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      Intraoral Laser Welding (ILW) in Implant Prosthetic Dentistry: Case Report

      case-report

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          Abstract

          The aim of this clinical study was to describe the possibility of using the Nd:YAG laser device utilized in the dental offices to weld metals intraorally. The authors, before applying this technique “in vivo” on human subjects, tested the “in vitro” metal welding efficacy of dental Nd:YAG device firstly by interferometry, SEM, and EDS and subsequently by thermal camera and thermocouples in order to record temperature changes during the welding process on bovine jaws. Four implants were inserted in the edentulous maxillary arch of a 67 years old male patient. Immediately after that, a bar previously made by the dental technician was intraorally welded to the abutments by Nd:YAG laser (Fidelis Plus III, Fotona, Slovenia) with these parameters: 9.90 mJ, 1 Hz, 15 msec, 0.6 mm spot. Then the prosthesis was connected to the bar with four OT Caps. This clinical study, even if preliminary, suggests that laser welding technique may be intraorally used without side effects.

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          Most cited references13

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          The laser welding technique applied to the non precious dental alloys procedure and results.

          The laser welding technique was chosen for its versatility in the repair of dental metal prosthesis. The aim of this research is to assess the accuracy, quality and reproducibility of this technique as applied to Ni-Cr-Mo and Cr-Co-Mo alloys often used to make prosthesis The alloy's ability to weld was evaluated with a pulsed Nd-Yag Laser equipment. In order to evaluate the joining, various cast wires with different diameters were used. The efficiency of the joining was measured with tensile tests. In order to understand this difference, metallographic examinations and X-Ray microprobe analysis were performed through the welded area and compared with the cast part. It was found that a very slight change in the chemistry of the Ni-Cr alloys had a strong influence on the quality of the joining. The Co-Cr alloy presented an excellent weldability. A very important change in the microstructure due to the effect of the laser was pointed out in the welding zone, increasing its micro-hardness. The higher level of carbon and boron in one of the two Ni-Cr was found to be responsible for its poor welding ability. However for the others, the maximum depth of welding was found to be around 2mm which is one of the usual thicknesses of the components which have to be repaired.
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            Intra-oral laser welding: an in vitro evaluation of thermal increase.

            The neodymium:yttrium-aluminium-garnet (Nd:YAG) laser is currently used in dental laboratories to weld metals on dental prostheses. Recently, the use of Nd:YAG has been suggested so that dentists themselves can repair broken fixed, removable and orthodontic prostheses by welding metals directly in the mouth. This work aimed to evaluate, through a four k-type thermocouple system on calf jaws, the thermal increase in the biological structures close to the metal parts during laser welding. We put two hemispherical metal plates onto mandibular molars and then laser welded them at three points with a four k-thermocouple system to determine the thermal rise in the pulp chamber, sulcus, root and bone. This procedure was carried out on 12 samples, and the results were processed. The highest values of thermal increase were found in the pulp chamber, 1.5 degrees C; sulcus, 0.7 degrees C; root, 0.3 degrees C; and bone, 0.3 degrees C. This study showed that thermal increases in pulp chamber, sulcus, root and bone were biologically compatible and that intra-oral laser welding, at the parameters used in this work, seems to be harmless to the biological structures close to the welding and thermally affected zones.
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              Welding in the dental office by fiber-delivered laser: a new technique.

              The aim of this study is to demonstrate the ability of dentists to weld different metals during daily practice using a fiber-delivered laser normally used for dental surgery, and to evaluate the possibilities offered by this new technique. Laser welding is a common technique that has long been used in dental technician laboratories. It has many advantages over conventional techniques: it may be applied directly to master casts, and it avoids damage to the acrylic or ceramic portions close to the welded area. In addition, it may be applied on different types of metallic alloys, and it may provide a stronger attachment than other more traditional techniques. The cost, size, and limited flexibility of laser transmission systems using fixed lenses have restricted their use to dental technician laboratories. The authors detail their experience with welding using an Nd:YAG fiberoptic-delivered laser that is normally used for dental therapy. This work describes some clinical cases that demonstrate the ease of use of this technique to weld broken appliances for both prosthetic and orthodontic therapy. Dentists using this technique can carry out immediate restoration of metallic fixed, removable, and orthodontic broken prostheses in their own offices, thus reducing the time needed for such repairs.
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                Author and article information

                Journal
                Case Rep Dent
                Case Rep Dent
                CRIM.DENTISTRY
                Case Reports in Dentistry
                Hindawi Publishing Corporation
                2090-6447
                2090-6455
                2012
                9 August 2012
                : 2012
                : 839141
                Affiliations
                1Oral Medicine and Laser-Assisted Surgery Unit, Dental School, Faculty of Medicine, University of Parma, 29017 Fiorenzuola d'Arda, Italy
                2School of Dental Science, Faculty of Medicine and Dentistry, University of Melbourne, Melbourne, VIC, Australia
                3Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Madrid, Spain
                Author notes

                Academic Editors: M. H. K. Motamedi and M. W. Roberts

                Article
                10.1155/2012/839141
                3423664
                22924134
                db71974f-6b4b-426c-aa9c-fa0b4ecdf5ac
                Copyright © 2012 Carlo Fornaini et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 May 2012
                : 17 July 2012
                Categories
                Case Report

                Dentistry
                Dentistry

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