3D - 2024 - Sprintray Crown
3D - 2024 - Sprintray Crown
3D - 2024 - Sprintray Crown
CERAMIC CROWN
S C I E N T I F I C ST U D I E S S U M M A RY
C O N T E N T S
3D Printed Crowns 2
SprintRay Ceramic Crown 3
Fracture Load with 10 Year Chewing Simulation 4
Abrasion Resistance with 10 Year Chewing Simulation 7
Occlusal Wall Thickness Effect on Fracture Load 9
Bonding Strength with Luting Composite 11
Shear Bond Strength Luting Workflow Comparison 13
Additional References 15
M AY 2 0 2 3
3D PRINTED CROWNS
Materials science has been integral to dentistry since the formation of the profession.
Since the introduction of composite materials in the 1960s, professionals across the
industry have sought to improve the quality and patient experience for indirect
restorations.1
CEREC by Dentsply Sirona, pioneered early in-office milling and digital imaging,
creating a commercially viable system for scanning, designing, and milling definitive
restorations out of composite blocks. This system introduced a new way to deliver
high-quality indirect restorations to patients, raising the standard of care and
providing clinics with newfound flexibility.3
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 2
Ceramics Unlock Restorative 3D Printing
In late 2022, the American Dental Association announced that the CDT code for
ceramic restorations would be amended by removing the language around
fabrication methods. In 2023 and beyond, 3D printed crowns formulated with pre-
dominantly ceramic can be qualified for reimbursement as a full ceramic restoration.
S P R I N T R AY C E R A M I C C R O W N
SprintRay Ceramic Crown is the first ceramic dominant 3D printing resin designed
as part of a comprehensive chairside restoration ecosystem. It is designed for use
in tandem with the groundbreaking Crown Kit, a compact 3D printing build platform
and resin tank system designed to fabricate multiple restoration types in 10–15
minutes. It addresses the updated definition of ceramic with its ceramic-dominant
formulation and is FDA-cleared for placement as definitive single-unit crowns, inlays,
onlays and veneers.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 3
Ceramic Crown Chemical Composition
SprintRay Ceramic Crown is designed for the fabrication of restorations that are
wear-resistant, while also being gentle on opposing dentition. The material is capable
of withstanding heavy occlusal forces, while remaining gentle on the opposing
teeth. This results in a longer-lasting, functional restoration that is comfortable for
the patient. It is a perfect choice for fabricating full-contour crowns, providing
long-lasting wear resistance and gentle contact with opposing teeth.
Objective
For this evaluation, full-contour crowns were fabricated from two milled materials
and two 3D printed materials. The CAD designs for all four crowns were identical
except for the support structures used during fabrication. The milled crowns were
prepared by Paramount Dental Studio (Huntington Beach, CA) according to
manufacturer IFU, and the 3D printed materials were prepared using a SprintRay
Pro55 S printer and SprintRay ProCure 2 also according to manufacturer IFU.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 4
Four crown replicates were made for each experimental group and cemented with
Panavia SA to 3D printed stumps designed to mimic a clinical prep scan. The crowns
were subjected to thermal cycling and antagonist loading with steatite material
which mimics the mechanical properties of natural enamel. The chewing simulation
comprised 400,000 cycles with a vertically applied load of 50N, with thermal cycling
of 10,700 cycles alternating between 5ºC and 55ºC.
The fracture load was evaluated using a universal testing machine. The specimens
were loaded with a 5mm diameter steel antagonist in the middle of the occlusal
surface, with load applied until failure (tested in accordance with DIN EN ISO 7500-1).
Failure load was evaluated with and without chewing simulation to determine the
effect of this simulated wear on functional mechanical performance. Statistical
analysis was performed using two-factor ANOVA and post-hoc Tukey pairwise
comparison.
Figure 1:
3D design used for
crowns and cemented
stumps (left) and
testing apparatus
(right).
3000
Figure 2: 2000
Fracture load of 1000
cemented crowns
before and after 0
Lithium Milled Hybrid Competitor SprintRay Ceramic
chewing simulation Disilicate* Ceramic Crown Resin Crown Resin
demonstrated Initial After 10-yr Wear
significant differences
* Note that the differences in mean between lithium disilicate conditions are not statistically significant,
between all materials as determined by two-factor ANOVA and post-hoc Tukey pairwise comparison (p > 0.1).
tested (p < 0.01).
Results
The fracture load of SprintRay Ceramic Crown averaged 3815 N prior to the chewing
simulation, and there was no significant change in this value after the simulation
which indicates no detectable material fatigue (p > 0.1). The 3D printed competitor
crown resin had a significantly lower fracture load of 2693 N (p < 0.01).
The milled lithium disilicate and hybrid ceramic materials had average fracture loads
of 4560 N and 2460 N, respectively. Milled lithium disilicate had a greater fracture
load compared to SprintRay Ceramic Crown, while milled hybrid ceramic had a
significantly lower fracture load. For all materials, the differences in fracture load
5 – Study conducted SD
Mechatronik GmbH, Germany. following the chewing simulation were not statistically significant (p>0.1).5 5
Discussion
SprintRay Ceramic Crown achieved fracture loads more than seven times the average
maximum human masticatory forces of 522 N.6 Crowns printed in this material had an
average fracture load of 3815 N before the 10-year chewing simulation and showed
no significant change in fracture load following simulated wear. This indicates no
significant material fatigue in SprintRay Ceramic Crown printed restorations after
the simulated wear. The marginal difference in average fracture load with chewing
simulation was within sample variance and differences in means were not statistically
significant as determined by post hoc Tukey pairwise comparison.
The milled lithium disilicate showed approximately a 20% higher fracture load than
6 – Apostolov N, Chakalov I, Drajev
T. Measurement of the maximum
SprintRay Ceramic Crown despite having a substantially higher reported flexural
bite force in the natural dentition
with a gnathodynamometer.
strength of 380MPa.7 This is likely due in part to the stiffness of lithium disilicate. Due
MedInform. 2014;1(2):70-75.
to its significantly greater flexural modulus (70–84 GPa) than the underlying dentition
7 – Al-Thobity AM, Alsalman A. (12–21 MPa), loads applied to milled lithium disilicate crown material may not be
Flexural properties of three lithium
disilicate materials: An in vitro distributed to the dentin beneath. This can result in stress concentrations that cause
evaluation. The Saudi Dental
Journal. 2021;33(7):620-627. failure in these milled crowns.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 6
A B R A S I O N R E S I S TA N C E W I T H
1 0 Y E A R C H E W I N G S I M U L AT I O N
Comparison of 3D Printed Crown Materials
Objective
Figure 3:
Chewing simulator,
test piece, and
profilometer output.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 7
Results
The abrasion resistance and volumetric wear of dental restorative materials were
evaluated following a 10-year chewing simulation. The results showed that the
competitor crown resin with 20–25% ceramic exhibited the highest volumetric wear
of 0.051 mm,3 whereas SprintRay Ceramic Crown showed the lowest volumetric
wear of 0.023 mm.3 Statistical analysis by one-way ANOVA indicated significant
differences between the groups (p<0.05). However, post-hoc Tukey pairwise
comparison showed no significant difference between the competitor crown resins
with 30–35% and 50–55% ceramic, and SprintRay Ceramic Crown (p>0.05). These
findings suggest that, although there are differences in the volumetric wear
between the tested materials, some of them have comparable performance. Further
studies are needed to investigate the clinical significance of these differences and
their impact on the longevity of dental restorations.
0.05
0.04
0.03
0.02
0.01
Figure 4:
Volumetric wear 0
comparison of 3D Competitor Resin A Competitor Resin B Competitor Resin C SprintRay
printed crown (20–25% Ceramic) (50–55% Ceramic) (30–35% Ceramic) Ceramic Crown
materials.8
Discussion
The present study investigated the abrasion resistance and volumetric wear of four
dental restorative materials following a 10-year chewing simulation. The results
indicate that the SprintRay Ceramic Crown material showed one of the lowest
volumetric wear rates amongst the 3D printed materials tested. This finding is
significant as low wear rates have been linked to clinical durability, meaning that
restorations made with this material may be expected to have a longer lifespan.
Abrasion resistance is a critical aspect of material performance that is directly
related to the longevity of dental restorations. The results of this study provide
8 – Study conducted by the
University of Alabama at valuable information that can assist clinicians in selecting materials with optimal
Birmingham, Division of
Biomaterials. abrasion resistance for their patients' dental restorations.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 8
O C C L U S A L WA L L T H I C K N E S S
E F F ECT O N F RACT U RE LOA D
Objective
The present study aimed to evaluate the performance of 3D printed dental crowns
made using SprintRay Ceramic Crown with different occlusal wall thicknesses.
Fracture load testing of crowns cemented to a stump was used as a functional test
of maximum load, with a focus on the effects of thin features on the material's
performance. Ceramic restorations typically recommend a minimum wall thickness
of 1mm to ensure optimal performance. Thin features resulting from inadequate
preparation of the tooth structure are a leading contributor to the failure of crown
restorations. Stress concentrations can occur in thin regions of the material, leading
to fractures that compromise the integrity of the restoration. The evaluation present-
ed in this study was designed to investigate the performance of SprintRay Ceramic
Crown in thin regions, an essential factor for assessing the material's suitability for
use in dental restorations.
This study aimed to evaluate the fracture load of dental restorative materials at
different occlusal thicknesses. Crowns were cemented to 3D printed stumps
designed from a clinical prep scan, with the crown STL file modified to have 0.5, 1,
and 1.5mm occlusal thickness. Four crown replicates were tested per experimental
group. To assess the fracture load of the specimens, an antagonist in the form of a
5mm diameter steel sphere was loaded in the middle of the occlusal region, with the
load applied until failure. Testing was conducted in accordance with DIN EN ISO
7500-1 standards to ensure accurate and reliable results. Fracture load was then
compared between the experimental groups to evaluate the performance of the
different occlusal thicknesses. Statistical analysis was conducted using ANOVA to
determine any significant differences between the experimental groups.
Figure 5:
Cross sections of
crown designs for
0.5mm, 1.0mm, and
1.5mm occlusal wall
thickness.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 9
Results
O C C LU S A L WA L L T H I C K N E S S
0.5 mm
1.0 mm
1.5 mm
Figure 6:
Fracture load of 0 1000 2000 3000 4000 5000
cemented crowns
with different Fracture Load (N)
wall thickness.9
Discussion
The findings of this study suggest that the use of SprintRay Ceramic Crown material
for the fabrication of dental restorations may provide a degree of flexibility with
respect to occlusal wall thickness. The comparable fracture loads observed across
all thickness groups suggest that this material is resilient to occlusal thicknesses
below the recommended minimum wall thickness of 1 mm. This may be due, in part,
to the strength of the cementation between the crown and the underlying prep, as
well as the distribution of the applied load across the underlying structure.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 10
BONDING STRENGTH WITH
LU T I N G C O M P O S I T E
Objective
This study was conducted to test the bonding strength between SprintRay Ceramic
Crown and a luting agent. To simulate clinical luting workflows, the study bonded a
luting agent to a substrate of Ceramic Crown. This same test was evaluated with
comparison to milled lithium disilicate using different adhesive primers. These
further tests were completed to understand Ceramic Crown’s position relative to well
established market competitors.
For this study, testing specimens consisted of printed cylinders. The printed speci-
mens were then fixed in acrylic material to ensure that they met the dimensional
requirements of the testing apparatus. To prepare the surfaces for testing, they were
ground flat using a wet sanding process. For the sandblasting groups, an additional
sandblasting treatment was applied to the bonding surface. The bonding surface
was treated with various adhesive primers according to the experimental group. A
2.5mm cylinder of Omnichroma resin cement (Tokuyama Dental) was applied to the
bonding surface. A universal testing machine with a notched attachment was used
to shear off the cylinder of dental cement from the printed crown material. The
failure load was measured, and statistics were evaluated by two-factor ANOVA with
post-hoc Tukey pairwise comparison.
Figure 7:
Shear bond testing,
cohesive failure,
adhesive failure.
The majority of
experimental
conditions failed by
cohesive failure.
S P R I N T R AY C E R A M I C C R O W N S T U D I E S S U M M A R Y 11
Results
The results of the bonding strength test are shown in the graphs below. All materials
and groups met the standard criteria of minimum bonding strength of 5 MPa, with
all samples exceeding this ISO requirement by a significant margin. Additionally, the
majority of conditions for SprintRay Ceramic Crown resulted in cohesive failures of
the underlying material. This mode of failure indicates high bond strength relative to
cohesive material strength.
10 – Study conducted by
the University of Alabama
Lithium Disilicate SprintRay Ceramic Crown
at Birmingham, Division
of Biomaterials
40
30
Figure 9: 20
Shear bond strength
10
comparison of
different surface 0
treatments and Control Silane Monobond ScotchBond Universal
adhesive primers.11
Untreated Sand Blasted
11 – Study conducted by the
University of Alabama at Birmingham,
Division of Biomaterials
S P R I N T R AY C E R A M I C C R O W N S T U D I E S S U M M A R Y 12
Discussion
The shear bond strength between dental restorative material and resin cements
is a crucial factor for the long-term success of dental restorations. The results of this
study showed that SprintRay Ceramic Crown had comparable bond strength to
milled lithium disilicate when bonded to resin cements. However, it is important to
note that the large standard deviations resulted in limited statistical significance
of the results for comparison of primers or surface treatment. All conditions out-
performed the ISO minimum requirement of 5 MPa. However, we did not observe
a significant difference in bond strength between the different primers or surface
treatments. These findings suggest that SprintRay Ceramic Crown provides
adequate bond strength when bonded with all different primer conditions tested.
S H E A R B O N D S T R E N GT H LU T I N G
W O R K F L O W C O M PA R I S O N
Objective
This study evaluated the bonding strength between SprintRay Ceramic Crown and a
luting agent. To simulate clinical luting workflows, the study bonded a luting agent to
a substrate of Ceramic Crown. Various common luting workflows were tested in order
to evaluate common resin cements.
For this study, testing specimens consisted of printed cylinders. The printed specimens
were then fixed in acrylic material to ensure that they met the dimensional require-
ments of the testing apparatus. To prepare the surfaces for testing, they were ground
flat. The bonding surface was treated with adhesive primers when indicated. A 2.5mm
cylinder of resin cement was applied to the bonding surface. A universal testing
machine with a notched attachment was used to shear off the cylinder of dental
cement from the printed crown material. The failure load was measured, and statistics
were evaluated by two-factor ANOVA with post-hoc Tukey pairwise comparison.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 13
Results & Discussion
The shear bond strength between dental restorative material and resin cements is a
critical factor for the long-term success of dental restorations. In this study, we aimed
to evaluate the shear bond strength of Ceramic Crown material when bonded to resin
cements under different test conditions and to assess the effect of adhesive primers
on bond strength. The results showed that all test conditions, except for Temp Bond,
significantly exceeded the minimum ISO requirement of 5 MPa.
45
40
35
30
25
20
15
Figure 10: 10
Comparison of work-
flows with common 5
resin cements.12 0
12 – Study conducted by SprintRay Temp Bond Panavia 5 Multilink 3M RelyX Monobond Panavia Kerr Clearfil +
Materials Science team. (no adhesive) (no adhesive) Unicem Multilink SA Maxcem Panavia V5
The most commonly observed fracture type among the Ceramic Crown samples
was cohesive fracture patterns in the substrate, indicating that the adhesive bond
strength between the Ceramic Crown material and luting composite is very high.
Clearfil V5 with Clearfil adhesive primer provided the highest shear bond strength
with an average value of 42.12 MPa, which was significantly higher than the other
adhesive systems tested in this study. In contrast, Temp Bond had the lowest
performance with a value of 0.62 MPa.
C E RA M I C C ROW N S C I E N T I F I C ST U D I E S S U M M A RY 14
R E F E R E N C E M AT E R I A L S
Instructions For Use (IFU) Safety Data Sheet (SDS) Workflow Guide
https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf
https://sprintray.com/oracle/uploads/2023/03/Ceramic-Crown-IFU.docx-20220308.pdf https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf https://sprintray.com/oracle/uploads/2023/03/Workflow-Guide-Crown-v.9-20230302-1.pdf
https://sprintray.com/oracle/uploads/2023/03/Ceramic-Crown-IFU.docx-20220308.pdf https://sprintray.com/oracle/uploads/2023/03/Workflow-Guide-Crown-v.9-20230302-1.pdf
VIEW
https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf
VIEW
https://sprintray.com/oracle/uploads/2023/03/Ceramic-Crown-IFU.docx-20220308.pdf
https://sprintray.com/oracle/uploads/2023/03/Ceramic-Crown-IFU.docx-20220308.pdf
VIEW
https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf
https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf
https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf
https://sprintray.com/oracle/uploads/2023/03/Workflow-Guide-Crown-v.9-20230302-1.pdf
https://sprintray.com/oracle/uploads/2023/03/Workflow-Guide-Crown-v.9-20230302-1.pdf
https://sprintray.com/oracle/uploads/2023/03/Ceramic-Crown-IFU.docx-20220308.pdf https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf https://sprintray.com/oracle/uploads/2023/03/Workflow-Guide-Crown-v.9-20230302-1.pdf
https://sprintray.com/oracle/uploads/2023/04/SDS-002_1-SprintRay-Ceramic-Crown-SDS-English.pdf