Retention and fatigue performance of modified polyetheretherketone clasps for removable prosthesis

PURPOSE

Polyetheretherketone (PEEK) is considered as an alternative to metal material for removable partial denture (RPD). However, the retentive force is not strong as a metal RPD. This study investigated the retention and fatigue performance of PEEK clasps with different proportions of clasp arm engaging the undercut to verify a new strategy to improve their clinical performance.

METHODS

Three groups (n = 10/group) of PEEK clasps with their terminal 1/3, 2/3 and the whole of retentive arms engaging the undercut were fabricated along with a group (n = 10) of conventional cobalt-chrome (CoCr) clasps as control group. Retentive forces were measured by universal testing machine initially and at an interval of 1500 cycles for a total of 15,000 fatigue cycles. The fatigue cycles were conducted by repeated insertion and removal of the clasp using fatigue testing machine. Each clasp was scanned by Trios3 scanner before and after fatigue test to obtain digital models. The deformation of the clasp was evaluated by root mean square (RMS) through aligning the two models in Geomagic wrap (2021). Scanning electron microscopy (SEM) and finite element analysis were carried out to observe the abrasion and the von Mises stress of the clasp arm. Kruskal-Wallis H test was used to compare the retentive forces and the RMSs of the studied groups followed by Bonferroni multiple comparisons.

RESULTS

The whole of PEEK clasp arm engaging the undercut provided higher mean retentive forces (7.99 ± 2.02 N) than other PEEK clasp groups (P < 0.001) and was closer to CoCr clasps (11.88 ± 2.05 N). The RMSs of PEEK clasps were lower than CoCr clasps (P < 0.05) while the differences among PEEK clasps were of no statistical significance (P > 0.05). SEM showed that evidences of surface abrasion were observed on the section that engaged the undercut for all groups of clasps. The stress concentration mainly occurred on the initial part of the retentive arm. The maximum von Mises stress of each group was below the compressive strength of PEEK.

CONCLUSIONS

Proportions of PEEK clasp arm engaging the undercut positively influenced the retentive force and the fatigue resistance of PEEK clasps was superior than CoCr clasps. It is a feasible method to improve the retention of PEEK clasps by increasing the proportion of clasp arm engaging the undercut. Clinical trials are needed to further verify this innovation.

Fatigue life prediction considering variability for additively manufactured pure titanium clasps

PURPOSE

This study aims to develop a numerical prediction method for the average and standard deviation values of the largely varied fatigue life of additively manufactured commercially pure titanium (CPTi grade 2) clasps. Accordingly, the proposed method is validated by applying it to clasps of different shapes.

METHODS

The Smith-Watson-Topper (SWT) equation and finite element analysis (FEA) were used to predict the average fatigue life. The variability was expressed by a 95% reliability range envelope based on the experimentally determined standard deviation.

RESULTS

When predicting the average fatigue life, the previously determined fatigue parameters implemented in the SWT equation were found to be useful after conducting fatigue tests using a displacement-controlled fatigue testing machine. The standard deviation with respect to stroke and fatigue life was determined for each clasp type to predict variability. The proposed prediction method effectively covered the experimental data. Subsequently, the prediction method was applied to clasps of different shapes and validated through fatigue tests using 22 specimens. Finally, the fracture surface was observed using scanning electron microscopy (SEM). Many manufacturing process-induced defects were observed; however, only the surface defects where the maximum tensile stress occurred were crucial.

CONCLUSIONS

It was confirmed that the fatigue life of additively manufactured pure titanium parts is predictable before the manufacturing process considering its variability by performing only static elasto-plastic FEA. This outcome contributes to the quality assurance of patient-specific clasps without any experimental investigation, reducing total costs and response time.

Influence of Different Undercut Depths of Clasp Fabricated by Selective Laser Melting on Retentive Force

INTRODUCTION

The purpose of this study was to investigate the influence of undercut depths on abutment teeth regarding the retentive force of clasps fabricated through selective laser melting (SLM), and to compare them with conventional cast clasps.

METHODS

Akers clasps made of cobalt chromium alloy were fabricated using the SLM method (SLM), and the retentive forces were compared with clasps made with the conventional cast method (Cast). Three undercut amounts (0.25 mm, 0.15 mm, and 0 mm) were applied on the abutment tooth. The specimens were subjected to 10,000 repetitive insertion/removal cycles.

RESULTS

SLM-0.15 showed slightly lower initial retentive force than the Cast specimens, it remained within an acceptable range. During insertion/removal test, the SLM-0.15 specimen showed a significant difference between the initial retentive force and the retentive force after 5,000 cycles, indicating that SLM-0.15 was the least likely to change in retentive force within the parameters established in this study. The inner clasp surface on the SLM groups had higher surface roughness before testing compared to the Cast specimen.

CONCLUSIONS

Akers clasps fabricated by SLM demonstrated optimal initial retentive forces with smaller undercuts than conventional Cast clasps, and the retentive forces changed less with repetitive insertion/removal.

In vitro study of optimal removable partial denture clasp design made from novel high-performance polyetherketoneketone

PURPOSE

This study aimed to investigate the retentive force and deformation of double Akers' polyetherketoneketone (PEKK) clasps on removable partial dentures (RPDs) with varying designs and undercut depths.

METHODS

Thirty double Akers' PEKK clasps with two different widths and heights (Groups I and II) were fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM). Each design was further subdivided (n = 5) into three undercut depths (0.25, 0.50, and 0.75 mm). The retentive force of the clasps was measured after 10 years of clinical use (15,000 insertion/removal cycles), and the deformation of the clasp tips was analyzed before and after cycling.

RESULTS

Clasps with 0.50-mm and 0.75-mm undercut depths exhibited greater initial retentive forces (3.15-3.51 N) compared to those in the 0.25-mm undercut group (2.40-2.80 N). Group I maintained consistent retentive forces over the cycles (P = 0.345), whereas Group II showed declining forces after the initial use (P < 0.003). In both groups, the 0.50-mm undercut exhibited a greater retentive force than the 0.25-mm (P < 0.001 and P < 0.004, respectively), with no significant differences between the 0.50-mm and 0.75-mm undercut depths. Despite a lower initial retentive force, the 0.25-mm undercut showed less deformation and clasp tip wear.

CONCLUSIONS

The PEKK clasps did not exhibit significantly reduced retentive forces or permanent deformations after 15,000 fatigue cycles. These results suggest that the PEKK polymer displays superior mechanical properties as an esthetic clasp material, and clasps with 0.50-mm and 0.75-mm undercut depths are recommended for long-term clinical use.

Comparison of the Retention and Fit of Polyether Ether Ketone Clasps during Fatigue Circulation Tests

Purpose

The purpose of this study was to evaluate the fit and retention of clasps made of polyether ether ketone (PEEK) or cobalt-chromium alloy (Co-Cr) at different tooth positions in experimental simulations of in vitro wear and removal for 5 years.

Methods

Standard crowns of the right mandibular first premolar (44) and first molar (46) were selected, and a circular three-arm clasp was designed, scanned and fabricated. Ten PEEK clasps were used as the experimental group, and 10 Co-Cr clasps were used as the control group. The seating channel was parallel to the side of the abutment base in both groups. The oral environment was simulated, and each clasp was tested in artificial saliva for 7200 cycles while the change in clasp retention force was recorded. The fit before and after the fatigue cycles was measured by the silicone rubber film copying method. Data were statistically analyzed using the independent samples t-test (α = 0.05).

Results

Before circulation, the retention forces of the clasps at position 44 were 4.61 ± 0.91 N (PEEK) and 47.50 ± 10.59 N (Co-Cr), and the forces at position 46 were 3.38 ± 0.49 N (PEEK) and 28.79 ± 10.99 N (Co-Cr). After circulation, the retention forces of the clasps at position 44 were 4.15 ± 0.91 N (PEEK) and 13.90 ± 6.59 N (Co-Cr), and the forces at position 46 were 2.93 ± 0.25 N (PEEK) and 11.56 ± 3.93 N (Co-Cr). Before circulation, the fit of each clasp at the reference points (clasp tip, clasp arm, and occlusal rest) was between 41.70 μm and 170.29 μm, and after circulation, they were between 64.05 μm and 182.59 μm. The retention force and fit of the PEEK clasps did not undergo statistically significant changes from before to after circulation (P > 0.05). However, there were statistically significant (P < 0.05) decreases in the retention force of the Co-Cr clasps and the fit of the clasp tip during circulation. In addition, there was a sudden and large change in the retention force of the Co-Cr clasps after approximately 360 cycles.

Conclusions

The retention force and suitability of the PEEK clasps met the requirements for clinical use during testing that simulated the in vitro wear and removal procedure for 5 years. Compared with the Co-Cr clasp, the PEEK clasp underwent less fatigue deformation, which makes it feasible for clinical applications.

Retentive force and fitness accuracy of cobalt-chrome alloy clasps for removable partial denture fabricated with SLM technique

PURPOSE

Evaluating the fitness accuracy and retentive force of cobalt-chrome (Co-Cr) alloy clasps fabricated using the selective laser melting (SLM) technique.

METHODS

Premolar and molar abutment models with a 0.5-mm undercut depth, 1.5-mm-thick occlusal rest seats, and guiding planes were designed and fabricated using a milling machine. On these models, Akers clasps with 0.25- and 0.5-mm undercut depths were designed and fabricated with SLM and a traditional lost wax casting method. Based on the manufacturing methods, abutment types, and undercut depths, the clasps were divided into eight groups (10 per group). The fitness accuracy of the clasps was evaluated by measuring the gap distance between the clasps and abutments using a silicone film method. The initial retentive force and changes in retention up to 7,200 insertion/removal cycles of the clasps were also measured. The data were analyzed using multiple linear regression, paired t-tests, and one-way ANOVA (α=0.05).

RESULTS

For both the SLM and cast clasps, the fitness accuracy of the rest was greater than that of the clasp tip and shoulder. No significant difference was found in the fitness accuracy between the SLM and cast clasps, regardless of the abutment type and undercut depth before or after insertion/removal cycles (p>0.05). There was also no significant difference in the initial retentive force between the SLM and cast clasps (p>0.05). After 7,200 insertion/removal cycles, the SLM clasp exhibited a greater residual retentive force (p<0.05).

CONCLUSION

The SLM technique for manufacturing the clasps of removable partial dentures has promising clinical applications.

Retentive Forces of Removable Partial Denture Clasp Assemblies Made from Polyaryletherketone and Cobalt-Chromium: A Comparative Study

PURPOSE

To compare retentive forces of removable partial denture clasps traditionally fabricated with cobalt-chromium (CoCr) material and two computer-aided design and computer-aided manufactured (CAD/CAM) thermoplastic polymers.

MATERIALS AND METHODS

Forty-eight clasp assemblies (16 CoCr, 16 polyetheretherketone (PEEK) and 16 polyetherketoneketone (PEKK) thermoplastic polymer) were fabricated for 48 mandibular tooth analogs. Individual clasps were inserted and removed on the tooth analogs utilizing a chewing simulator for 15,000 cycles to simulate 10 years of use. Retentive forces were measured utilizing a mechanical load tester at baseline and intervals of 1500 cycles. Data were analyzed with one-way Analysis of Variance, Tukey post-hoc, and paired T tests.

RESULTS

Mean retentive forces between all groups were significantly different (p < 0.001). Retentive forces of CoCr clasps were significantly higher than both polymers (p < 0.001). The mean retentive forces for PEEK were not significantly different from PEKK (p = 0.23). A significant increase in retentive forces was observed for all three clasps after the first period of cycling, followed by continual decrease for the remaining cycles. At the endpoint of 15,000 cycles, no clasp assemblies showed lower retentive forces than at initial baseline.

CONCLUSION

Thermoplastic polymer clasps demonstrated lower retentive forces compared to CoCr clasps. All three groups displayed a similar pattern of initial increase, followed by a gradual decrease, of retentive force. Despite this observation, the clasps maintained similar or higher retentive forces than measured at baseline. This resistance to fatigue and ability to fabricate with CAD/CAM technologies provides support for clinical use of these high-performance polymer (HPP) materials.

Effects of repetitive insertion/removal cycles and simulated occlusal loads on retention of denture retainers

The purpose of this study was to investigate the effects of repetitive insertion/removal cycle tests on denture retainers with simulated occlusal loads on the retentive force and deformation of clasp. Abutment teeth in the form of mandibular secondary premolars and clasp in the form of Akers clasps were prepared. The retentive force of the clasp on the abutment teeth were evaluated before and after undergoing repetitive insertion/removal cycle tests with or without cyclic loading. Changes in the clasp shape were monitored using a 3D scanner and scanning electron microscope. The initial retentive force was approximately 10 N and this value later decreased due to deformation of the clasp tips. In contrast to the non-load group, the load group exhibited a reduction in retentive force during earlier stages. Therefore, cyclic loading was related to a decrease in retentive forces, specifically in the early stages of repetitive insertion/removal cycles.

Retention force of polyetheretherketone and cobalt-chrome-molybdenum removable dental prosthesis clasps after artificial aging

OBJECTIVES

To examine the retention force of removable dental prosthesis (RDP) clasps made from polyetheretherketone (PEEK) and cobalt-chrome-molybdenum (CoCrMo, control group) after storage in water and artificial aging.

MATERIALS AND METHODS

For each material, 15 Bonwill clasps with retentive buccal and reciprocal lingual arms situated between the second pre- and first molar were manufactured by milling (Dentokeep [PEEKmilled1], NT digital implant technology; breCAM BioHPP Blank [PEEKmilled2], bredent), pressing (BioHPP Granulat for 2 press [PEEKpressed], bredent), or casting (remanium GM 800+ [CoCrMo], Dentaurum); N = 60, n = 15/subgroup. A total of 50 retention force measurements were performed for each specimen per aging level (initial; after storage [30 days, 37 °C] and 10,000 thermal cycles; after storage [60 days, 37 °C] and 20,000 thermal cycles) in a pull-off test. Data were statistically analyzed using one-way ANOVA, post hoc Scheffé and mixed models (p < 0.05).

RESULTS

Initial, PEEKpressed (80.2 ± 35.2) and PEEKmilled1 (98.9 ± 40.3) presented the lowest results, while PEEKmilled2 (170.2 ± 51.8) showed the highest values. After artificial aging, the highest retention force was observed for the control group (131.4 ± 56.8). The influence of artificial aging was significantly higher for PEEK-based materials. While PEEKmilled2 and PEEKpressed showed an initial decline in retention force, all other groups presented no impact or an increase in retention force over a repetitive insertion and removal of the clasps.

CONCLUSIONS

Within the tested PEEK materials, PEEKmilled2 presented superior results than PEEKpressed. Although CoCrMo showed higher values after artificial aging, all materials exhibited sufficient retention to recommend usage under clinical conditions.

CLINICAL RELEVANCE

As RDPs are still employed for a wide range of indications, esthetic alternatives to conventional CoCrMo clasps are sought.

Is the high-performance thermoplastic polyetheretherketone indicated as a clasp material for removable dental prostheses?

Objectives

To investigate the retention force of polyetheretherketone (PEEK) removable dental prosthesis clasps in comparison with a cobalt-chrome-molybdenum control group after storage in artificial saliva.

Materials and Methods

Clasps were milled (Dentokeep (PEEKmilled1), NT digital implant technology; breCAM BioHPP Blank (PEEKmilled2), bredent), pressed (BioHPP Granulat for 2 press (PEEKpressed), bredent), or cast (remanium GM 800+ (cobalt-chrome-molybdenum), Dentaurum); N = 60, n = 15/subgroup. Retention force was examined 50 times/specimen in a pull-off test using the universal testing machine (Zwick 1445), where pull-off force was applied with a crosshead speed of 5 mm/minute until the maximum force dropped by 10%, at different aging levels: (1) initial, after storage in artificial saliva for (2) 90 and (3) 180 days. Statistical analysis was performed using one-way ANOVA followed by post hoc Scheffé-test and mixed models (p < 0.05).

Results

Cobalt-chrome-molybdenum presented the highest retention force. No differences were observed between polyetheretherketone materials. Cobalt-chrome-molybdenum showed a significant decrease of its values after artificial aging, while polyetheretherketone materials presented similar results over the course of aging. Regarding a repetitive insertion and removal, even though PEEKmilled2 and cobalt-chrome-molybdenum showed an initial increase, ultimately, a decrease in retention force was observed for all tested groups.

Conclusions

Although the control group showed significantly higher results, the retention force of polyetheretherketone materials indicate a potential clinical application. Neither the manufacturing process nor artificial aging showed an impact on the retention force of polyetheretherketone clasps.

Clinical relevance

Mechanical properties of novel removable dental prosthesis clasp materials devised to meet the growing esthetic demands of patients need to be investigated to ensure a successful long-term clinical application.

Examination of inter-rater and intra-rater reliability during retentive force measurement of different clasps using the developed small-sized retentive force measurement device

BACKGROUND

The design process of a removable partial denture (RPD) consists of rests, major connectors, minor connectors, denture base, and retainer. The abutment tooth contour determines the location of the retention portion of the clasp at the retention areas. The load capacity of the clasp depends on various factors such as type, the position of a clasp, tooth position, clasp length, and pullout location. As a general rule, the amount of retention required to dislodge the RPD from the supporting structure should always be the minimum necessary to resist reasonable dislodging forces. Excessive force from the clasps may cause many problems. Although there are many reports on the retentive force of cast clasps using large devices, it has not been possible to measure it using simple devices until now.

METHOD

The purpose of the present study is to develop a small-sized retentive force measurement device that can easily measure the retentive force of a clasp used for an RPD. It is to examine inter-rater and intra-rater reliability. A small-sized retentive force measurement device that can be easily measured in the laboratory has been developed. Using commercially available hard plaster cast, a skilled dental technician has made 10 types of cast clasps used in clinical practice using conventional techniques. Three assessors measured the retentive force of 10 types of cast clasps. To confirm the reliability, the intra-class correlation coefficients ICC (1,1) and ICC (1,3) of the 3 assessors were calculated, and the reliability within the assessor was examined. The inter-class correlation coefficients ICC (3,1) and ICC (3,3) were calculated, and the reliability of the assessors was examined.

RESULT

The intra-class correlation coefficients of 3 assessors are as follows: assessor 1 has ICC (1,1) = 0.971, ICC (1,3) = 0.990, assessor 2 has ICC (1,1) = 0.967, ICC (1,3) = 0.989, assessor 3 has ICC (1,1) = 0.962, ICC (1,3) = 0.987. The inter-class correlation coefficients of 3 assessors are as follows: ICC (3,1) = 0.993, ICC (3,3) = 0.998. From the evaluation standard of the intraclass correlation coefficients of reliability value by ICC, it was evaluated as almost perfect and high reproducibility was confirmed.

CONCLUSION

The developed small-sized retentive force measurement device has reproducibility within and between the assessors.

Effect of different materials and undercut on the removal force and stress distribution in circumferential clasps during direct retainer action in removable partial dentures

OBJECTIVES

This study aimed to evaluate the effect of different materials and undercut on the removal force and stress distribution in the supporting tooth and in the circumferential clasp used in removable partial prosthesis.

METHODS

Upper molars prepared for Akers circumferential clasp with retention and opposing arm were modeled, scanned, elaborated with CAD software and the geometries imported in FEA and analyzed. Six different materials were selected for the clasp (Polyamide, Polyoxymethylene, Polyetheretherketone - PEEK, Gold alloy, Titanium and CoCr) and 3 different undercuts (0.25, 0.50 and 0.75mm), totaling 18 groups.

RESULTS

The clasps presented greater stress in their structure and potentially greater damage to the dental enamel when made with rigid materials and with more undercut; however, they presented greater ability to remain in position.

SIGNIFICANCE

Polyamide with a higher undercut is an esthetic alternative to rigid metallic clasps. It showed promising behavior because it strongly reduces the damage to the enamel, and even with an undercut of 0.75, the retention is lower than for CoCr with a 0.25 undercut, and this retention might still be sufficient. Polyoxymethylene and Polyetheretherketone (PEEK) are not suitable materials for the clasps, because the maximum stress occurring during removal with higher undercuts is higher than the material strength.

Internal porosities, retentive force, and survival of cobalt-chromium alloy clasps fabricated by selective laser-sintering

PURPOSE

The purpose of this study was to evaluate internal porosities, retentive force values and survival of cobalt-chromium (Co-Cr) alloy clasps fabricated by direct metal laser-sintering (DMLS) and compare them to conventionally cast clasps.

METHODS

Embrasure clasps were digitally designed fitting teeth 35 and 36 on identical metal models (N = 32). Sixteen clasps were fabricated using DMLS (group DMLS) and another sixteen clasps were additively manufactured from wax and then cast from a Co-Cr alloy (group CAST). Internal porosities were examined using micro-focus X-ray (micro-CT) and analyzed applying Kolmogorov-Smirnov test, Mann-Whitney test, and T test (significance level: p < 0.050). A universal testing machine was used to determine the retentive force values at baseline and after 1095, 5475, 10,950 and 65,000 cycles of simulated aging. Data were analyzed employing Kolmogorov-Smirnov test, one-way ANOVA, and Scheffé's post-hoc test (significance level: p < 0.050). Survival was estimated for 65,000 cycles of artificial aging using Kaplan-Meier analysis.

RESULTS

Micro-CT analysis revealed a higher prevalence (p < 0.001), but a more homogeneous size and a significantly smaller mean (p = 0.009) and total volume (p < 0.001) of internal porosities for group DMLS. The groups showed mean initial retentive force values of 13.57 N (CAST) and 15.74 N (DMLS), which significantly declined over aging for group CAST (p = 0.003), but not for group DMLS (p = 0.107). Survival was considerably higher for group DMLS (93.8%) than for group CAST (43.8%) after 65,000 cycles of aging.

CONCLUSIONS

Clasps made by laser-sintering could be an alternative to conventional cast clasps for the fabrication of removable partial denture frameworks.

Fatigue properties of removable partial denture clasps fabricated by selective laser melting followed by heat treatment

The aim of the study was to investigate the effect of post-heat treatment on the microstructures and fatigue strengths of Co-Cr-Mo (CCM) clasps prepared by selective laser melting (SLM). Clasp specimens and rod-shaped specimens were fabricated by SLM using CCM powders with different angulations (0°, 45°, and 90°). Two heat treatment conditions were used: 1 and 6 h at 1150 °C in an argon atmosphere followed by cooling in a furnace. Subsequently, the fatigue strength and microstructure were investigated. The results revealed that for the control group, the mean fatigue life was different when building angulations were changed as manifested by the control-90 specimen, which exhibited the highest fatigue life, followed by control-45 and then control-0. One-hour heat treated samples showed higher fatigue strength in all axes than the 0°- and 45°-axes control samples and lower fatigue strength than the 90°-axes control samples. The survival rate after heat treatment for 1 h exhibited no significant difference in all the axes. In terms of microstructure, after heat treatment, the samples showed homogeneous equiaxed grain and randomized texture in all angulations. Therefore, using a post-heat treatment can reduce the anisotropy effect on the microstructure and fatigue strength due to homogenized microstructure.

Deformation and retentive force following in vitro cyclic fatigue of cobalt-chrome and aryl ketone polymer (AKP) clasps

OBJECTIVE

To compare the retention force of individual clasps made from cobalt chromium (CoCr) or new aryl ketone polymer (AKP) material, Ultaire™ AKP, following prolonged fatigue testing along ideal and non-ideal paths of removal and to assess 3D deformation of the active and passive clasp tips.

METHODS

CoCr and AKP clasps were manufactured in their standard, respective processes, digitally scanned prior to testing, then cycled 15,000 times over an e.max analogue crown in artificial saliva. Retentive load was measured in situ, as a function of cycles. Clasps were rescanned to assess deformation and along with their antagonists subjected to SEM to assess localised wear.

RESULTS

Distortion of the CoCr clasps was consistently larger than Ultaire™ AKP clasps, irrespective of removal path. CoCr clasps had significantly higher retentive forces than AKP clasps, for both removal paths. Ultaire™ AKP clasps showed a lower but relatively constant retentive force. The non-ideal path of removal affected retentive forces for both clasp materials. SEM showed localised removal of glaze for e.max crowns used with CoCr clasps.

SIGNIFICANCE

Ultaire™ AKP clasps showed significantly less permanent deformation and lower retentive force than CoCr clasps. Unlike CoCr, the Ultaire™ AKP clasps did not work harden, nor had as large a reduction in retentive force and accompanying permanent deformation; the retentive force for the Ultaire™ AKP clasps was consistent over 15,000 cycles of fatigue mimicking prolonged clinical use. The AKP material was more robust; showing minimal deformation even in non-ideal paths of removal, as many patients would routinely use.

Retention of Approximal Guiding Plane Surfaces in Removable Partial Skeletal Prosthesis

BACKGROUND:

The morphology of the retention tooth often does not correspond with the required design; hence there is often an indication for enamel recontouring or other restorative procedures.

AIM:

The study aimed to determine the impact of changing the path of insertion of the prosthesis by reshaping the anatomical and morphological structures of the natural teeth predetermined for the retention of the prosthesis.

MATERIAL AND METHODS:

The group of 40 patients with Class II, Subclass 1 according to Kennedy was formed, and 120 approximal surfaces of retention teeth were obtained. Two different types of prostheses were made on the models: one group in the zero point position of the model, and another group in the zero position of the model, with changing of the direction of input at an angle of 2°.

RESULTS:

The difference between the established and theoretical normal distribution of frequencies was tested with the Kolmogorov-Smirnov and Lilliefors tests (r < 0.10; r < 0.01). The first group showed a retention force of 0.08 N. In the second group the retention force was 0.94 N.

CONCLUSION:

It could be concluded that the change in the path of insertion of the dental prosthesis with conservative restorations as composite inlays, as well as the accurate extension of the prosthesis onto guiding plane surfaces, will undoubtedly increase the retention force of the prosthesis.

Fitness and retentive force of cobalt-chromium alloy clasps fabricated with repeated laser sintering and milling

PURPOSE

With computer-aided design and computer-aided manufacturing (CAD/CAM), the study was conducted to create a removable partial denture (RPD) framework using repeated laser sintering rather than milling and casting techniques. This study experimentally evaluated the CAM clasp and compared it to a conventional cast clasp.

METHODS

After the tooth die was scanned, an Akers clasp was designed using CAD with and without 50μm of digital relief on the occlusal surface of the tooth die. Cobalt-chromium (Co-Cr) alloy clasps were fabricated using repeated laser sintering (RLS) and milling as one process simultaneously (hybrid manufacturing; HM). The surface roughness of the rest region, gap distances between clasp and tooth die, initial retentive forces, and changes of retentive forces up to 10,000 insertion/removal cycles were measured before and after heat treatment. The HM clasp was compared to the cast clasp and the clasp made by repeated laser sintering only without a milling process.

RESULTS

The HM clasp surface was smoother than those of cast and RLS clasps. With the digital relief, the fitness accuracy of the HM clasp improved. The retentive forces of the HM clasps with relief and after heat treatment were significantly greater than for the cast clasp. HM clasps demonstrated a constant or slight decrease of retention up to 10,000 cycles.

CONCLUSIONS

HM clasp exhibited better fitness accuracy and retentive forces. The possibility of clinically using HM clasps as well as conventional cast clasps can be suggested.

Prognosis of double crown-retained removable dental prostheses compared with clasp-retained removable dental prostheses: A retrospective study

PURPOSE

The present study compared the clinical prognosis of double crown-retained removable dental prostheses (D-DRPs) with that of clasp-retained removable dental prostheses (C-RDPs).

METHODS

Clinical records of 201 patients who had received 52 D-RDPs with 144 abutment teeth (D-teeth) and 199 C-RDPs with 399 abutment teeth (C-teeth) at the Prosthetic Dentistry Clinic in Hokkaido University Hospital between April 2005 and June 2015 were analyzed. Survival and complication probabilities of the two types of prostheses and abutment teeth were evaluated using the Kaplan-Meier method and compared using the log-rank test. Cox regression analysis was used to determine the impact of covariates on abutment teeth survival and complications such as gender, age, type of retainer, Eichner classification, jaw, type of tooth, endodontic therapy performed, type of edentulous space, and presence of opposing teeth.

RESULTS

Statistical analysis showed no significant differences between the two types of prostheses in terms of prostheses survival, prostheses complication, and abutment teeth survival. However, a significant difference was observed for complications of abutment teeth. Decementation was the most frequent cause of failure, which occurred in 76.9% of D-teeth and 28.3% of C-teeth. Patient's age, jaw, endodontic therapy performed, and type of edentulous space affected the survival of abutment teeth, whereas the type of retainer and edentulous space affected complications of abutment teeth.

CONCLUSION

The prognosis of both types of prostheses was considered to be acceptable. Although D-RDP had lower complication-free rates for abutment teeth, most of the observed complications were decementation, which was considered to be reparable.

Clasp fabrication using one-process molding by repeated laser sintering and high-speed milling

PURPOSE

A single machine platform that integrates repeated laser sintering and high-speed milling for one-process molding has been developed.

METHODS

The Akers clasp was designed using the CAD system (DWOS Partial Frameworks, Dental Wings) and fabricated using repeated laser sintering and a high-speed milling machine (LUMEX Advance-25, Matsuura) with 50-μm Co-Cr particles (CAM clasp). As controls, cast clasps of the same forms were also prepared using conventional casting methods with a Co-Cr alloy and CP titanium Grade 3. After the surface roughness was measured, the gap distance between the clasps and the tooth die was assessed using the silicone film method. The initial retentive force and changes in retention up to 10,000 cycles were also measured. The data were analyzed using two-way ANOVA and Tukey's multiple comparison test (α=0.05).

RESULTS

CAM clasps exhibited significantly smoother surfaces than those of cast Co-Cr and CP Ti clasps (p<0.05). However, the gap distances of the CAM clasps were significantly greater than those of the cast clasps (p<0.05). The retentive forces of both CAM and cast Co-Cr clasps were significantly higher than those of CP Ti clasps. (p<0.05). The retention of CAM clasps demonstrated a constant or slight decrease from 1000 up to 10,000 cycles.

CONCLUSIONS

The CAM clasp made by repeated laser sintering and high-speed milling can be used effectively as an RPD component.

Fatigue strength of Co-Cr-Mo alloy clasps prepared by selective laser melting

We aimed to investigate the fatigue strength of Co-Cr-Mo clasps for removable partial dentures prepared by selective laser melting (SLM). The Co-Cr-Mo alloy specimens for tensile tests (dumbbell specimens) and fatigue tests (clasp specimens) were prepared by SLM with varying angles between the building and longitudinal directions (i.e., 0° (TL0, FL0), 45° (TL45, FL45), and 90° (TL90, FL90)). The clasp specimens were subjected to cyclic deformations of 0.25mm and 0.50mm for 10(6) cycles. The SLM specimens showed no obvious mechanical anisotropy in tensile tests and exhibited significantly higher yield strength and ultimate tensile strength than the cast specimens under all conditions. In contrast, a high degree of anisotropy in fatigue performance associated with the build orientation was found. For specimens under the 0.50mm deflection, FL90 exhibited significantly longer fatigue life (205,418 cycles) than the cast specimens (112,770 cycles). In contrast, the fatigue lives of FL0 (28,484 cycles) and FL45 (43,465 cycles) were significantly shorter. The surface roughnesses of FL0 and FL45 were considerably higher than those of the cast specimens, whereas there were no significant differences between FL90 and the cast specimens. Electron backscatter diffraction (EBSD) analysis indicated the grains of FL0 showed preferential close to <001> orientation of the γ phase along the normal direction to the fracture surface. In contrast, the FL45 and FL90 grains showed no significant preferential orientation. Fatigue strength may therefore be affected by a number of factors, including surface roughness and crystal orientation. The SLM process is a promising candidate for preparing tough removable partial denture frameworks, as long as the appropriate build direction is adopted.

Length-dependent anisotropic scaling of spindle shape

Spindle length varies dramatically across species and during early development to segregate chromosomes optimally. Both intrinsic factors, such as regulatory molecules, and extrinsic factors, such as cytoplasmic volume, determine spindle length scaling. However, the properties that govern spindle shape and whether these features can be modulated remain unknown. Here, we analyzed quantitatively how the molecular players which regulate microtubule dynamics control the kinetics of spindle formation and shape. We find that, in absence of Clasp1 and Clasp2, spindle assembly is biphasic due to unopposed inward pulling forces from the kinetochore-fibers and that kinetochore-fibers also alter spindle geometry. We demonstrate that spindle shape scaling is independent of the nature of the molecules that regulate dynamic microtubule properties, but is dependent on the steady-state metaphase spindle length. The shape of the spindle scales anisotropically with increasing length. Our results suggest that intrinsic mechanisms control the shape of the spindle to ensure the efficient capture and alignment of chromosomes independently of spindle length.

Fatigue resistance and retentive force of cast clasps treated by shot peening

PURPOSE

The fatigue failure of denture clasps has often been observed in removable partial denture rehabilitation. To increase their fatigue strength, shot peening was evaluated as a surface treatment. In this study, we evaluated the fatigue resistance and retention of cast clasps by using a shot peening treatment.

METHODS

A cobalt-chromium (Co-Cr) alloy, commercial pure titanium (CP Ti), silver-palladium-gold (Ag-Pd-Au), and a gold-platinum (Au-Pt) alloy were cast and then treated with shot peening. The retentive forces of the clasps were measured up to a repetition of 10,000insertion/removal cycles in distilled water at 37°C. A fatigue test was also performed using a 15-mm cantilever. Specimens were loaded with a constant deflection of 2.0mm with 20Hz. A shot peening treatment indicated a better stability of retentive forces than that without shot peening. The retentive force of Co-Cr clasps without shot peening was remarkably decreased at 500 cycles of insertion/removal repetition.

RESULTS

The clasps with a shot peening treatment provided approximately 1.4-3.6 times higher fatigue strengths than those without a shot peening treatment.

CONCLUSION

To prevent the fatigue failure of the denture clasps and use the dentures for long term, a shot peening treatment would be recommended.