All that glitters is not gold: X-ray fluorescence analysis of a fixed dental prosthesis from Colecção de Esqueletos Identificados Século XXI, Portugal (CEI/XXI).

Access to better health care anticipates that more medical devices can be found alongside skeletal remains. Those employed in oral rehabilitation, with available brands or batch/series, can prove useful in the identification process. A previous study in the Colecção de Esqueletos Identificados Século XXI described macroscopically the dental prostheses. An unusual case of a dental device with chromatic alterations demonstrated to require a more detailed analysis. The individual, a 53-year-old male, exhibited, at both arches, a fixed tooth-supported rehabilitation, with gold colouring classified initially as a gold-palladium alloy. Simultaneously, a green pigmentation deposit was observable in bone and prosthesis. This investigation aimed to verify the elemental composition of the dental prosthesis alloy. Elemental analysis was performed by X-ray fluorescence in two regions (labial surface of the prosthetic crown and the root surface of the lower right lateral incisor). Both the spectra and the qualitative results found higher levels of copper and aluminium, followed by nickel, iron, zinc, and manganese. No gold or palladium was detected. The most probable assumption is that a copper-aluminium alloy was used, as its elemental concentration corresponds to those measured in similar devices. Dental prostheses of copper-aluminium alloys have been made popular since the 1980s, particularly in the USA, Japan, and Eastern Europe. Apart from the biographical information, it was also known that the individual's place of birth was an Eastern European country, which highlighted the usefulness of this type of information when dealing with missing people cases.

Microstructural and mechanical characterization of contemporary lingual orthodontic brackets.

OBJECTIVES: To investigate the composition and the microstructural and mechanical characterization of three different types of lingual brackets. MATERIALS AND METHODS: Incognito™ (3M Unitek), In-Ovation L (DENTSPLY GAC) and STb™ (Light Lingual System, ORMCO) lingual brackets were studied under the scanning electron microscope employing backscattered electron imaging and their elemental composition was analysed by energy-dispersive X-ray microanalysis. Additionally, Vickers hardness was assessed using a universal hardness-testing machine, and the indentation modulus was measured according to instrumented indentation test. Two-way analysis of variance was conducted employing bracket type and location (base and wing) as discriminating variable. Significant differences among groups were allocated by post hoc Student-Newman-Keuls multiple comparison analysis at 95% level of significance. RESULTS: Three different phases were identified for Incognito and In-Ovation L bracket based on mean atomic number contrast. On the contrary, STb did not show mean atomic contrast areas and thus it is recognized as a single phase. Incognito is a one-piece bracket with the same structure in wing and base regions. Incognito consists mainly of noble metals while In-Ovation L and STb show similar formulations of ferrous alloys in wing and base regions. No significant differences were found between ferrous brackets in hardness and modulus values, but there were significant differences between wing and base regions. Incognito illustrated intermediate values with significant differences from base and wing values of ferrous brackets. CONCLUSIONS/IMPLICATIONS: Significant differences exist in microstructure, elemental composition, and mechanical properties among the brackets tested; these might have a series of clinical implications during mechanotherapy.

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.

Elemental ion release from fixed restorative materials into patient saliva.

The objective of this study was to quantitatively investigate the elemental ion release from the fixed gold alloy and ceramic crowns into patient saliva. Twenty patients who participated in the study were divided into two equal groups; 1) full coverage type IV gold crowns and 2) full coverage CAD-CAM-fabricated ceramic crowns. Saliva collection and clinical evaluation of marginal integrity and gingival health were performed before crowns preparation, 3 months and 6 months after crowns placement. Clinical evaluations were conducted using California Dental Association criteria. Collected saliva samples were analysed for element release using inductively coupled plasma mass spectrometer. The zinc, copper, palladium, gold and silver were released from type IV gold crowns into saliva, while the silicon and aluminium were released from ceramic crowns. A clinically significant number of subjects had increased release of zinc from baseline to three-month recall and increased silicon release from baseline to both three-month and six-month recalls. For all elements, the subjects' counts for the case of three-month recall to six-month recall were never higher than that of the case of baseline to three-month recall except for palladium. No obvious adverse effects on marginal integrity or gingival health were noticed. Significant increased releases of zinc from cast gold crowns and silicon from CAD-CAM-fabricated ceramic crowns into the saliva were evident after 3 months of clinical service.

The effect of zinc levels in a gold-based alloy on porcelain-metal bonding.

OBJECTIVES: The purpose of this study was to ascertain whether the amount of Zn in gold alloys contributes to porcelain-metal bonding. METHODS: Experiments were carried out using a commercial Pd-free gold alloy with a nominal composition of 88.7 wt% Au, 9.49 wt% Pt, 1.5 wt% Zn, 0.1 wt% Mn, 0.2 wt% Rh, and 0.1 wt% Ir, which contains Zn and no other elements (In, Sn, Fe) known to affect porcelain-metal bond strength. To establish the effect of oxidation of the metal surface, porcelain was applied both to preoxidized and to non-preoxidized metal specimens. The bond strength was evaluated by means of the ISO 9693: 1999 crack initiation test. A conventional gold alloy was used as a control. The elemental distributions at the porcelain/alloy interfaces were analyzed in cross section by electron probe microanalysis. Additionally, after the bond strength test, cross-sections of the interfaces of the debonded specimens were microscopically analyzed to characterize the fracture mode. RESULTS: The Pd-free gold alloy joints showed significantly higher bond strength values than joints made with conventional gold alloy. Preoxidation treatment significantly increases the bond strength, in the preoxidized joints Zn was highly localized at the interface and diffused into the porcelain up to about 10 µm from the interface, and the joint failed by cohesive fracture in the porcelain. In contrast, the non-preoxidized joint showed mainly adhesive fracture at the porcelain/alloy interface. SIGNIFICANCE: The presence of Zn in gold alloys plays a part in establishing chemical bonding thus improving the bond strength between porcelain and alloy.

Corrosion behavior of as-received and previously cast type III gold alloy.

PURPOSE: The rationale for using gold alloys is based largely upon their alleged ability to resist corrosion, but little information is available to determine the corrosion behavior of recast alloys. This study characterized the elemental composition of as-received and recast type III gold alloy and examined the in vitro corrosion behavior in two media using a potentiodynamic polarization technique. MATERIALS AND METHODS: Seventy-eight disk-shaped specimens were prepared from a type III gold alloy under three casting protocols according to the proportion of as-received and recast gold alloy (n = 26). (1) Group as received (100% as-received metal), (2) group 50% to 50% (50% wt. new metal, 50% wt. once recast metal), and (3) group recast (100% once recast metal). The surface structures of 20 specimens from each group were examined under scanning electron microscopy, and their elemental compositions were determined using X-ray energy-dispersive spectroscopy. Further, the potentiodynamic cyclic polarization between -1000 and +1000 mV (SCE) were performed for six specimens from each casting protocol in 0.09% NaCl solution (n = 3) and Fusayama artificial saliva (n = 3) at 37 degrees C. Zero-current potential and corrosion current density were determined. The data were analyzed with 1-way ANOVA and the Ryan-Einot-Gabriel-Welsch multiple-range test t (alpha= 0.05). RESULTS: Elemental composition was significantly different among the casting groups (p < 0.001). The mean weight percentage values were 72.4 to 75.7% Au, 4.5 to 7.0% Pd, 10.7 to 11.1% Ag, 7.8 to 8.4% Cu, and 1.0 to 1.4% Zn. The mean values for Zero-current potential and corrosion current density for all casting protocols were not significant (p > 0.05); however, the difference between the electrolytes was significant (p < 0.001). Fusayama artificial saliva seemed to offer the most corrosive environment. CONCLUSIONS: Type III gold alloy in any casting protocol retained passivity under electrochemical conditions similar to the oral environment. Moreover, high-gold type III alloys from reputable manufacturers and recasting protocol tested should produce acceptable corrosion-resistant castings.

Effect of additive metals, Sn, Ga, and In in Ag-Pd-Au-Cu alloys on initial bond strength of 4-META adhesive cement to these alloys.

The purpose of this study was to investigate the effects of three additives, Sn, Ga, and In, as well as the main constituents, Pd and Cu, of Ag-Pd-Au-Cu alloys on the initial bond strength of 4-META adhesive cement to these alloys. The Ag-Pd-Au-Cu alloys consisted of 20%, 30% or 40% Pd, and 10%, 15% or 20% Cu, 20% Au, and Ag as balance. Besides, additive metals (Sn, Ga, and In) of 2% and 4% were added to these compositions. The addition of three additives, in general, increased the initial bond strength of the cement in comparison to the mother compositions (0% additives), although the degrees of effectiveness of the three additives were different and varied with their contents. Among these additives, a remarkable increase in bond strength was observed with the addition of In. The increase in Cu content, in many cases, resulted in an increase in bond strength at high Pd contents (30% and 40%), but a decrease at low Pd content (20%) in some cases. The positive effects of the three additives and Cu could be due to the formation of a suitable oxide layer for strong bonding with 4-META.

A correlation found between gold concentration in blood and patch test reactions in patients with coronary stents.

BACKGROUND: Patients with dental gold restorations are known to have a higher level of gold concentration in blood (B-Au). OBJECTIVES: To further investigate, in a study on patients with intracoronary stents and contact allergy to metals, the gold and nickel release from stainless steel stent with (Au stent) and without (Ni stent) gold plating. METHOD: A total of 460 patients treated with stenting underwent patch testing with metals, and information on gold and nickel exposure and blood samples were collected. About 200 blood samples were randomly selected and the analysis of B-Au and nickel concentration in blood (B-Ni) was made using inductively coupled plasma mass spectrometry. RESULTS: There was a correlation between the intensity of Au patch test reaction and B-Au (P < 0.001). This correlation could not be seen between Ni patch test reaction and B-Ni. A Au stent gave a fivefold higher B-Au than a Ni stent. CONCLUSIONS: Gold is released from the Au stent and patients with a Au stent have a fivefold higher B-Au than patients with an Ni stent. The patch test reactions for gold were correlated with B-Au.

Surface and elemental alterations of dental alloys induced by electro discharge machining (EDM).

OBJECTIVES: To evaluate the surface and elemental alterations induced by electro discharge machining (EDM) on the surface of dental cast alloys used for the fabrication of implant retained meso- and super-structures. METHODS: A completed cast model of an arch that received dental implants was used for the preparation of six wax patterns which were divided into three groups (Au, Co and Ti). The wax patterns of the Au and Co groups were invested with conventional phosphate-bonded silica-based investment material and the Ti group with magnesia-based investment material. The investment rings of the Au and Co groups were cast with an Au-Ag alloy (Stabilor G) and a Co-Cr base alloy (Okta C), respectively, while the investment rings of group Ti were cast with cp Ti (Biotan). One casting of each group was subjected to electro discharge machining (EDM); the other was conventionally ground and polished. The surface morphology and the elemental compositions of conventionally and EDM-finished surfaces were studied by SEM/X-ray EDS analysis. Six spectra were collected from each surface employing the area scan mode and the mean value of each element between conventionally and EDM-finished surfaces was statistically analyzed by t-test (a=0.05). Then the specimens of each group were cut perpendicular to their longitudinal axis and after metallographic grinding and polishing the cross-sections studied under the SEM. RESULTS: The EDM surfaces showed a significant increase in C due to the decomposition of the dielectric fluid during spark erosion. Moreover, a significant Cu uptake was noted on these surfaces from the decomposition of the Cu electrodes used for EDM. Cross-sectional analysis showed that all alloys developed a superficial zone (recast layer) varying from 2 microm for Au-Ag to 10 microm for Co-Cr alloy. SIGNIFICANCE: The elemental composition of dental alloy surfaces is significantly altered after EDM treatment.

Bonding indirect resin composites to metal: part 2. Effect of alloy surface treatment on elemental composition of alloy and bond strength.

PURPOSE: This laboratory study compared the effect of different surface treatments of a medium-gold, high-noble alloy on the shear bond strength of an indirect, highly filled resin composite to the alloy and on the elemental composition of the alloy surface. MATERIALS AND METHODS: Ninety disks, cast in a medium-gold, high-noble porcelain-fused-to-metal alloy (V-Deltaloy), received three different surface treatments: sandblasting with 50-microm Al2O3 (group 1) or 250-microm Al2O3 (group 2) and chemical agents, or with 250-microm Al2O3 without chemical agents (group 3) prior to bonding of an indirect resin composite (Artglass, and chemical agents Siloc-pre and Siloc-bond). The specimens were tested in shear, half of them after 24-hour dry storage at room temperature and the rest after 10-day storage in normal saline solution at 37 degrees C and thermocycling (2,500 cycles between 5 and 55 degrees C). Morphologic and qualitative changes on the alloy surface after sandblasting with 50- or 250-microm Al2O3 were examined by SEM using EDS analysis and compared with polished specimens. Statistical analysis was performed using two-factor ANOVA. RESULTS: The mean shear bond strengths (in MPa) after dry or wet storage and thermocycling were 29 and 24 for group 1, 21 and 18 for group 2, and 17 and 12 for group 3, respectively; there was a statistically significant difference among the groups. Sandblasting of the alloy surface led to statistically significant changes in elemental composition. These changes were of greater magnitude when 50-microm Al2O3 particles were used. CONCLUSION: The particle size used for sandblasting influences the shear bond strength between a high-noble alloy and a highly filled indirect resin composite, as well as the elemental composition of the alloy surface.

Age hardening by dendrite growth in a low-gold dental casting alloy.

Commercial low-gold dental casting alloy composed of Ag-Pd-In-Au-Zn was studied to clarify the age-hardening mechanism and related microstructural changes. The hardness of solution-treated specimen began to increase and reached the maximum value with ageing time, and then the maximum hardness value decreased by further ageing. The changes of X-ray diffraction (XRD) pattern during isothermal ageing revealed that the age hardening was not caused by phase transformation. By comparing the age-hardening curve with the changes in full-width at half-maximum of the XRD peaks at each ageing time, it was revealed that the coherency strains were formed in the Ag-rich matrix, which contributed to the hardness increase during ageing. From scanning electron microscopic observation and electron probe microanalysis, it was clarified that fine particle-like structures composed of InPd containing small amount of Zn gathered by diffusion in the Ag-rich matrix, and the coherency strains which formed during that time caused the hardness increase in the early stage of age-hardening process. The coherency strains were released by the progress of coarsening of Zn-containing InPd dendrite during further ageing, which caused the overaging in the later stage of age-hardening process.

Artifacts from dental casting alloys in magnetic resonance imaging.

The potential advantage of magnetic resonance imaging (MRI) has been limited by artifacts due to the presence of metallic materials. For quantitative evaluation of the magnitude of artifacts from dental casting alloys and implant materials in MR imaging, 11 dental casting or implant materials were imaged by means of 1.5 T MRI apparatus with three different sequences. Mean and standard deviation of water signal intensity (SI) around the sample in the region of interest (1200 mm(2)) were determined, and the coefficient of variation was compared for evaluation of the homogeneity of the SI. A variety of artifacts with different magnitudes was observed. Only one of the samples, composed mainly of Pd, In, and Sb, showed no artifacts in all imaging sequences. We concluded that selection of specific dental casting alloys according to their elemental compositions could minimize the metal artifacts in MRI; however, titanium alloys currently pose a problem with respect to causing MRI artifacts.

Metal content of biopsies adjacent to dental cast alloys.

Single case reports indicate that components of dental alloys accumulate in the adjacent soft tissue of the oral cavity. However, data on a wider range of dental alloys and patient groups are scarce. Therefore, the aim of the present study was to examine the metal content of oral tissues adjacent to dental alloys showing persisting signs of inflammation or other discoloration (affected sites) and of healthy control sites with no adjacent metal restoration in 28 patients. The composition of the adjacent alloys was analyzed and compared to the alloy components in the affected sites. Tissue analysis was performed using atomic absorption spectroscopy. Alloy analysis was performed with energy-dispersive X-ray analysis. In the affected sites, the metals Ag, Au, Cu, and Pd prevailed compared to control sites, reflecting the frequency distribution of single metals in the adjacent alloys. In most cases (84%), at least one of the analyzed metals was a component of the alloy and also detected in the tissue. Metal components from almost all dental cast alloys can be detected in adjacent tissue.

Defects in hexed gold prosthetic screws: A metallographic and tensile analysis.

STATEMENT OF PROBLEM: Prosthetic gold screw fracture remains a clinical problem in implant prosthodontics. PURPOSE: This study examined hexed gold prosthetic screws for internal defects and determined the effect of these defects on tensile strength. The microstructure, microhardness, and major constituents of the alloys also were determined. MATERIAL AND METHODS: Four intact hexed gold prosthetic screws, 1 from each of 2 different lots from 2 manufacturers (Implant Innovations and Nobel Biocare), were examined with standard metallographic techniques for defects, microstructure, microhardness, and major alloy constituents. Thirty-six screws, 9 from each of the 2 different lots of both manufacturers, were subjected to tensile testing to determine fracture load values. Analysis of variance and Tukey tests were used to identify differences between manufacturers and lots (P<.05). The fracture sites were examined retrospectively with a scanning electron microscope to identify defects that could have contributed to failure. The mode of fracture was characterized. RESULTS: There were no significant defects in the screws tested, but differences were observed in the microstructure, microhardness, alloy composition, and fracture load values for both manufacturers. Screws from the 2 manufacturers demonstrated distinctly different metallurgical characteristics, which highlighted differences in the manufacturing processes. Fracture load values ranged from 850 +/- 20 N to 1093 +/- 64 N. A significant difference was noted for mean fracture load values for the different lots of Implant Innovations screws (P<.05). Ductile fracture was the mode of failure. CONCLUSION: The results of this study suggest that variability in the physical properties of similar hexed gold prosthetic screws made by different manufacturers, as well as different lots from the same manufacturer, may affect clinical success.

Development of Ag-Pd-Au-Cu alloys for multiple dental applications. Part 2. Mechanical properties of experimental Ag-Pd-Au-Cu alloys containing Sn or Ga for ceramic-metal restorations.

Eighteen Ag-Pd-Au-Cu alloys, consisting of nine Ag-Pd-Au-Cu mother compositions (Pd: 20, 30 or 40%, Au: 20%, Cu: 10, 15 or 20%, Ag: balance) containing either 5% Sn or 5% Ga as an additive metal, were experimentally prepared. Tensile strength, proof stress, elongation, elastic modulus, and Vickers hardness of these alloys were evaluated to clarify the potential of these alloys for use as ceramic-metal restorations as well as the effects of the Pd and Cu contents on their mechanical properties. The tensile strength, proof stress, elongation, elastic modulus and Vickers hardness of the 18 experimental alloys were in the range of 410.0-984.0 MPa, 289.7-774.3 MPa, 2.2-23.7%, 81.3-123.0 GPa and 135.7-332.3 HV1, respectively. Ten of the 18 experimental alloys can be used for ultra-low fusing ceramics based on their proof stress, elastic modulus, elongation and hardness. Between the Ga- and Sn-added alloys, differences in tensile strength, proof stress, elongation and hardness were found at several Ag-Pd-Au-Cu compositions.

Urinary platinum levels associated with dental gold alloys.

Platinum concentrations were determined in 50 urine and 20 saliva samples obtained from 50 subjects who had gold dental restorations. In addition, 42 urine and 35 saliva samples were collected from subjects who did not have gold dental restorations. Subjects with gold alloys had significantly (p < .001) higher urinary platinum excretion (mean = 11.9 +/- 8.5 ng/gm creatinine, range = 1.9-45.8 ng/gm creatinine) than controls (mean = 6.2 +/- 3.2 ng/gm, range = 1.9-14.4 ng/gm creatinine). Mean saliva concentrations were significantly higher in subjects with dental gold alloys (526 pg/gm vs. 8.5 pg/gm; p < .001). A laboratory test with 5 commercially available dental gold/platinum alloys showed that 0.1% sodium chloride mobilized platinum within 1 hr (i.e., 1-18 pg/ml) of its introduction. In conclusion, dental gold/platinum alloys appear to be the main source for urinary platinum excretion from the occupationally unexposed population.

Effect of heat treatment on mechanical properties of age-hardenable gold alloy at intraoral temperature.

OBJECTIVE: The aim of this study was to investigate the effect of various heat treatments on the mechanical properties of gold alloys capable of age-hardening at intraoral temperature. METHODS: Dumbbell-shaped patterns (ISO 6871) were cast with three gold alloys (Sofard; NC Type-IV; Aurum Cast, NihombashiTokuriki Co.). The Sofard alloy is age-hardenable at intraoral temperature. The castings underwent various heat treatments [as-cast (AC); solution treatment (ST); high-temperature aging (HA); intraoral aging (IA)]. After these heat treatments, ultimate tensile strength (UTS), 0.2% offset yield strength (YS), and elongation (EL) were measured at a strain rate of 1.7x10(-4)/s. Fracture surfaces of the specimens after tensile testing were observed using SEM. Vickers hardness was also measured after heat treating. RESULTS: After IA, the hardness values of the Sofard alloy increased and reached values similar to the hardness of the Sofard specimens aged at high temperature (HA). The hardness values of the NC Type-IV and Aurum Cast specimens slightly increased after IA, but did not reach the values of the specimens after HA. All the Sofard, NC Type-IV and Aurum Cast specimens showed significantly (P<0.05) greater hardness values after HA, compared with the values after any other heat treatments (AC, ST and IA). The UTS and YS of the specimens indicated a tendency similar to the results obtained for hardness. The Sofard specimens with ST showed the greatest elongation compared to the corresponding NC Type-IV and Aurum Cast specimens. However, the elongation of the Sofard specimens was abruptly reduced after intraoral aging. CONCLUSION: Intraoral aging significantly improved the mechanical properties and hardness of the Sofard alloy.

Surface composition and structure of titanium polished with aqueous slurry of ferric oxide.

Cast plates were prepared from commercial titanium. The plates were polished with a slurry of fine ferric oxide powder. The surface composition and structure were investigated by electron probe microanalysis (EPMA) and X-ray photoelectron spectroscopy (XPS). In the high pressure-polished surface, iron was non-uniformly distributed but oxygen was mostly uniformly distributed, while in a light pressure-polished surface, iron and oxygen were uniformly distributed though at lower and higher concentrations, respectively. EPMA state analysis and XPS suggested that the iron might exist as Fe2+ in the outermost surface, while it might be in a metallic state in the inner surface layer.