Wear at the implant-framework interface between titanium implant platform and the additively manufactured titanium and cobalt-chromium frameworks

PURPOSE

To measure the wear at the implant interface between the Grade 4 titanium (Ti) of the implant and frameworks fabricated using two additively manufactured alloys (Ti alloy and cobalt-chromium [Co-Cr]) pre- and post-artificial aging.

MATERIAL AND METHODS

Three-unit frameworks supported by two implants were additively manufactured (Atlantis; Dentsply Sirona) using Ti and Co-Cr dental alloys. Two implants (OsseoSpeed EV, Astra Tech; Dentsply Sirona) were torqued on each non-engaging framework. The assembled implant-frameworks were secured into polyurethane foam blocks. Groups were created based on the material and surface assessed: framework (Ti-framework and Co-Cr-framework groups) and implant (Ti-implant group). Two subgroups were created depending on the location: premolar (PM) and molar (M). Computed tomography images were obtained pre- (as manufactured) and post-simulated mastication procedures. The pre- and post-simulated mastication files of each specimen were aligned using the best-fit algorithm using a metrology program. Wear was measured by calculating the volumetric discrepancies at the implant interface on 64 measurement points per area analyzed. Three-way ANOVA and Tukey tests were used to analyze the data (α = 0.05).

RESULTS

The mean volumetric discrepancy values ranged from 0.8 to 3.1 µm among all the subgroups tested. The group (framework vs. implant) (p < 0.001) and tooth location (p < 0.001) were significant factors of the mean volumetric discrepancy values obtained. The framework group presented with significantly lower volumetric discrepancy mean values (1 µm) compared with the implant group (3 µm), whereas the premolar area obtained significantly lower mean volumetric discrepancy values (1.9 µm) compared with the molar location (2.3 µm).

CONCLUSIONS

Volumetric discrepancies were found at the implant-framework interface tested between the pre- and post-artificial aging measurements ranging from 1 to 3 µm after 1,200,000 cyclic loading that simulated approximately 12 months of function.

SIRIM Berhad: The Frontier in Medical and Health Technology

With the world recovering from a public health disaster in the form of the COVID-19 pandemic and with political and social upheaval in the forms of wars such as in Ukraine and Sudan, localised fighting in various hotspots, the medical field faces huge challenges in addressing the needs of the various stakeholders. Still, these disasters represent opportunities to advance the new discoveries without compromising on the safety of the patients or general population. The COVID-19 vaccines were pushed through with great urgency driving on new discoveries of the genomic research, i.e. RNA based vaccines. This is complemented by the use of big data to monitor the disbursement of the vaccine to the general public. Unmistakably these new developments in tackling serious health disasters will lead to improvements on how the world tackle future crisis. Recent advances in artificial intelligence (AI), genomics discoveries and cell biology are driving research and fueling hope for the future. Amid this scenario of great upheavals and significant advances in technologies or emerging technologies for the health sector, SIRIM Berhad is increasing its preparedness in terms of development of new facilities and new competencies as well as building the platform for the communication of conventional health or medical technologies with other technologies particularly digital technologies to unlock the potential of emerging technologies in both medical and digital to develop novel solutions to future problems or challenges.

Additive manufacturing technologies in the oral implant clinic: A review of current applications and progress

Additive manufacturing (AM) technologies can enable the direct fabrication of customized physical objects with complex shapes, based on computer-aided design models. This technology is changing the digital manufacturing industry and has become a subject of considerable interest in digital implant dentistry. Personalized dentistry implant treatments for individual patients can be achieved through Additive manufacturing. Herein, we review the applications of Additive manufacturing technologies in oral implantology, including implant surgery, and implant and restoration products, such as surgical guides for implantation, custom titanium meshes for bone augmentation, personalized or non-personalized dental implants, custom trays, implant casts, and implant-support frameworks, among others. In addition, this review also focuses on Additive manufacturing technologies commonly used in oral implantology. Stereolithography, digital light processing, and fused deposition modeling are often used to construct surgical guides and implant casts, whereas direct metal laser sintering, selective laser melting, and electron beam melting can be applied to fabricate dental implants, personalized titanium meshes, and denture frameworks. Moreover, it is sometimes required to combine Additive manufacturing technology with milling and other cutting and finishing techniques to ensure that the product is suitable for its final application.

New Platforms Based on Frontal Cellular Automata and Lattice Boltzmann Method for Modeling the Forming and Additive Manufacturing

Materials science gives theoretical and practical tools, while new modeling methods and platforms provide rapid and efficient development, improvement, and optimization of old and new technologies. Recently, impressive progress has been made in the development of computer software and systems. The frontal cellular automata (FCA), lattice Boltzmann method (LBM), and modeling platforms based on them are considered in the paper. The paper presents basic information on these methods and their application for modeling phenomena and processes in materials science. Recrystallization, crystallization, phase transformation, processes such as flat and shape rolling, additive manufacturing technologies (Selective Laser Sintering (SLS)/ Selective Laser Melting (SLM)), and others are examples of comprehensive and effective modeling by the developed systems. Selected modeling results are also presented.

Influence of the layer thickness on the flexural strength of aged and non-aged additively manufactured interim dental material

PURPOSE

To measure the flexural strength and Weibull characteristics of aged and non-aged printed interim dental material fabricated with different layer thickness.

MATERIAL AND METHODS

Bars (25×2×2 mm) were additively fabricated by using a polymer printer (Asiga Max) and an interim resin (Nexdent C&B MFH). Specimens were fabricated with the same printing parameters and postprocessing procedures, but with 7 different layer thickness: 50 (control or 50-G group), 10 (10-G group), 25 (25-G group), 75 (75-G group), 100 (100-G group), 125 (125-G group), and 150 μm (150-G group). Two subgroups were created: non-aged and aged subgroups (n = 10). A universal testing machine was selected to measure flexural strength. Two-parameter Weibull distribution values were computed. Two-way ANOVA and Tukey tests were elected to examine the data (α = .05).

RESULTS

Artificial aging methods (P<.001) were a significant predictor of the flexural strength computed. Aged specimens acquired less flexural strength than non-aged specimens. The Weibull distribution obtained the highest shape for non-aged 50-G and 75-G group specimens compared with those of other non-aged groups, while the Weibull distribution showed the highest shape for aged 125-G specimens.

CONCLUSIONS

The flexural strength of the additively fabricated interim material examined was not influenced by the layer thickness at which the specimens were fabricated; however, artificial aging techniques reduced its flexural strength. Aged specimens presented lower Weibull distribution values compared with non-aged specimens, except for the 125-G specimens. This article is protected by copyright. All rights reserved.

The Influence of Selected Selective Laser Sintering Technology Process Parameters on Stress Relaxation, Mass of Models, and Their Surface Texture Quality

The article presents the results of research on the impact of basic process parameters of selective laser sintering technology on the mass of the produced models (density of the sintered material-polyamide PA 2200), stress relaxation during compression determined in accordance with the ISO 3384 standard, and geometric surface structure parameters (SGPs). During the tests, the influence of process parameters such as the location of the models on the virtual construction platform (printing direction), the density of the energy supplied to the sintered layer of powder, and the layer thickness of the manufactured material layer was taken into account. The test results confirmed that the process parameters have a significant impact on the density of the model material (in the sintered state), the mechanical properties (stress relaxation during compression), and the quality of the surface texture (SGPs). The most favorable positioning variants of the models on the construction platform were determined. The most favorable thickness variants of the combined layers and the density value of the energy supplied to the sintered powder layer were selected, depending on the expected mass, strength, and SGP quality. In addition, it has been shown that it is possible to build models with reduced mass (>20%), while maintaining satisfactory mechanical and qualitative properties of the surface texture.

Silicone Additive Manufactured Indices Performed from a Virtual Diagnostic Waxing for Direct Composite Diastema Closure Combined with Resin Infiltration Technique on White Spot Lesions: A Case Report

The present article describes the resin infiltration technique to address white spots lesions presented on anterior and premolar teeth of a young patient after orthodontic treatment and the digital workflow for planning a diastema closure on the maxillary anterior teeth using facial photographs, an intraoral scanner, a facially driven diagnostic waxing using a dental computer-aided design (CAD) software, and 3-piece additive manufactured (AM) clear silicone indices. The virtual design of the silicone indices was completed using an open-source CAD software and included a flexible clear buccal piece, flexible clear lingual piece, and rigid clear custom tray. The unique 3-piece index design allows a horizontal path of insertion, controlled uniform thickness of the indices, flexible and rigid material properties combination, accurate translation of the diagnostic waxing into the patient´s mouth, and digital storage of the designs.

Metal additive manufacturing technologies: literature review of current status and prosthodontic applications

OBJECTIVES

To review the current metal-based additive manufacturing (AM) technologies, namely powder bed fusion (PBF) technologies, and their current prosthodontic applications. The PBF technologies reviewed are selective laser sintering (SLS), selective laser melting (SLM), and electron beam melting (EBM).

MATERIALS AND METHODS

The literature on metal AM technologies was considered, and the AM procedures and their current applications in prosthodontics were collated and described. Published articles about AM metal in dental care were searched (MEDLINE, EMBASE, EBSCO, and Web of Science). All studies related to the description, analysis, and evaluation of prosthodontic applications using metal AM technologies.

RESULTS AND CONCLUSIONS

AM technologies are reliable for many applications in dentistry, including metal frameworks for removable partial dentures (RPDs), overdentures, tooth- and implant-supported fixed dental prostheses (FDPs), and metal frameworks for splinting implant impression abutments. However, further studies are needed in future to evaluate the accuracy, reproducibility, and clinical outcome throughout function of AM technologies.

Laboratory workflow to obtain long-term injected resin composite interim restorations from an additive manufactured esthetic diagnostic template

OBJECTIVE

An analogue and digital workflow for the fabrication of a diagnostic 3D printed polymer template and its duplication for long-term injected composite resin interim restorations is described, because of the lack of scientific evidence in 3-dimensional (3D) printing applied to dentistry in terms of printer technology, printer parameters, postpolymerization processes, and material characteristics. In addition, in the case of 3D printed temporary resins, they cannot be relined successfully and its mechanical properties in the mouth have not been tested yet.

CONCLUSIONS

The main benefits of this approach relate to the improvement of clinical and laboratory procedures, as conventional waxing is eliminated, conventional master casts are not needed and the process is entirely automatized, improving the workflow, with minimal intervention of the laboratory technician.

CLINICAL SIGNIFICANCE

The additive manufactured diagnostic template represents the materialization of the digital diagnostic waxing and provides a powerful tool to visualize the digital diagnostic waxing in the patient's mouth and face. Furthermore, the diagnostic 3D printed template can be used for multiple applications including interim restorations, radiographical, or surgical guide fabrication. The duplication technique described provides a predictable workflow to obtain long-term injected resin composite restorations from an additive manufactured esthetic diagnostic template, improving the laboratory and chairside procedures.

A review on chemical composition, mechanical properties, and manufacturing work flow of additively manufactured current polymers for interim dental restorations

OBJECTIVES

Additive manufacturing (AM) technologies can be used to fabricate 3D-printed interim dental restorations. The aim of this review is to report the manufacturing workflow, its chemical composition, and the mechanical properties that may support their clinical application.

OVERVIEW

These new 3D-printing provisional materials are typically composed of monomers based on acrylic esters or filled hybrid material. The most commonly used AM methods to manufacture dental provisional restorations are stereolithography (SLA) and material jetting (MJ) technologies. To the knowledge of the authors, there is no published article that analyzes the chemical composition of these new 3D-printing materials. Because of protocol disparities, technology selected, and parameters of the printers and material used, it is notably difficult to compare mechanical properties results obtained in different studies.

CONCLUSIONS

Although there is a growing demand for these high-tech restorations, additional information regarding the chemical composition and mechanical properties of these new provisional printed materials is required.

CLINICAL SIGNIFICANCE

Additive manufacturing technologies are a current option to fabricate provisional dental restorations; however, there is very limited information regarding its chemical composition and mechanical properties that may support their clinical application.

Position Accuracy of Implant Analogs on 3D Printed Polymer versus Conventional Dental Stone Casts Measured Using a Coordinate Measuring Machine

PURPOSE

To compare the accuracy of implant analog positions on complete edentulous maxillary casts made of either dental stone or additive manufactured polymers using a coordinate measuring machine (CMM).

MATERIAL AND METHODS

A completely edentulous maxillary model of a patient with 7 implant analogs was obtained. From this model, two types of casts were duplicated, namely conventional dental stone (CDS) using a custom tray impression technique after splinting (N = 5) and polymer cast using additive manufacturing based on the STL file generated. Polymer casts (N = 20; n = 5 per group) were fabricated using 4 different additive manufacturing technologies (multijet printing-MJP1, direct light processing-DLP, stereolithography-SLA, multijet printing-MJP2). CMM was used to measure the correct position of each implant, and distortion was calculated for each system at x-, y-, and z-axes. Measurements were repeated 3 times per specimen in each axis yielding a total of 546 measurements. Data were analyzed using ANOVA, Sheffé tests, and Bonferroni correction (α = 0.05).

RESULTS

Compared to CMM, the mean distortion (μm) ranged from 22.7 to 74.9, 23.4 to 49.1, and 11.0 to 85.8 in the x-, y-, and z-axes, respectively. CDS method (x-axis: 37.1; z-axis: 27.62) showed a significant difference compared to DLP on the x-axis (22.7) (p = 0.037) and to MJP1 on the z-axis (11.0) (p = 0.003). Regardless of the cast system, x-axes showed more distortion (42.6) compared to y- (34.6) and z-axes (35.97). Among additive manufacturing technologies, MJP2 presented the highest (64.3 ± 83.6), and MJP1 (21.57 ± 16.3) and DLP (27.07 ± 20.23) the lowest distortion, which was not significantly different from CDS (32.3 ± 22.73) (p > 0.05).

CONCLUSION

For the fabrication of the definitive casts for implant prostheses, one of the multijet printing systems and direct light processing additive manufacturing technologies showed similar results to conventional dental stone.

CLINICAL SIGNIFICANCE

Conventional dental stone casts could be accurately duplicated using some of the additive manufacturing technologies tested.