Exploring the degradation behavior of MgXAg alloys by in vitro electrochemical methods.

Magnesium as biodegradable biomaterial could serve as bone augmentation material in implant dentistry. The knowledge about the predictability of the biodegradation process is essential as this process needs to go hand in hand with the formation of new bone to gradually replace the augmentation material. Therefore, this work aimed to assess if the electrochemistry (EC) measurements of the corrosion process correlate with the surface features at various time points during the surface degradation, in order to describe the degradation process of Mg and Mg alloys more reliably, under the assumption that differences in EC behavior can be detected and related to specific patterns on the surface. In this test setup, a special optical chamber was used for electrochemical measurements on Mg and Mg-alloys (Mg2Ag, Mg4Ag, and Mg6Ag). Specimens were investigated using different circulating cell culture solutions as electrolytes, these were minimum essential medium (MEM), Hank's Balanced Salt Solution (HBSS), and MEM+ (MEM with added sodium hydrogen carbonate) at 37 °C. Open circuit potential measurements (OCP) over 30 min followed by cyclic polarization were performed. The electrochemistry data, including OCP, exchange current density and corrosion potential, were compared with visible changes at the surface during these treatments over time. The results show that the addition of silver (Ag) leads to a "standardization" of the degradation regardless of the selected test medium. It is currently difficult to correlate the visible microscopic changes with the data taken from the measurements. Therefore, further investigations are necessary.

The Video Microscopy-Linked Electrochemical Cell: An Innovative Method to Improve Electrochemical Investigations of Biodegradable Metals.

An innovative, miniature video-optical-electrochemical cell was developed and tested that allows for the conducting of electrochemical corrosion measurements and simultaneous microscopic observations over a small, well-defined surface area of corroding or degrading samples. The setup consisted of a miniature electrochemical cell that was clamped onto the metal sample and fixed under a video microscope before being filled with electrolyte. The miniature cell was comprised of afferent/efferent electrolyte ducts as well as a connection to the Mini Cell System (MCS) for electrochemical measurements. Consequently, all measured and induced currents and voltages referred to the same small area corroding completely within the field of view of the microscope, thus allowing for real-time observation and linking of surface phenomena such as hydrogen evolution and oxide deposition to electrochemical data. The experimental setup was tested on commercial purity (cp) and extra-high purity (XHP) magnesium (Mg) samples using open circuit potential and cyclic voltammetry methods under static and flowing conditions. The corrosion potential was shifted more anodically for cp Mg in comparison to XHP Mg under dynamic conditions. The corrosion current assessed from the cyclic voltametric curves were higher for the cp Mg in comparison to XHP Mg. However, there were no differences between static and flow conditions in the case of XHP Mg in contrast to cp Mg, where the current density was two times higher at dynamic conditions. The measurements and observations with this new method pave the way for a more detailed understanding of magnesium corrosion mechanisms, thus improving predictive power of electrochemical corrosion measurements on newly developed magnesium or other biodegradable alloys applied for medical devices. Different electrochemical tests can be run under various conditions, while being easy to set up and reproduce as well as being minimally destructive to the sample.

Bacterial leakage and bending moments of screw-retained, composite-veneered PEEK implant crowns.

Due to its elastic modulus close to bone, the high-performance material PEEK (polyetheretherketone) represents an interesting material for implant-supported dental prostheses. Besides a damping effect of masticatory forces, it might have a sealing effect against bacterial leakage of the implant-abutment interface (IAI). So far, PEEK has only been used for provisional implant crowns. Therefore, the aim of the study was the evaluation of the bacterial tightness of screw-retained PEEK crowns on titanium implants with conical IAI during masticatory simulation and subsequent bending moment testing. Ten screw-retained implant crowns in the shape of an upper central incisor consisting of a PEEK crown framework veneered with composite were connected to NobelActive RP titanium implants (4.3 × 11.5 mm, Nobel Biocare AB, Göteborg, Sweden) with a tightening torque of 15 Ncm. Prior to tightening, the interior of the implant was inoculated with a bacterial suspension of Enterococcus faecium. The specimens were overmolded with indicating agar (Kanamycin-Aesculin-Azid-Agar (KAAA), Oxoid Limited, Basingstoke United Kingdom), that turns black in contact with E. faecium. The specimens were subjected to a cyclic masticatory simulation whereby a force of 50 N cm was applied at an angle of 30° to the implant axis for 1.2 million cycles. Afterwards, the specimens were subjected to a static loading test according to ISO 14801:2007 to determine the bending moment. During masticatory simulation neither a loosening of the implant screws nor any damage to the veneer or the PEEK framework occurred. Furthermore, no bacterial leakage could be observed in any of the specimens. The average maximum bending moment was measured at 352.13 ±â€¯48.96 N cm. Regarding masticatory forces, PEEK implant crowns seem to be applicable as definitive implant-supported restorations. Furthermore, the bacterial tightness of the IAI of screw-retained one-piece PEEK implant crowns is advantageous compared to superstructures of conventional materials. Further studies are necessary to substantiate the clinical significance of these findings.

In vitro degradation of a biodegradable polylactic acid/magnesium composite as potential bone augmentation material in the presence of titanium and PEEK dental implants.

OBJECTIVE: The aim of this study was to assess the degradation behavior by measuring the H2 release of a biodegradable composite consisting of a polylactic acid matrix reinforced with 30% wt. spherical magnesium microparticles (PLA/Mg) as potential bone augmentation material in combination with dental implants of either titanium or polyetheretherketone (PEEK) in order to evaluate the potential influence of the titanium dental implants on the corrosion behavior of the Mg particles within the PLA matrix. METHODS: Three PEEK dental implants and three titanium dental implants were put into a central perforation of six PLA/Mg-discs. These samples were incubated at 37°C for 30days in McCoy's 5A modified medium and the H2 release was evaluated. RESULTS: Between day 7 and day 16 the average H2 release per cm2 of the surface of the PLA/Mg-samples in combination with the titanium implants was significantly higher than that of the sample group combined with the implants of PEEK (3.1±0.4ml vs. 2.8±0.4ml). This significant difference disappeared afterwards, whereas the H2 release was highest at day 30 and amounted 3.5±0.7ml/cm2 for the group with the titanium implants and 3.2±0.8ml/cm2 for the group with the PEEK implants. SIGNIFICANCE: Regarding the similar values of the degradation depending H2 release of the two implant material groups, the co-implantation of a PLA/Mg composite is not only possible with new metal-free implant materials such as PEEK, but also with conventional implants of titanium.

Influence of different low-pressure plasma process parameters on shear bond strength between veneering composites and PEEK materials.

OBJECTIVE: The aim of this study was to evaluate the impact of oxygen and argon/oxygen low-pressure plasma on the shear bond strength (SBS) between dental PEEK compounds and veneering composites as a function of plasma process time. METHODS: Of an unfilled PEEK ("Juvora") and two pigment powder filled PEEK compounds ("DC4420", "DC4450"), 273 rectangular plates were prepared and polished up to 1200 grit. Afterwards the samples were sandblasted and randomly assigned to five different surface pre-treatment groups (1. No plasma (control); 2. O2 plasma for 3min; 3. O2 plasma for 35min; 4. Ar/O2 plasma for 3min; 5. Ar/O2 plasma for 35min). Surface roughness and water contact angles were recorded using three samples of each PEEK compound for each of the plasma treatment groups. An adhesive (visio.link, Bredent GmbH & Co KG, Senden, Germany) was applied onto the specimen surfaces and light cured. A mold was used to shape three different veneering composites (a) Vita VM LC, "Vita" (Vita Zahnfabrik, Bad Säckingen, Germany); (b) GC GRADIA, "Gradia" (GC Europe, Leuven, Belgium); (c) GC GRADIA DIRECT Flo, "Gradia Flo" (GC Europe, Leuven, Belgium)) into a cylindrical form on the sample surface before light curing. SBS was measured using a universal testing machine after 24h of incubation in distilled water at 37°C. RESULTS: The two pigment filled PEEK compounds treated with O2 plasma and veneered with Gradia Flo showed the highest SBS values (34.92±6.55MPa and 34.2±1.87MPa) followed by the combination of the unfilled PEEK material with Gradia Flo (29.57±3.71MPa). The SBS values of the samples veneered with Gradia were lower, but not significantly so. The SBS values of the specimens with Vita were for the most part associated with significantly lower results. SIGNIFICANCE: A low-pressure plasma process using oxygen plasma for a duration of 35min, preceded by sandblasting, seems to be the most effective in increasing shear bond strength between veneering composites and PEEK materials.

Maximum insertion torque of a novel implant-abutment-interface design for PEEK dental implants.

Frequent reports attest to the various advantages of tapered implant/abutment interfaces (IAIs) compared to other types of interfaces. For this reason, a conical IAI was designed as part of the development of a PEEK (polyetheretherketone)-based dental implant. This IAI is equipped with an apically displaced anti-rotation lock with minimal space requirements in the form of an internal spline. The objective of this study was the determination of the average insertion torque (IT) at failure of this design, so as to determine its suitability for immediate loading, which requires a minimum IT of 32Ncm. 10 implants each made of unfilled PEEK, carbon fiber reinforced ("CFR") PEEK (> 50vol% continuous axially parallel fibers) as well as of titanium were produced and tested in a torque test bench. The average IT values at failure of the unfilled PEEK implants were measured at 22.6 ± 0.5Ncm and were significantly higher than those of the CFR-Implants (20.2 ± 2.5Ncm). The average IT values at failure of the titanium specimens were significantly higher (92.6 ± 2.3Ncm) than those of the two PEEK variants. PEEK- and CFR-PEEK-implants in the present form cannot adequately withstand the insertion force needed to achieve primary stability for immediate loading. Nevertheless, the achievable torque resilience of the two PEEK-variants may be sufficient for a two-stage implantation procedure. To improve the torque resistance of the PEEK implant material the development of a new manufacturing procedure is necessary which reinforces the PEEK base with continuous multi-directional carbon fibers as opposed to the axially parallel fibers of the tested PEEK compound.

The impact of argon/oxygen low-pressure plasma on shear bond strength between a veneering composite and different PEEK materials.

OBJECTIVE: The aim of the study was to evaluate the impact of low-pressure argon/oxygen plasma with and without previous sandblasting on the shear bond strength (SBS) between dental PEEK compounds and a veneering composite. METHODS: Of one type of unfilled PEEK and two pigment powder filled PEEK compounds, forty rectangular plates each were prepared and polished up to 4000 grit. The samples were randomly assigned to four surface pre-treatment groups, each consisting of ten specimens (1. Untreated; 2. Plasma treatment; 3. Sandblasting; 4. Sandblasting+plasma treatment). Plasma treatment was performed for 35min using a low-pressure plasma system with a 1:1 mixture of the process gases argon and oxygen. Surface roughness and water contact angles were recorded. An adhesive (Visio.link, Bredent GmbH & Co KG, Senden, Germany) was applied onto the specimen surfaces and light cured. A mold was used to shape the veneering composite (Vita VM LC, Vita Zahnfabrik, Bad Säckingen, Germany) into a cylindrical form on the sample surface before light curing. SBS was measured after 24h incubation at 37°C in distilled water using a universal testing machine. RESULTS: The samples pre-treated according to group 4 (sandblasting and plasma treatment) showed the highest SBS overall, whereas the unfilled PEEK showed the highest SBS (19.8±2.46MPa) compared to the other PEEK materials (15.86±4.39MPa and 9.06±3.1MPa). SIGNIFICANCE: Sandblasting and surface activation with low-pressure argon/oxygen plasma in combination with an adhesive causes a favorable increase in shear bond strength, especially on unfilled PEEK material.

Fatigue limits of different PEEK materials for dental implants.

The increasing use of PEEK (poly-ether-ether-ketone) as a substitute for metal implant components has led to the suggestion that it could also be used as an alternative to titanium in the field of dental implants. A major requirement for dental implant materials is their resistance to cyclic loading due to mastication. A special fatigue test was designed to evaluate the elastic behavior and long-term form stability of cylindrically shaped PEEK specimens of 4, 5 and 6mm in diameter, using 11 different PEEK materials of various grades: unfilled, filled with titanium dioxide or barium sulfate powder, reinforced with short carbon fibers or short glass fibers, and reinforced with continuous carbon fibers. The samples were exposed to cyclic loads of up to 2000N. The elastic limits ranged between 46.57±6.44MPa for short carbon fiber reinforced specimens of 6mm diameter and 107.62±8.23MPa for samples of a different short carbon fiber reinforced PEEK compound of 4mm diameter. The elastic limits of the two PEEK grades containing continuous carbon fibers could not be observed because they exceeded the limits of the test specification. The elastic moduli ranged between 2.06±0.18GPa for barium sulfate powder filled PEEK-specimens of 6 mm diameter and 57.53±14.3GPa for continuous carbon fibers reinforced PEEK-specimens of 4 mm diameter. In terms of the elastic limit all the PEEK materials in consideration were able to resist the pressure caused by maximum masticatory forces.

The applicability of PEEK-based abutment screws.

The high-performance polymer PEEK (poly-ether-ether-ketone) is more and more being used in the field of dentistry, mainly for removable and fixed prostheses. In cases of screw-retained implant-supported reconstructions of PEEK, an abutment screw made of PEEK might be advantageous over a conventional metal screw due to its similar elasticity. Also in case of abutment screw fracture, a screw of PEEK could be removed more easily. M1.6-abutment screws of four different PEEK compounds were subjected to tensile tests to set their maximum tensile strengths in relation to an equivalent stress of 186MPa, which is aused by a tightening torque of 15Ncm. Two screw types were manufactured via injection molding and contained 15% short carbon fibers (sCF-15) and 40% (sCF-40), respectively. Two screw types were manufactured via milling and contained 20% TiO2 powder (TiO2-20) and >50% parallel orientated, continuous carbon fibers (cCF-50). A conventional abutments screw of Ti6Al4V (Ti; CAMLOG(®) abutment screw, CAMLOG, Wimsheim, Germany) served as control. The maximum tensile strength was 76.08±5.50MPa for TiO2-20, 152.67±15.83MPa for sCF-15, 157.29±20.11MPa for sCF-40 and 191.69±36.33MPa for cCF-50. The maximum tensile strength of the Ti-screws amounted 1196.29±21.4MPa. The results of the TiO2-20 and the Ti screws were significantly different from the results of the other samples, respectively. For the manufacturing of PEEK abutment screws, PEEK reinforced by >50% continuous carbon fibers would be the material of choice.

A Novel Approach to Prove Bacterial Leakage of Implant-Abutment Connections In Vitro.

Bacterial leakage from the implant-abutment-interface (IAI) is suspected of contributing to the development of peri-implantitis. The aim of the study was to develop a straightforward test setup to evaluate the bacterial leakage of the IAI of 2-piece implant systems under laboratory conditions. A test suspension of Enterococcus faecium was injected into 7 implants (PerioType Rapid Implants) prior to abutment fixation. The IAI was covered by kanamycin aesculn azide agar (KAAA), which serves as an optical indicator for E. faecium . The specimens were cyclically loaded with a force of 120 N for up to 1 000 000 cycles in a universal testing machine in accordance with the ISO 14801:2007 standard. The color change of the KAAA was recorded. Three of the 7 implants showed bacterial leakage before the cyclic loading test started. The bacterial tightness of the IAIs of the 4 remaining implants lasted for 35 680 ± 22 467 cycles on average. The experimental setup at hand provides the means for a straightforward evaluation of the bacterial tightness of the IAI of 2-piece dental implants.