A status report of possible risks of base metal alloys and their components

Iatrogenic Damage to Periodontium by Restorative Treatment Procedures: An Overview

The regenerative capability found in most other tissues is not possessed by teeth. Hence, enamel or dentin once lost as a result of caries, trauma, wear, and restorative materials must be replaced to restore form and function. Teeth require preparation to receive restorations, and these preparations must be based on fundamental principles from which basic criteria can be developed to help predict the success of restorative treatment.

Evaluation of the marginal and internal gap of metal-ceramic crown fabricated with a selective laser sintering technology: two- and three-dimensional replica techniques

PURPOSE

One of the most important factors in evaluating the quality of fixed dental prostheses (FDPs) is their gap. The purpose of this study was to compare the marginal and internal gap of two different metal-ceramic crowns, casting and selective laser sintering (SLS), before and after porcelain firing. Furthermore, this study evaluated whether metal-ceramic crowns made using the SLS have the same clinical acceptability as crowns made by the traditional casting.

MATERIALS AND METHODS

The 10 study models were produced using stone. The 20 specimens were produced using the casting and the SLS methods; 10 samples were made in each group. After the core gap measurements, 10 metal-ceramic crowns in each group were finished using the conventional technique of firing porcelain. The gap of the metal-ceramic crowns was measured. The marginal and internal gaps were measured by two-dimensional and three-dimensional replica techniques, respectively. The Wilcoxon signed-rank test, the Wilcoxon rank-sum test and nonparametric ANCOVA were used for statistical analysis (α=.05).

RESULTS

In both groups, the gap increased after completion of the metal-ceramic crown compared to the core. In all measured areas, the gap of the metal cores and metal-ceramic crowns produced by the SLS was greater than that of the metal cores and metal-ceramic crowns produced using the casting. Statistically significant differences were found between cast and SLS (metal cores and metal-ceramic crown).

CONCLUSION

Although the gap of the FDPs produced by the SLS was greater than that of the FDPs produced by the conventional casting in all measured areas, none exceeded the clinically acceptable range.

Urinary levels of nickel and chromium associated with dental restoration by nickel-chromium based alloys

This paper aims to investigate if the dental restoration of nickel–chromium based alloy (Ni–Cr) leads to the enhanced excretions of Ni and Cr in urine. Seven hundred and ninety-five patients in a dental hospital had single or multiple Ni–Cr alloy restoration recently and 198 controls were recruited to collect information on dental restoration by questionnaire and clinical examination. Urinary concentrations of Ni and Cr from each subject were measure by graphite furnace atomic absorption spectrometry. Compared to the control group, the urinary level of Ni was significantly higher in the patient group of <1 month of the restoration duration, among which higher Ni excretions were found in those with either a higher number of teeth replaced by dental alloys or a higher index of metal crown not covered with the porcelain. Urinary levels of Cr were significantly higher in the three patient groups of <1, 1 to <3 and 3 to <6 months, especially in those with a higher metal crown exposure index. Linear curve estimations showed better relationships between urinary Ni and Cr in patients within 6-month groups. Our data suggested significant increased excretions of urinary Ni and Cr after dental restoration. Potential short- and long-term effects of Ni–Cr alloy restoration need to be investigated.

Evaluation of the shear bond strength of the union between two CoCr-alloys and a dental ceramic

INTRODUCTION

Based on the importance of the integrity of the metal/ceramic interface, the purpose of this work was to evaluate the shear bond strength of the metal-ceramic union of two Co-Cr alloys (Wirobond C, Bego; Remanium 2000, Dentaurum) combined with Omega 900 ceramic (Vita Zahnfabrik).

MATERIAL AND METHOD

Eleven cylindrical matrixes were made for each alloy, and the metallic portion was obtained with the lost wax casting technique with standardized waxing of 4mm of height and of 4mm of diameter. The ceramic was applied according to the manufacturer's recommendations with the aid of a teflon matrix that allowed its dimension to be standardized in the same size as the metallic portion. The specimens were submitted to the shear bond test in an universal testing machine (EMIC), with the aid of a device developed for such intention, and constant speed of 0.5mm/min.

RESULTS AND CONCLUSIONS

The mean resistance was 48.387MPa for Wirobond C alloy, with standard deviation of 17.718, and 55.956MPa for Remanium 2000, with standard deviation of 17.198. No statistically significant difference was observed between the shear strength of the two metal-ceramic alloys.

Multidisciplinary approach for esthetic, functional, and quality-of-life outcome in soft palate cleft patient

The fabrication of a Suersen obturator prosthesis with titanium framework is described in the case of a 43-year-old man with congenital absence of the soft palate. The patient revealed an open soft palate, bilateral cleft lip and palate, Angle Class III dental malocclusion, and anterior and posterior crossbite. He was treated with a multidisciplinary approach. A Dolder bar was fabricated between the maxillary canines, and telescopic crowns were prepared for maxillary premolars. Angle Class III tooth relation was readjusted to tooth-tooth relation; closure of the nasopharynx and oropharynx was performed by Suersen method, which improves speech.

Evaluation of Ion Release from Two Base-Metal Alloys at Various pH Levels

We examined the influence of salivary pH on the corrosion of two base-metal alloys. Cobalt — chromium (Co — Cr) and nickel — chromium (Ni — Cr) alloy samples were created and submerged in artificial saliva of different pH values (pH 4, pH 5 and pH 7). The amount of each ion present in solution 1 month later was measured by flame atomic absorption spectrophotometry. Statistical analysis showed that pH significantly affected total and Co ion release, but not Ni or Cr ion release. The alloy type did not affect total ion release, but was significant for Cr ion release. Alloy — pH interaction significantly affected Cr and total ion release. To prevent metal particle release, the alloys used for dental restoration should, whenever possible, be made from noble metals and corrosion-resistant alloys.

A titanium and visible light-polymerized resin obturator

Obturator prostheses are typically large, and their weight and size are often important design factors. This article describes the fabrication of an obturator prosthesis with a titanium framework and visible light-polymerized denture base resin. It is speculated that these low-density materials may produce prostheses lighter than similar ones made with conventional materials. An added advantage is that visible light-polymerizing resins facilitate relining.

Crowns and extra-coronal restorations: materials selection

Materials selection is the second in the series on crowns and other extra-coronal restorations. Some of us are less than inspired by dental materials science. Nevertheless, many of the things that concern us clinically with crowns and their alternatives are based on material properties. We worry about the strength of the restoration, how well it fits and its aesthetics. We also worry about wear, occlusal control and biocompatibility. Not least of our concerns are dental laboratory charges, which inevitably have to be passed on to the patient.

Quantitative thin-layer chromatographic identification of dental base alloys

In the corrosively aggressive medium of the oral cavity, the use of identical dental alloys requires identification of the existing metal construction. One of the methods allowing this identification is quantitative thin-layer chromatography with anodic sampling. Using a 4.5-V battery and suitable electrolytes, seven dental alloys for fixed and removable dentures based on cobalt were analysed. Chromatograms of alloy samples were developed with a mixture of acetone and 2 M HCl. Scanning of the thin-layer chromatographic spots produced chromatographic curves and the area under the curve was proportional to the content of cobalt in the alloy studied. Regression analysis showed a very high coefficient of correlation (r=0.999) between the area of the spot and the proportion of cobalt.

The effect of dental alloys on mouse lymphocyte subpopulations

The aim of the present study was to determine the effect of nickel-containing alloys on lymphocyte subsets in an experimental setting. Plates of alloys containing nickel (Ceramalloy, Talladium, Cerillium, Rexillium) or gold (Orion) were implanted subcutaneously into mice. The levels of CD4+ and CD8+ T-lymphocyte subpopulations and of Smig+ B lymphocytes were determined at various intervals following implantation, using monoclonal antibodies and flow cytometry. No changes were detected in the proportion of the lymphocyte subsets tested. One month after implantation, the mean fluorescence intensity of CD4, CD8 or Smig, in the peripheral blood lymphocytes (PBL) of the nickel alloy-implanted animals, was significantly higher than that prior to this procedure. Only a mild increase in CD4 and CD8 was noted after implantation of the gold alloy. The observed effects are most likely attributable to the surgical trauma, and do not indicate that nickel-containing dental alloys influence T cell subsets in this murine model.

Leaching of nickel, chromium, and beryllium ions from base metal alloy in an artificial oral environment

The use of base metal alloys in dentistry has gained wide popularity in recent years. However, claims of their safety have not been universally accepted. An artificial oral environment capable of reproducing three-dimensional force-movement cycles of human mastication was used to determine whether nickel, chromium, and beryllium ions were leached from base metal alloy. Twelve pairs of crowns were articulated in the following combinations: metal versus metal, metal versus enamel, metal versus porcelain, and metal versus metal without chewing as a control. In a simulated 1-year period of mastication, the results showed that nickel and beryllium metals were released both by dissolution and occlusal wear. These findings suggest that if these conditions occur in the oral cavity, the stability of base-metal alloys is subject to question. Further studies are needed to determine whether the leaching reported has long-term consequences for patients receiving base metal restorations.

Human cell culture studies with dental metallic materials

The compatibility of cast non-alloyed titanium and eight dental castable alloys (precious, low noble, non-precious) was determined by means of human primary oral fibroblasts derived from the attached gingiva and the periodontium. Furthermore, cast non-alloyed Ti was tested in a human permanent cell culture (MOLT 4). All investigated metallic materials showed cytotoxic properties in primary cultures. The differences in cytotoxicity between the various materials were statistically significant. The best results were found for one noble alloy and for non-alloyed titanium, whereas all non-precious alloys almost completely inhibited cell growth. The cytotoxic potential of the investigated materials might contribute to the irritating effect of dental cast restorations adjacent to the gingiva and the periodontium.