Microstructure, mechanical properties, and retentive forces of cobalt-chromium removable partial denture frameworks fabricated by selective laser melting followed by heat treatment

An Update on Implant-Associated Malignancies and Their Biocompatibility

Implanted medical devices are widely used across various medical specialties for numerous applications, ranging from cardiovascular supports to orthopedic prostheses and cosmetic enhancements. However, recent observations have raised concerns about the potential of these implants to induce malignancies in the tissues surrounding them. There have been several case reports documenting the occurrence of cancers adjacent to these devices, prompting a closer examination of their safety. This review delves into the epidemiology, clinical presentations, pathological findings, and hypothesized mechanisms of carcinogenesis related to implanted devices. It also explores how the surgical domain and the intrinsic properties and biocompatibility of the implants might influence the development of these rare but serious malignancies. Understanding these associations is crucial for assessing the risks associated with the use of medical implants, and for developing strategies to mitigate potential adverse outcomes.

Development of lightweight and high-strength hollow titanium-plated denture material using three-dimensional printing

Owing to its desirable ability to fabricate complex shapes, three-dimensional printing is preferred over casting for manufacturing dentures. Furthermore, titanium is widely used in dental implants and dentures because of its high corrosion resistance, biocompatibility, strength, and low density. In this study, we aimed to develop a new metal denture material from three-dimensional-printed (3DP) to achieve lighter weight and greater strength than those of PMMA dentures. Hollow (3DP-H) structure and solid (3DP-S) structure titanium plate specimens of 0.5, 1.0, and 3.0 mm in thickness were used. Casted Ti, casted Co-Cr, and PMMA plates were fabricated for comparison. Elastic modulus, density, thermal conductivity, hardness, and proof stress of the specimens were measured and plotted on a radar chart to enable multifaceted evaluation. The results indicated that the density of the 3DP-H plates reduced by 28-36% compared with those of 3DP-S and cast Ti plates. The weight of the metal-denture-equivalent section of the 0.5-mm-thick 3DP-H titanium-plated denture reduced to two-thirds that of the 2.0-mm-thick PMMA denture. The proof stress of the 0.5-mm-thick 3DP-H plate increased to about 3 times that of the 2.0-mm-thick PMMA plate. The total value of the 0.5-mm-thick 3DP-H titanium plates was higher than it of the 1.0-mm-thick PMMA plates. This study suggests that it is possible to produce 3DP-H titanium plate dentures exhibiting not only extremely lightweight compared to conventional PMMA dentures but also sufficient strength.

Effect of different framework materials on stresses induced in distal extension removable partial dentures: A strain gauge analysis

PURPOSE

Evaluation of the strain transmitted to the abutments and residual ridge by polyetherketoneketone material compared to the cobalt-chromium one in distal extension removable partial dentures (RPDs) to fulfill the objective of preservation of the supporting structures.

MATERIALS AND METHODS

A virtual model simulating a Kennedy class I partially edentulous mandibular arch was designed. Two models, one for each group, were printed. Five RPDs were made in each group. In group CR, the framework was milled from a cobalt-chromium alloy. While in group PK, it was milled from a polyetherketoneketone blank. Strain gauge rosettes were bonded distal to the last abutment and posteriorly in the distal end of the residual ridge. Unilateral vertical and oblique loadings were applied. Mann-Whitney U test was used for inter-group comparisons while the Friedman test was used for intra-group comparisons and corrected by Wilcoxon Signed-Rank Sum. The significance level was set at p ≤ 0.05.

RESULTS

During unilateral vertical load application, a statistically significant difference was found between both groups distal to the abutment in the loaded and unloaded sides as well as the residual ridge on the unloaded side. During oblique load application, a statistically significant difference was found between both groups in all slots.

CONCLUSION

Polyetherketoneketone material induces less stress on the abutments and more stress on the residual ridges compared to the cobalt-chromium ones. Therefore, it may be recommended for weak abutments supporting RPDs.

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2022 dental literature to briefly touch on several topics of interest to modern restorative dentistry. Each committee member brings discipline-specific expertise in their subject areas that include (in order of the appearance in this report): prosthodontics; periodontics, alveolar bone, and peri-implant tissues; dental materials and therapeutics; occlusion and temporomandibular disorders; sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence the daily dental treatment decisions of the reader with an emphasis on innovations, new materials and processes, and future trends in dentistry. With the tremendous volume of literature published daily in dentistry and related disciplines, this review cannot be comprehensive. Instead, its purpose is to update interested readers and provide valuable resource material for those willing to subsequently pursue greater detail on their own. Our intent remains to assist colleagues in navigating the tremendous volume of newly minted information produced annually. Finally, we hope that readers find this work helpful in managing patients.

Fit and Retention of Cobalt-Chromium Removable Partial Denture Frameworks Fabricated with Selective Laser Melting

PURPOSE

To evaluate fit and retention of cobalt-chromium removable partial denture (RPD) frameworks fabricated with selective laser melting (SLM).

METHODS

Three types of framework for clasp-retained RPDs were virtually designed and fabricated using SLM (n = 30). For comparison, 30 additional frameworks were produced using conventional lost-wax casting. A biomechanical model was created, incorporating extracted teeth mounted on flexible metal posts. Using this model, horizontal constraint forces resulting from a misfit were measured using strain gauges, while vertical forces were not recorded. The constraint force components and resultant forces were determined for all abutment teeth, and the maximum retention force during RPD removal from the model was also assessed. For statistical evaluation, the two fabrication methods were analyzed by calculating the means and standard deviations.

RESULTS

The average horizontal constraint forces showed similar values for both fabrication methods (SLM: 3.5 ± 1.0 N, casting: 3.4 ± 1.6 N). The overall scatter of data for cast RPDs was greater compared to those fabricated using SLM, indicating a better reproducibility of the SLM process. With regard to retention, the intended retention force of 5-10 N per abutment tooth was not attained in one of the cast groups, while it was consistently achieved in all SLM groups.

CONCLUSIONS

This in vitro study found that SLM is a promising option for the manufacture of cobalt-chromium RPD frameworks in terms of fit and retention.

Comparative Study of the Microstructure and Properties of Cast-Fabricated and 3D-Printed Laser-Sintered Co-Cr Alloys for Removable Partial Denture Frameworks

Since additive technologies in dentistry are gradually replacing metal casting technology, it is necessary to evaluate new dental constructions intended for the development of removable partial denture frameworks. The aim of this research was to evaluate the microstructure and mechanical properties of 3D-printed, laser-melted and -sintered Co-Cr alloys, and perform a comparative study with Co-Cr castings for the same dental purposes. The experiments were divided into two groups. The first group consisted of samples produced by conventional casting of the Co-Cr alloy. The second group consisted of 3D-printed, laser-melted and -sintered specimens produced from a Co-Cr alloy powder divided into three subgroups, depending on the technological parameters chosen for manufacturing (angle, location and heat treatment). Examination of the microstructure was carried out by classical metallographic sample preparation, using optical microscopy and scanning electron microscopy with energy dispersive X-ray spectroscopy (EDX) analysis. A structural phase analysis was also performed by XRD. The mechanical properties were determined using a standard tensile test. The microstructure observation showed a dendritic character in the case of castings, while in the case of 3D-printed, laser-melted and -sintered Co-Cr alloys, the microstructure was typical for additive technologies. The XRD phase analysis confirmed the presence of Co-Cr phases (ε and γ). The results of the tensile test showed remarkably higher yield and tensile strength values and slightly lower elongation of the 3D-printed, laser-melted and -sintered samples than those produced by conventional casting.

Mechanical properties and accuracy of removable partial denture frameworks fabricated by digital and conventional techniques: A systematic review

STATEMENT OF PROBLEM

Providing a removable partial denture (RPD) can be a complex, time-consuming, and error-prone procedure. Computer-aided design and computer-aided manufacturing (CAD-CAM) techniques have shown promising clinical outcomes; however, the influence of manufacturing techniques on the properties of RPD components is unclear.

PURPOSE

The purpose of this systematic review was to determine the accuracy and mechanical properties of RPD components fabricated with conventional and digital methods.

MATERIAL AND METHODS

This study followed the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) and was registered on the international prospective register of systematic reviews (PROSPERO) database (CRD42022353993). An electronic search was conducted on PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library in August 2022. Only in vitro studies comparing the digital with the lost-wax casting technique were included. The quality of the studies was assessed by using the methodological index for nonrandomized studies (MINORS) scale.

RESULTS

Of the 17 selected studies, 5 evaluated the accuracy of RPD components as well as the mechanical properties, 5 studies evaluated only the component accuracy, and another 7 evaluated only the mechanical properties. The accuracy was similar regardless of the technique, with discrepancies within clinically acceptable values (50 to 426.3 μm). The surface roughness was higher for 3D-printed clasps and lower for milled clasps (P<.05). The metal alloy significantly influenced the porosity, with the highest number of pores obtained by casting for Ti clasps and by rapid prototyping for Co-Cr clasps.

CONCLUSIONS

In vitro studies showed that the digital technique provided similar accuracy to that of the conventional technique within a clinically acceptable range. The manufacturing technique influenced the mechanical properties of RPD components.

Combination of Scanning Strategies and Optimization Experiments for Laser Beam Powder Bed Fusion of Ti-6Al-4V Titanium Alloys

This paper studies the effects of different combinations of scanning strategies between layers on the surface quality, tensile properties, and microstructure of samples in a laser beam powder bed fusion (L-PBF) formation experiment of Ti-6Al-4V titanium alloy. The purpose of this experiment was to improve the comprehensive performance of the piece by selecting the optimal combination of scanning strategies. The results show that the surface roughness of the L-PBF specimen was the lowest under the combination of the CHESS scanning strategy, reaching 14 μm. The surface hardness of the samples was generally higher with the LINE scanning strategy and the angle offset of 90°, reaching 409 HV. The overall density of the samples was higher under the combination of CHESS scanning strategies, reaching 99.88%. Among them, the CHESS&45° sample had the best comprehensive properties, with a density of 99.85%, a tensile strength of up to 1125 MPa, a yield strength of 912 MPa, and an elongation of 8.2%. The fractured form was a ductile fracture, with many dimple structures. Compared with the CHESS scanning strategy, the tensile properties of the CHESS&45° samples were improved by 12.8%. The microstructure of the L-PBF sample was mainly composed of the primary β phase and α’ martensite phase. The upper surface of the CHESS scanning strategy combination sample had a clear melt channel, and the distribution of each phase was uniform. A certain number of columnar β crystals were distributed in the longitudinal section of the sample, which was paralleled to the build direction. The columnar β crystals of CHESS&45° were relatively coarse, which enhanced the tensile properties of the sample.