Evaluation of Cast Re-Orientation on a Dental Surveyor Using Three Tripod Techniques: A Survey and In Vitro Study.

PURPOSE: To survey different educational levels (i.e., students, interns, technicians, and prosthodontic faculty) with regard to their opinions, attitudes, and adoption of three selected tripod techniques. The study will also investigate the accuracy of these techniques to reposition casts on the dental surveyor in anterio-posterior (AP) and lateral directions at both technique and educational levels. MATERIALS AND METHODS: Tripod points, scored lines, and cemented post tripod techniques were used in this study. Three Kennedy class II modification I stone casts, duplicated from a standard cast, were assigned to each of the tripod techniques. The tilt angles of all casts were set on the dental surveyor to 10° (control angle) in AP and lateral directions using a digital angle gauge with an accuracy of 0.2°. The casts were tripoded accordingly. A total of 243 participants were involved in this study. Participants were first asked to remount the three casts on three different dental surveyors using the tripod technique noted on each cast. Questionnaires were then given to each participant in an individual interview setting; this assured a 100% response rate. The angle differences were calculated. All data were coded and entered into an Excel Spreadsheet file. Statistical analyses were performed using a paired Chi-square, Wilcoxon Matched-pairs, ANOVA, and Tukey post hoc tests at 5% level of significance. RESULTS: No significant difference was found between the educational levels relative to the responses to technique demands, sensitivity, and time required for reorientation (p = 0.08202, 0.8108, 0.6874, respectively); however, the majority of respondents reported low technique demands, low sensitivity, and time saving for technique C in comparison to techniques A and B. Significant differences were noted among the educational levels in response to preference and adoption questions (p = 0.0035 and 0.0015, respectively). The highest percentage of faculty chose technique A for inclusion into the academic curriculum. Wilcoxon Matched-pairs test revealed that technique C was the least difficult and most practical (p = 0.0001, 0.0427, respectively). One-way ANOVA revealed significance in angle differences from the set position for technique A in lateral tilt and techniques A and B in AP tilt (p = 0.0466, 0.0194, 0.0424, respectively). A comparison of positivity (overtilt) and negativity (undertilt) between the three techniques in lateral and AP tilts using Chi-square test resulted in significant differences in both directions of tilt (p < 0.0001). Technique C resulted in remounting the casts at the control position in 15.64% in both directions; this was a higher percentage than the other two techniques (A and B). Wilcoxon Matched-pairs test was used to compare between the techniques relative to angle differences from the standard position. No differences were found between technique A and B in lateral tilt position (p = 0.9271), while significance was detected in AP tilt (p < 0.0001). Significant differences were detected between technique C in comparison to A (p < 0.0001, p = 0.0303) and B (p < 0.0001) in lateral and AP tilt directions. CONCLUSIONS: Within the limitations of this study, it can be concluded that technique C (cemented post technique) was more favored among the respondents across all educational levels. This technique presented high potential in accurately reorienting casts on the dental surveyor in comparison to the tripod points and scoring techniques (p < 0.0001).

Cast erosion from the cleaning of debris after the use of a cast trimmer.

STATEMENT OF PROBLEM: Whether using tap water to rinse off debris will make a clinical difference to the surface detail of a gypsum cast is unknown. In addition, how best to remove debris from the cast is unknown. PURPOSE: The purpose of this in vitro study was to evaluate the efficiency of different methods of cleaning a gypsum cast after trimming and the effect of short-term exposure to tap water on the surface quality of the cast. MATERIAL AND METHODS: A die fitting American National Standards Institute/American Dental Association specification 25 (International Standards Organization specification 6873) for dental gypsum products was embedded in a Dentoform with the machined lines positioned at the same level as the occlusal surface of the posterior teeth. A flat plate was used to ensure that the plane of occlusion for the die was at the same position as the posterior teeth. Forty polyvinyl siloxane impressions of the Dentoform were made and poured with vacuum-mixed improved Type IV dental stone. Each cast was inspected for the accurate reproduction of the lines. The base of the 2-stage pour was trimmed with a cast trimmer with water, and surface debris was removed by rinsing by hand under tap water for 10 seconds, by brushing the cast with a soft toothbrush for 10 seconds, or by resoaking the cast and using a soft camel hair brush in slurry water for 10 seconds. The amount of debris was evaluated on a scale of 1 to 4, and the quality of the 20-µm line was evaluated on a scale of 1 to 4 under ×15 magnification. The nonparametric Kruskal-Wallis ranks test was used to identify significant differences among the different cleaning methods (α=.05). RESULTS: Results of the Kruskal-Wallis and Kruskal-Wallis Z-value tests demonstrated that all cleaning methods produced cleaner casts than were observed for uncleansed controls (P<.001), but no differences in debris removal were found among the different cleaning methods (.065≤P≤.901). The ability to see the quality of a 20-µm line (P=.974) was not statistically different among the groups. CONCLUSIONS: Rinsing the cast under flowing tap water and brushing, or hand washing under flowing tap water, or using a soft camel hair brush in slurry water for 10 seconds had no noticeable effects on the quality of a 20-µm line, and all 3 methods resulted in a clean cast.

Effect of casting atmosphere on the marginal deficiency and misfit of Ni-Cr alloys with and without beryllium.

STATEMENT OF PROBLEM: The marginal adaptation of prosthetic crowns is still a significant clinical problem. PURPOSE: The purpose of this in vitro study was to evaluate the marginal deficiency and misfit of Ni-Cr alloys with and without beryllium under different casting conditions. MATERIAL AND METHODS: Four casting conditions were selected: flame-torch, induction/argon, induction/vacuum, and induction/air; and 2 alloys were used, Ni-Cr-Be and Ni-Cr. For each group, 10 metal specimens were prepared. Silicone indirect impressions and analysis of the degree of rounding were used to evaluate the marginal deficiencies of metal copings, and a standardized device for the setting pressure associated with optical microscopy was used to analyze the marginal misfit. Results were evaluated with 2-way ANOVA (α=.05), followed by the Tukey honest significant difference post hoc test, and the Pearson correlation test (α=.05). RESULTS: Alloy (P<.001) and casting technique (P<.001) were shown to affect marginal deficiencies. The Ni-Cr cast using the torch technique showed the highest marginal deficiency, and the Ni-Cr-Be cast in a controlled argon atmosphere showed the lowest (P<.001). Alloy (P=.472) and casting techniques (P=.206) did not affect the marginal misfit, but significant differences were found in the interaction (P=.001); the lowest misfit was achieved using the Ni-Cr-Be, and the highest misfit occurred with the molten Ni-Cr, using the cast torch technique. No correlation was found between deficiency and marginal misfit (r=.04, P=.69). CONCLUSIONS: The interactions demonstrated that the alloy containing beryllium that was cast in an argon atmosphere led to reduced marginal deficiency. Improved marginal adaptation can be achieved for the same alloy by using the torch technique.

Two-Colored Dental Surveying Tool as an Alternative for Carbon Marker.

Various tools are used with a dental surveyor, including analyzing rods, carbon markers, undercut gauges, and protective sheaths for a specific function. A carbon marker is a parallel-sided carbon rod used to mark the survey line on a cast or a crown on a cast. The carbon marker (with or without protective sheath) cannot differentiate more than one survey line on the cast if needed. The wear of the carbon marker along the parallel walls after repeated use may give an incorrect survey line. We suggest a simple modification in the analyzing rod to prepare a two-colored surveying tool. An analyzing rod is a parallel-sided rod used to analyze the relative parallelism of two or more surfaces of a cast and to mark survey lines on wax patterns. With the modified analyzing rod, the survey lines can be marked with two colors, and the problem of breaking of the carbon marker also can be eliminated.

Characterization of the interface between cast-to Co-Cr implant cylinders and cast Co-Cr alloys.

STATEMENT OF PROBLEM: The affordable Co-Cr cast alloy should provide an ideal interface with prefabricated cast-to cylinders from the same alloy family. The alloy microstructures should be maintained up to the interface, and porosities and reaction regions should be absent, and sufficient bond strength between alloys should be provided. PURPOSE: The purpose of this in vitro study was to evaluate the metallurgical interfacial compatibility between Co-Cr dental casting alloys and a prefabricated Co-Cr dental implant cast-to-cylinder. MATERIAL AND METHODS: A Co-Cr alloy was cast to Co-Cr implant cylinders. Specimens were cross-sectioned longitudinally and divided into as-cast and heat-treated groups. The microstructures of specimens were evaluated by optical and scanning electron microscopy. The elemental composition of as-received prefabricated implant cylinders and diffusion characteristics of cast interfacial regions were determined by energy dispersive x-ray spectroscopy. Vickers hardness values were defined across the interface on cast specimens and for the as-received implant cylinders. ANOVA and Tukey honest significant differences tests were used for the statistical evaluation of hardness values. RESULTS: No significant reaction regions or porosity were present in the interface. Microstructural aspect and interdiffusion indicated a metal-metal bond between the Co-Cr implant cylinder and cast alloy. Mean hardness values demonstrated a significant rise across the interface (373.5 ±12.8; 363.8 ±12.6, respectively) from the wrought cylinder (338.6 ±10.5; 329 ±9.7, respectively) to the cast alloy (399.8 ±7.4; 392.3 ±10.3, respectively) for the as-cast and heat-treated conditions, respectively. CONCLUSIONS: Co-Cr casting alloy cast on to prefabricated Co-Cr implant cylinders provided interfaces which appear to fulfill the requirements of the established criteria.

The Accuracy of Fit of Crowns Made From Wax Patterns Produced Conventionally (Hand Formed) and Via CAD/CAM Technology.

OBJECTIVE: The aim of this study was to compare the marginal and internal fit accuracy of crowns constructed using three different wax production methods; conventional, milled, and 3D printed and utilizing three different cement gap thicknesses. METHODS: 15 identical stone dies were made for each method. Wax patterns were produced and then cast into metal crowns, which were assessed for differences in accuracy of both marginal and internal fit. Measurement points were 4 points per crown; occlusal, axial, marginal gap, and marginal discrepancy points. A silicone impression technique and conventional cementation technique were employed to facilitate the measurements. RESULTS: There was no significant difference (p > 0.05) in accuracy between the digitally and manually produced crowns, with the 3D printed crowns being slightly more accurate. Whereas, statistically significant differences were noticed between the conventional versus printed groups, in occlusal and marginal gap points (p < 0.05). CONCLUSION: The marginal and internal fit of 3D printed wax patterns is more accurate than the other two production methods. The milling of wax crowns is as accurate as the conventional hand carved production in terms of internal and marginal fit. The manufacturer recommended offset/die-spacer of 30 µm produced the most accurate internal and marginal fits.

Comparison of the linear dimensional accuracy of the maxillary denture teeth by three flask closure methods. An in vitro study.

PURPOSE: This laboratory study conducted to evaluate and compare the influence of different flask closure methods on linear dimensional changes of standardized simulated maxillary complete dentures. MATERIALS AND METHODS: Thirty casts were made from a silicone mold representing an edentulous maxillary arch. Thirty identical maxillary dentures were made and randomly assigned to 3 test groups (A, B, C). In Group A, flasks were placed directly in pressure clamp after trial closure. Group B: The final closure was done in a hydraulic press then transferred to pressure clamp. Group C: After trial closure flask was positioned between the two iron plates of the Restriction System flask closure (RSFC) method. Then linear distances were measured three times before and after polymerization: right incisor to left incisor (RI-LI), right premolar to left premolar (RPM-LPM), right molar to left molar (RM-LM) and left incisor- to- left molar (LI-LM) and right incisor- to- right molar (RI-RM) with the help of digital caliper with an accuracy of 0.01mm. ANOVA and Tuckey's test were used to compare the groups (p < 0.05). RESULTS: Inter molar (LM-RM) width showed the greatest dimensional change after processing and Linear dimensions were not significantly influenced by the packing procedure. CONCLUSION: Within the limitations of this study, Restriction System flask closure (RSFC) method demonstrated a similar performance in reducing the tooth movement when compared with other flask closure methods. The posterior region of the denture may present changes in the tooth position after processing, which need to be clinically adjusted.

Fabrication of a customized tray for preventing fracture of isolated abutment teeth in definitive casts.

Isolated abutment teeth with advanced bone resorption on definitive casts for a partial removable dental prosthesis can fracture when the definitive cast is removed from the impression or during subsequent laboratory procedures. This report describes a technique that avoids fracture of the definitive cast during its fabrication. A separating line is formed on the custom tray, which enables removal of the definitive cast without fracturing the isolated tooth. In addition, if the cervical line is sharp and appears compromised, then the impression can be trimmed at the clinical cervical line to enlarge the abutment diameter and increase its resistance to fracture without altering the shape of critical areas.

Experimental study on the use of spacer foils in two-step putty and wash impression procedures using silicone impression materials.

STATEMENT OF PROBLEM: The 2-step putty and wash impression technique is commonly used in fixed prosthodontics. However, cutting sluiceways to allow the light-body material to drain is time-consuming. A solution might be the use of a spacer foil. PURPOSE: The purpose of this study was to evaluate the influence of spacer foil on the margin reproduction and dimensional accuracy of 2-step putty and wash impressions. MATERIAL AND METHODS: Two methods of creating space for the wash material in a 2-step putty and wash impression were compared: the traditional cutout technique and a spacer foil. Eleven commercially available combinations of silicone impression materials were included in the study. The impressions and the cast production were carried out under standardized conditions. All casts were measured with a 3-dimensional (3D) coordinate measuring machine. Preparation margin reproduction and the diameters and spacing of the stone cast dies were measured (α=.05). RESULTS: The 2 methods showed significant differences (P<.05) in the reproduction of the preparation margins (complete reproduction cutout, 90% to 98%; foil, 74% to 91%). The use of a foil resulted in greater dimensional accuracy of the cast dies compared to the cutout technique. Cast dies from the cutout technique were significantly smaller than the metallic original cast (cutout median, 4.55 mm to 4.61 mm; foil median, 4.61 to 4.64). Spacing between the dies revealed only a few additional significant differences between the techniques. CONCLUSIONS: When spacer foils were used, dies were obtained that better corresponded to the original tooth.

Effect of Luting Cement Space on the Strain Response of Gold Crowns Under Static Compressive Loading.

The aim the work was to investigate the effect of varying degrees of luting cement thickness on the strain of the cemented gold alloy crowns under compression. Five dies with their corresponding crowns were fabricated using a lost wax technique. Three gold crowns for each die were fabricated under the control of specific die spacer layers to provide a space of 40 µm (10 layers of die-spacer thickness) and 80 µm (20 layers of die-spacer thickness). The crowns were subsequently cemented using zinc phosphate cement. The crowns were subjected to gradual static compressive loading between 10N to 250N (Newton) and the strain measured simultaneously. The results were statistically analysed using Independent t-test for the different die-spacer thickness at the 95% confidence interval (p = 0.05). It was found that a significant relationship in the three thicknesses. It was concluded that the absence of die-spacer significantly reduced strain response, whereas a very little change in the strain recorded as the die spacer layers has increased. Clinically, decreasing the number of die-spacer layers is advantageous as it provides a lower strain response under static compressive loading that would improve the longevity of the cemented full crowns inside the patient's mouth.

A comparison of corrosion resistance of cobalt-chromium-molybdenum metal ceramic alloy fabricated with selective laser melting and traditional processing.

STATEMENT OF PROBLEM: A cobalt-chromium-molybdenum alloy fabricated by selective laser melting is a promising material; however, there are concerns about the change in its corrosion behavior. PURPOSE: The purpose of this study was to evaluate the changes in corrosion behavior of a cobalt-chromium-molybdenum alloy fabricated by the selective laser melting technique before and after ceramic firing, with traditional processing of cobalt-chromium-molybdenum alloy serving as a control. MATERIAL AND METHODS: Two groups of specimens were designated as group selective laser melting and group traditional. For each group, 20 specimens with a cylindrical shape were prepared and divided into 4 cells: selective laser melting as-cast, selective laser melting fired in pH 5.0 and 2.5, traditional as-cast, and traditional fired in pH 5.0 and 2.5. Specimens were prepared with a selective laser melting system for a selective laser melting alloy and the conventional lost wax technique for traditional cast alloy. After all specimen surfaces had been wet ground with silicon carbide paper (1200 grit), each group of 10 specimens was put through a series of ceramic firing cycles. Microstructure, Vickers microhardness, surface composition, oxide film thickness, and corrosion behavior were examined for specimens before and after ceramic firing. Three-way ANOVA was used to evaluate the effect of porcelain firing and pH values on the corrosion behavior of the 2 alloys (α=.05). Student t tests were used to compare the Vickers hardness. RESULTS: Although porcelain firing changed the microstructure, microhardness, and x-ray photoelectron spectroscopy results, it showed no significant influence on the corrosion behavior of the selective laser melting alloy and traditional cast alloy (P>.05). No statistically significant influence was found on the corrosion behavior of the 2 alloys in different pH value solutions (P>.05). CONCLUSIONS: The porcelain firing process had no significant influence on the corrosion resistance results of the 2 alloys. Compared with traditional cast cobalt-chromium-molybdenum alloy, selective laser melting alloy exhibited the same properties in both test solutions (pH, 5.0 or 2.5).

Fabrication of titanium alloy frameworks for complete dentures by selective laser melting.

STATEMENT OF PROBLEM: Casting difficulties have led to the limited use of titanium in dental prostheses. The selective laser melting system was recently developed to fabricate biomedical components from titanium alloys. However, the fabrication of a titanium alloy framework for a maxillary complete denture by selective laser melting has not yet been investigated. PURPOSE: The purpose of the study was to fabricate thin titanium alloy frameworks for a maxillary complete denture with a selective laser melting system and to evaluate their hardness and microstructure. MATERIAL AND METHODS: A cast of an edentulous maxilla was scanned with a dental 3-dimensional cone-beam computed tomography system, and standard triangulation language data were produced with the DICOM Viewer (Digital Imaging and Communications in Medicine). Two types of metal frameworks for complete dentures were designed with 3-dimensional computer-aided design software. Two titanium alloy frameworks, SLM-1 and SLM-2, were fabricated from these designs with the selective laser melting system. Plate-shaped specimens were cut from the central flat region of SLM-1, SLM-2, and as-cast Ti-6Al-4V (As-cast). Vickers hardness testing, optical microscopy, and x-ray diffraction measurements were performed. RESULTS: Thin titanium alloy frameworks for maxillary complete dentures could be fabricated by selective laser melting. The hardness values for SLM-1 and SLM-2 were higher than that for the as-cast specimen. Optical microscopy images of the SLM-1 and SLM-2 microstructure showed that the specimens did not exhibit pores, indicating that dense frameworks were successfully obtained with the selective laser melting process. In the x-ray diffraction patterns, only peaks associated with the α phase were observed for SLM-1 and SLM-2. In addition, the lattice parameters for SLM-1 and SLM-2 were slightly larger than those for the as-cast specimen. CONCLUSIONS: The mechanical properties and microstructure of the denture frameworks prepared by selective laser melting indicate that these dentures are appropriate for clinical use.

Effect of fluoride content on ion release from cast and selective laser melting-processed Co-Cr-Mo alloys.

STATEMENT OF PROBLEM: Selective laser melting (SLM) alloy is gaining popularity in prosthetic dentistry. However, its biocompatibility has been of some concern because of long-term exposure to fluoride in the oral environment. PURPOSE: The purpose of this study was to examine the effect of fluoride concentration on ion release from Co-Cr-Mo alloy specimens fabricated using either SLM or lost-wax casting when immersed in an artificial saliva solution containing fluoride. MATERIAL AND METHODS: Specimens were prepared with either a SLM system for the SLM alloy or conventional lost-wax techniques for the cast alloy. The specimen surfaces were wet ground with silicon carbide paper (400, 800, and 1200 grit) and immersed in modified artificial saliva solutions, the pH of which had been adjusted to 5.0 with lactic acid and which contained NaF at concentrations of 0.00%, 0.05%, 0.1%, or 0.2%. The metal ion content of the solution was determined with an inductively coupled plasma mass spectrometer. The results were submitted to 2-way ANOVA and regression analysis (α=.05). RESULTS: Fluoride concentration significantly influenced the elemental ion release from both the SLM and cast alloys. The quantity of ions released increased significantly with increasing fluoride concentration. The ion release from the cast specimens was significantly greater than that from the SLM specimens. CONCLUSIONS: The performance of the SLM alloy in immersion tests demonstrates that this new technique is a superior choice because of its good biocompatibility.

Accuracy of ringless casting and accelerated wax-elimination technique: a comparative in vitro study.

PURPOSE: The purpose of this study was to determine whether the ringless casting and accelerated wax-elimination techniques can be combined to offer a cost-effective, clinically acceptable, and time-saving alternative for fabricating single unit castings in fixed prosthodontics. MATERIALS AND METHODS: Sixty standardized wax copings were fabricated on a type IV stone replica of a stainless steel die. The wax patterns were divided into four groups. The first group was cast using the ringless investment technique and conventional wax-elimination method; the second group was cast using the ringless investment technique and accelerated wax-elimination method; the third group was cast using the conventional metal ring investment technique and conventional wax-elimination method; the fourth group was cast using the metal ring investment technique and accelerated wax-elimination method. The vertical marginal gap was measured at four sites per specimen, using a digital optical microscope at 100× magnification. The results were analyzed using two-way ANOVA to determine statistical significance. RESULTS: The vertical marginal gaps of castings fabricated using the ringless technique (76.98 ± 7.59 µm) were significantly less (p < 0.05) than those castings fabricated using the conventional metal ring technique (138.44 ± 28.59 µm); however, the vertical marginal gaps of the conventional (102.63 ± 36.12 µm) and accelerated wax-elimination (112.79 ± 38.34 µm) castings were not statistically significant (p > 0.05). CONCLUSIONS: The ringless investment technique can produce castings with higher accuracy and can be favorably combined with the accelerated wax-elimination method as a vital alternative to the time-consuming conventional technique of casting restorations in fixed prosthodontics.

The quality of written instructions for dental prostheses in China.

PURPOSE: To investigate the quality of written instructions for dental prostheses in China, including metal-ceramic fixed restorations and removable partial dentures (RPDs). MATERIALS AND METHODS: A total of 1600 prepiloted questionnaires were distributed to five major commercial dental laboratories in different regions in China. The opinions of dental technicians on the written instructions provided by dentists were investigated. In addition, this study also revealed the technicians' responses to poorly written instructions. RESULTS: Seven percent of the written instructions clarified the disinfection status of the impressions or casts, while 32% of the instructions provided general patient information (e.g., gender and age). In cases of metal-ceramic fixed restorations, percentages of written instructions specifying shade, ceramic veneering area, and margin design were 72%, 20%, and 9%, respectively. In fixed partial denture cases, 60% of written instructions provided the number of pontics, while 22% specified the pontic design. In the case of RPDs, 90% of instructions showed the type and position of clasps, 88% provided connector design, while 68% mentioned information regarding the artificial teeth. Dental technicians claimed that 78% of the written instructions involved were inadequately prescribed to some extent, but only about one-third of them would contact dentists for clarification. CONCLUSIONS: Written instructions are not well prescribed in many cases. This situation may jeopardize the quality of prosthodontic treatment. It is necessary to shape responsible policy and mandatory professional guidelines for prosthodontic treatment procedures including dental laboratory services.

Comparison of internal fit between implant abutments and cast metal crowns vs laser-sintered crowns.

AIM: A common problem related to cemented single crowns is the internal misfit, which may cause inadequate retention, especially when seated on the implant abutment. The aim of this study was to compare the internal fit of Co-Cr crowns using a traditional lost-wax casting technique from laser-sintered Co-Cr alloy crowns. MATERIALS AND METHODS: Twelve metallic crowns per each technique were fabricated. The effect of the thickness of cement, originated internal gap was evaluated. Crowns were cemented on the implant abutments with resin cement, and the internal fit of crowns was measured at five areas with an optical microscope. The data were analyzed, and the means were compared with a t-test (p<0.05). RESULTS: The internal gap width measurements for the laser-sintered group (min. 52.19 ± 11.61 µm and max. 140.01 ± 31.84 µm) indicated the presence of a significantly closed internal gap compared to the crowns obtained through the lost wax method (min. 65.50 ± 9.54 µm and max. 313.46 ± 48.12 µm). CONCLUSION: The fit of the metal crown likely varies with the fabrication technique. The use of techniques that enable the adjustment of crown parameters, such as the laser sintering technique, maintains the desired fit between casting and implant abutments. CLINICAL SIGNIFICANCE: This study investigated which technique affects the internal fit of cemented implant-supported crowns, comparing the use of lost wax casting and laser-sintered metal dental alloys. The results of this study indicate that the use of laser-sintered crowns can improve for crown accuracy.

Design and fabrication of a sleep apnea device using computer-aided design/additive manufacture technologies.

The aim of this study was to analyze the latest innovations in additive manufacture techniques and uniquely apply them to dentistry, to build a sleep apnea device requiring rotating hinges. Laser scanning was used to capture the three-dimensional topography of an upper and lower dental cast. The data sets were imported into an appropriate computer-aided design software environment, which was used to design a sleep apnea device. This design was then exported as a stereolithography file and transferred for three-dimensional printing by an additive manufacture machine. The results not only revealed that the novel computer-based technique presented provides new design opportunities but also highlighted limitations that must be addressed before the techniques can become clinically viable.

Reinforcement of a mandibular complete denture with internal metal framework.

Metal framework reinforcement is used in complete dentures to improve the fracture resistance, dimensional stability, accuracy, weight, and retention of a definitive prosthesis. A novel technique for suspending a metal framework within the denture base of mandibular complete dentures is described.

Analysis of four dental alloys following torch/centrifugal and induction/ vacuum-pressure casting procedures.

STATEMENT OF PROBLEM: Previous studies have shown casting methodology to influence the as-cast properties of dental casting alloys. It is important to consider clinically important mechanical properties so that the influence of casting can be clarified. PURPOSE: The purpose of this study was to evaluate how torch/centrifugal and inductively cast and vacuum-pressure casting machines may affect the castability, microhardness, chemical composition, and microstructure of 2 high noble, 1 noble, and 1 base metal dental casting alloys. MATERIAL AND METHODS: Two commonly used methods for casting were selected for comparison: torch/centrifugal casting and inductively heated/ vacuum-pressure casting. One hundred and twenty castability patterns were fabricated and divided into 8 groups. Four groups were torch/centrifugally cast in Olympia (O), Jelenko O (JO), Genesis II (G), and Liberty (L) alloys. Similarly, 4 groups were cast in O, JO, G, and L by an inductively induction/vacuum-pressure casting machine. Each specimen was evaluated for casting completeness to determine a castability value, while porosity was determined by standard x-ray techniques. Each group was metallographically prepared for further evaluation that included chemical composition, Vickers microhardness, and grain analysis of microstructure. Two-way ANOVA was used to determine significant differences among the main effects. Statistically significant effects were examined further with the Tukey HSD procedure for multiple comparisons. Data obtained from the castability experiments were non-normal and the variances were unequal. They were analyzed statistically with the Kruskal-Wallis rank sum test. Significant results were further investigated statistically with the Steel-Dwass method for multiple comparisons (α=.05). RESULTS: The alloy type had a significant effect on surface microhardness (P<.001). In contrast, the technique used for casting did not affect the microhardness of the test specimen (P=.465). Similarly, the interaction between the alloy and casting technique was not significant (P=.119). A high level of castability (98.5% on average) was achieved overall. The frequency of casting failures as a function of alloy type and casting method was determined. Failure was defined as a castability index score of <100%. Three of 28 possible comparisons between alloy and casting combinations were statistically significant. The results suggested that casting technique affects the castability index of alloys. Radiographic analysis detected large porosities in regions near the edge of the castability pattern and infrequently adjacent to noncast segments. All castings acquired traces of elements found in the casting crucibles. The grain size for each dental casting alloy was generally finer for specimens produced by the induction/vacuum-pressure method. The difference was substantial for JO and L. CONCLUSIONS: This study demonstrated a relation between casting techniques and some physical properties of metal ceramic casting alloys.

A comparison of the accuracy of three removable die systems and two die materials.

The purpose of this study was to evaluate the dimensional shift of three commonly used die systems (Conventional system, Pindex system, Di-Lok tray system) with two commercially available type IV die stones (Ultra rock and Pearl stone). Under controlled conditions, ten casts, each with two removable dies, were constructed for each system for a total of 30 casts and 60 removable dies. Before and after sectioning measurements to within 0.01 mm in horizontal and vertical planes were recorded and differences calculated. Data were analyzed with 't' tests, one way analysis of variance and post hoc Tukey test. The results demonstrated that among the die systems compared, no single system was superior to the others in all respects. But among the die materials, dies poured in Pearl stone exhibited more dimensional changes than Ultra rock (p<0.05). Selection of die material is as critical as selection of any particular die system for successful fabrication of fixed partial denture and implant prosthesis.