Microleakage of chairside moulded, 3D-printed and milled provisional restorations using a curve-fit approach.

The purpose of this study was to evaluate and measure the microleakage inhibiting quality of provisional restorations manufactured using computer-aided manufacturing, 3D printing, and chairside molded provisional restorative materials. Fifteen provisional restorations each from 3D printed, milled, and chairside molded were manufactured. All restorations were cemented onto sintered zirconia abutment dies and adhered with zinc-oxide non-eugenol temporary cement. Artificial aging was conducted by thermocycling for 800 cycles to simulate 1 month of clinical use. All specimens were submerged in 2% (w/w) methylene blue for 24 hours at 37°C, sectioned, and analyzed digitally for the distance of dye penetration through image analysis. The data were analyzed using the Kruskal-Wallis test with Dunn-Bonferroni post-hoc. Significant differences in dye penetration depth were observed between all groups except milled vs chairside molded. Light microscopy revealed differences in mean cement thickness for 3D printed, milled, and chairside molded of 83.6 µm (1σ = 31.9 µm), 149.1 µm (1σ = 88.7 µm) and 137.9 µm (1σ = 67.2 µm) respectively. Conclusion: 3D printed provisional restorations were found to have the least amount of microleakage compared to milled and chairside molded provisional restorations.

Dental high-speed handpiece and ultrasonic scaler aerosol generation levels and the effect of suction and air supply.

OBJECTIVE: Exposure to aerosol spray generated by high-speed handpieces (HSHs) and ultrasonic scalers poses a significant health risk to oral health practitioners from airborne pathogens. Aerosol generation varies with different HSH designs, but to date, no study has measured this. MATERIALS AND METHODS: We measured and compared aerosol generation by (1) dental HSHs with 3 different coolant port designs and (2) ultrasonic scalers with no suction, low-volume evacuation (LVE) or high-volume evacuation (HVE). Measurements used a particle counter placed near the operator's face in a single-chair, mechanically ventilated dental surgery. Volume concentrations of aerosol, totaled across a 0.3-25-µm size range, were compared for each test condition. RESULTS: HSH drilling and scaling produced significantly high aerosol levels (P < .001) with total volume concentrations 4.73×108µm3/m3 and 4.18×107µm3/m3, respectively. For scaling, mean volume of aerosol was highest with no suction followed by LVE and HVE (P < .001). We detected a negative correlation with both LVE and HVE, indicating that scaling with suction improved operator safety. For drilling, simulated cavity preparation with a 1-port HSH generated the most aerosol (P < .01), followed by a 4-port HSH. Independent of the number of cooling ports, lack of suction caused higher aerosol volume (1.98×107 µm3/m3) whereas HVE significantly reduced volume to -4.47×105 µm3/m3. CONCLUSIONS: High concentrations of dental aerosol found during HSH cavity preparation or ultrasonic scaling present a risk of infection, confirming the advice to use respiratory PPE. HVE and LVE both effectively reduced aerosol generation during scaling, whereas the new aerosol-reducing 'no air' function was highly effective and can be recommended for HSH drilling.

Microleakage of chairside moulded, 3D-printed and milled provisional restorations using a curve-fit approach

Abstract The purpose of this study was to evaluate and measure the microleakage inhibiting quality of provisional restorations manufactured using computer-aided manufacturing, 3D printing, and chairside molded provisional restorative materials. Fifteen provisional restorations each from 3D printed, milled, and chairside molded were manufactured. All restorations were cemented onto sintered zirconia abutment dies and adhered with zinc-oxide non-eugenol temporary cement. Artificial aging was conducted by thermocycling for 800 cycles to simulate 1 month of clinical use. All specimens were submerged in 2% (w/w) methylene blue for 24 hours at 37°C, sectioned, and analyzed digitally for the distance of dye penetration through image analysis. The data were analyzed using the Kruskal-Wallis test with Dunn-Bonferroni post-hoc. Significant differences in dye penetration depth were observed between all groups except milled vs chairside molded. Light microscopy revealed differences in mean cement thickness for 3D printed, milled, and chairside molded of 83.6 µm (1σ = 31.9 µm), 149.1 µm (1σ = 88.7 µm) and 137.9 µm (1σ = 67.2 µm) respectively. Conclusion: 3D printed provisional restorations were found to have the least amount of microleakage compared to milled and chairside molded provisional restorations.

Resumo O objetivo deste estudo foi avaliar e medir a qualidade de inibição de microinfiltração de restaurações provisórias fabricadas usando manufatura assistida por computador, impressão 3D e materiais de restauração provisória moldados no consultório. Foram fabricadas 15 restaurações provisórias impressas em 3D, fresadas e moldadas em consultório. Todas as restaurações foram cimentadas em matrizes de pilar de zircônia sinterizada e aderidas com cimento temporário de óxido de zinco sem eugenol. O envelhecimento artificial foi conduzido por termociclagem por 800 ciclos para simular 1 mês de uso clínico. Todos os espécimes foram submersos em azul de metileno a 2% (p/p) por 24 horas a 37°C, seccionados e analisados digitalmente quanto à distância de penetração do corante por meio de análise de imagem. Os dados foram analisados usando o teste de Kruskal-Wallis com post-hoc de Dunn-Bonferroni. Foram observadas diferenças significativas na profundidade de penetração do corante entre todos os grupos, exceto entre fresado e moldado na cadeira. A microscopia óptica revelou diferenças na espessura média do cimento para as restaurações impressas em 3D, fresadas e moldadas em cadeira de 83,6 µm (1σ = 31,9 µm), 149,1 µm (1σ = 88,7 µm) e 137,9 µm (1σ = 67,2 µm), respectivamente. Conclusão: As restaurações provisórias impressas em 3D apresentaram a menor quantidade de microinfiltração em comparação com as restaurações provisórias fresadas e moldadas no consultório.

Wear Behavior of Occlusal Splint Materials Manufactured By Various Methods: A Systematic Review.

PURPOSE: To systematically review studies on various materials and methods used for wear testing of occlusal devices and their antagonists in vitro and in vivo. METHODS: An electronic search in OVID, Web of Science, PubMed and Scopus was conducted using the following terms (MeSH words) with any synonyms and closed terms: "Splint*" OR "occlusal splint*" OR "night guard" OR "occlusal device" OR "occlusal devices" OR "deprogrammer" OR "bite splint" OR "bite plane" OR "orthotic appliance*" OR "orthotic devices" AND "wear" OR "two-body wear" OR "three-body wear" OR "tooth wear" OR "wear measurement*" OR "wear behaviour" OR "wear behavior" OR "abrasion" AND "Polymethyl Methacrylate" OR "PMMA" OR "acrylic resin*" OR "dental material*" OR "dental enamel" OR "CAD" OR "CAM" OR "PEEK" OR "material* testing". Database search was limited to English-language publications and published between 2001 and 1st of September 2021. A further hand search was done to ensure all materials were captured. RESULTS: After the removal of duplicates, 115 studies were identified, and 11 were chosen for review. Studies showed that the lowest volumetric loss was observed in PEEK occlusal device materials, whereas heat-cure, CAD-milled, and 3D printed occlusal device materials had no significant difference in wear. Vacuum-formed materials showed the highest wear among all groups. Testing parameters were found to be inconsistent across all studies. CONCLUSION: There is a need for standardization of in vitro and in vivo wear measurement and testing protocols as this study revealed a wide variety of testing protocols which potentially could influence the outcome. Polishing procedures are required for the material. Limited studies are available on 3D printed occlusal device materials and would therefore require further investigation, especially on printing build angles and settings. Further clinical studies would be advantageous to provide guidance on the selection of the best occlusal device material that would last the longest without remake.

Bonding Universal Dental Adhesive to Developmentally Hypomineralised Enamel.

PURPOSE: To investigate the effect of pretreatment protocols involving Papacarie Duo gel and Scotchbond Universal (SU) on the microshear bond strength (µSBS) of resin composite (RC) to hypomineralised enamel (HE). MATERIALS AND METHODS: Specimens of normal enamel (NE) and HE were derived from extracted hypomineralised first permanent molars (FPMs). Based on the colour of demarcated opacities, HE specimens were classified as creamy/white (CW) or yellow/brown (YB). The specimens were randomly allocated into eight groups (n = 20). Each group involved pretreatment with Papacarie Duo gel or no pretreatment, and SU applied in etch-and-rinse (E&R) or self-etch (SE) mode. All specimens were bonded with RC and subjected to µSBS testing. Failure modes were analysed using an optical microscope and SEM. RESULTS: Comparing NE with HE, the following factors were found to be significant (p < 0.001): type of enamel substrate, deproteinising pretreatment, and etching mode. Comparing CW HE with YB HE, a significant interaction between "deproteinising pretreatment" and "etching mode" was demonstrated (p = 0.028). When subjected to the concurrent use of Papacarie Duo gel and phosphoric acid etching, HE specimens showed a significant increase in µSBS (p < 0.001). CONCLUSION: Deproteinising pretreatment using Papacarie Duo gel followed by the application of SU in E&R mode led to increased µSBS of resin composite to HE.

Can the Measurement of Jaw-Opening Forces Assist in the Diagnosis of Temporomandibular Disorders?

AIMS: To investigate the effectiveness of a novel jaw-opening-force measuring device as a screening tool to aid in the diagnosis of temporomandibular disorders (TMD). METHODS: Symptomatic TMD patients (n = 58) and control TMD-free participants (n = 56) were screened by an oral medicine specialist according to the Diagnostic Criteria for TMD (DC/TMD). TMD patients were divided into three subcategories based on TMD symptoms (myofascial pain, disc displacement, and both combined). Jaw-opening forces were measured in both groups with an adjustable head device connected to a 1,000-N-load cell. Seven attempts were recorded at 10-second intervals by a data-capturing system. The geometric mean force values were obtained after discarding the first and last attempts. RESULTS: TMD-free participants had greater jaw-opening forces than TMD patients both without and with adjustments for age, sex, height, and weight (both P < .001). The geometric mean ± standard deviation values for TMD patients were 18.5 ± 1.62 N and 47.7 ± 1.53 N for TMD-free participants. Differences in jaw-opening forces among the three TMD subcategories were not statistically significant; however, patients with disc displacement (23.7 ± 1.46 N) had greater jaw forces than patients with myofascial pain (17.0 ± 1.74 N) and both myofascial pain and disc displacement (17.0 ± 1.56 N). CONCLUSION: This study demonstrated that differences in jaw-opening forces could be used as a diagnostic tool for TMD. Future studies should explore the potential of this device to measure improvement in jaw-opening forces following TMD treatment.

Structure and properties of baleen in the Southern right (Eubalaena australis) and Pygmy right whales (Caperea marginata).

Baleen is a resilient and keratinised filter-feeding structure attached to the maxilla of mysticete whales. It is strong and tough, yet a pliant and resilient material, that withstands extreme pressures in the oral cavity during feeding. We investigated the structure, water content, wettability and mechanical properties of baleen of the Southern right (SRW) and Pygmy right whales (PRW), to understand the effects of hydration on the physical and mechanical properties of baleen. Sixty 25 × 15mm baleen subsamples were prepared from one individual of SRW and PRW. Half were hydrated in circulated natural seawater for 21 days and half were dry. Water content analysis showed that SRW baleen was 21.2% water weight and PRW was 26.1%. Wettability testing indicated that surfaces of both hydrated and dried SRW and PRW baleen were hydrophilic, with hydrated samples of both species having lower contact angle values. For the SRW, the average contact angle of hydrated baleen was 40° ± 13.2 and 73° ± 6 for dried samples. Hydrated PRW baleen had an average contact angle of 44° ± 15.3, which was lower than in dried samples (74° ± 2.9). Three-point bending mechanical tests showed that the average maximum flexural stress of dried SRW (134.1 ± 34.3 MPa) and PRW samples (117.8 ± 22.3 MPa) were significantly higher than those of hydrated SRW (25.7 ± 6.3 MPa) and PRW (19.7 ± 4.8 MPa) baleen. Scanning electron microscope images showed the stratification of the outer cortical layer, with cross-linked keratin fibres observed within and between baleen keratin sheets. Hydrated baleen, as in its natural and functional behaviour, has greater flexibility and strength, attributes necessary for the complex filter feeding mechanism characteristic of whales. Hydration must be considered when addressing the physical and mechanical properties of baleen, especially when using dried museum specimens.

Simulated clinical adjustment and intra-oral polishing of two translucent, monolithic zirconia dental ceramics: An in vitro investigation of surface roughness.

OBJECTIVE: To assess the surface roughness and residual flaws in two translucent zirconia substrates following simulated clinical adjustment and intra-oral finishing/polishing. MATERIALS AND METHODS: Specimens were prepared from two translucent (5Y-ZP/8Y-ZP) and one conventional (3Y-TZP) zirconia substrates (n = 84 p/g). Arithmetic mean roughness parameter (Ra) was determined for all experimental groups at four stages (n = 21 p/g): (1) as-sintered, (2) surface grinding using a zirconia cutting diamond bur, (3) polishing using 1-step, 2-step or 4-step intra-oral polishing kits, and (4) laboratory polishing/glazing. Scanning electron microscopy (SEM) was used to evaluate residual surface flaws. Data were statistically analysed using a two-way ANOVA test, multiple and pairwise comparisons were performed using a Bonferroni post hoc test. RESULTS: Ra was significantly higher for as-sintered and ground 5Y-ZP/8Y-ZP compared to 3Y-TZP (p ≤ 0.001). Material type and polishing protocol had statistically significant effect on Ra (p < 0.001). The 4-step polishing resulted in the lowest Ra in 3Y-TZP/5Y-ZP (p ≤ 0.001). No significant differences were observed between different polishing protocols in 8Y-ZP (p≥0.655). Glazing significantly reduced Ra in all materials compared to other polishing protocols (p ≤ 0.001) except for the 4-step protocol in 3Y-TZP (p = 0.195). SEM revealed pronounced surface flaws in ground 5Y-ZP/8Y-ZP. Grinding of 3Y-TZP induced ductile material removal and thereby, minimal cohesive material loss. The 4-step polishing protocol resulted in the fewest and shallowest surface flaws in all groups. Glazing of 3Y-TZP resulted in the most homogenous surface contrary to 5Y-ZP/8Y-ZP. CONCLUSIONS: The finest surface finish was achieved using the 4-step polishing protocol in all studied materials. This protocol might be inadequate however for polishing of ground 5Y-ZP/8Y-ZP as a result of the pronounced surface damage induced by the grinding process. The glazing of 5Y-ZP/8Y-ZP might not be as predictable as for 3Y-TZP. CLINICAL SIGNIFICANCE: The higher susceptibility to surface damage, as a result of increasing dopant concentration, may render polishing of ground, translucent zirconia more complicated compared to the conventional 3Y-TZP counterparts.

Adhesion of porcelain to three-dimensionally printed and soft milled cobalt chromium.

PURPOSE: To investigate the adhesion strength and bonding interface of layered porcelain to powdered cobalt-chromium (CoCr) processed by two different computer-aided manufacturing methods. METHODS: Sixteen specimens were manufactured from each of Three-dimensionally -printed/laser-sintered (LS) CoCr and milled pre-sintered (SM) CoCr. The specimens were layered with porcelain and 4-point bending was carried out. Nanoindentation was used to calculate changes in elastic modulus and hardness before and after porcelain firing along with adhesion energy. Fracture surface and microstructural changes were examined before and after porcelain firing observed using scanning electron microscopy. RESULTS: The adhesion energy of the LS specimens bonded porcelain were higher than the SM specimens (P<0.05). Analysis of the fracture surfaces showed a predominantly adhesive mode of failure. Elastic-modulus and hardness of the CoCr specimens increased post porcelain firing. Examination using electron-backscatter diffraction (EBSD) showed a fine grain structure for both manufacturing methods. Significant localized changes in the crystal structure post firing were only observed at the surface of the SM specimens. CONCLUSIONS: Both manufacturing methods showed regular microstructures prior to porcelain firing. Laser-sintered CoCr had stronger bonding to porcelain than milled pre-sintered CoCr and was also more stable microstructurally post-ceramic firing. However, both manufacturing methods were deemed to have satisfactory adhesion strength to porcelain. It was also found that increased hardness of CoCr had an inverse relationship with bonding strength. High strength porcelain bonding and stability following multiple ceramic firings indicate suitability for use of these CoCr materials with implant or tooth supported long-span frameworks.

Reusing Titanium Healing Abutments: Comparison of Two Decontamination Methods.

PURPOSE: To assess the amount of contamination remaining on used healing abutments after autoclaving and to compare the effectiveness of two additional decontamination methods. MATERIALS AND METHODS: After autoclaving, a total of 120 used healing abutments were divided equally into three groups: used healing abutments after autoclaving only (group 1); used healing abutments after autoclaving and air-flow polishing (Master Piezon, EMS) using erythritol powder (AIR-FLOW PLUS, EMS) (group 2); and used healing abutments after autoclaving and sodium hypochlorite (NaOCl; 25 g/L) treatment (group 3). Residual contaminants were stained using Phloxine B (400 g/mL), and healing abutments were photographed using a light microscope with digital capture system (Nikon SMZ800). The proportion of stained (ie, contaminated) areas on each healing abutment was then measured using imaging software (ImageJ). The healing abutments were also examined using scanning electron microscopy (SEM). RESULTS: Mean proportion of surface area affected by residual contaminants on the body, top (screwdriver-engaging), and bottom (implant-abutment interface) surfaces for group 1 was 38.2% ± 28.34%, 30.0% ± 19.55%, and 18.7% ± 17.87%, respectively; group 2 showed 3.5% ± 4.90%, 5.3% ± 3.74%, and 5.4% ± 8.49%, respectively; and group 3 showed 0.3% ± 0.16%, 1.9% ± 2.14%, and 0.7% ± 1.02%, respectively. Autoclaving alone was insufficient for successful decontamination, while additional decontamination procedures significantly reduced remaining contaminants. NaOCl was significantly more effective than air polishing. SEM analysis showed no detectable differences in the surface appearance of titanium healing abutments. CONCLUSION: The results show that decontamination of used healing abutments is achievable, thus strengthening the feasibility of reusing healing abutments.

Mechanical properties of the human scalp in tension.

Mechanical properties of the human scalp have not been investigated to a great extent with limited information available. The purpose of this study was to provide new baseline material data for human scalp tissue of various ages, which can be applied to experimental and constitutive models, such as in the area of impact biomechanics. This study used specimens from the left and right temporal, fronto-parietal and occipital regions of the human scalp. It investigated the tensile behavior of scalp tissue using tissues harvested from unfixed, fresh cadavers. These samples were subjected to an osmotic stress analysis and upon testing, cyclic loading followed by stretching until failure in a universal testing machine. Strain evaluation was conducted using digital image correlation in a highly standardized approach. Elastic modulus, tensile strength, strain at maximum load and strain to failure were evaluated computationally. No significant differences were observed comparing the tensile strength between males and females. In contrast to that, a sex-dependent difference was found for the elastic modulus of the occipital scalp region and for the elongation properties. Additionally, regional differences within the male group, as well as an age dependent correlation for females were found in the elastic modulus and tensile strength. Scanning electron microscope analyses have shown the ultrastructural failure patterns, indicated by damaged keratin plates, as well as partially disrupted and retraced collagens at the failure site. The novel data obtained in this study could add valuable information to be used for modeling purposes, as well as provide baseline data for simulant materials and comparisons of tissue properties following head injury or forensic investigations.

Elastic behavior of brain simulants in comparison to porcine brain at different loading velocities.

Blunt force impacts to the head and the resulting internal force transmission to the brain and other cranial tissue are difficult to measure. To model blunt force impact scenarios, the compressive properties resembling tissue elasticity are of importance. Therefore, this study investigated and compared the elastic behavior of gelatin, alginate, agar/glycerol and agar/glycerol/water simulant materials to that of porcine brain in a fresh and unfixed condition. Specimens, 10 × 10 × 10mm3, were fabricated and tested at 22°C, apart from gelatin which was conditioned to 4°C prior to testing. For comparison, fresh porcine brains were sourced and prepared to the same dimensions as the simulants. Specimens underwent compression tests at crosshead displacement rates of 2.5, 10 and 16mms-1 (equivalent to strain rates of 0.25, 1 and 1.6s-1), obtaining apparent elastic moduli values at different strain rate intervals (0-0.2, 0.2-0.4 and 0.4-0.5). The results of this study indicate that overall all simulant materials had an apparent elastic moduli similar in magnitude across all strain ranges compared to brain, even though comparatively higher, especially the apparent elastic moduli values of alginate. In conclusion, while agar/glycerol/water and agar/glycerol had similar apparent elastic moduli in magnitude and the closest apparent elastic moduli in the initial strain range (E1), gelatin showed the most similar values to fresh porcine brain at the transitional (E2) and higher strain range (E3). The simulant materials and the fresh porcine brain exhibited strain rate dependent behavior, with increasing elastic moduli upon increasing loading velocities.

Surface Characteristics and Biofilm Development on Selected Dental Ceramic Materials.

BACKGROUND: Intraoral adjustment and polishing of dental ceramics often affect their surface characteristics, promoting increased roughness and consequent biofilm growth. This study correlated surface roughness to biofilm development with four commercially available ceramic materials. METHODS: Four ceramic materials (Vita Enamic®, Lava™ Ultimate, Vitablocs Mark II, and Wieland Reflex®) were prepared as per manufacturer instructions. Seventeen specimens of each material were adjusted and polished to simulate clinical intraoral procedures and another seventeen remained unaltered. Specimens were analysed by SEM imaging, confocal microscopy, and crystal violet assay. RESULTS: SEM images showed more irregular surface topography in adjusted specimens than their respective controls. Surface roughness (Ra ) values were greater in all materials following adjustments. All adjusted materials with the exception of Vitablocs Mark II promoted significantly greater biofilm growth relative to controls. CONCLUSION: Simulated intraoral polishing methods resulted in greater surface roughness and increased biofilm accumulation.

Investigation of the elastic modulus, tensile and flexural strength of five skull simulant materials for impact testing of a forensic skin/skull/brain model.

Conducting in vitro research for forensic, impact and injury simulation modelling generally involves the use of a skull simulant with mechanical properties similar to those found in the human skull. For this study epoxy resin, fibre filled epoxy resin, 3D-printing filaments (PETG, PLA) and self-cure acrylic denture base resin were used to fabricate the specimens (n=20 per material group), according to ISO 527-2 IBB and ISO20795-1. Tensile and flexural testing in a universal testing machine was used to measure their tensile/flexural elastic modulus and strength. The results showed that the epoxy resin and fibre filled epoxy resin had similar tensile elastic moduli (no statistical significant difference) with lower values observed for the other materials. The fibre filled epoxy resin had a considerably higher flexural elastic modulus and strength, possibly attributed to the presence of fibres. Of the simulants tested, epoxy resin had an elastic modulus and flexural strength close to that of mean human skull values reported in the literature, and thus can be considered as a suitable skull simulant for a skin/skull/brain model for lower impact forces that do not exceed the fracture stress. For higher impact forces a 3D printing filament (PLA) may be a more suitable skull simulant material, due to its closer match to fracture stresses found in human skull bone. Influencing factors were also anisotropy, heterogeneity and viscoelasticity of human skull bone and simulant specimens.

Additive Technology: Update on Current Materials and Applications in Dentistry.

Additive manufacturing or 3D printing is becoming an alternative to subtractive manufacturing or milling in the area of computer-aided manufacturing. Research on material for use in additive manufacturing is ongoing, and a wide variety of materials are being used or developed for use in dentistry. Some materials, however, such as cobalt chromium, still lack sufficient research to allow definite conclusions about the suitability of their use in clinical dental practice. Despite this, due to the wide variety of machines that use additive manufacturing, there is much more flexibility in the build material and geometry when building structures compared with subtractive manufacturing. Overall additive manufacturing produces little material waste and is energy efficient when compared to subtractive manufacturing, due to passivity and the additive layering nature of the build process. Such features make the technique suitable to be used with fabricating structures out of hard to handle materials such as cobalt chromium. The main limitations of this technology include the appearance of steps due to layering of material and difficulty in fabricating certain material generally used in dentistry for use in 3D printing such as ceramics. The current pace of technological development, however, promises exciting possibilities.

Use of agar/glycerol and agar/glycerol/water as a translucent brain simulant for ballistic testing.

The suitability of agar/glycerol/water and agar/glycerol mixtures as brain simulants was investigated. Test specimens (n=15) (50x27×37mm) were fabricated for these different mixtures and conditioned to 12°C, 22°C, and 26°C prior to testing. For comparison, fresh deer brain specimens (n=20) were sourced and prepared to the same dimensions as the agar/glycerol(/water) mixtures and conditioned to 12°C and 37°C. High impact tests were carried out with a 0.22-caliber air rifle pellet and a high-speed camera was used to record the projectile as it passed through the specimens, allowing for energy loss and vertical displacement velocity calculation. Although the agar/glycerol/water mixture presented with similar vertical expansion and contraction of the specimens to the warm and cold deer brains, a two-fold decrease of the vertical expansion and contraction was noticed with the agar/glycerol specimens. Also considerably less extrusion of this mixture out of the exit and entry sides after specimen penetration was observed. Of the simulants tested, agar/glycerol/water was the most suitable brain simulant for ballistic testing and impact studies.

Porcelain bonding to novel Co-Cr alloys: Influence of interfacial reactions on phase stability, plasticity and adhesion.

OBJECTIVE: The objective of the present study was to determine the hardness and adhesion strength at the porcelain to alloy interface. METHODS: 15 bi-layer porcelain veneered Co-Cr specimens of each alloy group [cast, powder metallurgy (PM), CAD/CAM(CC)] were manufactured. 12 bi-layered specimens were tested using four-point bend strain energy release rate adhesion test. One before and after porcelain firing specimen of each alloy group were nano-indented at the bulk and metal-porcelain interface to determine the mechanical properties. Electron backscatter diffraction was used to determine the microstructure and phase of the indented areas. RESULTS: The results obtained from the four-point bend strain energy release rate test indicated highest adhesion energy of 92.15J/m2 observed in the CC produced Co-Cr alloy. This was followed by the PM alloy with an adhesion energy of 62.24J/m2 and cast alloy with an adhesion energy of 42.83J/m2. All comparisons of adhesion energy between the three alloys were found to be statistically significant (p<.05). Nano-indentation test indicated higher hardness values of 4.6-6.1GPa at the metal-porcelain interface compared to the bulk, which had hardness values of 3.1-3.9GPa. SIGNIFICANCE: The adhesion of the alloy to porcelain was found to be inversely related to the hardness of the interfacial layer at the alloy surface. Lower interfacial hardness was found to be accompanied with higher adhesion energy due to the additional plastic energy consumed during crack propagation along the more ductile interface region of the alloy.

Maxillary Three-Implant Overdentures Opposing Mandibular Two-Implant Overdentures: 10-Year Prosthodontic Outcomes.

PURPOSE: This study aimed to evaluate the 10-year prosthodontic outcomes with splinted and unsplinted designs for maxillary overdentures on three implants opposing mandibular two-implant overdentures. MATERIALS AND METHODS: Using two similar implant systems, 40 edentulous participants with existing mandibular two-implant overdentures were randomly allocated to two prosthodontic treatment groups (splinted design with bar units; unsplinted design with ball attachments). Participants had three narrow-diameter implants placed in their edentulous maxillae using a one-stage surgical procedure, and they were conventionally loaded with overdentures. Prosthodontic maintenance events were documented at 1-, 2-, 5-, 7-, and 10-year recalls. RESULTS: Progressive attrition of the cohort resulted in 36 participants being seen for the 1-year recall, 31 participants for the 2-year recall, 30 participants for the 3-year recall, 28 participants for the 5-year recall, 26 participants for the 7-year recall, and 23 participants (nearly 60%) for the 10-year recall. Data showed no significant differences in prosthodontic maintenance or success associated with patrices, matrices, or other aspects of the overdentures using the different attachment systems and designs. CONCLUSION: Maxillary three-implant overdentures are a viable treatment option for edentulous patients wearing opposing mandibular two-implant overdentures. There were no differences in prosthodontic maintenance and success between the splinted (bar) and unsplinted (ball) designs.

Biomechanical investigation of impact induced rib fractures of a porcine infant surrogate model.

This study investigated the structural, biomechanical and fractographic features of rib fractures in a piglet model, to test the hypothesis that fist impact, apart from thoracic squeezing, may result in lateral costal fractures as observed in abused infants. A mechanical fist with an accelerometer was constructed and fixed to a custom jig. Twenty stillborn piglets in the supine position were impacted on the thoracic cage. The resultant force versus time curves from the accelerometer data showed a number of steps indicative of rib fracture. The correlation between impact force and number of fractures was statistically significant (Pearson׳s r=0.528). Of the fractures visualized, 15 completely pierced the parietal pleura of the thoracic wall, and 5 had butterfly fracture patterning. Scanning electron microscopy showed complete bone fractures, at the zone of impact, were normal to the axis of the ribs. Incomplete vertical fractures, with bifurcation, occurred on the periphery of the contact zone. This work suggests the mechanism of rib failure during a fist impact is typical of the transverse fracture pattern in the anterolateral region associated with cases of non-accidental rib injury. The impact events investigated have a velocity of ~2-3m/s, approximately 2×10(4) times faster than previous quasi-static axial and bending tests. While squeezing the infantile may induce buckle fractures in the anterior as well as posterior region of the highly flexible bones, a fist punch impact event may result in anterolateral transverse fractures. Hence, these findings suggest that the presence of anterolateral rib fractures may result from impact rather than manual compression.

Investigation of dental alginate and agar impression materials as a brain simulant for ballistic testing.

Routine forensic research into in vitro skin/skull/brain ballistic blood backspatter behavior has traditionally used gelatin at a 1:10 Water:Powder (W:P) ratio by volume as a brain simulant. A limitation of gelatin is its high elasticity compared to brain tissue. Therefore this study investigated the use of dental alginate and agar impression materials as a brain simulant for ballistic testing. Fresh deer brain, alginate (W:P ratio 91.5:8.5) and agar (W:P ratio 81:19) specimens (n=10) (11×22×33mm) were placed in transparent Perspex boxes of the same internal dimensions prior to shooting with a 0.22inch caliber high velocity air gun. Quantitative analysis to establish kinetic energy loss, vertical displacement elastic behavior and qualitative analysis to establish elasticity behavior was done via high-speed camera footage (SA5, Photron, Japan) using Photron Fastcam Viewer software (Version 3.5.1, Photron, Japan) and visual observation. Damage mechanisms and behavior were qualitatively established by observation of the materials during and after shooting. The qualitative analysis found that of the two simulant materials tested, agar behaved more like brain in terms of damage and showed similar mechanical response to brain during the passage of the projectile, in terms of energy absorption and vertical velocity displacement. In conclusion agar showed a mechanical and subsequent damage response that was similar to brain compared to alginate.