Q1: Material Degradation & Aging by exposure
to:
Chewing-Bruxism-Grinding-Thermocycling-
Environmental Imapact-Cyclic Loading
And their effect on:
Shape memory - Optical Properities of material?
Q2: Does the rigid nature of Graphy resin
require different attachment shapes or sizes
for optimal "tracking"?
Q3:Reactivation Potential?
Can PT re-activate a used graphy by using hot
water ?
Q4:Force Stability & Stress Relaxation Over
time?
Objective:
To compare water absorption, desorption, and diffusion behavior
between thermoformed (Invisalign, ClearCorrect) and 3D-printed (Tera
Harz TC-85) aligners.
Experimental Results:
-Diffusion Model: All materials strictly followed Fickian diffusion profiles.
-Absorption (Day 14):
- Thermoformed: Significantly higher uptake (4.91% for Invisalign).
-3D-Printed: Significantly lower uptake (2.76% for Clear A).
-Desorption Speed:
-Invisalign: Fastest initial release (93.7% within the first hour).
-3D-Printed: Slower early release but reached parity with others by 24
hours.
-Correlation: High absorption strongly correlates with rapid early
desorption .
Conclusion
-Material Degradation: Moisture causes "hydrolytic degradation,"
disrupting hydrogen bonds and increasing intermolecular spacing.
-Dimensional Stability: Water absorption leads to polymer chain
relaxation and swelling, causing aligner expansion or deformation that
compromises clinical fit.
-Thermoforming: Leads to uneven thickness and higher permeability
(especially TPU layers).
-3D Printing: Provides consistent material thickness and a densely
cross-linked structure, offering superior resistance to moisture-induced
changes.
-Wear Protocols: High moisture interaction in thermoformed materials
may necessitate stricter adherence to wear cycles to manage
dimensional changes.
Mechanical Properties: Thermoformed vs. 3D-Printed
Aligners
Objective:
Compare elastic modulus (stiffness), ultimate tensile strength (UTS), and
stress relaxation between thermoformed (EX30, LD30) and 3D-printed
(Material X, OD-Clear TF) resins in dry vs. simulated oral (wet)
environments.
Elastic UTS Residual
Material State
Modulus (MPa) (MPa) Stress (2hr)
EX30 61.43 ±
Wet 114.4 ± 17.9 59.99%
(Invisalign) 7.41
LD30 30.09 ±
Wet 103.5 ± 11.4 52.57%
(Invisalign) 1.50
Material X 27.57 ±
Wet 139.9 ± 34.6 6.98%
(3D) 4.09
OD-Clear TF 8.27 ±
Wet 38.3 ± 8.4 4.39%
(3D) 0.93
Critical Findings
-Environmental Sensitivity: Moisture significantly degrades the
mechanical properties of 3D-printed resins compared to thermoformed
materials.
-Stiffness (Modulus): Material X (3D) showed extreme drop-off from dry
(431 MPa) to wet (139 MPa), indicating high instability in the oral cavity.
-Force Maintenance (Stress Relaxation):
Thermoformed: Retained over 50-60% of their initial stress after 2 hours.
-3D-Printed: Retained less than 7% of initial stress, indicating a rapid
loss of orthodontic force.
Conclusion
Direct 3D-printed aligners currently struggle to maintain adequate force
levels for tooth movement in wet conditions. While 3D printing offers
superior geometric precision, the high stress relaxation in the oral
environment suggests they may be less effective than traditional
thermoformed aligners (EX30/LD30) at delivering sustained orthodontic
loads.
Optical Properties & Color Stability:
3D-Printed vs. Thermoformed
Objective:
To compare the transparency (transmittance), light absorption, and
color stability of 3D-printed (TC-85) vs. thermoformed (PETG) aligners
after 14 days of intraoral wear.
Crucial Observations
Initial Esthetics:
Even at baseline (before wearing), 3D-printed aligners are less "clear"
than thermoformed PETG, showing higher absorbance and lower
transmittance.
Intraoral Degradation:
Both materials showed a significant increase in absorbance and
decrease in transmittance after 14 days. However, the 3D-printed
aligners degraded significantly more than the thermoformed ones.
Color Stability:
While thermoformed aligners showed better color stability (Delta below
the clinically perceptible limit of 3.7), the statistical difference between
the two groups for Delta specifically was not significant (P > 0.05).
Salivary Impact:
The study noted that maxillary and mandibular aligners face different
conditions due to salivary pooling, but 3D-printed materials were more
susceptible to optical changes in both arches.
Biocompatibility and Surface Changes: 3D-Printed Aligners
Objective:
To investigate how clinical intraoral wear (10 days) affects the surface
hardness, topography, and biological safety (cytotoxicity and
inflammation) of 3D-printed aligners.
Conclusion on Surface Properties:
Hardness:
No significant difference in Shore D hardness was found between
unexposed, artificial saliva-exposed, and clinically used aligners.
Topography:
Scanning electron microscopy (SEM) showed increased surface
irregularities (roughness) after exposure to saliva, which may promote
bacterial adhesion.
Cytotoxicity (Cell Safety):
General Safety: All groups maintained >70% cell viability, meeting the
standard for being non-cytotoxic to normal L929 cells.
Surprising Result: The clinically used group actually showed higher cell
viability than the unexposed group. This suggests that the initial
"leaching" of potentially toxic unreacted monomers happens early or is
diluted/washed away during clinical wear.
Proinflammatory Response (The "Presensitized" Risk)
While the aligners were safe for healthy cells, the study tested their
impact on presensitized cells (simulating patients with existing gingivitis
or inflammation):
Inflammatory Triggers: When cells were already in a "proinflammatory"
state, exposure to 1-week extracts from clinically used aligners
significantly increased the expression of:
Interleukin-6 (IL-6)
Tumor Necrosis Factor-α (TNF-α)
Conclusion on Inflammation:
Clinical wear may exacerbate existing oral inflammation, even if the
material is technically "non-toxic" to healthy tissue.
Surface Roughness & Biofilm Risk: 3D-Printed vs. Invisalign
Objective:
Compare surface roughness and porosity of 3D-printed aligners
(TC-85) vs. Invisalign after 1 week of clinical wear using confocal
laser scanning microscopy.
Results & Conclusion:
Surface Roughness
Aligner Type Porosity & Voids
Change
3D-Printed Increased (Higher peak/valley
Significant Increase
(DPA) differences)
Invisalign Decreased (Surface became
Significant Decrease
(INV) smoother)
Material Degradation:
3D-printed resins (DPAs) undergo surface breakdown during use,
leading to higher arithmetic mean deviation and void volumes.
The "Polishing" Effect: Invisalign aligners actually become smoother
over time, likely due to the abrasive action of soft tissues and saliva
against the thermoplastic material.
Bacterial Risk:
The increased roughness and porosity in DPAs create micro-
environments that promote:
Bacterial adhesion
Biofilm formation
Loss of transparency (cloudiness)
Discoloration
Polymerization Factor:
The study notes that 3D-printed resins are highly sensitive to oxygen
during curing; improper polymerization can exacerbate surface leaching
and roughness.