The Impact of Additive and Subtractive Manufacturing on the Adhesion and Durability of Titanium-Zirconia Restorative Materials.

This study aimed to investigate the bonding strength and durability of titanium alloys bonded to zirconia-based materials produced using subtractive and additive digital methods. Two titanium alloy groups (N = 20) and two zirconia ceramic groups (N = 60) were fabricated using CAD/CAM milling from prefabricated discs (Ti-ML and Zr-ML), and 3D printing via SLM (Ti-3D) and DLP/LCM systems (Zr-3D). The specimens were bonded with dental cement to form four test groups: Zr-ML/Ti-ML, Zr-ML/Ti-3D, Zr-3D/Ti-ML, and Zr-3D/Ti-3D. Half of the specimens in each group underwent thermocycling to assess the effect of aging on bond strength. The density, microhardness, and surface morphology were evaluated, along with the shear bond strength and failure modes of the resin composites. Statistical differences were analyzed using one-way ANOVA and Tukey's HSD test across all groups. The 3D-printed specimens of both materials exhibited higher microhardness and lower surface roughness than the milled specimens. The shear bond strength (SBS) was the highest in the Ti-ML/Zr-ML combination group before and after thermocycling, which had more cohesive failures, whereas the lowest bond strength was observed in the Ti-3D/Zr-ML group. The adhesion between titanium and zirconia-based materials was the strongest when both were fabricated using subtractive methods, followed by additive and mixed-method combinations.