Repairing an implant titanium milled framework using laser welding technology: a clinical report

Evaluation and comparison of vertical marginal fit of three different types of multiunit screw-retained framework fabricated for an implant-supported prosthesis - An in vitro study

Aim

The present study aimed to evaluate on a comparative basis the vertical marginal fit between conventionally casted, direct metal laser sintered (DMLS), and milled computer-aided design/computer-aided manufacturing (CAD-CAM) one-piece metal framework supported by five implants using one-screw test and screw resistance test.

Settings and Design

This is an in vitro study.

Materials and Methods

Five implants were placed parallel to one other in a Styrofoam master model. A total of 30 implant-supported screw-retained superstructures were manufactured using three techniques, i.e., conventionally casted, milled, and sintered. To evaluate the vertical marginal discrepancy, screw resistance test, and one-screw test were used, and measurements were made using a stereomicroscope.

Statistical Analysis Used

The data was analysed using two statistical tests, i.e., ANOVA and the post hoc Bonferroni test.

Results

On evaluating the frameworks using one-screw test, the mean vertical misfit value at the terminal implant for the control group was 292.58 ± 15.46μm, for conventionally casted framework 398.41 ± 21.13 μm, for DMLS 343.44 ± 24.73 μm, and for CAD-CAM was 304.03 ± 14.23 μm, whereas the average misfit values at four implants on applying screw resistance test were 1268.65 ± 84.24 (control), 1774.88 ± 67.70 (casted), 1508.02 ± 62.19 (DMLS), and 1367.29 ± 81.87 (CAD-CAM). The average misfit values on two implants using screw resistance test were 635.02 ± 57.33 for the control group; for conventionally casted, it was 879.75 ± 35.93; for (DMLS) framework, it was 761.51 ± 32.85; and for milled CAD-CAM framework, it was 687.07 ± 42.17 μm.

Conclusion

The mean vertical marginal discrepancy, when compared with control, was least in milled CAD-CAM frameworks, followed by sintered DMLS and conventionally casted frameworks. Hence, according to the present study, CAD/CAM technique is recommended to achieve maximum marginal fit in full mouth screw-retained implant-supported FDPs.

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.

Assessment of the Stress Transmitted to Dental Implants Connected to Screw-Retained Bars Using Different Casting Techniques

Passive fit of the prosthetic superstructure is important to avoid complications; however, evaluation of passive fit is not possible using conventional procedures. Thus, the aim of this study was to check and locate mechanical stress in bar restorations fabricated using two casting techniques. Fifteen patients received four implants in the interforaminal region of the mandible, and a bar was fabricated using either the cast-on abutment or lost-wax casting technique. The fit accuracy was checked according to the Sheffield's test criteria. Measurements were recorded on the master model with a gap-free, passive fit using foil strain gauges both before and after tightening the prosthetic screws. Data acquisition and processing was analyzed with computer software and submitted to statistical analysis (ANOVA). The greatest axial distortion was at position 42 with the cast-on abutment technique, with a mean distortion of 450 μm/m. The lowest axial distortion occurred at position 44 with the lost-wax casting technique, with a mean distortion of 100 μm/m. The minimal differences between the means of axial distortion do not indicate any significant differences between the techniques (P = 0.2076). Analysis of the sensor axial distortion in relation to the implant position produced a significant difference (P < 0.0001). Significantly higher measurements were recorded in the axial distortion analysis of the distal sensors of implants at the 34 and 44 regions than on the mesial positions at the 32 and 42 regions (P = 0.0481). The measuring technique recorded axial distortion in the implant-supported superstructures. Distortions were present at both casting techniques, with no significant difference between the sides.

Temperature changes of pulp chamber during in vitro laser welding of orthodontic attachments

The use of lasers has been suggested for orthodontists to fabricate or repair orthodontic appliances by welding metals directly in the mouth. This work aimed to evaluate the temperature changes in the pulp chamber during welding of an orthodontic wire to an orthodontic molar band using Nd : YAG laser in vitro. A freshly extracted human third molar with eliminated pulpal tissues was used. J-type thermocouple wire was positioned in the pulp chamber. A conductor gel was used in the transferring of outside temperature changes to the thermocouple wire. An orthodontic band was applied to the molar tooth and bonded using light cured orthodontic cement. Twenty five mm length of 0.6 mm diameter orthodontic stainless steel wires was welded to the orthodontic band using Nd : YAG laser operated at 9.4 watt. Temperature variation was determined as the change from baseline temperature to the highest temperature was recorded during welding. The recorded temperature changes were between 1.8 and 6.8°C (mean: 3.3 ± 1.1°C). The reported critical 5.5°C level was exceeded in only one sample. The results of this study suggest that intraoral use of lasers holds great potential for the future of orthodontics and does not present a thermal risk. Further studies with larger samples and structural analysis are required.

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.