Failure modes with point loading of three commercially available denture teeth.

PURPOSE: A common problem associated with implant-supported prostheses is the fracture of denture teeth. This study was designed to compare the fracture modes of three denture teeth by compressive load at a 30 degrees off-axis angle. MATERIAL AND METHODS: Three denture teeth (Vident Duostat, Ivoclar Vivadent, and Dentsply Trubyte) processed to two denture base processing systems [injection-molded (IM) SR-Ivocap system and compression-molded (CM) denture base resin] were evaluated. Each specimen was processed to a metal framework. Ultimate failure strength of each system when point loaded at a 30 degrees off-axis angle was recorded, along with a visual inspection of each specimen. RESULTS: The average load fracture for each group was (in N): Vident CM 1106.97 +/- 223.20, Vident IM 1168.18 +/- 322.52, Dentsply CM 1098.08 +/- 286.32, Dentsply IM 1023.80 +/- 282.45, Ivoclar CM 1616.98 +/- 204.87, and Ivoclar IM 1373.54 +/- 282.58. There was a significant difference between the groups and the Ivoclar CM group. The Ivoclar CM group had the highest average load force, and the Dentsply IM group had the lowest average load force. On average, the teeth within the groups fractured at a higher compression force than the average maximum occlusal force in natural dentition. Dentsply and Vident denture teeth fractured more horizontally, and the Ivoclar denture teeth fractured more vertically within the groups. There was no significant difference among the groups between the IM and CM processing methods. CONCLUSIONS: In the present in vitro study, all specimens were able to withstand 30 degrees off-axis loading with the exception of one specimen. With these results, this would indicate that these denture teeth are able to withstand normal occlusal forces.

Osseointegration of dental implants complexed with rhBMP-2: a comparative histomorphometric and radiographic evaluation.

PURPOSE: To evaluate the effect of rhBMP-2 on implant osseointegration using histomorphometric and radiographic imaging analyses and determine the diagnostic accuracy of periapical radiographs regarding clinical bone-implant contact levels. MATERIALS AND METHODS: Hollow-cylinder implants were filled with an absorbable collagen sponge soaked with recombinant human bone morphogenetic protein-2 (rhBMP-2) or left empty and implanted in the mandibles of dogs. Animals were followed for 2, 4, 8, or 12 weeks. At the end of each time interval, the animals were sacrificed and specimens were collected for histomorphometric and radiographic evaluation of the bone-implant contact levels. RESULTS: Both groups exhibited the same mean histologic bone-implant contact on the outer surface of the implant, except for the 4-week group. The radiographic evaluation of bone-implant contact overestimated the actual osseointegration levels by at least 30%, a significant amount. DISCUSSION: The osteoinductive and regenerative potential of rhBMP-2 is of clinical benefit in cases where bone augmentation is indicated and improved levels of osseointegration are expected. Radiographic evaluation has been the most widely employed technique in clinical practice for assessing bone levels around dental implants and comparing changes over time. However, there is a limit to the diagnostic accuracy of conventional radiographs when compared to the data obtained by histologic analysis. CONCLUSION: Application of rhBMP-2 within the confined boundaries of the hollow chamber of the implant had a limited effect on the osseointegration level along its outer surface, perhaps because of physically restricted diffusion. Radiographic evaluation resulted in the overestimation of bone-implant contact, and poor correlation with the histomorphometric data was found.

Fracture resistance of three all-ceramic restorative systems for posterior applications.

STATEMENT OF PROBLEM: The failure loads of all-ceramic crowns are influenced not only by the fracture resistance of the component materials but also by prosthesis geometry and size and location of flaws, thus there is a need for a study that compares the fracture resistance of all-ceramic systems using a simple and reproducible specimen geometry that includes flaws occurring at material interfaces. PURPOSE: The research aim was to compare the in vitro fracture resistance and origin of failure of simulated first molar crowns fabricated using 3 all-ceramic systems, IPS Empress 2, Procera AllCeram, and In-Ceram Zirconia. MATERIAL AND METHODS: Twenty axisymmetric crowns of each system were fabricated to fit a preparation with 1.5- to 2.0-mm occlusal reduction. The center of the occlusal surface on each of 15 specimens per ceramic system was axially loaded to fracture in a universal testing machine, and the maximum load (N) was recorded. Fractured surfaces were examined using optical and electron microscopy to determine the most prevalent origin of failure in each ceramic system. Five crowns per system were sectioned, and thickness of the luting agent, core material, and veneer porcelain layers were measured. The 95% confidence intervals of the Weibull modulus and characteristic failure load were compared between the 3 systems. Two-way multivariate analysis of variance was used to analyze the thickness of the luting agent, ceramic core, and veneer porcelain layers (alpha=.05). RESULTS: The 95% confidence intervals for Weibull modulus were 1.8 to 2.3 (IPS Empress 2), 2.8 to 3.6 (Procera AllCeram), and 3.9 to 4.9 (In-Ceram Zirconia). The 95% confidence intervals for characteristic failure load were 771 to 1115 N (IPS Empress 2), 859 to 1086 N (Procera AllCeram), and 998 to 1183 (In-Ceram Zirconia). The origin of failure was most commonly found at the interface between the ceramic core and veneer porcelain for IPS Empress 2 and between the ceramic core and luting agent layer for the other systems. CONCLUSIONS: There was no significant difference in fracture resistance; however, there was a significant difference in failure origin between the all-ceramic systems studied.

Evaluation of the ITI Morse taper implant/abutment design with an internal modification.

PURPOSE: The purpose of this study was to compare internal Morse taper connections in 2 separate modes: repeated torque/reverse-torque values and compressive bending at a 30-degree off-axis angle. MATERIALS AND METHODS: Three sample groups (n = 12 in each group)--a solid-screw implant paired with a 5.5-mm solid abutment (SSI), a synOcta implant with a 5.5-mm solid abutment (SOI), and a synOcta implant with a synOcta 5.5-mm solid abutment (SOSA)--were torqued to 35 Ncm, and the reverse torque to remove the abutment was recorded. This was repeated for 3 trials. Additionally, the sample groups were loaded 30 degrees off-axis, and the ultimate compressive values were recorded. RESULTS: There was a significant difference in the initial reverse-torque values. The SOSA setup showed significantly lower torque than the SOI and SSI setups (P < .05). In addition, the compressive bending test showed that the SOSA setup was significantly different (P < .05) from the SSI and SOI setups. Radiographic survey of the test groups following compressive bending revealed no implant fractures, but bending of the implant-abutment complex occurred. DISCUSSION: The alteration within the Morse taper did not reduce the strength of the implant-abutment connection, ie, the reduction in surface area did not significantly reduce the torque properties or tensile properties. The new 2-piece synOcta 5.5-mm solid abutment was shown to have a stronger implant-abutment connection when torqued down a second time. CONCLUSIONS: In this in vitro study, alteration of the Morse taper with an internal octagon indexing did not significantly reduce the strength of the implant connection. Sufficient strength was exhibited, which would indicate this implant-abutment design for anterior as well as posterior edentulous sites.

Effects of bur abrasive particle size and abutment composition on preparation of ceramic implant abutments.

STATEMENT OF PROBLEM: Amid increasing use of preparable ceramic implant abutments, there is a lack of quantitative data to show which abrasive particle size of diamond bur yields the fastest reduction and provides the smoothest surface. PURPOSE: The research aim was to determine the effects of diamond bur abrasive particle size and abutment material composition on preparation efficiency, prepared surface roughness, and surface deterioration of diamond burs. MATERIAL AND METHODS: Fifteen alumina (Cera Base) and 15 zirconia (ZiReal) implant abutments were each machined using a high-speed hand piece with a diamond bur having 1 of 3 abrasive particle sizes (150, 100, or 30 microm) (n=5). Control abutments (n=5) were analyzed without machining. Abutments were weighed before starting and between machining cycles. Three profilometry measurements (root mean square surface roughness) were made for each abutment. Scanning electron micrographs were made of each bur. Lost abrasive particles were then counted on each micrograph through a randomly placed template. Two-way analysis of variance (alpha=0.05) was used to test for significant effects. RESULTS: Bur abrasive particle size and ceramic type had a significant interactive effect on the amount of material removed (P<.001). Super coarse (150 microm) burs yielded the roughest surfaces for each abutment material (P<.001), and prepared alumina surfaces were rougher than zirconia surfaces (P<.001). Super coarse burs showed the highest proportion of lost particles (P<.001). Abutment composition did not significantly affect bur wear. CONCLUSION: Super coarse burs yielded the most efficient material removal for alumina abutments. All abrasive particle sizes removed a similar amount of material from zirconia abutments. Fine-grained alumina abutments experienced greater material removal and rougher prepared surfaces compared with zirconia abutments. Material was removed by an intergranular fracture mechanism for alumina abutments, in contrast to transgranular fracture for zirconia abutments.

Effects of interfacial variables on ceramic adherence to cast and machined commercially pure titanium.

STATEMENT OF THE PROBLEM: Titanium-ceramic bonding is less optimal than conventional metal-ceramic bonding, due to excessive oxidation of titanium during porcelain firing. PURPOSE: This in vitro study evaluated the effects of porcelain firing atmosphere and gold sputter coating on titanium surfaces on porcelain bonding to machined and as-cast titanium substrates. Material and methods Eight groups of ASTM grade 2 commercially pure (CP) titanium specimens (13 mm x13 mm x1 mm) were prepared (n=10). A conventional Au-Pd-In metal-ceramic alloy (Orion) and an ultra low-fusing porcelain (Finesse) served as the control (n=10). Forty machined titanium specimens were prepared from 1.00-mm thick titanium sheets with a diamond band saw. Forty titanium specimens were produced in a centrifugal dental titanium casting machine. All titanium specimens were airborne particle abraded with 110-microm alumina particles, whereas the control specimens were airborne particle abraded with 50-microm alumina particles. Forty titanium specimens (20 specimens each of as-cast and machined titanium) were randomly selected for gold sputter coating before ceramic firing. An ultra low-fusing porcelain (Vita Titankeramik) was fused on the central 6-mm diameter circular area on each titanium specimen. Porcelain firing environments for the titanium specimens consisted of vacuum and a reduced argon atmosphere. Porcelain was debonded by a biaxial flexure, constant strain test at a cross-head speed of 0.25 mm/min. Specimens were analyzed by standardized SEM/EDS analysis 3 times throughout the study to determine the silicon atomic percentage (Si at %): (1) after airborne particle abrasion, before porcelain application; (2) after the application of the first layer of porcelain; and (3) after the fracture of porcelain from the metal substrate. The titanium-ceramic adhesion was characterized by determining the area fraction of adherent porcelain (AFAP). Results were analyzed by analysis of variance and the Student-Newman-Keuls test (alpha=.05). RESULTS: Statistical analysis showed a significant difference in the AFAP values among all the groups. AFAP value of the control group was significantly higher (135.35 +/- 23.68) than those of the experimental groups (P<.001). For the machined titanium, AFAP value of gold sputter-coated/argon group (91.38 +/- 7.93) was significantly higher than the rest of the groups (P<.001). For the as-cast titanium fired in vacuum, significantly lower AFAP values (P<.001) were found in the gold sputter-coated group (50.2 +/- 11.26 vs 66.15 +/- 10.41). AFAP values between the argon groups with or without the gold coating were not significantly different (P=.303); however, both argon groups (93.83 +/- 4.65 and 98.09 +/- 6.35) showed significantly higher AFAP values compared with the vacuum groups (P<.001). CONCLUSION: Firing porcelain in a reduced argon atmosphere significantly improved titanium-ceramic bonding for machined and as-cast titanium. The sputter-coated gold layer on titanium provided improved titanium-ceramic bonding only when combined with firing porcelain in reduced argon atmosphere. When porcelain was fired in vacuum in the presence of the gold layer, the titanium-ceramic bonding was weakened in as-cast titanium and was not affected in machined titanium. Conventional noble metal-ceramic bonding was superior to titanium-ceramic bonding regardless of the interfacial variables examined in this study.

Implant materials, design, and surface topographies: their influence on osseointegration of dental implants.

The purpose of this review is to describe commonly used dental implants with reference to their material composition, design factors, and surface topographies. The review includes a discussion of the biological principle of osseointegration and how this process of bone-implant interaction is influenced by different implant materials, designs, and surface characteristics

Macro design morphology of endosseous dental implants.

STATEMENT OF PROBLEM: The identification of dental implant bodies in patients without available records is a considerable problem due to increased patient mobility and to the large number of implant systems with different designs. PURPOSE: The purpose of this study was to document the designs of selected implants to help clinicians identify these implants from their radiographic images. MATERIAL AND METHODS: More than 50 implant manufacturers were contacted and asked to provide implants with dimensions as close as possible to 3.75 mm (diameter) x 10 mm (length). Forty-four implants were donated, separated into threaded and non-threaded categories, and further sorted into tapered and non-tapered categories. The implants were examined visually, and features on the entire circumference and length of each implant were recorded and categorized as coronal, midbody, or apical. RESULTS: A series of tables describe the 44 implants according to coronal, midbody, and apical features. CONCLUSION: The results of this project offer dentists basic knowledge of the design of selected dental implants. Such knowledge can aid the radiographic identification of these implants.

Radiographic identification of nonthreaded endosseous dental implants.

STATEMENT OF PROBLEM: The identification of dental implant bodies in patients without available records is a considerable problem due to increased patient mobility and to the large number of implant systems with different designs. PURPOSE: The purpose of this study was to document features that would help dentists identify non-threaded implant bodies from their radiographic images. MATERIAL AND METHODS: More than 50 implant manufacturers were contacted and asked to provide implants with dimensions as close as possible to 3.75 mm (diameter) x 10 mm (length). Forty-four implants were donated, 16 of which were identified as non-threaded. Radiographs were made of these implants at 0 degrees, 30 degrees, 60 degrees, and 90 degrees horizontal rotation combined with -20 degrees, -10 degrees, 0 degrees, +10 degrees, and +20 degrees vertical inclination relative to the radiographic beam and film. A total of 20 images per implant were taken and examined to identify consistent, unique features that would aid in implant identification. At a 20 degrees vertical inclination, vital features of implants were distorted enough to be deemed unrecognizable. Therefore, only those observations made from radiographs between -10 degrees and +10 degrees vertical inclination were used for implant identification purposes. RESULTS: All implants could be recognized from radiographs made between -10 degrees and +10 degrees vertical inclination. A series of tables and flowcharts describe the implants according to their identifying features. CONCLUSION: Information from this study should help dentists identify non-threaded endosseous implants from their radiographic images.

Radiographic identification of threaded endosseous dental implants.

STATEMENT OF PROBLEM: The identification of dental implant bodies in patients without available records is a considerable problem due to increased patient mobility and to the large number of implant systems with different designs. PURPOSE: The purpose of this study was to document features that would help dentists identify threaded implant bodies from their radiographic images. MATERIAL AND METHODS: More than 50 implant manufacturers were contacted and asked to provide implants with dimensions as close as possible to 3.75 mm (diameter) x 10 mm (length). Forty-four implants were donated, 28 of which were identified as threaded. Radiographs were made of these implants at 0 degrees, 30 degrees, 60 degrees, and 90 degrees horizontal rotation combined with -20 degrees, -10 degrees, 0 degrees, +10 degrees, and +20 degrees vertical inclination relative to the radiographic beam and film. A total of 20 images per implant were taken and examined to identify consistent, unique features that would aid in implant identification. At a 20 degrees vertical inclination, vital features of implants were distorted enough to be deemed unrecognizable. Therefore, only those observations made from radiographs between -10 degrees and +10 degrees vertical inclination were used for implant identification purposes. RESULTS: All implants could be recognized from radiographs made between -10 degrees and +10 degrees vertical inclination. A series of tables and flowcharts describe the implants according to their identifying features. CONCLUSION: Information from this study should help dentists identify threaded endosseous implants from their radiographic images.