Microstructures and Mechanical Properties of Co-Cr Dental Alloys Fabricated by Three CAD/CAM-Based Processing Techniques

Microstructural and mechanical characterization of six Co-Cr alloys made by conventional casting and selective laser melting

STATEMENT OF PROBLEM

Three Co-Cr alloy types (Co-Cr-Mo, Co-Cr-W, and Co-Cr-Mo-W) have been commonly used in the fabrication of dental prostheses. These alloys can be manufactured using either conventional casting or selective laser melting (SLM) techniques. Nevertheless, research that directly compares these materials and/or manufacturing processes in terms of their microstructural and mechanical characteristics is sparse.

PURPOSE

The purpose of this in vitro study was to conduct microstructural and mechanical analysis via X-ray interpretation, optical microscopy, scanning electron microscopy/energy dispersive X-ray spectroscopy (SEM/EDS), image analysis, X-ray diffraction (XRD), instrumented indentation testing (IIT), and 3-point bending testing to characterize Co-Cr-Mo, Co-Cr-W, and Co-Cr-Mo-W alloys produced through conventional casting and SLM.

MATERIAL AND METHODS

Six Co-Cr-based alloys were analyzed and divided into 3 types based on their elemental composition (Co-Cr-Mo, Co-Cr-W, and Co-Cr-Mo-W). Additionally, each group was categorized based on the manufacturing process used (casting or SLM). X-ray scans were used to assess porosity. The microstructures of the specimens were assessed through SEM/EDS examination and XRD analysis. IIT was used to determine the Martens hardness (HM) and elastic index (ηIT), while the elastic modulus (E) was estimated through the 3-point bending test. The mechanical properties were statistically analyzed using 2-way analysis of variance (ANOVA) and the Tukey multiple comparison post hoc test, with alloy type and manufacturing process as discriminating variables (α=.05).

RESULTS

All cast groups exhibited gross porosity, while no pores or other flaws were found in the SLM groups. Based on the XRD results, the crystalline structure of all Co-Cr specimens consisted of the face-centered cubic γ phase (γ-fcc), along with the hexagonal close-packed ε phase (ε-hcp) and Cr23C6 carbide. Different microstructures were identified between the cast and SLM alloys. Significant differences were identified for the mean standard deviation HM (ranging from 2601 ±94 N/mm2 to 3633 ±61 N/mm2) and mean ±standard deviation ηIT (ranging from 16.8 ±0.3% to 20.9 ±0.3%) among alloys prepared by the same manufacturing process, while all SLM alloys had statistically higher HM and ηIT results than their cast counterparts (P<.05). No statistically significant differences were identified for the mean ±standard deviation Eb (ranging from 170 ±25 GPa to 244 ±36 GPa) among the groups prepared with the same manufacturing process (P>.05), but the SLM alloys had significantly higher results (P<.05) than the cast alloys.

CONCLUSIONS

In general, the manufacturing procedure significantly affected the porosity, microstructure, and mechanical properties of the tested Co-Cr alloys. SLM decreased the internal porosity, provided a uniform microstructure, and improved the mechanical properties for all the tested alloy types.

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.

Simulating porcelain firing effect on the structure, corrosion and mechanical properties of Co-Cr-Mo dental alloy fabricated by soft milling

This study aims at evaluating the effect of simulating porcelain firing on the microstructure, corrosion behavior and mechanical properties of a Co-Cr-Mo alloy fabricated by Metal Soft Milling (MSM). Two groups of Co-28Cr-5Mo specimens (25 × 20 × 3 mm) were prepared by MSM: The as-sintered (AS) specimens and the post-fired (PF) specimens that were subjected to 5 simulating porcelain firing cycles without applying the ceramic mass onto their surface. Phase identification by X-ray Diffraction (XRD), microstructure examination by optical microscopy and Scanning Electron Microscopy combined with Energy-Dispersive X-ray Spectroscopy (SEM/EDX), corrosion testing by cyclic polarization and chronoamperometry in simulated body fluid (SBF), the latter test accompanied by Cr3+ and Cr6+ detection in the electrolyte through the 1.5-diphenylcarbazide (DPC) method and UV/visible spectrophotometry, and mechanical testing by micro-/nano-indentation were conducted to evaluate the effect of the post-firing cycles on the properties of Co-Cr-Mo. The results were statistically analyzed by the t test (p < 0.05: statistically significant). All specimens had a mixed γ-fcc and ε-hcp cobalt-based microstructure with a dispersion of pores filled with SiO2 and a fine M23C6 intergranular presence. PF led to an increase in the ε-Co content and slight grain coarsening. Both AS and PF alloys showed high resistance to general and localized corrosion, whereas neither Cr6+ nor Cr3+ were detected during the passivity-breakdown stage. PF improved the mechanical properties of the AS-alloy, especially the indentation modulus and true hardness (statistically significant differences: p = 0.0009 and 0.006, respectively). MSM and MSM/simulating-porcelain firing have been proven trustworthy fabrication methods of Co-Cr-Mo substrates for metal-ceramic prostheses. Moreover, the post-firing cycles improve the mechanical behavior of Co-Cr-Mo, which is vital under the dynamically changing loads in the oral cavity, whereas they do not degrade the corrosion performance.

Metal-Ceramic Compatibility in Dental Restorations According to the Metallic Component Manufacturing Procedure

In terms of production technology, metal-ceramic systems for dental restorations comply with a concrete algorithm, the efficiency of which is always dependent on the applications for which they are intended. The first stage involves obtaining metal support, followed by firing the ceramic on the surface of the metal to meet the list of functional and aesthetic requirements of a future restoration. The compatibility of the two materials-the metal component and the ceramic component-must be ensured in several respects: chemical compatibility, thermo-chemical compatibility, and mechanical compatibility. Thus, there is a need to simulate the thermal behavior of the metal-ceramic couple in its processing to achieve appropriate dental prostheses. In this study, three types of Co-Cr metal frames were manufactured using three different production technologies: conventional casting, milling (CAM), and selective laser melting (SLM). Composition analyses, scanning electron microscopy (SEM), and microstructural analyses of the metal-ceramic interface for each type of production technology, as well as the determination of the hardness and the thermal expansion coefficients of experimental materials and three-point bending tests, were carried out in this study. Considering all these aspects, we demonstrated the influence of the technology of producing the metallic part of the metal-ceramic bonding process in dental prostheses.

Cobalt chromium alloys in fixed prosthodontics: Investigations of mechanical properties and microstructure

STATEMENT OF PROBLEM

Cobalt chromium (Co-Cr) alloys possess beneficial mechanical properties because alloys, even in thin sections, can resist high mastication forces and exhibit an acceptable bond to the surface porcelain layer. Traditional manufacturing techniques of Co-Cr alloys such as casting have been replaced with newer fabrication techniques, such as milling, laser melting, and presintered milling. Despite scarce documentation, these new manufacturing techniques are being used to fabricate dental and implant constructions.

PURPOSE

This in vitro study investigates the hardness, yield strength, elastic modulus, and microstructure of the most commonly used Co-Cr alloys for fixed prosthodontics based on manufacturing technique. In addition, this study investigates the effect of heat treatment on the mechanical properties and microstructure of these materials.

MATERIAL AND METHODS

Five Co-Cr alloys were included (dumbbell and rectangular shaped) based on four manufacturing techniques: cast, milled, laser melted, and presintered milled. Commercially pure titanium grade 4 and titanium-6 aluminum-4 vanadium ELI (extra low interstitial) were included for comparison, and yield strength and elongation after fracture were evaluated. The specimens were tested for hardness using the Vickers test and for elastic modulus using a nondestructive impulse excitation technique. The microstructure of selected specimens was analyzed using focused ion beam-scanning electron microscopy (FIB-SEM) and energy dispersive X-ray spectroscopy (EDS).

RESULTS

The mechanical properties depend on the manufacturing technique used; the laser-melted and presintered Co-Cr specimens demonstrated the highest mechanical properties, followed by the milled and cast groups. Both the laser-melted and the presintered milled Co-Cr specimens showed smaller grain size compared with the cast and milled Co-Cr specimens. The titanium-6 aluminum-4 vanadium ELI demonstrated higher hardness and yield strength compared to commercially pure titanium grade 4. No major differences were observed for the selected materials regarding the mechanical properties and microstructural appearance after heat treatment.

CONCLUSIONS

The laser melting and presintered milling techniques produced higher mechanical properties compared with the cast and milled Co-Cr. These findings were confirmed through microstructural analysis with respect to the grain size, precipitation, and number of pores.

Effects of hollow structures added by selective laser sintering on the mechanical properties of Co-Cr alloy

PURPOSE

This study investigates the effects of hollow structures, added by selective laser sintering (SLS), on the mechanical properties of a Co-Cr alloy for providing an optimal structural property to the framework components of removable partial dentures (RPDs).

METHODS

The specimens produced using the 3D data of the dumbbell-shaped cylinders were divided into four groups based on the manufacturing method: Cast, Mill, SLS-solid, and SLS-hollow. Tensile tests were performed to measure the mechanical properties of the specimens. The mechanical property values among the four groups were statistically compared using the Kruskal-Wallis test followed by the Steel-Dwass test (α = 0.05).

RESULTS

The median elastic modulus was the largest in the Cast, followed by SLS-solid, Mill, and SLS-hollow, with no significant differences observed between all conditions. The median ultimate tensile strength was the largest in the order of SLS-solid, Mill, SLS-hollow, and Cast. The median 0.2% proof stress was the largest in SLS-solid, followed by SLS-hollow, Cast, and Mill. The median elongation was the highest in the order of Mill, SLS-solid, SLS-hollow, and Cast.

CONCLUSIONS

With the addition of hollow structures, the elastic modulus decreased while the mechanical strength and proof stress remained high in SLS specimens. In addition, the ISO 22674 standard for dental metals was met, suggesting that SLS may be a possible method to design RPD frameworks with high strength and optimal structural properties.

Microscopic and Mechanical Characterization of Co-Cr Dental Alloys Joined by the TIG Welding Process

Due to their good mechanical and other properties, cobalt-chromium alloys (Co-Cr) are often used in prosthetic therapy. The metal structures of prosthetic works can be damaged and break, and depending on the extent of the damage, they can be re-joined. Tungsten inert gas welding (TIG) produces a high-quality weld with a composition very close to that of the base material. Therefore, in this work, six commercially available Co-Cr dental alloys were joined by TIG welding, and their mechanical properties were evaluated to determine the quality of the TIG process as a technology for joining metallic dental materials and the suitability of the Co-Cr alloys used for TIG welding. Microscopic observations were made for this purpose. Microhardness was measured using the Vickers method. The flexural strength was determined on a mechanical testing machine. The dynamic tests were carried out on a universal testing machine. The mechanical properties were determined for welded and non-welded specimens, and the results were statistically evaluated. The results show the correlation between the investigated mechanical properties and the process TIG. Indeed, characteristics of the welds have an effect on the measured properties. Considering all the results obtained, the TIG-welded I-BOND NF and Wisil M alloys showed the cleanest and most uniform weld and, accordingly, satisfactory mechanical properties, highlighting that they withstood the maximum number of cycles under dynamic load.

Fundamental Properties and Clinical Application of 3D-Printed Bioglass Porcelain Fused to Metal Dental Restoration

The purpose of this study is to evaluate the mechanical properties and clinical fitness of 3D-printed bioglass porcelain fused to metal (PFM) dental crowns. To evaluate the mechanical properties, tensile strength, Vickers microhardness, shear bond strength, and surface roughness tests of the SLM printed Co-Cr alloy was conducted. A right mandibular 1st molar tooth was prepared for a single dental crown (n = 10). For a three-unit metal crown and bridge, the right mandibular first premolar and first molar were prepared. Bioglass porcelain was fired to fabricate PFM dental restorations. A clinical gap was observed and measured during each of the four times porcelain was fired. A statistical analysis was conducted. The SLM technique showed the largest statistically significant tensile strength and a 0.2% yield strength value. The milling technique had the lowest statistically significant compressive strength value. The shear bond strength and surface roughness showed no statistically significant difference between the fabricated method. There was a statistically significant change in marginal discrepancy according to the porcelain firing step. The casting technique showed the greatest statistically significant margin discrepancy value. The SLM method showed better fitness than the traditional casting method and showed better mechanical properties as a dental material.

Study on Hardness of Heat-Treated CoCrMo Alloy Recycled by Electron Beam Melting

The hardness of heat (thermally) treated CoCrMo ingots, recycled by electron beam melting and refining (EBMR) of a technogenic CoCrMo material (waste from the dental technology) under different process conditions (temperature and residence time) is examined. The heat treatment consists of two-step heating up to temperatures of 423 K and 1343 K and retention times of 40 and 60 min, respectively. The influence of various loads (0.98 N, 1.96 N, 2.94 N, 4.9 N, and 9.8 N) on the hardness of the CoCrMo alloy, recycled by EBMR, before and after heat treatment is studied. It has been found that regardless of the EBMR process conditions, the obtained samples after heat treatment have similar hardness values (between 494.2 HV and 505.9 HV) and they are significantly lower than the hardness of the specimens before the heat treatment. The highest hardness (600 HV) is measured in the alloy recycled at 1845 K refining temperature for 20 min. This is due to the smaller crystal structure of the resulting alloy and the higher cobalt content. The results obtained show that the heat treatment leads to considerable changes in the microstructure of the CoCrMo ingots recycled by EBMR. With the increase of the e-beam refining temperature, after the heat treatment, the grains' size increases and the grains' shape indicates an incomplete phase transition from γ-fcc to ε-hcp phase. This leads to a slight increase in the hardness of the alloy.

Outcomes and Complications of 33 Soft-Milled Cobalt-Chromium-Ceramic Full-Arch Screw-Retained Implant-Supported Prostheses: A Retrospective Study with up to 10-Year Follow-up

This retrospective study assessed outcomes and complications related to implants and prostheses in edentulous patients treated with soft-milled cobalt-chromium-ceramic full-arch screw-retained implant-supported prostheses (SCCSIPs). After the final prosthesis was delivered, patients participated in an annual dental check-up program, including clinical and radiographic assessments. Outcomes of implants and prostheses were evaluated, and biological and technical complications were categorized as major or minor. Implant and prosthesis cumulative survival rates were assessed using the life table analysis. A total of twenty-five participants (mean age 63.6 ± 7.3 years) with 33 SCCSIPs were observed for a mean of 68.9 ± 27.9 months (range 1–10 years). A total of 7 out of 245 implants were lost, with no effect on prosthesis survival, leading to cumulative survival rates of 97.1% for implants and 100% for prostheses. The most recurrent minor and major biological complications were soft tissue recession (9%) and late implant failure (2.8%). Among 25 technical complications, porcelain fracture was the only major technical complication, requiring prosthesis removal (1%). Porcelain chipping was the most frequent minor technical complication, affecting 21 crowns (5.4%), which required polishing only. At the end of the follow-up, 69.7% of the prostheses were free of technical complications. Within the limitations of this study, SCCSIP showed promising clinical performance after 1–10 years.

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.

Effect of internal design changes on the mechanical properties of laser-sintered cobalt-chromium specimens

STATEMENT OF PROBLEM

Changing the internal design of a metal framework may decrease the manufacturing time, the weight of the restoration, and the amount of alloy powder used, as well as simplify the fabrication process.

PURPOSE

The purpose of this in vitro study was to evaluate the effect of framework internal design changes on the mechanical properties of cobalt-chromium (Co-Cr) specimens manufactured by using direct metal laser sintering (DMLS).

MATERIAL AND METHODS

Dumbbell-shaped test specimens were designed as per the International Organization for Standardization (ISO) 22674(E) standard by using a 3-dimensional software program. A total of 70 dumbbell-shaped specimens were prepared by using Co-Cr alloy powder and DMLS (n=10). The control group specimens were solid with the internal completely filled. For the test groups, the internal design of the dumbbell-shaped specimens was modified. Leaving the outer shell thickness of the specimens at 0.5 mm for all test groups, 6 different internal designs were created, and the specimens were weighed. The tensile strength test was used to evaluate the mean peak strength, elastic modulus, and percentage elongation of the specimens. One-way ANOVA followed by the Dunnett T3 test was used for statistical analysis (α=.05).

RESULTS

A statistically significant difference was found among the groups in terms of bar weight and peak strength (P<.05). The highest values were observed in the control group for all evaluated parameters (mean ±standard deviation bar weight: 1321.3 ±36.6 mg, peak strength: 1045 ±36.7 MPa, elastic modulus: 284.2 ±71.9 GPa, and elongation: 28.7 ±7%). However, no statistically significant difference was observed for elastic modulus or percentage of elongation (P>.05).

CONCLUSIONS

Decreasing the weight of the frameworks by changing the internal design of the specimens also decreased the peak strength. However, it did not affect the elastic modulus or the percentage of elongation.

Metallic Dental Implants Wear Mechanisms, Materials, and Manufacturing Processes: A Literature Review

OBJECTIVES

From the treatment of damaged teeth to replacing missing teeth, dental biomaterials cover the scientific interest of many fields. Dental biomaterials are one of the implants whose effective life depends vastly on their material and manufacturing techniques. The purpose of this review is to summarize the important aspects for metallic dental implants from biomedical, mechanical and materials science perspectives. The review article will focus on five major aspects as mentioned below. Tooth anatomy: Maximizing the implant performance depends on proper understanding of human tooth anatomy and the failure behavior of the implants. Major parts from tooth anatomy including saliva characteristics are explored in this section. Wear mechanisms: The prominent wear mechanisms having a high impact on dental wear are abrasive, adhesive, fatigue and corrosion wear. To imitate the physiological working condition of dental implants, reports on the broad range of mastication force and various composition of artificial saliva have been included in this section, which can affect the tribo-corrosion behavior of dental implants. Dental implants classifications: The review paper includes a dedicated discussion on major dental implants types and their details for better understanding their applicability and characteristics. Implant materials: As of today, the most established dental implant materials are SS316L, cobalt chrome alloy and titanium. Detailed discussion on their material properties, microstructures, phase transformations and chemical compositions have been discussed here. Manufacturing techniques: In terms of different production methods, the lost wax casting method as traditional manufacturing is considered. Selective Laser Melting (SLM) and Directed Energy Deposition (DED) as additive manufacturing techniques (AM) have been discussed. For AM, the relationships between process-property-performance details have been explored briefly. The effectiveness of different manufacturing techniques was compared based on porosity distribution, mechanical and biomechanical properties.

SUMMARY

Despite having substantial research available on dental implants, there is a lack of systematic reviews to present a holistic viewpoint combining state-of-the-art from biomedical, mechanical, materials science and manufacturing perspectives. This review article attempts to combine a wide variety of analyzing approaches from those interdisciplinary fields to deliver deeper insights to researchers both in academia and industry to develop next-generation dental implants.

Effect of Internal Design Modification on the Mechanical Properties of Laser Sintered Cobalt-Chromium Multi-Unit Metal-Ceramic Frameworks

PURPOSE

The purpose of the study was to assess the effect of internal design modifications on the mechanical properties of multi-unit Cobalt-Chromium (Co-Cr) metal-ceramic frameworks manufactured by direct metal laser sintering.

MATERIAL AND METHODS

Four-unit fixed partial denture metal-ceramic frameworks were digitally designed on a metal die model using 3D software. A total of 30 specimens were prepared using Co-Cr alloy powder with direct metal laser sintering (n = 10). The control group specimens were solid where the inside of the specimens was completely full. For the test groups, the internal design of the framework was modified. Leaving the outer shell thickness of the framework at 0.5 mm, two different internal designs with hollow geometries were created (1.5 mm and 2 mm inner bar distances) and a cross section area of the connector was calculated. The weights of the specimens were measured and subjected to a 3-point-bending test at 1 mm/min crosshead speed. Data were statistically analyzed using One-way ANOVA followed by Tukey (α = 0.05).

RESULTS

There was a statistically significant difference among the groups in terms of weight of the specimens (p ≤ 0.05). However, no significant difference was observed among groups in term of both flexural strength and flexural modulus (p ≤ 0.05).

CONCLUSIONS

Within the limitations of the study, it was concluded that changing the internal design of the metal frameworks decreases the weight of the framework, but does not affect the flexural strength and flexural modulus. Therefore, clinical applications of internally modified frameworks seem promising for metal-ceramic restorations.

Functional engineering strategies of 3D printed implants for hard tissue replacement

Three-dimensional printing technology with the rapid development of printing materials are widely recognized as a promising way to fabricate bioartificial bone tissues. In consideration of the disadvantages of bone substitutes, including poor mechanical properties, lack of vascularization and insufficient osteointegration, functional modification strategies can provide multiple functions and desired characteristics of printing materials, enhance their physicochemical and biological properties in bone tissue engineering. Thus, this review focuses on the advances of functional engineering strategies for 3D printed biomaterials in hard tissue replacement. It is structured as introducing 3D printing technologies, properties of printing materials (metals, ceramics and polymers) and typical functional engineering strategies utilized in the application of bone, cartilage and joint regeneration.

Investigation of the effect of bonding factors on strength of porcelain bond to soft metal alloys after application of thermal cycle

BACKGROUND

The chemical bond between the metal and the porcelain component is likely to fail in metal-porcelain restorations. This is due to the thick oxide layer that Cr-Co alloys create. This study aimed to investigate the effect of metal conditioner on controlling the oxide layer formed on the surface of the Sintron alloy and the strength of the metal-porcelain bond.

MATERIALS AND METHODS

In this in vitro study, 33 samples were divided into three groups based on surface treatment (n = 11). In all three groups, an oxide layer was created. In the first group, Shofu metal conditioner, in the second group, metal conditioner of Creation, and in the third group, no metal conditioner was applied. All samples were then subjected to 3000 heat cycles between 5° and 55°C with a stop time of 5 s. The specimens were then placed in a universal testing machine for shear bond testing. A force was applied between the alloy and the porcelain by a 5 kN load cell at the speed of 1 mm/min until a fraction occurred. Intergroup comparison was made by the one-way analysis of variance followed by the Tukey's multiple comparisons test (α = 0.05) .

RESULTS

The mean shear bond strength of the first group was 34.93 MPa and the mean shear bond strength of the second group was 31.37 MPa. The mean shear bond strength of the first and the second group was significantly higher than the third group (23.37 MPa) (PV < 0.001).

CONCLUSION

The use of metal conditioners between ceramill Sintron alloy and porcelain (Vita VMK MASTER) led to increasing the bond strength.

Mechanical and Wetting Properties of Ta2O5 and ZnO Coatings on Alloy Substrate of Cardiovascular Stents Manufactured by Casting and DMLS

In the last years, additive manufacturing technologies have been developed, especially direct metal laser sintering, and used in the dental and medical implant domains. Cardiovascular stents have evolved from bioinert, bare metal cages to biomimetic devices that promote tissue regeneration or healing. In this paper, comparisons concerning mechanical properties between Co-Cr alloy and cast 304L stainless steel were realized using FEM analysis, necessary for manufacturing cardiovascular stents by DMLS technology using Co-Cr alloy. The purpose of this paper consists of the evaluation of the contact angle at the interface of the Co-Cr alloy manufactured by DMLS, respectively, cast stainless steel 304L, and thin film deposition realized by the e-gun method (Ta₂O₅ and ZnO). Scanning electronic microscopy SEM and EDX techniques were employed for morphological investigation of the sintered samples manufactured by the DMLS process. They were also used for semi-quantitative and qualitative chemical and metallographic analyses. The e-gun coating was used to obtain thin films with the nanometer order of Ta₂O₅ and ZnO with a protective role to improve the corrosion resistance, roughness, and antiseptic role.

Characterization of Co-Cr-W Dental Alloys with Veneering Materials Manufactured via Subtractive Milling and Additive Manufacturing LDED Methods

Laser-directed energy deposition (LDED) is an additive manufacturing (AM) technology which can be an alternative to the traditional subtractive milling process for the obtention of porcelain-fused-to-metal (PFM) prosthesis. Still, the adhesion performance of the veneering ceramics for this material has been not studied yet. The main objective of this study is to perform a systematic comparison of the adhesion performance of Co-Cr-W metal frameworks obtained through LDED and conventional milling techniques. Comparison includes microstructural, superficial, and adhesion analysis. Co-Cr manufactured via LDED technique presents similar behavior (p < 0.05) in comparison to the material obtained via milling techniques, and its performance was validated with the veneering ceramics and veneering composites currently employed in the dental industry.

Effect of Palatal Vault Depth on the Trueness of Metal Laser-Sintered and Cast Cobalt-Chromium Removable Partial Denture Frameworks

PURPOSE

This in vitro study compares the trueness of removable partial denture cobalt-chromium (Co-Cr) frameworks fabricated by 3D-printed pattern casting and those fabricated by selective laser sintering (SLS) of different palate vault depths.

MATERIALS AND METHODS

A partially edentulous Kennedy class II mod.1 maxillary model with a deep palatal vault was used, which was modified and duplicated to produce another model with medium palatal vault depth. After model scanning, the partial denture framework was designed using CAD software to fabricate 20 removable partial denture (RPD) frameworks. For each model, two types of frameworks were fabricated. For the 1^st type, the 3D-printed resin patterns were formed using a 3D printer, and then casting was performed (AM-cast framework). For the 2^nd type, a direct metal laser sintering machine was used for the RPD frameworks fabrication (SLS framework). 3D scanning of fabricated frameworks was performed, and the standard tessellation language (STL) file was superimposed over the STL file from the original design, and the average deviation was recorded. Data were statistically analyzed.

RESULTS

Two-way ANOVA test was used, followed by the least significant difference (LSD) for pair-wise comparisons to estimate any significant differences between groups. The RPD frameworks with high palatal vault depth represent larger discrepancies mean value than that with the medium palatal vault depth with a highly significant statistical difference. SLS shows less deviation than AM-cast CO-Cr frameworks with highly significant statistical differences whatever palatal vault depth.

CONCLUSION

RPD metal frameworks fabricated with SLS have better accuracy compared to those fabricated by AM-cast, regardless of the depth of the palatal vault. This article is protected by copyright. All rights reserved.

Recycling of Technogenic CoCrMo Alloy by Electron Beam Melting

In the current work, the possibility of the recycling of technogenic CoCrMo material by electron beam melting is investigated. The influence of thermodynamic and kinetic parameters (temperature and melting time) on the behavior of the main components of the alloy (Co, Cr, and Mo) and other elements (Fe, Mn, Si, W, and Nb) present in it, and on the microstructure of the ingots obtained after e-beam processing is studied. The vapor pressure of the alloy is determined taking into account the activities of the main alloy components (Co, Cr, and Mo). The relative volatility of the metal elements present in the alloy was also evaluated. An assessment of the influence of the temperature and the retention time on the degree of elements removal from CoCrMo technogenic material was made. The results obtained show that the highest degree of refining is achieved at 1860 K and a residence time of 20 min. The conducted EDS analysis of the more characteristic phases observed on the SEM images of the samples shows distinct micro-segregation in the matrix composition.

Investigation of the Interface between Laser-Melted CoCr and a Stainless Steel Substrate

Recent advances in laser technologies offer significant flexibility in the additive manufacturing domain. Extensive work was focused on material processing using laser-directed energy deposition for repairing parts. This pilot study investigated the use of selective laser melting (SLM) for depositing a superior material such as CoCr on an existing stainless steel base. The interface between these dissimilar materials was analyzed. During fabrication, both metals were gradually mixed in the liquid state as the first CoCr powder layer was melded on the steel base without obvious defects. According to SEM and EDAX, the heat-affected zone has a limited depth (<20 µm). XRD patterns recorded across the CoCr–304 interface show a homogenous mixture of γ(Fe) and α(Co) solid solutions. The microporosity calculated by CT was under 0.5%. Microhardness was measured at and near the interface region, showing that the intermixing zone has high hardness (470–480 HV1), which may be related to the fine-grained microstructure. Mechanical testing reveals that the adhesion strength at rupture is 35% higher compared with the ultimate tensile strength of 304 steel. This adhesion strength can be attributed to the complete melting of CoCr particles after laser irradiation and to the reduced thickness of the HAZ and the IZ.

Finite element analysis of the influence of porosity and pore geometry on mechanical properties of orthopaedic scaffolds

PURPOSE

Scaffolds play a key role in regenerative medicine in the repair of injuries, defects and cancerous changes in long bones. For this reason, scaffolds should meet certain mechanobiological requirements, such as adequate porosity and pore geometry to ensure appropriate osteointegration as well as load transfer. Taking into account the most frequently used cell units, this study attempted to evaluate the porous structures of orthopaedic scaffolds in terms of their strength parameters.

MATERIALS AND METHODS

Four pore geometries were selected for analyses: sphere, octagonal prism, cube and triangular prism, all with porosities of 10% up to 60%. Three different material properties were considered: Ti6Al4V alloy, CoCr alloy, 316 L steel. Strength compression simulations were carried out on 144 models, 72 structures of cell units with dimensions of 4 × 4 × 4 mm and 72 structures of scaffolds with a diameter of 16 mm and a height of 15 mm. Effective Young's modulus, as well as 0.2%, offset effective yield strength was estimated.

RESULTS

Research has shown that scaffolds with bone-like strength properties should be made of Ti6Al4V alloy. The value of 40% turned out to be of the best porosity. The remaining porosities showed much lower or much higher strength parameters and were significantly different from the properties of the bones.

CONCLUSIONS

The obtained data allow to indicate the most functional porous structure with Young's modulus similar to that possesses by core bone, while maintaining mechanical strength, allowing for its appropriate use in orthopaedic regenerative medicine.

Wear Resistance and Biocompatibility of Co-Cr Dental Alloys Fabricated with CAST and SLM Techniques

Cobalt–chromium (Co-Cr) alloys have been widely used as dental-restoration materials for many years. This study sought to investigate whether selective laser melting (SLM) is a more appropriate process than traditional casting (CAST) for fabricating dental Co-Cr alloys. Metallurgical microscopy, X-ray photoelectron spectroscopy (XPS), Vickers hardness and nanoindentation tests, and friction and wear tests were used to evaluate the microstructure, surface compositions, mechanical properties, and wear resistance, respectively. Additionally, the biocompatibilities and cell adhesion of the alloys were evaluated with L-929 fibroblasts via CCK-8 assay, Live/Dead staining, flow cytometric analysis, scanning electron microscopy (SEM) observation and real-time PCR (RT-PCR) assay. The XPS results showed that the two alloys were all mainly comprised of Co, Cr, and O. The hardness in the CAST group equaled 7.15 ± 0.48 GPa, while in the SLM group, it equaled 9.06 ± 0.49 GPa. The friction coefficient of SLM alloys remained at approximately 0.46, but the CAST specimens fluctuated significantly. SLM alloys exhibited shallower wear scars and less wear debris compared with CAST alloys, simultaneously. Additionally, there were higher survival and expression of cell-adhesion-related genes on SLM alloys of L-929 cells, which meant that the deleterious effect on L-929 cells was significantly reduced compared with that for the CAST alloys. Overall, the wear resistances and biocompatibilities of the Co-Cr dental alloys were dramatically affected by the fabrication technique. The SLM technique is advantageous over the CAST technique for fabricating Co-Cr dental alloys.

Study on the Surface of Cobalt-Chromium Dental Alloys and Their Behavior in Oral Cavity as Cast Materials

This study presents the correct processing of Co–Cr alloys as a method of preserving the properties of the materials as-cast, and therefore they can be safely placed in contact with the oral cavity tissues as resistance frameworks. The basic materials analyzed in this study were five commercial Co–Cr dental alloys with different components obtained in three processing steps. The analysis of the electrochemical behavior at the surface of the Co–Cr alloys was performed by electrochemical measurements: impedance spectroscopy (EIS), open circuit electrical potential (OCP), and linear polarization (LP). In terms of validation, all five alloys had a tendency to generate a stable oxide layer at the surface. After the measurements and the graphical representation, the alloy that had a higher percentage of tungsten (W) and iron (Fe) in composition showed a higher tendency of anodizing. After the application of the heat treatment, the disappearance of the hexagonal phase was observed, with the appearance of new phases of type (A,B)₂O₃ corresponding to some oxide compounds, such as Fe₂O₃, Cr₂O₃, (Cr,Fe)₂O₃, and CoMnO₃. In conclusion, the processing of Co–Cr alloys by melting and casting in refractory molds remains a viable method that can support innovation, in the context of technology advance in recent years towards digitalization of the manufacturing process, i.e., the construction of prosthetic frameworks conducted by additive methods using Co–Cr powder alloy.

Advances in Laser Additive Manufacturing of Cobalt–Chromium Alloy Multi-Layer Mesoscopic Analytical Modelling with Experimental Correlations: From Micro-Dendrite Grains to Bulk Objects

This study presents two analytical models for the laser powder bed fusion (LPBF) process. To begin, the single layer’s dimensions were measured using principal operating conditions, including laser power, laser scanning speed, powder layer thickness, and hatch distance. The single-layer printing dimensions were transformed into multi-layer printing using the hatch distance. The thermal history of the printed layers was used as an input to the Johnson–Mehl–Avrami-Kolmogorov model to estimate the average dendrite grain size. LPBF experiments were conducted for a Cobalt–chromium (Co–Cr) alloy to validate the developed model. The average dendrite grain size was estimated using a scanning electron microscope (SEM) combined with “Image J” software. The Vickers hardness test was performed to correlate the average dendrite grain size and operating conditions. A 10–15% mean absolute deviation was presented between experiments and simulation results. In all samples, a Co-based γ-FCC structure was identified. An inverse correlation was established between the laser power and smaller average dendrite grain, while a direct relationship has been determined between laser scanning speed and average dendrite grain size. A similar trend was identified between hatch distance and average dendrite grain size. A direct link has been determined between the average dendrite grain size and hardness value. Furthermore, a direct relationship has connected the laser volume energy density and hardness value. This study will help experimentalists to design operating conditions based on the required grain size and corresponding mechanical characteristics.

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.

Effects of heat treatment on the microstructure, residual stress, and mechanical properties of Co-Cr alloy fabricated by selective laser melting

The mechanical properties and residual stress of dental Co-Cr-Mo (CCM) alloy depend on the manufacturing and post-processing methods, which affect the prognosis of dental prostheses. Two CCM alloys manufactured by casting and selective laser melting (SLM) were compared, and the effect of heat treatment temperature for CCM alloys manufactured by SLM method was evaluated. Specimens were fabricated by casting (Cast Co-Cr) and SLM (SLM Co-Cr). SLM Co-Cr specimens were heat treated at 750, 950, and 1150 °C to compare their properties. Microstructures were analyzed via scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), and electron backscattered diffraction (EBSD), and the residual stress was measured via x-ray diffraction (XRD). Mechanical properties were evaluated by a Vickers hardness test and a tensile test; fractography was performed after this. The SLM Co-Cr group exhibited a decrease in porosity, grain size, increase in solid solution limit, and high residual stress compared to Cast Co-Cr; the ultimate tensile strength, yield strength, and hardness were also higher. The microstructures, residual stresses, and mechanical properties differed significantly depending on the heat treatment, and the strength and hardness showed a tendency inverse to that of the elongation. Type I residual stresses mostly decreased after 750 °C heat treatment, however type II and III residual stresses remained even after 1150 °C heat treatment. SLM presented superior mechanical properties to casting. Considering the reduction of tensile residual stress and increased ductility, CCM alloys should be heat treated at a temperature of 950 °C or higher.

Influence of Digital Technologies and Framework Design on the Load to Fracture of Co-Cr Posterior Fixed Partial Denture Frameworks

PURPOSE

To compare the load to fracture of cobalt-chromium (Co-Cr) 3-unit posterior fixed partial denture (FPD) frameworks manufactured by conventional and digital techniques and to evaluate the influence of the framework design on the fracture load.

MATERIAL AND METHODS

Eighty 3-unit Co-Cr posterior FPD frameworks were fabricated with two designs: intermediate pontic (n = 40) and cantilever (n = 40). Each design was randomly divided into four groups (n = 10): casting, direct metal laser sintering, soft metal milling, and hard metal milling. After thermal cycling, all specimens were subjected to a 3-point bending test until fracture. Data were statistically analyzed using one-way ANOVA, Welch and Brown-Forsythe test, Ryan-Einot-Gabriel-Welsch F and Tamhane T2 post hoc test, Student's t test, and Weibull statistics (α = 0.05).

RESULTS

Significant differences (p < 0.001; F = 39.59) were found among intermediate pontic frameworks (except between laser sintering and hard metal milling), and cantilevered frameworks (F = 36.75) (except between laser sintering and hard metal milling, and casting and soft metal milling). The cantilever groups showed load to fracture values significantly lower than those of the intermediate pontic (p < 0.001; F = 28.29). The Weibull statistics corroborated the results.

CONCLUSIONS

Hard metal milling and laser sintered frameworks exhibited the highest load to fracture values. However, all tested frameworks demonstrated clinically acceptable load to fracture values. The framework design directly affected the fracture load, with drastically lower values in cantilevered frameworks.

Experimental Study Regarding the Behavior at Different pH of Two Types of Co-Cr Alloys Used for Prosthetic Restorations

Cobalt-chromium (Co-Cr) alloys are widely utilized in dentistry. The salivary pH is a significant factor, which affects the characteristics and the behavior of dental alloys through corrosion. This study aimed to evaluate the corrosion behavior in artificial saliva with different pH values (3, 5.7, and 7.6) of two commercial Co-Cr dental alloys manufactured by casting and by milling. Corrosion resistance was determined by the polarization resistance technique, and the tests were carried out at 37 ± 1 °C, in Carter Brugirard artificial saliva. After the electrochemical parameters, it can be stated that the cast Co-Cr alloy has the lowest corrosion current density, the highest polarization resistance, and the lowest speed of corrosion in artificial saliva with pH = 7.6. In the case of milled Co-Cr alloy, the same behavior was observed, but in artificial saliva with pH = 5.7, it recorded the most electropositive values of open circuit potential and corrosion potential. Although both cast and milled Co-Cr alloys presented a poorer corrosion resistance in artificial saliva with a more acidic pH value, the milled Co-Cr alloy had better corrosion behavior, making this alloy a better option for the prosthetic treatment of patients suffering from GERD.

Analytical model of I-bar clasps for removable partial dentures

OBJECTIVE

Clasps of removable partial dentures (RPDs) often suffer from fatigue stress that leads to plastic deformation, loss of retention, and RPD failure. Recently, computer-based technologies were proposed to optimize clasp geometry design. The objective of this study was to create an analytic model of I-bar clasps for computer-aided design (CAD)-RPD.

METHODS

The analytical model based on mechanical laws was established to simulate I-bar clasp retention, and optimize its design. The model considered the lengths of the vertical (L₁) and horizontal (L₂) arms of the I-bar as well as the radius (r) of its half-round cross-section. The analytical model was validated with mechanical experiments evaluating the retention of cobalt-chromium (Co-Cr) clasps in vitro and compared with finite element analysis (FEA).

RESULTS

The analytical model was in good agreement with the mechanical experiments and FEA, and showed that I-bar clasp design could provide optimal mechanical performance as long as the length of arms (L₁ and L₂) do not exceed 6 mm. Clasps with L₁ > 8 mm and L₂ > 9 mm presented stress values exceeding the fatigue limit of Co-Cr. The proposed solution was to increase the radius of I-bar to conserve the initial mechanical performance of Co-Cr.

SIGNIFICANCE

Co-Cr I-bar clasps perform best on teeth with reduced mesiodistal dimensions (canine and premolar), and their designs could be optimized to prevent stress from reaching the yield strength and the fatigue failure limit.

Corrosion Resistance of Cr–Co Alloys Subjected to Porcelain Firing Heat Treatment—In Vitro Study

The procedure of ceramics fusion to cobalt–chromium (Co–Cr) base dental crowns affects their corrosion behavior and biological tolerance. This study’s purpose was to comparatively evaluate the effect of heat treatment (HT) applicable for dental ceramics firing on the corrosion properties among Co–Cr base alloys fabricated via different methods: casting (CST), milling soft metal and post sintering (MSM), and selective laser melting (SLM). All specimens were subjected to a heat treatment corresponding to a full firing schedule. The microstructure and elemental composition of oxidized surfaces were investigated by scanning electron microscopy and energy dispersive spectroscopy. Corrosion properties were examined by electrochemical potentiodynamic polarization tests. The values of jcorr, Ecorr, Rp, and breakdown potential Ebr were estimated. The oxide layers formed during the HT process corresponded to the composition of the original alloys’ structure. Among the thermal treated alloys, SLM showed the highest corrosion resistance, followed by the MSM and CST. This may be attributed to uniform distribution of alloying elements in homogenous structure and to the reduced porosity, which enhances corrosion resistance and decreases the risk of crevice corrosion. The overall corrosion behavior was strongly influenced by the segregation of alloying elements in the microstructure, thus, is directly determined by the manufacturing method.

PICN Nanocomposite as Dental CAD/CAM Block Comparable to Human Tooth in Terms of Hardness and Flexural Modulus

Polymer infiltrated ceramic network (PICN) composites are an increasingly popular dental restorative material that offer mechanical biocompatibility with human enamel. This study aimed to develop a novel PICN composite as a computer-aided design and computer-aided manufacturing (CAD/CAM) block for dental applications. Several PICN composites were prepared under varying conditions via the sintering of a green body prepared from a silica-containing precursor solution, followed by resin infiltration. The flexural strength of the PICN composite block (107.8–153.7 MPa) was similar to a commercial resin-based composite, while the Vickers hardness (204.8–299.2) and flexural modulus (13.0–22.2 GPa) were similar to human enamel and dentin, respectively. The shear bond strength and surface free energy of the composite were higher than those of the commercial resin composites. Scanning electron microscopy and energy dispersive X-ray spectroscopic analysis revealed that the microstructure of the composite consisted of a nanosized silica skeleton and infiltrated resin. The PICN nanocomposite block was successfully used to fabricate a dental crown and core via the CAD/CAM milling process.

3D and 4D printing in dentistry and maxillofacial surgery: Printing techniques, materials, and applications

3D and 4D printing are cutting-edge technologies for precise and expedited manufacturing of objects ranging from plastic to metal. Recent advances in 3D and 4D printing technologies in dentistry and maxillofacial surgery enable dentists to custom design and print surgical drill guides, temporary and permanent crowns and bridges, orthodontic appliances and orthotics, implants, mouthguards for drug delivery. In the present review, different 3D printing technologies available for use in dentistry are highlighted together with a critique on the materials available for printing. Recent reports of the application of these printed platformed are highlighted to enable readers appreciate the progress in 3D/4D printing in dentistry.

Effect of layer thickness on the flexural strength of multiple-unit laser-sintered metal frameworks

STATEMENT OF PROBLEM

Laser sintering devices have been increasingly used to fabricate the metal frameworks of metal-ceramic restorations. In the fabrication process, the sintering layer thickness is an important parameter; however, information on how it may affect the flexural strength of metal frameworks remains limited.

PURPOSE

The purpose of this in vitro study was to evaluate the flexural strength of 3-unit and 4-unit cobalt-chromium (Co-Cr) metal frameworks laser sintered with 20-μm, 30-μm, and 40-μm layer thicknesses.

MATERIAL AND METHODS

Three-unit and 4-unit master metal die models with premolar and molar abutments were prepared through direct metal laser sintering (DMLS). A total of 40 metal frameworks (n=10 for each metal die model) were fabricated by the lost-wax technique (group C, served as the control group) and through DMLS with 20-μm, 30-μm, and 40-μm layer thickness (experimental groups LS20, LS30, and LS40, respectively). Each metal framework was cemented to a master die with a polyvinyl siloxane impression material and then subjected to a 3-point bend test at a crosshead speed of 1 mm/min. The yield force of each metal framework was used to calculate the flexural strength. Data were statistically analyzed by using 1-way ANOVA followed by a Tukey honestly significant difference (HSD) test and an independent-samples t test (α=.05) The microstructure of the fracture surface was evaluated by scanning electron microscopy.

RESULTS

Group C reported the lowest mean flexural strength (P<.05), whereas group LS20 reported the highest mean flexural strength, although no significant difference (P>.05) in flexural strength was observed among the DMLS groups. The 3-unit metal frameworks exhibited a statistically significant higher mean flexural strength than the 4-unit metal frameworks (P<.05).

CONCLUSIONS

The sintering layer thickness did not significantly affect the flexural strength of the laser-sintered metal frameworks. However, the DMLS groups reported a higher mean flexural strength than the cast group.

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.

Impact of laser parameters on additively manufactured cobalt-chromium restorations

STATEMENT OF PROBLEM

The selective laser melting (SLM) process has become popular for the fabrication of frameworks for metal-ceramic restorations, although their surface roughness is greater than with cast or milled frameworks. Limited information is available regarding the surface mechanical characteristics of cobalt-chromium (Co-Cr) SLM-manufactured restorations.

PURPOSE

The purpose of this in vitro study was to adapt the laser parameters for a remelting strategy, scanning the outer boundary of Co-Cr specimens, to reduce surface roughness and solidification defects, to determine microhardness, to investigate surface morphology and microstructure, and to establish surface mechanical characteristics.

MATERIAL AND METHODS

Co-Cr specimens were SLM manufactured by using a typical melting (TM) strategy and an adaptive remelting (AR) strategy. The AR strategy involves rescanning 50% of the contour, varying the laser parameters. The roughness parameters considered were Ra and Rz. Vickers hardness was measured by microindentation with a 9.81-N force (ASTM E384-17). The surface morphology was investigated by scanning electron microscopy, the chemical composition by energy-dispersive X-ray spectroscopy, and the phase identification by using X-ray diffraction. The mechanical surface properties measured were the nanohardness, elastic modulus, and dissipation energy. One-way ANOVA with the Tukey procedure was used to compare the groups (α=.05).

RESULTS

The innovative AR strategy reduced the surface roughness by 45% compared with TM, comparable with their cast counterpart. The smoothest AR surface was obtained by using 75 W and 350 mm/s for the first scanning of the contour, followed by a second remelting with 80 W and 700 mm/s. The microstructure of AR specimens had limited solidification defects, a chemical composition similar to that of raw powder, and a surface microhardness over 600 HV1. A fine grain structure in a single matrix phase was detected both on TM and AR specimens. The mechanical characteristics of the smoothest Co-Cr surface were 218 GPa elastic modulus, 746 HV_IT Vickers nanohardness, 21 243 pJ plastic energy, and 26% nanoindentation work ratio. Significant differences were observed between the melting strategies (P<.05) both for surface roughness and microhardness.

CONCLUSIONS

The laser scanning strategy affects both the surface roughness and the hardness of SLM-manufactured specimens. The results show that using the AR strategy and proper laser parameters can reduce the roughness and increase the surface hardness of Co-Cr specimens made of conventional powder feedstock.

In-Situ XRD Study of Phase Transformation Kinetics in a Co-Cr-W-Alloy Manufactured by Laser Powder-Bed Fusion

The additive manufacturing process of laser powder-bed fusion (L-PBF) is an increasingly popular approach for patient-specific production of dental frameworks made from Co-Cr alloys. Macroscopically, frameworks produced in this way exhibit high anisotropy especially in Young’s modulus, and are missing standardized requirements. Microscopically, pronounced texture and high residual stresses are characteristic. To reduce resulting detrimental effects, the as-built (AB) parts are heat treated. Dependent on the treatment temperature, effects like the transformation of the γ-phase matrix in the AB condition to ϵ-phase, precipitation, stress relief, and grain growth were observed. While the existence of these processes was established in the past, little is known about their kinetics. To fill this gap, these effects were studied with in-situ X-ray diffraction (XRD) methods in isothermal heat treatments (HTs) at four different sample surface temperatures TS reaching from 650∘C to 900∘C. Furthermore, room temperature ex situ XRD and SEM/EDS measurements completed the analysis. An evaluation of the datasets, with single peak fitting and QXRD methods, yielded the following results. In the HTs below a certain threshold, a γ-to-ϵ transformation was observed in the sample bulk and close to the sample surface. In the latter case, evidence for a partially strain-induced transformation related to oxide formation was present. Above this threshold and possibly slightly below, σ- and Laves-phase precipitated. Additionally, peak profile evolutions hinted at a drop of inter- and intragranular stresses within the first 30 to 60 min. Therefore, an HT of about 30 to 60 min slightly above the threshold is proposed as optimal for reducing residual stresses while retaining a predominantly single-phased microstructure, possibly superior in corrosion properties and likewise in bio-compatibility.

Mechanical Properties and Metal-Ceramic Bond Strength of Co-Cr Alloy Manufactured by Selective Laser Melting

Cobalt–chromium (Co-Cr) metal is one of the widely used biomaterials in the fabrication of dental prosthesis. The purpose of this study was to investigate whether there are differences in the properties of metals and bond strength with ceramics depending on the manufacturing methods of Co-Cr alloy. Co-Cr alloy specimens were prepared in three different ways: casting, milling, and selective laser melting (SLM). The mechanical properties (elastic modulus, yield strength, and flexural strength) of the alloys were investigated by flexure method in three-point bending mode, and microstructures of the specimens were analyzed. After application of the veneering ceramic through the three-point bending test, bond strength of the Metal-Ceramic was investigated. The cracked surfaces were observed by means of energy dispersive X-ray (EDX) spectroscopy and scanning electron microscopy (SEM) with backscattered electron (BSE) images. In mechanical properties, the elastic modulus was highest for the casting group, and the yield strength and flexural strength were lowest for the milling group. The SLM group showed finer homogeneous crystalline-microstructure, and a layered structure was observed at the fractured surface. After the ceramic bond strength test, all groups showed a mixed failure pattern. The casting group showed the highest bond strengths, whereas there was no significant difference between the other two groups. However, all groups have met the standard of bond strength according to international standards organization (ISO) with the appropriate passing rate. The results of this study indicate that the SLM manufacturing method may have the potential to replace traditional techniques for fabricating dental prosthesis.

Comparison of microstructures and mechanical properties of 3 cobalt-chromium alloys fabricated with soft metal milling technology

STATEMENT OF PROBLEM

Although several manufacturers market soft metal milling blanks and systems, comprehensive comparative studies of differences in properties across commercially available soft metal milling alloys are lacking.

PURPOSE

The purpose of this in vitro study was to compare the microstructures and mechanical properties of 3 soft metal milling cobalt-chromium (Co-Cr) alloys (Ceramill Sintron, Soft Metal, and Sintermetall).

MATERIAL AND METHODS

Disk-shaped specimens (for surface characterization and hardness test) and dumbbell-shaped specimens (for tensile test as per International Organization for Standardization (ISO) 22674) were prepared by following each soft metal milling manufacturer's instructions. The crystal structures and microstructures of the 3 alloys were evaluated with optical microscopy, X-ray diffractometry (XRD), and scanning electron microscopy with electron backscattered diffraction (EBSD). The mechanical properties were investigated with a tensile test and Vickers hardness test (n=6). The results of the mechanical (tensile and hardness) tests were analyzed with 1-way ANOVA and the post hoc Tukey multiple comparison test (α=.05).

RESULTS

The Sintermetall specimen showed a finer microstructure and more porosity than the other 2 alloys. The XRD and EBSD analyses showed that the γ (face-centered cubic, fcc) matrix phase was predominant in the Ceramill Sintron alloy and the ε (hexagonal close-packed, hcp) matrix phase was predominant in the Soft Metal alloy. The Sintermetall alloy showed a slightly higher amount of ε phase than γ phase, with more chromium carbide formation than the other 2 alloys. The Ceramill Sintron alloy showed a significantly higher tensile strength than the other 2 alloys (P<.05), but a significantly lower 2% offset yield strength than the other 2 alloys (P<.05). The highest elongation was found in the Ceramill Sintron alloy, followed by the Sintermetall and Soft Metal alloys. The elastic modulus was the highest in the Sintermetall alloy, followed by the Soft Metal and Ceramill Sintron alloys. No significant differences in Vickers hardness values were detected among the 3 alloys (P=.263).

CONCLUSIONS

The different commercially available soft metal milling blanks and systems produced dissimilar alloys in terms of crystal structures and microstructures and, as a result, different mechanical properties.

Mechanical Properties of Laser-Sintered 3D-Printed Cobalt Chromium and Soft-Milled Cobalt Chromium

Purpose: To compare the mechanical properties and fracture behaviour of laser-sintered/3D-printed cobalt chromium (LS CoCr) with soft-milled cobalt chromium (SM CoCr) to assess their suitability for use in high-stress areas in the oral cavity. Material and Method: Two computer-aided manufacturing methods were used to fabricate dumbbell specimens in accordance with the ASTM standard E8. Specimens were fractured using tensile testing and elastic modulus, and proof stress and ultimate tensile strength were calculated. Fracture surfaces were examined using scanning electron microscopy. Plate specimens were also fabricated for the examination of hardness and elastic modulus using nanoindentation. Unpaired t-test was used to evaluate statistical significance. Results: LS CoCr specimens were found to have significantly higher ultimate tensile strength (UTS) and proof stress (PS) (p < 0.05) but not a significantly higher elastic modulus (p > 0.05). Examination of the dumbbell fracture surfaces showed uniform structure for the LS CoCr specimens whilst the SM CoCr specimens were perforated with porosities; neither showed an obvious point of fracture. Nanoindentation also showed that LS CoCr specimens possessed higher hardness compared with SM CoCr specimens. Conclusion: LS CoCr and SM CoCr specimens were both found to exhibit uniformly dense structure; although porosities were noted in the SM CoCr specimens. LS CoCr specimens were found to have superior tensile properties, likely due to lack of porosities, however both had mean values higher than those reported in the literature for cast CoCr. Uniformity of structure and high tensile strength indicates that LS CoCr and SM CoCr fabricated alloys are suitable for long-span metallic frameworks for use in the field of prosthodontics.

Corrosion Resistance and Ion Release of Dental Prosthesis of CoCr Obtained by CAD-CAM Milling, Casting and Laser Sintering

Corrosion resistance and ion release behavior have been evaluated for thirty dental restoration samples obtained by three different manufacturing systems: computer-aided design and manufacturing (CAD-CAM), traditional casting and laser sintering. The alloy used was the CoCr alloy (same batch) generally used in clinical dentistry. Corrosion resistance has been evaluated by electrochemical testing in an artificial saliva medium at 37 °C. Corrosion parameters such as critical current density (icr), corrosion potential (Ecorr), and passive current density (ip), have been determined. Cobalt and Chromium ions released from the different samples have also been analyzed in an artificial saliva medium at 37 °C by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at different immersion times. The casted samples showed higher corrosion rates and ion-release levels. The CAD-CAM milled samples presented lower ion-release levels and better corrosion resistance due to the total solubility of the chemical elements in only one phase with the same chemical composition. This homogeneity avoids the formation of electrochemical corrosion. Moreover, the absence of defects and residual stresses increases the corrosion resistance. Casted and laser sintered prostheses have shown the presence of Cr, W, and Nb rich-precipitates which are detrimental to the corrosion resistance. These precipitates produce a decrease in the Cr content on the surface. It is well known that the corrosion resistance increases with the Cr content by the formation of Chromium oxide on the surface that increases passivation. Consequently, the decrease in Cr induces an increase in corrosion and ion release.

Mechanical Properties of CoCr Dental-Prosthesis Restorations Made by Three Manufacturing Processes. Influence of the Microstructure and Topography

The aim of this study is to compare the mechanical properties of three different dental restorations’ manufacturing processes (CADCAM milling, casting and laser sintering) generated by only one laboratory scanner focusing on marginal fit analysis and their mechanical properties. A chrome-cobalt (Cr-Co) alloy from the same batch was used for three different methods to make an implant abutment. This simulates a maxillary right first molar that was fixed in a hemi-maxillary stone model. Five scans were performed by each tested framework. Nine frameworks were manufactured for each manufacture procedure. Field-Emission Scanning Electron Microscope (FE-SEM) direct vision was used to marginal gap measurement in five critical points for each specimen. In order to fix the samples in the microscope chamber, the restorations were submitted at a compression load of 50 N. The samples always have the same orientation and conditions. The resolution of the microscope is 4 nm and it is equipped by J image software. The microstructure of the samples was also determined with the FE-SEM equipped with EDS-microanalysis. Roughness parameters were measured using White Light Interferometry (WLI). The arithmetical mean for the Ra and Rq of each sample was calculated. The samples were mechanically characterized by means of microhardness and flexural testing. Servo-hydraulic testing machine was used with cross-head rate of 1 mm/min. Two-way ANOVA statistical analysis was performed to determine whether the marginal discrepancies and mechanical properties were significantly different between each group (significance level p < 0.05). The overall mean marginal gap values were: from 50.53 ± 10.30 µm for the samples produced by CADCAM to 85.76 ± 22.56 µm for the samples produced by the casting method. Laser sintering presents a marginal gap of 60.95 ± 20.66 µm. The results revealed a statistically significant difference (p-value < 0.005) in the mean marginal gap between the CADCAM systems studied. The higher flexure load to fracture for these restorations were for CADCAM restoration and the lower was for the casting samples. For these restorations, CADCAM Restoration yielded a higher flexure load to fracture and Casting ones yielded the lower. Porosity and microstructure play a very important role in the mechanical properties.

3D metal printing in dentistry: An in vitro biomechanical comparative study of two additive manufacturing technologies for full-arch implant-supported prostheses

The use of 3D technologies is progressing in the dental field. However, little is known about the biomechanical behavior of the additive manufacturing of full-arch fixed dental prostheses (FAFDPs) for the establishment of clinical protocols. We investigated the influence of three CAD/CAM technologies: milling (control), Selective Laser Melting (SLM) and Electron Beam Melting (EBM) for FAFDP manufacturing. Also, the effects of ceramic veneer and spark erosion on marginal misfits of FAFDPs, the stability of prosthetic screws, strain and stress on the implant-supported system, as well as the effect of chewing simulation on screw stability were evaluated. Fifteen Ti-6Al-4V alloy FAFDPs were obtained by means of CAD/CAM systems: milling, SLM and EBM (n = 5/group). The marginal misfit was analyzed according to the single-screw test protocol. Screw stability was analyzed by screw-loosening torque. Strain-gauge analysis investigated the strain on the mini-abutment analog, and photoelastic analysis investigated the stress on the peri-implant region. Subsequently, all frameworks underwent ceramic veneer and spark erosion procedures. Marginal misfit, screw-loosening and strain and stress analyses were assessed after each evaluation time: initial, ceramic veneer and spark erosion. Finally, all prostheses were subjected to 10⁶ mechanical cycles (2 Hz/150 N), and screw-loosening was re-evaluated. Data were subjected to two-way ANOVA for repeated measures, and the Bonferroni test as a post hoc technique (α = 0.05). At the initial time, the milling group presented the lowest marginal misfit (p < 0.001). Ceramic veneer did not alter marginal misfit for all groups (p > 0.05); spark erosion decreased the misfit values for the SLM and EBM groups (p < 0.05). Evaluation time did not alter screw-loosening values for all groups (p = 0.191), although the milling group presented the highest screw-loosening values (p < 0.05). Ceramic veneer and spark erosion reduced strain in the components regardless of the manufacturing technology used (p < 0.05). The milling group presented the lowest stress values regardless of evaluation time (p = 0.001), and lower stress values were found after spark erosion regardless of the manufacturing group (p = 0.016). In conclusion, although milled frameworks exhibited the best biomechanical behavior, frameworks manufactured by additive technologies presented acceptable values of screw-loosening torque, strain and stress. Ceramic veneer did not negatively interfere in the biomechanical tests of the study, and clinically acceptable marginal misfit was achieved after spark erosion. Therefore, such 3D printing technologies seem to be feasible for the manufacturing of full-arch implant-supported frameworks.

Development of AM Technologies for Metals in the Sector of Medical Implants

Additive manufacturing (AM) processes have undergone significant progress in recent years, having been implemented in sectors as diverse as automotive, aerospace, electrical component manufacturing, etc. In the medical sector, different devices are printed, such as implants, surgical guides, scaffolds, tissue engineering, etc. Although nowadays some implants are made of plastics or ceramics, metals have been traditionally employed in their manufacture. However, metallic implants obtained by traditional methods such as machining have the drawbacks that they are manufactured in standard sizes, and that it is difficult to obtain porous structures that favor fixation of the prostheses by means of osseointegration. The present paper presents an overview of the use of AM technologies to manufacture metallic implants. First, the different technologies used for metals are presented, focusing on the main advantages and drawbacks of each one of them. Considered technologies are binder jetting (BJ), selective laser melting (SLM), electron beam melting (EBM), direct energy deposition (DED), and material extrusion by fused filament fabrication (FFF) with metal filled polymers. Then, different metals used in the medical sector are listed, and their properties are summarized, with the focus on Ti and CoCr alloys. They are divided into two groups, namely ferrous and non-ferrous alloys. Finally, the state-of-art about the manufacture of metallic implants with AM technologies is summarized. The present paper will help to explain the latest progress in the application of AM processes to the manufacture of implants.

Effect of cooling rate on hardness and microstructure of Pd-Ag-In-Sn-Ga alloy during porcelain firing simulation

This study examined the effect of the cooling rate on the hardness and its effect on the microstructure during porcelain firing simulation of a Pd-Ag-In-Sn-Ga metal-ceramic alloy. In practice, after each firing step for porcelain bonding, the prosthesis is cooled to room temperature before proceeding to the next firing step. The cooling step is known to allow the hardness of the metal substructure to increase. The aim of the study was to determine whether controlling the cooling rate after each porcelain-firing step increases the hardness of the Pd-Ag-based metal-ceramic alloy. The results showed that the hardness of specimens cooled at a higher cooling rate increased after each firing step compared to specimens cooled at a lower cooling rate (p < 0.05). During cooling after the firing simulation the InPd₃-based phase of tetragonal structure precipitated from the Pd-Ag-rich matrix of the face-centered cubic structure. Hardening by cooling at a higher cooling rate after firing was the result of the coherency strains that formed at the interface of the Pd-Ag-rich matrix and the metastable phase based on the InPd₃ phase. . The reduced hardness obtained in the specimen cooled at a lower cooling rate after firing resulted from the loss of coherency strains as the fine metastable phases based on the InPd₃ phase were transformed into the coarser stable phase with decreased (c/a) of 0.88. This finding revealed that controlling the cooling rate during porcelain firing simulation improves the hardness of the Pd-Ag-In-Sn-Ga metal-ceramic alloy without an additional heat treatment of the alloy.

Application of a Novel CVD TiN Coating on a Biomedical Co-Cr Alloy: An Evaluation of Coating Layer and Substrate Characteristics

Titanium nitride (TiN) was deposited on the surface of a cobalt–chromium (Co–Cr) alloy by a hot-wall type chemical vapor deposition (CVD) reactor at 850 °C, and the coating characteristics were compared with those of a physical vapor deposition (PVD) TiN coating deposited on the same alloy at 450 °C. Neither coating showed any reactions at the interface. The face-centered cubic (fcc) structure of the alloy was changed into a hexagonal close-packed (hcp) phase, and recrystallization occurred over at 10 μm of depth from the surface after CVD coating. Characteristic precipitates were also generated incrementally depending on the depth, unlike the precipitates in the matrix of the as-cast alloy. On the other hand, the microstructure and phase of the PVD-coated alloy did not change. Depth-dependent nano-hardness measurements showed a greater increase in hardness in the recrystallization zone of the CVD-coated alloy than in the bulk center of the alloy. The CVD coating showed superior adhesion to the PVD coating in the progressive scratch test. The as-cast, PVD-coated, and CVD-coated alloys all showed negative cytotoxicity. Within the limitations of this study, CVD TiN coating to biomedical Co–Cr alloy may be considered a promising alternative to PVD technique.

Comparative clinical study of the marginal discrepancy of fixed dental prosthesis fabricated by the milling-sintering method using a presintered alloy

PURPOSE

The present study was designed to examine the clinical fit of fixed dental prosthesis fabricated by the milling-sintering method using a presintered cobalt-chromium alloy.

MATERIALS AND METHODS

Two single metal-ceramic crowns were fabricated via milling-sintering method and casting method in each of the twelve consecutive patients who required an implant-supported fixed prosthesis. In the milling-sintering method, the prosthetic coping was designed in computer software, and the design was converted to a non-precious alloy coping using milling and post-sintering process. In the casting method, the conventional manual fabrication process was applied. The absolute marginal discrepancy of the prostheses was evaluated intraorally using the triple-scan technique. Statistical analysis was conducted using Mann-Whitney U test (α=.05).

RESULTS

Eight patients (66.7%) showed a lower marginal discrepancy of the prostheses made using the milling-sintering method than that of the prosthesis made by the casting method. Statistically, the misfit of the prosthesis fabricated using the milling-sintering method was not significantly different from that fabricated using the casting method (P=.782). There was no tendency between the amount of marginal discrepancy and the measurement point.

CONCLUSION

The overall marginal fit of prosthesis fabricated by milling-sintering using a presintered alloy was comparable to that of the prosthesis fabricated by the conventional casting method in clinical use.