Influence of silver coated zeolite fillers on the chemical and mechanical properties of 3D-printed polyphenylene sulfone restorations

Objectives: To investigate the chemical and mechanical properties of polyphenylene sulfone (PPSU) depending on its composition and manufacturing. Methods: Unfilled-PPSU1 and with antimicrobial silver coated zeolites filled-PPSU2 specimens were made of granulate-GR, filament-FI, or printed-3D. Scanning microscopy and X-ray spectroscopy were performed. Martens hardness-HM, elastic indentation modulus-E-IT and flexural strength-FS were determined initially and after aging. Shear bond strength-SBS to veneering and luting composite after conditioning with 7 adhesive systems were examined after aging. Silver leaching was tested after 1-, 3-, 7-, 14-, 21-, 28- and 42 days. Analyses of variance, Kolmogorov-Smirnov, Kruskal-Wallis, Mann-Whitney U , unpaired t-tests and Weibull modulus were computed (p < 0.05). Results: Zeolites were homogeneously distributed. PPSU1-GR and PPSU1-FI showed the highest HM/E-IT, followed by PPSU2-GR, PPSU1-3D and PPSU2-3D. PPSU2-FI presented the lowest HM/E-IT, displaying micro pits. Aging showed reduced HM/E-IT in PPSU1 and no impact on PPSU2, while FS increased (PPSU1) or decreased (PPSU2). PPSU2-3D presented lower FS than PPSU1-3D. High SBS to the luting (7.0-16.2 MPa) and veneering composite (11.8-22.2 MPa), except for adhesive system PR, were observed. PPSU2-3D showed the highest silver release (9.6%), with all compositions dispensing silver over 42 days. Conclusions: For the examined period of 6 weeks, antimicrobial silver ions were released from filled PPSU. The high SBS between PPSU and veneering/luting composite confirmed the feasibility of esthetically veneering and luting filled PPSU. To achieve mechanical properties like unfilled PPSU, the processing parameters of filled PPSU require refinement. Clinical significance: This investigation provides proof of principle that PPSU can be successfully doped with silver-coated zeolites. The combination of 3D-printing with an antimicrobial thermoplastic constitutes a great opportunity in the field of prosthetic dentistry. Potential applications include clasps for removable dental prostheses, provisional or permanent fixed dental prostheses and implant abutments.