The impact of print orientation and graphene nanoplatelets on biaxial flexural strength and cytotoxicity of a 3D printable resin for occlusal splints

3D printing found its way into various medical applications and could be particularly beneficial for dentistry. Currently, materials for 3D printing of occlusal splints lack mechanical strength compared to polymethyl methacrylate (PMMA) used for standard milling of occlusal splints. It is known that print orientation and graphene nanoplatelets (GNP) can increase biaxial strength in a variety of materials. Thus, the aim of this study was to assess if adjustment of print orientation and addition of GNP improve biaxial strength and if they affect cytotoxicity of a 3D printable resin for occlusal splints. Specimens were printed vertically and horizontally with a stereolithography (SLA) printer and multilayered GNP powder was added to the resin at different concentrations. Printed specimens were characterized by Raman spectroscopy, optical profilometer analysis and scanning electron microscopy. Biaxial strength was evaluated by biaxial flexural testing. Cytotoxicity of specimens on L929 and gingival stromal cells (GSC) was assessed by the toxdent test, the resazurin-based toxicity assay and live-dead staining. Horizontally printed specimens showed significantly higher biaxial strength and lower deformation. GNP did not improve biaxial strength and material deformation of 3D-printed resins. None of the specimens were cytotoxic to L929 cells or GSC. Print orientation in SLA printing has a significant impact on biaxial strength and material deformation. 3D printable materials can reach comparable or even improved biaxial strength compared to PMMA when using the optimal print orientation while GNP has no beneficial effects on the biaxial strength of resins for 3D printing of occlusal splints.