Sex Identification Based on Tooth Crown Trait Analysis Among the Mongoloid Race

Abstract Objective: To determine whether anterior and posterior tooth crown traits exhibit sexual dimorphism and identify traits characteristic to the Mongoloid race, especially among the Indonesian population. Material and Methods: This study cross-sectional study analyzed 108 dental casts from 36 males and 72 females. The traits analyzed included winging, shoveling, double shoveling, canine mesial ridge, canine distal accessory ridge, hypocone, metaconule, Carabelli's cusp, protostylid, metaconulid, enteconulid, and hypoconulid. All tooth crown traits were scored based on the ASUDAS scoring system. Descriptive statistics were used to calculate the absolute and relative frequencies. The Chi-square tests was used to determine significant differences in anterior and posterior tooth crown traits between males and females. Level of significance was set at 5%. Results: None of the traits showed sexual dimorphism. Moreover, the most common traits among the Mongoloid race were hypocone (94.4%) and shoveling (86.1%). Conclusion: Although none of the traits exhibited sexual dimorphism, most of them had a higher incidence among females than males. Nonetheless, further research including adequate samples and a similar number of females and males, is needed, especially for population studies.

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).

Desajuste vertical entre implante de hexágono interno e pilares Ucla totalmente calcináveis e com base de CoCr após a fundição pelo processo convencional / Vertical misfit between internal hexagon implants and Ucla burnout and CoCr prefabricated base abutments after conventional casting procedures

Objetivo: avaliar, por meio de um microdurômetro, o grau de desajuste na adaptação de pilares Ucla em implantes. Material e métodos: foram utilizados dez implantes de hexágono interno de plataforma regular, e seus respectivos componentes protéticos do tipo Ucla com antirrotacional, como seguem: dez pilares Ucla totalmente calcináveis e dez pilares Ucla com base de CoCr. Todos os pilares Ucla foram fundidos pelo mesmo laboratório de prótese e pelo mesmo processo laboratorial. Cada implante recebeu apenas dois pilares, que foram anexados por meio de um parafuso de titânio quadrado utilizando-se torque de 30 Ncm com torquímetro manual. Cada conjunto implante/pilar recebeu quatro marcações aleatórias em torno da circunferência, na qual foram feitas as medições do espaço existente entre as peças utilizando uma lupa estereoscópica de 100 vezes de aumento. Resultados: os resultados obtidos mostraram diferenças significativas entre os grupos submetidos ao teste Mann-Whitney (p < 0,05). Conclusão: o pilar Ucla com base de CoCr apresentou menor desajuste marginal vertical, quando comparado ao pilar Ucla totalmente calcinável, após o processo de fundição nos implantes de hexágono interno.

Objective: to evaluate, using a microhardness device, the misfit between Ucla abutments and internal hex implants. Material and methods: 10 internal hex implants received 10 Ucla burnout and 10 Ucla abutments with CoCr collar. All the abutments were cast in the same laboratory and under the same protocol. A square-head titanium screw was tightened to a 30 Ncm using a manual wrench. Each abutment/implant set receive four random markings around its perimeter. A stereoscopic lens was used to investigate the misfi t at 100 magnification. Results: there was a statistically significant difference between tested abutments (Mann-Whitney p < 0.05). Conclusion: the Ucla abutment with the CoCr collar presented less vertica misfit values after casting for internal hex dental implants.

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.

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.

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.

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.

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.

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.

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.

Strain gauges's analysis on implant-retained prosthesis' cast accuracy.

INTRODUCTION: A proper cast is essential for a successful rehabilitation with implant prostheses, in order to produce better structures and induce less strain on the implants. AIMS: The aim of this study was to evaluate the precision of four different mold filling techniques and verify an accurate methodology to evaluate these techniques. MATERIALS AND METHODS: A total of 40 casts were obtained from a metallic matrix simulating three unit implant-retained prostheses. The molds were filled using four different techniques in four groups (n = 10): Group 1 - Single-portion filling technique; Group 2 - Two-step filling technique; Group 3 - Latex cylinder technique; Group 4 - Joining the implant analogs previously to the mold filling. A titanium framework was obtained and used as a reference to evaluate the marginal misfit and tension forces in each cast. Vertical misfit was measured with an optical microscope with an increase of 120 times following the single-screw test protocol. Strain was quantified using strain gauges. Data were analyzed using one-way ANOVA (Tukey's test) (α =0.05). The correlation between strain and vertical misfit was evaluated by Pearson test. RESULTS: The misfit values did not present statistical difference (P = 0.979), while the strain results showed statistical difference between Groups 3 and 4 (P = 0.027). CONCLUSIONS: The splinting technique was considered to be as efficient as the conventional technique. The strain gauge methodology was accurate for strain measurements and cast distortion evaluation. There was no correlation between strain and marginal misfit.

The influence of digital fabrication options on the accuracy of dental implant-based single units and complete-arch frameworks.

PURPOSE: To compare the accuracy and reproducibility of digital versus conventional dental impressions and fabrication techniques for single units and full-arch implant frameworks. MATERIALS AND METHODS: A total of 24 samples, divided into four groups, were created using conventional and digital implant impression/fabrication techniques: group 1 (conventional single implant), group 2 (digital single implant), group 3 (conventional complete arch), and group 4 (digital complete arch). All impressions were made at the abutment level. Marginal fit measurements were made using an optical microscope at two points (buccal and lingual) for each sample. Statistical analysis was performed using F and t tests (α = .05). RESULTS: For single implants, the conventional impression/fabrication pathway resulted in a mean marginal discrepancy of 24.1 µm compared to 61.43 µm for the digital impression/fabrication pathway. For full-arch frameworks, the conventional impression/fabrication pathway resulted in a mean marginal discrepancy of 135.1 µm compared to 63.14 µm for the digital technique. CONCLUSION: The conventional pathway resulted in a smaller marginal discrepancy for single-implant frameworks. In contrast, the digital pathway resulted in a smaller marginal discrepancy for full-arch implant frameworks.

A comparison of the accuracy of polyether, polyvinyl siloxane, and plaster impressions for long-span implant-supported prostheses.

PURPOSE: The purpose of this study was to compare the capacity of different impression materials to accurately reproduce the positions of five implant analogs on a master model by comparing the resulting cast with the stainless steel master model. The study was motivated by the knowledge that distortions can occur during impression making and the pouring of casts and that this distortion may produce inaccuracies of subsequent restorations, especially long-span castings for implant superstructures. MATERIALS AND METHODS: The master model was a stainless steel model with five implant analogs. The impression materials used were impression plaster (Plastogum, Harry J Bosworth), a polyether (Impregum Penta, 3M ESPE), and two polyvinyl siloxane (PVS) materials (Aquasil Monophase and Aquasil putty with light-body wash, Dentsply). Five impressions were made with each impression material and cast in die stone under strictly controlled laboratory conditions. The positions of the implants on the master model, the impression copings, and the implant analogs in the subsequent casts were measured using a coordinate measuring machine that measures within 4 µm of accuracy. RESULTS: Statistical analyses indicated that distortion occurred in all of the impression materials, but inconsistently. The PVS monophase material reproduced the master model most accurately. Although there was no significant distortion between the impressions and the master model or between the impressions and their casts, there were distortions between the master model and the master casts, which highlighted the cumulative effects of the distortions. The polyether material proved to be the most reliable in terms of predictability. The impression plaster displayed cumulative distortion, and the PVS putty with light body showed the least reliability. CONCLUSIONS: Some of the distortions observed are of clinical significance and likely to contribute to a lack of passive fit of any superstructure. The inaccuracy of these analog materials and procedures suggested that greater predictability may lie in digital technology.

Vertical microgap and passivity of fit of three-unit implant-supported frameworks fabricated using different techniques.

PURPOSE: This study compared the vertical microgaps of milled zirconia and cobalt-chromium (Co-Cr) implant-supported fixed dental prosthesis frameworks to those seen in one-piece frameworks cast with different techniques. MATERIALS AND METHODS: Two threaded implants were used to simulate the rehabilitation of a maxillary partially edentulous space from the second premolar to the second molar. Three-unit screw-retained prosthetic frameworks were fabricated and divided into the following groups (n = 10 in each group): 1 = cast in Co-Cr using burnout cylinders; 2 = cast in Co-Cr using cast-on Co-Cr cylinders; 3 = one-piece cast in Co-Cr using a passive fitting technique; 4 = milled Co-Cr framework; 5 = milled zirconia framework. The microgap was measured under an optical microscope at ×25. Readings were made with one screw tightened and with both screws tightened. Data were submitted to statistical analysis to enable comparison between groups (α = .05). RESULTS: All frameworks presented microgaps less than 70 µm under all reading conditions, except for group 1 with the readings made on the side opposite the tightened side (124.22 µm). With one screw tightened, the microgap on the tightened side was significantly smaller in groups 2, 3, and 4. On the opposite side, groups 3, 4, and 5 presented significantly smaller microgaps compared to the other groups. When both screws were tightened, the microgap was significantly smaller in groups 2, 3, and 4. CONCLUSION: One-piece cast frameworks associated with a passive fitting technique and milled Co-Cr frameworks presented smaller microgaps than the other fabrication methods and materials that were tested.

An efficient and accurate approach for fabricating dental implant surgical guides.

The aim of this research was to develop an efficient and accurate method to fabricate a dental implant surgical guide. The surgical guide is adapted from the patient's vacuum-formed clear template with the use of a plate with three ceramic balls, a six-axis drilling machine and its fixture. The plate, with the ceramic balls used as radiographic markers, is glued to the template, and the patient bites this template during a CT scan. Then, the surgeon can plan the locations and orientations of the implants on the CT-based model in the dental planning software. The drilling information is exported directly to the computer-controlled drilling machine for subsequent drilling on the template to complete the surgical guide. This method allows the surgical guide to be made without any measurements, which reduces the fabrication time, but increases the drilling accuracy. The preliminary results show that the average location error was 0.31 ± 0.17 mm and the average orientation error was 0.53 ± 0.24°, which can be considered accurate in comparison with the results reported in the literature.

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.

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.

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).