2022.09.017 ↗
22. Effects of postpolymerization conditions on the physical properties, cytotoxicity, and dimensional accuracy of a 3D-printed dental restorative material10.1016/j.prosdent.2022.04.024 ↗
23. Postpolymerization of a 3D-printed denture base polymer: Impact of post-curing methods on surface characteristics, flexural strength, and cytotoxicity10.1016/j.jdent.2021.103856 ↗
24. Effects of heat-treatment methods on cytocompatibility and mechanical properties of dental products 3D-printed using photopolymerized resin10.2186/jpr.JPR_D_21_00345 ↗
25. Oh, R., Lim, J.-H., Lee, C.-G., Lee, K.-W., Kim, S.-Y., and Kim, J.-E. (2023). Effects of washing solution temperature on the biocompatibility and mechanical properties of 3D-Printed dental resin material. J. Mech. Behav. Biomed. Mater., 143.10.1016/j.jmbbm.2023.105906 ↗
26. CAD-CAM complete denture resins: An evaluation of biocompatibility, mechanical properties, and surface characteristics10.1016/j.jdent.2021.103785 ↗
27. Cytotoxicity of printed resin-based splint materials10.1016/j.jdent.2022.104097 ↗
28. Effect of post-rinsing time on the mechanical strength and cytotoxicity of a 3D printed orthodontic splint material10.1016/j.dental.2021.01.016 ↗
29. Cytotoxicity of denture base acrylic resins: A literature review10.1016/S0022-3913(03)00349-4 ↗
30. (2009). Biological Evaluation of Medical Devices—Part 5: Tests for In Vitro Cytotoxicity (Standard No. ISO 10993-5:2009). Available online: https://www.iso.org/standard/36406.html.
31. Applications of additive manufacturing in dentistry: A review10.1002/jbm.b.33961 ↗
32. Cytotoxic effects of denture base materials on a permanent human oral epithelial cell line and on primary human oral fibroblasts in vitro
33. Influence of polymerization method on the cytotoxicity of three different denture base acrylic resins polymerized in different methods10.1016/j.sjbs.2020.05.039 ↗
34. Maktabi, H., Ibrahim, M.S., Balhaddad, A.A., Alkhubaizi, Q., Garcia, I.M., Collares, F.M., Strassler, H., Fugolin, A.P.P., Pfeifer, C.S., and Melo, M.A.S. (2021). Improper Light Curing of Bulkfill Composite Drives Surface Changes and Increases S. mutans Biofilm Growth as a Pathway for Higher Risk of Recurrent Caries around Restorations. Dent. J., 9.10.3390/dj9080083 ↗