Ricardo Faria Ribeiro

Effect of beryllium on the castability and resistance of ceramometal bonds in nickel-chromium alloys.

STATEMENT OF PROBLEM Castability and ceramometal bond resistance play an important role in accepting nickel-chromium alloys as a substitute for gold alloys in dentistry. PURPOSE This study was developed to verify the effect of beryllium on these factors in several compositions of nickel-based alloys by submitting them to castability and ceramometal bonding resistance tests. MATERIAL AND METHODS Three experimental compositions of Ni-Cr alloys with different amounts of beryllium were used. One beryllium-free alloy was used as the control. RESULTS Analysis of variance and Tukeys test showed significant differences (alpha = .001) for the castability test results and significant differences (alpha = .05) for ceramometal bond resistance between alloys. CONCLUSIONS Although the amounts of chromium, manganese, and niobium were maintained, the variations in the amounts of beryllium allowed the estimation that Be-containing alloys presented better castability than Be-free alloys. The 0.9% Be-containing alloy demonstrated higher resistance of the ceramometal bond than the Be-free alloy.

Effect of repeated torque/mechanical loading cycles on two different abutment types in implants with internal tapered connections: an in vitro study

OBJECTIVES Internal tapered connections were developed to improve biomechanical properties and to reduce mechanical problems found in other implant connection systems. The purpose of this study was to evaluate the effects of mechanical loading and repeated insertion/removal cycles on the torque loss of abutments with internal tapered connections. MATERIAL AND METHODS Sixty-eight conical implants and 68 abutments of two types were used. They were divided into four groups: groups 1 and 3 received solid abutments, and groups 2 and 4 received two-piece abutments. In groups 1 and 2, abutments were simply installed and uninstalled; torque-in and torque-out values were measured. In groups 3 and 4, abutments were installed, mechanically loaded and uninstalled; torque-in and torque-out values were measured. Under mechanical loading, two-piece abutments were frictionally locked into the implant; thus, data of group 4 were catalogued under two subgroups (4a: torque-out value necessary to loosen the fixation screw; 4b: torque-out value necessary to remove the abutment from the implant). Ten insertion/removal cycles were performed for every implant/abutment assembly. Data were analyzed with a mixed linear model (P< or =0.05). RESULTS Torque loss was higher in groups 4a and 2 (over 30% loss), followed by group 1 (10.5% loss), group 3 (5.4% loss) and group 4b (39% torque gain). All the results were significantly different. As the number of insertion/removal cycles increased, removal torques tended to be lower. It was concluded that mechanical loading increased removal torque of loaded abutments in comparison with unloaded abutments, and removal torque values tended to decrease as the number of insertion/removal cycles increased.

Endodontically treated teeth: Characteristics and considerations to restore them

The restoration of endodontically treated teeth is a topic that is extensively studied and yet remains controversial. This article emphasizes the characteristics of endodontically treated teeth and some principles to be observed when restorations of these teeth are planned. It was concluded that the amount of remaining coronal tooth structure and functional requirements determine the best way to restore these teeth, indicating the material to be used, direct or indirect restorations, associated or not to posts.

Relation between implant/abutment vertical misfit and torque loss of abutment screws

This study investigated whether there is a direct correlation between the level of vertical misfit at the abutment/implant interface and torque losses (detorque) in abutment screws. A work model was obtained from a metal matrix with five 3.75 x 9 mm external hex implants with standard platform (4.1 mm). Four frameworks were waxed using UCLA type abutments and one-piece cast in commercially pure titanium. The misfit was analyzed with a comparator microscope after 20 Ncm torque. The highest value of misfit observed per abutment was used. The torque required to loose the screw was evaluated using a digital torque meter. The torque loss values, measured by the torque meter, were assumed as percentage of initial torque (100%) given to abutment screws. Pearsons correlation (alpha=0.05) between the misfit values (29.08 +/- 8.78 microm) and the percentage of detorque (50.71 +/- 11.37%) showed no statistically significant correlation (p=0.295). Within the limitations of this study, it may be concluded that great vertical misfits dot not necessarily implies in higher detorque values.

Correlation between vertical misfits and stresses transmitted to implants from metal frameworks

An inappropriate prosthetic fit could cause stress over the interface implant/bone. The objective of this study was to compare stresses transmitted to implants from frameworks cast using different materials and to investigate a possible correlation between vertical misfits and these stresses. Fifteen one-piece cast frameworks simulating bars for fixed prosthesis in a model with five implants were fabricated and arranged into three different groups according to the material used for casting: CP Ti (commercially pure titanium), Co-Cr (cobalt-chromium) or Ni-Cr-Ti (nickel-chromium-titanium) alloys. Each framework was installed over the metal model with all screws tightened to a 10 N cm torque and then, vertical misfits were measured using an optical microscope. The stresses transmitted to implants were measured using quantitative photoelastic analysis in values of maximum shear stress (τ), when each framework was tightened to the photoelastic model to a 10 N cm standardized torque. Stress data were statistically analyzed using one-way ANOVA and Tukeys test and correlation tests were performed using Pearsons rank correlation (α = 0.05). Mean and standard deviation values of vertical misfit are presented for CP Ti (22.40 ± 9.05 μm), Co-Cr (66.41 ± 35.47 μm) and Ni-Cr-Ti (32.20 ± 24.47 μm). Stresses generated by Co-Cr alloy (τ = 7.70 ± 2.16 kPa) were significantly higher than those generated by CP Ti (τ = 5.86 ± 1.55 kPa, p = 0.018) and Ni-Cr-Ti alloy (τ = 5.74 ± 3.05 kPa, p = 0.011), which were similar (p = 0.982). Correlations between vertical misfits and stresses around the implants were not significant as for any evaluated materials.

Digital image correlation analysis of the load transfer by implant-supported restorations

This study compared splinted and non-splinted implant-supported prosthesis with and without a distal proximal contact using a digital image correlation method. An epoxy resin model was made with acrylic resin replicas of a mandibular first premolar and second molar and with threaded implants replacing the second premolar and first molar. Splinted and non-splinted metal-ceramic screw-retained crowns were fabricated and loaded with and without the presence of the second molar. A single-camera measuring system was used to record the in-plane deformation on the model surface at a frequency of 1.0Hz under a load from 0 to 250N. The images were then analyzed with specialist software to determine the direct (horizontal) and shear strains along the model. Not splinting the crowns resulted in higher stress transfer to the supporting implants when the second molar replica was absent. The presence of a second molar and an effective interproximal contact contributed to lower stress transfer to the supporting structures even for non-splinted restorations. Shear strains were higher in the region between the molars when the second molar was absent, regardless of splinting. The opposite was found for the region between the implants, which had higher shear strain values when the second molar was present. When an effective distal contact is absent, non-splinted implant-supported restorations introduce higher direct strains to the supporting structures under loading. Shear strains appear to be dependent also on the region within the model, with different regions showing different trends in strain changes in the absence of an effective distal contact.

Modified section method for laser-welding of ill-fitting cp Ti and Ni–Cr alloy one-piece cast implant-supported frameworks

This study aimed to verify the effect of modified section method and laser-welding on the accuracy of fit of ill-fitting commercially pure titanium (cp Ti) and Ni-Cr alloy one-piece cast frameworks. Two sets of similar implant-supported frameworks were constructed. Both groups of six 3-unit implant-supported fixed partial dentures were cast as one-piece [I: Ni-Cr (control) and II: cp Ti] and evaluated for passive fitting in an optical microscope with both screws tightened and with only one screw tightened. All frameworks were then sectioned in the diagonal axis at the pontic region (III: Ni-Cr and IV: cp Ti). Sectioned frameworks were positioned in the matrix (10-Ncm torque) and laser-welded. Passive fitting was evaluated for the second time. Data were submitted to anova and Tukey-Kramer honestly significant difference tests (P < 0.05). With both screws tightened, one-piece cp Ti group II showed significantly higher misfit values (27.57 +/- 5.06 microm) than other groups (I: 11.19 +/- 2.54 microm, III: 12.88 +/- 2.93 microm, IV: 13.77 +/- 1.51 microm) (P < 0.05). In the single-screw-tightened test, with readings on the opposite side to the tightened side, Ni-Cr cast as one-piece (I: 58.66 +/- 14.30 microm) was significantly different from cp Ti group after diagonal section (IV: 27.51 +/- 8.28 microm) (P < 0.05). On the tightened side, no significant differences were found between groups (P > 0.05). Results showed that diagonally sectioning ill-fitting cp Ti frameworks lowers misfit levels of prosthetic implant-supported frameworks and also improves passivity levels of the same frameworks when compared to one-piece cast structures.

Implant/abutment vertical misfit of one-piece cast frameworks made with different materials

This study compared vertical and passive fit of one-piece cast frameworks made with 3 different materials: commercially pure titanium (CP Ti - G1), cobalt-chromium alloy (Co-Cr - G2) and nickel-chromium-titanium alloy (Ni-Cr-Ti - G3). Fifteen frameworks were obtained simulating bars for fixed prosthesis in a model with 5 implants. The passive and vertical fit of the framework interface was measured using an optical microscope at x30 magnification. Data were statistically analyzed by ANOVA and LSD tests (α=0.05). Mean and standard deviation values for passive fit and vertical fit were, respectively: G1 [472.49 (109.88) µm and 29.9 (13.24) µm], G2 [584.84 (120.20) µm and 27.05 (10.30) µm], and G3 [462.70 (179.18) µm and 24.95 (11.14) µm]. For vertical fit, there were no significant differences among G1, G2 and G3 (p=0.285). There were no significant differences for passive fit between G1 and G3 (p=0.844), but both differed significantly from G2 (p=0.028 and p=0.035, respectively), which showed the highest misfit values. It may be concluded that the vertical fit of frameworks was not affected by the tested materials, and that one-piece cast frameworks resulted in inadequate passive fit. The Co-Cr alloy presented the worst values for passive fit.

Evaluation of the adaptation interface of one-piece implant-supported superstructures obtained in Ni-Cr-Ti and Pd-Ag alloys

Several formulations of alternative alloys have been proposed for the substitution of gold-based alloys used in Dentistry. Recently, a Ni-Cr-Ti-based alloy has been introduced. The purpose of this work was to verify the marginal adaptation obtained with one-piece superstructures for implant-supported prostheses obtained in Ni-Cr-Ti alloy, compared to a semi-noble alloy Pd-Ag. Eight superstructures for each alloy were produced over 4 implants in the anterior region of the mandible. The superstructures were placed in a torquemeter and the fixation screw of implant #1 was tightened with a 20 Ncm load with the others loosened (Sheffield test). The unfitness (in mm) was measured using a three-dimensional optical measurer in each implant, in the buccal and lingual aspects. The obtained data were submitted to statistical analysis by the analysis of variance and Tukeys test at 5% level. Significant differences were found for the factors material (p< or =0.05), with Ni-Cr-Ti pieces better than Pd-Ag ones, and implants (p< or =0.01). There were no significant differences for the factor position and interactions among factors (p>0.05). Based on the analysis of the data, it is possible to conclude that the Ni-Cr-Ti alloy makes possible the obtainment of one-piece implant-supported superstructures with a smaller misfit compared to the one obtained in Pd-Ag alloy, traditionally indicated for this situation. Additional tests may verify the superiority of the Ni-Cr-Ti alloy.

Validation of finite element models for strain analysis of implant-supported prostheses using digital image correlation

OBJECTIVES A validated numerical model for stress/strain predictions is essential in understanding the biomechanical behavior of implant-supported dental prostheses. The digital image correlation (DIC) method for full-field strain measurement was compared with finite element analysis (FEA) in assessing bone strain induced by implants. METHODS An epoxy resin model simulating the lower arch was made for the experimental test with acrylic resin replicas of the first premolar and second molar and threaded implants replacing the second premolar and first molar. Splinted (G1/G3) and non-splinted (G2/G4) metal-ceramic screw-retained crowns were fabricated and loaded with (G1/G2) or without (G3/G4) the second molar that provided proximal contact. A single-camera, two-dimensional DIC system was used to record deformation of the resin model surface under a load of 250N. Three-dimensional finite element (FE) models were constructed for the physical models using computer-aided design (CAD) software. Surface strains were used for comparison between the two methods, while internal strains at the implant/resin block interface were calculated using FEA. RESULTS Both methods found similar strain distributions over the simulant bone block surface, which indicated possible benefits of having splinted crowns and proximal contact in reducing bone strains. Internal strains predicted by FEA at the implant-resin interface were 8 times higher than those on the surface of the model, and they confirmed the results deduced from the surface strains. FEA gave higher strain values than experiments, probably due to incorrect material properties being used. SIGNIFICANCE DIC is a useful tool for validating FE models used for the biomechanical analysis of dental prosthesis.