Comparison of properties and cost efficiency of zirconia processed by DIW printing, casting and CAD/CAM-milling

Objectives: The aim of this study was to evaluate the mechanical properties and cost efficiency of direct ink writing (DIW) printing of two different zirconia inks compared to casting and subtractive manufacturing. Methods: Zirconia disks were manufactured by DIW printing and the casting process and divided into six subgroups (n = 20) according to sintering temperatures (1350 & DEG;C, 1450 & DEG;C and 1550 & DEG;C) and two different ink compositions (Ink 1, Ink 2). A CAD/CAM-milled high strength zirconia (3Y-TZP) was added as reference group. The biaxial flexural strength (BFS) was measured using the piston-on-three-balls test. X-ray-diffraction (XRD) was used for microstructural analysis. The cost efficiency was compared for DIW printing and subtractive manufacturing by calculation of the manufacturing costs of one dental crown. Results: Using XRD, monoclinic and tetragonal phases were detected for Ink 1, for all other groups no monoclinic phase was detected. The CAD/CAM-milled ceramic showed a significantly higher BFS than all other groups. The BFS of Ink 2 was significantly higher than the BFS of Ink 1. At a sintering temperature of 1550 & DEG;C the mean BFS of the printed Ink 2 was 822 & PLUSMN; 174 MPa. The BFS of the cast materials did not show a significantly higher BFS than the corresponding printed group for any tested parameter-set. The manufacturing costs of DIW printed crowns are lower than the manufacturing costs of CAD/CAM-milled crowns. Conclusion: DIW has a high potential to replace subtractive processes for dental applications, as it shows promising mechanical properties for appropriate ink compositions and facilitates a highly cost effective production.