Chikahiro Ohkubo

Shear bond strengths of polymethyl methacrylate to cast titanium and cobalt-chromium frameworks using five metal primers

STATEMENT OF PROBLEM Poor chemical bonding of a denture base resin to cast titanium frameworks often introduces adhesive failure and increases microleakage. PURPOSE This study examined the shear bond strengths of a denture base resin to cast pure titanium, Ti-6Al-4V, and a cobalt-chromium alloy using various adhesive primers. MATERIAL AND METHODS Disks (6.0 mm diameter, 2.5 mm thick) were cast of the 3 alloys. The disk surfaces were grit-blasted with 50 microm alumina and treated with 5 different metal primers (Metal Primer II ¿MP]; Cesead Opaque primer ¿OP]; Meta Base ¿MB]; experimental primer ¿EP]; Siloc bonding system ¿SI]). A denture base resin (Palapress Vario) was then applied on the disks with hole-punched sticky tape (bonding area of 5.0 mm) and a Teflon (PTFE, New Age Industries Inc, Willow Grove, Pa.) ring (6.0 mm diameter x 2.0 mm thick). Specimens without primer were also prepared as controls. All specimens were immersed in 37 degrees C water and thermocycled up to 2,000 cycles. Shear bond strength values were determined at a crosshead speed of 0.5 mm/min. Data were statistically analyzed using 3-way ANOVA, followed by 1-way ANOVA and the Scheffé multiple range test. RESULTS Primers significantly (P <.05) improved shear bond strengths of denture base resin to all metals, among which no significant differences were found. Specimens primed with OP, MP, and EP showed higher bond strengths than did those primed with MB. After thermocycling, the bond strengths of MB and SI decreased substantially; MB showed the least durability (22.8% to 35.5% decrease) among the primers. CONCLUSION The application of 5 primers significantly improved the shear bond strengths of a denture base resin to cast CP titanium, Ti-6Al-4V, and Co-Cr alloy. OP and MP primers exhibited greater bond strength and durability than did MB and SI.

The machinability of cast titanium and Ti-6Al-4V.

This study investigated the machinability (ease of metal removal) of commercially pure (CP) titanium and Ti-6Al-4V alloy. Both CP Ti and Ti-6Al-4V were cast into magnesia molds. Two types of specimens (with alpha-case and without alpha-case) were made for CP Ti and Ti-6Al-4V. Machinability (n = 5) was evaluated as volume loss (mm3) by cutting/grinding the 3.0 mm surface using fissure burs and silicon carbide (SiC) under two machining conditions: (1) two machining forces (100 or 300 gf) at two rotational speeds (15000 or 30000 rpm) for 1 min, and (2) constant machining force of 100 gf and rotational speed of 15000 rpm for 1, 2, 5, 10, and 30 min. As controls, conventionally cast Co-Cr and Type IV gold alloys were evaluated in the same manner as the titanium. When fissure burs were used, there was a significant difference in the machinability between CP titanium with alpha-case and without alpha-case. On the other hand, there was no appreciable difference in the amount of metal removed for each tested metal when using the SiC points.

Wear resistance of experimental Ti-Cu alloys.

After using cast titanium prostheses in clinical dental practice, severe wear of titanium teeth has been observed. This in vitro study evaluated the wear behavior of teeth made with several cast titanium alloys containing copper (CP Ti+3.0 wt% Cu; CP Ti+5.0 wt% Cu; Ti-6Al-4V +1.0 wt% Cu; Ti-6Al-4V+4.0 wt% Cu) and compared the results with those for commercially pure (CP) titanium, Ti-6Al-4V, and gold alloy. Wear testing was performed by repeatedly grinding upper and lower teeth under flowing water in an experimental testing apparatus. Wear resistance was assessed as volume loss (mm(3)) at 5kgf (grinding force) after 50,000 strokes. Greater wear was found for the six types of titanium than for the gold alloy. The wear resistance of the experimental CP Ti+Cu and Ti-6Al-4V+Cu alloys was better than that of CP titanium and Ti-6Al-4V, respectively. Although the gold alloy had the best wear property, the 4% Cu in Ti-6Al-4V alloy exhibited the best results among the titanium metals. Alloying with copper, which introduced the alpha Ti/Ti(2)Cu eutectoid, seemed to improve the wear resistance.

Cutting efficiency of air-turbine burs on cast titanium and dental casting alloys

OBJECTIVE The purpose of this study was to investigate the cutting efficiency of air-turbine burs on cast free-machining titanium alloy (DT2F) and to compare the results with those for cast commercially pure (CP) Ti, Ti-6Al-4V alloy, and dental casting alloys. METHODS The cast metal (DT2F, CP Ti, Ti-6Al-4V, Type IV gold alloy and Co-Cr alloy) specimens were cut with air-turbine burs (carbide burs and diamond points) at air pressures of 138 or 207 kPa and a cutting force of 0.784 N. The cutting efficiency of each bur was evaluated as volume loss calculated from the weight loss cut for 5 s and the density of each metal. The bulk microhardness was measured to correlate the machinability and the hardness of each metal. RESULTS The amounts of DT2F cut with the carbide burs were significantly (p < 0.05) greater than for the other titanium specimens at either 138 or 207 kPa. The diamond points exhibited similar machining efficiency among all metals except for Type IV gold alloy. The increase in the volume loss of Co-Cr alloy (Vitallium) cut with the diamond points showed a negative value (-29%) with an increase in air pressure from 138 to 207 kPa. There was a negative correlation between the amounts of metal removed (volume loss) and the hardness (r2 = 0.689) when the carbide burs were used. SIGNIFICANCE The results of this study indicated that a free-machining titanium alloy (DT2F) exhibited better machinability compared to CP Ti and Ti-6Al-4V alloy when using carbide fissure burs. When machining cast CP Ti and its alloys, carbide fissure burs possessed a greater machining efficiency than the diamond points and are recommended for titanium dental prostheses.

Present status of titanium removable dentures--a review of the literature.

Although porcelain and zirconium oxide might be used for fixed partial dental prostheses instead of conventional dental metals in the near future, removable partial denture (RPD) frameworks will probably continue to be cast with biocompatible metals. Commercially pure (CP) titanium has appropriate mechanical properties, it is lightweight (low density) compared with conventional dental alloys, and has outstanding biocompatibility that prevents metal allergic reactions. This literature review describes the laboratory conditions needed for fabricating titanium frameworks and the present status of titanium removable prostheses. The use of titanium for the production of cast RPD frameworks has gradually increased. There are no reports about metallic allergy apparently caused by CP titanium dentures. The laboratory drawbacks still remain, such as the lengthy burn-out, inferior castability and machinability, reaction layer formed on the cast surface, difficulty of polishing, and high initial costs. However, the clinical problems, such as discoloration of the titanium surfaces, unpleasant metal taste, decrease of clasp retention, tendency for plaque to adhere to the surface, detachment of the denture base resin, and severe wear of titanium teeth, have gradually been resolved. Titanium RPD frameworks have never been reported to fail catastrophically. Thus, titanium is recommended as protection against metal allergy, particularly for large-sized prostheses such as RPDs or complete dentures.

Clinical evaluation of posterior all-ceramic FPDs (Cercon): A prospective clinical pilot study

PURPOSE This study prospectively evaluated the clinical performance of posterior zirconium-oxide-based all-ceramic fixed partial dentures (FPDs). METHODS Forty-two abutments of 21 Cercon FPDs were fitted in 20 patients at the Tsurumi University Dental Hospital from August 2005 to August 2006. The performance of these FPDs was evaluated using the California Dental Association (CDA) quality assessment system at baseline and at all follow-up examinations. RESULTS All FPDs were examined after a mean observation period of 28.1 (+/-3.4) months. During the observation period, no fracturing of FPDs was seen. All of the FPDs examined were rated as satisfactory with regard to all factors at the follow-up examinations based on the CDA quality assessment criteria. CONCLUSION Within the limitations of this short-term clinical study, no core framework fractures were seen. According to the CDA criteria, 100% of the FPDs were rated as satisfactory during this observation period.

Clinical application of removable partial dentures using thermoplastic resin. Part II: Material properties and clinical features of non-metal clasp dentures

This position paper reviews physical and mechanical properties of thermoplastic resin used for non-metal clasp dentures, and describes feature of each thermoplastic resin in clinical application of non-metal clasp dentures and complications based on clinical experience of expert panels. Since products of thermoplastic resin have great variability in physical and mechanical properties, clinicians should utilize them with careful consideration of the specific properties of each product. In general, thermoplastic resin has lower color-stability and higher risk for fracture than polymethyl methacrylate. Additionally, the surface of thermoplastic resin becomes roughened more easily than polymethyl methacrylate. Studies related to material properties of thermoplastic resin, treatment efficacy and follow-up are insufficient to provide definitive conclusions at this time. Therefore, this position paper should be revised based on future studies and a clinical guideline should be provided.

Interactions between occlusion and human brain function activities

There are few review articles in the area of human research that focus on the interactions between occlusion and brain function. This systematic review discusses the effect of occlusion on the health of the entire body with a focus on brain function. Available relevant articles in English from 1999 to 2011 were assessed in an online database and as hard copies in libraries. The selected 19 articles were classified into the following five categories: chewing and tongue movements, clenching and grinding, occlusal splints and occlusal interference, prosthetic rehabilitation, and pain and stimulation. The relationships between the brain activity observed in the motor and sensory cortices and movements of the oral and maxillofacial area, such as those produced by gum chewing, tapping and clenching, were investigated. It was found that the sensorimotor cortex was also affected by the placement of the occlusal interference devices, splints and implant prostheses. Brain activity may change depending on the strength of the movements in the oral and maxillofacial area. Therefore, mastication and other movements stimulate the activity in the cerebral cortex and may be helpful in preventing degradation of a brain function. However, these findings must be verified by evidence gathered from more subjects.

Effects of in vitro cyclic dislodging on retentive force and removal torque of three overdenture attachment systems.

BACKGROUND Mandibular two-implant-retained overdentures were suggested as first choice of treatment for edentulous mandibles. However, wear of the attachments may reduce their retention and compromise long-term clinical success. AIM The aim of this in vitro study was to compare the change in the retentive force and removal torque of three attachment systems during simulation of insertion-removal cycles. MATERIALS AND METHODS Thirty custom-manufactured polyvinyl chloride blocks mimicking an implant-retained overdenture using Locator(®) -, spherical Dalbo(®) -PLUS - and SFI(®) -Bar-attachments on Straumann(®) RN Implants were fabricated. The samples were distributed equally into three groups which were subdivided into two sets of five blocks, one set with implants parallel to one another and the other with angulated implants (12°). All attachments were tightened to 35Ncm, while the fixation screws of the SFI(®) -Bar were tightened to 15Ncm. Testing was carried out with an Instron(®) universal testing machine for a total of 14,600 insertion-removal cycles in 0.9% sodium chloride solution. Retentive forces from cycles 10, 100, 1000, 5000, 10,000 and 14,600 were used for the analysis. The removal torque of the attachments was measured before and at the end of the study. Statistical analysis comprised three-way ANOVA and multiple linear regression models. RESULTS Initially, all three attachment systems demonstrated increasing retentive forces. From cycle 5000 on, Locator(®) -attachments showed lower mean retentive forces than the Dalbo(®) -PLUS and SFI(®) -Bar-groups. The Dalbo(®) -PLUS and SFI(®) -Bar-attachments showed a steady yet not significant increase during the whole observation period. Implant-angulation had no significant influence on the retention forces. The final mean removal torques were significantly reduced. No complete failure was observed. CONCLUSIONS AND CLINICAL IMPLICATIONS Within the limits of this in vitro study, it can be concluded that the investigated overdenture attachment systems are sufficiently resistant to wear. However, the Dalbo(®) -Plus- and SFI(®) -Bar- exhibit higher retentive capacities than the Locator(®) -attachment over time. The fixation screw of the SFI(®) -Bar may loosen during long-term use, but these observations might be less important if 1-year recall intervals are respected. An angulation of up to 12° between implants does not seem to have a significant effect on attachment wear.

Effect of implant support on mandibular distal extension removable partial dentures: Relationship between denture supporting area and stress distribution

PURPOSE This study explored the relationship between implant support and the denture-supporting area by comparing the stability of an implant-supported distal extension removable partial denture and a conventional distal extension removable partial denture. METHODS A model simulating a mandibular bilateral distal extension missing (#34-37 and #44-47) was fabricated using silicone impression material as soft tissue (2 mm thick) on an epoxy resin bone model. The denture base was reduced by 5 mm cutting part of both the retromolar pad and the lingual border. Loads of up to 5 kg were applied, and the pressure and displacement of the RPDs were simultaneously measured and analyzed using the Wilcoxon test (α<0.05). RESULTS The pressure on the bilateral first molar and the middle areas of the implant-supported distal extension removable partial denture (ISRPD) was significantly less than on the conventional RPD (CRPD). As the supporting area of the denture base decreased, the pressure and the denture displacement of the CRPD were greater than for the ISRPD. CONCLUSION This study indicated that implant placement at the distal edentulous ridge can prevent denture displacement of the distal extension bases, regardless of the supporting area of the denture base.