Effect of nanomodified 3D printed photopolymerizable resin on flexural strength, color, and antimicrobial efficacy: An in vitro study

Statement of problem Three-dimensional (3D) printing has become popular in dentistry, but studies on the influence of incorporating organic and inorganic nanofillers on 3D printed materials are lacking. Purpose The purpose of this in vitro study was to assess the flexural strength, color, and antimicrobial efficacy of 3D printed photopolymerizable resin upon adding titanium dioxide nanoparticles (TiO2 NPs) and silanized chitosan nanoparticles (sCS NPs). Material and methods A stereolithographic material (VarseoSmile Crown plus; Bego) was used as a control group (VSC resin), and 3 nanocomposite resin groups were prepared by adding nanoparticles as follow: titanium dioxide group (VSC resin + 0.4% wt. TiO2 NPs), chitosan group (VSC resin + 0.4% wt. sCS NPs), and hybrid group (VSC resin + 0.2% wt. TiO2 NPs + 0.2% wt. sCS NPs). A total of 132 specimens were designed by using a free computer-aided design software program, printed, postpolymerized, and divided into 4 groups. The nanocomposite resins were characterized using scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDX), and Fourier-transform infrared spectroscopy (FTIR). Bar shaped specimens (n=44) were tested for 3-point flexural strength using a universal testing machine followed by the color measurement of disk-shaped specimens (n=44) with a spectrophotometer. Antimicrobial capacity was measured with Streptococcus mutans, and absorbance was measured using a microplate reader (n=44). Statistical assessments were made with 1-way ANOVA followed by the Tukey post hoc test with Bonferroni adjustment (α=.05). Results The hybrid group recorded the highest mean value of flexural strength 135.51 MPa, showing a significant difference compared with that of the control group (P=.022). Regarding color, the mean ∆E00 for titanium was 1.18, for chitosan was 4.26, and for the hybrid group was 3.23 (P<.001). The optical density of the chitosan (2.42) was significantly higher than that of the titanium 1.36 (P=.007) and that of the control 1.63 (P=.042). Conclusions The incorporation of nanofillers resulted in an increase in flexural strength, but it adversely affected the color of nanocomposite resins. Antimicrobial efficacy was improved by incorporating titanium nanofillers.