Effects of surface treatment of powder metallurgy manufactured titanium on bond strength to veneering ceramics

Komercijalno čisti titan (CP Ti) dobiven hladnim izostatičkim i toplo-vakuumskim tlačenjem (CIP/HVP) postupcima metalurgije praha (PM) dosad nije korišten u stomatološkoj protetici. Svrha je istraživanja istražiti utjecaj obrade površine osnovne konstrukcije iz CP Ti dobivenog postupcima PM na veznu čvrstoću s tri obložne keramike te istražiti mehanička svojstva CP Ti dobivenog PM. Istraživanje je provedeno na 120 uzoraka CP Ti dobivenog metalurgijom praha izrezanih na erozimatu podijeljenih u pet skupina prema načinu obrade površine: 1. neobrađena; 2. pjeskarena Al2O3; 3. naneseno vezno sredstvo; 4. pjeskarena Al2O3 i naneseno vezno sredstvo; 5. djelovanje klorovodične kiseline. Svaka skupina podijeljena je u tri podskupine po osam uzoraka te je na njih napečena određena obložna keramika. Testiranje i izračun vezne čvrstoće provedeni su prema ISO 9693. Površina uzoraka prije i poslije obrade te nakon napečenja keramike i provedenog loma snimljena je SEM-om, EDS-om, izmjerena je hrapavost površine profilometrom te je analizirana površinska struktura XRD-om. Rezultati su pokazali da su mehanička svojstva CP Ti/PM usporediva s konvencionalno dobivenim CP Ti i zadovoljavaju za upotrebu u kliničkoj praksi. Također su sve skupine uzoraka osim Initial Ti skupine 1 i Titankeramik skupina 1, 3 i 5 zadovoljile uvjete vrijednosti vezne čvrstoće (> 25 MPa) postavljenih standardom ISO 9693. Za Duceratin Kiss keramiku optimalna obrada površine uključuje pjeskarenje Al2O3 i nanošenje veznog sredstva, dok je za Initial Ti i Titankeramik obložne keramike dovoljno samo pjeskarenje Al2O3. Nije pronađena statistički značajna razlika vrijednosti vezne čvrstoće između triju vrsta obložnih keramika. Komercijalno čisti titan dobiven postupcima metalurgije praha pokazuje sva svojstva potrebna za upotrebu u kliničkoj praksi.Introduction: Commercially pure titanium (CP Ti) manufactured by cold isostatic and hot vacuum pressing (CIP/HVP) processes of powder metallurgy has not been used in prosthodontics. The aim was to evaluate the effects of surface modification of CP Ti substructures manufactured by PM processes on bond strength with three veneering ceramics, and the mechanical properties of CP Ti manufactured by PM. Materials and methods: 120 samples of CP Ti manufactured by PM shaped on WEDM were divided into 5 groups according to surface modifications: 1. untreated; 2. sandblasted (Al2O3); 3. applied bonding agent; 4. sandblasted (Al2O3) and applied bonding agent; 5. etched with hydrochloric acid. Each group was divided into 3 subgroups of 8 samples and veneering ceramics was applied. Bond strength evaluation was done according to ISO 9693. The surface of the samples was evaluated before and after modifications, after applying veneering ceramics and bond strength testing with SEM, EDS, the roughness was measured with a profilometer, and surface structural analysis was done by XDR. Results: Dynamic mechanical analysis revealed values of Young's module of elasticity (E) 104 GPa, proof strength (Rp0.2) 503 MPa, tensile strength (Rm) 698. Vickers hardness testing showed microhardness values of (HV 0,1) 167. After initial inspection of surface quality, which was satisfactory, bond strength values were measured and the following results were obtained. The results of bond strength testing showed the following values: for the Duceratin Kiss veneering ceramics values range from 25,6 MPa to 41,2 MPa; for the Initial Ti from 12,7 MPa to 38,5 MPa; for the Titankeramik from 17,3 MPa to 38,5 MPa. ANOVA showed statistically significant differences in bond strength values within a group of veneering ceramics for the Duceratin Kiss group 4, the Initial Ti group 2 and the Titankeramik group 2. No statistically significant differences in bond strength values were found between the veneering ceramics. The SEM, EDS and XRD analyses of samples showed predominantly adhesive fractures between veneering ceramics and metal samples. Surface roughness showed significantly higher values of roughness parameter Ra, Rz and Rmax for sandblasted samples. Pearson correlation coefficient between surface roughness and bond strength values was: the Duceratin Kiss r235 %, the Initial Ti r260 % and the Titankeramik r282 %. Conclusion: CP Ti manufactured by PM can be used in prosthodontics as a metal base material in metal ceramic systems

Effects of surface treatment of powder metallurgy manufactured titanium on bond strength to veneering ceramics

Komercijalno čisti titan (CP Ti) dobiven hladnim izostatičkim i toplo-vakuumskim tlačenjem (CIP/HVP) postupcima metalurgije praha (PM) dosad nije korišten u stomatološkoj protetici. Svrha je istraživanja istražiti utjecaj obrade površine osnovne konstrukcije iz CP Ti dobivenog postupcima PM na veznu čvrstoću s tri obložne keramike te istražiti mehanička svojstva CP Ti dobivenog PM. Istraživanje je provedeno na 120 uzoraka CP Ti dobivenog metalurgijom praha izrezanih na erozimatu podijeljenih u pet skupina prema načinu obrade površine: 1. neobrađena; 2. pjeskarena Al2O3; 3. naneseno vezno sredstvo; 4. pjeskarena Al2O3 i naneseno vezno sredstvo; 5. djelovanje klorovodične kiseline. Svaka skupina podijeljena je u tri podskupine po osam uzoraka te je na njih napečena određena obložna keramika. Testiranje i izračun vezne čvrstoće provedeni su prema ISO 9693. Površina uzoraka prije i poslije obrade te nakon napečenja keramike i provedenog loma snimljena je SEM-om, EDS-om, izmjerena je hrapavost površine profilometrom te je analizirana površinska struktura XRD-om. Rezultati su pokazali da su mehanička svojstva CP Ti/PM usporediva s konvencionalno dobivenim CP Ti i zadovoljavaju za upotrebu u kliničkoj praksi. Također su sve skupine uzoraka osim Initial Ti skupine 1 i Titankeramik skupina 1, 3 i 5 zadovoljile uvjete vrijednosti vezne čvrstoće (> 25 MPa) postavljenih standardom ISO 9693. Za Duceratin Kiss keramiku optimalna obrada površine uključuje pjeskarenje Al2O3 i nanošenje veznog sredstva, dok je za Initial Ti i Titankeramik obložne keramike dovoljno samo pjeskarenje Al2O3. Nije pronađena statistički značajna razlika vrijednosti vezne čvrstoće između triju vrsta obložnih keramika. Komercijalno čisti titan dobiven postupcima metalurgije praha pokazuje sva svojstva potrebna za upotrebu u kliničkoj praksi.Introduction: Commercially pure titanium (CP Ti) manufactured by cold isostatic and hot vacuum pressing (CIP/HVP) processes of powder metallurgy has not been used in prosthodontics. The aim was to evaluate the effects of surface modification of CP Ti substructures manufactured by PM processes on bond strength with three veneering ceramics, and the mechanical properties of CP Ti manufactured by PM. Materials and methods: 120 samples of CP Ti manufactured by PM shaped on WEDM were divided into 5 groups according to surface modifications: 1. untreated; 2. sandblasted (Al2O3); 3. applied bonding agent; 4. sandblasted (Al2O3) and applied bonding agent; 5. etched with hydrochloric acid. Each group was divided into 3 subgroups of 8 samples and veneering ceramics was applied. Bond strength evaluation was done according to ISO 9693. The surface of the samples was evaluated before and after modifications, after applying veneering ceramics and bond strength testing with SEM, EDS, the roughness was measured with a profilometer, and surface structural analysis was done by XDR. Results: Dynamic mechanical analysis revealed values of Young's module of elasticity (E) 104 GPa, proof strength (Rp0.2) 503 MPa, tensile strength (Rm) 698. Vickers hardness testing showed microhardness values of (HV 0,1) 167. After initial inspection of surface quality, which was satisfactory, bond strength values were measured and the following results were obtained. The results of bond strength testing showed the following values: for the Duceratin Kiss veneering ceramics values range from 25,6 MPa to 41,2 MPa; for the Initial Ti from 12,7 MPa to 38,5 MPa; for the Titankeramik from 17,3 MPa to 38,5 MPa. ANOVA showed statistically significant differences in bond strength values within a group of veneering ceramics for the Duceratin Kiss group 4, the Initial Ti group 2 and the Titankeramik group 2. No statistically significant differences in bond strength values were found between the veneering ceramics. The SEM, EDS and XRD analyses of samples showed predominantly adhesive fractures between veneering ceramics and metal samples. Surface roughness showed significantly higher values of roughness parameter Ra, Rz and Rmax for sandblasted samples. Pearson correlation coefficient between surface roughness and bond strength values was: the Duceratin Kiss r235 %, the Initial Ti r260 % and the Titankeramik r282 %. Conclusion: CP Ti manufactured by PM can be used in prosthodontics as a metal base material in metal ceramic systems

Immediate Implantation in Infected Tooth Sockets

Although immediate implantation has not been previously recommended in infected sites, it is now becoming a procedure of choice in modern implant dentistry. We report a case of a 65-year-old male patient, who required multiple tooth extractions in the lower jaw and fabrication of a new overdenture in the lower jaw and a complete denture in the upper jaw. Immediate implantation in infected tooth sockets followed extraction. Two NobelReplace™ Tapered implants (Nobel BioCare, Zürich, Switzerland), one 13 mm long and 4.3 mm wide and the other 13 mm long and 5.0 mm wide, were placed in the position 33 and 43. The site was sutured and a temporary denture was fabricated by adjusting the old denture. After a period of three months the implant site was reopened and healing abutments were placed. Impressions were made using the Impregum Penta Soft (3M ESPE, St. Paul, Minn, USA) polyether material. Ball Abutment Titanium™ was used as a patrix attachment and a matrix was inserted into the denture. Clinical examination and x-ray analysis after six months showed no significant changes of the implants. Bone resorption was within standard values. Although it is still a controversial subject, immediate implantation in infected sites can be a safe and predictable procedure if surgical protocols are followed. However, further research is needed to draw firm conclusions

Immediate Implantation in Infected Tooth Sockets

Although immediate implantation has not been previously recommended in infected sites, it is now becoming a procedure of choice in modern implant dentistry. We report a case of a 65-year-old male patient, who required multiple tooth extractions in the lower jaw and fabrication of a new overdenture in the lower jaw and a complete denture in the upper jaw. Immediate implantation in infected tooth sockets followed extraction. Two NobelReplace™ Tapered implants (Nobel BioCare, Zürich, Switzerland), one 13 mm long and 4.3 mm wide and the other 13 mm long and 5.0 mm wide, were placed in the position 33 and 43. The site was sutured and a temporary denture was fabricated by adjusting the old denture. After a period of three months the implant site was reopened and healing abutments were placed. Impressions were made using the Impregum Penta Soft (3M ESPE, St. Paul, Minn, USA) polyether material. Ball Abutment Titanium™ was used as a patrix attachment and a matrix was inserted into the denture. Clinical examination and x-ray analysis after six months showed no significant changes of the implants. Bone resorption was within standard values. Although it is still a controversial subject, immediate implantation in infected sites can be a safe and predictable procedure if surgical protocols are followed. However, further research is needed to draw firm conclusions

Implantoprotetičko zbrinjavanje kompjutorski navođenom implantologijom (M-guide): prikaz slučaja

Correct implant positioning poses a major challenge in modern dentistry and mismatch between the planned and final implant position is one of the most common treatment complications. A surgical guide or a template is a ‘’transmission device’’ which enables the implant placement in the intended position as accurate as possible. Case study: A woman aged 60 came into dental office to resolve a single tooth loss in regions 15 and 24. Radiographic analysis and clinical examination showed a lack of transversal space in the regions of implantation. Considering the fact of having a narrow area available for implantation, a computer-guided implant therapy using the M-Guide system was selected. The treatment plan was a prosthetic restoration involving the placement of two implants in areas 15 and 24 and the fabrication of zirconium oxide crowns. After digital planning, a fully guided surgical protocol was performed. Immediately after implantation, a temporary suprastructure and temporary crowns were placed. After a period of osseointegration, a definitive prosthetic restoration was made.Uvod: Pravilno pozicioniranje implantata velik je izazov u suvremenoj dentalnoj medicini, a nesklad između njegova planiranoga i konačnoga položaja jedna je od najčešćih terapijskih komplikacija. Kirurška vodilica ili šablona „prijenosno je sredstvo“ kojim se postiže što vjernije postavljanje implantata u planirani položaj. Prikaz slučaja: Žena u dobi od 60 godina došla je u ordinaciju radi sanacije pojedinačne bezubosti u regijama 15 i 24. Radiološkom analizom i kliničkim pregledom ustanovljen je manjak transverzalnoga prostora u regijama implantacije. Zbog manjka prostora za implantaciju izabrana je kompjutorski vođena implantoprotetička terapija s pomoću sustava M-Guide. Plan terapije bio je izraditi protetički rad koji uključuje postavljanje dvaju implantata u područja 15 i 24 i izradu cirkonij-oksidnih krunica. Nakon digitalnog planiranja pripremljen je potpuno navođeni kirurški protokol. Odmah poslije implantacije postavljena je privremena suprastruktura i privremeni protetički rad. Nakon oseointegracije pristupilo se izradi definitivnoga protetičkog rada

Oral Hygiene and Gingival Health in Patients with Fixed Prosthodontic Appliances – A 12-Month Follow-Up

The aim of this study was to assess and observe the oral hygiene and gingival condition in patients before and after fixed prosthodontic therapy through a 12-month period in combination with oral hygiene instructions. It was also analysed how factors, such as type of fixed prosthodontic appliance, constructive material, the position of a fixed partial denture (FPD) in the mouth, age and gender influenced oral hygiene. The dental arches were divided into three segments each and teeth and gingiva were examined using the Plaque and Gingiva Index by Silness and Löe, and for the mineralized deposits assessment the Calculus Index by Green and Vermillion was employed. The preliminary examination was conducted before the prosthodontic therapy, and the reexaminations were carried out 14 days, 1, 6 and 12 months after crown and/or FPD placement. A total of 93 subjects from the original study group of 146 patients attended all clinical examinations, while the rest was excluded. The sample consisted of 60 women, 33 men at age between 21 and 95 (average 51.8). A total of 39 patients had single crowns (C), 50 FPDs and 5 C+FPD. The frequency of plaque found during the preliminary visit was higher than that found in the other periods (p<0.001). Patients with C showed better oral hygiene levels than patients with FPDs or C+FPDs (p=0.001). Our results revealed no significant difference in oral hygiene status among patients with FPDs made of different materials (p=0.083). The worst hygiene levels were found in patients with fixed prosthodontic appliances in both jaws (p=0.012). Younger patients showed better hygiene levels than the older ones (p=0.002). Our research showed that appropriate educational and motivational measures can lead to improved oral hygiene, even after FPD placement. Presumably, the oral health in a group of adult patients can be kept acceptable by providing a prophylactic oral hygiene program

Effects of Wire EDM on the Microstructure of P/M Titanium Samples

Komercijalno čisti titanij (CP Ti) se koristi u dentalnoj medicini zbog biokompatibilnosti, dobrih mehaničkih svojstava i otpornosti na koroziju. Konvencionalni proizvodni procesi izrade takvog titanija mogu utjecati na kvalitetu površine uzoraka i rezultirati slabim vezanjem CP Ti s dentalnom keramikom. Zato se uvode nove tehnologije proizvodnje titanija, primjerice metalurgija praha i oblikovanje na erozimatu s žicom (WEDM). Svrha ovog istraživanja jest odrediti utjecaj WEDM-a na površinu uzoraka P/M CP Ti proizvedenih za ispitivanje vezne čvrstoće prema normi ISO 9693. Materijali i metode: Osam uzoraka P/M CP Ti dimenzija prema normi ISO 9693 proizvedeno je korištenjem WEDM-a i podijeljeno u dvije grupe – u neobrađene i brušene. Površine obje grupe uzoraka analizirane su metodama SEM, EDS i XDR. Rezultati: Analize neobrađenih uzoraka metodama SEM i EDS pokazuju tanki sloj različitog sastava i frakture. Brušeni uzorci imaju homogenu strukturu bez fraktura. Analiza metodom XDR pokazuje visoku koncentraciju titanijevih oksida na površini neobrađenih uzoraka, a nakon brušenja dobivena je samo čista α-faza. Zaključak: WEDM je metoda prikladna za proizvodnju uzoraka prema normi ISO 9693, ako se uzorci naknadno bruse.Purpose: Commercially pure titanium (CP Ti) has been recognized in dentistry for its biocompatibility, good mechanical properties and corrosion resistance. Conventional manufacturing processes can affect surface quality and result in poor bonding of dental ceramics to CP Ti. This is why powder metallurgy (P/M) and wire electro-discharge machining (WEDM) are being introduced in the manufacturing process. The aim of this study was to evaluate the effect of WEDM on the surface composition and microstructure of P/M CP Ti samples produced for bond strength testing according to ISO 9693. Materials and methods: Eight samples of P/M CP Ti, dimensions according to ISO 9693, were made using WEDM and divided in two groups (untreated and grinded). Microanalyses of chemical composition and microstructure of both groups were made using SEM, EDS and XDR. Results: SEM and EDS analysis of untreated samples showed a thin layer on surfaces with fractures in it. Grinded samples showed homogenous structure with no layer and no fractures. XDR analysis showed high level of oxides on the surface of untreated samples, while after grinding only pure α-phase was found. Conclusion: WEDM is a suitable method of sample production for ISO 9693 if accompanied by grinding with silicon carbide papers P320-P4000