Fabrication systems for restorations and fixed dental prostheses made of titanium and titanium alloys

Growth factor-functionalized titanium implants for enhanced bone regeneration: A review

Titanium and titanium alloys are widely favored materials for orthopedic implants due to their exceptional mechanical properties and biological inertness. The additional benefit of sustained local release of bioactive substances further promotes bone tissue formation, thereby augmenting the osseointegration capacity of titanium implants and attracting increasing attention in bone tissue engineering. Among these bioactive substances, growth factors have shown remarkable osteogenic and angiogenic induction capabilities. Consequently, researchers have developed various physical, chemical, and biological loading techniques to incorporate growth factors into titanium implants, ensuring controlled release kinetics. In contrast to conventional treatment modalities, the localized release of growth factors from functionalized titanium implants not only enhances osseointegration but also reduces the risk of complications. This review provides a comprehensive examination of the types and mechanisms of growth factors, along with a detailed exploration of the methodologies used to load growth factors onto the surface of titanium implants. Moreover, it highlights recent advancements in the application of growth factors to the surface of titanium implants (Scheme 1). Finally, the review discusses current limitations and future prospects for growth factor-functionalized titanium implants. In summary, this paper presents cutting-edge design strategies aimed at enhancing the bone regenerative capacity of growth factor-functionalized titanium implants-a significant advancement in the field of enhanced bone regeneration.

In vitro damping and strain distribution for implant-supported crowns using 5 different CAD-CAM crowns and 3 different luting cements

STATEMENT OF PROBLEM

Dental implants are particularly susceptible to occlusal overloading because, unlike natural teeth, they lack a periodontal ligament to help absorb occlusal forces. However, studies evaluating the impact of different crown and luting materials on the damping behavior and strain distribution of implant-supported crowns are lacking.

PURPOSE

The purpose of this in vitro study was to investigate the damping behavior and strain distribution of peri-implant bone associated with 5 different CAD-CAM implant-supported crowns and 3 luting materials.

MATERIAL AND METHODS

A titanium implant was embedded in a plastic tube with epoxy resin and 5 different crown materials (polymethyl methacrylate, resin-infiltrated ceramic, lithium disilicate, titanium, and zirconia) luted to prosthetic abutments with 3 different luting materials (zinc oxide non-eugenol cement, zinc phosphate cement, and adhesive resin cement) and an uncemented condition were tested (n=5). Strain gauges were attached at the crestal and apical levels of the implant model. All specimens were load tested from 0 to 200 N. Slopes of load/time, microstrain/time, and time required to reach the maximum load were examined to represent the damping behavior. Absolute maximum strain (AMS) and its occurrence level were examined to represent the strain distribution. Two-way ANOVA, followed by the Tukey HSD test, were used for statistical analysis (α=.05).

RESULTS

All slopes and times to reach the maximum load in each crown material were statistically similar (P>.05), except for the polymethyl methacrylate group, which showed less steepness in all slopes and more time required to reach the maximum load significantly (P<.05). Both the polymethyl methacrylate group (224.5 ±30.2) and the titanium group (224.0 ±24.3) exhibited significantly higher AMS at the crestal level compared with the resin-infiltrated ceramic group (210.6 ±5.0) (P<.05). The lithium disilicate (218.1 ±15.0) and zirconia groups (217.3 ±14.8) demonstrated comparable AMS values with the others (P>.05). The uncemented group demonstrated steeper slopes and less time required to reach the maximum load compared with the adhesive resin group (P<.05), while slopes and times of the zinc phosphate and zinc oxide non-eugenol groups were comparable (P>.05). The uncemented group (242.7 ±25.3) exhibited significantly higher AMS at the crestal level than the other groups (P<.05).

CONCLUSIONS

The crown material significantly affected the damping behavior of peri-implant bone, unlike the luting material. Polymethyl methacrylate with a high damping behavior exhibited high strain at the crestal level. In contrast, resin-modified ceramic with a moderate damping behavior exhibited low strain at the crestal level. Strain at the crestal level could be effectively reduced by approximately 13% through cementation.

Use of Biomaterials in 3D Printing as a Solution to Microbial Infections in Arthroplasty and Osseous Reconstruction

The incidence of microbial infections in orthopedic prosthetic surgeries is a perennial problem that increases morbidity and mortality, representing one of the major complications of such medical interventions. The emergence of novel technologies, especially 3D printing, represents a promising avenue of development for reducing the risk of such eventualities. There are already a host of biomaterials, suitable for 3D printing, that are being tested for antimicrobial properties when they are coated with bioactive compounds, such as antibiotics, or combined with hydrogels with antimicrobial and antioxidant properties, such as chitosan and metal nanoparticles, among others. The materials discussed in the context of this paper comprise beta-tricalcium phosphate (β-TCP), biphasic calcium phosphate (BCP), hydroxyapatite, lithium disilicate glass, polyetheretherketone (PEEK), poly(propylene fumarate) (PPF), poly(trimethylene carbonate) (PTMC), and zirconia. While the recent research results are promising, further development is required to address the increasing antibiotic resistance exhibited by several common pathogens, the potential for fungal infections, and the potential toxicity of some metal nanoparticles. Other solutions, like the incorporation of phytochemicals, should also be explored. Incorporating artificial intelligence (AI) in the development of certain orthopedic implants and the potential use of AI against bacterial infections might represent viable solutions to these problems. Finally, there are some legal considerations associated with the use of biomaterials and the widespread use of 3D printing, which must be taken into account.

Surveillance study on the application of titanium and its alloys to removable dental prostheses

This review describes individual studies of removable dental prostheses, evaluated their performance and clinical applicability for the proposal to expand health insurance coverage of titanium and its alloys to removable dental prostheses. Titanium and its alloys have become clinically applicable as prosthetic materials by improving dental casting systems. They have high biosafety and good mechanical properties, are excellent substitutes for the silver-palladium-gold alloys for casting, and are highly useful for removable dental prostheses. Therefore, the introduction of health insurance coverage for removable dental prostheses made of titanium and its alloys is worthy of consideration.

Effect of internal design changes on the mechanical properties of laser-sintered cobalt-chromium specimens

STATEMENT OF PROBLEM

Changing the internal design of a metal framework may decrease the manufacturing time, the weight of the restoration, and the amount of alloy powder used, as well as simplify the fabrication process.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of framework internal design changes on the mechanical properties of cobalt-chromium (Co-Cr) specimens manufactured by using direct metal laser sintering (DMLS).

MATERIAL AND METHODS

Dumbbell-shaped test specimens were designed as per the International Organization for Standardization (ISO) 22674(E) standard by using a 3-dimensional software program. A total of 70 dumbbell-shaped specimens were prepared by using Co-Cr alloy powder and DMLS (n=10). The control group specimens were solid with the internal completely filled. For the test groups, the internal design of the dumbbell-shaped specimens was modified. Leaving the outer shell thickness of the specimens at 0.5 mm for all test groups, 6 different internal designs were created, and the specimens were weighed. The tensile strength test was used to evaluate the mean peak strength, elastic modulus, and percentage elongation of the specimens. One-way ANOVA followed by the Dunnett T3 test was used for statistical analysis (α=.05).

RESULTS

A statistically significant difference was found among the groups in terms of bar weight and peak strength (P<.05). The highest values were observed in the control group for all evaluated parameters (mean ±standard deviation bar weight: 1321.3 ±36.6 mg, peak strength: 1045 ±36.7 MPa, elastic modulus: 284.2 ±71.9 GPa, and elongation: 28.7 ±7%). However, no statistically significant difference was observed for elastic modulus or percentage of elongation (P>.05).

CONCLUSIONS

Decreasing the weight of the frameworks by changing the internal design of the specimens also decreased the peak strength. However, it did not affect the elastic modulus or the percentage of elongation.

Titanium and titanium alloys in dentistry: current trends, recent developments, and future prospects

Many implant materials have been used in various dental applications depending on their efficacy and availability. A dental implant must possess the required characteristics, such as biocompatibility, corrosion & wear resistance, adequate mechanical properties, osseointegration, etc., to ensure its safe and optimum use. This review analyzes various aspects of titanium (Ti) and Ti alloys, including properties, manufacturing processes, surface modifications, applications as dental implants, and limitations. In addition, it also presents a perception of recent advances in Ti-based implant materials and the futuristic development of innovative dental implants.

Bonding of resin luting materials to titanium and titanium alloy

Recently in Japan, due to the increased prices of palladium and gold, cast titanium restorations have been included in the Japanese national health insurance system. The purpose of this review was to survey the available literature on titanium bonding systems, focusing on the adhesive monomer in the luting agent in order to expand the application of resin-bonded fixed prostheses made of titanium or titanium alloys. It was found that adhesive monomers are effective for bonding to titanium, and provide results equal to the procedures of silanization and tribochemical silica coating. A primer or a luting agent, including 10-methacryloyloxydecyl dihydrogen phosphate (MDP), methacryloyloxyalkyl thiophosphate derivative (MEPS), 6-methacryloxyhexyl phosphonoacetate (6-MHPA), and 4-methacryloyloxyethl trimellitate anhydride (4-META) promotes bonding characteristics between titanium and the resin material.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.

Fabrication of titanium restoration by means of calcium aluminate-bonded magnesia investment material and one-chamber arc casting apparatus

Cast titanium restoration for molars has high biocompatibility and is covered by the Japanese national health insurance. Titanium casting requires specific investment material and casting apparatus. A cast restoration for the mandibular left second molar was fabricated using titanium in this study. A wax pattern fabricated on a definitive cast was invested in calcium aluminate-bonded magnesia investment material. Titanium was cast using an argon gas pressure one-chamber casting apparatus. No defects were observed on the surface and the hole was clearly reproduced. A smooth surface on the restoration was obtained by polishing at low speed. Reproductivity and polishing properties of the titanium restoration fabricated in this study were comparable to those of conventional dental metal restorations.