ANALYSES of ALTERNATIVES non-confidental report Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments (issue date 2015-09-18). Legal name of applicant(s): W&H Dentalwerk Bürmoos GmbH Bien Air Dental S.A. Sirona Dental GmbH SycoTec GmbH & Co. KG Submitted by: W&H Dentalwerk Bürmoos GmbH Substance: Chromium trioxide EC No: 215-607-8, CAS No: 1333-82-0 Use Title: Functional chrome plating with decorative character Use Number: 3 The intent of this evaluation of analysis of alternatives of metallic coatings from chromium trioxide is to point out the differentiation of requirements on key functionality and technical feasibility related to devices or hand-pieces of dental practices, dental hospitals, dental laboratories and microsurgery. Therefore this document contains additional statements respectively supplements to the considered “List of plating alternatives categorized” (in Table 5) referring to the existing (non-confidential) report of “Analysis of Alternatives” released on 12.08.2015 via http://echa.europa.eu/addressing-chemicals-of-concern/authorisation/applications-forauthorisation/-/substance-rev/10111/term which is mainly considered and issued by sanitary and automotive sector. Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 1 of 8 Supplement to 3.3.2. Key functionalities of chromium trioxide based electroplating according to dental and surgical devices: Tab. 1. Sector Specific key functionalities of chromium trioxide based electroplating Key Functionality Chemical resistance /Corrosion protection of substrate dental (surgical) device surfaces Up to 336 h EN ISO 21530 disinfectants and cleaning agents, continuous immersion tests No visual degradation of the coating or corrosion of the substrate material after testing with different chemicals. Thermal disinfection ISO EN 15883-3 Chemical + Temperature change/heat- resistance Wear/abrasion resistance Aesthetics Hot steam sterilisation 135°C (ISO 17664) Haptic, non-slip grip Adhesion Biocompatibility Ni-leaching Hygienic aspects OEM Specification Surface has to be free of any kind of defects as pores, cracks, and blistering. Bright homogenous finish quality. Colour testing to EN ISO 11664. No or only little smoothening or planing of sand blasted pre-treated surfaces depending on coating thickness and surface energy. Evaluation per IEC 62366 Cross cut test EN ISO 2409 (GT0 to GT1) after hot stem sterilisation cycling tests on Brass substrates ISO EN 10993-1 (no cytotoxic, irritating and/or sensitisation effects) ISO EN 10993-12 (limitation for leachable substances) < 0,5µg/cm2 per week Surface has to be free of any kind of defects as cracks, blistering and pores as growth sites for microbes or diminished cleanability . Supplement to 3.3.2.1 Chemical resistance/ Corrosion protection of substrate: The coating has to be adequately (corrosion-) resistant against common cleaning and disinfectant solutions and thermal disinfection which are used for reprocessing treatment of dental/surgical devices. Moreover the coatings have to build a dense barrier to prevent chemical agents to penetrate and attack the substrate material and protect this from corroding. For evaluation immerging test as per EN ISO 21530 and high cycle thermal disinfection treatments are performed. Supplement to 3.3.2.4. Nickel leaching and biocompatibility The surfaces of product parts which come in contact with patients must not cause any toxic, irritating and/or sensitisation effects to human skin or body according to standard 10993-1 (Biological evaluation of medical devices). Supplement to 3.3.2.5. Adhesion The adhesion of the coatings must not degrade after several disinfection, thermal disinfection and sterilization treatments/cycles. Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 2 of 8 Supplement to 3.3.2.7. (Chemical-) and Temperature change/heat resistance Hot steam sterilisation is a combination of chemical and temperature changing exposure. The coating has to fulfill requirements on durable adhesion to substrate, corrosion resistance and sealing performance for a high number of sterilization cycles up to 2000 sterilisation cycles Manufactures have to provide information for the processing of re-sterilisable medical devices per ISO 17664. Supplement to 3.3.2.10. Aesthetics: Surface has to be free of any kind of visible defects as pores, cracks, and blistering. Bright silvery colours with homogenous finish quality are required for clean and hygienic characteristic. Evaluation is performed by visual inspection using specific internal reference samples. Haptic, non-slip grip Safe handling of devices must be ensured during treatment (ISO 14457). Good grip is mostly achieved by roughened handle surfaces. Evaluation according to IEC 62366 (Application of usability engineering to medical devices) Supplement to 5. General Overview on sector specific approval processes for 5.x Dental / Surgical Sector : Dental and surgical precision devices are used for the preparation and processing of human dental and bone tissue. These products are subjected to the directive 93/42/EWG – Medical devices and thus have to fulfill specific requirements on reprocessing in terms of cleaning, disinfection, thermal disinfection and sterilization. For premium-quality products with high global export rate also design and aesthetics as well as the product lifetime (life time warranty) is an important basic requirement, which is currently provided through the use of metallic coatings from chromium trioxide. The fabrication of dental precision devices and instruments requires a great manufacturing expertise. The production of several high-precision small parts with closest tolerances (in the range of microns) is only (economically) feasible by the use of brass alloys because of their good machinability and dimensional stability. Brass as basic material on the other side only offers a restricted chemical resistance, so it has to be protected against aggressive cleaning and disinfectant solutions and sterilization procedures by coating. Up to now there is no economically and technically feasible alternative to the metallic coatings from chromium trioxide which is confirmed by several experiments on various new coating systems including PVD, CVD, some lacquer Technologies, Ni-Co platings and anodized aluminum surfaces. An increase of manufacturing costs and / or loss of product quality would lead to an aggravation of the already tight competitive situation especially with Asian or non-EU manufacturers so that production location in Europe would become even less attractive for necessity of profit-oriented companies. Any new and following potential alternatives for chromium trioxide for use in dental sector must be in compliance with the high demands and requirements regarding their critical performance properties (Tab.1.) within manufacturing processes and their final use. Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 3 of 8 Supplement to: 7. Suitability and availability of possible alternatives assessment: dental / surgical devices. for sector specific 7.1.1. Alternative 1: trivalent chromium plating: Conclusion of Technical feasibility: Not an alternative to coatings from chromium trioxide because: Intricate control of electrolyte baths as result of extreme sensitivity to bath impurities Deviation of silvery-bluish color to yellowish brownish color does not fulfill the aesthetic requirements Too little process stability for assuring homogenous constant color shade. Insufficient corrosion and wear resistance deduced from automotive and sanitary requirements and assessments chemical resistance /corrosion protection Cleaning and Substrate disinfectant compatibility to solutions and brass alloys thermal disinfection Hot steam sterilisation (change/heatresistance) Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative Biocompatibility & Nickel Leaching (no toxicity) yellowish brownish color 7.1.2. Alternative 2: PVD based processes – lacquer + PVD + lacquer and PVD metal Conclusion of Technical feasibility: Not an alternative to coatings from chromium trioxide because: PVD Metal PVD Metal: microporous morphology of coatings results in insufficient sealing and corrosion protection of the substrate against hot water steam and cleaning/disinfectants chemicals Lower Adhesion strength for coating thickness higher than 2-5 µm. Lacquer + PVD-Systems Poor temperature change/heat- resistance because of different thermal expansion behavior between substrate, lacquer- and PVD-layer results in delamination and infiltration of lacquer coating during hot steam sterilization. chemical resistance /corrosion protection Cleaning and Hot steam Substrate disinfectant sterilisation compatibility solutions/ (change/heatto brass alloys thermal resistance) disinfection not directly on brass / precoating Wear/abrasion Adhesion to substrate resistance poor after sterilisation of lacqer containing systems Aesthetics/ Decorative Biocompatibility & Nickel Leaching (no toxicity) depending on deposed metal depending on deposed metal and lacquer Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 4 of 8 7.1.3. Alternative 3 : Satin & black anodized Aluminum: Conclusion of Technical feasibility: Not an alternative to coatings from chromium trioxide because: black, gray, dark colors do not fulfill the requirements to bright shiny surface restricted to Aluminum substrate only. Low strength of Aluminum substrates Insufficient chemical resistance of anodized aluminum according alkaline containing cleaning/disinfectant agents. chemical resistance /corrosion protection Substrate compatibility to brass alloys Cleaning and disinfectant solutions/ thermal disinfection only for Al substartes poor resistance aganst thermal desinfection Hot steam sterilisation (change/heatresistance) Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative Biocompatibility & Nickel Leaching (no toxicity) only for Al Substartes 7.1.4. Alternative 4: Chromium free electroplating: multi-component coatings systems (Cu,Ni,Zn,Ni,Co) gold and platinum electroplating, zinc electroplating: Conclusion of technical feasibility: Not an alternative to coatings from chromium trioxide because: Coatings do not fulfill the aesthetic requirements if golden or grey Cu, Zn based coatings are not usable for sterilization and thermal disinfection As Ni-Co Multilayer: coating thickness very high and poor resistance against frequent sterilization chemical resistance /corrosion protection Substrate compatibility to brass alloys Cleaning and disinfectant solutions/ thermal disinfection Hot steam sterilisation (change/heatresistance) Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative Biokompatibility & Nickel Leaching (no toxicity) depending on metal Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 5 of 8 7.1.5./9. Alternative 5 Wet lacquering and Alternative 9: Powder Coating: Conclusion of technical feasibility: Not an alternative to coatings from chromium trioxide because: Insufficient sterilization/thermal-heat resistance Poor wear resistance because of low hardness of lacquers compared with metal surfaces Larger coating thickness (> 80 µm) leads to smoothening of pre- roughened surface and a loss of slip resistance Minor value and aesthetic impression of lacquered surfaces compared with metal surfaces chemical resistance /corrosion protection Substrate compatibility to brass alloys Cleaning and disinfectant solutions/ thermal disinfection Hot steam Adhesion to sterilisation Wear/abrasion substrate (change/heat- resistance resistance) Aesthetics/ Decorative coating thickness ideally < 50 µm low hardness of lacquer Biocompatibility & Nickel Leaching (no toxicity) depending on lacquer 7.1.6 Alternative 6: CVD - Chemical Vapor Deposition: Conclusion of technical feasibility: Not an alternative to coatings from chromium trioxide because: High process Temperatures > 800°C not applicable for temperature sensitive substrates as brass Do not fulfill the aesthetic requirements if golden, grey or black CVD coatings do not provide sufficient sealing and corrosion protection of the substrate against hot water steam and cleaning/disinfectants chemicals chemical resistance /corrosion protection Cleaning and Substrate disinfectant compatibility to solutions/ brass alloys thermal disinfection Hot steam sterilisation (change/heatresistance) not directly on brass / precoating depending on substarte Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative depending on substrate and pre-coatings black/dark Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 6 of 8 Biocompatibility & Nickel Leaching (no toxicity) 7.1.7. Alternative 7: DLC - Diamond Like Carbon: Conclusion of technical feasibility: Not an alternative to coatings from chromium trioxide because: Not directly applicable on brass substrates, pre-coating is required Poor adhesion performance on soft substrate materials like brass Black color does not fulfill the aesthetic requirements on bright shiny surfaces Limited sterilization cycles on pre nickel-coated substrates chemical resistance /corrosion protection Cleaning and Substrate disinfectant compatibility to solutions/ brass alloys thermal disinfection Hot steam sterilisation (change/heatresistance) not directly on brass / precoating depending on subtarte Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative depending on substrate and pre-coatings black/dark Biocompatibility & Nickel Leaching (no toxicity) 7.1.8. Alternative 8: Electroless Nickelplating: Conclusion of technical feasibility: Not an alternative to coatings from chromium trioxide because: Biocompatibility according sensitization effects of human skin cannot be guaranteed, nickel leaching Minor aesthetic of finish quality due brightness and brilliance of color chemical resistance /corrosion protection Substrate compatibility to brass alloys Cleaning and disinfectant solutions/ thermal disinfection Hot steam sterilisation (change/heatresistance) Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 7 of 8 Biocompatibility & Nickel Leaching (no toxicity) 7.1.10. Alternative 10: Stainless steel (alternative substrate) Conclusion of technical economical economic feasibility: Not an alternative to coatings from chromium trioxide because: chemical resistance is depending on steel grade. Stainless steel grades with good machinability have only limited corrosion resistance due to high cycle reprocessing. Steel grades with excellent corrosion resistance are problematic in machining and processing small precision parts with complex machining geometry and result in much higher production costs and lower processing quality (increasing defectives and major increase of machining costs) chemical resistance /corrosion protection Substrate compatibility to brass alloys Hot steam Cleaning and sterilisation disinfectant (temperature solutions/ thermal change/heatdisinfection resistance) Wear/abrasion resistance Adhesion to substrate Aesthetics/ Decorative depending on steel grade Biocompatibility & Nickel Leaching (no toxicity) depending on steel grade Final Statement to metallic coating from chromium trioxide for dental and surgical hand piece-applications: For dental or surgical hand-piece applications there are no acceptable alternatives to metallic plating from chromium trioxide. None of the alternatives would fulfill the technical requirements of dental and surgical instruments. For this reason, we also advocate for continued use of chromium trioxide for dental and surgical instruments for “functional chromium plating with decorative character” and a further review period of 7 years. Chromium trioxide - Functional chrome plating with decorative character for dental and surgical instruments Site 8 of 8