<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2 20190208//EN" "http://jats.nlm.nih.gov/publishing/1.2/JATS-journalpublishing1.dtd"><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" article-type="research-article" dtd-version="1.2" xml:lang="en">
    <front>
        <journal-meta>
            <journal-id journal-id-type="pmc">F1000Research</journal-id>
            <journal-title-group>
                <journal-title>F1000Research</journal-title>
            </journal-title-group>
            <issn pub-type="epub">2046-1402</issn>
            <publisher>
                <publisher-name>F1000 Research Limited</publisher-name>
                <publisher-loc>London, UK</publisher-loc>
            </publisher>
        </journal-meta>
        <article-meta>
            <article-id pub-id-type="doi">10.12688/f1000research.166989.2</article-id>
            <article-categories>
                <subj-group subj-group-type="heading">
                    <subject>Research Article</subject>
                </subj-group>
                <subj-group>
                    <subject>Articles</subject>
                </subj-group>
            </article-categories>
            <title-group>
                <article-title>Fracture resistance of nanocomposite 3D-printed resins designated for teeth fabrication: An in vitro analysis before and after thermal aging</article-title>
                <fn-group content-type="pub-status">
                    <fn>
                        <p>[version 2; peer review: 2 approved with reservations]</p>
                    </fn>
                </fn-group>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Y. Alshaikhnasser</surname>
                        <given-names>Farah</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Conceptualization</role>
                    <role content-type="http://credit.niso.org/">Data Curation</role>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Y. Alboryh</surname>
                        <given-names>Shaymaa</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Data Curation</role>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>H. Al Dawood</surname>
                        <given-names>Zainab</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Funding Acquisition</role>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Validation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>F. Almedarham</surname>
                        <given-names>Rawan</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Data Curation</role>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Funding Acquisition</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>A. Alhassan</surname>
                        <given-names>Fatimah</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Data Curation</role>
                    <role content-type="http://credit.niso.org/">Funding Acquisition</role>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Visualization</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <xref ref-type="aff" rid="a1">1</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>M. Alatiyyah</surname>
                        <given-names>Fatimah</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Data Curation</role>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Software</role>
                    <role content-type="http://credit.niso.org/">Supervision</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="aff" rid="a2">2</xref>
                    <xref ref-type="aff" rid="a3">3</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>A. Nassar</surname>
                        <given-names>Essam</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Supervision</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="aff" rid="a4">4</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Akhtar</surname>
                        <given-names>Sultan</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Funding Acquisition</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="aff" rid="a5">5</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Q. Khan</surname>
                        <given-names>Soban</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Data Curation</role>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Software</role>
                    <role content-type="http://credit.niso.org/">Validation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <uri content-type="orcid">https://orcid.org/0000-0002-8573-3080</uri>
                    <xref ref-type="aff" rid="a6">6</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>A. Balhaddad</surname>
                        <given-names>Abdulrahman</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Formal Analysis</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Resources</role>
                    <role content-type="http://credit.niso.org/">Software</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <uri content-type="orcid">https://orcid.org/0000-0001-6678-7940</uri>
                    <xref ref-type="aff" rid="a7">7</xref>
                </contrib>
                <contrib contrib-type="author" corresp="no">
                    <name>
                        <surname>Tharwat Al Ammary</surname>
                        <given-names>Ahmed</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Supervision</role>
                    <role content-type="http://credit.niso.org/">Visualization</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <xref ref-type="aff" rid="a3">3</xref>
                </contrib>
                <contrib contrib-type="author" corresp="yes">
                    <name>
                        <surname>M. Gad</surname>
                        <given-names>Mohammed</given-names>
                    </name>
                    <role content-type="http://credit.niso.org/">Conceptualization</role>
                    <role content-type="http://credit.niso.org/">Investigation</role>
                    <role content-type="http://credit.niso.org/">Methodology</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Original Draft Preparation</role>
                    <role content-type="http://credit.niso.org/">Writing &#x2013; Review &amp; Editing</role>
                    <uri content-type="orcid">https://orcid.org/0000-0003-3193-2356</uri>
                    <xref ref-type="corresp" rid="c1">a</xref>
                    <xref ref-type="aff" rid="a8">8</xref>
                </contrib>
                <aff id="a1">
                    <label>1</label>College of Dentistry, Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
                <aff id="a2">
                    <label>2</label>Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Eastern Province, Saudi Arabia</aff>
                <aff id="a3">
                    <label>3</label>Assistant Professor of Operative Dentistry Department, Faculty of Dental Medicine, Al-Azhar University College for Boys' Faculty of Dental Medicine Assiut, Asyut, Assiut Governorate, Egypt</aff>
                <aff id="a4">
                    <label>4</label>Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
                <aff id="a5">
                    <label>5</label>Department of Biophysics Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University Institute for Research and Medical Consultations, Dammam, Eastern Province, Saudi Arabia</aff>
                <aff id="a6">
                    <label>6</label>Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
                <aff id="a7">
                    <label>7</label>Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
                <aff id="a8">
                    <label>8</label>Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
            </contrib-group>
            <author-notes>
                <corresp id="c1">
                    <label>a</label>
                    <email xlink:href="mailto:mmjad@iau.edu.sa">mmjad@iau.edu.sa</email>
                </corresp>
                <fn fn-type="conflict">
                    <p>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>23</day>
                <month>2</month>
                <year>2026</year>
            </pub-date>
            <pub-date pub-type="collection">
                <year>2025</year>
            </pub-date>
            <volume>14</volume>
            <elocation-id>894</elocation-id>
            <history>
                <date date-type="accepted">
                    <day>24</day>
                    <month>12</month>
                    <year>2025</year>
                </date>
            </history>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2026 Y. Alshaikhnasser F et al.</copyright-statement>
                <copyright-year>2026</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
                <license>
                    <license-p>The author(s) is/are employees of the US Government and therefore domestic copyright protection in USA does not apply to this work. The work may be protected under the copyright laws of other jurisdictions when used in those jurisdictions.</license-p>
                </license>
            </permissions>
            <self-uri content-type="pdf" xlink:href="https://f1000research.com/articles/14-894/pdf"/>
            <abstract>
                <sec>
                    <title>Background:</title>
                    <p>this study was to evaluate the fracture resistance and elastic modulus of modified 3D-printed resins containing zirconium dioxide nanoparticles (ZNPs) and silicon dioxide nanoparticles (SNPs).</p>
                </sec>
                <sec>
                    <title>Methods:</title>
                    <p>Tooth-colored 3D-printed resin samples (ASIGA (AS)) and NextDent (ND)) were modified with silanized ZNPs and SNPs. Five groups (n=100) were prepared for each resin type, one without nanoparticles, and four groups (n=20 per group) with varying nanoparticles concentrations (0.5 wt. %ZNP, 1 wt.%ZNP, 0.5 wt.%SNP, and 1 wt.%SNP). Half of the specimens (110 samples) were subjected to thermal aging (TA; 5000 cycles). The fracture resistance and elastic modulus were evaluated, followed by Fourier-transform infrared and scanning electron microscopy analyses. An analysis of variance and Tukey&#x2019;s post-hoc test were applied for data analysis.</p>
                </sec>
                <sec>
                    <title>Results:</title>
                    <p>Incorporating SNPs and ZNPs into the ND material significantly improved the fracture resistance compared to that of the control group, with 1 wt.%SNP showing the highest resistance (1405.9&#x00b1;128.4 MPa) and 0.5 wt.%ZNP the lowest (1047.5&#x00b1;100.6 MPa). However, the elastic modulus decreased notably with these additions, with the ND control group (3097.5&#x00b1;115.9 MPa) exhibiting the highest elastic modulus and ZNP groups (1772.0&#x00b1;128.8 MPa) exhibiting the lowest. In between NPs-reinforced groups per NPs type, there were no significant differences between SNPs groups (p=0.064) as well as ZNPs groups (p=0.072). For the AS material, similar enhancements in fracture resistance occurred; however, reductions in the elastic modulus were more significant in the ND material (p&lt;0.001*). For the AS material, SNP and ZNP addition improved fracture resistance relative to that of the control group. Post-TA, the elastic modulus significantly decreased in both the ND and AS materials (p &lt; 0.05). Compared to ND material, the increase in fracture resistance was less pronounced in the AS material.</p>
                </sec>
                <sec>
                    <title>Conclusion:</title>
                    <p>The addition of ZNPs and SNPs increased the fracture resistances of both materials. TA significantly reduced the fracture resistance and elastic modulus in most NP-incorporated groups. The ASIGA resin demonstrated superior performance and enhancements were more prominent which demonstrates promising characteristics for clinical use.</p>
                </sec>
            </abstract>
            <kwd-group kwd-group-type="author">
                <kwd>3D printing; thermal aging; nanoparticles; fracture resistance; resin teeth</kwd>
            </kwd-group>
            <funding-group>
                <funding-statement>The author(s) declared that no grants were involved in supporting this work.</funding-statement>
            </funding-group>
        </article-meta>
        <notes>
            <sec sec-type="version-changes">
                <label>Revised</label>
                <title>Amendments from Version 1</title>
                <p>All modifications required in the abstract were changed accordingly and highlighted. Some paragraphs were added to the introduction, methodology, and discussions. Some figures are added and highlighted while no changes in the Author list."</p>
            </sec>
        </notes>
    </front>
    <body>
        <sec id="sec5" sec-type="intro">
            <title>Introduction</title>
            <p>Artificial teeth for removable dentures are manufactured from various materials, including acrylic resin, ceramics, 3D-printed materials, and resin composites.
                <sup>
                    <xref ref-type="bibr" rid="ref1">1</xref>,
                    <xref ref-type="bibr" rid="ref2">2</xref>
                </sup> These artificial teeth must be durable enough to withstand fractures induced by contact with the opposing teeth and abrasive foods.
                <sup>
                    <xref ref-type="bibr" rid="ref2">2</xref>,
                    <xref ref-type="bibr" rid="ref3">3</xref>
                </sup> Conventionally, prefabricated denture teeth are made of acrylic resin, making them prone to fracture or chipping, particularly in situations in which a complete denture opposes natural teeth or an implant-supported overdenture.
                <sup>
                    <xref ref-type="bibr" rid="ref4">4</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref6">6</xref>
                </sup> With growing demand for artificial teeth with enhanced fracture resistance, various approaches have been proposed, including the use of different monomers, cross-linking agents, and organic and inorganic fillers in polymer matrices.
                <sup>
                    <xref ref-type="bibr" rid="ref7">7</xref>,
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> Despite these advancements, denture-teeth fractures continue to be a persistent issue, highlighting the need for the development of denture teeth fabricated using innovative methods capable of withstanding higher loads and forces.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref9">9</xref>
                </sup>
            </p>
            <p>Digital dentures can be produced by using subtractive or additive manufacturing techniques.
                <sup>
                    <xref ref-type="bibr" rid="ref3">3</xref>
                </sup> In the additive process, a photopolymerized liquid resin is used to build removable prostheses layer-by-layer.
                <sup>
                    <xref ref-type="bibr" rid="ref3">3</xref>,
                    <xref ref-type="bibr" rid="ref4">4</xref>,
                    <xref ref-type="bibr" rid="ref10">10</xref>
                </sup> This method offers several benefits, including the significantly lower cost of 3D printers compared with milling machines, which facilitates its broader adoption in clinical practice.
                <sup>
                    <xref ref-type="bibr" rid="ref3">3</xref>
                </sup> Additionally, unlike subtractive milling, 3D-printing generates less material waste.
                <sup>
                    <xref ref-type="bibr" rid="ref3">3</xref>,
                    <xref ref-type="bibr" rid="ref11">11</xref>,
                    <xref ref-type="bibr" rid="ref12">12</xref>
                </sup> Occlusal stability, function, and esthetics are all reduced when the fracture resistance and elastic modulus of denture teeth are compromised, which is why high strength is crucial.
                <sup>
                    <xref ref-type="bibr" rid="ref7">7</xref>,
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref13">13</xref>
                </sup> Moreover, 3D-printed denture teeth are typically manufactured from methacrylate-based photopolymerized resin, a material specifically designed for processing through 3D-printing technology.
                <sup>
                    <xref ref-type="bibr" rid="ref11">11</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref14">14</xref>
                </sup> This method provides flexibility and precision, and improves functionality in the fabrication of removable dentures, making it a modern alternative to traditional techniques. Further advancements in digital dentistry are needed to further enhance the quality and durability of dental prostheses.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref14">14</xref>
                </sup>
            </p>
            <p>

                <italic toggle="yes">Gad et al.,
</italic>
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> studied the fracture resistance of a specific type of 3D-printed teeth (NextDent), and showed that they exhibited greater fracture resistance than traditional prefabricated teeth. However, their strength decreased after exposure to thermal cycling. Similarly, 
                <italic toggle="yes">Chun et al.</italic>,
                <sup>
                    <xref ref-type="bibr" rid="ref10">10</xref>
                </sup> examined another variety of 3D-printed resin teeth (Dentca) and reported that their fracture resistance was comparable to that of prefabricated teeth. These studies
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref10">10</xref>
                </sup> identified the potential of 3D-printed resins and highlighted the need to improve their strength, especially after thermal aging (TA). The absence of nanoparticle (NP) reinforcement in previous research left a gap in the exploration of how NPs can enhance durability.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>
                </sup> Therefore, exploring the incorporation of different NPs may be an effective approach for improving the mechanical properties of 3D-printed resin teeth.</p>
            <p>Owing to the capacity of 3D-printed resins for reinforcement, zirconium dioxide nanoparticles (ZNPs) and silicon dioxide nanoparticles (SNPs) have attracted considerable interest. When added to a resin matrix, ZNPs, which are well known for their antibacterial properties, increase the mechanical strength and wear resistance of dental composites.
                <sup>
                    <xref ref-type="bibr" rid="ref4">4</xref>,
                    <xref ref-type="bibr" rid="ref13">13</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref16">16</xref>
                </sup> Similarly, SNPs enhance the hardness, fracture toughness, and elastic modulus of dental materials owing to their large surface area and compatibility with resin matrices.
                <sup>
                    <xref ref-type="bibr" rid="ref15">15</xref>
                </sup> By resolving the drawbacks of conventional materials, previous studies
                <sup>
                    <xref ref-type="bibr" rid="ref4">4</xref>,
                    <xref ref-type="bibr" rid="ref13">13</xref>
                </sup> have shown that the addition of these NPs to interim resins has yielded encouraging results, resulting in long-lasting and resilient interim restorations.</p>
            <p>The vitro testing of NP addition, with a shape that replicates clinical use through a standardized procedure, may provide valuable insights into material-specific properties that are critical for understanding their behavior. The addition of NPs to 3D printed resins was investigated in previous studies however, there is still a lack of information in the literature about the addition effect of ZNPs and SNPs with different concentrations to 3D printed resin designated for teeth fabrication. Up to author knowledge, no previous studies have thoroughly investigated the strength of 3D-printed nanocomposite teeth in comparison with prefabricated teeth; therefore, this study aimed to assess the fracture resistance and elastic modulus of newly introduced 3D-printed nanocomposite denture teeth before and after TA.</p>
            <p>The study tested two null hypotheses: first, that incorporating zirconium dioxide (ZrO
                <sub>2</sub>) and silicon dioxide (SiO
                <sub>2</sub>) nanoparticles into 3D-printed denture-tooth resins would have no significant effect on their fracture resistance or elastic modulus; and second, that thermal aging would not significantly influence these mechanical properties in any of the tested materials.</p>
        </sec>
        <sec id="sec6">
            <title>Methodology</title>
            <p>The sample size for this in vitro investigation was determined using data gathered from a prior study
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> that evaluated the mechanical characteristics of temporary crowns made of 3D-printed resin. The World Health Organization (Geneva, Switzerland) specified the formulae, and power analysis was used in the counting procedure. The study was conducted using a significance threshold of 5%, power of 80%, and marginal error of 5%. A total of 220 specimens were fabricated and subdivided as follows: 20 prefabricated teeth, 100 ASIGA, 100 NextDent. The prefabricated group (n = 20) consisted of mandibular molar teeth (Major Dent-V, MAJOR Prodotti Dentari S.P.A., Moncalieri (TO), Italy). For the printed groups, two types of photopolymerized resins were used to create the 3D-printed resin teeth (n = 100/resin): NextDent C&amp;B MFH (NextDent, 3D Systems, Soesterberg, The Netherlands) and ASIGA (Asiga DentaTOOTH, Shade A1, ASIGA, Erfurt, Germany).</p>
            <p>In this study, 3D-printed groups were reinforced with two types of NPs: ZNPs (Shanghai Richem International Co., Ltd., Shanghai, China) and SNPs (AEROSIL R812; Evonik-Degussa, Essen, Germany). Each NP type was incorporated into the resin fluid at two different concentrations (0.5 wt.% and 1 wt.%). The NPs were treated and silanized before being added to the resin.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref15">15</xref>,
                    <xref ref-type="bibr" rid="ref16">16</xref>
                </sup> The silanized NPs were carefully weighed using a digital balance (S-234; Denver Instruments, Gottingen, Germany) to ensure precise measurements.
                <sup>
                    <xref ref-type="bibr" rid="ref15">15</xref>,
                    <xref ref-type="bibr" rid="ref16">16</xref>
                </sup> Subsequently, the resin/NP mixtures were thoroughly mixed using a magnetic stirrer for 30 min to ensure the homogeneity of the NPs within the resin matrix.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>
                </sup> A total of five groups were prepared for each resin type: one control group without any reinforcement, and four experimental groups containing varying NP concentrations (0.5 wt.% ZNP, 1 wt.% ZNP, 0.5 wt.% SNP, 1 wt.% SNP). This design enabled a comprehensive evaluation of the effects of both the NP type and concentration on the mechanical performance of 3D-printed resin.</p>
            <p>A standard tessellation language (STL) file was created by scanning the prefabricated mandibular molar teeth standardized to the dimensions of the mandibular molar (10.2 &#x00d7; 11.1 &#x00d7; 7.3 mm). Each STL file was printed in a horizontal orientation (0&#x00b0; build angle) with a desktop laser scanner (E3; 3Shape A/S, Copenhagen, Denmark), and the file was then exported to the respective 3D printer.8 Each specimen was manufactured in a 3D-printer chamber in accordance with the digital blueprint and required standards.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref13">13</xref>
                </sup> The manufacturer&#x2019;s guidelines for the NextDent 5100 (3D Systems, Rock Hill, SC, USA) and ASIGA MAX (Asiga, Alexandria, NSW, Australia) 3D printers were followed to accurately convert the resin material into the specified dental components. With advanced technology, the printers employed layer-by-layer techniques (
                <xref ref-type="fig" rid="f1">Figure 1</xref>). Once printing was completed, the specimens underwent post-processing using the post-curing units of each printing system with the recommended post-curing process and conditions.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref15">15</xref>,
                    <xref ref-type="bibr" rid="ref16">16</xref>
                </sup> The post-polymerization protocol for ND was using curing unit (LC-D Print Box, 3D systems Vertex Dental B.V., Soesterberg, Netherland) for 15 min with wavelength measured 360&#x2013;435 nm and ASIGA underwent for (Asiga Flash UV Curing Chamber) for 20 min with wavelength 480&#x2013;530 nm. After curing, a diamond disc was used to remove the support structure. Half of the specimens (N = 110) were subjected to 5000 TA cycles at 5&#x00b0;C and 55&#x00b0;C with a dwell time of 30 s (
                <xref ref-type="fig" rid="f1">Figure 1</xref>). The TA process was performed using a Thermocycler (Thermocycler THE- 1100, Mechatronik GmbH, Feldkirchen-Westerham, Germany), simulating intraoral temperature changes for six months of clinical use.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref17">17</xref>
                </sup>
            </p>
            <fig fig-type="figure" id="f1" orientation="portrait" position="float">
                <label>
Figure 1. </label>
                <caption>
                    <title>Diagram illustrating the study design.</title>
                </caption>
                <graphic id="gr1" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure1.gif"/>
            </fig>
            <p>A stainless-steel ball indenter with a 7 mm radius was used to load the specimens at the occlusal surfaces using a universal testing apparatus (Instron model 5965, Massachusetts, United States) with a 5 kN load cell at a loading rate of 1 mm/min until failure occurred (
                <xref ref-type="fig" rid="f1">Figure 1</xref>). A 1.5 mm-thick rubber sheet was positioned between the occlusal surface and indenter to reduce contact damage and aid in distributing the load.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref17">17</xref>
                </sup>
            </p>
            <p>Essential data on the fracture behavior of the modified 3D-printed denture teeth were obtained through fracture-site analysis using scanning electron microscopy (SEM; TESCAN VEGA3 LM model, TESCAN Orsay Holding, Kohoutovice, Czech Republic). To ensure optimal image quality, the fractured samples were cleaned and prepared by coating nonconductive polymer or resin materials with a thin layer of conductive gold (Quorum, Q150R ES, UK). This coating, applied at an accelerating voltage of 20 kV, prevented charging effects and enhanced image clarity. The specimens were then placed in the SEM chamber for analysis, where fracture surfaces were examined at a magnification of 2000&#x00d7; with a scale bar of 50 &#x03bc;m. Key fracture characteristics such as initiation sites, crack-propagation patterns, and interactions between the polymer matrix and reinforcing particles were identified. The NPs, with an average size of 40 nm and surface area of 9 m
                <sup>2</sup>/g, were analyzed using both SEM and transmission electron microscopy (TEM).</p>
            <p>Fourier transform infrared (FTIR) analysis is an essential tool for examining the bonding interactions between NPs and the polymer matrix because it offers comprehensive details on the chemical structure and functional groups present in the material. FTIR analysis assisted in identifying any changes in the molecular bonding caused by the addition of NPs. The specimens were placed inside an FTIR spectrometer for transmission spectroscopy (Hartmann &amp; Braun, MB series), and two readings were obtained per specimen. FTIR spectra were obtained at a resolution of 4 cm
                <sup>&#x2212;1</sup>, spanning a wavenumber range of 4000 to 400 cm
                <sup>&#x2212;1</sup>. The resultant spectra showed distinctive peaks corresponding to certain functional groups; thus, the bond types and any matrix chemical changes caused by the presence of NPs could be identified.</p>
            <p>The means and standard deviations of the data were calculated for a descriptive analysis by using SPSS v.23. The normality of the data was assessed using the Shapiro&#x2013;Wilk test, with nonsignificant results indicating that the data followed a normal distribution. Consequently, parametric tests were applied for an inferential analysis. A two-sample t-test was used to evaluate the effect of TA on fracture resistance. To explore the effects of the NP concentration on the fracture resistance and elastic modulus, a one-way analysis of variance (ANOVA) was performed. If the ANOVA results were significant, pairwise comparisons were conducted using Tukey&#x2019;s post hoc test. A three-way ANOVA was used to examine the interaction effects of the NPs, their concentration levels, and their properties. Statistical significance was set at p &lt; 0.05.</p>
        </sec>
        <sec id="sec7" sec-type="results">
            <title>Results</title>
            <p>
                <xref ref-type="table" rid="T1">
Table 1</xref> shows the three-way ANOVA of the three variables (NP type, material type, and impact of TA) and their interactions for fracture resistance. The combined interaction effect showed a significant interaction only between TA and the material type (P &lt; 0.001) while no significant when combined with other variables (P &gt; 0.05).</p>
            <table-wrap id="T1" orientation="portrait" position="float">
                <label>
Table 1. </label>
                <caption>
                    <title>Three-way ANOVA results of combined factors for fracture resistance (N).</title>
                </caption>
                <table content-type="article-table" frame="hsides">
                    <thead>
                        <tr>
                            <th align="left" colspan="1" rowspan="1" valign="top">Source</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Type III sum of squares</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">df</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Mean square</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">F</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">P</th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Intercept</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">516513388.282</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">516513388.282</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">3087.313</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn1">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">concentration * TA effect</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">651393.526</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">130278.705</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.779</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.566</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">concentration * material</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1224234.417</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">306058.604</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1.829</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.125</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">TA effect * material</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">8297039.229</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">8297039.229</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">49.593</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn1">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">concentration * TA effect * material</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1140271.465</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">285067.866</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1.704</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.151</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Error</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">33125781.671</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">198</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">167301.928</td>
                            <td colspan="1" rowspan="1"/>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Total</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">582653174.952</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">220</td>
                            <td colspan="1" rowspan="1"/>
                            <td colspan="1" rowspan="1"/>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                    </tbody>
                </table>
                <table-wrap-foot>
                    <fn-group content-type="footnotes">
                        <fn id="tfn1">
                            <label>*</label>
                            <p>Statistically significant at the 0.05 level of significance.</p>
                        </fn>
                    </fn-group>
                </table-wrap-foot>
            </table-wrap>
            <p>The fracture resistance results are summarized in 
                <xref ref-type="table" rid="T2">
Table 2</xref> and 
                <xref ref-type="fig" rid="f2">Figure 2</xref>. For ND pre-TA, in comparison to pure resin, the addition of both SNPs and ZNPs significantly increased the fracture resistance (p &lt; 0.001) except 0.5%ZNPs (p &gt; 0.05) which showed the lowest fracture resistance value (1047.5 &#x00b1; 100.6 MPa). In between NPs groups, SNPs showed significant increase compared to ZNPs while SNPs groups demonstrated an insignificant difference in fracture resistance compared to the prefabricated teeth (p &gt; 0.05). For ND post-TA, in comparison to pure resin, the addition of both SNPs and ZNPs significantly increased the fracture resistance (p &lt; 0.001) except 0.5%ZNPs (p &gt; 0.05) which showed the lowest fracture resistance value (984.5 &#x00b1; 81.9 N). In between NPs groups, 0.5 wt.% SNPs with the highest fracture resistance value (1387.1 &#x00b1; 101.4 N) significantly showed an increase in the fracture resistance compared to all reinforced groups and demonstrated an insignificant difference in fracture resistance compared to prefabricated teeth (p &gt; 0.05). In terms of the TA effect on ND, the fracture resistance was significantly decreased (P &lt; 0.05) except the prefabricated (p = 0.087) and 0.5%SNP (P = 0.656).</p>
            <table-wrap id="T2" orientation="portrait" position="float">
                <label>
Table 2. </label>
                <caption>
                    <title>Variations based on material and NP types and thermal aging (TA) effect on fracture resistance (MPa).</title>
                </caption>
                <table content-type="article-table" frame="hsides">
                    <thead>
                        <tr>
                            <th align="left" colspan="1" rowspan="1" valign="top">Materials</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">NPs/%</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Pre-TA
</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Post-TA
</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">
P</th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Prefabricated</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">-</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1517.1 &#x00b1;121.9
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1221.6 &#x00b1; 103.5
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.087</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="6" valign="top">NextDent (ND)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1097.8 &#x00b1; 167.7
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">844.4 &#x00b1; 136.8
                                <sup>c</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.032
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1357.5 &#x00b1; 110.1
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1387.1 &#x00b1; 101.4
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.656</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1405.9 &#x00b1; 128.4
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1102.7 &#x00b1; 114.8
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1047.5 &#x00b1; 100.6
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">984.5 &#x00b1; 81.9
                                <sup>c</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.034
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1209.1 &#x00b1; 140.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1050.1 &#x00b1; 75.8
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.012
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">P</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.003
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Prefabricated</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">-</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1517.1 &#x00b1; 121.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1221.6 &#x00b1; 93.5
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.087</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="6" valign="top">ASIGA (AS)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2346.6 &#x00b1; 162.9
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1437.3 &#x00b1; 101.7
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.001
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2192.2 &#x00b1; 181.5
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1352.9 &#x00b1; 116.4
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.004
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2250.1 &#x00b1; 168.6
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1691.3 &#x00b1; 110.8
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.005
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2185.2 &#x00b1; 117.8
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1498.6 &#x00b1; 156.3
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.003
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2321.6 &#x00b1; 171.3
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1492.9 &#x00b1; 118.2
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.009
                                <xref ref-type="table-fn" rid="tfn2">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">P</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.031</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.042</td>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                    </tbody>
                </table>
                <table-wrap-foot>
                    <fn-group content-type="footnotes">
                        <fn id="tfn2">
                            <label>*</label>
                            <p>Statistically significant at the 0.05 level of significance. The same lowercase alphabets in each column indicate statistical insignificance between the pairs. NP) nanoparticles, TA) thermal aging, NTA) no thermal aging.</p>
                        </fn>
                    </fn-group>
                </table-wrap-foot>
            </table-wrap>
            <fig fig-type="figure" id="f2" orientation="portrait" position="float">
                <label>
Figure 2. </label>
                <caption>
                    <title>Fracture resistance of prefabricated and 3D-printed resins before and after thermal aging.</title>
                </caption>
                <graphic id="gr2" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure2.gif"/>
            </fig>
            <p>For ASIGA pre-TA, the pure resin exhibited the highest fracture resistance value (2346.6 &#x00b1; 162.9 N). In comparison to pure resin, the addition of both SNPs and SNPs showed no insignificant increase in fracture resistance (p &gt; 0.05). In between NPs groups, no significance was found between all groups (p &gt; 0.05); however, all reinforced groups and the pure group showed a significant increase in fracture resistance compared to the prefabricated group which showed the lowest fracture resistance value (1517.1 &#x00b1; 121.9 N).</p>
            <p>For ASIGA post-TA, the results showed the same behavior before TA, no significant differences were found between groups (p &gt; 0.05) except 0.5%SNPs which showed a decrease fracture resistance recorded the lowest value (1352.9 &#x00b1; 116.4 N). In comparison to the prefabricated group, all reinforced groups showed a significant increase in fracture resistance (P &lt; 0.001) except 0.5%SNPs (p = 0.921) and the prefabricated group showed the lowest fracture resistance value (1352.9 &#x00b1; 116.4 N). In terms of the TA effect on ND, the fracture resistance was significantly decreased per respective group (P &lt; 0.05) except for the prefabricated group (p = 0.087).</p>
            <p>The statistical T-test analysis for fracture resistance in 
                <xref ref-type="table" rid="T3">
Table 3</xref> highlights the material-specific differences per respective NP type and concentration. Pre-AT, ASIGA significantly showed an increase in the fracture resistance (p &lt; 0.05). Post-TA, significant differences in the fracture resistance were observed between the ND and AS materials across all NP-incorporated groups (p &lt; 0.05), except for the pure resin (p = 0.387) and 1 wt.% SNPs (p = 0.657) groups.</p>
            <table-wrap id="T3" orientation="portrait" position="float">
                <label>
Table 3. </label>
                <caption>
                    <title>T-Test compression of fracture resistance (MPa) between 3D-printed materials.</title>
                </caption>
                <table content-type="article-table" frame="hsides">
                    <thead>
                        <tr>
                            <th align="left" colspan="1" rowspan="1" valign="top">Materials</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">NPs/%</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">NextDent (ND)</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">ASIGA (AS)</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">
P</th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr>
                            <td align="left" colspan="1" rowspan="5" valign="top">Pre-TA
</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1097.8 &#x00b1; 167.7</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2346.6 &#x00b1; 162.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.000
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1357.5 &#x00b1; 110.1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2192.2 &#x00b1; 181.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.004
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1405.9 &#x00b1; 128.4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2250.1 &#x00b1; 168.6</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.001
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1047.5 &#x00b1; 100.6</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2185.2 &#x00b1; 117.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1209.1 &#x00b1; 140.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2321.6 &#x00b1; 171.3</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="5" valign="top">Post-TA
</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1221.6 &#x00b1; 103.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1221.6 &#x00b1; 93.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.387</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">844.4 &#x00b1; 136.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1437.3 &#x00b1; 101.7</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.003
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1387.1 &#x00b1; 101.4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1352.9 &#x00b1; 116.4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.657</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1102.7 &#x00b1; 114.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1691.3 &#x00b1; 110.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">984.5 &#x00b1; 81.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1498.6 &#x00b1; 156.3</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn3">*</xref>
                            </td>
                        </tr>
                    </tbody>
                </table>
                <table-wrap-foot>
                    <fn-group content-type="footnotes">
                        <fn id="tfn3">
                            <label>*</label>
                            <p>Statistically significant at the 0.05 level of significance. NP) nanoparticles, TA) thermal aging, NTA) no thermal aging.</p>
                        </fn>
                    </fn-group>
                </table-wrap-foot>
            </table-wrap>
            <p>
                <xref ref-type="table" rid="T4">
Table 4</xref> shows the three-way ANOVA of the three variables (NP type, material type, and impact of TA) and their interactions for the elastic modulus. The results showed a significant interaction between all variables (P &lt; 0.05) and when the three variables were combined (P = 0.007).</p>
            <table-wrap id="T4" orientation="portrait" position="float">
                <label>
Table 4. </label>
                <caption>
                    <title>Three-way ANOVA results of combined factor for elastic modulus (MPa).</title>
                </caption>
                <table content-type="article-table" frame="hsides">
                    <thead>
                        <tr>
                            <th align="left" colspan="1" rowspan="1" valign="top">Source</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">
Type III sum of squares</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">df</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Mean square</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">F</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">
P</th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Intercept</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">619284785.339</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">619284785.339</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4469.913</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn4">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">concentration * TA effect</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">10514215.811</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2102843.162</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">15.178</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn4">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">concentration * material</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2097194.635</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">524298.659</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">3.784</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.005
                                <xref ref-type="table-fn" rid="tfn4">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">TA effect * material</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">918520.695</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">918520.695</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">6.630</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.011
                                <xref ref-type="table-fn" rid="tfn4">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">concentration * TA effect * material</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2031145.360</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">507786.340</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">3.665</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.007
                                <xref ref-type="table-fn" rid="tfn4">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Error</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">27431940.310</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">198</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">138545.153</td>
                            <td colspan="1" rowspan="1"/>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Total</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1013871903.958</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">220</td>
                            <td colspan="1" rowspan="1"/>
                            <td colspan="1" rowspan="1"/>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                    </tbody>
                </table>
                <table-wrap-foot>
                    <fn-group content-type="footnotes">
                        <fn id="tfn4">
                            <label>*</label>
                            <p>Statistically significant at the 0.05 level of significance.</p>
                        </fn>
                    </fn-group>
                </table-wrap-foot>
            </table-wrap>
            <p>The elastic modulus results are summarized in 
                <xref ref-type="table" rid="T5">
Table 5</xref> and 
                <xref ref-type="fig" rid="f3">Figure 3</xref>. The prefabricated teeth significantly showed the highest elastic modulus values pre-TA (5002.0 &#x00b1; 172.8 MPa) and post-TA (4255.5 &#x00b1; 100.5 MPa). For ND pre-TA, the addition of SNPs and ZNPs significantly decreased the elastic modulus when compared with the pure resin (p &lt; 0.001) and the lowest elastic modulus value was recorded with 1%ZNPs (1772.0 &#x00b1; 128.8 MPa). In between NPs-reinforced groups per NPs type, there were no significant differences between SNPs groups (p = 0.064) as well as ZNPs groups (p = 0.072). When comparing NPs type, ZNPs showed a significant decrease in elastic modulus and the highest elastic modulus value was found with 1%SNPs (2048.2 &#x00b1; 132.8 MPa) and the lowest values with 1%ZNP (1772.0 &#x00b1; 128.8 MPa). For ND post-TA, in comparison to the prefabricated group, the elastic modulus of pure and NP-modified groups were significantly decreased (P &lt; 0.001). While no significant differences between the pure and NP-modified groups (p &lt; 0.05) and the pure group showed the highest elastic modulus value (376.6 &#x00b1; 35.6 MPa). In terms of the TA effect, the elastic modulus of prefabricated, pure, and NP-modified groups was significantly decreased per respective NP type and concentration (p &lt; 0.05).</p>
            <table-wrap id="T5" orientation="portrait" position="float">
                <label>
Table 5. </label>
                <caption>
                    <title>Variations based on material and NP types and thermal aging (TA) effect on elastic modulus (MPa).</title>
                </caption>
                <table content-type="article-table" frame="hsides">
                    <thead>
                        <tr>
                            <th align="left" colspan="1" rowspan="1" valign="top">Materials</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">NPs/%</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Pre-TA
</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">Post-TA
</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">
P</th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Prefabricated</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">-</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">5002.0 &#x00b1; 172.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4255.5 &#x00b1; 100.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.002
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="6" valign="top">NextDent (ND)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">3097.5 &#x00b1; 115.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">376.6 &#x00b1; 35.6
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1951.9 &#x00b1;147.3
                                <sup>a,b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">370.2 &#x00b1; 36.4
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2048.2 &#x00b1; 132.8
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">357.3 &#x00b1; 31.9
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.%ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1891.1 &#x00b1;112.5
                                <sup>b,c</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">364.5 &#x00b1; 35.1
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1772.0 &#x00b1; 128.8
                                <sup>c</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">359.8 &#x00b1; 21.8
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">P</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">Prefabricated</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">-</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">5002.0 &#x00b1; 172.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4255.5 &#x00b1; 102.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.002
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="6" valign="top">ASIGA (AS)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2725.2 &#x00b1; 115.3
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2364.1 &#x00b1; 42.2
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1951.1 &#x00b1; 161.9
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">376.3 &#x00b1; 25.6
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2608.1 &#x00b1; 94.1
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">345.8 &#x00b1; 91.5
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2639.0 &#x00b1; 93.0
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">362.0 &#x00b1; 29.3
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2201.8 &#x00b1; 108.1
                                <sup>b</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">390.0 &#x00b1; 25.1
                                <sup>a</sup>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">P</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn5">*</xref>
                            </td>
                            <td colspan="1" rowspan="1"/>
                        </tr>
                    </tbody>
                </table>
                <table-wrap-foot>
                    <fn-group content-type="footnotes">
                        <fn id="tfn5">
                            <label>*</label>
                            <p>Statistically significant at the 0.05 level of significance. The same lowercase alphabets in each column indicate statistical insignificance between the pairs. NP) nanoparticles, TA) thermal aging, NTA) no thermal aging.</p>
                        </fn>
                    </fn-group>
                </table-wrap-foot>
            </table-wrap>
            <fig fig-type="figure" id="f3" orientation="portrait" position="float">
                <label>
Figure 3. </label>
                <caption>
                    <title>Elastic modulus of prefabricated and 3D-printed resins before and after thermal aging.</title>
                </caption>
                <graphic id="gr3" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure3.gif"/>
            </fig>
            <p>For ASIGA pre-TA, the pure resin and NP-modified groups showed a significant decrease in elastic modulus when compared with the prefabricated group (p &lt; 0.001). In comparison to the pure group, the addition of both NPs showed a significant decrease in elastic modulus with 0.5%SNP and 1%ZNPs and 0.5%SNPs showed the lowest elastic modulus value (1951.1 &#x00b1; 161.9 MPa). While no significant differences between pure resin and other NP-modified groups (pure vs. 1%SNPs and pure vs. 0.5%ZNPs, p &gt; 0.05). in between NP-modified groups, 1%SNPs and 0.5%ZNPs significantly showed higher elastic modulus compared with 0.5%SNPs and 1%ZNPs and the highest values were recorded with 0.5%ZNPs (2639.0 &#x00b1; 93.0 MPa) followed by 1%SNPs (2608.1 &#x00b1; 94.1 MPa). For ASIGA post-TA, the elastic modulus was significantly decreased in pure and NP-modified groups when compared with the prefabricated group (p &lt; 0.001). While no significant differences between the pure and NP-modified groups (P &gt; 0.05) and 1%ZNPs showed the highest elastic modulus value (390.0 &#x00b1; 25.1 MPa). In terms of the TA effect, the elastic modulus of prefabricated, pure, and NP-modified groups was significantly decreased per respective NP type and concentration (p  &lt; 0.05).</p>
            <p>The statistical T-test analysis for elastic modulus in 
                <xref ref-type="table" rid="T6">
Table 6</xref> highlights the material-specific differences per respective NP type and concentration. Pre-AT, pure ASIGA significantly showed a decrease in the elastic modulus compared with pure NextDent (p = 0.003). While NP-modified ASIGA groups showed a significant increase in elastic modulus except at 0.5 wt.% SNPs (p = 0.998). Post-TA and Pre-AT, pure ASIGA significantly showed a decrease in the elastic modulus compared with pure NextDent (p = 0.032*). While no significant differences in the elastic modulus were observed between the ND and AS materials across all NP-incorporated groups (p &gt; 0.05).</p>
            <table-wrap id="T6" orientation="portrait" position="float">
                <label>
Table 6. </label>
                <caption>
                    <title>T-Test compression of elastic modulus (MPa) between materials.</title>
                </caption>
                <table content-type="article-table" frame="hsides">
                    <thead>
                        <tr>
                            <th align="left" colspan="1" rowspan="1" valign="top">Materials</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">NPs/%</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">NextDent (ND)</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">ASIGA (AS)</th>
                            <th align="left" colspan="1" rowspan="1" valign="top">
P</th>
                        </tr>
                    </thead>
                    <tbody>
                        <tr>
                            <td align="left" colspan="1" rowspan="5" valign="top">Pre-TA
</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">3097.5 &#x00b1; 115.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2725.2 &#x00b1; 115.3</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.003
                                <xref ref-type="table-fn" rid="tfn6">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1951.9 &#x00b1; 147.3</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1951.1 &#x00b1; 161.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.998</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2048.2 &#x00b1; 132.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2608.1 &#x00b1; 94.1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn6">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1891.1 &#x00b1; 112.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2639.0 &#x00b1; 93.0</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">&lt;0.001
                                <xref ref-type="table-fn" rid="tfn6">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">1772.0 &#x00b1; 128.8</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2201.8 &#x00b1; 108.1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.022
                                <xref ref-type="table-fn" rid="tfn6">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="5" valign="top">Post-TA
</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0 (pure)</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">4255.5 &#x00b1; 100.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">2364.1 &#x00b1; 42.2</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.032
                                <xref ref-type="table-fn" rid="tfn6">*</xref>
                            </td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">376.6 &#x00b1; 35.6</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">376.3 &#x00b1; 25.6</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.531</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% SNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">370.2 &#x00b1; 36.4</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">345.8 &#x00b1; 91.5</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.712</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.5 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">357.3 &#x00b1; 31.9</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">362.0 &#x00b1; 29.3</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.809</td>
                        </tr>
                        <tr>
                            <td align="left" colspan="1" rowspan="1" valign="top">1 wt.% ZNPs</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">364.5 &#x00b1; 35.1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">390.0 &#x00b1; 25.1</td>
                            <td align="left" colspan="1" rowspan="1" valign="top">0.070</td>
                        </tr>
                    </tbody>
                </table>
                <table-wrap-foot>
                    <fn-group content-type="footnotes">
                        <fn id="tfn6">
                            <label>*</label>
                            <p>Statistically significant at the 0.05 level of significance. NP) nanoparticles, TA) thermal aging, NTA) no thermal aging.</p>
                        </fn>
                    </fn-group>
                </table-wrap-foot>
            </table-wrap>
            <p>
                <xref ref-type="fig" rid="f4">
Figure 4</xref> shows the entire range of the infrared spectrum, 4000&#x2013;500 cm
                <sup>&#x2212;1</sup>, demonstrating the bonding of AS and ND with different types of NPs at varied concentrations. The FTIR spectra of the AS and ND materials revealed characteristic bonds attributed to carbonyl groups. All the groups of specimens exhibit the C-H bond at approximately 2900 cm
                <sup>&#x2212;1</sup> and C=O double bond at approximately 1703 cm
                <sup>&#x2212;1</sup>. The most significant difference between the AS and ND groups was observed in the spectral region of 1144&#x2013;1034 cm
                <sup>&#x2212;1</sup> in the FTIR spectrum. This range corresponded to the stretching vibrations of the C&#x2013;O&#x2013;C (ether) functional group. The differences in this region indicate that the chemical environment or bonding characteristics of the C&#x2013;O&#x2013;C group vary, suggesting structural or compositional differences between the materials.</p>
            <fig fig-type="figure" id="f4" orientation="portrait" position="float">
                <label>
Figure 4. </label>
                <caption>
                    <title>FTIR spectra of modified pure and nanoparticle-incorporated resins.</title>
                    <p>(A) Modified pure and nanoparticle-incorporated ASIGA specimens. (B) Modified pure and nanoparticle-incorporated NextDent specimens. The important bands are labelled in each set of specimens.</p>
                </caption>
                <graphic id="gr4" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure4.gif"/>
            </fig>
            <p>
                <xref ref-type="fig" rid="f5">
Figures 5</xref>&#x2013;
                <xref ref-type="fig" rid="f7">7</xref> display the SEM images of both the occlusal and fracture surfaces. The fracture behavior of the occlusal surface showed more crack propagation in the NP-reinforced groups than in the pure-resin smooth fracture and absence of cracks. Prefabricated teeth (
                <xref ref-type="fig" rid="f5">Figure 5</xref>) include a smooth occlusal surface and smooth fracture line. An additional note regarding 3D-printed teeth is the stepwise effect, representing printing layers on curved surfaces, such as cusp tips and cusp slopes (
                <xref ref-type="fig" rid="f6">Figures 6</xref> and 
                <xref ref-type="fig" rid="f7">7</xref>). While comparing the two groups, pure ND and AS exhibited deep and multiple cracks. NP- incorporated AS are showing multiple and long propagated crack as compared to NP- incorporated ND. These SEM findings are useful while evaluating the mechanical strength of two types of specimens. Some cracks followed the line between the printed layers, which may be a reason for the weakened strength of printed teeth compared with prefabricated teeth that showed a smooth occlusal surface (absence of the staircase effect). In the cross-sectional surface analysis, most of the groups reinforced with NPs showed a rough surface with some lamellae as well as prefabricated teeth, whereas the pure teeth showed a smooth fracture side. Compared with AS groups the ND cross-sections showed higher surface roughness with several lamellar surfaces as marked with white arrows (
                <xref ref-type="fig" rid="f7">Figure 7</xref>).</p>
            <fig fig-type="figure" id="f5" orientation="portrait" position="float">
                <label>
Figure 5. </label>
                <caption>
                    <title>Representative SEM images of prefabricated teeth.</title>
                    <p>a) Occlusal surface, b) fracture surface. SEM magnifications are &#x00d7;11 (a) and &#x00d7;10 (b).</p>
                </caption>
                <graphic id="gr5" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure5.gif"/>
            </fig>
            <fig fig-type="figure" id="f6" orientation="portrait" position="float">
                <label>
Figure 6. </label>
                <caption>
                    <title>Representative SEM images of 3D-printed teeth for both materials showing the occlusal surface.</title>
                    <p>SEM magnifications from top row left to right are: &#x00d7;35, &#x00d7;22, &#x00d7;35, &#x00d7;35, &#x00d7;40 and bottom row left to right are: &#x00d7;40, &#x00d7;40, &#x00d7;32, &#x00d7;38, &#x00d7;33.</p>
                </caption>
                <graphic id="gr6" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure6.gif"/>
            </fig>
            <fig fig-type="figure" id="f7" orientation="portrait" position="float">
                <label>
Figure 7. </label>
                <caption>
                    <title>Representative SEM images of 3D-printed teeth for both materials showing the fracture surface.</title>
                    <p>The cracks propagations are highlighted with red arrows while lamella structures are marked with white arrows. SEM magnifications top row are: &#x00d7;40 and bottom row left to right are: &#x00d7;33, &#x00d7;39, &#x00d7;40, &#x00d7;40, &#x00d7;40.</p>
                </caption>
                <graphic id="gr7" orientation="portrait" position="float" xlink:href="https://f1000research-files.f1000.com/manuscripts/190325/6b32c169-b537-4648-89b2-6bcda0900b19_figure7.gif"/>
            </fig>
        </sec>
        <sec id="sec8" sec-type="discussion">
            <title>Discussion</title>
            <p>The aim of this study was to examine the fracture resistance and elastic modulus of 3D-printed denture-teeth pre- and post-TA with the addition of ZNPs and SNPs to the 3D-printing resins. The first and second null hypotheses were rejected because of the significant effect of NP addition and TA on the fracture resistance and elastic modulus when compared with the prefabricated teeth. These findings are consistent with previous investigations that demonstrated the reinforcing effects of nanoparticle incorporation on 3D-printed dental resins. For instance, Alshamrani et al.
                <sup>
                    <xref ref-type="bibr" rid="ref22">22</xref>
                </sup> and Alhotan et al.
                <sup>
                    <xref ref-type="bibr" rid="ref23">23</xref>
                </sup> reported that adding silica or zirconia nanoparticles significantly enhanced the mechanical and thermal stability of photopolymer resins. In contrast, Yan et al.
                <sup>
                    <xref ref-type="bibr" rid="ref24">24</xref>
                </sup> noted that higher nanoparticle concentrations could disrupt polymer cross-linking, reducing the elastic modulus. Our results align with these reports, highlighting the importance of maintaining optimal nanoparticle concentrations (0.5&#x2013;1 wt%) to achieve a balance between strength and flexibility. Furthermore, compared with Gad et al.,
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> who examined the strength of unmodified 3D-printed denture teeth, our findings show superior fracture resistance due to nanoparticle reinforcement, confirming the benefit of composite modification.</p>
            <p>In this study, the incorporation of SNPs at varying concentrations into 3D-printed denture teeth increased the fracture resistance at immediate testing prior to TA in 3D-printed ND materials. This enhancement occurred by reinforcing the polymer matrix, which increased stiffness, reduced crack propagation, and boosted toughness through mechanisms such as crack deflection and energy dissipation.
                <sup>
                    <xref ref-type="bibr" rid="ref18">18</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref20">20</xref>
                </sup> The findings of the present study agree with those of previous studies
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref17">17</xref>,
                    <xref ref-type="bibr" rid="ref20">20</xref>
                </sup> that have examined the potential benefits of integrating low concentrations of SNPs into 3D-printed interim resins to enhance their flexural properties. These studies reported that the addition of SNPs can effectively strengthen the mechanical properties of 3D-printed ND materials. In addition, previous studies have investigated the fracture resistances of 3D-printed resins containing 0.5 and 1 wt.% SNP concentrations.
                <sup>
                    <xref ref-type="bibr" rid="ref20">20</xref>
                </sup> The results indicate that the addition of 1 wt.% SNP significantly improved the fracture resistances of both the ND and AS 3D-printed resins.</p>
            <p>Based on previous studies,
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref16">16</xref>,
                    <xref ref-type="bibr" rid="ref17">17</xref>
                </sup> ZNPs have been recommended for incorporation into dental composites to improve their mechanical qualities, as ZNPs are well known for their remarkable hardness and capacity to reinforce resin composites. This investigation demonstrates that ZNPs improve the fracture resistance of 3D-printed ND only at 1 wt.% before TA. The improvements in fracture resistance resulting from ZNP integration align with previous studies, demonstrating the ability of ZNPs to enhance the mechanical properties of polymer-based materials.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>,
                    <xref ref-type="bibr" rid="ref16">16</xref>
                </sup> The primary mechanism proposed in previous studies is the ability of ZNPs to interact with polymer chains, distribute applied stress, and inhibit fracture formation. 16 For the ND material, the enhancement in fracture resistance at 1 wt.% concentrations is attributed to the stiffening effect of zirconia, which reinforces the polymer matrix by promoting crack deflection and energy dissipation.
                <sup>
                    <xref ref-type="bibr" rid="ref21">21</xref>,
                    <xref ref-type="bibr" rid="ref22">22</xref>
                </sup>
            </p>
            <p>Before TA, the ND resin exhibited a greater increase in fracture resistance than the AS resin when the same amount of SNPs was added. While both resins benefited from SNP addition, ND significantly increased the fracture resistance with 1 wt.%SNP. In comparison to previous study, the fracture resistance of AS was reported to be 1305.7 &#x00b1; 197.4.8. In contrast, significantly higher values were observed in the current study, with AS showing a fracture resistance of more than 2,000 N with and without NPs. Similarly, the fracture resistance of ND in earlier study
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> was 867.8 &#x00b1; 108.4, whereas in the present study, it was 1097.8 &#x00b1; 167.7. This difference may be due to the stronger intrinsic mechanical qualities of AS, a potentially higher cross-linking density, and variations in matrix-nanoparticle compatibility, making it less dependent on external reinforcements than ND.
                <sup>
                    <xref ref-type="bibr" rid="ref12">12</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref14">14</xref>
                </sup> This finding also supported by FTIR analysis with shifts in C&#x2013;O&#x2013;C regions suggesting polymer&#x2013;filler bonding differences between AS and ND.</p>
            <p>No significant differences were observed (p = 0.981) in a comparison between the prefabricated teeth and ZNP-AS. In contrast, although ZNPs were incorporated into the AS resin, the overall improvement in fracture resistance was not as significant as that in the ND. This is because of the better baseline mechanical characteristics of the AS resin, which inherently has a higher fracture resistance. Previous studies investigating the fracture strength of different dental materials have shown similar findings, in which resin materials with higher intrinsic fracture strengths demonstrate less improvement when reinforced with NPs.
                <sup>
                    <xref ref-type="bibr" rid="ref19">19</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref23">23</xref>
                </sup>
            </p>
            <p>It is important to investigate the strength of dental materials following artificial aging as many products experience decay in their strength after aging. In this study, the effect of thermal stress on the mechanical properties of the materials revealed significant differences between the pure and NP-modified groups in their fracture resistance. In pure groups, thermal stress generally led to a substantial reduction in the fracture resistance. This reduction in fracture resistance is attributed to the development of micro-cracks and other defects arising from repeated expansion and contraction under temperature changes.
                <sup>
                    <xref ref-type="bibr" rid="ref24">24</xref>
                </sup> These internal stresses lead to material weakening, making the material more prone to fracture. Owing to the addition of the NPs, the thermal stress caused thermal stability in the nanocomposite materials to some extent, thereby sustaining the properties of the materials and maintaining their elastic modulus.
                <sup>
                    <xref ref-type="bibr" rid="ref22">22</xref>&#x2013;
                    <xref ref-type="bibr" rid="ref24">24</xref>
                </sup>
            </p>
            <p>Following TA, the 3D-printed resins with 1 and 0.5 wt.%SNP maintained superior mechanical properties and were comparable to the performance of traditional prefabricated resins and higher than pure control in ND 3D-printed resins. In AS 3D-printed resins, 0.5 wt.% of SNP revealed higher strength than the prefabricated teeth and the pure control. These findings indicate that the incorporation of an optimal amount of 0.5 wt.% concentrations can enhance the ability of 3D-printed interim restorations from the ASIGA and NextDent manufacturers to endure thermal stresses in the oral environment, positioning them as a feasible alternative to conventional prefabricated resins.
                <sup>
                    <xref ref-type="bibr" rid="ref23">23</xref>
                </sup> These findings suggest that while developing nanocomposite 3D-printed resins for dental applications, attention must be given to the concentration of incorporated ZrO
                <sub>2</sub> nanoparticles, as higher levels may compromise color stability following thermal aging and beverage exposure, potentially affecting both esthetic durability and clinical performance.
                <sup>
                    <xref ref-type="bibr" rid="ref21">21</xref>,
                    <xref ref-type="bibr" rid="ref25">25</xref>
                </sup> Such findings agree with previous studies indicating that the addition of SNP increased the fracture resistances of 3D-printed resins even after TA.
                <sup>
                    <xref ref-type="bibr" rid="ref17">17</xref>,
                    <xref ref-type="bibr" rid="ref20">20</xref>
                </sup> After TA in the ZNPs groups, the incorporation of 1 and 0.5 wt.% of ZNPs in ND 3D-printed resin was associated with higher fracture resistance than pure control but not prefabricated teeth. While in AS 3D-printed resins, ZNPs incorporation did not offer additional strength following TA compared to pure control, but the fracture resistance was higher than prefabricated teeth. Such findings may suggest that NPs in general as reinforcing particles could be preferred to improve the strength of dental materials. The results found in this study may indicate that the incorporated NPs were more effective in maintaining the fracture resistance of the 3D-printed resins when compared to the pure control and prefabricated teeth.</p>
            <p>For the elastic modulus, all the groups experienced significant reduction in their elastic modulus pre-TA compared to the prefabricated teeth, suggesting that the addition of NPs may alter the stiffness of the polymer network. The highest elastic modulus in the ND control group (3097.5 &#x00b1; 115.9 MPa) indicates that the base resin formulation provides higher rigidity, which is reduced upon NP incorporation.
                <sup>
                    <xref ref-type="bibr" rid="ref12">12</xref>,
                    <xref ref-type="bibr" rid="ref22">22</xref>
                </sup> This decline aligns with the findings who reported that, while ZNPs enhanced flexural strength, excessive concentrations may disrupt polymer cross-linking, leading to reduced stiffness. Also, there is frequently a nonlinear relationship between the mechanical properties of composite materials and their filler content.
                <sup>
                    <xref ref-type="bibr" rid="ref22">22</xref>
                </sup> Such an explanation could be applied as well when the elastic modulus values of the SNPs groups are observed. However, our findings contraindicate other studies showing that the addition of 1 wt.% SNP significantly improved the elastic modulus of 3D-printed resins compared with the control groups without the NPs.
                <sup>
                    <xref ref-type="bibr" rid="ref17">17</xref>,
                    <xref ref-type="bibr" rid="ref20">20</xref>
                </sup> This may suggest that other parameters could affect how NPs may influence the elastic modulus of dental materials. This study revealed that TA significantly reduced the elastic modulus for pure control and experimental groups of 3D-printed resins, but not the prefabricated teeth. This significant reduction is mainly related to the 3D-printed resins rather than the incorporated NPs. The significant reduction in elastic modulus observed after thermal aging can be attributed to several material-related mechanisms. Repeated thermal cycling induces microstructural stress and hydrolytic degradation within the resin matrix, leading to plasticization and the gradual breakdown of polymer cross-links.
                <sup>
                    <xref ref-type="bibr" rid="ref24">24</xref>
                </sup> Similar findings were reported by Yan et al.,
                <sup>
                    <xref ref-type="bibr" rid="ref24">24</xref>
                </sup> and Alhotan et al.,
                <sup>
                    <xref ref-type="bibr" rid="ref23">23</xref>
                </sup> who observed that prolonged exposure to alternating hot and cold temperatures compromises the molecular integrity of polymer-based materials. In addition, the incorporation of nanoparticles at higher concentrations may interfere with polymer chain mobility and cross-linking efficiency, resulting in a more brittle and less elastic network.
                <sup>
                    <xref ref-type="bibr" rid="ref22">22</xref>
                </sup> These findings suggest that both intrinsic polymer degradation and filler&#x2013;matrix interactions contribute to the observed decline in stiffness after aging, highlighting the need for further optimization of nanoparticle content to balance strength and flexibility.</p>
            <p>In this study, two fracture modes are identified: brittle and ductile. The fracture mode serves as a guide for the material strength and microstructural properties.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref26">26</xref>
                </sup> According to SEM findings, the fracture resistance of denture teeth with a ductile fracture pattern before breakage was greater than that of teeth without this pattern, such as in the AS group. The weakened structure of the teeth, which enables them to support their weight for an extended period, appears to be the cause of such outcomes.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> Notably, the NextDent groups exhibited more pronounced structural degradation and surface defects following thermal cycling and staining, indicating lower resistance to aging compared to other tested resins.
                <sup>
                    <xref ref-type="bibr" rid="ref25">25</xref>
                </sup> As the material ages or is subjected to elevated temperatures, its degradation rate significantly increases. This accelerated deterioration is often due to thermal-oxidative processes and molecular changes within the polymer matrix. The primary consequence is a progressive weakening of the crucial interfacial bond between the reinforcing fibers and the surrounding matrix. This compromised adhesion leads to a shift in failure mode, where fibers tend to pull out effortlessly from the matrix rather than remaining firmly anchored and fracturing within the material.
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>,
                    <xref ref-type="bibr" rid="ref26">26</xref>
                </sup> This phenomenon was empirically confirmed by microscopic observations revealing smooth fiber surfaces, notably lacking the typical embedded nanoparticles or matrix material. Such an appearance is a clear indicator that the interface between the fiber and the matrix has catastrophically failed, suggesting a loss of chemical bonding, mechanical interlocking, and overall load transfer capability at the critical interface.
                <sup>
                    <xref ref-type="bibr" rid="ref13">13</xref>
                </sup> Similar to the findings of the current study, 
                <italic toggle="yes">Chung et al</italic>.,
                <sup>
                    <xref ref-type="bibr" rid="ref26">26</xref>
                </sup> showed that quasi-plastic materials exhibited a more gradual loss of strength than stiff materials. Furthermore, 
                <italic toggle="yes">Gad et al.,
</italic>
                <sup>
                    <xref ref-type="bibr" rid="ref8">8</xref>
                </sup> illustrated that the scattered fractures in AS demonstrated that these materials have a stronger fracture resistance, which is further corroborated by their higher strengths. However, the ND materials showed a fracture mode that was characterized by an early failure dominated by brittle fractures and a lack of dispersed fractures. This implies that the strength threshold of the ND material is lower, resulting in early breaking without the progressive deformation observed in stronger quasi-plastic materials. The existence of brittle fracture modes in the ND material emphasizes the necessity of strengthening its mechanical characteristics to increase its resistance to fractures.</p>
            <p>In general, SNPs demonstrated greater strength in ND than ZNPs, but both NPs (SNPs and ZNPs) had similar ASIGA values per concentration. This highlighted the significance of NP type selection and the type of resin to be reinforced. Based on the findings of this study, the use of the investigated nanocomposites in clinical applications has both potential benefits and limitations. The practical importance of this project lies in its potential to enhance the durability and lifetime of 3D-printed denture teeth. As this is the one of primary project investigated 3D printed nanocomposite resin for denture teeth, the results should be interpreted with caution. The observed improvements in fracture resistance suggest that these nanocomposites may reduce the risk of denture fractures in high-stress areas. However, the decline in the elastic modulus post-TA indicates potential limitations in structural stiffness and durability over time. Therefore, further optimization is recommended to mitigate the effects of TA.</p>
            <p>The findings of this study suggest several potential clinical applications for nanocomposite 3D-printed resins in removable prosthodontics. The enhanced fracture resistance of the nanoparticle-reinforced materials&#x2014;particularly those containing 0.5&#x2013;1 wt.% SNP or ZNP indicates their suitability for fabricating denture teeth in situations where high occlusal loads are expected. Such cases include complete dentures opposing natural dentition or implant-supported overdentures, where conventional acrylic teeth are more prone to fracture and wear. Additionally, these reinforced 3D-printed resins could be beneficial for partial denture prostheses or interim restorations that require improved mechanical strength and dimensional stability over time. The lower elastic modulus observed, may contribute to a more favorable stress distribution under masticatory forces, potentially reducing the risk of debonding or microfracture at the tooth&#x2013;base interface. From a clinical standpoint, the combination of digital fabrication precision and improved material durability positions these nanocomposite resins as a promising option for custom-made prostheses, particularly when individualized esthetics and load-bearing performance are priorities. Further in vivo studies are recommended to evaluate long-term outcomes, wear behavior, and bonding integrity under functional conditions.</p>
            <p>Despite the important findings of this study, some limitations exist. First, the study focused solely on two types of NPs and did not investigate additional potentially helpful NPs that may improve the mechanical characteristics of 3D-printed materials. Second, the study evaluated a narrow range of NP concentrations, which may not have captured the complete range of interactions between the NPs and polymer matrix. Furthermore, the long-term impacts of environmental elements such as saliva and oral-temperature fluctuations were not assessed, which may affect the longevity of materials in real-world clinical settings. Besides, the absence of long-term aging and fatigue testing in this study presents significant limitations. Without long-term aging tests, critical data on the materials&#x2019; performance over extended periods is missing, which can lead to an overestimation of their lifespan and reliability. Additionally, fatigue testing is essential for identifying failure modes that may only emerge under repeated stress. Therefore, further investigations on the effects of different NPs with different percentages added to different tooth resins are required. In addition, performing all tests under similar oral conditions and environments. At the printing-technology level, further research is needed to fully understand the synergistic interactions between the NP content, 3D-printing parameters, and fracture resistance of these materials in dental applications.</p>
        </sec>
        <sec id="sec9" sec-type="conclusions">
            <title>Conclusions</title>
            <p>In conclusion, this study demonstrates that the incorporation of ZNPs and SNPs enhances the fracture resistance of the tested materials. TA significantly decreased the fracture resistances and elastic moduli of most of the NP-incorporated groups, except at certain NP concentrations in both materials. AS exhibited the most favorable fracture resistance profile under the tested conditions, suggesting the need for further in vivo investigation. Further optimization is recommended to mitigate the effects of TA.</p>
        </sec>
        <sec id="sec10">
            <title>Ethics and consent</title>
            <p>Ethical approval and consent were not required.</p>
        </sec>
    </body>
    <back>
        <sec id="sec12" sec-type="data-availability">
            <title>Data availability</title>
            <p>Dataset available upon request from the authors.</p>
        </sec>
        <ack>
            <title>Acknowledgements</title>
            <p>Not applicable.</p>
        </ack>
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    <sub-article article-type="reviewer-report" id="report462252">
        <front-stub>
            <article-id pub-id-type="doi">10.5256/f1000research.190325.r462252</article-id>
            <title-group>
                <article-title>Reviewer response for version 2</article-title>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author">
                    <name>
                        <surname>ALTINTA&#x015e;</surname>
                        <given-names>EYY&#x00dc;P</given-names>
                    </name>
                    <xref ref-type="aff" rid="r462252a1">1</xref>
                    <role>Referee</role>
                    <uri content-type="orcid">https://orcid.org/0000-0002-7767-9694</uri>
                </contrib>
                <contrib contrib-type="author">
                    <name>
                        <surname>Yal&#x00e7;&#x0131;n</surname>
                        <given-names>Elif</given-names>
                    </name>
                    <xref ref-type="aff" rid="r462252a1">1</xref>
                    <role>Co-referee</role>
                </contrib>
                <aff id="r462252a1">
                    <label>1</label>Firat University, El&#x00e2;z&#x0131;&#x011f;, El&#x00e2;z&#x0131;&#x011f;, Turkey</aff>
            </contrib-group>
            <author-notes>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>4</day>
                <month>3</month>
                <year>2026</year>
            </pub-date>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2026 Yal&#x00e7;&#x0131;n E and ALTINTA&#x015e; E</copyright-statement>
                <copyright-year>2026</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <related-article ext-link-type="doi" id="relatedArticleReport462252" related-article-type="peer-reviewed-article" xlink:href="10.12688/f1000research.166989.2"/>
            <custom-meta-group>
                <custom-meta>
                    <meta-name>recommendation</meta-name>
                    <meta-value>approve-with-reservations</meta-value>
                </custom-meta>
            </custom-meta-group>
        </front-stub>
        <body>
            <p>Referee Report</p>
            <p> This manuscript evaluates the effect of zirconium dioxide (ZNPs) and silicon dioxide nanoparticles (SNPs), incorporated at two concentrations (0.5 wt.% and 1 wt.%), into two 3D-printed denture tooth resins (NextDent and ASIGA). Mechanical performance was assessed through fracture resistance and elastic modulus testing before and after thermal aging (5000 cycles). SEM and FTIR analyses were additionally conducted to explore fracture behavior and potential chemical interactions within the reinforced systems.</p>
            <p> The topic is timely and relevant, particularly within the expanding field of additive manufacturing in prosthodontics and nanoparticle reinforcement strategies. The factorial design, relatively large sample size (n = 220), and inclusion of both mechanical and microstructural analyses represent strengths of the study. Previous literature supports the importance of post-processing conditions and nanoparticle dispersion in influencing mechanical performance of photopolymerized dental resins (Revilla-Le&#x00f3;n &amp; &#x00d6;zcan, 2019 - Ref 1; Tahayeri et al., 2018 - Ref 2). However, several issues related to clarity of reporting, statistical interpretation, and methodological transparency must be addressed to ensure scientific robustness and reproducibility.</p>
            <p> A primary concern relates to the inconsistency in reporting fracture resistance units. In some sections, fracture resistance is presented in Newton (N), whereas in others it is reported in MPa. Since the described mechanical protocol involves compressive loading using a universal testing machine, clarification is required as to whether the analyzed parameter represents fracture load (N) or calculated stress (MPa). If stress values were derived, the method of stress calculation&#x2014;including area assumptions&#x2014;must be explicitly described. Consistent unit reporting is essential for transparency and scientific validity, and this issue should be resolved.</p>
            <p> Regarding statistical interpretation, the three-way ANOVA indicates that the interaction between thermal aging and material type is statistically significant, while interactions involving nanoparticle concentration are not consistently significant. Nonetheless, the manuscript emphasizes enhancement associated with nanoparticle incorporation in generalized terms. Interpretation should more closely reflect the statistical outcomes, distinguishing between significant main effects and non-significant interaction effects. The rejection of null hypotheses should be aligned precisely with the statistical evidence.</p>
            <p> The substantial reduction in elastic modulus observed in the ND control group after thermal aging warrants deeper discussion. While thermal aging is expected to affect mechanical properties, the magnitude of the reported decline is notable. The authors are encouraged to confirm the calculation method for elastic modulus and expand discussion of potential degradation mechanisms. It is well established that post-polymerization conditions significantly influence degree of conversion and mechanical performance in photopolymerized resins (Revilla-Le&#x00f3;n &amp; &#x00d6;zcan, 2019 - Ref 1), and the differing post-curing protocols between materials may represent a confounding variable that should be discussed more explicitly.</p>
            <p> An inconsistency between the narrative discussion and tabulated results should also be corrected. The manuscript indicates that the elastic modulus of prefabricated teeth did not significantly decrease after aging; however, the corresponding table suggests a statistically significant reduction. Alignment between textual interpretation and statistical data is essential.</p>
            <p> Although many methodological parameters are reported, additional detail would enhance reproducibility. Clear explanation of how elastic modulus was determined, clarification of fracture resistance calculation, and expanded reporting of printing parameters (e.g., exposure settings, curing conditions) would improve transparency. Providing a concise table summarizing subgroup allocation&#x2014;including aging distribution&#x2014;would further improve clarity.</p>
            <p> Finally, while summary statistics are provided, the underlying raw data are not included. Sharing individual specimen values as supplementary material would strengthen transparency and allow independent verification of the statistical analyses, consistent with principles of open scientific reporting.</p>
            <p> Overall, this study contributes valuable data to the field of nanoparticle-reinforced 3D-printed denture materials. The experimental framework is generally appropriate, and the inclusion of SEM and FTIR analyses adds depth. The identified concerns primarily relate to clarity, statistical alignment, and methodological reporting rather than fundamental flaws in study design.</p>
            <p> In conclusion, the manuscript is potentially suitable for indexing following revision. Clarification of unit consistency improved statistical interpretation, correction of textual inconsistencies, and enhanced methodological transparency are required to ensure that the work is scientifically sound and fully reproducible.</p>
            <p> Recommendation: Approved with Reservations.</p>
            <p>Is the work clearly and accurately presented and does it cite the current literature?</p>
            <p>Partly</p>
            <p>If applicable, is the statistical analysis and its interpretation appropriate?</p>
            <p>I cannot comment. A qualified statistician is required.</p>
            <p>Are all the source data underlying the results available to ensure full reproducibility?</p>
            <p>Partly</p>
            <p>Is the study design appropriate and is the work technically sound?</p>
            <p>Partly</p>
            <p>Are the conclusions drawn adequately supported by the results?</p>
            <p>Partly</p>
            <p>Are sufficient details of methods and analysis provided to allow replication by others?</p>
            <p>Partly</p>
            <p>Reviewer Expertise:</p>
            <p>Prosthodontics; Digital Dentistry; Dental Biomaterials</p>
            <p>We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.</p>
        </body>
        <back>
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        <sub-article article-type="response" id="comment15608-462252">
            <front-stub>
                <contrib-group>
                    <contrib contrib-type="author">
                        <name>
                            <surname>Gad</surname>
                            <given-names>Mohammed</given-names>
                        </name>
                        <aff>Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
                    </contrib>
                </contrib-group>
                <author-notes>
                    <fn fn-type="conflict">
                        <p>
                            <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                    </fn>
                </author-notes>
                <pub-date pub-type="epub">
                    <day>8</day>
                    <month>3</month>
                    <year>2026</year>
                </pub-date>
            </front-stub>
            <body>
                <p>
                    <bold>Response to reviewer 2 </bold>
                </p>
                <p> This manuscript evaluates the effect of zirconium dioxide (ZNPs) and silicon dioxide nanoparticles (SNPs), incorporated at two concentrations (0.5 wt.% and 1 wt.%), into two 3D-printed denture tooth resins (NextDent and ASIGA). Mechanical performance was assessed through fracture resistance and elastic modulus testing before and after thermal aging (5000 cycles). SEM and FTIR analyses were additionally conducted to explore fracture behavior and potential chemical interactions within the reinforced systems.</p>
                <p> The topic is timely and relevant, particularly within the expanding field of additive manufacturing in prosthodontics and nanoparticle reinforcement strategies. The factorial design, relatively large sample size (n = 220), and inclusion of both mechanical and microstructural analyses represent strengths of the study. Previous literature supports the importance of post-processing conditions and nanoparticle dispersion in influencing mechanical performance of photopolymerized dental resins (Revilla-Le&#x00f3;n &amp; &#x00d6;zcan, 2019 - Ref 1; Tahayeri et al., 2018 - Ref 2). However, several issues related to clarity of reporting, statistical interpretation, and methodological transparency must be addressed to ensure scientific robustness and reproducibility.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this constructive and encouraging comment. We appreciate the reviewer&#x2019;s recognition of the relevance of the topic and the strengths of the study design. The manuscript has been carefully revised to improve clarity of reporting, statistical presentation, and methodological transparency. The statistical analysis and presentation of results have also been rechecked and clarified, and the tables have been revised to ensure consistent reporting and interpretation of statistical groupings. These revisions were implemented to enhance the scientific rigor, transparency, and reproducibility of the study.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> A primary concern relates to the inconsistency in reporting fracture resistance units. In some sections, fracture resistance is presented in Newton (N), whereas in others it is reported in MPa. Since the described mechanical protocol involves compressive loading using a universal testing machine, clarification is required as to whether the analyzed parameter represents fracture load (N) or calculated stress (MPa). If stress values were derived, the method of stress calculation&#x2014;including area assumptions&#x2014;must be explicitly described. Consistent unit reporting is essential for transparency and scientific validity, and this issue should be resolved.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this important observation. We agree that consistent reporting of mechanical test outcomes is essential for clarity and scientific transparency. In the present study, the parameter evaluated was fracture load, which was recorded directly from the universal testing machine (Instron) as the maximum load at failure and expressed in Newtons (N) while the elastic modulus was calculated from the load&#x2013;deflection data generated by the universal testing machine. Please, see highlighted added statements in methodology.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Regarding statistical interpretation, the three-way ANOVA indicates that the interaction between thermal aging and material type is statistically significant, while interactions involving nanoparticle concentration are not consistently significant. Nonetheless, the manuscript emphasizes enhancement associated with nanoparticle incorporation in generalized terms. Interpretation should more closely reflect the statistical outcomes, distinguishing between significant main effects and non-significant interaction effects. The rejection of null hypotheses should be aligned precisely with the statistical evidence.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this valuable comment regarding the interpretation of the statistical findings. We appreciate the reviewer&#x2019;s attention to the alignment between statistical outcomes and their interpretation in the manuscript. The three-way ANOVA results were reviewed again to ensure accurate interpretation, particularly with respect to the interaction effects. Furthermore, the null hypotheses were revised and modified as well as the acceptance or rejection of the null hypotheses has been aligned explicitly with the statistical evidence obtained from the ANOVA analysis.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The substantial reduction in elastic modulus observed in the ND control group after thermal aging warrants deeper discussion. While thermal aging is expected to affect mechanical properties, the magnitude of the reported decline is notable. The authors are encouraged to confirm the calculation method for elastic modulus and expand discussion of potential degradation mechanisms. It is well established that post-polymerization conditions significantly influence degree of conversion and mechanical performance in photopolymerized resins (Revilla-Le&#x00f3;n &amp; &#x00d6;zcan, 2019 - Ref 1), and the differing post-curing protocols between materials may represent a confounding variable that should be discussed more explicitly.</p>
                <p> 
                    <bold>Response</bold>: Thank you for this detailed and insightful comment. We acknowledge the reviewer&#x2019;s concern regarding the notable reduction in elastic modulus observed in the ND control group after thermal aging. In response, the calculation method for elastic modulus was carefully rechecked and confirmed to be correct, derived from the linear portion of the load&#x2013;deflection curve generated by the universal testing machine (Instron) according to standard three-point bending calculations. No errors in the measurement or analysis were identified. Additionally, the Discussion section has been expanded to address potential degradation mechanisms. The observed reduction in elastic modulus may be attributed to water sorption, plasticization of the polymer matrix, hydrolytic degradation, and weakening of intermolecular bonds within the resin network, all of which are known to compromise stiffness over time. We also explicitly discuss the role of post-polymerization conditions, including differences in light intensity, exposure duration, wavelength, and temperature, which can affect the degree of conversion and cross-link density. Suboptimal post-curing can result in lower monomer conversion and higher residual monomer content, which may exacerbate the reduction in mechanical properties during thermal aging. These additions provide a more comprehensive understanding of both intrinsic material degradation and potential confounding factors affecting the ND control group, in line with previously reported findings (Revilla-Le&#x00f3;n &amp; &#x00d6;zcan, 2019; Tahayeri et al., 2018; Stansbury &amp; Idacavage, 2016).</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> An inconsistency between the narrative discussion and tabulated results should also be corrected. The manuscript indicates that the elastic modulus of prefabricated teeth did not significantly decrease after aging; however, the corresponding table suggests a statistically significant reduction. Alignment between textual interpretation and statistical data is essential.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this careful observation. We appreciate the reviewer for identifying this inconsistency. After re-examining the results and the corresponding table, we confirm that the elastic modulus of the prefabricated teeth showed a statistically significant reduction after thermal aging, as indicated in the tabulated data. The statement corrected in the Discussion.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Although many methodological parameters are reported, additional detail would enhance reproducibility. Clear explanation of how elastic modulus was determined, clarification of fracture resistance calculation, and expanded reporting of printing parameters (e.g., exposure settings, curing conditions) would improve transparency. Providing a concise table summarizing subgroup allocation&#x2014;including aging distribution&#x2014;would further improve clarity.</p>
                <p> 
                    <bold>Response</bold>: thank you for your valuable comment. Measurement details were added to the methods section as well as more details about printing parameters. Regarding subgroups allocations, this was clarified in the methods sections.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Finally, while summary statistics are provided, the underlying raw data are not included. Sharing individual specimen values as supplementary material would strengthen transparency and allow independent verification of the statistical analyses, consistent with principles of open scientific reporting.</p>
                <p> 
                    <bold>Response:</bold> thank you for your comment and recommendation. Raw data uploaded as a supplementary file</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Overall, this study contributes valuable data to the field of nanoparticle-reinforced 3D-printed denture materials. The experimental framework is generally appropriate, and the inclusion of SEM and FTIR analyses adds depth. The identified concerns primarily relate to clarity, statistical alignment, and methodological reporting rather than fundamental flaws in study design.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this positive and constructive assessment of our work. The manuscript has been carefully revised to improve clarity of presentation, consistency in statistical reporting, and methodological transparency. Specifically, the Materials and Methods section has been expanded to provide clearer descriptions of specimen preparation, nanoparticle incorporation, and testing procedures. In addition, the statistical analyses and the presentation of results have been rechecked, and the tables and corresponding descriptions in the Results section have been revised to ensure proper alignment and clarity. These revisions were made to enhance the overall readability, reproducibility, and scientific rigor of the study.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> In conclusion, the manuscript is potentially suitable for indexing following revision. Clarification of unit consistency improved statistical interpretation, correction of textual inconsistencies, and enhanced methodological transparency are required to ensure that the work is scientifically sound and fully reproducible.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this constructive evaluation and for considering the manuscript potentially suitable for indexing following revision. We appreciate the reviewer&#x2019;s recommendations aimed at improving the scientific clarity and reproducibility of the work. In response, the manuscript has been carefully revised to address the points raised. Unit consistency has been corrected throughout the manuscript, particularly regarding the reporting of mechanical properties, to ensure uniformity and clarity. The statistical analyses and their interpretation have been rechecked, and the presentation of results in the text and tables has been revised to eliminate inconsistencies. Additionally, the Materials and Methods section has been expanded to provide clearer and more detailed descriptions of specimen preparation, nanoparticle incorporation procedures, and testing protocols, thereby enhancing methodological transparency and reproducibility. We believe that these revisions have strengthened the scientific rigor and overall clarity of the manuscript.</p>
            </body>
        </sub-article>
    </sub-article>
    <sub-article article-type="reviewer-report" id="report414809">
        <front-stub>
            <article-id pub-id-type="doi">10.5256/f1000research.184057.r414809</article-id>
            <title-group>
                <article-title>Reviewer response for version 1</article-title>
            </title-group>
            <contrib-group>
                <contrib contrib-type="author">
                    <name>
                        <surname>Tosun</surname>
                        <given-names>B&#x00fc;&#x015f;ra</given-names>
                    </name>
                    <xref ref-type="aff" rid="r414809a1">1</xref>
                    <role>Referee</role>
                </contrib>
                <aff id="r414809a1">
                    <label>1</label>Bolu Abant &#x0130;zzet Baysal University Faculty of Dentistry, Bolu, Turkey</aff>
            </contrib-group>
            <author-notes>
                <fn fn-type="conflict">
                    <p>
                        <bold>Competing interests: </bold>No competing interests were disclosed.</p>
                </fn>
            </author-notes>
            <pub-date pub-type="epub">
                <day>30</day>
                <month>9</month>
                <year>2025</year>
            </pub-date>
            <permissions>
                <copyright-statement>Copyright: &#x00a9; 2025 Tosun B</copyright-statement>
                <copyright-year>2025</copyright-year>
                <license xlink:href="https://creativecommons.org/licenses/by/4.0/">
                    <license-p>This is an open access peer review report distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p>
                </license>
            </permissions>
            <related-article ext-link-type="doi" id="relatedArticleReport414809" related-article-type="peer-reviewed-article" xlink:href="10.12688/f1000research.166989.1"/>
            <custom-meta-group>
                <custom-meta>
                    <meta-name>recommendation</meta-name>
                    <meta-value>approve-with-reservations</meta-value>
                </custom-meta>
            </custom-meta-group>
        </front-stub>
        <body>
            <p>1. Abstract</p>
            <p> Although the abstract briefly presents the study's objective and key findings, it lacks numerical data on statistical significance (e.g., p-values). The absence of these values makes it difficult for readers to assess the strength and reliability of the reported outcomes.</p>
            <p> The results section in the abstract mentions the general effects of nanoparticle incorporation, yet it fails to highlight which specific group demonstrated superior performance or in which material these enhancements were more prominent. This weakens the interpretability and impact of the findings.</p>
            <p> The final sentence of the abstract should be revised to clearly express the clinical relevance of the study. For instance, a conclusive statement such as &#x201c;The ASIGA resin appears to be more suitable for clinical use&#x201d; would provide a more concrete and impactful takeaway.</p>
            <p> 2. Introduction</p>
            <p> While the introduction demonstrates a comprehensive understanding of the topic, it does not adequately emphasize the study&#x2019;s novelty or specific contribution to the existing literature. The authors should clearly state what research gap this study fills or what unique question it attempts to answer that has not been addressed previously.</p>
            <p> The null hypotheses are technically stated but should be presented in a more concise and isolated format to enhance the logical clarity of the study's objectives and to ensure readers can easily identify the guiding assumptions of the research.</p>
            <p> 3. Materials and Methods</p>
            <p> Although the sample dimensions, geometric shapes, and build orientations are partially described, further clarification is necessary to ensure the methodology is reproducible by other researchers. Detailed specifications are essential for standardization and transparency.</p>
            <p> The post-curing protocol is briefly mentioned; however, critical technical parameters such as the type of light source (LED/UV), wavelength, and total curing duration are missing. These details should be explicitly included, as they significantly influence the mechanical behavior of photopolymer resins.</p>
            <p> The statistical software used for the data analysis (e.g., SPSS, Jamovi) is not specified, nor is the exact strategy for data interpretation. Without this information, methodological transparency is compromised, and it becomes challenging to assess the validity of the statistical approach.</p>
            <p> Although the text mentions that a power analysis was performed, there is no information about the effect size used, or whether a post hoc power analysis was conducted. Including these details would enhance the statistical rigor and reliability of the findings.</p>
            <p> 4. Results</p>
            <p> The results are presented only in tabular format, without any supporting graphical representations such as bar charts or error bars. The lack of visual data summaries makes it more difficult for readers to quickly interpret the findings and compare group performances.</p>
            <p> FTIR and SEM analyses are discussed within the text, but the associated figures are lacking essential annotations, such as peak labels, magnification levels, and explanatory captions. These omissions hinder the reader&#x2019;s ability to critically evaluate the microstructural and chemical characterization data.</p>
            <p> In the SEM section, terms like &#x201c;crack propagation&#x201d; and &#x201c;lamellar surfaces&#x201d; are briefly mentioned; however, the specific groups where these fracture patterns occurred are not clearly identified, nor are they visually indicated on the figures. This limits the clarity and scientific depth of the microstructural analysis.</p>
            <p> 5. Discussion</p>
            <p> The discussion follows the literature reasonably well, but the comparisons remain superficial in several areas. Each key finding should be more critically analyzed in light of previous studies, with proper referencing to enhance the scholarly depth of the interpretation.</p>
            <p> The discussion should more explicitly address which type of nanoparticle (ZNP or SNP) was more effective within which resin system (ASIGA or NextDent). Presenting these outcomes with clear material-specific insights would improve the applicability and specificity of the conclusions.</p>
            <p> Clinical implications are not sufficiently discussed. The authors should elaborate on how these materials might be implemented in practice&#x2014;such as which types of dentures or patient scenarios would most benefit from the enhanced properties of these nanocomposite resins.</p>
            <p> The observed decrease in elastic modulus following thermal aging should be analyzed more thoroughly. Possible mechanisms such as network degradation or disruption of polymer cross-linking due to increased nanoparticle content should be hypothesized and supported with relevant references.</p>
            <p> 6. Figures and Tables</p>
            <p> In the FTIR spectra, significant peaks should be clearly labeled, and the corresponding functional groups identified. This would improve the interpretability of the chemical bonding analysis.</p>
            <p> Statistically significant differences between groups should be visually summarized using bar graphs with standard deviation/error bars and appropriate significance indicators (e.g., asterisks). This would allow readers to more quickly grasp the magnitude and relevance of the differences reported.</p>
            <p> </p>
            <p> Recommendation: Major Revision</p>
            <p> The manuscript addresses a relevant topic and presents valuable findings. However, significant improvements are required in data presentation, methodological transparency, and clinical interpretation. I recommend major revision before the manuscript can be considered for indexing.</p>
            <p>Is the work clearly and accurately presented and does it cite the current literature?</p>
            <p>Partly</p>
            <p>If applicable, is the statistical analysis and its interpretation appropriate?</p>
            <p>I cannot comment. A qualified statistician is required.</p>
            <p>Are all the source data underlying the results available to ensure full reproducibility?</p>
            <p>Partly</p>
            <p>Is the study design appropriate and is the work technically sound?</p>
            <p>Partly</p>
            <p>Are the conclusions drawn adequately supported by the results?</p>
            <p>Partly</p>
            <p>Are sufficient details of methods and analysis provided to allow replication by others?</p>
            <p>Yes</p>
            <p>Reviewer Expertise:</p>
            <p>Prosthodontics</p>
            <p>I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.</p>
        </body>
        <sub-article article-type="response" id="comment14821-414809">
            <front-stub>
                <contrib-group>
                    <contrib contrib-type="author">
                        <name>
                            <surname>Gad</surname>
                            <given-names>Mohammed</given-names>
                        </name>
                        <aff>Imam Abdulrahman Bin Faisal University College of Dentistry, Dammam, Eastern Province, Saudi Arabia</aff>
                    </contrib>
                </contrib-group>
                <author-notes>
                    <fn fn-type="conflict">
                        <p>
                            <bold>Competing interests: </bold>The authors declare no conflicts of interest</p>
                    </fn>
                </author-notes>
                <pub-date pub-type="epub">
                    <day>20</day>
                    <month>10</month>
                    <year>2025</year>
                </pub-date>
            </front-stub>
            <body>
                <p>
                    <bold>Response to reviewer comments</bold>
                </p>
                <p> 
                    <bold>Recommendation: Major Revision</bold>
                </p>
                <p> The manuscript addresses a relevant topic and presents valuable findings. However, significant improvements are required in data presentation, methodological transparency, and clinical interpretation. I recommend major revision before the manuscript can be considered for indexing.</p>
                <p> 
                    <bold>Response:</bold> We sincerely thank the reviewer for their thoughtful evaluation and constructive feedback. We appreciate the recognition of the relevance of our topic and the value of our findings. In response to the reviewer&#x2019;s comments, we have thoroughly revised the manuscript to enhance the clarity and transparency of data presentation, provide more detailed descriptions of the methodology, and strengthen the discussion of the clinical implications of our results. We believe these revisions have substantially improved the overall quality and interpretability of the manuscript.</p>
                <p> </p>
                <p> 
                    <bold>1. Abstract</bold>
                </p>
                <p> 
                    <bold>Comment:</bold> Although the abstract briefly presents the study's objective and key findings, it lacks numerical data on statistical significance (e.g., p-values). The absence of these values makes it difficult for readers to assess the strength and reliability of the reported outcomes.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your comment. P values added to the abstract</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The results section in the abstract mentions the general effects of nanoparticle incorporation, yet it fails to highlight which specific group demonstrated superior performance or in which material these enhancements were more prominent. This weakens the interpretability and impact of the findings.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your comment. The most superior performance material is added</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The final sentence of the abstract should be revised to clearly express the clinical relevance of the study. For instance, a conclusive statement such as &#x201c;The ASIGA resin appears to be more suitable for clinical use&#x201d; would provide a more concrete and impactful takeaway.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your comment and recommendation. The statement was revised.</p>
                <p> </p>
                <p> 
                    <bold>2. Introduction</bold>
                </p>
                <p> 
                    <bold>Comment:</bold> While the introduction demonstrates a comprehensive understanding of the topic, it does not adequately emphasize the study&#x2019;s novelty or specific contribution to the existing literature. The authors should clearly state what research gap this study fills or what unique question it attempts to answer that has not been addressed previously.</p>
                <p> 
                    <bold>Response: </bold>thank you for your comment.&#x00a0; the research gap added at the end of introduction and the clarifying of novelty was highlighted
                    <bold> </bold>
                </p>
                <p> 
                    <bold>Comment:</bold> The null hypotheses are technically stated but should be presented in a more concise and isolated format to enhance the logical clarity of the study's objectives and to ensure readers can easily identify the guiding assumptions of the research.</p>
                <p> 
                    <bold>Response</bold>: Thank you for your valuable suggestion. The null hypotheses have been revised to appear in a clearer and more concise format, presented in a separate paragraph within the Introduction section</p>
                <p> </p>
                <p> 
                    <bold>3. Materials and Methods</bold>
                </p>
                <p> 
                    <bold>Comment:</bold> Although the sample dimensions, geometric shapes, and build orientations are partially described, further clarification is necessary to ensure the methodology is reproducible by other researchers. Detailed specifications are essential for standardization and transparency.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your valuable observation. Additional details regarding the specimen dimensions, geometric configuration, and build orientation have been added to the Materials.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The post-curing protocol is briefly mentioned; however, critical technical parameters such as the type of light source (LED/UV), wavelength, and total curing duration are missing. These details should be explicitly included, as they significantly influence the mechanical behavior of photopolymer resins.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your valuable suggestion, the recommended topic was done.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The statistical software used for data analysis (e.g., SPSS, Jamovi) is not specified, nor is the exact strategy for data interpretation. Without this information, methodological transparency is compromised, and it becomes challenging to assess the validity of the statistical approach.</p>
                <p> 
                    <bold>Response:</bold> the name of the statistical software has been added</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Although the text mentions that a power analysis was performed, there is no information about the effect size used, or whether a post hoc power analysis was conducted. Including these details would enhance the statistical rigor and reliability of the findings.</p>
                <p> Response: we added all the information while writing statements related to sample size, which was used to entire for the sample size computation.</p>
                <p> </p>
                <p> 
                    <bold>4. Results</bold>
                </p>
                <p> 
                    <bold>Comment:</bold> The results are presented only in tabular format, without any supporting graphical representations such as bar charts or error bars. The lack of visual data summaries makes it more difficult for readers to quickly interpret the findings and compare group performances.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your response. In reference to Tables 2 and 5, two supplementary charts&#x00a0;have&#x00a0;been&#x00a0;added (figure 6 and 7).</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> FTIR and SEM analyses are discussed within the text, but the associated figures are lacking essential annotations, such as peak labels, magnification levels, and explanatory captions. These omissions hinder the reader&#x2019;s ability to critically evaluate the microstructural and chemical characterization data.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your comment. Main peaks have labeled of each spectrum and corresponding groups are discussed in the relevant text. For SEM the given magnification for each image is provided along with figures captions as recommended.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> In the SEM section, terms like &#x201c;crack propagation&#x201d; and &#x201c;lamellar surfaces&#x201d; are briefly mentioned; however, the specific groups where these fracture patterns occurred are not clearly identified, nor are they visually indicated on the figures. This limits the clarity and scientific depth of the microstructural analysis.</p>
                <p> 
                    <bold>Response:</bold> &#x00a0;Thank you for your comment, we considered your suggestion and extended the results part with more details about the &#x201c;crack propagation&#x201d; and &#x201c;lamellar surfaces&#x201d;. The corresponding (fig. 5) is modified accordingly where crack propagation and lamellar surfaces are identified and marked with arrows (see modified fig. 5)</p>
                <p> </p>
                <p> 
                    <bold>5. Discussion</bold>
                </p>
                <p> 
                    <bold>Comment:</bold> The discussion follows the literature reasonably well, but the comparisons remain superficial in several areas. Each key finding should be more critically analyzed in light of previous studies, with proper referencing to enhance the scholarly depth of the interpretation.</p>
                <p> 
                    <bold>Response:</bold> thank you for your Comment, comparison with other studies have been added in lines 324-337</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The discussion should more explicitly address which type of nanoparticle (ZNP or SNP) was more effective within which resin system (ASIGA or NextDent). Presenting these outcomes with clear material-specific insights would improve the applicability and specificity of the conclusions.</p>
                <p> 
                    <bold>Response</bold>: thank you for your valuable comments. Referral to NPs type effect was added to discussion&#x00a0;</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Clinical implications are not sufficiently discussed. The authors should elaborate on how these materials might be implemented in practice&#x2014;such as which types of dentures or patient scenarios would most benefit from the enhanced properties of these nanocomposite resins.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your insightful comment. To address this point, a graph illustrating the clinical relevance and potential applications of the nanocomposite 3D-printed resins has been added to the Discussion section (page 14).</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> The observed decrease in elastic modulus following thermal aging should be analyzed more thoroughly. Possible mechanisms such as network degradation or disruption of polymer cross-linking due to increased nanoparticle content should be hypothesized and supported with relevant references.</p>
                <p> 
                    <bold>Response:</bold> thank you for the comment, more details have been added in lines 437-448</p>
                <p> </p>
                <p> 
                    <bold>6. Figures and Tables</bold>
                </p>
                <p> 
                    <bold>Comment:</bold> In the FTIR spectra, significant peaks should be clearly labeled, and the corresponding functional groups identified. This would improve the interpretability of the chemical bonding analysis.</p>
                <p> 
                    <bold>Response:</bold> Thank you for your valuable comment, we have labeled the main peaks of each spectra and corresponding groups are discussed in the relevant text. However, these functional groups could not be mentioned within the figures due to limited space.</p>
                <p> </p>
                <p> 
                    <bold>Comment:</bold> Statistically significant differences between groups should be visually summarized using bar graphs with standard deviation/error bars and appropriate significance indicators (e.g., asterisks). This would allow readers to more quickly grasp the magnitude and relevance of the differences reported.</p>
                <p> 
                    <bold>Response:</bold> Thank you for this helpful suggestion. Bar graphs have been added to visually summarize the statistically significant differences between groups. These additions are now presented in Figures 6 and 7.</p>
            </body>
        </sub-article>
    </sub-article>
</article>
