Abstract：
Different printing technologies can be used for prosthetically oriented implant placement, however the influence of different printing orientations and steam sterilization remains unclear. In particular, no data is available for the novel technology Continuous Liquid Interface Production. The objective was to evaluate the dimensional accuracy of surgical guides manufactured with different printing techniques in vertical and horizontal printing orientation before and after steam sterilization. A total of 80 surgical guides were manufactured by means of continuous liquid interface production (CLIP; material: Keyguide, Keyprint), digital light processing (DLP; material: Luxaprint Ortho, DMG), stereolithography (SLA; Surgical guide, Formlabs), and fused filament fabrication (FFF; material: Clear Base Support, Arfona) in vertical and horizontal printing orientation (n = 10 per subgroup). Spheres were included in the design to determine the coordinates of 17 reference points. Each specimen was digitized with a laboratory scanner after additive manufacturing (AM) and after steam sterilization (134 °C). To determine the accuracy, root mean square values (RMS) were calculated and coordinates of the reference points were recorded. Based on the measured coordinates, deviations of the reference points and relevant distances were calculated. Paired t-tests and one-way ANOVA were applied for statistical analysis (significance p < 0.05). After AM, all printing technologies showed comparable high accuracy, with an increased deviation in z-axis when printed horizontally. After sterilization, FFF printed surgical guides showed distinct warpage. The other subgroups showed no significant differences regarding the RMS of the corpus after steam sterilization (p > 0.05). Regarding reference points and distances, CLIP showed larger deviations compared to SLA in both printing orientations after steam sterilization, while DLP manufactured guides were the most dimensionally stable. In conclusion, the different printing technologies and orientations had little effect on the manufacturing accuracy of the surgical guides before sterilization. However, after sterilization, FFF surgical guides exhibited significant deformation making their clinical use impossible. CLIP showed larger deformations due to steam sterilization than the other photopolymerizing techniques, however, discrepancies may be considered within the range of clinical acceptance. The influence on the implant position remains to be evaluated.
摘要：
不同的印刷技术可用于修复定向的植入物放置，然而，不同印刷方向和蒸汽灭菌的影响尚不清楚。特别是,没有新技术连续液体界面生产的数据。目的是评估蒸汽灭菌前后，在垂直和水平打印方向上使用不同打印技术制造的手术导向器的尺寸精度。通过连续液体界面生产（CLIP；材料：Keyguide，按键打印)，数字光处理(DLP;材质:LuxaprintOrtho,DMG),立体光刻(SLA；手术指南，Formlabs),和熔丝制造(FFF；材料：透明底座支撑，Arfona）在垂直和水平印刷方向（每个子组n=10）。设计中包括球体，以确定17个参考点的坐标。在增材制造(AM)和蒸汽灭菌(134°C)之后,用实验室扫描仪将每个样本数字化。为了确定准确性，计算均方根值(RMS),并记录参考点的坐标.根据测量的坐标，计算了参考点和相关距离的偏差。应用配对t检验和单因素方差分析进行统计学分析(显著性p<0.05)。AM之后,所有印刷技术都显示出相当高的精度，水平打印时，z轴偏差增加。灭菌后,FFF打印的手术指南显示出明显的翘曲。蒸汽灭菌后其他亚组的RMS没有显着差异（p>0.05）。关于参考点和距离，与SLA相比，CLIP在蒸汽灭菌后的两个打印方向上显示出更大的偏差，而DLP制造的导板尺寸最稳定。总之,不同的印刷技术和方向对灭菌前手术导向器的制造精度影响不大。然而,灭菌后，FFF手术引导件表现出明显的变形，使其无法临床使用。由于蒸汽灭菌，CLIP比其他光聚合技术显示出更大的变形，然而,在临床接受范围内可以考虑差异。对植入物位置的影响仍有待评估。
