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PRESENTED BY-
SAPNA YADAV
PG 1st YEAR
DEPT. OF PROSTHODONTICS
INTRODUCTION
WHAT IS AN ALLOY?
YEAR EVENTS
Alloys are essentially crystalline in structure. The crystals that initially form then grow
towards each other until they touch. This is similar to how ice crystals form. At the point
where the crystals touch, the water is fully frozen. In the same way, the metallic crystals
grow as the alloy cools. The arrangement of the crystals depends on the size of the atoms
of the various constituent metals. If these are similar, then atoms of one constituent can
replace those of another. If one metal’s atoms are much smaller, they may be trapped
between the larger atoms, filling the interstitial space between the crystals.
The metals used in dental alloys may be divided into two categories: noble and base metals.
Examples of noble metals are gold, platinum, rhodium, ruthenium, iridium and osmium.
Such elements are good for dental use as they are resistant to corrosion in the hostile
environment of the mouth. From a chemistry perspective, silver is a noble metal but as far
as dentistry is concerned it is not considered so because it corrodes in the mouth. These
preceding elements are sometimes referred to as precious metals as they tend to be
expensive. This term can be confusing as it does not refer solely to cost and therefore
should be used carefully. Equally it does not mean noble as in noble elements, as silver and
palladium are not dental precious metals. The term is more descriptive of the physical
properties of the alloy. Nobility of the alloy depends on the sum of the amount of noble
elements contained in it. The American Dental Association has defined alloys as high noble,
noble and base metal alloys
Base metals refer to metals which are not noble, e.g. titanium, nickel,
copper, silver and zinc. These elements corrode more than noble alloys
but are alloyed with noble metals as they have a significant effect on
the properties of the alloy, such as increasing strength, decreasing
flexibility and increasing wear resistance of the alloy.
In dentistry, metals are subdivided into two major groups: noble metals and base metals
(see Figure 11-3). Noble metals are defined by their resistance to corrosion even under
extreme conditions that occur in the oral cavity. There are seven noble metals in the
periodic table, but only three are common in dental casting alloys: gold (periodic table
symbol Au), palladium (Pd), and platinum (Pt). Some metallurgists also consider silver (Ag)
a noble metal, but because of its tendency to corrode in the oral environment, silver is not
considered a noble metal in dentistry. Noble metals are expensive simply because they are
rare. For this reason, noble metals are traded as precious metals in commodities markets.
However, the term precious should not be used to describe dental metals or alloys as this
term indicates only costs on the free market. Furthermore, there are precious metals that
are not noble. The term noble is preferred because it describes an important physical
property of the metal or alloy.
In dentistry, base metals are metals that are not noble metals (see Figure 11-3). In dental
casting alloys, common base metals are titanium (Ti), nickel (Ni), copper (Cu), silver (Ag),
cobalt (Co), and zinc (Zn). Base metals often are mistakenly viewed as being “bad” metals.
In fact, base metals are required in alloys to ensure the strength, flexibility, and wear
resistance necessary for dental restorations. However, in pure form, base metals have a
greater tendency to corrode in the oral environment than noble metals. For this reason,
pure base metals are almost never used for dental restorations. One exception is titanium,
which is used in nearly pure form for endosseous implants (Chapter 15).
In dentistry, metals are subdivided into two
major groups: noble metals and base metals
(see Figure 11-3). Noble metals are defined by
their resistance to corrosion even under
extreme conditions that occur in the oral
cavity. There are seven noble metals in the
periodic table, but only three are common in
dental casting alloys: gold (periodic table
symbol Au), palladium (Pd), and platinum (Pt).
Some metallurgists also consider silver (Ag) a
noble metal, but because of its tendency to
corrode in the oral environment, silver is not
considered a noble metal in dentistry. Noble
metals are expensive simply because they are
rare. For this reason, noble metals are traded
as precious metals in commodities markets.
However, the term precious should not be
used to describe dental metals or alloys as this
term indicates only costs on the free market.
Furthermore, there are precious metals that
are not noble. The term noble is preferred
because it describes an important physical
property of the metal or alloy.
In dentistry, base metals are metals that are
not noble metals (see Figure 11-3). In dental
casting alloys, common base metals are
titanium (Ti), nickel (Ni), copper (Cu), silver
(Ag), cobalt (Co), and zinc (Zn). Base metals
often are mistakenly viewed as being “bad”
metals. In fact, base metals are required in
alloys to ensure the strength, flexibility, and
wear resistance necessary for dental
restorations. However, in pure form, base
metals have a greater tendency to corrode in
the oral environment than noble metals. For
this reason, pure base metals are almost never
used for dental restorations. One exception is
titanium, which is used in nearly pure form for
endosseous implants (Chapter 15).
Base metal alloys contain no gold, platinum or palladium. Their composition and properties
are specified in three ISO standards for alloys. ISO 6871 specifies composition limits and
requirements for dental base metal casting alloys used to construct removable dental
appliances. There are two parts to this standard reflecting the two main groups of materials
used, namely the Co/Cr alloys (part I) and the Ni/Cr alloys (part II). ISO 16744 specifies
requirements for base metal alloys used to construct fixed dental restorations. There is no
provision within this latter standard to further describe alloys according to composition
(except for limiting the quantity of hazardous metals) but greater emphasis is placed upon
classifying materials according to properties and aligning these properties to the four types
of casting gold alloys described in the previous chapter.
Properties
he properties of these alloys vary from one brand to another but typical values are listed in
ables 8.1 and 8.2. The ISO standards for both materials require a minimum of 0.2% proof stress
f 500 MPa and a minimum elongation after fracture of 3%. Hence an ability to withstand
ermanent deformation under stress and a reasonable ductility are deemed to be important
haracteristics of these alloys.
he Co/Cr and Ni/Cr alloys are very hard materials and although this makes the polishing of
astings a difficult process the final polished surface is very durable and resistant to scratching.
n addition, fine margins seem less likely to be lost during finishing of a base metal alloy.
o/Cr and Ni/Cr alloys have very good corrosion resistance by virtue of the passivating effect
see Section 2.7). The alloys are covered with a tenacious thin layer of chromic oxide which
rotects the bulk of the alloy from attack. Unlike chromium-plated metals, which lose their
orrosion resistance if the surface layer becomes scratched, these alloys are permanently
esistant to corrosion since the oxide layer immediately becomes replenished if the surface is
amaged.
able 8.2 Comparative properties of Ni/Cr alloys and type 3 casting gold alloys for cast
estorations.
CLASSIFICATION OF DENTAL ALLOYS
Dental alloys are classified mainly under 2 categories-
ACCORDING ACCORDING
TO
TO MECHANICAL
NOBILITY PROPERTY
Alloy Classification by Noble Metal Content
In 1984, the American Dental Association (ADA) proposed a simple classification for dental
casting alloys based on the content of noble metals. Three categories were described: high
noble (HN), noble (N), and predominantly base metal (PB). This classification is presented in
Table 16-1. Noble metals comprise a group of seven metals that are resistant to corrosion
and tarnish in the mouth. In order of increasing melting temperature, they include gold,
palladium, platinum, rhodium, ruthenium, iridium, and osmium. Only gold, palladium, and
platinum, which have the lowest melting temperatures of the seven noble metals, are
currently of major importance in dental casting alloys. The noble metals and silver are
sometimes called precious metals, referring to their high economic values, but the term
precious is not synonymous with noble. Silver is reactive in the oral cavity and is not
considered a noble metal.
Alloy Classification by Noble Metal Content—
American Dental Association (1984)
Alloy Type Total Noble Metal Content
High noble (HN) Must contain ≥40% Au and
≥60% by weight of noble metal elements*
Noble (N) Must contain ≥25% by weight of noble
metal elements
Predominantly base metal (PB) Contains
<25% by weight of noble metal elements
*Noble metal elements include Au, Pd, Pt, Rh,
Ru, Ir, and Os.
Alloy Classification by Mechanical Properties
Over the past few decades base metal alloys have been developed to the point where they
are superior to high noble and noble alloys in several respects, such as low cost and low
density, excellent strength, high stiffness, and stable oxide formation (which is required for
bonding to porcelain). The classification described in ADA specifications and ISO standards
has changed over time.
ADA Specification No. 5 formerly classified gold alloys as types 1 through 4, depending on
the content of gold, palladium, and platinum. The content of noble metals by weight ranges
from 83% (type 1) to 75% (type 4). Both the current ADA Specification No. 5 (1997) and ISO
Standard 1562 (2004) have classified four types of casting alloys using similar minimal yield
strength and percent elongation values for each type of alloy. The only difference is that the
ISO standard is specific for casting gold alloys whereas ADA Specification No. 5 covers all
Mechanical
alloys thatProperty
pass theRequirements Proposed
tests for toxicity in ISOTable
and tarnish. Draft16-2
International Standard 1562
lists the classification andfor
Casting Gold Alloys
mechanical (2002)described in ISO 1562.
properties
TypeDescriptor Yield Strength (MPa) Elongation (%) Examples of Applications
1 Low 80 18 Inlays
2 Medium 180 10 Inlays and onlays
3 Hard270 5 Onlays, thin cast backings, pontics, full crowns, saddles
4 Extra hard 360 3 Saddles, bars, claps, crowns, bridges, and partial denture
frameworks
The more recent ISO 22674 standard classifies metallic materials for fixed and removable
restorations and appliances into six types according to their mechanical properties without
referring to the composition of the alloys (Table 16-3). Although the properties for heat-treated
specimens are not given in the table, it is assumed that the specimens are bench-cooled.
Classification of Metallic Material for Dental Applications—ISO 22674 (2006)*
TypeYield Strength (MPa) Elongation (%) Examples of Applications
0* – – Single-tooth fixed restorations—e.g., small veneered one-surface inlays, veneered
crowns
1 80 18 Single-tooth fixed restorations, veneered or nonveneered one-surface inlays,
veneered crowns
2 180 10 For single-tooth fixed restorations—e.g., crowns or inlays without restriction on
the number of surfaces
3 270 5 For multiple-unit fixed restorations—e.g., bridges
4 360 2 For appliances with thin cross sections that are subjected to very high forces—
e.g., removable partial dentures, clasps, thin veneered crowns, wide-span bridges or bridges
with small cross sections, bars, attachments, implant retained superstructures
5 500 2 For thin removable partial dentures, parts with tin cross sections, clasps
*Metallic materials for metal-ceramic crowns produced by electroforming or sintering belong to
type 0.
Alloy Classification by Principal Elements
Alloys may be classified based on the principal or most abundant element (e.g., a
palladium-based alloy), or they may be named based on the two or three most
important elements (e.g., Pd-Ag, Co-Cr, or Ni-Cr-Be alloys). When an alloy is identified
according to the elements it contains, the components are listed in declining order of
composition, with the largest constituent first followed by the second largest
constituent. An exception to this rule is the identification of certain alloys by elements
that significantly affect physical properties, which represent potential biocompatibility
concerns, or both. For example, Ni-Cr-Mo-Be alloys are often designated as Ni-Cr-Be
alloys because of the contributions of beryllium to the control of castability and surface
oxidation at high temperatures and the relative toxicity potential of beryllium compared
with other metals. Alloy groups shown in Table 16-4 are identified by principal elements.
TABLE 16-4
Alloy Classification by Dental Applications
There are three categories of dental alloys designated by their applications, including all-
metal fixed prostheses, metal-ceramic prostheses, or removable partial dentures. Alloys for
all-metal prostheses are also used as substrates for resin-veneered metal prostheses. As
shown in Table 16-4, each type of alloy by noble metal content (HN, N, and PB) is available
in all three categories. High noble and noble alloys for metal-ceramic prostheses can be
used for all-metal prostheses, whereas those for all-metal restorations are rarely used for
metal-ceramic restorations. The reasons are as follows: (1) the alloys may not form thin,
stable oxides required for porcelain bonding; (2) their melting range may be too low to
resist deformation or melting at porcelain-firing temperatures; and (3) their thermal
contraction coefficients may not be close enough to those of commercial porcelains. The
introduction of ultralow-fusion high-expansion porcelains, which sinter below 850 °C, has
led to the use of some yellow-colored, high gold alloys that can be veneered with porcelain.
There is a group of high gold-containing alloys that are designated for both all-metal and
metal-ceramic applications.
Base metal alloys, on the other hand, are often marketed for both all-metal and metal-
ceramic prostheses because of their oxide formation at room temperature. In this chapter,
dental alloys are discussed by their applications.
ADA COUNCIL in March 2003 added Titanium alloys to
the classification-
Revised Classification System for Alloys for Fixed Prosthodontics
Classification Requirement
• White
• Composition-predominately silver & at least
25% Pd
• Pd provides tarnish resistance
• May or may not contain copper and small
amount of gold
• 70-72%Ag + 25%Pd = Type III Gold alloys
• 60%Ag + 25%Pd + 15%Cu = Type IV Gold alloys
Silver-Palladium Alloys
These alloys are white and predominantly silver in composition, but they contain at least 25%
of palladium to provide nobility and increase the tarnish resistance of the alloy. They may also
contain copper and a small amount of gold. Casting temperatures are in the range of those for
yellow gold alloys. The copper-free Ag-Pd alloys may have physical properties similar to those
of a type 3 gold alloy. With 15% or more copper, the alloy may have properties more like those
of a type 4 gold alloy. Despite reports of poor castability because of the lower density and
propensity of dissolving oxygen in the molten-state, Ag-Pd alloys can produce acceptable
castings when close attention is paid to precise control of the casting and mold temperatures.
The major limitation of Ag-Pd alloys in general and in the Ag-Pd-Cu alloys in particular is their
greater potential for tarnish and corrosion. The amount of corrosion expected during service is
negligible if the palladium content is greater than 25%.
By melting palladium and indium at the composition of 50% In and 50% Pd in atomic percent
(52% In and 48% Pd by weight), the alloy is copper colored but increasing the palladium
content causes the alloy to lose its reddish color and acquire a gold color. A minimum of 15%
by weight of Pd-In intermetallic compound is needed to maintain the yellowish color. A much
higher proportion of Pd-In intermetallic compound is used in commercial dental alloys (see
Table 16-5). The tarnish resistance of the alloys is especially dependent upon the composition
and the integrity of the casting. The colored phase of the Pd-In binary alloy system is hard and
brittle and is not a strenghener. Silver, copper, and/or gold can be added to increase the
ductility and improve the castability of the alloy for dental applications.
image Critical Questions
What is the role of chromium in predominantly base metal alloys? How does beryllium
improve the properties of nickel-based metal alloys?
NICKEL CHROMIUM AND COBALT
CHROMIUM ALLOYS
• Rarely used for all metal restorations
• Nickel haslimited application in gold and palladium
alloy
• Common component in non-noble dental alloys
• Used in small quantities in gold based alloys to
whiten and increase strength and hardness of alloy
Predominantly Base Metals
Base metal alloys generally comprise the group of cast metals that rely on chromium for
corrosion resistance. Chromium on the surface of the alloy rapidly oxidizes to form a thin layer
of chromium oxide, which prevents the diffusion of oxygen into the underlying metals and
improves its corrosion resistance. Chromium also strengthens the alloy by solution hardening.
Since the introduction of cobalt-chromium alloys as cast dental appliances in 1928 and
subsequent development of nickel-chromium and cobalt-nickel-chromium alloys, base metal
alloys have gained widespread acceptance as the predominant choice for the fabrication of
removable partial denture frameworks. Because of the high cost of noble metals, these base
metals have been adapted also for dual applications such as the production of all-metal and
metal-ceramic prostheses.
Currently there are two main groups of base metal dental alloys: nickel-chromium (Ni-Cr) and
cobalt-chromium (Co-Cr). The Ni-Cr alloys can be further divided into those with and without
beryllium, which improves castability and promotes the formation of a stable metal oxide for
porcelain bonding. The majority of Ni-Cr alloys are for small castings such as crowns and FDPs,
and Co-Cr alloys are primarily used for casting removable partial dentures in which high elastic
modulus and yield strength are needed. Some Ni-Cr alloys, which are used for partial denture
frameworks, are formulated for their relative ease of finishing and polishing compared with
Co-Cr alloys, which are used for crowns and FDPs in spite of their low ductility. Table 16-7 lists
compositions and properties of selected base alloys for all metal and metal–ceramic
applications. Molybdenum increases corrosion resistance and strength and decreases the
thermal expansion coefficient of base metal alloys. The latter is beneficial for porcelain
bonding and minimizes the risk of porcelain cracking or fracture. Base metal alloys for partial
frameworks are discussed later.
TITANIUM AND TITANIUM ALLOYS
• White colored
• Contains 12-22% Ag,39-53%Au and 25-35%Pd
• Low cost
• High Pd content improves resistance to creep
PALLADIUM-GOLD-SILVER ALLOYS
• Similar to Au-Pd-Ag alloys
• Contains Ag-5 to 32% and Ag-6 to 14%
• Porcelain discolaration
PALLADIUM-SILVER ALLOYS
PALLADIUM-GALLIUM-SILVER ALLOYS
Summary. The single most relevant property of a casting alloy to its biologic safety is its corrosion. Systemic
and local toxicity, allergy, and carcinogenicity all result from elements in the alloy being released into the
mouth during corrosion. Little evidence supports concerns of casting alloys causing systemic toxicity. The
occurrence of local toxic effects (adjacent to the alloy) is not well documented, but is a higher risk, primarily
because local tissues are exposed to much higher concentrations of released metal ions. Several elements
such as nickel and cobalt have relatively high potential to cause allergy, but the true risk of using alloys
containing these elements remains undefined. Prudence dictates that alloys containing these elements be
avoided if possible. Several elements in casting alloys are known mutagens, and a few such as beryllium and
cadmium are known carcinogens in different chemical forms. Despite these facts, carcinogenic effects from
dental casting alloys have not been demonstrated. Prudent practitioners should avoid alloys containing these
known carcinogens.
Conclusion. To minimize biologic risks, dentists should select alloys that have the lowest release of elements
(lowest corrosion). This goal can be achieved by using high-noble or noble alloys with single-phase
microstructures. However, there are exceptions to this generality, and selection of an alloy should be made
on a case-by-case basis using corrosion and biologic data from dental manufacturers. (J Prosthet Dent
2000;83:223-34.)
Artifacts from Dental Casting Alloys in Magnetic Resonance Imaging
Show all authors
F. Shafiei1*2, E. Honda23, H. Takahashi1, ...
First Published August 1, 2003 Others
The potential advantage of magnetic resonance imaging (MRI) has been limited by
artifacts due to the presence of metallic materials. For quantitative evaluation of
the magnitude of artifacts from dental casting alloys and implant materials in MR
imaging, 11 dental casting or implant materials were imaged by means of 1.5 T MRI
apparatus with three different sequences. Mean and standard deviation of water
signal intensity (SI) around the sample in the region of interest (1200 mm2) were
determined, and the coefficient of variation was compared for evaluation of the
homogeneity of the SI. A variety of artifacts with different magnitudes was
observed. Only one of the samples, composed mainly of Pd, In, and Sb, showed no
artifacts in all imaging sequences. We concluded that selection of specific dental
casting alloys according to their elemental compositions could minimize the metal
artifacts in MRI; however, titanium alloys currently pose a problem with respect to
causing MRI artifacts.
Penetration depth into dental casting alloys by Nd:YAG laser
Authors
N. Baba,
I. Watanabe
First published: 9 August 2004
This study investigated the effect of laser-beam welding conditions [voltage (V) and spot
diameter (mm)] on the penetration depth into dental casting alloys. Castings (3.0 mm ×
8.0 mm × 50 mm) were prepared from the metals used in this study: commercially pure
titanium (CP Ti), Ti-6Al-4V, Ti-6Al-7Nb, cobalt–chromium alloy (Co–Cr) and Type IV gold
alloy. Two cast blocks of each metal were butted against one another at the 8.0 × 50-mm
surfaces. They were then welded at their interface under the following conditions: voltage
of 160–340 V, spot diameter of 0.4–1.6 mm, and pulse duration of 10 ms. After laser
welding, the blocks were separated, and the penetration depth into each alloy was
measured. The data were analyzed with the use of ANOVA at the p < 0.05 level of
significance. The penetration depths were as follows: CP Ti (0.29–6.45 mm), Ti-6Al-4V
(0.32–5.24 mm), Ti-6Al-7Nb (0.34–5.65 mm), Co–Cr (0.24–6.15 mm), and Type IV gold
alloy (0.12–5.22 mm). The voltage and spot diameter affected the penetration depth into
the metals tested. When the voltage increased and the spot diameter decreased, the
penetration depth increased for each metal. Selecting suitable conditions for laser
welding to obtain sufficient penetration depth for the optimal thickness of the metal is
important when welding prostheses. © 2004 Wiley Periodicals, Inc. J Biomed Mater Res
Part B: Appl Biomater 72B: 64–68, 2005
Effect of chemical composition on the corrosion behavior of Ni-Cr-Mo dental casting
alloys
Authors
Her-Hsiung Huang
First published: 22 February 2002
The objective of this investigation was to study the compositional influence on the
corrosion behavior of Ni-Cr-Mo dental casting alloys in acidic artificial saliva. Cyclic
potentiodynamic and potentiostatic tests were used to evaluate the corrosion behavior
of different Ni-Cr-Mo dental casting alloys in deaerated artificial saliva with pH 5 at
37°C. Optical microscope observations were made following the cyclic potentiodynamic
tests. Surface chemical analyses were characterized by X-ray photoelectron
spectroscopy and auger electron spectroscopy following the potentiostatic tests. The
results show that the corrosion resistance of the Ni-Cr-Mo casting alloys investigated is
associated with the formation of passive film containing Ni(OH)2, NiO, Cr2O3, and
MoO3, on the surface. The pitting potential and passive range, respectively, were
statistically different among the different Ni-Cr-Mo alloys. The Ni-Cr-Mo alloys with
higher Cr (≈21%) and Mo (≈8%) contents had a much larger passive range in the
polarization curve and were immune to pitting corrosion due to the presence of high Cr
(maximum ≈31–35%) and Mo (maximum ≈12%) contents in the surface passive film.
The presence of Ti lower than 4% in the Ni-Cr-Mo casting alloy had no effect on
corrosion resistance. A pitting resistance equivalent (PRE) of about 49 could provide the
Ni-Cr-Mo alloy with a good pitting corrosion resistance. © 2002 Wiley Periodicals, Inc. J
Biomed Mater Res 60: 458–465, 2002; DOI 10.1002/jbm.10080
Elements Released from Dental Casting Alloys and Their Cytotoxic Effects.
Source: International Journal of Prosthodontics . Sep/Oct2002, Vol. 15 Issue 5, p473-478.
6p. 3 Charts, 1 Graph.
Author(s): Al-Hiyasat, Ahmad S.; Bashabsheh, Omar M.; Darmani, Homa
Purpose: This in vitro study investigated the element release from seven commercially
available dental casting alloys and tested their cytotoxic effects. Materials and Methods:
The casting alloys tested were one high-noble alloy (Bioherador N) and six base-metal
alloys, including four Ni-Cr alloys (Remanium CS, Heranium NA, Wiron 99, CB Soft), one Co-
Cr alloy (Wirobond C), and one Cu-based alloy (Thermobond). Ten specimens from each
alloy were prepared in the form of disks, and each of the seven dental casting alloys (10
disks per group) were conditioned in distilled water at 37°C for either 72 or 168 hours. The
conditioning media were analyzed for element release, and the cytotoxic effects were
assessed on Balb C fibroblasts using MTT assay.
Results: Element release was greater at 168 hours of conditioning than at 72 hours. The
extract from the high-noble alloy showed the least amount of element release (only Zn),
with no cytotoxic effects. The greatest amount of element release was detected in the Cu-
based alloy Thermobond and the Ni-Cr alloy CB Soft; their extracts were significantly more
toxic than all the other alloy extracts. The cytotoxic effects of the other Ni-Cr alloy extracts
were not statistically significantly different from the high-noble alloy extract. However, the
Co-Cr alloy (Wirobond C) extract was significantly more cytotoxic than the high-noble alloy
extract. Conclusion: Element release from casting alloys is proportional to the conditioning
time. The content of Cr and Mo in the alloy protects the alloy from dissolution, while the Cu
content makes it more susceptible to corrosion and dissolution, rendering it more cytotoxic.
Assessment of Nickel Release from Stainless Steel Crowns
Nahid Ramazani,1 Rahil Ahmadi,2 and Mansure Darijani3
Purpose of Study:The purpose of this study was to determine the amount of nickel
released from stainless steel crowns in artificial saliva.
Materials and Methods:In this in-vitro study, 270 stainless steel crowns were divided into
five groups, each with nine subgroups. Each group (I to V) was comprised of four, five, six,
seven and eight crowns, respectively. Each subgroup was placed in a polyethylene jar
containing artificial saliva and held in an incubator at 37°C for four weeks. The amount of
released nickel was determined on days 1, 7, 14, 21 and 28, using an atomic absorption
spectrophotometer. Wilcoxon Signed-Rank and Kruskal-Wallis with Dunn’s post hoc tests
(SPSS software, v. 18) were used for statistical analysis at a significance level of 0.05.
Results:The mean level of nickel on day 1 was more than that of day 7; this difference was
statistically significant for all groups (P < 0.05), except for group II (P = 0.086). Also, the
mean difference of released nickel between the groups was significant on day 1 (P =
0.006) and was insignificant on day 7 (P = 0.620). The nickel levels were zero on days 14,
21, and 28.
Conclusion:The amount of nickel was below the toxic level and did not exceed the dietary
intake.
Allergic reactions associated with metal alloys in porcelain-fused-to-metal fixed prosthodontic
devices-A systematic review.Levi L1, Barak S, Katz J.
OBJECTIVE:To systematically review the allergic reactions associated with metal alloys in
porcelain-fused-to-metal (PFM) fixed prosthetic devices.
METHOD AND MATERIALS:After reviewing the titles and abstracts of the articles as well as
removing duplicates, 22 articles were considered relevant. PubMed, Web of Science,
ScienceDirect, and Google Scholar from 1970 to 2012 were evaluated, and randomized studies,
review articles, case reports, cross-sectional surveys, and abstracts were included. Conference
papers and posters were excluded.
RESULTS:Although reported, allergic reactions to metallic alloys in the context of PFM devices
are not well documented. Allergic reactions to high noble and noble metal alloy cores of
palladium and gold and to base metal alloys nickel and cobalt in the context of PFM fixed partial
dentures (FPDs) are reported. Each type of metal is associated with a different rate of allergic
reactions, which may be attributed to the extent of corrosion of the alloy, population exposure,
and the biologic environment. Because few studies document allergic reactions to metals that
comprise PFM crowns and partial dentures, further research in this field is necessary to
determine the frequency and type of reactions elicited.
CONCLUSION:Though allergic reactions to metal alloys used in dentistry are well documented,
only few articles focus on the correlation between FPDs and metal allergies. Thus, this paper
surveys case reports of hypersensitivity reactions linked to FPDs and reviews the current
literature on allergic reactions to the metallic elements comprising those devices.