Shear bond strength of porcelain to a new millable alloy and a conventional castable alloy

Effect of laser etching on surface characteristics and porcelain bond to soft milled and direct metal laser sintered cobalt chromium alloys

STATEMENT OF PROBLEM

The surface topography of metal substrate can affect its bond to porcelain. A neodynium-doped yttrium aluminum garnet (Nd:YAG) laser has been introduced to modify the metal surface topography and improve porcelain bond strength. However, studies on the effect of laser etching on metal to porcelain bond strength are lacking.

PURPOSE

The purpose of this in vitro study was to determine the effect of Nd:YAG laser etching on the surface roughness and wettability of and the porcelain bond strength to cobalt chromium (Co-Cr) substrate fabricated by milling and direct metal laser sintering (DMLS).

MATERIAL AND METHODS

Thirty-two 0.5×3×25-mm Co-Cr specimens were fabricated by milling soft Co-Cr (M group) and DMLS Co-Cr metal powder (DML group). The surface topography of representative specimens from each study group was assessed under a scanning electron microscope (SEM) and an atomic force microscope (AFM). All specimens were assessed for surface roughness using a contact profilometer, and for wettability with a contact angle goniometer. Half of the specimens of each study group (n=8) were subjected to surface laser etching by using a Nd:YAG laser. The specimens subjected to etching were assessed again for surface topography and wettability. All specimens in both study groups were veneered with porcelain. The porcelain bond strength was tested with a 3-point bend test in a universal testing machine. The results were statistically analyzed with 2-way ANOVA test followed by the post hoc Tukey test for pairwise comparisons (α=.05).

RESULTS

After etching, the M group had a higher mean ±standard deviation Ra and Rz of 2.9 ±0.6 and 17.7 ±3.2 µm and significantly better wettability and bond strength of 79 ±6 and 52 ±13 MPa. In contrast, after etching, the DMLS group had a significantly lower Ra and Rz of 7.9 ±2.4 and 41.8 ±9.3 µm and significantly lower wettability and bond strength of 87 ±4 and 70 ±10 MPa. The DMLS group had a significantly higher roughness and bond strength than the M group before and after laser etching. The SEM and AFM showed different surface topography in the study groups.

CONCLUSIONS

The manufacturing process of Co-Cr substrate had a significant effect on surface characteristics and porcelain bond strength. Laser etching improved the surface topography and bond strength of milled Co-Cr but not of DMLS Co-Cr.

The effect of ceramic bonder on shear bond strength at the metal-ceramic interface in casted and direct metal laser sintering cobalt-chromium alloy - An in vitro study

Aim:

(1) The aim of this study was to evaluate the effect of a ceramic bonder at the metal ceramic interface in sintered and casted cobalt–chromium (Co–Cr) alloy. (2) To compare the shear bond strength between the different manufacturing techniques: Casting and direct metal laser sintering (DMLS).

Setting and Design:

In vitro comparative study.

Materials and Methods:

For the casting group, 40 clear acrylic patterns with dimensions of 20 mm × 10 mm × 2.5 mm were designed in a software and casted with Co–Cr alloy. For DMLS samples, a standard tessellation language file with the abovementioned dimensions was created through a software to fabricate 40 samples. All the samples were equally distributed into the following four groups:

Group A – Casted samples with the application of Cerambond (n = 20) Group B – Casted samples without application of Cerambond (n = 20) Group C – DMLS samples with application of Cerambond (n = 20) Group D – DMLS without application of Cerambond (n = 20).

Ceramic buildup was done on all 80 samples, followed by firing up to a temperature of 920°C in a ceramic furnace. SBS was evaluated using a universal testing machine and failure modes were examined under the electron microscope.

Statistical Analysis Used:

ANOVA test and Tukey’s honestly significance difference post hoc test for multiple comparisons.

Results:

One-way analysis of variance test revealed that the shear load and bond strength values of all four groups were statistically different with P < 0.001. Post hoc Tukey’s test showed statistically significant difference among the four groups. The mean shear strength of Group C was significantly greater when compared to other groups, respectively.

Conclusions:

Within the limitations of this study, the application of Cerambond to both casted and sintered samples showed significantly increased SBS values and it was also observed that sintered samples had higher strength than casted samples. Altogether, the results indicate that the use of Cerambond increased the shear strength between cobalt Cr alloy and ceramics, thereby prolonging the longevity of the restorations.

Evaluating the effect of the protector cap for castable implant abutments on reverse tightening values

STATEMENT OF PROBLEM

Screw loosening is the most common mechanical complication with implant prostheses. How the alteration of implant-to-abutment connection surfaces that occurs during laboratory procedures affects screw loosening is unclear.

PURPOSE

The purpose of this in vitro study was to compare the reverse tightening value (RTV) differences between custom castable abutments before casting, after casting in a conventional manner, and after casting with custom protector caps and pegs.

MATERIAL AND METHODS

Thirty implants with a standard-diameter conical connection (NobelReplace Conical Connection 4.3×13 mm; Nobel Biocare AG) and 30 premachined 4.3-mm GoldAdapt abutments (GoldAdapt; Nobel Biocare AG) were selected for this study. Specimens were divided into 3 groups (n=10): the uncast custom castable abutment group (UCCA) in which abutments were new and not cast; the unprotected custom castable abutment group (UPCCA) in which abutments were cast and devested with airborne-particle abrasion; and the protected custom castable abutment group (PCCA) in which abutments were cast by using protector caps and pegs made by milling zirconia and then devested with airborne-particle abrasion. All abutments in each group were tightened to 35 Ncm with a calibrated digital tightening device. After 10 minutes, all screws were retightened to 35 Ncm. At 3 hours, each screw was loosened, and the value at which the initial loosening occurred was documented as the RTV. The results were statistically analyzed with 1-way ANOVA to explore differences, and post hoc tests with Tukey adjustment were used for multiple comparisons.

RESULTS

Among the tested groups, the mean RTV ranged from 19.89 Ncm to 27.19 Ncm: UCCA 27.19 Ncm, UPCCA 19.89 Ncm, and PCCA 24.24 Ncm. A significant difference was found among the tested groups (P<.05).

CONCLUSIONS

Casting procedures, especially devestment with airborne-particle abrasion, affected implant-abutment connections and the seat site of the screw. Protecting the implant connection site and the seat site of the abutment screw with protector caps and pegs prevented a significant loss of the RTV.

Evaluation of the relationship between metallurgical properties and metal-ceramic bond characteristics of Co-Cr alloys manufactured by different techniques

STATEMENT OF PROBLEM

Metal-ceramic restorations made from cobalt chromium (Co-Cr) alloy have been increasing, but studies on the effects of different manufacturing techniques on metal-ceramic interface characteristics and metal-ceramic bond strength are sparse.

PURPOSE

The purpose of this in vitro study was to examine the metal-ceramic interface and the metal-ceramic bond strength of a Co-Cr alloy produced by casting, milling, and selective laser melting (SLM) with or without thermal cycling.

MATERIAL AND METHODS

Co-Cr alloys were prepared by casting, milling, and SLM. Two different SLM devices were used. Ninety-six specimens (25×3×0.5 mm) were manufactured. The structure of the oxidation surface of Co-Cr specimens was examined by scanning electron microscopy (SEM) and by X-ray fluorescence spectroscopy (XRFS). After porcelain application, selected specimens were thermal cycled, and the strength of the metal-ceramic bond was measured by the 3-point bend test. All specimens were analyzed for failure type with a stereomicroscope. The elemental composition and morphology of the metal-ceramic interface were examined by XRFS and SEM with energy-dispersive X-ray (EDX). The results of bond strength were analyzed using a 2-way analysis of variance (ANOVA) for manufacturing methods and testing conditions and the Tukey honest significant difference (HSD) test (α=.05).

RESULTS

The main effect of the interactions of the testing condition and manufacturing method variables on the bond strength variable was not statistically significantly different. No significant differences were found among the testing conditions tested (P=.638). Significant differences were found among the manufacturing methods tested statistically (P<.001). Statistically significant differences were found in the CAD-CAM and CONSEPT LASER groups, the CAD-CAM and SLM LASER groups, the CAD-CAM and CAST groups, and the CAST-SLM LASER groups (P<.05). Differences were observed among the interface morphologies of casting, milling, and the two SLM groups.

CONCLUSIONS

The bond strength between Co-Cr alloy and ceramic is affected by the manufacturing method. The metal-ceramic bond strength is independent of thermal cycling. The bond strength value in all groups was over 25 MPa, which has been considered clinically acceptable. The interface metallurgical structures of Co-Cr alloys were affected by different manufacturing techniques.

Bond strength of ceramic veneered CAD-milled alloy upon prolonged sintering

OBJECTIVES

Ceramic-sintering affects bond strength and longevity of metal-ceramic. This study investigated the effect of sintering temperatures and times on metal-ceramic bond strength vis-a-vis interfacial fracture toughness.

MATERIALS AND METHODS

One hundred eighty rectangular-shaped (25 × 8 × 1 mm) casting (Auriloy® (CA)) and CAD-milling (Ceramill Sintron® (MA)) alloys were prepared and randomly veneered with ceramic at normal (930 °C; (TN)), increased (940 °C; (TI)), and extremely increased (950 °C; (TE)) sintering temperatures and normal (1 min; (HN)), increased (2 min; (HI)), and extremely increased (3 min; (HE)) sintering time (n = 10/group). Pre-cracked was subjected to four loading-unloading cycles at 0.05 mm/min speed to determine interfacial fracture toughness from strain energy release rate (G). Microstructures were examined with a scanning electron microscope (SEM), energy-dispersive X-ray (EDX), and atomic force microscopy (AFM). ANOVA and Tukey comparisons were determined for significant differences (α = 0.05).

RESULTS

Significant differences in G due to the effect of alloy, sintering temperature, and time (p < 0.05) were indicated. MA revealed higher G than CA. Raising temperatures enabled increasing G for CA, not for MA. Extended sintering permitted increasing G for both alloys. Rougher surface of MA than CA was observed. Interfacial ion exchange was differently indicated between CA and MA.

CONCLUSIONS

Bond strength was influenced by alloy, sintering temperature, and time. Ceramic has better adhesion to MA than CA. Enhancing bond for CA was succeeded through increasing sintering temperature and time, whereas through extended sintering for MA.

CLINICAL RELEVANCE

MA offers stronger bond than CA. Enhancing bond is suggested by extended sintering. Raising temperature can enhance bond for CA, not for MA.

New generation CAD-CAM materials for implant-supported definitive frameworks fabricated by using subtractive technologies

Innovations in digital manufacturing enabled the fabrication of implant-supported fixed dental prostheses (ISFDPs) in a wide variety of recently introduced materials. Computer-aided design and computer-aided manufacturing (CAD-CAM) milling allows the fabrication of ISFDPs with high accuracy by reducing the fabrication steps of large-span frameworks. The longevity of ISFDPs depends on the overall mechanical properties of the framework material including its fit, and the physical properties of the veneering material and its bond with the framework. This comprehensive review summarizes the recent information on millable CAD-CAM framework materials such as pre-sintered soft alloys, fiber-reinforced composite resins, PEEK, and PEKK in high-performance polymer family, and 4Y-TZP. Even though promising results have been obtained with the use of new generation millable CAD-CAM materials for ISFDPs, clinical studies are lacking and future research should focus on the overall performance of these millable materials in both static and dynamic conditions.

Comparative analysis of the surface properties and corrosion resistance of Co-Cr dental alloys fabricated by different methods

STATEMENT OF PROBLEMS

The complex oral environment leads to the corrosion of dental alloy materials and the release of metal ions that may have a negative impact on health. Digital manufacturing is increasingly being used in dentistry, but whether digitally manufactured prostheses have better resistance to corrosion than traditional cast prostheses is unclear.

PURPOSE

The purpose of this in vitro study was to determine the surface properties and corrosion resistance of dental cobalt-chromium (Co-Cr) alloys fabricated by lost-wax casting (CAST), selective laser melting (SLM), and computer numerical control milling (CNC).

MATERIAL AND METHODS

The surface characteristics of the specimens were analyzed via scanning electron microscopy and energy-dispersive spectroscopy (SEM-EDS), metallurgical observation, and X-ray diffraction (XRD). For corrosion resistance, the specimens were immersed in artificial saliva at a pH 2.3 and 6.8 for 1, 4, and 7 weeks. Then, inductively coupled plasma-mass spectrometry (ICP-MS) was used to detect the main metal ion. Electrochemical impedance spectroscopy (EIS) was conducted based on a 3-electrode system to assess the electrochemical corrosion resistance. An ANOVA test was used to evaluate statistically significant differences among the groups (α=.05).

RESULTS

The SLM and CNC specimens showed more homogenous microstructures, less ion release at different times and pH, and more charge transfer resistance than CAST specimens.

CONCLUSIONS

Compared with casting, SLM-printing and CNC-milling have advantages in terms of surface properties and corrosion resistance.

Effect of multiple firings on the shear bond strength of presintered cobalt-chromium alloy and veneering ceramic

STATEMENT OF PROBLEM

How multiple firing cycles may affect the oxide layer and, consequently, the shear bond strength of metal-ceramic restorations is unclear.

PURPOSE

The purpose of this in vitro study was to determine the effect of multiple firings on the shear bond strength of porcelain to cobalt-chromium (Co-Cr) alloy.

MATERIAL AND METHODS

Forty cylinders (Ø6.8×9 mm) of a representative presintered Co-Cr alloy (Ceramill Sintron) were prepared with computer-aided design and computer-aided manufacturing (CAD-CAM) technology. After airborne-particle abrasion and polishing, the specimens were ultrasonically cleaned of surface contaminants. A circular surface (Ø4×2 mm) was veneered on each specimen with porcelain (VM13) after 3 firings (wash opaque, opaque, and dentin). The specimens were then randomly divided into 4 groups (n=10). The normal group underwent 3 firings. The other groups underwent an additional porcelain firing: the one-plus firing group underwent 4 firings, the two-plus firing group underwent 5 firings, and the three-plus firing group underwent 6 firings. Next, the specimens were mounted in autopolymerized acrylic resin and tested in a universal testing machine and loaded at a crosshead speed of 0.5 mm/min at the metal-ceramic interface until fracture occurred. The average shear bond strength (MPa) was calculated by dividing the maximum fracture force (N) by the bonded surface of the specimens (mm²). The fracture patterns were observed microscopically and classified as adhesive, cohesive, or mixed. One-way ANOVA was used to determine differences between groups (α=.05).

RESULTS

No significant differences were found among the shear bond strengths of specimens after 3, 4, 5, and 6 porcelain firings (P>.05). The mean bond strength of all groups ranged from 30 to 34 MPa. The fracture pattern of all specimens was mixed, indicating that multiple firings had no significant effect on the failure pattern.

CONCLUSIONS

Multiple porcelain firings under controlled conditions had no significant effect on the fracture pattern or shear bond strength of porcelain to a presintered Co-Cr alloy.

Bond Strength of Porcelain to Milled Sintered and Casting Base Metal Alloys

Statement of the Problem:

The success of metal-ceramic restorations depends on the bond strength between porcelain and alloy. These restorations can be fabricated through different casting and computer-aided design/computer-aided manufacturing (CAD/CAM) techniques.

Purpose:

This study aimed to compare the bond strength of porcelain to milled sintered (Sintron) and casting (Co-Cr and Ni-Cr) base metal alloys.

Materials and Method:

In this in vitro experimental study, 63 rectangular bars (25×3×0.5 mm) were fabricated of three base metal alloys: casting Ni-Cr, casting Co-Cr, and milled sintered Co-Cr alloy. Feldspathic porcelain (3×8 mm) was applied at the center of each bar with 1.5 mm thickness. The specimens were thermally aged. Bond strength was evaluated through three-point flexural test. Failure mode was evaluated by optical and electron microscope. Data were analyzed with one-way ANOVA and Tukey's post hoc test (α=0.05).

Results:

The mean flexural bond strength of porcelain to milled sintered Co-Cr alloy (24.58±5.16 MPa) was significantly higher than that of casting Ni-Cr (21.13±6.34 MPa) (p= 0.03) and casting Co-Cr (20.98±4.84 MPa) alloys (p= 0.04). However, the two casting alloys were not significantly different in this regard (p= 0.93). The failure mode in all specimens was of cohesive type.

Conclusion:

Bond strength of CAD/CAM milled sintered Co-Cr alloy was better than that of the conventional casting alloys and could serve as a suitable alternative to those alloys.

Dental implant-abutment fracture resistance and wear induced by single-unit screw-retained CAD components fabricated by four CAM methods after mechanical cycling

STATEMENT OF PROBLEM

Computer-aided design and computer-aided manufacturing (CAD-CAM) methodologies allow the fabrication of custom dental implant abutments with a variety of materials and techniques. Studies on the mechanical strength of such components and the wear induced at their coupling interface during mechanical cycling are sparse.

PURPOSE

The purpose of this in vitro study was to measure the wear patterns at the hexagonal platform of dental implants induced by the installation and mechanical cycling of custom abutments fabricated by using 4 different CAD-CAM methods and to determine the compressive static resistance of the implant-abutment combinations.

MATERIAL AND METHODS

A CAD software program was used to design a custom abutment for a single-unit screw-retained external hexagon dental implant crown. The same design file was used to manufacture with 4 CAM methods (N=40): milling and sintering of zirconium dioxide (ZO), cobalt-chromium (Co-Cr) sintered by selective laser melting (SLM), fully sintered machined Co-Cr alloy (MM), and machined and sintered agglutinated Co-Cr alloy powder (AM). Prefabricated titanium abutments were used as a control (TI). Each abutment was installed onto a dental implant (4.1×11 mm), and the specimens were mechanically aged (1 million cycles, 2 Hz, 100N, 37 °C). After mechanical cycling, the hexagonal connection of the dental implants was examined with a scanning electron microscope (SEM), and unused dental implants (NI) were examined as a control (n=10). The images were analyzed with a software program to quantify the areas that showed wear. The implant-abutment combinations were reassembled and submitted to a compression test (1mm/min) with a universal testing machine. The data obtained were submitted to 1-way ANOVA (α=.05).

RESULTS

The mean ±standard deviation fracture load (N) of the specimens of each group were 1005 ±187 (ZO), 1074 ±123 (SLM), 1033 ±109 (MM), 1019 ±149 (AM), and 923 ±129 (TI). These values were statistically similar (P=.213). The mean ±standard deviation wear of the implants in squared-pixels were 1.1 ±0.38×10⁵ (ZO), 2.0 ±0.29×10⁵ (SLM), 1.0 ±0.38×10⁵ (MM), 1.1 ±0.27×10⁵ (AM), 1.1 ±0.33×10⁵ (TI), and 0.51 ±0.29×10⁵ (NI). The results indicated that, although significantly higher than those in in the control group (NI), the wear values found in the groups TI, ZO, MM, and AM were significantly lower than in the SLM group (P<.001).

CONCLUSIONS

The CAD-CAM abutments presented the same mechanical fracture load and wear measurements as the TI group, except for the SLM material, which showed increased wear. The failure mode from the load bearing test was the fracture of the abutments for the ZO group. The implants permanently deformed or fractured for the metal abutment groups.

Survival and success rates of soft-milled cobalt-chromium-ceramic full-arch screw-retained implant-supported prostheses: a 2- to 7-year follow-up retrospective study

OBJECTIVES

To retrospectively assess implant and prosthesis survival and success and patient satisfaction in edentulous patients treated with soft-milled cobalt-chromium-ceramic full-arch screw-retained implant-supported prostheses (SCCSIPs) over a mean clinical follow-up period of 4 years.

MATERIALS AND METHODS

Twenty-one edentulous patients, aged 47-80 years, underwent restoration with 27 SCCSIPs (210 implants, 349 crown units). After definitive prosthesis insertion, patients participated in a yearly dental check-up recall program, including clinical and radiographic examinations. All supporting implants were examined for biological and technical complications, and the restorations were evaluated using modified California Dental Association (CDA) criteria. Life table and Kaplan-Meier survival analyses were performed. Patient satisfaction regarding chewing, esthetics, comfort, and phonetics was evaluated using a visual analog scale (VAS).

RESULTS

After a mean of 4 years, two implants (3.8%) failed, with no effect on prosthesis survival. The cumulative survival rate was 98.6% and 100% for implants and prostheses, respectively. The most frequent minor biological complication was soft tissue recession (11%). Porcelain fracture was the only major technical complication (0.6% of crown units), while the only minor technical complication was porcelain chipping (4% of crown units), which required only polishing. Overall, 66.7% of the prostheses were free of technical complications. Patient satisfaction was high to very high. Less satisfaction was noted with comfort due to soft tissue recession and food impaction.

CONCLUSIONS

Within the limitations of this study, we conclude that the survival and success rates of SCCSIPs in edentulous patients were excellent.

CLINICAL RELEVANCE

SCCSIPs should be considered when planning metal-ceramic implant-supported restorations.

Comparison of marginal adaptation and internal fit of monolithic lithium disilicate crowns produced by 4 different CAD/CAM systems

OBJECTIVES

To evaluate the marginal adaptation and internal space of crowns produced by 4 CAD/CAM systems using microcomputed tomography (μCT) and replica technique (RT).

MATERIALS AND METHODS

Monolithic lithium disilicate crowns were milled (Ceramill, Cerec, EDG, and Zirkonzahn) (n = 10). The cement film obtained with low viscosity silicone was scanned by the μCT system and captured by a stereomicroscope, according to RT. Two-way ANOVA followed by Tukey's test were used for statistical analysis (α = 0.05). A uniformity index (UI) was idealized to describe the distribution of crowns' internal space and submitted to the Kruskal-Wallis and Tukey's test (α = 0.05). The correlation between μCT and RT was performed by Pearson's Correlation Coeficient (α = 0.05).

RESULTS

Marginal adaptation and internal space were statistically significant different between the experimental groups for the μCT and RT (p < 0.05). The medians of the 4 systems tested were within clinically acceptable range and the mean (± SD) highest marginal discrepancy was recorded in the Ceramill group at 133.0 ± 71.5 μm (μCT) and 90.6 ± 38.5 μm (RT). For internal fit, the UI disclosed a better distribution of the internal space for the Zirkonzahn group (p < 0.001). There was a strong correlation between the methods (p = 0.01 and r = 0.69).

CLINICAL RELEVANCE

Because of the variability of the CAD/CAM systems available, evaluating their accuracy is of clinical interest. The 4 systems are capable to produce restorations adaptated within clinically appropriate levels. The μCT and RT are efficient adaptation methodologies.

Comparative In Vitro Study of the Bond Strength of Composite to Carbon Fiber Versus Ceramic to Cobalt-Chromium Alloys Frameworks for Fixed Dental Prostheses

Purpose: The aim of this comparative in vitro study was to assess the bond strength and mechanical failure of carbon-fiber-reinforced composites against cobalt–chrome structures with ceramic veneering. Materials and methods: A total of 24 specimens (12 per group) simulating dental prosthetic frameworks were fabricated. The experimental specimens were subjected to a thermocycling aging process and to evaluate bond strength. All specimens were subjected to a three-point bending test to fracture using a universal testing machine. Results: The cobalt–chrome/ceramic group yielded a bond strength value of 21.71 ± 2.16 MPa, while the carbon-fiber-reinforced composite group showed 14.50 ± 3.50 MPa. The failure assessment reported statistical significance between groups. Although carbon-fiber-reinforced composite group showed lower bond strength values, the chipping incidence in this group was as well lower. Conclusions: The chrome–cobalt/ceramic group showed greater bonding strength compared to the carbon-fiber-reinforced composite; most of the fractures within the cobalt–chrome/ceramic group, had no possibility of direct clinical repair.

Shear Bond Strength of Ceramic Bonded to Different Core Materials and Their Pattern of Failure: An In Vitro Study

Introduction

In metal-ceramic restoration, most of the bond failures between the ceramic layer and the metal coping is the chipping of the ceramic layer, thus exposing the metal surface, which compromises the aesthetics. Hence, this leads to the introduction of zirconia-based restorations in dentistry. However, even zirconium coping has the common complication of delamination or porcelain chipping from the zirconium core. Hence, the shear bond strength between the commonly used core materials and ceramic requires investigation to facilitate the materials in clinical use for longevity. Therefore, this study was conducted to compare the shear bond strength between different core materials and ceramic layering to find out the best core material for ceramic bonding.

Materials and methods

A total number of 45 samples were made as per ISO standardization (base 5 mm diameter and 1 mm thickness, step with 4 mm diameter and 4 mm in length). These samples were divided into three groups, Group A: Nickel-chromium, Group B: Cobalt-chromium, and Group C: Zirconium. Ceramic layering was layered on the top surface of each sample until an ideal height of 4 mm was obtained, and it was subjected to shear bond strength using a universal testing machine with a 50-KN load cell. This was followed by analyzing the nature of the fracture pattern using scanning electron microscopy (SEM).

Results

 There were no significant differences found for the shear bond strength among group A and group B. The zirconium (group C), however, had significantly lower values than both group A and group B. The microscopic examination also revealed that the failure between the coping and the ceramic layer primarily occurred near the interface with the residual veneering porcelain remaining on the core.

Conclusions

It was found that the shear bond strength of the metal-ceramic group is better than the zirconium ceramic group, however, the fracture between the copings and the ceramic layering is found to be similar for both adhesive and cohesive failure.

Influence of ceramic firing on marginal gap accuracy and metal-ceramic bond strength of 3D-printed Co-Cr frameworks

STATEMENT OF PROBLEM

The marginal gap and ceramic bond strength of metal-ceramic restorations are important for success. However, studies evaluating the marginal gap and ceramic bond strength of fixed partial dentures (FPDs) produced with 3D printing technologies such as selective laser melting (SLM) are scarce.

PURPOSE

The purpose of this in vitro study was to investigate the marginal gap of cobalt-chromium (Co-Cr) alloy frameworks produced by SLM technology before and after ceramic firing. Additionally, the metal-ceramic bond strength was evaluated with the Schwickerath crack-initiation test according to the International Standards Organization (ISO) 9693-1:2012.

MATERIAL AND METHODS

Conventional impressions were made, and the definitive cast of a patient requiring a 4-unit FPD was scanned. After designing the FPD, the files were sent to a service center for the fabrication of a metal master model, 80 Co-Cr frameworks, and 80 flat specimens (25×3×0.5 mm) with SLM technology. The marginal gap between frameworks and the abutment tooth of the metal master model was nondestructively measured by using an optical coordinate-measuring machine. A total of 80 sets, consisting of 1 framework and 1 flat specimen, were sent to 80 dental laboratory technicians for ceramic firing. Detailed instructions for correct manipulation of the framework and flat specimen were provided. The marginal gap was remeasured, and the 3-point bend test was used to evaluate metal-ceramic bond strength.

RESULTS

Only 28 of the 80 dental technicians returned the specimens within a prespecified time and/or in adequate condition. The mean ±standard deviation marginal gap of the framework before ceramic firing was 25 ±9 μm and 34 ±12 μm after firing. The difference was statistically significant (P=.001). The mean ±standard deviation 3-point bend strength was 33 ±9 MPa.

CONCLUSIONS

Ceramic firing affected the marginal gap; however, all Co-Cr frameworks had a marginal gap lower than 120 μm, which is reported to be a clinically acceptable limit. Most of the specimens (80%) had a metal-ceramic bond strength value higher than the 25-MPa ISO 9693 requirement. Five of 28 dental laboratory technicians were not able to comply with ceramic firing instructions.

Marginal fit of metal-ceramic crowns fabricated by using a casting and two selective laser melting processes before and after ceramic firing

STATEMENT OF PROBLEM

Few studies have investigated changes in the marginal fit of metal-ceramic restorations fabricated by selective laser melting (SLM) techniques after the application of veneering ceramic.

PURPOSE

The purpose of this in vitro study was to evaluate the marginal fit (silicone replica technique) and internal porosity (cross-section analysis) of cobalt-chromium (Co-Cr) alloy metal crowns prepared by using 2 SLM processes together with a casting technique before and after ceramic veneering.

MATERIAL AND METHODS

Cast single Co-Cr crowns and SLM-processed crowns with large (SLML) or small (SLMS) porosity were prepared (n=20/group), and half were subjected to ceramic veneering. On a single Co-Cr master die, the marginal discrepancy (MD) and absolute marginal discrepancy (AMD) of the crowns were measured by using the silicone replica technique, in which each replica was cut into 4 sections before and after ceramic veneering (n=10 for each subgroup). After marginal fit measurements, each metal coping was cross-sectioned into 4 parts, and 5 rectangular optical microscope images were acquired on both outer corners of each quarter. The porosity was then calculated as the ratio of the black-to-white pixels on the binarized images. The data were analyzed by 2-way ANOVA and the post hoc test (Tukey or Student t test) (α=.05).

RESULTS

Before ceramic veneering, the 2 SLM groups showed significantly larger MDs than the casting group (56.4 ±10.4 μm) (P<.05). A significant increase in MD after ceramic veneering was detected only in the SLML group (P<.001). The AMD values showed a similar trend with MD values. The 2 SLM groups (in particular, SLML) showed a significantly higher amount of porosity than the casting group before ceramic veneering (P<.001). Only the SLML group showed a significant decrease in the amount of porosity after ceramic veneering (P<.001).

CONCLUSIONS

Within the limitations of this in vitro study, large internal porosity within the SLM-fabricated Co-Cr metal copings affected the marginal fit of the metal-ceramic crowns. However, all the MD values of the 3 groups were lower than the acceptable range even after the application of veneering ceramic.

Evaluation of dimensional accuracy of dental bridges manufactured with conventional casting technique and CAD/CAM system with Ceramill Sintron blocks using CMM

Background. Recently, non-presintered chromium-cobalt (Cr-Co) blocks with the commercial name of Ceramill Sintron were introduced to the market. However, comprehensive studies on the dimensional accuracy and fit of multi-unit frameworks made of these blocks using the coordinate measuring machine (CMM) are lacking. This study aimed to assess and compare the dimensional changes and fit of conventional casting and milled frameworks using Ceramill Sintron.

Methods. A metal model was designed and scanned and 5-unit frameworks were fabricated using two techniques: (I) the conventional casting method (n=20): the wax model was designed, milled in the CAD/CAM machine, flasked and invested; (II) the milling method using Ceramill Sintron blocks (n=20): the wax patterns of group 1 were used; Ceramill Sintron blocks were milled and sintered. Measurements were made on the original reference model and the fabricated frameworks using the CMM in all the three spatial dimensions, and dimensional changes were recorded in a checklist. Data were analyzed with descriptive statistics, and the two groups were compared using one-way ANOVA and Tukey test (α=0.05).

Results. The fabricated frameworks in both groups showed significant dimensional changes in all the three dimensions. Comparison of dimensional changes between the two groups revealed no significant differences (P>0.05) except for transverse changes (arch) that were significantly greater in Ceramill Sintron frameworks (P<0.05).

Conclusion. The two manufacturing processes were the same regarding dimensional changes and the magnitude of marginal gaps and both processes resulted in significant dimensional changes in frameworks. Ceramill Sintron frameworks showed significantly greater transverse changes than the conventional frameworks.

Comparative Study of the Fit Accuracy of Full-Arch Bar Frameworks Fabricated with Different Presintered Cobalt-Chromium Alloys

Purpose

This study was to measure the geometric discrepancies that occur during the sintering contraction of presintered Co-Cr alloys in a full-arch bar framework and to compare the variations between alloys from different manufacturers.

Materials and Methods

Eighteen implant-supported full-arch bar frameworks were fabricated through a soft-machining process using presintered Co-Cr alloy blocks: Ceramill Sintron (CS), Soft Metal (SM), and Sintermetall (SML) (n=6 for each group). The sintered frameworks were digitized using a structured light scanner, and the scan images were superimposed on the reference design. The geometric discrepancies of the sintered frameworks were three-dimensionally analyzed for horizontal, angular, and internal discrepancies. Kruskal-Wallis and Mann-Whitney U tests were used to compare the discrepancies among the groups (α=.05).

Results

Significant differences were found in the geometric discrepancy measurements among the groups. The CS group showed larger horizontal and angular discrepancies, followed by the SM and SML groups (P<.001). The root mean square (RMS) values for internal discrepancy were not statistically different among the groups (P=.778).

Conclusion

The geometric discrepancies of full-arch bar frameworks fabricated using the soft-machining process were affected by accuracies in sintering contraction of presintered alloys.

Precision of the milled full-arch framework fabricated using pre-sintered soft alloy: A pilot study

PURPOSE

This study aimed to evaluate the marginal discrepancy of full-arch frameworks in implant-supported prostheses fabricated using pre-sintered soft alloy (PSA).

MATERIALS AND METHODS

Full-arch metal frameworks were fabricated on the edentulous implant model using casting alloy (CA), fully-sintered hard alloy (FHA), and PSA (n = 4 in each group). To evaluate the misfit of the framework to the abutments, the absolute marginal discrepancy (AMD) values of the frameworks were measured in cross-sectional images that had been drawn as part of the triple-scan protocol. The AMD values were compared among the tested alloy groups using the Kruskal-Wallis test, with a post hoc Mann-Whitney U test (α=.05).

RESULTS

The FHA and PSA groups showed lower marginal discrepancies than the CA group (P<.001). However, the FHA group did not differ significantly from the PSA group.

CONCLUSION

Soft alloy milling is comparable to hard alloy milling, and it is more precise than casting in terms of the marginal fit of implant-supported, full-arch prostheses.

The Effect of Multiple Firings on the Shear Bond Strength of Porcelain to a New Millable Alloy and a Conventional Casting Alloy

This study compared the effect of multiple firings on the shear bond strength (SBS) of porcelain to the new millable alloy (Ceramill Sintron) and a conventional casting alloy (4-all). Thirty-six cylindrical cores (6.8 × 9 mm) were made of millable and castable alloy through CAD/CAM and casting techniques, respectively (n = 18). In the center of each bar, a 4 × 4 × 2-mm shot of porcelain was fused. Having divided each group into 3 subgroups based on the number of firing cycles (3, 5, 7), the specimens were fixed in a universal testing machine and underwent a shear force test (1.5 mm/min crosshead speed) until fractured. Then the SBS values (MPa) were calculated, and the failure patterns were microscopically characterized as adhesive, cohesive, or mixed. Two-way ANOVA statistical test revealed that the number of porcelain firings had no significant effect on the SBS of any of the metal groups (p = 0.1); however, it was statistically higher in the millable group than the castable group (p < 0.05). Moreover, detecting the mixed failure pattern in all the specimens implied that the multiple firings had no significant effect on the failure pattern. The multiple porcelain firings had no significant effect on the SBS of porcelain to neither the millable nor castable alloys.

Effects of abutment diameter, luting agent type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments

PURPOSE

The aim of this study was to evaluate the effects of abutment diameter, cement type, and re-cementation on the retention of implant-supported CAD/CAM metal copings over short abutments.

MATERIALS AND METHODS

Sixty abutments with two different diameters, the height of which was reduced to 3 mm, were vertically mounted in acrylic resin blocks with matching implant analogues. The specimens were divided into 2 diameter groups: 4.5 mm and 5.5 mm (n=30). For each abutment a CAD/CAM metal coping was manufactured, with an occlusal loop. Each group was sub-divided into 3 sub-groups (n=10). In each subgroup, a different cement type was used: resin-modified glass-ionomer, resin cement and zinc-oxide-eugenol. After incubation and thermocycling, the removal force was measured using a universal testing machine at a cross-head speed of 0.5 mm/min. In zinc-oxide-eugenol group, after removal of the coping, the cement remnants were completely cleaned and the copings were re-cemented with resin cement and re-tested. Two-way ANOVA, post hoc Tukey tests, and paired t-test were used to analyze data (α=.05).

RESULTS

The highest pulling force was registered in the resin cement group (414.8 N), followed by the re-cementation group (380.5 N). Increasing the diameter improved the retention significantly (P=.006). The difference in retention between the cemented and recemented copings was not statistically significant (P=.40).

CONCLUSION

Resin cement provided retention almost twice as strong as that of the RMGI. Increasing the abutment diameter improved retention significantly. Re-cementation with resin cement did not exhibit any difference from the initial cementation with resin cement.

Evaluation of metal-ceramic bond characteristics of three dental Co-Cr alloys prepared with different fabrication techniques

STATEMENT OF PROBLEM

Limited information is available regarding the metal-ceramic bond strength of dental Co-Cr alloys fabricated by casting (CAST), computer numerical control (CNC) milling, and selective laser melting (SLM).

PURPOSE

The purpose of this in vitro study was to evaluate the metal-ceramic bond characteristics of 3 dental Co-Cr alloys fabricated by casting, computer numerical control milling, and selective laser melting techniques using the 3-point bend test (International Organization for Standardization [ISO] standard 9693).

MATERIAL AND METHODS

Forty-five specimens (25×3×0.5 mm) made of dental Co-Cr alloys were prepared by CAST, CNC milling, and SLM techniques. The morphology of the oxidation surface of metal specimens was evaluated by scanning electron microscopy (SEM). After porcelain application, the interfacial characterization was evaluated by SEM equipped with energy-dispersive spectrometry (EDS) analysis, and the metal-ceramic bond strength was assessed with the 3-point bend test. Failure type and elemental composition on the debonding interface were assessed by SEM/EDS. The bond strength was statistically analyzed by 1-way ANOVA and Tukey honest significant difference test (α=.05).

RESULTS

The oxidation surfaces of the CAST, CNC, and SLM groups were different. They were porous in the CAST group but compact and irregular in the CNC and SLM groups. The metal-ceramic interfaces of the SLM and CNC groups showed excellent combination compared with those of the CAST group. The bond strength was 37.7 ±6.5 MPa for CAST, 43.3 ±9.2 MPa for CNC, and 46.8 ±5.1 MPa for the SLM group. Statistically significant differences were found among the 3 groups tested (P=.028). The debonding surfaces of all specimens exhibited cohesive failure mode.

CONCLUSIONS

The oxidation surface morphologies and thicknesses of dental Co-Cr alloys are dependent on the different fabrication techniques used. The bond strength of all 3 groups exceed the minimum acceptable value of 25 MPa recommended by ISO 9693; hence, dental Co-Cr alloy fabricated with the SLM techniques could be a promising alternative for metal ceramic restorations.

Clinical evaluations of cast gold alloy, machinable zirconia, and semiprecious alloy crowns: A multicenter study

STATEMENT OF PROBLEM

Few studies have compared the marginal and internal fits of crowns fabricated from machinable palladium-silver-indium (Pd-Ag-In) semiprecious metal alloy.

PURPOSE

The purpose of this clinical study was to evaluate and compare the marginal and internal fits of machined Pd-Ag-In alloy, zirconia, and cast gold crowns.

MATERIAL AND METHODS

A prospective clinical trial was performed on 35 participants and 52 abutment teeth at 2 centers. Individuals requiring prosthetic restorations were treated with gold alloy or zirconia crowns (2 control groups) or Pd-Ag-In alloy crowns (experimental group). A replica technique was used to evaluate the marginal and internal fits. The buccolingual and mesiodistal cross-sections were measured, and a noninferiority comparison was conducted.

RESULTS

The mean marginal gaps were 68.2 μm for the gold crowns, 75.4 μm for the zirconia crowns, and 76.9 μm for the Pd-Ag-In alloy crowns. In the 5 cross-sections other than the distal cross-section, the 2-sided 95% confidence limits for the differences between the Pd-Ag-In alloy crowns and the 2 control groups were not larger than the 25-μm noninferiority margin. The control groups displayed smaller internal gaps in the line angle and occlusal spaces compared with the Pd-Ag-In crown group.

CONCLUSION

The marginal gaps of machinable Pd-Ag-In alloy crowns did not meet the noninferiority criterion in the distal margin compared with zirconia and gold alloy crowns. Nonetheless, all 3 crowns had clinically applicable precision.