Additive Technology: Update on Current Materials and Applications in Dentistry

Layered Manufacturing of Dental Ceramics: Fracture Mechanics, Microstructure, and Elemental Composition of Lithography-Sintered Ceramic

PURPOSE

To compare the fracture mechanics, microstructure, and elemental composition of lithography-based ceramic manufacturing with pressing and CAD/CAM.

MATERIALS AND METHODS

Disc-shaped specimens (16 mm diameter, 1.2 mm thick) were used for mechanical testing (n = 10/group). Biaxial flexural strength of three groups (In-Ceram alumina [ICA], lithography-based alumina, ZirkonZahn) were determined using the "piston on 3-ball" technique as suggested in test Standard ISO-6872. Vickers hardness test was performed. Fracture toughness was calculated using fractography. Results were statistically analyzed using Kruskal-Wallis test followed by Dunnett T3 (α = 0.05). Weibull analysis was conducted. Polished and fracture surface characterization was made using scanning electron microscope (SEM). Energy dispersive spectroscopy (EDS) was used for elemental analysis.

RESULTS

Biaxial flexural strength of ICA, LCM alumina (LCMA), and ZirkonZahn were 147 ± 43 MPa, 490 ± 44 MPa, and 709 ± 94 MPa, respectively, and were statistically different (P ≤ 0.05). The Vickers hardness number of ICA was 850 ± 41, whereas hardness values for LCMA and ZirkonZahn were 1581 ± 144 and 1249 ± 57, respectively, and were statistically different (P ≤ 0.05). A statistically significant difference was found between fracture toughness of ICA (2 ± 0.4 MPa⋅m^1/2 ), LCMA (6.5 ± 1.5 MPa⋅m^1/2 ), and ZirkonZahn (7.7 ± 1 MPa⋅m^1/2 ) (P ≤ 0.05). Weibull modulus was highest for LCMA (m = 11.43) followed by ZirkonZahn (m = 8.16) and ICA (m = 5.21). Unlike LCMA and ZirkonZahn groups, a homogeneous microstructure was not observed for ICA. EDS results supported the SEM images.

CONCLUSIONS

Within the limitations of this in vitro study, it can be concluded that LCM seems to be a promising technique for final ceramic object manufacturing in dental applications. Both the manufacturing method and the material used should be improved.

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.

Cobalt-chromium alloys in fixed prosthodontics in Sweden

Aim: The aim of this study was to compile the usage of Co-Cr alloys in fixed prosthodontics (FP) among dental laboratories in Sweden.

Methods: From March to October 2015, questionnaires were sent to 542 registered dental laboratories in Sweden. The questionnaires were divided in two parts, one for fixed dental-supported prosthodontics (FDP) and one for fixed implant-supported prosthodontics (FIP). Reminders were sent three times.

Results: In total of 542 dental laboratories, 55% answered the questionnaires. Most dental laboratories use Co-Cr in FP, 134 (74%) in FDP and 89(66%) in FIP. The laboratories used Co-Cr alloys of various compositions in the prostheses, 35 for FDP and 30 for FIP. The most commonly used Co-Cr alloys for tooth-supported FDPs were (a) Wirobond^® 280, (b) Cara SLM and (c) Wirobond^® C. For implant-supported frameworks the frequently used alloys were: (a) Cara SLM, (b) Cara Milled and (c) Wirobond^® 280. Except for the difference in composition of these alloys, they were also manufactured with various techniques. In tooth-supported prostheses the dominating technique was the cast technique while newer techniques as laser-sintering and milling were more commonly reported for implant-supported constructions. A fourth technique; the ‘pre-state’ milling was reported in FDP.

Conclusion: More than 30 different Co-Cr alloys were reported as being used in FP. Thus, there is a need for studies exploring the mechanical and physical behavior and the biological response to the most commonly used Co-Cr alloys.