An in vitro study using confocal laser scanning microscopy to evaluate the marginal misfits of different implant-supported frameworks.

PURPOSE: This study aimed to develop and evaluate a simple, non-destructive method for assessing the misfit and passivity of implant-retained prostheses frameworks. MATERIALS AND METHODS: To simulate the rehabilitation of a mandible posterior partially edentulous area using 3-unit screw-retained frameworks supported by two implants were fabricated and divided into the following five groups (n = 10 in each group): OP = one-piece framework cast in Co-Cr with the conventional method (control-group); Co-Cr frameworks sectioned and welded by laser (=LAS) or tungsten inert gas (=TIG); Co-Cr CAD-CAM = milled Co-Cr framework; Zir CAD-CAM = milled zirconia framework. The horizontal |X| and vertical |Y| misfits were measured using confocal laser scanning microscopy with one or both screws tightened. Data were analyzed by a two-way ANOVA with repeated measures and Bonferroni correction (α = 0.05). RESULTS: The greatest |X| misfit was observed in the OP group with both screws tightened (290 µm) and one screw tightened (388 and 340 µm). The conventional casting groups sectioned and welded by laser or TIG had lower mean values (235.35 µm, both screws tightened; and 275 µm, one screw tightened) than the OP framework. However, these values still exceeded those of the milled Co-Cr and zirconia frameworks (190 and 216 µm with both screws tightened). Across all reading conditions, every framework subjected to testing consistently maintained vertical |Y| misfit levels below the threshold of 53 µm; however, the milled frameworks exhibited higher vertical misfits than the frameworks obtained by the conventional cast method. CONCLUSIONS: The frameworks, whether cast and sectioned with laser welding or milled from Co-Cr, exhibit improved marginal misfit and enhanced passive fit when compared to other fabrication methods. Additionally, the use of confocal laser scanning microscopy is highly effective for passivity and misfit analysis.

Effect of effervescent tablets on removable partial denture hygiene.

PURPOSE: To evaluate the effectiveness of five alkaline peroxide-based effervescent tablets in reducing both biofilms and the food layer adhered on the cobalt-chromium surface. METHODS: Cobalt-chromium metal alloy specimens were contaminated with Candida albicans, Candida glabrata, Streptococcus mutans and Staphylococcus aureus. After biofilm maturation, the specimens were immersed in Polident 3 Minute, Polident for Partials, Efferdent, Steradent, Corega Tabs or distilled water (control). Residual biofilm rates were determined by colony forming units counts and biofilm biomass. In parallel, to investigate the denture cleaning capability of effervescent tablets, artificially contaminated removable partial dentures were treated with each cleanser. Data were analyzed by Kruskal-Wallis followed by Dunn post hoc test or ANOVA followed by Tukey post hoc test (α= 0.05). RESULTS: None of the hygiene solutions reduced C. albicans biofilm. Efferdent and Corega Tabs promoted reduction of C. glabrata biofilm, while Steradent was favorable against S. aureus biofilm. For S. mutans, lower biofilm rates were observed after immersion in Polident for Partials and Steradent. The effervescent tablets showed good cleaning performance, removing an artificial layer with carbohydrates, proteins, and fats, however, they were not effective in removing aggregated mature biofilm. CLINICAL SIGNIFICANCE: The different effervescent tablets presented favorable antimicrobial activity against C. glabrata, S. mutans and S. aureus on cobalt-chromium surfaces and showed cleaning capability. However, for an appropriate biofilm control, a complementary method should be evaluated since none of the peroxide-based solutions reduced C. albicans biofilms or substantially removed aggregated biofilm.

Effect of oxidation heat treatment with airborne-particle abrasion on the shear bond strength of ceramic to base metal alloys.

STATEMENT OF PROBLEM: Oxidation heat treatment has been studied to increase the metal-ceramic bond strength. However, information about its use with cobalt-chromium (Co-Cr) alloys is lacking. PURPOSE: The purpose of this study was to evaluate the effect of oxidation heat treatment and oxidation heat treatment with alumina airborne-particle abrasion on the metal-ceramic bond strength of Co-Cr alloys compared with that of nickel-chromium (Ni-Cr) alloys. MATERIAL AND METHODS: In total, 165 metal cylinders (∅5×8 mm) made of 5 base metal alloys were obtained by casting: 2 Ni-Cr (Fit Cast-SB and Fit Cast-V) and 3 Co-Cr alloys (Keragen, StarLoy C, and Remanium 2001). The specimens were divided into groups (n=11): no treatment, oxidation heat treatment, and oxidation heat treatment with airborne-particle abrasion. Oxidation heat treatment was performed starting at 650 °C and rising to 980 °C. The airborne-particle abrasion was performed with 100-µm alumina (0.2-MPa pressure, 5 seconds). One specimen had the surface topography and composition evaluated by scanning electron microscopy and energy dispersive X-ray spectrometry. The feldspathic ceramic was applied to the base metal alloy specimens (n=10). Shear tests were performed to obtain the metal-ceramic bond strength (MPa). The failure modes were evaluated. Data were evaluated by 2-way ANOVA and the Tukey post hoc test, Pearson correlation, and Fisher exact tests (α=.05). RESULTS: The group without treatment showed the highest roughness. The treatments increased oxygen and chromium levels and decreased nickel, molybdenum, and tungsten levels. Oxidation heat treatment provided an increase in metal-ceramic bond strength (P<.05) for base metal alloys with over 7% molybdenum (Fit Cast-SB, Fit Cast-V, and Remanium 2001). With oxidation heat treatment with airborne-particle abrasion, there was improvement only in Fit Cast-SB. No treatment was better for StarLoy C. A weak correlation was found between metal-ceramic bond strength and failure mode (ρ=.166; P=.043). The mixed failures were prevalent in Co-Cr alloys (P<.001) and oxidation heat treatment with airborne-particle abrasion (P=.008). CONCLUSIONS: The oxidation heat treatment was only beneficial for base metal alloy with a molybdenum content of over 7%. Although the oxidation heat treatment with alumina airborne-particle abrasion was a better treatment for Fit Cast-SB, its use is not justified because it showed no difference for oxidation heat treatment and requires another step in the surface treatment.