Youssef S. Al Jabbari

Selective Laser Melting Technique of Co-Cr Dental Alloys: A Review of Structure and Properties and Comparative Analysis with Other Available Techniques.

PURPOSE The aim of this study was to review the effect of selective laser melting (SLM) procedure on the properties of dental structures made of Co-Cr alloys and to evaluate its quality and compare it to those produced by conventional casting and milling fabrication techniques. MATERIALS AND METHODS A computerized database search using PubMed and Scopus was conducted for peer-reviewed scientific research studies regarding the use of SLM in Co-Cr dental alloys with no restrictions for publication years. The search engines provided hundreds of results, and only 48 scientific research papers, case studies, or literature reviews were considered relevant for this review. RESULTS The innovative manufacturing concept of SLM offers many advantages compared with casting and milling fabrication techniques. SLM provides different microstructure from casting and milling with minimal internal porosity and internal fitting, marginal adaptation, and comparable bond strength to porcelain. Mechanical and electrochemical properties of SLM structures are enhanced compared to cast, while clinical longevity of single-metal ceramic crowns is comparable to Au-Pt dental alloy. CONCLUSION The SLM technique provides dental prosthetic restorations more quickly and less expensively without compromising their quality compared with restorations prepared by casting and milling techniques. CLINICAL SIGNIFICANCE The current SLM devices provide metallic restorations made of Co-Cr alloys for removable and fixed partial dentures without compromising the alloy or restoration properties at a fraction of the time and cost, showing great potential to replace the aforementioned fabrication techniques in the long term; however, further clinical studies are essential to increase the acceptance of this technology by the worldwide dental community.

Physico-mechanical properties and prosthodontic applications of Co-Cr dental alloys: a review of the literature

Cobalt-Chromium (Co-Cr) alloys are classified as predominantly base-metal alloys and are widely known for their biomedical applications in the orthopedic and dental fields. In dentistry, Co-Cr alloys are commonly used for the fabrication of metallic frameworks of removable partial dentures and recently have been used as metallic substructures for the fabrication of porcelain-fused-to-metal restorations and implant frameworks. The increased worldwide interest in utilizing Co-Cr alloys for dental applications is related to their low cost and adequate physico-mechanical properties. Additionally, among base-metal alloys, Co-Cr alloys are used more frequently in many countries to replace Nickel-Chromium (Ni-Cr) alloys. This is mainly due to the increased concern regarding the toxic effects of Ni on the human body when alloys containing Ni are exposed to the oral cavity. This review article describes dental applications, metallurgical characterization, and physico-mechanical properties of Co-Cr alloys and also addresses their clinical and laboratory behavior in relation to those properties.

Mechanical Behavior and Failure Analysis of Prosthetic Retaining Screws after Long‐term Use in vivo. Part 4: Failure Analysis of 10 Fractured Retaining Screws Retrieved from Three Patients

PURPOSE The aim of this study was to perform a failure analysis on fractured prosthetic retaining screws after long-term use in vivo. Additionally, the study addresses the commonly asked question regarding whether complex repeated functional occlusal forces initiate fatigue-type cracks in prosthetic retaining screws. MATERIALS AND METHODS Ten fractured prosthetic retaining screws retrieved from three patients treated with fixed detachable hybrid prostheses were subjected to a failure analysis. In patients 1 and 2, the middle three retaining screws of the prostheses were found fractured at retrieval time after they had been in service for 20 and 19 months, respectively. In patient 3, the middle three and one of the posterior retaining screws were found to be fractured at retrieval after they had been in service for 18 months. Low power stereomicroscopy and high-power scanning electron microscopy (SEM) were performed to analyze the fractured surfaces of the retaining screws examining fatigue cracks in greater detail. RESULTS Typical fatigue failure characterized by ratchet mark formation was revealed by light microscopy and SEM for all examined screws. Using low magnification light microscopy, ratchet marks were visible on the fracture surfaces of only two screws. SEM examination revealed all three classical stages of fatigue failure, and it was possible to see the ratchet marks on the fracture surfaces of all specimens, indicating a fatigue zone. The final catastrophic overload fracture appeared fibrous, indicating ductile fracture. The final overload ductile fracture surfaces showed equiaxed dimples, suggesting tensile overload in all examined screws except in two specimens that showed an elongated dimple pattern indicating shear/tearing overload forces. CONCLUSIONS Fracture of prosthetic retaining screws in hybrid prostheses occurs mainly through a typical fatigue mode involving mostly the middle anterior three screws. Fatigue cracks can grow in more than one prosthetic retaining screw, leading to fracture before the patient or clinician determines that any problem exists.

Mechanical Behavior and Failure Analysis of Prosthetic Retaining Screws after Long-term Use In Vivo. Part 3: Preload and Tensile Fracture Load Testing

PURPOSE The aim of this study was to determine the preload and tensile fracture load values of prosthetic retaining screws after long-term use in vivo compared to unused screws (controls). Additionally, the investigation addressed whether the preload and fracture load values of prosthetic retaining screws reported by the manufacturer become altered after long-term use in vivo. MATERIALS AND METHODS For preload testing, 10 new screws (controls) from Nobel Biocare (NB) and 73 used retaining screws [58 from NB and 15 from Sterngold (SG)] were subjected to preload testing. For tensile testing, eight controls from NB and 58 used retaining screws (46 from NB and 12 from SG) were subjected to tensile testing. Used screws for both tests were in service for 18-120 months. A custom load frame, load cell, and torque wrench setup were used for preload testing. All 83 prosthetic screws were torqued once to 10 Ncm, and the produced preload value was recorded (N) using an X-Y plotter. Tensile testing was performed on a universal testing machine and the resulting tensile fracture load value was recorded (N). Preload and tensile fracture load values were analyzed with 2-way ANOVA and Tukey post-hoc tests. RESULTS There was a significant difference between preload values for screws from NB and screws from SG (p < 0.001). The preload values for gold alloy screws from NB decreased as the number of years in service increased. There was a significant difference between tensile fracture values for the three groups (gold alloy screws from NB and SG and palladium alloy screws from NB) at p < 0.001. The tensile fracture values for gold alloy screws from NB and SG decreased as the number of years in service increased. CONCLUSIONS In fixed detachable hybrid prostheses, perhaps as a result of galling, the intended preload values of prosthetic retaining screws may decrease with increased in-service time. The reduction of the fracture load value may be related to the increase of in-service time; however, the actual determination of this relationship is not possible from this study alone.

Metallurgical and electrochemical characterization of contemporary silver-based soldering alloys

OBJECTIVE To investigate the microstructure, hardness, and electrochemical behavior of four contemporary Ag-based soldering alloys used for manufacturing orthodontic appliances. MATERIALS AND METHODS The Ag-based alloys tested were Dentaurum Universal Silver Solder (DEN), Orthodontic Solders (LEO), Ortho Dental Universal Solder (NOB), and Silver Solder (ORT). Five disk-shaped specimens were produced for each alloy, and after metallographic preparation their microstructural features, elemental composition, and hardness were determined by scanning electron microscopy with energy-dispersive X-ray (EDX) microanalysis, X-ray diffraction (XRD) analysis, and Vickers hardness testing. The electrochemical properties were evaluated by anodic potentiodynamic scanning in 0.9% NaCl and Ringers solutions. Hardness, corrosion current (Icorr), and corrosion potential (Ecorr) were statistically analyzed by one-way analysis of variance and Tukey test (α=.05). RESULTS EDX analysis showed that all materials belong to the Ag-Zn-Cu ternary system. Three different mean atomic contrast phases were identified for LEO and ORT and two for DEN and NOB. According to XRD analysis, all materials consisted of Ag-rich and Cu-rich face-centered cubic phases. Hardness testing classified the materials in descending order as follows: DEN, 155±3; NOB, 149±3; ORT, 141±4; and LEO, 136±8. Significant differences were found for Icorr of NOB in Ringers solution and Ecorr of DEN in 0.9% NaCl solution. CONCLUSION Ag-based soldering alloys demonstrate great diversity in their elemental composition, phase size and distribution, hardness, and electrochemical properties. These differences may anticipate variations in their clinical performance.

Multitechnique characterization of CPTi surfaces after electro discharge machining (EDM).

ObjectivesThe aim of this study was to comparatively assess the surface roughness parameters, the hardness, and the elemental and molecular alterations induced on CPTi surfaces after conventional finishing and finishing with electro discharge machining (EDM).Materials and methodsA completed cast model of an arch that received four implants was used for the preparation of two grade II CPTi castings. One framework was conventionally finished (CF), whereas the other was subjected to EDM finishing. The surface morphology was imaged employing SEM. 3D surface parameters (Sa, Sq, Sz, Sds, Sdr, and Sci) were calculated by optical profilometry. The elemental composition of the treated surfaces was determined by energy dispersive X-ray analysis, whereas the elemental and chemical states of the outmost layer were investigated by X-ray photoelectron spectrometry. Surface hardness was also tested with a Knoop indenter. The results of surface roughness parameters, elemental analysis, and hardness were compared using unpaired t test (a = 0.05).ResultsThe EDM group demonstrated a rougher surface, with a significant uptake of C and Cu. The CF surface mainly consisted of TiO2. On EDM surface though, Ti was probed in different chemicals states (TiO2, Ti2O3, TiC and metallic Ti) and Cu was traced as Cu2O and CuO. Hardness after EDM was almost ten times higher than CF.ConclusionsEDM significantly affected surface roughness, chemical state, and hardness properties of grade II CPTi castings in comparison with CF.Clinical relevanceThe morphological and elemental alterations of EDM-treated CPTi surfaces may strongly contribute to the reduced corrosion resistance documented for this procedure. The degradation of electrochemical properties may have further biological implications through ionic release in the oral environment.

Frenectomy for improvement of a problematic conventional maxillary complete denture in an elderly patient: a case report

Maxillary labial and buccal frena are considered as normal anatomic structures in the oral cavity. However, they may exist intraorally as a thick broad fibrous attachment and/or become located near the crest of the residual ridge, thus interfering with proper denture border extension resulting in inferior denture stability, retention and overall patient satisfaction. This case report highlights the importance of clinical examination and treatment planning which may mandate preprosthetic surgery prior to fabrication of a new conventional complete denture. Adequate patient satisfaction with conventional complete dentures can be significantly increased after frenectomy.

Galvanic coupling of steel and gold alloy lingual brackets with orthodontic wires: Is corrosion a concern?

OBJECTIVES The aim of this research was to assess galvanic behavior of lingual orthodontic brackets coupled with representative types of orthodontic wires. MATERIALS AND METHODS Three types of lingual brackets: Incognito (INC), In-Ovation L (IOV), and STb (STB) were combined with a stainless steel (SS) and a nickel-titanium (NiTi) orthodontic archwire. All materials were initially investigated by scanning electron microscopy / x-ray energy dispersive spectroscopy (SEM/EDX) while wires were also tested by x-ray diffraction spectroscopy (XRD). All bracket-wire combinations were immersed in acidic 0.1M NaCl 0.1M lactic acid and neutral NaF 0.3% (wt) electrolyte, and the potential differences were continuously recorded for 48 hours. RESULTS The SEM/EDX analysis revealed that INC is a single-unit bracket made of a high gold (Au) alloy while IOV and STB are two-piece appliances in which the base and wing are made of SS alloys. The SS wire demonstrated austenite and martensite iron phase, while NiTi wire illustrated an intense austenite crystallographic structure with limited martensite. All bracket wire combinations showed potential differences below the threshold of galvanic corrosion (200 mV) except for INC and STB coupled with NiTi wire in NaF media. CONCLUSIONS The electrochemical results indicate that all brackets tested demonstrated galvanic compatibility with SS wire, but fluoride treatment should be used cautiously with NiTi wires coupled with Au and SS brackets.

Surface and cross-sectional characterization of titanium-nitride coated nickel–titanium endodontic files

Background/purpose Although the effect of experimental surface modifications on various properties (e.g., fatigue, wear) on coated files have been tested in the past, there is no report for the coating quality of commercially available TiN coated files. The aim of this study was to characterize the surface and cross section of TiN coated endodontic files. Materials and methods TiN coated nickel–titanium endodontic files (EasyShape) were surface and cross-sectionally analyzed via scanning electron microscopy backscattered electron imaging and energy-dispersive X-ray spectroscopy analysis in spot, area, and line scan modes. Results Surface imaging revealed parallel oblong regions with higher mean atomic contrast, a finding attributed to increased Ni content. Cross-sectional analysis showed that the coating’s average total thickness was 0.31 μm and consisted of a thin layered film. Energy-dispersive X-ray spectroscopy analysis revealed the presence of Ti, Ni, N, and O in the coating, whereas only Ni and Ti were identified in the bulk of the file. Ti and O showed their peak compositions at the bulk/coating and coating/surface interfaces, respectively, whereas N displayed a rather constant content within the coated region. The N and O contents started increasing inner to the coating/bulk interface, denoting possible diffusion of both elements to the subcoating region. Conclusion Surface and bulk characterization showed no uncoated areas of the files tested. Apart from Ti, Ni, and N, oxygen was also identified within the coating region.

Does long-term intraoral service affect the mechanical properties and elemental composition of multistranded wires of lingual fixed retainers?

Purpose The aim of this study was to evaluate the elemental and mechanical alterations of stainless steel (SS) multistranded orthodontic wires used in fixed retention after intraoral ageing. Materials and Methods Two types of 0.022-inch, seven-stranded wires, Lingual Retainer Wire (LRW) and Tru-Chrome (TCH), from the same manufacturer (Rocky Mountain Orthodontics, Denver, Colo, USA) were tested. Thirty-three samples from LRW group and thirty-seven from TCH were collected, whereas three unused wires from each package were used as controls. The median ageing time for LRW was 7.4 years and 8.4 for TCH. All samples were subjected to scanning electron microscope/X-ray energy dispersive spectroscopy analysis. Three spectra were taken from the surface of each wire and then all samples were used for the assessment of Martens hardness, indentation modulus (EIT), and elastic index (ηIT) with the instrumented indentation testing method (IIT). The intraoral ageing time was statistically compared between the two groups by Mann-Whitney rank sum test and the compositional and mechanical properties were compared by unpaired t-test. The Spearman correlation between elemental content and ageing time was carried out for all elements (a = 0.05). Results No significant differences were found for both the elemental content and for the mechanical properties between the wires tested. Spearman analysis revealed no correlation between elemental content and intraoral time while two groups share statistically equal intraoral ageing times (P > 0.05). Conclusions Both wires seemed to maintain their mechanical and elemental integrity within a period of 14-year intraoral exposure, whereas no measurable ionic release could be identified.