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Effect of Non-ionizing Radio Frequency Signals of

Magnetic Resonance Imaging on Physical Properties


of Dental Alloys and Metal-Ceramic Adhesion
Abu Bakr El-Bediwia / Abeer El-Fallalb / Samah Sakerc / Mutlu zcand

Purpose: To assess the influence of non-ionizing radio frequency signals of magnetic resonance imaging (MRI)
on physical properties of dental alloys and metal-ceramic adhesion.
Materials and Methods: A total of 120 disk-shaped wax patterns (10 mm x 10 mm x 1 mm) were cast in a base
metal alloy (Ni-Cr alloy) and commercially pure titanium (Ti) following the manufacturing recommendation. After
casting, air abrasion and ultrasonic cleaning, feldspathic ceramic was applied and fired according to manufacturers instructions using a standard mold. The specimens were subjected to 3000 thermocycles in distilled
water between 5C and 55C, then veneered alloy specimens were randomly assigned to three groups according
to MRI exposure time: a) 15 min of MRI exposure, b) 30 min of MRI exposure and c) no MRI exposure (control
group). The specimens were subjected to shear loading until failure. A separate set of Ni-Cr and Ti specimens
were prepared, and after exposure to MRI for 15 and 30 min, x-ray diffraction (XRD) analysis, surface roughness,
and Vickers hardness were measured.
Results: Both the alloy type (p < 0.005) and exposure duration (p < 0.005) had a significant effect on the bond
results. While the control group presented the highest bond strength for Ni-Cr and Ti (36.9 1.4 and 21.5 1.6
MPa, respectively), 30 min MRI exposure significantly decreased the bond strength for both alloys (29.4 1.5
and 12.8 1.5 MPa, respectively) (p < 0.05). XRD analysis indicated formation of the crystalline phase as well
as change in crystal size and position for Ni-Cr and Ti after MRI. Compared to the control group where alloys
were not exposed to MRI (Ni-Cr: 0.40 m; Ti: 0.17 m), surface roughness increased (Ni-Cr: 0.54 m; Ti: 1.1
m). Vickers hardness of both alloys decreased after 30 min MRI (Ni-Cr: 329.5; Ti: 216.1) compared to the control group c (Ni-Cr: 356.1; Ti: 662.1), being more significant for Ti (p < 0.005).
Conclusion: Ni-Cr alloy is recommended over Ti for the fabrication of metal-ceramic restorations for patients with
a history of frequent exposure to MRI.
Keywords: adhesion, base alloy, chipping, magnetic resonance imaging, metal-ceramic, roughness, titanium.
J Adhes Dent 2014; 16: 407413
doi: 10.3290/j.jad.a32664

Professor, Metal Physics Laboratory, Physics Department, Faculty of Science, Mansoura University, Egypt. Performed experiments, collected and
analyzed data, wrote the manuscript, discussed the results, commented on
the manuscript at all stages.

Professor, Biomaterials Department, Faculty of Dentistry, Mansoura University,


Egypt. Performed experiments, collected and analyzed data, wrote the manuscript, discussed the results, commented on the manuscript at all stages.

Asistant Professor, Conservative Dentistry Department, Faculty of Dentistry,


Mansoura University, Egypt. Performed experiments, collected and analyzed
data, wrote the manuscript, discussed the results, commented on the manuscript at all stages.

Professor, Dental Materials Unit, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Center for Dental and Oral Medicine,
University of Zrich, Zurich, Switzerland. Experimental design, analyzed data,
wrote and edited manuscript, discussed the results, commented on the
manuscript at all stages.

Correspondence: Dr. Samah Saker, Mansoura University, Faculty of Dentistry,


Conservative Dentistry Department, Mansoura, 35516 Egypt. Tel: +20-128745-7890. e-mail: samah_saker@hotmail.com

Vol 16, No 5, 2014

Submitted for publication: 28.03.13; accepted for publication: 17.06.14

lthough the use of all-ceramic or polymeric materials


is increasing in dental applications, metal-ceramic
restorations are still being widely used in dental practice
due to the long-term clinical success.19,29 The considerable increase in the price of gold starting in the 1970s
has resulted in the development of alternative metallic
systems for dental use. In comparison to noble alloys,
Ni-Cr and Co-Cr base metal alloys melt at higher temperatures, require more critical handling during melting,
and are more difficult to finish. Such limitations are
minimized with recent technological developments, and
the biomechanical properties of these alloys could be
considered superior to noble alloys.1 In prosthetic applications so far, the success of metal-ceramic fixed
dental prostheses (FDP) depends primarily on optimal
adhesion of the veneering ceramic on the framework
alloy.2,3,7,17,23,26 Metal-ceramic adhesion necessitates
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El-Bediwi et al

chemical and thermal compatibility during both ceramic


sintering and function. Three possible mechanisms,
namely micromechanical retention, chemical bonding,
and van der Waals forces, dictate metal-ceramic adhesion. Chemical bonding of the union is characterized by
the direct transfer of electrons between oxygen in the
vitreous part of the ceramic and the metal oxides.15,18
Depending on the test method employed, bond strength
results of Co-Cr or Ni-Cr dental alloys and ceramics range
between 35 and 95 MPa in the dental literature.6,10,12
Among all dental alloys, commercial pure titanium (Ti)
has been the material of choice in several disciplines in
dentistry due to its biocompatibility, resistance to corrosion, and mechanical properties similar to that of gold
alloys. Despite these favorable characteristics, Ti casting
for prosthetic purposes has not been viable for many
years, since casting procedures led to the formation of an
undesirable crust resulting in high reactivity and fragility.
This coating is called alpha-case and is formed by incorporation of the elements from the investment that may
impair the adhesion between Ti and ceramics, yielding
bond strength results between 29 and 32 MPa.20 Despite
all improvements in casting methods, clinical studies still
report ceramic fractures associated with FDPs, predominantly between metals and ceramics.22
Magnetic resonance imaging (MRI) is widely used as
an important diagnostic tool for the whole body, but especially for orthopedic and brain surgery. MRI has remarkable advantages, as it provides cross-sectional views and
assists diagnostics of diseases in the human body with
no invasion and no exposure to x-ray radiation.16,19,24 Unfortunately, the use of MRI diagnostics can be risky when
metals are present as implants or prosthetic devices in
the body, that is, metallic materials become magnetized
in the intense magnetic field of the MRI device.4,11 Recently, MRI was reported to impair the surface and bulk
properties as well as corrosion resistance of Co-Cr and
Ni-Cr.13,14 The information on magnetic susceptibility of
dental alloys and its effect on metal-ceramic adhesion mechanical properties are not readily available for commonly
used metals in dentistry.
The objectives of this study were thus to evaluate the
effect of non-ionizing radio frequency signals of MRI for
short and long durations on the physical properties of NiCr and commercially pure Ti and metal-ceramic adhesion.

MATERIALS AND METHODS


Specimen Preparation
Ni-Cr (N = 30) specimens (Durabond; Sylmar, CA, USA)
and commercially pure titanium (Ti) alloys (N = 30)
(ASTM, Grade II, Modern Techniques and Materials
Engineering Center; Nasr City, Cairo, Egypt) of 10 mm
x 10 mm x 1 mm size were obtained. Initially, a wax
sprue was attached perpendicular to the specimen at
one end of the template and connected to a central
wax rod of 5 mm diameter (wax wire for casting sprues,
Dentaurum; Pforzheim, Germany). The assembly was
mounted in a silicone ring and poured with investment
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material (Rematitan, Ultra, Dentaurum) that was mixed


at a ratio of 100 g of powder to 14 ml of liquid. After the
investment material set, the silicone ring and sprue former were separated from the investment mold. Metallic
frameworks of Ti were cast in an electrical induction furnace (Rematitan Autocast, Dentaurum) under argon gas.
Ni-Cr was cast following the manufacturers instructions.
Elimination of sprues and separation of metallic strips
were performed using carbide disks at low speed.
After divesting, the metal specimens were airborneparticle abraded with 110-m aluminum oxide (Korax,
Bego; Bremen Germany) at a pressure of 2.5 bar from
a distance of approximately 2 cm at an angle of 45 degrees for 10 s (Blastmate II, CFI 9441-113, Ney Dental;
Yucaipa, CA, USA). The metal specimens were then ultrasonically cleaned (Vitasonic II, Vita Zahnfabrik; Bad Sckingen, Germany) in distilled water and isopropyl alcohol
for 5 min each.
Two layers of opaque ceramic (thickness: 0.1 mm
each) (VMK900, Vita Zahnfabrik) were applied by homogenously mixing the powder of opaque ceramic and liquid
in a container, and applied with a thin brush by the same
operator onto the metallic surface using a standard mold.
The thickness of the opaque layer was carefully measured
using a digital caliper (StarrettR 727, Starrett; Itu, Brazil).
The veneering ceramic (Shade 2M1) was then fired
onto Ni-Cr and Ti alloys. A specially designed split polyethylene mold (diameter: 6 mm, thickness: 4 mm) was
positioned in the center of each plate and the ceramic was
applied onto the metal plate. Sintering of the veneering
ceramics was accomplished in an oven (Vacumat, VITA
Zahnfabrik). A second firing was performed to compensate for sintering shrinkage of the ceramics according
to manufacturers recommendations. The veneered alloy specimens were then thermocycled in distilled water
3000x between 5C and 55C (dwell time: 30 s; transfer
time between baths: 2 s).
The specimens were randomly assigned to three
groups: a) 15 min of MRI non-ionizing radio frequency
(RF) signal exposure (1.5 T, Magnetom Vision, Siemens;
Erlangen, Germany), b) 30 min of MRI exposure, and c) no
MRI exposure (control group).
The specimens were embedded in auto-polymerized
acrylic resin (Acrostone; Alexandria, Egypt) using plastic molds (diameter: 25 mm, height 20 mm). They were
mounted in the jig of a universal testing machine (Lloyd
Model TT-B, Instron; Canton, MA, USA) and loading was
applied to the metal-ceramic interface until failure occurred (crosshead speed: 0.5 mm/min). The shearing
blade was a 30-degree mono-bevelled chisel positioned
0.1 mm away from the bonded interface. The maximum
force to produce failure (MPa) was recorded by the corresponding software, dividing the fracture load (F) in Newtons by the surface area (A) in mm2.
X-Ray Diffraction Analysis (XRD)
In another set of Ni-Cr and Ti specimens (N = 60,
n = 10 per group), surface characterization was performed on the flat surfaces of the specimens using an
x-ray diffractometer (Shimadzu, Dx30; Tokyo, Japan).
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El-Bediwi et al

Table 1 Two-way ANOVA results comparing mean


shear bond strength of ceramics onto Ni-Cr and commercially pure Ti as a function of MRI exposure duration
Sum
of
squares

df

Mean
square

F value

Type of alloy

4247.051

MRI duration

675.52

337.765

132.029 0.000

Type x duration 26.133

13.067

5.108 0.009

Total

60

Table 2 Mean (SD) bond strength values in MPa of


ceramic-alloy combinations (Ni-Cr, commercially pure
Ti) before (control) and after MRI exposure
Alloy type

Groups

Mean

SD

Ni-Cr

Control

36.9

1.4

15 min

33.4

1.9

30 min

29.4

1.5

Control

21.5

1.6

15 min

14.8

1.8

30 min

12.8

1.5

4247.051 1660.133 0.000

Ti

41979.3

Similar to the shear test, the alloy surfaces were initially exposed to either a) 15 min of MRI non-ionizing RF
signal exposure (1.5 T, Magnetom Vision) or b) 30 min
of MRI exposure. The control group was not exposed to
MRI.
Cu-K radiation (l = 1.54056 at 45 kV and 35 mA)
and Ni-filter in the angular range of 2q from 0 to 100 degrees was applied in continuous mode with a scan speed
of 5 degrees/min for surface characterization.
Surface Roughness Test
Surface roughness (Ra) of the control group and the
MRI exposed groups was measured by using a portable
profilometer (Surftest SJ-201 P, Mitutoyo; Tokyo, Japan).
A diamond stylus with a radius of 5 m took three measurements and the average was calculated.
Vickers Hardness Test
The microhardness of each group was calculated using
a digital Vickers microhardness tester (Model FM-7,
Future Tech; Tokyo, Japan), applying a load of 100 g for
5s by means of a Vickers diamond tip.
Statistical Analysis
Statistical analysis was performed using SPSS 11.0
software for Windows (SPSS; Chicago, IL, USA). Bond
strength data (MPa) were submitted to two-way ANOVA
with the bond strength as the dependent variable and
the alloy type and MRI duration as independent variables. For surface roughness and Vickers hardness,
two-way ANOVA and Tukeys tests were used. Due to
significant differences between groups, multiple comparisons were made using Tukeys tests. P-values less
than 0.05 were considered to be statistically significant
in all tests.

RESULTS
Shear Bond Strength
Both the alloy type (p < 0.005) and exposure duration (p < 0.005) had a significant effect on the
bond results. Interaction terms were also significant
Vol 16, No 5, 2014

(p = 0.009) (Table 1). While the control group presented


the highest bond strength for Ni-Cr and Ti (36.9 1.4
and 21.5 1.6 MPa, respectively), 30 min MRI exposure significantly decreased the bond strength of both
alloys (29.4 1.5 and 12.8 1.5 MPa, respectively)
(Table 2).
XRD Analysis
According to XRD analysis, Ni-Cr alloy consisted of
gamma solid solution, (Ni-Cr) and Ni cubic phase. After
exposure to MRI for 15 and 30 min, the intensity of the
peaks indicated the formation of crystalline phases.
Broad bands denoted changes in crystal size and position (Fig 1). For Ti in the control group, hexagonal Ti
phase could be observed. Similar to Ni-Cr, exposure
to MRI for 15 and 30 min changed the intensity of Ti
phase, indicating position change (Fig 2).
Surface Roughness
Compared to the control group (Ni-Cr: 0.40 m; Ti:
0.17 m), surface roughness increased for Ni-Cr (0.54
m) and Ti (1.1 m). Surface roughness was significantly higher for Ti in all conditions (p < 0.05) (Table 3).
The duration of MRI exposure did not show a significant
difference between 15 and 30 min (p > 0.05).
Vickers Hardness
Vickers hardness of both alloys decreased significantly
after 30 min MRI (Ni-Cr: 329.5; Ti: 216.1) compared to
the control group (Ni-Cr: 356.1; Ti: 662.1) (Table 4). The
decreased Vickers hardness for Ti was more significant
(p<0.005).

DISCUSSION
As the use of metal-ceramic FDPS continues in dentistry, additional investigation of the metal-ceramic
bond is indicated to study the possible effect of MRI
on the surface properties of commonly used alloys and
ceramic-alloy adhesion. Fractures or delamination of
the veneering ceramic are costly problems in dentistry,
causing functional and esthetic inconveniences for both
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El-Bediwi et al

Control (Ni-Cr)

Alloy type Groups Mean SD

30
20

Ni-Cr
Ni (222)

Ni (220)

40

Ni (311)

Ni (111)

50

Ni (200)

60

Lin (Counts)

Table 3 Mean (SD) surface


roughness (Ra) values (m) of
Ni-Cr and commercially pure Ti
before (control) and after MRI
exposure

10
0

Ti
30

40

50

70

60

70

80

90

100

110

Control

0.40

0.025

15 min

0.51

0.032

30 min

0.54

0.086

Control

0.17

0.021

15 min

0.86

0.01

30 min

1.1

0.014

15 min MRI (Ni-Cr)

30
20

Ni (222)

Ni (220)

40

Ni (311)

Ni (111)

Lin (Counts)

50

Ni (200)

60

10
0 30

40

50

60

70

80

90

100

110

100

110

80
Ni (111)

40

Ni (311)

30
20

Ni (222)

50
Ni (220)

Lin (Counts)

60

Ni (200)

30 min MRI (Ni-Cr)

70

10
0

30

40

50

60

70

80

90

Fig 1 X-ray diffraction patterns of Ni-Cr alloy a) before exposure to MRI (control), b) after
15 min MRI exposure, c) after 30 min MRI exposure. Broad bands denote changes in crystal size and position.

410

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El-Bediwi et al

Ti (101)

15 min

341.8

3.8

30 min

329.5

2.9

Control

662.1

61.1

15 min

167.7

36.8

30 min

216.1

11

30
20
10
0

30

40

50

60

Ti (004)

3.7

Ti (112)
Ti (201)

356.1

Ti (110)

Ti

Control

Ti (102)

Ni-Cr

Ti (100)

SD

Lin (Counts)

40

Alloy type Groups Mean

Control (Ti)

Ti (002)

50

Ti (103)

Table 4 Mean (SD) Vickers


hardness values of Ni-Cr and
commercially pure Ti before
(control) and after MRI exposure

70

80

90

70

80

90

70

80

90

15 min MRI (Ti)

Lin (Counts)

30

20

10

30

40

50

60

40

30 min MRI (Ti)

Lin (Counts)

30

20

10

30

40

50

60

Fig 2
X-ray diffraction patterns of commercially pure Ti a) before exposure to MRI (control), b) after 15 min MRI exposure, c) after 30 min MRI exposure. Changes in intensity of
Ti phase indicate position change.

Vol 16, No 5, 2014

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El-Bediwi et al

the patient and the dentist.22 Therefore, the primary


requirement for a successful metal-ceramic restoration
is achieving long-lasting adhesion between the ceramic
and metal alloy. Although many factors come into play in
ceramic-alloy adhesion,21 this study concentrated on a
less-studied factor, namely, MRI exposure.
Several testing methodologies such as shear, tensile,
and microtensile tests have been suggested for evaluation of the bond strength of ceramic materials to dental alloys. These test methods are based on the application of
load in order to generate stress at the adhesive joints until
failure occurs. Hence, for the test to accurately measure
the bond strength values between an adherent and a substrate, it is crucial that the bonding interface should be the
most stressed region, regardless of the test method being
employed.5,8,9,27 Many studies using stress distribution
analyses have reported that some bond strength tests
do not appropriately stress the interfacial zone.5,8,9,27
Shear tests have been criticized for the development of
non-homogeneous stress distributions in the bonded interface, inducing either underestimation or misinterpretation of the results, since the failure often starts in one of
the substrates and not at the adhesive zone.27 On the
other hand, the microtensile test allows better alignment
of the specimens and a more homogeneous distribution
of stress, in addition to a more sensitive comparison or
evaluation of bond performances.27 However, during cutting to create the bar-shaped specimens, many pre-test
failures occur due to the brittle nature of the ceramics,
which often makes it difficult to obtain sufficient specimens.27 For this reason, the shear test was employed in
this study.
MRI is based on the signal of nuclear magnetic resonance emitted by the interaction of atomic nuclei that possess spin with incident radiofrequency within a static magnetic field. MRI is used to distinguish between pathologic
and normal tissues. One advantage of an MRI scan is
that it is harmless to the patient. It uses strong magnetic
fields and non-ionizing radiation in the radio frequency
range, unlike CT scans and traditional radiographs, both
of which use ionizing radiation. Magnetic susceptibility is
one of the physical properties of a material and can be
defined as the ratio of magnetic response of a material
to the applied magnetic field.24 There are three types of
substances according to their magnetic susceptibility: Ferromagnetic substances that are strongly attracted by magnetic fields, such as iron, cobalt, and nickel; paramagnetic
substances that have unpaired electrons and become
demagnetized once the field is switched off; diamagnetic
substances that have few unpaired orbital electrons and
therefore induce weak magnetic fields. When such a diagmagnetic substance is placed in an external magnetic
field, a weak magnetic field is induced in the direction opposite to the external magnetic field. Thus, diamagnetic
substances have a small negative magnetic susceptibility
and could be basically considered non-magnetic.
Previous studies concentrated on the extent of artefacts
caused by metallic dental devices/restorations,16,19,24
but dental manufacturers and dentists did not focus on
the impact of stresses on the crystalline structure, and to
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a limited extent, the shape, size, and orientation of crystalline structure. Since the MR-relevant physical parameters of a metallic material ie, its magnetic susceptibility
and electrical conductivity depend on its microstructure
in a complex way, the two parameters are convenient
indicators of its quality when exposed to MR. Most metallic dental materials can be considered MR compatible
for brain and neck MRI.25 However, in the present study,
changes in the microstructure of Ni-Cr and Ti were observed after exposure to 1 T of MRI non-ionizing RF signal
exposure for 15 and 30 min. The shape of the crystalline
phases and the degree of crystalline structure showed
changes conceivably due to the interaction of the signal of
non-ionizing MRI with the metal structure, Ni-Cr-Mo-Fe-Si,
and other elements constituting the main composition of
the alloys and its effect on atomic aggregation.
Interestingly, the average surface roughness parameter (Ra) value for Ni-Cr and Ti increased after exposure
to MRI for 15 and 30 min. This could be attributed to the
formation of cracks or pits on the alloy surface due to the
effect of non-ionizing MRI. Exposure to MRI causes some
inclusions and weak discontinuity spots or irregularities in
the amorphous matrix of titanium oxides and hydroxides.
Such nucleation sites may result in cracks that increase
surface roughness.13
In general, hardness is defined as the resistance of a
material to plastic deformation under indentation. However, the term hardness may also refer to stiffness, temper, or resistance to scratching abrasion or cutting. In
this study, the Vickers hardness of Ni-Cr alloy decreased
after exposure to MRI for 15 and 30 min. Non-ionizing
MRI signals might have caused movement of ions in the
metal due to the heat produced, which in turn reduced
hardness values. On the other hand, Vickers hardness
of Ti was substantially decreased after exposure to MRI
for either 15 or 30 min. Commercially pure Ti is slightly
paramagnetic and has a few impurities such as iron, oxygen, nitrogen, and other elements. It is possible that the
magnetic field caused matrix defects, thus decreasing its
hardness. Further studies should be conducted to study
the real mechanism responsible for decreased physical
properties of Ti as opposed to Ni-Cr. It is possible that
some heating occurred in the scanner at 1.5 T in the
closed unit with a higher magnetic field than an open unit.
The magnetic properties of investing material should also
be focussed on in further studies.
Overall, the shear bond strength of the ceramic tested
in combination with Ni-Cr alloy demonstrated higher mean
values than in combination with Ti, although the MRI exposure decreased the results for both alloys. The analysis of
surface characteristics should to be supported by atomic
force microscopy in future studies. Nevertheless, the clinical relevance of these findings needs to be verified in clinical, cross-sectional studies.
Considering both microstructural and physical changes
as well as the decreased ceramic adhesion to the metals
after MRI exposure, shielding metal-ceramic restorations
with a non-magnetic material could be recommended to
protect the materials from MRI signals. Even though the
metals are covered with veneering ceramic in FDPs, the
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El-Bediwi et al

interface between metal and ceramic may hypothetically


suffer from MRI irradiation. However, this aspect needs
to be verified in clinical situations by careful observation
of the location of chippings or fractures. Ni-Cr alloy may
be an option for the fabrication of metal-ceramic restorations for patients with a history of frequent MRI exposure.

CONCLUSIONS
MRI exposure of 15 or 30 min decreased the adhesion
of veneering ceramic to commercially pure Ti and Ni-Cr
alloy but the effect was less on Ni-Cr. MRI exposure increased the roughness and decreased the Vickers hardness of Ni-Cr alloy and commercially pure Ti.

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Clinical relevance: In patients exposed to magnetic


resonance imaging irradiation, metal-ceramic adhesion of FDPs may suffer.

413

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