Titanium removable partial denture clasp repair using laser welding: a clinical report

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

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

Modification of clinically short Locator abutments using laser welding

As dental implants continue to survive longer, managing and maintaining implant prostheses can be complicated by the lack of compatible parts or the discontinuation of implant systems. This report describes a laser welding procedure for the management of clinically short Locator abutments (Zest Anchors Inc) that lacked a commercially available, compatible alternative.

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.

Mechanical properties of thin films of laser-welded titanium and their associated welding defects

The aim of this study was to evaluate the mechanical properties of thin films of laser-welded cast titanium using an interference strain/displacement gauge (ISDG) and to analyze factors that affect laser welding. Dog-bone-shaped small specimens of cast titanium were prepared by wire cutting after they were laser-welded. The specimens were divided into three groups according to the gap distance of the laser weld; the control was non-welded titanium. Small specimens without cast defects detected by X-ray screening were measured by a tensile test machine using ISDG, and stress-strain curves were drawn. Finally, the fracture texture was analyzed. The ultimate tensile strengths (UTSs) of specimens with a gap distance of 0.00, 0.25, and 0.50 mm were 492.16 ± 33.19, 488.09 ± 43.18, and 558.45 ± 10.80 MPa, respectively. There were no significant differences in UTS between the test groups and the control group (p > 0.05). However, the plastic deformation and the percent elongation increased as the gap distance increased. Incomplete penetration defects appeared in groups that had small gap distances, which may have affected the properties of the laser-welded titanium. However, the welding material was still pure titanium. These results suggest that an appropriate gap distance should be maintained to improve the application of dental laser welding.

Deflection load characteristics of laser-welded orthodontic wires

OBJECTIVE

To compare the deflection load characteristics of homogeneous and heterogeneous joints made by laser welding using various types of orthodontic wires.

MATERIALS AND METHODS

Four kinds of straight orthodontic rectangular wires (0.017 inch × 0.025 inch) were used: stainless-steel (SS), cobalt-chromium-nickel (Co-Cr-Ni), beta-titanium alloy (β-Ti), and nickel-titanium (Ni-Ti). Homogeneous and heterogeneous end-to-end joints (12 mm long each) were made by Nd:YAG laser welding. Two types of welding methods were used: two-point welding and four-point welding. Nonwelded wires were also used as a control. Deflection load (N) was measured by conducting the three-point bending test. The data (n  =  5) were statistically analyzed using analysis of variance/Tukey test (P < .05).

RESULTS

The deflection loads for control wires measured were as follows: SS: 21.7 ± 0.8 N; Co-Cr-Ni: 20.0 ± 0.3 N; β-Ti: 13.9 ± 1.3 N; and Ni-Ti: 6.6 ± 0.4 N. All of the homogeneously welded specimens showed lower deflection loads compared to corresponding control wires and exhibited higher deflection loads compared to heterogeneously welded combinations. For homogeneous combinations, Co-Cr-Ni/Co-Cr-Ni showed a significantly (P < .05) higher deflection load than those of the remaining homogeneously welded groups. In heterogeneous combinations, SS/Co-Cr-Ni and β-Ti/Ni-Ti showed higher deflection loads than those of the remaining heterogeneously welded combinations (significantly higher for SS/Co-Cr-Ni). Significance (P < .01) was shown for the interaction between the two factors (materials combination and welding method). However, no significant difference in deflection load was found between four-point and two-point welding in each homogeneous or heterogeneous combination.

CONCLUSION

Heterogeneously laser-welded SS/Co-Cr-Ni and β-Ti/Ni-Ti wires provide a deflection load that is comparable to that of homogeneously welded orthodontic wires.

Effect of laser irradiation conditions on the laser welding strength of cobalt-chromium and gold alloys

Using tensile tests, this study investigated differences in the welding strength of casts of cobalt-chromium and gold alloys resulting from changes in the voltage and pulse duration in order to clarify the optimum conditions of laser irradiation for achieving favorable welding strength. Laser irradiation was performed at voltages of 150 V and 170 V with pulse durations of 4, 8, and 12 ms. For cobalt-chromium and gold alloys, it was found that a good welding strength could be achieved using a voltage of 170 V, a pulse duration of 8 ms, and a spot diameter of 0.5 mm. However, when the power density was set higher than this, defects tended to occur, suggesting the need for care when establishing welding conditions.

Non-destructive three-dimensional evaluation of pores at different welded joints and their effects on joints strength

OBJECTIVES

The purpose of this study was to measure the porosity in different laser welded cast alloys non-destructively using X-ray micro-focus computerized tomography (micro-CT) and to evaluate the effect of porosity on the tensile strength of the welded joints.

MATERIALS AND METHODS

The welding procedure was conducted in rectangular cast metals, CoCr, Ti and platinum added gold alloy (AuPt). The metal plates were butted CoCr to CoCr (CoCr/CoCr) or Ti to Ti (Ti/Ti) for welding of similar metals and Ti to AuPt (Ti/AuPt) for welding of dissimilar metals. Specimens were welded under several laser-welding conditions; with groove (normal), without groove (no groove), spatter, crack, or no overlapped welding (no overlap) (n=5). Porosity in the welded area was evaluated using a micro-CT. Tensile strength of the welded specimens was measured at a crosshead speed of 1mm/min. Multiple comparisons of the group means were performed using ANOVA and Fisher's multiple comparisons test (α=.05). The relationship between the porosity and the tensile strength was investigated with a regression analysis.

RESULTS

Three-dimensional images of Ti/AuPt could not be obtained due to metal artifacts and the tensile specimens of Ti/AuPt were debonded prior to the tensile test. All other welded specimens had porosity in the welded area and the porosities ranged from 0.01% to 0.17%. The fractures of most of the CoCr/CoCr and Ti/Ti specimens occurred in the parent metals. Joint strength had no relationship with the porosity in the welded area (R(2)=0.148 for CoCr/CoCr, R(2)=0.088 for Ti/Ti, respectively).

SIGNIFICANCE

The small amount of porosity caused by the laser-welding procedures did not affect the joint strength. The joint strength of Ti/AuPt was too weak to be used clinically.

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.

Bond strength of gold alloys laser welded to cobalt-chromium alloy

The objective of this study was to investigate the joint properties between cast gold alloys and Co-Cr alloy laser-welded by Nd:YAG laser. Cast plates were fabricated from three types of gold alloys (Type IV, Type II and low-gold) and a Co-Cr alloy. Each gold alloy was laser-welded to Co-Cr using a dental laser-welding machine. Homogeneously-welded and non-welded control specimens were also prepared. Tensile testing was conducted and data were statistically analyzed using ANOVA. The homogeneously-welded groups showed inferior fracture load compared to corresponding control groups, except for Co-Cr. In the specimens welded heterogeneously to Co-Cr, Type IV was the greatest, followed by low-gold and Type II. There was no statistical difference (P<0.05) in fracture load between Type II control and that welded to Co-Cr. Higher elongations were obtained for Type II in all conditions, whereas the lowest elongation occurred for low-gold welded to Co-Cr. This study indicated that, of the three gold alloys tested, the Type IV gold alloy was the most suitable alloy for laser-welding to Co-Cr.

A feasibility study on laser rapid forming of a complete titanium denture base plate

This work attempted to integrate the technologies of computer-aided design and computer-aided manufacture (CAD/CAM) and laser rapid forming (LRF) for the fabrication of the titanium plate of a complete denture. By the combination of laser scan and reverse engineering software, the standard triangulation language (STL)-formatted denture base plate was finally designed and sliced into a sequence of numerical controlled codes. The titanium (Ti) complete denture plate was finally built, layer-by-layer, on the LRF system. To evaluate the quality of fit, a virtual adaptation test that measured and compared the profiles of the laser free formed denture plate and those of the edentulous plaster cast had been conducted, and the mean deviation was found to be 0.34 mm. After traditional dental finishing techniques, a complete denture with a Ti base plate was then made and judged to be acceptable. The CAD/CAM/LRF system is a potential candidate and a new platform for the design and manufacture of custom-made Ti denture plates and restorations.

Effect of arm design and chemical polishing on retentive force of cast titanium alloy clasps

PURPOSE

Titanium dentures have recently increased in popularity. A decrease in the retentive force of the titanium clasps has frequently been observed. This study investigated the effect of retentive arm design and chemical polishing of titanium clasps.

MATERIALS AND METHODS

Four Akers clasps with 0.25-mm and 0.5-mm undercuts were designed so that the retentive arms were placed at 1/2 and 2/3 of the undercut area. Wax patterns were fabricated and invested in phosphate-bonded Al2O3/LiAl SiO6. They were cast with CP Ti Grade 2, CP Ti Grade 3, and Ti-6Al-7Nb using an argon gas-pressure casting unit (Autocast HC-III). After sandblasting, the castings were chemically treated with an HNO3/HF solution. The retentive force (N) was measured up to 10,000 insertion/removal times. The results (n = 5) were analyzed by ANOVA/Tukey's test (alpha= 0.05).

RESULTS

The retentive forces significantly decreased with increasing immersion time in the HNO3/HF solution (p < 0.05). The retentive force of the 2/3 undercut was significantly greater than that of the 1/2 undercut (p < 0.05). Excluding the initial insertion/removal period of the 2/3 undercut, there were no significant differences among all the titanium metals tested (p > 0.05). As the number of insertion/removal times increased, the retentive force of the 2/3 undercut greatly decreased. The retentive force of the Ti-6Al-7Nb clasps for the 1/2 undercut decreased the least after 10,000 insertion/removal times.

CONCLUSIONS

Chemical treatment for titanium clasps should be performed for 1-5 minutes due to the following factors: accuracy, surface roughness, surface structure, initial retention, and stability of retention. To maintain appropriate long-term retentive force, the retentive arms should be placed in the 1/2 undercut area of the abutment tooth.