Mechanical properties of CAD/CAM-fabricated in comparison to conventionally fabricated functional regulator 3 appliances

Manufacturing of Fränkel's functional regulator 3 (FR3) is complicated and requires extensive knowledge from the dental technician. To determine whether FR3s produced by CAD/CAM techniques (CAD-FR3) meet similar mechanical properties like conventional FR3s (Con-FR3), for each of 10 patient cases, three CAD-FR3 designs (palatal connector cross-section 3 × 3 mm, 4 × 1 mm or 5 × 2 mm) and one Con-FR3 were subjected to cyclic loading and subsequent fracture testing in a universal testing device. Transversal load capacity (F(max(FR3))) and stiffness were compared among the different CAD-FR3 designs and Con-FR3s using Friedman and Wilcoxon tests with a significance level of α = 0.05. All CAD-FR3 designs had significantly higher mean F(max(FR3)) (p ≤ 0.007) and stiffness (p ≤ 0.005) than the Con-FR3s. The CAD-FR3(3×3) had the highest mean F(max(FR3)) (98.2 ± 26.2 N) and stiffness (37.1 ± 15.5 N/mm), closely followed by the CAD-FR3(5×2) (F(max(FR3)): 90.3 ± 24.7 N; stiffness: 30.0 ± 12.3 N/mm). Among the CAD appliances, CAD-FR3(4×1) had the lowest values (p ≤ 0.007 for all pairwise tests) with F(max(FR3)) of 45.8 ± 17.9 N and stiffness of 12.5 ± 7.3 N/mm. CAD-FR3s have superior mechanical properties in comparison to Con-FR3s if certain design parameters are followed. Further clinical investigations have to examine if they can serve as an alternative in practice.