Fabrication trueness and internal fit of different lithium disilicate ceramics according to post-milling firing and material type.

OBJECTIVES: To evaluate whether post-milling firing and material type affect the fabrication trueness and internal fit of lithium disilicate crowns. METHODS: A prefabricated cobalt chromium abutment was digitized to design a mandibular right first molar crown. This design file was used to fabricate crowns from different lithium disilicate ceramics (nano-lithium disilicate (AM), fully crystallized lithium disilicate (IN), advanced lithium disilicate (TS), and lithium disilicate (EX)) (n = 10). Crowns, the abutment, and the crowns when seated on the abutment were digitized by using an intraoral scanner. Fabrication trueness was assessed by using the root mean square method, while the internal fit was evaluated according to the triple scan method. These processes were repeated after the post-milling firing of AM, TS, and EX. Paired samples t-tests were used to analyze the effect of post-milling firing within AM, TS, and EX, while all materials were compared with 1-way analysis of variance and Tukey HSD tests (α = 0.05). RESULTS: Post-milling firing reduced the surface deviations and internal gap of AM and EX (P ≤ 0.014). AM mostly had higher deviations and internal gaps than other materials (P ≤ 0.030). CONCLUSIONS: Post-milling firing increased the trueness and internal fit of tested nano-lithium disilicate and lithium disilicate ceramics. Nano-lithium disilicate mostly had lower trueness and higher internal gap; however, the maximum meaningful differences among tested materials were small. Therefore, the adjustment duration and clinical fit of tested crowns may be similar. CLINICAL SIGNIFICANCE: Tested lithium disilicate ceramics may be suitable alternatives to one another in terms of fabrication trueness and internal fit, considering the small differences in measured deviations and internal gaps.

Does the choice of the measuring technique affect the comparison of fit between zirconia and cobalt-chromium prostheses?

AIMS: The objectives of the study were to compare the adaptation of presintered zirconia and cobalt- chromium prostheses using microcomputed tomography (µCT), scanning electron microscopy (SEM), and stereomicroscope (SM). MATERIALS AND METHODS: Twenty-four fixed dental prostheses (FDPs) were fabricated on metal abutments, duplicated from maxillary first premolar and first molar prepared on a typodont model. Teeth were reduced to obtain chamfer of 1.2 mm and reduction occlusaly of 2 mm occlusal. Scanning of the abutments was done with random assignment to two groups receiving the FDPs made from soft-milled Co-Cr (n = 12) and zirconia (n = 12). Marginal and internal gaps were assessed using three evaluation techniques (X-ray microcomputer tomography, SEM, and stereomicroscopy). STATISTICAL ANALYSIS USED: Comparison of the results was made using Levene and analysis of variance tests (α =0.05). RESULTS: Irrespective of the material tested, statistical differences were found between the measuring techniques (P = 0.001 overall); the obtained mean gaps were for CT scan (92.60 ± 13.31), for SEM (101.92 ± 23.03), and for SM (113.44 ± 14.68): the multiple comparisons between techniques found a significant difference between CT and SM (P < 0.001), and SEM and SM (P = 0.025). When materials were compared within each measuring technique, Co-Cr showed lower values compared to zirconia in SEM (P < 0.001) and Stereo (P = 0.049); similar results were found in CT. CONCLUSIONS: Results values differed with the chosen measuring technique. Co-Cr prostheses had a better fit than zirconia prostheses in SEM and Stereo. µCT showed comparable results to SEM, smaller than SM results.

The Effect of Different Ageing Protocols on the Shear Bond Strength of the Ceromer Indirect Composite on Two Different Substructure Materials.

BACKROUND: The evolution of restorative materials in prosthodontics has led to the emergence of indirect composite resins, including ceromers, as alternatives to traditional metal-ceramic restorations. However, research gaps exist regarding the impact of ageing protocols on the bond strength of ceromer composites to different metal substructures, necessitating further investigation in this area. AIM: This study aimed to determine the effect of five different ageing protocols on the shear bond strength (SBS) of ceromer indirect composites on two different substructures. METHODS: In this in vitro study, 120 metallic discs (10 × 2 mm) were cast from cobalt-chromium (Co-Cr) alloy (n = 60) and spark erosion treated from grade V titanium (n = 60). Each sample was sandblasted. The M.L. primer (Shofu, Germany) and layers of opaque were applied to the surface following the manufacturer's instructions. A special jig (6 × 2 mm) was placed on each disc. The ceromer was condensed in it and light-cured separately for 90 s. Following polishing, specimens were separated into five ageing groups: distilled water (as a control), thermal cycling, tea, coffee, and gastric acid immersion. All samples were placed in 37°C incubation for 28 days for distilled water, coffee, and tea, and 7 days for gastric acid immersion and thermal cycling for 5000 cycles (5-55°C). A universal test machine was used to measure the SBS. The samples were evaluated for failure modes using stereomicroscopy. Data were analyzed using one-way analysis of variance (ANOVA) (P < 0.05). RESULTS: According to one-way ANOVA, the mean SBS (MPa) between the two groups was compared in each ageing protocol, and there were no significant differences between the Co-Cr-C and Ti-C groups (P > 0.05). The most frequent mode of failure in all groups was mixed. CONCLUSIONS: Applying the ageing protocols, the type of substructure material had no significant effect on the SBS of the ceromer indirect composite except for tea immersion.

Evaluation of the relationship between metallurgical properties and metal-ceramic bond characteristics of Co-Cr alloys manufactured by different techniques.

STATEMENT OF PROBLEM: Metal-ceramic restorations made from cobalt chromium (Co-Cr) alloy have been increasing, but studies on the effects of different manufacturing techniques on metal-ceramic interface characteristics and metal-ceramic bond strength are sparse. PURPOSE: The purpose of this in vitro study was to examine the metal-ceramic interface and the metal-ceramic bond strength of a Co-Cr alloy produced by casting, milling, and selective laser melting (SLM) with or without thermal cycling. MATERIAL AND METHODS: Co-Cr alloys were prepared by casting, milling, and SLM. Two different SLM devices were used. Ninety-six specimens (25×3×0.5 mm) were manufactured. The structure of the oxidation surface of Co-Cr specimens was examined by scanning electron microscopy (SEM) and by X-ray fluorescence spectroscopy (XRFS). After porcelain application, selected specimens were thermal cycled, and the strength of the metal-ceramic bond was measured by the 3-point bend test. All specimens were analyzed for failure type with a stereomicroscope. The elemental composition and morphology of the metal-ceramic interface were examined by XRFS and SEM with energy-dispersive X-ray (EDX). The results of bond strength were analyzed using a 2-way analysis of variance (ANOVA) for manufacturing methods and testing conditions and the Tukey honest significant difference (HSD) test (α=.05). RESULTS: The main effect of the interactions of the testing condition and manufacturing method variables on the bond strength variable was not statistically significantly different. No significant differences were found among the testing conditions tested (P=.638). Significant differences were found among the manufacturing methods tested statistically (P<.001). Statistically significant differences were found in the CAD-CAM and CONSEPT LASER groups, the CAD-CAM and SLM LASER groups, the CAD-CAM and CAST groups, and the CAST-SLM LASER groups (P<.05). Differences were observed among the interface morphologies of casting, milling, and the two SLM groups. CONCLUSIONS: The bond strength between Co-Cr alloy and ceramic is affected by the manufacturing method. The metal-ceramic bond strength is independent of thermal cycling. The bond strength value in all groups was over 25 MPa, which has been considered clinically acceptable. The interface metallurgical structures of Co-Cr alloys were affected by different manufacturing techniques.

Recycling selective laser melting alloy powder on cobalt chromium-to-ceramic bond strength.

STATEMENT OF PROBLEM: Reusing the powder in selective laser melting machines after multiple cycles is a cost-effective procedure for dental laboratories. However, information on the metal-ceramic bond strength of the framework fabricated by using recycled powder is lacking. PURPOSE: The purpose of this in vitro study was to investigate how the bonding agent and repeated alloy powder reuse affected the metal-ceramic bond strength of cobalt chromium frameworks fabricated by using selective laser melting. MATERIAL AND METHODS: Four square and 40-bar-shaped cobalt chromium frameworks were fabricated by selective laser melting. Half were produced by using virgin alloy powder (Group V; nsquare=2, nbar=20), and half with 30-times reused powder (Group R; nsquare=2, nbar=20). The particle size of each powder was measured by using scanning electron microscopy, and its phase composition was characterized by using radiograph diffraction. Each group was divided into 2 subgroups (Group W [Wash Opaque] and Group N [NP-Bond]) according to the brand of bonding agent used. After ceramic application, the metal-ceramic bond strengths were evaluated by using 3-point bend tests. The bonding agents' chemical composition was analyzed by using radiograph fluorescence. Bond strength data were analyzed by using a 2-way analysis of variance (α=.05). RESULTS: Mean ±standard deviation bond strengths did not differ significantly (P>.05) between Groups V (31.25 ±4.65) and R (30.88 ±4.78). Group W (35.34 ±1.78) had significantly higher bond strength than Group N (26.80 ±1.74; P<.001). Radiograph diffraction analysis found that the phase composition of all powders was similar. The bonding agent in Group W contained cerium, whereas, that in Group N did not. CONCLUSIONS: Metal-ceramic bond strength was unaffected by alloy powder reuse. However, the bonding agent brand may affect the bond strength of cobalt chromium frameworks fabricated by using selective laser melting.

Bond strength of ceramic veneered CAD-milled alloy upon prolonged sintering.

OBJECTIVES: Ceramic-sintering affects bond strength and longevity of metal-ceramic. This study investigated the effect of sintering temperatures and times on metal-ceramic bond strength vis-a-vis interfacial fracture toughness. MATERIALS AND METHODS: One hundred eighty rectangular-shaped (25 × 8 × 1 mm) casting (Auriloy® (CA)) and CAD-milling (Ceramill Sintron® (MA)) alloys were prepared and randomly veneered with ceramic at normal (930 °C; (TN)), increased (940 °C; (TI)), and extremely increased (950 °C; (TE)) sintering temperatures and normal (1 min; (HN)), increased (2 min; (HI)), and extremely increased (3 min; (HE)) sintering time (n = 10/group). Pre-cracked was subjected to four loading-unloading cycles at 0.05 mm/min speed to determine interfacial fracture toughness from strain energy release rate (G). Microstructures were examined with a scanning electron microscope (SEM), energy-dispersive X-ray (EDX), and atomic force microscopy (AFM). ANOVA and Tukey comparisons were determined for significant differences (α = 0.05). RESULTS: Significant differences in G due to the effect of alloy, sintering temperature, and time (p < 0.05) were indicated. MA revealed higher G than CA. Raising temperatures enabled increasing G for CA, not for MA. Extended sintering permitted increasing G for both alloys. Rougher surface of MA than CA was observed. Interfacial ion exchange was differently indicated between CA and MA. CONCLUSIONS: Bond strength was influenced by alloy, sintering temperature, and time. Ceramic has better adhesion to MA than CA. Enhancing bond for CA was succeeded through increasing sintering temperature and time, whereas through extended sintering for MA. CLINICAL RELEVANCE: MA offers stronger bond than CA. Enhancing bond is suggested by extended sintering. Raising temperature can enhance bond for CA, not for MA.

Research on the Role of Surface Treatment of the Metal Surface on the Strength of the Metal-Ceramic Bond.

AIM: The aim of the present study is to investigate the metal-ceramic bond strength as a result of three different surface treatment methods: (1) oxidation, (2) oxidation and sandblasting, and (3) double oxidation on the metal substrate. MATERIALS AND METHODS: A total of 72 metal substrates were made from two different types of metal-ceramic alloys (n = 36): group I, Ni-Cr and group II, Co-Cr alloys. Each group was further divided and subjected to three different surface treatments (n = 12): (1) oxidation in accordance with the manufacturer's instructions; (2) oxidation according to the manufacturer's instructions and then sandblasting with Al2O3, with a grain size of 110 µm, a pressure of 75 psi for 10 sec with a distance of 5 cm and steam cleaning; and (3) double oxidation. The bond strength of the specimens was evaluated with the three-point bending process. The data were recorded, tabulated, and statistically analyzed. RESULTS: For group I, the materials with oxidation based on the specifications, show mean value of 64.02 Nt. The oxidation and sandblasting materials have mean 55.92 Nt. The double oxidation materials have mean 55.47. For group II, the materials with oxidation based on the specifications, show mean value of 58.46 Nt. The oxidation and sandblasting materials have a mean value of 42.56 Nt. The double oxidation materials have mean 42.96 Nt. CONCLUSION: The best method of treatment of the metal substrate is specification oxidation, in terms of the strength of the metal-ceramic bond. Further treatment of the metal substrate reduces the strength of the metal-ceramic bond. CLINICAL SIGNIFICANCE: A prerequisite for clinical success of metal-ceramic prosthetic restorations is the increased strength of the bond between ceramic material and metal substrate. With that in mind, the present research gives important insight into best practices for prosthetic restorations.

Cobalt chromium alloys in fixed prosthodontics: Investigations of mechanical properties and microstructure.

STATEMENT OF PROBLEM: Cobalt chromium (Co-Cr) alloys possess beneficial mechanical properties because alloys, even in thin sections, can resist high mastication forces and exhibit an acceptable bond to the surface porcelain layer. Traditional manufacturing techniques of Co-Cr alloys such as casting have been replaced with newer fabrication techniques, such as milling, laser melting, and presintered milling. Despite scarce documentation, these new manufacturing techniques are being used to fabricate dental and implant constructions. PURPOSE: This in vitro study investigates the hardness, yield strength, elastic modulus, and microstructure of the most commonly used Co-Cr alloys for fixed prosthodontics based on manufacturing technique. In addition, this study investigates the effect of heat treatment on the mechanical properties and microstructure of these materials. MATERIAL AND METHODS: Five Co-Cr alloys were included (dumbbell and rectangular shaped) based on four manufacturing techniques: cast, milled, laser melted, and presintered milled. Commercially pure titanium grade 4 and titanium-6 aluminum-4 vanadium ELI (extra low interstitial) were included for comparison, and yield strength and elongation after fracture were evaluated. The specimens were tested for hardness using the Vickers test and for elastic modulus using a nondestructive impulse excitation technique. The microstructure of selected specimens was analyzed using focused ion beam-scanning electron microscopy (FIB-SEM) and energy dispersive X-ray spectroscopy (EDS). RESULTS: The mechanical properties depend on the manufacturing technique used; the laser-melted and presintered Co-Cr specimens demonstrated the highest mechanical properties, followed by the milled and cast groups. Both the laser-melted and the presintered milled Co-Cr specimens showed smaller grain size compared with the cast and milled Co-Cr specimens. The titanium-6 aluminum-4 vanadium ELI demonstrated higher hardness and yield strength compared to commercially pure titanium grade 4. No major differences were observed for the selected materials regarding the mechanical properties and microstructural appearance after heat treatment. CONCLUSIONS: The laser melting and presintered milling techniques produced higher mechanical properties compared with the cast and milled Co-Cr. These findings were confirmed through microstructural analysis with respect to the grain size, precipitation, and number of pores.

Effects of tetrabutylammonium dihydrogen trifluoride etchant on bond strengths of resin composites with Ti-6Al-4V and Co-Cr alloys.

PURPOSE: This study aimed at evaluating the effects of surface treatments with tetrabutylammonium dihydrogen trifluoride (TDTF) on the bond strengths of indirect resin composites with titanium-aluminum-vanadium (Ti-6Al-4V) and cobalt-chromium (Co-Cr) alloys. METHODS: Disk-shaped Ti-6Al-4V and Co-Cr alloy specimens were air-abraded with alumina, treated with an etchant (MEP) containing TDTF for 10 s (MEP10) or 30 s (MEP30), and rinsed with water. Subsequently, a primer containing 6-methacryloyloxyhexyl phosphonoacetate was applied to the surfaces, and the specimens were veneered with a light-curing indirect resin composite. Specimens without MEP were prepared as controls (no-MEP). Shear bond strengths were determined before or after 100,000 thermocycles, and the data were analyzed using the Steel-Dwass test (α = 0.05, n = 10). RESULTS: No significant difference was found in the bond strengths between the Ti-6Al-4V and Co-Cr alloys. In each metal alloy, the MEP10 and MEP30 specimens exhibited higher bond strengths than the no-MEP controls after 100,000 thermocycles. Scanning electron microscopy observations revealed that submicron-pits and crevices were formed on both the metal alloys upon applying the MEP etchant. CONCLUSION: Surface treatments with TDTF following air abrasion are useful for improving bonding durability while veneering resin composites on Ti-6Al-4V or Co-Cr alloy frameworks.

Has Wrought Cobalt-Chromium-Molybdenum Alloy Changed for the Worse Over Time?

BACKGROUND: Total hip arthroplasty (THA) failure due to tribocorrosion of modular junctions and resulting adverse local tissue reactions to corrosion debris have seemingly increased over the past few decades. Recent studies have found that chemically-induced column damage seen on the inner head taper is enabled by banding in the alloy microstructure of wrought cobalt-chromium-molybdenum alloy femoral heads, and is associated with more material loss than other tribocorrosion processes. It is unclear if alloy banding represents a recent phenomenon. The purpose of this study was to examine THAs implanted in the 1990s, 2000s, and 2010s to determine if alloy microstructure and implant susceptibility to severe damage has increased over time. METHODS: Five hundred and forty-five modular heads were assessed for damage severity and grouped based on decade of implantation to serve as a proxy measure for manufacturing date. A subset of heads (n = 120) was then processed for metallographic analysis to visualize alloy banding. RESULTS: We found that damage score distribution was consistent over the time periods, but the incidence of column damage significantly increased between the 1990s and 2000s. Banding also increased from the 1990s to 2000s, but both column damage and banding levels appear to recover slightly in the 2010s. CONCLUSION: Banding, which provides preferential corrosion sites enabling column damage, has increased over the last 3 decades. No difference between manufacturers was seen, which may be explained by shared suppliers of bar stock material. These findings are important as banding can be avoidable, reducing the risk of severe column damage to THA modular junctions and failure due to adverse local tissue reactions.

Fundamental Properties and Clinical Application of 3D-Printed Bioglass Porcelain Fused to Metal Dental Restoration.

The purpose of this study is to evaluate the mechanical properties and clinical fitness of 3D-printed bioglass porcelain fused to metal (PFM) dental crowns. To evaluate the mechanical properties, tensile strength, Vickers microhardness, shear bond strength, and surface roughness tests of the SLM printed Co-Cr alloy was conducted. A right mandibular 1st molar tooth was prepared for a single dental crown (n = 10). For a three-unit metal crown and bridge, the right mandibular first premolar and first molar were prepared. Bioglass porcelain was fired to fabricate PFM dental restorations. A clinical gap was observed and measured during each of the four times porcelain was fired. A statistical analysis was conducted. The SLM technique showed the largest statistically significant tensile strength and a 0.2% yield strength value. The milling technique had the lowest statistically significant compressive strength value. The shear bond strength and surface roughness showed no statistically significant difference between the fabricated method. There was a statistically significant change in marginal discrepancy according to the porcelain firing step. The casting technique showed the greatest statistically significant margin discrepancy value. The SLM method showed better fitness than the traditional casting method and showed better mechanical properties as a dental material.

Feasibility study and material selection for powder-bed fusion process in printing of denture clasps.

BACKGROUND AND OBJECTIVE: The retention of selective laser melting (SLM)-built denture clasps is inferior to that of cast cobalt-chromium (Co-Cr) clasps engaging 0.01-in undercuts, which are commonly used in clinical practice. Either the clasps engage in excessively deep undercuts or inappropriate printing process parameters are applied. With appropriate undercut engagement and levels of process parameters, the retention of SLM-built clasps (including Co-Cr, commercially pure titanium [CP Ti], and Ti alloy [Ti-6Al-4V] ones) may be comparable to that of cast Co-Cr clasps. Therefore, this feasibility study aimed to evaluate their retention to guide dentists during material selection for the powder-bed fusion process during the printing of denture clasps. METHODS: We engaged the clasp arm at an appropriate undercut depth (0.01 or 0.02 in), built clasps at the orientation of their longitudinal axes approximately parallel to the build platform, generated square prism support structures at a critical overhang angle of 30°, applied optimized laser parameters (laser power, scan speed, and hatch space), and adopted annealing treatment for Co-Cr, CP Ti, and Ti-6Al-4V clasps. After postprocessing and accuracy measurement, an insertion/removal test of the clasps for 15,000 cycles was performed to simulate 10 years of clinical use, and the retentive force was recorded every 1500 cycles. Permanent deformation of the retentive arms of the clasps was measured. Cast Co-Cr clasps engaging 0.01-in undercuts were designated the control group. RESULTS: The initial retentive forces of the SLM-built Co-Cr clasps engaging 0.01-in undercuts and CP Ti and Ti-6Al-4V clasps engaging 0.02-in undercuts were comparable to those of the control group. SLM-built Co-Cr clasps engaging 0.01-in undercuts and Ti-6Al-4V clasps engaging 0.02-in undercuts had similar final retentive force and less permanent deformation compared with those of the control group; SLM-built CP Ti clasps engaging 0.02-in undercuts had lower final retentive force and greater permanent deformation. CONCLUSIONS: Considering the long-term retention and permanent deformation of the retentive arms, Co-Cr and Ti-6Al-4V alloys, except CP Ti, are recommended for printing denture clasps. SLM-built Co-Cr clasps should engage 0.01-in undercuts, and Ti-6Al-4V clasps should engage 0.02-in undercuts.

Effects of post-treatment on metal-ceramic bond properties of selective laser melted Co-Cr dental alloy. Part 1: Annealing temperature.

STATEMENT OF PROBLEM: Dental cobalt-chromium (Co-Cr) alloy manufactured by selective laser melting (SLM) is not recommended for clinical applications before annealing because of excessive residual stress. However, limited information is available regarding the relationship between annealing temperature and the metal-ceramic bond properties of SLM Co-Cr alloys. PURPOSE: The purpose of this in vitro study was to investigate the effects of annealing temperature on the metal-ceramic bond properties of SLM Co-Cr alloys. MATERIAL AND METHODS: Four groups with different annealing temperatures (850 °C; 950 °C; 1050 °C; 1150 °C) were prepared by using SLM techniques. Bond strengths were measured by using a 3-point bend test; subsequently, debonded surface morphologies and elements were assessed by using a scanning electron microscopy (SEM) coupled with energy-dispersive X-ray spectroscopy (EDS). The area fraction of adherence porcelain (AFAP) value was introduced to analyze fracture characteristics. Microstructural and interfacial characteristics were characterized by SEM/EDS and X-ray diffraction analysis. The coefficient of thermal expansion (CTE) test was used to analyze thermal matching. A 1-way ANOVA and the Tukey honestly significant difference tests were used to analyze bond strengths and AFAP values statistically (α=.05). RESULTS: The mean ±standard deviation values of the metal-ceramic bond strengths were 40.68 ±4.34 MPa for the 850 °C group, 37.54 ±5.34 MPa for the 950 °C group, 45.97 ±2.18 MPa for the 1050 °C group, and 50.79 ±1.79 MPa for the 1150 °C group. Significant differences (P<.05) were observed among all groups. Debonded surfaces and AFAP analysis displayed a mixed fracture mode of adhesive and cohesive fracture, and 1150 °C-annealing specimens exhibited better fracture characteristics close to cohesive fractures. As the temperature increased, native oxide film thicknesses remained unchanged; the 850 °C group had the thinnest diffusion layer, while the other 3 groups had similar thicknesses. Although the 1050 °C and 1150 °C groups displayed higher CTE values, their microstructures were more conducive to atomic diffusion and improved chemical bonding. Microstructure analysis found that ε phase and second-phase precipitates jointly affected metal-ceramic bond strength. CONCLUSIONS: Annealing temperatures affected the metal-ceramic bond strengths of SLM Co-Cr porcelain specimens. 1150 °C annealing SLM Co-Cr specimens displayed higher bond strengths and improved fracture and interface characteristics among the 4 groups.

Mechanical and surface properties of Co-Cr alloy produced by additive manufacturing for removable partial denture frameworks.

STATEMENT OF PROBLEM: Conventional analog methods have been replaced with digital methods for removable partial denture (RPD) frameworks. However, limited information is available regarding the build direction of RPD frameworks and its effect on properties. PURPOSE: The purpose of this in vitro study was to evaluate the mechanical and surface properties of the cobalt chromium (Co-Cr) alloy produced at different build angles by the laser powder bed fusion additive manufacturing (AM) technology used for RPD framework fabrication. MATERIAL AND METHODS: Plate-shaped Co-Cr specimens (n=6) were produced by the AM technology and divided into 3 groups depending on the build angle (0, 45, or 90 degrees). The elastic modulus and fracture properties were evaluated by flexural testing. Additionally, 15 disks were printed by using the same parameters of the plates (n=5) to analyze the surface hardness with microhardness testing, and surface properties were determined by surface free energy by using the contact angle and surface roughness measured by using a profilometer. Twelve Co-Cr cylindrical specimens were produced by using the same parameters (n=4), and their microstructure was examined by using an optical microscope. One-way ANOVA was used to evaluate the overall effects of the interaction between groups, and the Tukey test was applied when the interaction was statistically significant (α=.05). RESULTS: The flexural strength showed a statistically significant difference (P<.05), with the peak value exhibited by the 0-degree group. A statistical difference was also observed between the angulation and modulus of elasticity; however, the highest value was exhibited by the 45-degree group. For the fracture topography, all groups observed a dimple-like fracture, although the 45-degree group showed wider cleavage planes of fractures than other angulations. For microhardness, the 0- and 45-degree groups exhibited a statistical difference in relation to the 90-degree group (P<.05). For surface properties, no statistically significant difference (P>.05) was found in any of the evaluated parameters. Dependence on the build angles was evidenced by the molten pool boundaries during observation of the microstructure. CONCLUSIONS: The build angle influenced the flexural strength and microhardness of the Co-Cr alloy produced by AM; however, it does not affect surface free energy and surface roughness.

Surface Characteristics and Adhesion of Veneering Composite Resin to PAEK-Based Substructure Restorative Materials.

PURPOSE: To evaluate and compare the shear bond strength (SBS) of composite veneering material to polyetherketoneketone (PEKK), polyetheretherketone (PEEK), zirconia (YZ), and nickel-chromium alloy (NiCr) substructure restorative materials. MATERIALS AND METHODS: Forty samples (12 × 2 mm) were prepared from four materials: PEKK, PEEK, zirconia, and NiCr alloy (n = 10). The Vickers hardness was evaluated before preparing the surface for bonding by shot-blasting using 110 µm Al2 O3 particles. The surface roughness (Ra) of each sample was determined using a noncontact optical profilometer. The veneering resin was bonded onto each sample following primer application. The prepared samples were then subjected to an SBS test using a universal testing machine at 0.5 mm/min crosshead speed. Failure modes and surface topography following debonding were assessed. The data were statistically analyzed using ANOVA and Tukey's post-hoc comparison test (p < 0.05).  RESULTS: The highest and lowest mean surface roughness was observed in PEEK (3.45 ±0.13 µm) and NiCr (1.87 ±0.07 µm) materials, respectively. A significant difference in roughness values was observed between the materials except for NiCr and YZ (p = 0.547). Concerning SBS, PEEK and NiCr exhibited the highest (16.23 ±0.96 MPa) and lowest (10.1 ±0.63 MPa) values. The mean difference in SBS indicated a statistically significant difference between the material groups (p < 0.01). CONCLUSIONS: PEKK materials demonstrated significantly lower SBS than PEEK and significantly higher SBS values than conventional zirconia and alloy materials. A positive and significant correlation between mean roughness and SBS was observed, but the causality could be either intrinsic to the material or the roughness.

Ion release and biocompatibility of Co-Cr alloy fabricated by selective laser melting from recycled Co-Cr powder: An in vitro study.

STATEMENT OF PROBLEM: As the cobalt chromium (Co-Cr) powder used in selective laser melting (SLM) is costly, reusing the remaining powder after multiple cycles provides an economic and environmental benefit. However, knowledge of the cytotoxic effect of the alloy fabricated from recycled powder is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the biological effects of the Co-Cr ions released from the alloy fabricated from the recycled powder on the human gingival fibroblasts (HGFs) and normal oral keratinocytes (NOKs). MATERIAL AND METHODS: Disk-shaped Co-Cr specimens were fabricated by using the SLM technique from powders with different proportions of recycled to unused and from different recycling times. Co and Cr ions released from the disks immersed in the Dulbecco Modified Eagle Medium (DMEM) for 24 hours or 7 days were measured by inductively coupled plasma mass spectrometry (ICP-MS). Biocompatibility of Co-Cr alloy was detected by incubation of HGFs and NOKs in DMEM containing Co and Cr ions for 24 hours. The ANOVA test was used to evaluate statistically significant differences among different groups (α=.05). RESULTS: Compared with the alloy fabricated from 100% unused powder, the concentrations of Co and Cr ions increased with the increase of recycled to unused powder ratio or with the increase in the recycling times. HGFs and NOKs showed an increase in apoptosis, intracellular oxidative stress (ROS), hypoxia-inducing factor1α (HIF-1α), and proinflammatory cytokines (tumor necrosis factor alpha [TNF- α], interleukin 6 [IL-6], interleukin 8 [IL-8], and vascular endothelial growth factor [VEGF]) with the increase of Co-Cr ions in a concentration-dependent manner. A significant reduction in cell proliferation was found with the increase in the concentrations of Co and Cr ions (P<.05). CONCLUSIONS: The results of this study indicated that Co-Cr alloy fabricated from partially recycled powder or powder with different recycling times released significantly more Co and Cr ions and showed higher cytotoxicity to HGFs and NOKs than the alloy fabricated from unused powder.

Effects of hollow structures added by selective laser sintering on the mechanical properties of Co-Cr alloy.

PURPOSE: This study investigates the effects of hollow structures, added by selective laser sintering (SLS), on the mechanical properties of a Co-Cr alloy for providing an optimal structural property to the framework components of removable partial dentures (RPDs). METHODS: The specimens produced using the 3D data of the dumbbell-shaped cylinders were divided into four groups based on the manufacturing method: Cast, Mill, SLS-solid, and SLS-hollow. Tensile tests were performed to measure the mechanical properties of the specimens. The mechanical property values among the four groups were statistically compared using the Kruskal-Wallis test followed by the Steel-Dwass test (α = 0.05). RESULTS: The median elastic modulus was the largest in the Cast, followed by SLS-solid, Mill, and SLS-hollow, with no significant differences observed between all conditions. The median ultimate tensile strength was the largest in the order of SLS-solid, Mill, SLS-hollow, and Cast. The median 0.2% proof stress was the largest in SLS-solid, followed by SLS-hollow, Cast, and Mill. The median elongation was the highest in the order of Mill, SLS-solid, SLS-hollow, and Cast. CONCLUSIONS: With the addition of hollow structures, the elastic modulus decreased while the mechanical strength and proof stress remained high in SLS specimens. In addition, the ISO 22674 standard for dental metals was met, suggesting that SLS may be a possible method to design RPD frameworks with high strength and optimal structural properties.

Evaluation of ceramic adherence to cobalt-chromium alloys fabricated by different manufacturing techniques.

STATEMENT OF PROBLEM: Selective laser melting has been increasingly used in the fabrication of metal-ceramic prostheses. The longevity of the prostheses depends on the strength of the metal-ceramic bond, which may differ with the framework manufacturing technique. PURPOSE: The purpose of this in vitro study was to compare the bond strength of ceramic to cobalt-chromium (Co-Cr) alloys fabricated by different manufacturing methods. MATERIAL AND METHODS: Sixty Ø15×2-mm disk-shaped specimens were prepared and assigned to 3 groups (n=20) with different manufacturing methods: milled Co-Cr (M), selective laser melted Co-Cr (SLM), and cast Co-Cr (C). The disks were ceramic layered with a 2-mm thickness. Half of the specimens from each group were thermocycled. The shear bond strength (SBS) test was applied to all specimens. The microstructure changes after ceramic layering were evaluated by X-ray diffraction (XRD). The specimens' surface morphology was analyzed by using scanning electron microscopy (SEM). RESULTS: Thermocycling had a significant effect on SBS values in the SLM group (P=.017). Considering the registered Fmax (force inducing bonding failure), a significant difference was found between SLM and both M and C groups (P<.001). No significant difference was found between milled and cast Co-Cr (P=.885). The failure types were mostly mixed failures. Ceramic layering induced a crystallization increase in groups C and SLM. CONCLUSIONS: The adhesion strength of ceramic to Co-Cr differed with alloy composition and manufacturing technique. The aging process influenced the results in the SLM group.

Physicomechanical properties of cobalt-chromium removable partial denture palatal major connectors fabricated by selective laser melting.

STATEMENT OF PROBLEM: Additive manufacturing by selective laser melting (SLM) has been claimed to be less challenging than conventional casting of cobalt-chromium (Co-Cr) removable partial dentures (RPDs), providing significant improvements. However, how the physicomechanical properties of Co-Cr RPDs fabricated by SLM compare with those fabricated by conventional casting is unclear. PURPOSE: The purpose of this in vitro study was to evaluate the physicomechanical properties of Co-Cr RPD palatal major connectors fabricated by SLM compared with those fabricated by conventional casting. MATERIAL AND METHODS: A master die simulating a maxillary arch of Kennedy class III modification 1 was scanned to create a virtual 3-dimensional (3D) cast. Two groups of 5 Co-Cr RPD major connectors were fabricated. In the 3D printing group, the Co-Cr major connector was virtually designed and exported for direct SLM 3D printing. For the conventional group, Co-Cr major connectors were constructed conventionally. The Co-Cr major connectors were virtually superimposed with the master die for surface adaptation analysis. Additional comparative analyses of surface roughness, relative density, microhardness, and microstructure of the 2 groups were performed. Data were analyzed by using independent t tests (α=.05). RESULTS: The overall volumetric and linear discrepancies were significantly higher (P<.05) in the 3D printing group. Significant differences in the surface roughness (P<.05) and microhardness (P<.05) were observed, with the 3D printing group having higher surface roughness and microhardness than the conventional group. Unlike conventional connectors, the microstructure of 3D-printed connectors showed fine homogeneous granules. CONCLUSIONS: Compared with the conventional casting technique, SLM 3D printing enabled the fabrication of Co-Cr RPD major connectors with higher microhardness and fine homogenous microstructure. However, the surface adaptation and surface roughness of SLM 3D printing Co-Cr connectors were worse than those produced conventionally. Both techniques showed similar relative densities.

Corrosion properties of low carbon CoCrMo and additively manufactured CoCr alloys for dental applications.

OBJECTIVES: Additive manufacturing (AM) is being applied to metallic biomaterials and dental alloys, including CoCrMo. CoCrMo mechanical properties and corrosion resistance are vital to the structural integrity of implants and dental appliances. The goal of this work is to assess the resistivity of AM cobalt chromium alloys by comparing them with traditional CoCrMo, regarding electrochemical properties resulting from microstructural and oxide film differences. METHODS: In this work, selective laser melting (SLM), was used to manufacture CoCrMoW. The corrosion characteristics of AM alloy were compared to that of wrought LC CoCrMo (ASTM F-1537) in both phosphate buffered saline (PBS) and PBS with 10 mM H2O2 to simulate increased inflammatory conditions. Anodic polarization and electrochemical impedance spectroscopy (EIS) were performed. RESULTS: Both alloys were substantially similar in corrosion behavior in both solutions. They exhibited changes with the different solutions. Polarization resistances were statistically lower (RpAM = 1.4 MΩcm2 (PBS) vs. 0.72 MΩcm2 (H2O2), RpLC = 1.86 MΩcm2 (PBS) vs. 0.55 MΩcm2 (H2O2)), and open circuit potentials (OCP's) were statistically higher in 10 mM H2O2 for both alloys (0.20 V (in H2O2) vs. - 0.09 V in PBS). Chemistry variations were revealed by the corrosion tests indicating that wrought LC CoCrMo retained its casting-based chemical heterogeneity, while AM CoCrMoW had sub-cell structures within the solidified grains. SIGNIFICANCE: As novel production methods like AM arise, it is necessary to understand any microstructural differences that may diminish the corrosion resistance properties. AM CoCrMoW alloys hold significant promise for use in dentistry where complex geometries are required.