RESEARCH AND EDUCATION A study of the flexural strength and surface hardness of different materials and technologies for occlusal device fabrication Vladimir Prpic, DMD, a Ivan Slacanin, MME, b Zdravko Schauperl, BSME, c Amir Catic, DMD, d Niksa Dulcic, DMD, e and Samir Cimic, DMD f Temporomandibular disorder (TMD) is a collective term that involves several clinical prob- lems affecting the masticatory muscles, temporomandibular joints, and associated struc- tures. 1 Bruxism is defined as a diurnal or nocturnal parafunc- tional activity that includes un- consciously clenching, grinding, or bracing the teeth. 2 The inci- dence of TMD is over 10% in the general population, 3 whereas some studies confirm an overall 8% incidence of bruxism, although this differs with age. 4,5 Occlusal devices are often used to manage TMD symptoms and prevent the negative effects of bruxism on the stomatognathic system. Occlusal devices are usually made of poly(methyl methacry- late) (PMMA)-based polymers, whose mechanical properties and ease of use represent the gold standard for occlusal device material. Recently, although the most common technique of occlusal device fabrication remains vacuum- thermoforming foil and autopolymerizing PMMA, 6 occlusal devices can be made by using computer-aided design and computer-aided manufacturing (CAD-CAM) This study was supported, in part, by University of Zagreb scientific support “Diagnostic and therapy of craniomandibular dysfunctions.” a Doctoral student, School of Dental Medicine, University of Zagreb, Zagreb, Croatia. b Postgraduate student, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia. c Associate Professor, Department for Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Zagreb, Croatia. d Associate Professor, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia. e Associate Professor, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia. f Assistant Professor, Department of Prosthodontics, School of Dental Medicine, University of Zagreb, Zagreb, Croatia. ABSTRACT Statement of problem. With the emergence of digital technologies, new materials have become available for occlusal devices. However, data are scarce about these different materials and technologies and their mechanical properties. Purpose. The purpose of this in vitro study was to investigate the flexural strength and surface hardness of different materials using different technologies for occlusal device fabrication, with an emphasis on the digital technologies of computer-aided design and computer-aided manufacturing (CAD-CAM) and 3D printing. Material and methods. A total of 140 rectangular specimens were fabricated from two 3D-printed (VarseoWax Splint and Ortho Rigid), 2 CAD-CAMeproduced (Ceramill Splintec and CopraDur), and 3 conventional autopolymerizing occlusal device materials (ProBase Cold, Resilit S, and Orthocryl) according to ISO 20795-1:2013. Flexural strength and surface hardness were determined for 10 specimens of each tested material using the 3-point bend test and the Brinell method. The data were analyzed using descriptive statistics and 1-way ANOVA with Bonferroni corrections (a=.05). Results. Surface hardness values ranged from 28.5 ±2.5 MPa to 116.2 ±1.6 MPa. During flexural testing, neither the CopraDur nor the VarseoWax Splint specimens fractured during loading within the end limits of the penetrant’s possible movement. Flexural strength values for other groups ranged from 75.0 ±12.0 MPa to 104.9 ±6.2 MPa. Statistical analysis determined significant differences among the tested materials for flexural strength and surface hardness. Conclusions. Mechanical properties among different occlusal device materials were significantly different. Acrylic resins were less flexible than polyamide and nonacrylic occlusal device materials for 3D printing but had higher and more consistent values of surface hardness. Clinicians should consider the different mechanical properties of the available materials when choosing occlusal device materials. (J Prosthet Dent 2018;-:---) THE JOURNAL OF PROSTHETIC DENTISTRY 1