Titanium applications in dentistry

Mandibular biomechanics rehabilitated with different prosthetic restorations under normal and impact loading scenarios

BACKGROUND

Restorative treatment options for edentulous patients range from traditional dentures to fixed restorations. The proper selection of materials greatly influences the longevity and stability of fixed restorations. Most prosthetic parts are frequently fabricated from titanium. Ceramics (e.g. zirconia) and polymers (e.g. PEEK and BIOHPP) have recently been included in these fabrications. The mandibular movement produces complex patterns of stress and strain. Mandibular fractures may result from these stresses and strains exceeding the critical limits because of the impact force from falls or accidents. Therefore, it is necessary to evaluate the biomechanical behavior of the edentulous mandible with different restorations under different loading situations.

OBJECTIVE

This study analyzes the biomechanical behavior of mandibles after four prosthetic restorations for rehabilitation under normal and impact loading scenarios.

MATERIAL AND METHODS

The mandibular model was constructed with a fixed restoration, which was simulated using various materials (e.g. Titanium, Zirconia & BIOHPP), under frontal bite force, maximum intercuspation, and chin impact force. From the extraction of tensile and compressive stresses and strains, as well as the total deformation of mandible segments, the biomechanical behavior and clinical situations were studied.

RESULTS

Under frontal bite, the anterior body exhibited the highest tensile (60.34 MPa) and compressive (108.81 MPa) stresses using restoration 4, while the condyles and angles had the lowest tensile (7.12 MPa) and compressive (12.67 MPa) stresses using restoration 3. Under maximum intercuspation, the highest tensile (40.02 MPa) and compressive (98.87 MPa) stresses were generated on the anterior body of the cortical bone using restoration 4. Additionally, the lowest tensile (7.7 MPa) and compressive (10.08 MPa) stresses were generated on the condyles and angles, respectively, using restoration 3. Under chin impact, the highest tensile (374.57 MPa) and compressive (387.3 MPa) stresses were generated on the anterior body using restoration 4. Additionally, the lowest tensile (0.65 MPa) and compressive (0.57 MPa) stresses were generated on the coronoid processes using restoration 3. For all loading scenarios, the anterior body of the mandible had the highest stress and strain values compared with the other segments. Compared to the traditional titanium restoration.2, restoration.1(zirconia) increases the tensile and compressive stresses and strains on the mandibular segments, in contrast to restoration.3 (BIOHPP). In addition, zirconia implants exhibited higher displacements than the other implants.

CONCLUSION

In the normal loading scenario, the tensile and compressive stresses and strains on the mandible were within the allowable limits when all restorations were used. Under the chin impact loading scenario, the anterior body of the mandible was damaged by restorations 1 and 4.

Enhanced osteogenic and antibacterial properties of titanium implant surface modified with Zn-incorporated nanowires: Preclinical in vitro and in vivo investigations

OBJECTIVE

This study aimed to synthesize zinc-incorporated nanowires structure modified titanium implant surface (Zn-NW-Ti) and explore its superior osteogenic and antibacterial properties in vitro and in vivo.

MATERIALS AND METHODS

Zn-NW-Ti was synthesized via displacement reactions between zinc sulfate solutions and the titanium (Ti) surface, which was pretreated by hydrofluoric acid etching and hyperthermal alkalinization. The physicochemical properties of the Zn-NW-Ti surface were examined. Moreover, the biological effects of Zn-NW-Ti on MC3T3-E1 cells and its antibacterial property against oral pathogenic bacteria (Staphylococcus aureus, Porphyromonas gingivalis, and Actinobacillus actinomycetemcomitans) compared with sandblasted and acid-etched Ti (SLA-Ti) and nanowires modified Ti (NW-Ti) surface were assessed. Zn-NW-Ti and SLA-Ti modified implants were inserted into the anterior extraction socket of the rabbit mandible with or without exposure to the mixed bacterial solution (S. aureus, P. gingivalis, and A. actinomycetemcomitans) to investigate the osteointegration and antibacterial performance via radiographic and histomorphometric analysis.

RESULTS

The Zn-NW-Ti surface was successfully prepared. The resultant titanium surface appeared as a nanowires structure with hydrophilicity, from which zinc ions were released in an effective concentration range. The Zn-NW-Ti surface performed better in facilitating the adhesion, proliferation, and differentiation of MC3T3-E1 cells while inhibiting the colonization of bacteria compared with SLA-Ti and NW-Ti surface. The Zn-NW-Ti implant exhibited enhanced osseointegration in vivo, which was attributed to increased osteogenic activity and reduced bacterial-induced inflammation compared with the SLA-Ti implant.

CONCLUSIONS

The Zn-incorporated nanowires structure modified titanium implant surface exhibited improvements in osteogenic and antibacterial properties, which optimized osteointegration in comparison with SLA titanium implant surface.

Biological characterization of surface-treated dental implant materials in contact with mammalian host and bacterial cells: titanium versus zirconia

Early-colonizing oral bacterial adhesion and mammal cell proliferation were similar on surface-treated titanium and zirconia.

Titanium removable denture based on a one-metal rehabilitation concept

The use of a single metal for all restorations would be necessary because it protects against metal corrosion caused by the contact of different metals. For this "one-metal rehabilitation" concept, non-alloyed commercially pure (CP) titanium should be used for all restorations. Titanium frameworks have been cast and used for the long term without catastrophic failure, whereas they have been fabricated recently using computer-aided design/computer-aided manufacturing (CAD/CAM). However, the milling process for the frameworks of removable partial dentures (RPDs) is not easy because they have very complicated shapes and consist of many components. Currently, the fabrication of RPD frameworks has been challenged by one-process molding using repeated laser sintering and high-speed milling. Laser welding has also been used typically for repairing and rebuilding titanium frameworks. Although laboratory and clinical problems still remain, the one-metal rehabilitation concept using CP titanium as a bioinert metal can be recommended for all restorations.

The Mechanical Properties and Biometrical Effect of 3D Preformed Titanium Membrane for Guided Bone Regeneration on Alveolar Bone Defect

The purpose of this study is to evaluate the effect of three-dimensional preformed titanium membrane (3D-PFTM) to enhance mechanical properties and ability of bone regeneration on the peri-implant bone defect. 3D-PFTMs by new mechanically compressive molding technology and manually shaped- (MS-) PFTMs by hand manipulation were applied in artificial peri-implant bone defect model for static compressive load test and cyclic fatigue load test. In 12 implants installed in the mandibular of three beagle dogs, six 3D-PFTMs, and six collagen membranes (CM) randomly were applied to 2.5 mm peri-implant buccal bone defect with particulate bone graft materials for guided bone regeneration (GBR). The 3D-PFTM group showed about 7.4 times higher mechanical stiffness and 5 times higher fatigue resistance than the MS-PFTM group. The levels of the new bone area (NBA, %), the bone-to-implant contact (BIC, %), distance from the new bone to the old bone (NB-OB, %), and distance from the osseointegration to the old bone (OI-OB, %) were significantly higher in the 3D-PFTM group than the CM group (p < .001). It was verified that the 3D-PFTM increased mechanical properties which were effective in supporting the space maintenance ability and stabilizing the particulate bone grafts, which led to highly efficient bone regeneration.

Corrosion Analysis of an Experimental Noble Alloy on Commercially Pure Titanium Dental Implants

Objective:

To determine whether the Noble Bond^® Argen^® alloy was electrochemically suitable for the manufacturing of prosthetic superstructures over commercially pure titanium (c.p. Ti) implants. Also, the electrolytic corrosion effects over three types of materials used on prosthetic suprastructures that were coupled with titanium implants were analysed: Noble Bond^® (Argen^®), Argelite 76sf +^® (Argen^®), and commercially pure titanium.

Materials and Methods:

15 samples were studied, consisting in 1 abutment and one c.p. titanium implant each. They were divided into three groups, namely: Control group: five c.p Titanium abutments (B&W^®), Test group 1: five Noble Bond^® (Argen^®) cast abutments and, Test group 2: five Argelite 76sf +^® (Argen^®) abutments. In order to observe the corrosion effects, the surface topography was imaged using a confocal microscope. Thus, three metric parameters (Sa: Arithmetical mean height of the surface. Sp: Maximum height of peaks. Sv: Maximum height of valleys.), were measured at three different areas: abutment neck, implant neck and implant body. The samples were immersed in artificial saliva for 3 months, after which the procedure was repeated. The metric parameters were compared by statistical analysis.

Results:

The analysis of the Sa at the level of the implant neck, abutment neck and implant body, showed no statistically significant differences on combining c.p. Ti implants with the three studied alloys. The Sp showed no statistically significant differences between the three alloys. The Sv showed no statistically significant differences between the three alloys.

Conclusion:

The effects of electrogalvanic corrosion on each of the materials used when they were in contact with c.p. Ti showed no statistically significant differences.

Corrosion behavior of dental alloys used for retention elements in prosthodontics

The purpose of this study was to investigate the corrosion behavior of 10 different high noble gold-based dental alloys, used for prosthodontic retention elements, according to ISO 10271. Samples of 10 high-noble and noble gold-based dental alloys were subjected to: (i) static immersion tests with subsequent analysis of ion release for eight different elements using mass spectrometry; (ii) electrochemical tests, including open-circuit potential and potentiodynamic scans; and (iii) scanning electron microscopy, followed by energy-dispersive X-ray microscopy. The results were analyzed using one-way ANOVA and Sidak multiple-comparisons post-hoc test at a level of significance of α = 0.05. Significant differences were found among the 10 alloys studied for all ions (P < 0.001). The potentiodynamic analysis showed values from -82.5 to 102.8 mV for the open-circuit potential and from 566.7 to 1367.5 mV for the breakdown potential. Both the open-circuit and the breakdown potential varied considerably among these alloys. Scanning electron microscopy analysis confirmed the existence of typically small-diameter corrosion defects, whilst the energy-dispersive X-ray analysis found no significant alteration in the elemental composition of the alloys. The results of this study reveal the variability in the corrosive resistance among the materials used for retention elements in prosthodontics.

Effect of metal type and surface treatment on shear bond strength of resin cement (in vitro study)

BACKGROUND

Resin-bonded fixed partial dentures appeared to prevent the excessive preparation of dental tissue. Investigation of surface treatments to improve the bond of resin cements to metals may contribute to the longevity of these restorations. Due to the potential lack of ideal preparation form, the type of alloy and its surface pretreatment may have clinically relevant correlations with the retentive strength of castings to minimally retentive preparations.

AIM

The aim of this search is to study the bonding resin cement strength to different types of the metal alloy due to the surface treatment.

PURPOSE

Evaluate the effects of two different surface treatments on shear bond strength (SBS) between a palladium-silver alloy (Pb-Ag) and commercially pure titanium (CP Ti) cast alloy with resin luting cements.

MATERIALS AND METHODS

A total of 120 cylinders having 5 mm in diameter and 4 mm in height were divided into two different main groups of metal type: 60 cylinders cast from CP Ti Grade I (Tritan - Reintitan - Germany-Dentaurum) as a base metal and 60 cylinders cast from Pb-Ag (Status-Yamakin, Japan) as a noble metal. 30 cylinders from each type were embedded in acrylic resin, and the rest were left without embedded in acrylic resin. All of the cylinders were smoothed with silicon carbide papers and sandblasting with 50-μm aluminum oxide. Specimens of each metal type were divided into two subgroups, which received one of the following luting techniques: (1) Multilink (Ivoclar Vivadent), (2) Multilink (Ivoclar Vivadent) plus metal zirconia primer (MZP). Every two cylinders from the same metal type and surface treatment were bonded to each other. All specimens were stored in distilled water at 37°C for 24 h and then thermal cycled (500 cycles, 5-55°C). After thermal cycling, the specimens were stored in 37°C distilled water for an additional 24 h before being tested in shear strength. Data (MPa) were analyzed using T-s tests to study the significance of various - means among groups and perform a comparison between each two groups of them.

RESULTS

The T-s tests indicated significant effect of combination of the sandblasting technique (aluminum oxide particles 50 μm) with the application of primer MZP before using resin cement (P < 0.05) independent of the metal type used. The metal type did not significantly affect SBS for any of the compared surface pretreatments.

CONCLUSION

Metal primer application significantly enhanced SBS to base and a noble metal. No significant differences in shear strength were found between alloys.

Fabrication of titanium alloy frameworks for complete dentures by selective laser melting

STATEMENT OF PROBLEM

Casting difficulties have led to the limited use of titanium in dental prostheses. The selective laser melting system was recently developed to fabricate biomedical components from titanium alloys. However, the fabrication of a titanium alloy framework for a maxillary complete denture by selective laser melting has not yet been investigated.

PURPOSE

The purpose of the study was to fabricate thin titanium alloy frameworks for a maxillary complete denture with a selective laser melting system and to evaluate their hardness and microstructure.

MATERIAL AND METHODS

A cast of an edentulous maxilla was scanned with a dental 3-dimensional cone-beam computed tomography system, and standard triangulation language data were produced with the DICOM Viewer (Digital Imaging and Communications in Medicine). Two types of metal frameworks for complete dentures were designed with 3-dimensional computer-aided design software. Two titanium alloy frameworks, SLM-1 and SLM-2, were fabricated from these designs with the selective laser melting system. Plate-shaped specimens were cut from the central flat region of SLM-1, SLM-2, and as-cast Ti-6Al-4V (As-cast). Vickers hardness testing, optical microscopy, and x-ray diffraction measurements were performed.

RESULTS

Thin titanium alloy frameworks for maxillary complete dentures could be fabricated by selective laser melting. The hardness values for SLM-1 and SLM-2 were higher than that for the as-cast specimen. Optical microscopy images of the SLM-1 and SLM-2 microstructure showed that the specimens did not exhibit pores, indicating that dense frameworks were successfully obtained with the selective laser melting process. In the x-ray diffraction patterns, only peaks associated with the α phase were observed for SLM-1 and SLM-2. In addition, the lattice parameters for SLM-1 and SLM-2 were slightly larger than those for the as-cast specimen.

CONCLUSIONS

The mechanical properties and microstructure of the denture frameworks prepared by selective laser melting indicate that these dentures are appropriate for clinical use.

Metallic ion content and damage to the DNA in oral mucosa cells patients treated dental implants

The aim of this study was to assess the potential genotoxicity of dental implants, evaluating biomarkers of DNA damage (micronuclei and/or nuclear buds), cytokinetic defects (binucleated cells) and the presence of trace metals in gingival cells of patients with implants, comparing these with a control group. A total of 60 healthy adults (30 patients with dental implants and 30 control patients without) were included in the study. Medical and dental histories were made for each including life-style factors. Genotoxicity effects were assessed by micronucleus assays in the gingival epithelial cells of each patient; 1,000 epithelial cells were analyzed, evaluating the frequency of micronucleated cells and other nuclear anomalies. The concentration of metals (Al(27), Ag(107), Co (59), Cr (52), Cu(63), Fe(56), Sn(118), Mn(55), Mo(92), Ni(60), Pb(208), Ti(47)) were assayed by means of coupled plasma-mass spectrophotometry (ICP-MS). The frequency of micronuclei in the patient group with implants was higher than in the control group but without statistically significant differences (P > 0.05). Similar results were found for binucleated cells and nuclear buds (P > 0.05). For metals assayed by ICP-MS, significant differences were found for Ti(47) (P ≤ 0.045). Univariate analysis identified a significant association between the presence of micronuclei and age. Dental implants do not induce DNA damage in gingival cells, the slight effects observed cannot be indicated as biologically relevant.

Micronucleus assay assessment of possible genotoxic effects in patients treated with titanium alloy endosseous implants or miniplates

The use of titanium and its alloys (Ti-6Al-4V) for oral surgery has increased dramatically in recent years. Ti is a stable biocompatible metal suitable for oral applications and it has been used for endosseous subperiosteal implants and miniplate fixation for more than 25 years. Dental implants are typically made of Ti or Ti alloys. The alloys are potentially toxic due to release of vanadium and aluminum. We tested the possible genotoxicity of Ti alloy endosseous implants and miniplates on the oral mucosal tissues of two groups of patients: 17 patients receiving Ti miniplate and screw fixation, and 37 endosseous dental implant placement patients. Preoperative and postoperative mucogingival cell samples were collected. Genotoxicity was assessed by the micronucleus assay (MN). There were slight but not statistically significant increases in the frequencies of MN (p=0.087 and p=0.047) post-operation in both groups. In summary, neither of the applications showed genotoxicity in the oral epithelial cells of patients.

Titanium in dentistry: historical development, state of the art and future perspectives

Titanium is a metallic element known by several attractive characteristics, such as biocompatibility, excellent corrosion resistance and high mechanical resistance. It is widely used in Dentistry, with high success rates, providing a favorable biological response when in contact with live tissues. Therefore, the objective of this study was to describe the different uses of titanium in Dentistry, reviewing its historical development and discoursing about its state of art and future perspective of its utilization. A search in the MEDLINE/PubMed database was performed using the terms 'titanium', 'dentistry' and 'implants'. The title and abstract of articles were read, and after this first screening 20 articles were selected and their full-texts were downloaded. Additional text books and manual search of reference lists within selected articles were included. Correlated literature showed that titanium is the most used metal in Implantology for manufacturing osseointegrated implants and their systems, with a totally consolidated utilization. Moreover, titanium can be also employed in prosthodontics to obtain frameworks. However, problems related to its machining, casting, welding and ceramic application for dental prosthesis are still limiting its use. In Endodontics, titanium has been used in association to nickel for manufacturing rotatory instruments, providing a higher resistance to deformation. However, although the different possibilities of using titanium in modern Dentistry, its use for prostheses frameworks still needs technological improvements in order to surpass its limitations.

Tissue engineering approaches for regenerative dentistry

Although teeth can withstand enormous abrasive forces, they are susceptible to damage due to trauma, acids and bacterial attack. Conventional treatment relies on synthetic materials to fill defects and replace whole teeth, but these remain substitutes and cannot restore the tissues' physiological architecture and function. With the isolation of postnatal stem cells from various sources in the oral cavity and the development of smart materials for cell and growth factor delivery, possibilities for alternative, biology-based treatments arise. Interdisciplinary approaches are needed to move from replacement to regeneration, involving clinicians as well as biologists, stem cell researchers and material scientists. First, in order to provide an appreciation for the complexity of the tooth as a whole, its components and surrounding structures will be described. Next, the basic principles of tooth development will be presented, which can be applied to recreate signaling events and utilize them to build whole teeth. For the regeneration of individual tooth structures, the classical tissue engineering triad can be utilized, using dental stem cells, scaffold materials and relevant growth and differentiation factors. Recent successful engineering initiatives on whole teeth as well as on specific tissues such as enamel, the dentin-pulp complex or periodontal ligament will be discussed. In projecting future research directions, we conclude with a brief discussion of key components necessary to develop effective strategies for dental tissue engineering, which might enable us to implement novel regenerative strategies in clinical practice in the near future.

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.

Base metal alloys used for dental restorations and implants

One of the primary reasons for the development of base metal alloys for dental applications has been the escalating cost of gold throughout the 20th century. In addition to providing lower cost alternatives, these nonprecious alloys were also found to provide better mechanical properties and aesthetics for some oral applications. Additionally, certain base metal alloy systems are preferred because of their superior mechanical properties, lower density, and in some cases, their capability to osseo-integrate. The base metal alloy systems most commonly used in dentistry today include stainless steels, nickel-chromium, cobalt-chromium, titanium, and nickel-titanium alloys. Combined, these alloy systems provide a wide range of available properties to choose the correct material for both temporary and long-term restoration and implant applications.

Precious Metals in Dentistry

Precious alloys are an important material group in dentistry because of their ease of use, excellent compatibility, favorable mechanical and physical properties, and application in ceramometal bonding. Although new precious alloys have been introduced in the past decades, frequently because of economic pressure, gold-based alloys remain a popular choice. Researchers have suggested that alloys should be chosen based on an understanding of the alloy system, selection of proven alloys from quality manufacturers, and consideration of the requirements of a given clinical situation.

The effects of different types of investments on the alpha-case layer of titanium castings

STATEMENT OF PROBLEM

Different types of investments affect the formation of the alpha-case (alpha-case) layer on titanium castings. This alpha-case layer may possibly alter the mechanical properties of cast titanium, which may influence the fabrication of removable and fixed prostheses. The formation mechanism for the alpha-case layer is not clear.

PURPOSE

The aim of this study was to evaluate the effect of 3 types of investments on the microstructure, composition, and microhardness of the alpha-case layer on titanium castings.

MATERIAL AND METHODS

Fifteen wax columns with a diameter of 5 mm and a length of 40 mm were divided into 3 groups of 5 patterns each. Patterns were invested using 3 types of investment materials, respectively, and were cast in pure titanium. The 3 types of materials tested were SiO(2)-, Al(2)O(3)-, and MgO-based investments. All specimens were sectioned and prepared for metallographic observation. The microstructure and composition of the surface reaction layer of titanium castings were investigated by scanning electron microscopy (SEM) and electron probe microanalysis (EPMA). The surface microhardness (VHN) for all specimens was measured using a hardness testing machine, and a mean value for each group was calculated.

RESULTS

The alpha-case layer on titanium castings invested with SiO(2)-, Al(2)O(3)-, and MgO-based investments consisted of 3 layers-namely, the oxide layer, alloy layer, and hardening layer. In this study, the oxide layer and alloy layer were called the reaction layer. The thickness of the reaction layer for titanium castings using SiO(2)-, Al(2)O(3)-, and MgO-based investments was approximately 80 microm, 50 microm, and 14 microm, respectively. The surface microhardness of titanium castings made with SiO(2)-based investments was the highest, and that with MgO-based investments was the lowest.

CONCLUSIONS

The type of investment affects the microstructure and microhardness of the alpha-case layer of titanium castings. Based on the thickness of the surface reaction layer and the surface microhardness of titanium castings, MgO-based investment materials may be the best choice for casting these materials.

Marginal accuracy of titanium copings fabricated by casting and CAD/CAM techniques

STATEMENT OF PROBLEM

Advances in computer-aided design/computer-assisted manufacturing (CAD/CAM) technology purportedly enhance the marginal fit of dental restorations. However, little information is available on the marginal accuracy of restorations manufactured with various CAD/CAM systems.

PURPOSE

The purpose of this study was to evaluate and compare the marginal accuracy and refinement time of titanium copings fabricated by 3 different CAD/CAM systems relative to standard casting techniques.

MATERIAL AND METHODS

Sixty-four stone die duplicates of a human maxillary central incisor, prepared for a metal-ceramic crown, with a uniform chamfer design, were divided into 4 groups (n=16). The specimens were restored with titanium copings using CAD/CAM systems Pro 50 (PRO), DCS (DCS), and Everest (EVE). A conventional titanium casting technique, Biotan (BIO), served as a control. Vertical and horizontal discrepancies between restoration margins and the preparations were each measured before and after manual refinement. This refinement was completed using a disclosing agent and by removing the internal positive defects of the copings. The marginal discrepancies of the copings were evaluated at 4 standard areas using 10 measurements, for a total of 160 measurements of each margin. Repeated-measures ANOVA was used for analyzing marginal accuracy. The coping refinement time was analyzed with the Kruskal-Wallis and post hoc Wilcoxon rank sum tests (alpha=.05).

RESULTS

The marginal discrepancies (microm) ranged from 32.9 to 127.8 before and from 3.4 to 58.4 after the manual refinement of copings. Manual refinement significantly improved the marginal accuracy (P<.0001) when compared with the initial fabrication. The relative (%) gain of marginal accuracy was PRO, 74.1%; DCS, 69.7%; EVE, 68.7%; and the control, BIO, 69.2%. The median duration of manual refinement time in minutes was 6.0 for PRO, 9.5 for DCS, 4.0 for EVE, and 4.0 for BIO (Kruskal-Wallis-test: P<.0001).

CONCLUSION

Manual adjustment significantly improves the marginal accuracy of CAD/CAM system-fabricated titanium copings. The highest marginal accuracy was achieved with the DCS system, using a longer refinement time.

Titanium Casting Using Commercial Phosphate-bonded Investments with Quick Heating Method

The purpose of this study was to investigate the possible use of quick heating method for titanium casting using two commercial investments (Rematitan Plus and Tancovest). The resulting characteristics of the investments with the quick heating method were as follows: residual thermal expansion at the casting temperature was in the range of 0.39 to 0.64%; green strength and fired strength ranged from 4.4 to 10.3 MPa and from 13.8 to 17.6 MPa, respectively. Five full crown titanium castings from each casting condition were obtained using an argon arc melting and gas pressure casting machine. The thickness of cast surface reaction layer was approximately 200 microm, regardless of heating methods or investments. Further, the heating method did not significantly influence either the accuracy or surface roughness of the titanium castings. These results therefore suggested that these commercial investments for titanium could be used for the quick heating method.

The effect of investment material type on the contamination zone and mechanical properties of commercially pure titanium castings

STATEMENT OF PROBLEM

Different types of investment materials affect the formation of a surface contamination zone within commercially pure titanium (cpTi) castings. This contamination zone may possibly alter the mechanical properties of cast titanium, which may be problematic for castings used in the fabrication of removable and fixed prostheses.

PURPOSE

The purpose of this study was to evaluate the effect of different types of investments on the extent of contamination zone and the modulus of elasticity, yield strength, elongation, and hardness of cpTi castings.

MATERIAL AND METHODS

Forty wax patterns were fabricated according to ISO 9693 for tensile testing. The patterns were divided into 2 groups of 20 patterns each, invested, and cast in pairs using cpTi. The first group (P) was invested with a phosphate-bonded silica-based investment material (Ticoat S+L), and the second group (M), with a magnesia-alumina investment material (Rematitan Ultra). Investment materials were examined by x-ray diffraction analysis (XRD). One specimen from each group was sectioned and prepared for metallographic observation. The extent of the contamination zone was determined by scanning electron microscopy, using back-scattering electron imaging and energy dispersive spectroscopy analysis, as well as microhardness testing. The tensile strength of the specimens was determined in a universal testing machine. From the derived tensile curves, the modulus of elasticity, yield strength, and percentage elongation were calculated and statistically evaluated among the groups using the Student t test (alpha=.05). Three fractured specimens from each group were examined by scanning electron microscopy to determine the mode of fracture.

RESULTS

XRD analysis showed that silica and magnesia were the dominant phases of Ticoat S+L and Rematitan Ultra, respectively. The contamination zone was found to extend 50 to 80 mum for the P specimens and 15 to 20 mum for the M specimens. No significance difference was found for the modulus of elasticity (P=85 +/- 11 GPa, M=79 +/- 13 GPa), whereas significant differences were found for the yield strength (P=462 +/- 48 MPa, M=321 +/- 54 MPa; P<.001) and percentage elongation (P=12 +/- 2, M=21 +/- 7; P=.002) between the groups tested. The fracture mode was brittle externally and ductile internally for both groups.

CONCLUSIONS

According to the results of this study, the extent of the contamination zone as well as the yield strength and percentage elongation of the cpTi castings were significantly affected by the type of the investment material.

Surface free energy and bacterial retention to saliva-coated dental implant materials--an in vitro study

The aim of the present investigation was to compare the in vitro bacterial retention on saliva-coated implant materials (pure titanium grade 2 (cp-Ti) and a titanium alloy (Ti-6Al-4V) surfaces), presenting similar surface roughness, and to assess the influence of physico-chemical surface properties of bacterial strain and implant materials on in vitro bacterial adherence. Two bacterial strains (one hydrophilic strain and one hydrophobic strain) were used and the following were evaluated: bacterial cell adherence, SFE values as well as the Lifshitz-van-der Waals, the Lewis acid base components of SFE, the interfacial free energy and the non-dispersive interactions according to two complementary contact angle measurement methods: the sessile drop method and the captive bubble method. Our results showed similar patterns of adherent bacterial cells on saliva-coated cp-Ti and saliva-coated Ti-6Al-4V. These findings could suggest that bacterial colonization (i.e. plaque formation) is similar on saliva-coated cp-Ti and Ti-6Al-4V surfaces and indicate that both materials could be suitable for use as transgingival abutment or healing implant components. The same physico-chemical properties exhibited by saliva-coated cp-Ti and TA6V, as shown by the sessile drop method and the captive bubble method, could explain this similar bacterial colonisation. Therefore, higher values of total surface free energy of saliva-coated cp-Ti and saliva-coated TA6V samples (gamma(SV) approximately 65mJ/m(2)) were reported using the captive bubble method indicating a less hydrophobic character of these surfaces than with the sessile drop method (gamma(S) approximately 44.50mJ/m(2)) and consequently possible differences in oral bacterial retention according the theory described by Absolom et al. The number of adherent hydrophobic S. sanguinis cells was two-fold higher than that of hydrophilic S. constellatus cells. Our results confirm that physico-chemical surface properties of oral bacterial strains play a role in bacterial retention to implant materials in the presence of adsorbed salivary proteins.