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アメリカ口腔インプラント学会

アメリカ口腔インプラント学会に行ってきました。

Table Clinics

Table Clinics

Table Clinics will be offered during the 60-minute refreshment break on the afternoon of Friday, October 25.

Descriptive Title
The usefulness of  porcelain for titanium in making the implant superstructure.

Keiji Kasai,DDS    JAPAN

 

 

As for a case of the edentulous of the lower jaw, I report a case that I make the frame of the implant superstructure by producing titanium alloy in CAD/CAM and bonded porcelain for titanium to the surface. The frame of the implant superstructure body has been produced by casting the metal conventionally.

After that, I stuck porcelain and composite resin on the surface to secure the sensuousness. It is very difficult to produce the big framework of the full mouse with the high precision by casting and the expert skill of the dental technician is demanded. In addition, it is getting difficult to use a gold alloy as a dental material because of the recent steep rise in gold prices. Therefore, the material which takes the place of gold is demanded. Thanks to the evolution of cad/cam, we can make the framework of the superstructure body easier and more precise than before by using the materials such as titanium, cobalt-chromium alloy and zirconia I have been used a method to bond composite resin to the surface of the metal frame frequently, but it was necessary to wash and stretch the composite resin surface regularly because of deterioration after several years. To solve these problems, I made a superstructure body using porcelain for titanium on the surface of the titanium frame. I will consider the making method of the implant superstructure from a production aspect / precision side / cost side / maintenance side through this case.

 

 

I process titanium alloy in CAD/CAM and, in the case of the edentulous jaw of the lower jaw, make the frame of the implant superstructure and report one case that bonded porcelain for titanium to the surface.

The frame of the implant superstructure body has been produced conventionally by casting metal. I stuck porcelain and composite resin on the surface, and securing of sensuousness has been accomplished afterwards.

The big framework of the full mouse

It is very difficult to produce it with high precision by casting, and the expert skill of the dental technician is demanded.

In addition, the material which replaces this because it becomes difficult to use a gold alloy as dental material is demanded from the remarkable rise of the price of recent money.

In late years it was easy and highly precise conventionally and came to be able to make the framework of the superstructure body using material such as titanium and cobalt-chromium alloy and zirconia by evolution of cad/cam.

I used a method to bond composite resin to the surface of the metal frame frequently, but deterioration is seen when I use it in the oral cavity for several years, and washing and stretching of the regularly surface composite resin is necessary.

I made a superstructure body using porcelain for titanium on the surface of the frame of titanium to solve these problems.

I consider the making method of the implant superstructure through this case from a production aspect / precision side / cost side / maintenance side.

 

 

When producing an implant superstructure, I select the material of the abutment considering portion for prosthetic and number of teeth prosthesis.

And I select how to retain the abutment.

When deciding the material of the implant superstructure, I consider the precision, aesthetics, strength, biocompatibility, and economic.

 

 

Descriptive Title
The usefulness of  porcelain for titanium
in making the implant superstructure.

 

Introduction

•I report a edentulous case that I make the frame of the implant superstructure by producing titanium alloy in CAD/CAM and bonded porcelain for titanium to the surface.

 

 

The usefulness of  porcelain for titanium
in making the implant superstructure.

 

•-Introduction

•The frame of the implant superstructure body has been produced by casting the metal conventionally.

•After that, I stuck porcelain or bonded composite resin on the surface to secure the sensuousness.

•It is very difficult to produce the big framework of the full mouse with the high precision by casting.

•The expert skill of the dental technician is demanded.

 

 

Gold price trends

In addition, it is getting difficult to use a gold alloy as a dental material because of the recent steep rise in gold prices.

 

 

New material of frame

•Therefore, the material which takes the place of gold is demanded.

•Currently, material as an alternative to gold alloy is titanium / zirconia/ cobalt chromium.

 

Material as an alternative to gold alloy

 

Thanks to the evolution of cad/cam, we can make the framework of the superstructure body easier and more precise than before by using the materials such as titanium, cobalt-chromium alloy and zirconia I have been used a method to bond composite resin to the surface of the metal frame frequently, but it was necessary to wash and stretch the composite resin surface regularly because of deterioration after several years. To solve these problems, I made a superstructure body using porcelain for titanium on the surface of the titanium frame. I will consider the making method of the implant superstructure from a production aspect / precision side / cost side / maintenance side through this case.

 

 

The material of lining

•It is necessary to consider in what to do lining for the frame further

 

 

Summary

•Thanks to the evolution of cad/cam, we can make the framework of the superstructure body easier and more precise than before by using the materials such as titanium, cobalt-chromium alloy and zirconia .

•I have been used a method to bond composite resin to the surface of the metal frame frequently, but it was necessary to wash and stretch the composite resin surface regularly because of deterioration after several years.

•To solve these problems, I made a superstructure body using porcelain for titanium on the surface of the titanium frame.

•I will consider the making method of the implant superstructure from a production aspect / precision side / cost side / maintenance side through this case.

 

 

Material selection

•Titanium / cobalt chrome / hybrid resin and the like as the material of the frame

 

 

Material selection

•Ceramic / metal / resin can be cited as a material for lining

 

 

Material and methods

•porcelain for titanium

•Titanium bonder

•CAD/CAM abutment and framework

 

Using titanium bonder before firing the porcelain for titanium against titanium frame time.

 

 

Ability of titanium bonder

Where KLEMA Dentalprodukte GmbH titanium bonder manufacturer makes a destructive test, baking strength when using titanium bonder indicates the value of the average 41.8MPa> 25MPa.

Further, the ceramic remains in the surface crown with titanium bonder, which was the state of cohesive failure.

 

State that destroyed titanium ceramic with titanium bonder. It was in the state of cohesive failure that ceramic remaining on the surface.

 (KLEMA Dentalprodukte GmbH offer)

 

 

Single crown

Abutment = Custom abutment

Ten years ago, I retained  the crown on cast abutment using temporary cement.

 

 

Loosen screws

 

However, loosen screws occured from time to time, Re-tightenning the screw with the removal of the crown was very difficult indeed.

Sometimes, it needed to destroy the crown for removal. Therefore, I choose the technique of hand-fixed screw retain for the built-in superstructure utilizing cast abutment.

 

 

Now that I used the same way by performing segmentation in cases edentulous,I fabricated metal frame by casting abutment.

 

 

Fixture fracture

However, in some cases using the cast abutment, I noticed that the slack of the screw occurred and then experienced fracture of fixture several years later.

 

 

Cause of the fixture fracture

•I have experienced implant treatment of more than 1,000 so far.

•No case using the ready-made titanium abutments made caused the fixture fracture.

• Common feature of fixture fracture case was the use of cast abutments.

•I have experienced implant treatment of more than 1,000 so far.

•No case using the ready-made titanium abutments made caused the fixture fracture.

• Common feature of fixture fracture case was the use of cast abutments.

 

 

 

It is thought that the slack of the screw is caused by the non-conformity by the casting defect or transformation at the time of the casting of the cast abutment.


So, I fixed all ceramic crowns with cement on a ready-made titanium abutment.

 

 

Remaining of the surplus cement

•There was a problem with cement retain.

•Ording to the report, the remainder rate of the cement is very high.

 

 

TiDesign+Multilink Implant+ e.max

•Prevent removal of remnants cement

•Removable

•Aesthetic

•Durability

•Cleanability

I use technique to cement the product made in e max castable ceramic crown which gave an access hall on a product made in ready-made titanium abutment in a laboratory side frequently more now to acquire the merit of screw retain and cement retain both sides.
A problem such as the slack of the screw decreased sharply after I came to use this technique.

In addition, many problems such as porcelain fracture which became the problem when I layer porcelain for a cast abutment, metal charges, plaque adhesion for the cast abutment, the cleansability of the custom abutment were improved.

 

 

•I use technique to cement the product made in e max castable ceramic crown which gave an access hall on a product made in ready-made titanium abutment in a laboratory side frequently more now to acquire the merit of screw retain and cement retain both sides.
A problem such as the slack of the screw decreased sharply after I came to use this technique.


 

 

Material cost

•Precious metal  5,000yen〜6,500yen

•Semi Precious metal  4,000yen〜5,500yen

•Gold alloy  4,000yen〜5,500yen

•Gold and silver palladium alloy  900yen〜1,000yen

•Cobalt-chromium alloy CAD/CAM  80yen〜120yen

•Titanium alloy CAD/CAM  50yen〜90yen

•Zirconia CAD/CAM  ?yen

 

 

The material selection in Edentulous 〜Segment of Two or More

Cr & Br, with gum or without gum

Control of power

Stability of occlusion

Braxism-clenching

Maintenance (repair)

 

 

Screw retain type

CAD / CAM Titanium frame / Hybrid resin Advantage

You can respond to trouble after setting

Fit is hard distortion good

We do not have to worry about the desorption

 lightweight

 

 

 In the prosthetic implant of edentulous , that implant bridge of the screw fixed is selected in anticipation of maintenance / repair in the future in many cases.

 

 

Ceramic or hybrid resin is used as a lining material in that case .

Since the deposition of plaque and discoloration is remarkable , I do not want to be first choice hybrid resin .

Ceramic less susceptible alkali or acid, and water in the oral cavity , chemical stability is good , removal is relatively easy even coloring .

Porcelain baking type a translation increases the adaptive case the most , as a problem , frame becomes large edentulous cases , the casting process of the conventional casting mistakes and the generation of gas by the nest , strength reduction due to brazing cast it and that, surface There are problems such as the deflection of the frame by firing and often error of porcelain build-up at the time .

 

 

If milling by CAD / CAM, it is possible to build-up the porcelain directly to the titanium frame is superior in fit accuracy.

The ability to build-up to the frame there is no joint by brazing without casting defects and distortion due to casting , the problem was solved .

As a countermeasure agains Braxiser like , in order to prevent a fracture , it is then milled until the occlusal surface and facing titanium porcelain only buccal side is also possible for large molars .

The prosthesis design in esthetic zone is where zirconia is the first choice , it is not necessarily the case when considering the strength .

 

 

Compensation of parallelism

In edenturous case to connect all abutments, parallelism of the fixture is required.

When using the fixtures Astra Tech implant, the use of UniAbutment is one way of correcting the parallelism of the fixture.

 

When I connect all abutments in the case of the full mouse, Compensation of parallelism is required.

 

When I use Astra tech implant, the use of the uni-abutment is representative method to compensate the parallellism.

 

 

GC porcelain for titanium to AISUS titanium frame

Implant bridge made of titanium that is milled with CAD / CAM

and porcelain for titanium as lining material

 

 

Another reason to use uni abutment

When I burn porcellain for titunium to a titanium frame, titanium is easy to oxidize and forms an oxidation film on the surface contacting with a uni-abutment.

A microgap may be formed by removing the oxidation film by sandblast.

Thus, I aim at existing the junction between an abutment and the titanium frame above margin.

 

 

Hybrid resin or artificial teeth had been used before for covering titanium frame .

Problems of artificial teeth

Attrition of artificial teeth is so remarkable, and a re-arrangement on a regular basis is required.

Problems of hybrid resin

Dullness of resin, coloring, adhesion of plaque is remarkable

 

 

 Affinity for oxygen is very strong, metallic titanium high temperature easily oxidized very. However, this characteristic shows oxide film and stable (passivation film), and the corrosion resistance is excellent at room temperature.

 

 

•Adhesion of the oxide film by firing noticeable than the precious metals from the properties of titanium, fit accuracy is a concern.

 

 

Final restration

I could be produced more easily than conventional prosthesis with high aesthetics and precision strength and excellent corrosion resistance high.

 

 

Conclusion

Implant bridge made of titanium that is milled with CAD / CAM had been produced in Japan for several years, but the hybrid resin was popular as lining material.

Combinations of porcelain for titanium and titanium frame, made​it possible precision, high biocompatibility, high corrosion resistance, high aesthetic, the stable cost.

In future, improvement of the intensity of the surface would be required.

 

 

Future material

I considered the risk of fracture, the risk of wear of the abutment or fixture for zirconia abutments

 

 

Bibliography

•Titanium for porcelain as "initial Ti”Is CAD / CAM titanium frame likely to bring to the prosthesis design

    Dental bio vision  takahiro tsuji


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