Influence of sterilization on the retention properties of magnetic attachments for dental implants.

OBJECTIVES: When used with dental implants advantages of the magnetic attachments include control of load transmitted to implants, improvements in stability, support and retention for the prosthesis, and the relative ease of prostheses fabrication. Clinically, the use of sterilized components is required, and this may be problematic as magnetic alloys are sensitive to temperature. The purpose of this study was to evaluate the influence of autoclave sterilization on the maximum retentive forces and characteristic curves for magnetic attachments recommended for use with dental implants. MATERIAL AND METHODS: Eleven SmCo and NeFeB implant magnetic attachments were evaluated as provided by the respective manufacturers. Implant magnetic abutment and the corresponding denture magnet (n=5 magnet pairs) were tested before and after standardized autoclave sterilization (10 min at 134 degrees C). Each magnet pair was tested 10 times in a calibrated universal testing machine using a non-magnetic test device (s=40 mm, v=20 mm/min). Results were recorded electronically and statistically analyzed using t-test and ANOVA (Welch and Brown-Forsythe test; P<0.05). RESULTS: After autoclave sterilization all magnetic pairs produced lower (though statistically insignificant) overall retention forces compared with the untreated pairs. After sterilization mean maximum retentive forces (SD) ranged from 5.65 (0.33) to 1.41 (0.07) N. The characteristic force-displacement curves of the tested magnetic systems showed differences among the single products. CONCLUSIONS: Autoclave sterilization caused a non-significant reduction in retentive force of 0.04-14.6% when compared with the unsterilized magnet pairs. There were differences between the tested magnetic pairs for both the initial breakaway forces and the characteristic force-displacement curves. Within the limitations of this study all tested magnetic attachments were sterilized in an autoclave without significant change of retention properties. Nevertheless magnetic implant abutments should be sterilized with caution to reduce the risk of alterations of the retention properties.

Corrosion of dental magnet attachments for removable prostheses on teeth and implants.

PURPOSE: For a long time, the use of magnets for the anchorage of dental prostheses failed due to lack of biocompatibility and the magnets' high susceptibility to corrosion in the mouth. These facts make encapsulation of the magnetic alloy with a corrosion-resistant, tight, and functionally firm sealing necessary. Due to different products and analysis methods, it is not feasible to compare the findings for contemporary products with the sparse and rather old test results in the literature. Therefore, the aim of this study was the standardized control and the comparison of the corrosion behavior of modern magnetic attachments for use on teeth and dental implants. MATERIALS AND METHODS: Thirty-seven components of magnetic attachments on implants and natural teeth from different alloys (NdFeB, SmCo, Ti, CrMoMnTiFe, etc.) as delivered by the manufacturers or fabricated according to their instructions were examined for their corrosion behavior using the statical immersion analysis (ISO 10271:2001). Four specimens of every product with the same design were used. An uncased SmCo magnet served as control. Analyses after 1, 4, 7, and 28 days of the storage in corrosion solution were made. The eluate was examined quantitatively on the alloy components of the respective component with the help of optical emission spectrometry (microg/cm(2)). The results were compared to the requirements of ISO standard 22674:2006. In addition, existing corrosion products were also defined in the solution after 28 days. The results were analyzed descriptively and statistically to determine possible significant differences (t-test and Mann-Whitney-Wilcoxon rank-sums test; p < 0.05). RESULTS: Dissolved metal ions could be found on all tested products. The release after 1 and 4 days was different for all specimens. In the group of implant abutments, the highest ion release after 7 days was found (all measurements microg/cm(2)): Fe (13.94, Magfit-IP-IDN dome type), Pd (1.53, Medical-anchor), Cr (1.32, Magfit-IP-IDN dome type), Ti (1.09, Magfit-IP-IDN abutment), Co (0.81, Medical-anchor), and B (0.6, Magfit-IP-IDN dome type). After 28 days, the analyzed ion release increased irregularly: Fe (173.58, Magfit-IP-IDN dome type), Pd (44.17, Medical-anchor), Cr (2.02, Magfit-IP-IDN dome type), Ti (2.11, Magfit-IP-IDN abutment), Co (26.13, Medical-anchor), B (1.77, Magfit-IP-IDN dome type), and Nd (79.18, Magfit-IP-IDN dome type). In the group of magnetic systems on natural teeth, the highest ion release after 7 days was found for Fe (4.81, Magfit DX 800 keeper), Cr (1.18, Magfit DX 800 keeper), Pd (0.21, Direct System Keeper), Ni (0.18, WR-Magnet S3 small), Co (0.12, Direct System Keeper), and Ti (0.09, Magna Cap - Mini). After 28 days, the analyzed ion release increased non-uniformly: Fe (31.92, Magfit DX 800 Keeper), Cr (6.65, Magfit DX 800 Keeper), Pd (18.19, Direct System Keeper), Ni (0.61, WR-Magnet S3 small), Co (10.94, Direct System Keeper), Ti (0.83, Magna Cap - Mini), and Pd (2.78, EFM Alloy). In contrast, the uncased control magnet showed an exponential release after 7 days of Sm ions (55.06) and Co-ions (86.83), after 28 days of Sm ions (603.91) and Co ions (950.56). The release of corrosion products of all tested products stayed significantly under the limit of 200 microg/cm(2) (ISO 22674:2006). In contrast, the non-encapsulated control magnet exceeded that limit significantly. CONCLUSION: The analysis of the corrosion behavior of modern magnetic attachments for use on teeth and dental implants according to ISO 10271:2001 showed that metal ions had dissolved on all specimens. In the case of one product, the magnet corroded. For this product, an improvement of the capsulation would be desirable. None of the products reached the limit specified in ISO 22674:2006. All products seem to be suitable for dental application. Further studies in regard to the specific biocompatibility and possible cytotoxic effects on mucosa and tissue would be desirable.

Mechanical properties of magnetic attachments for removable prostheses on teeth and implants.

PURPOSE: Magnetic attachments on teeth and implants may be used to improve stability, support, and retention of removable prostheses. Various forms of magnetic attachments are available, divided according to the design, the mechanical properties of the attachments, and the clinical indication. Recently developed attachment systems are small and promise improved retentive capacity, while existing magnetic attachments continue to be technologically modified and improved. This investigation reviewed and compared maximum retentive forces and characteristic curves for magnetic attachments indicated for use as root anchors and on implants. MATERIALS AND METHODS: Twenty-four samarium-cobalt (SmCo) and neodym-iron-boron (NeFeB) magnetic attachments (12 tooth- and 12 implant-borne) were evaluated. Specimens were delivered by the manufacturers or fabricated according to their instructions. Five magnet pairs of each product and each combination were tested 10 times in a calibrated universal testing machine using a nonmagnetic test device (s = 40 mm, v = 20 mm/min). Results were recorded electronically and compared to manufacturers' details. RESULTS: Maximum retentive forces for root keepers ranged from 1.4 to 6.6 N. Maximum retentive forces for magnetic attachments on implants ranged from 0.7 to 5.8 N. After a distance of 0.1 mm, a complete reversed distribution of the different systems became obvious. The retentive force provided by the manufacturer was achieved in one implant abutment, with retentive force (as compared to those provided by the manufacturers) for root keepers ranging between 42.5% and 92.9% and for implant abutments between 43.0% and 99.4%. CONCLUSION: There were differences between magnetic attachments for both the initial retentive capabilities and the characteristic curves. Recently introduced products provided relatively high initial retentive forces despite their small size. The measured retentive forces and the manufacturer's information differed in the majority of magnetic systems evaluated.