• Journal of Periodontal and Implant Science
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• 제37권4호
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• pp.671-679
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• 2007

Background: $TiUnite^{TM}$ is a highly crystalline and phosphate enriched titanium oxide surface which has a unique porous surface structure. This improved implant surface enhances bone response and reduces healing period. It also assures early stability of implant. These help to increase the success of implant. The aim of this study is to evaluate the survival rate of $TiUnite^{TM}$ surfaced single implant. Materials and methods: A retrospective analysis of 89 $TiUnite^{TM}$ surfaced implants replacing a single tooth was assessed according to their dental record. The age of the patients ranged from 17 to 82 years (mean age: $45.8{\pm}14.6)$. Data were recorded regarding the survival rate of these implants. Results: Fifty-two implants (57%) were placed in the maxilla, and 37 (43%) in the mandible. Over 75% were placed in the posterior area. Of the placed implants, 67% were the wide type. while 25% were the regular type and only 8% were of the narrow type. The single implants produced an overall clinical survival rate of 96.6% over the observation period (mean 17.9 months). Among 89 implants, only 2 implants were removed and one implant was submerged. Conclusion: According to these data, $TiUnite^{TM}$ surfaced implant in a single tooth restoration showed favorable survival rate although this study was done in a short term period.

• 구강회복응용과학지
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• 제25권3호
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• pp.267-277
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• 2009

구강 내 단일 치아를 상실한 경우 기존에는 고정성 보철물을 이용하여 수복하는 방법이 일반적이었지만, 최근에 와서는 임플란트를 이용하여 수복하는 것이 보편화되고 있다. 본 연구는 단일 치아 결손 시 $TiUnite^{TM}$ 표면 처리한 임플란트를 이용하여 수복한 경우를 후향적으로 조사하여 그 생존율을 분석한 것이다. 2002년 9월부터 2006년 12월까지 삼성서울병원에서 단일 치아 결손 부위에 식립된 총 269개의 $TiUnite^{TM}$ 표면 처리한 임플란트 중 21개는 인접한 임플란트가 있거나, 기록이 누락되거나 관찰 기간이 짧아 연구에서 제외되었다. 248개의 임플란트 중 상악에는 129개(52.0%) 하악에는 119개(48.0%) 식립되었다. 수술 부위에 치조골 재생술을 시행한 경우는 총 100개(40.3%)였으며, 상악동 거상술이 시행된 증례는 총 36개(14.5%)였다. 수술 당일부터 관찰 기간은 평균 $26.0{\pm}11.8$ 개월이었으며, 그 기간 동안 실패한 것으로 간주된 임플란트는 12개로 생존율은 95.2%였다. 그 중 상악에서 실패한 경우가 10개, 하악에서는 2개로 각각의 생존율은 92.2%, 98.3% 이다. 단일 치아 결손 시 $TiUnite^{TM}$ 표면 처리한 임플란트를 이용하여 수복한 경우 단기간 동안 높은 생존율을 보였다.

• 대한치과보철학회지
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• 제50권1호
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• pp.61-66
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• 2012

연구 목적: 이 연구는 Br${\aa}$nemark 임플란트의 후향적인 연구를 통해 machined 임플란트 의 15년, TiUnite$^{TM}$ 임플란트의 5년 누적 생존율을 구하여 비교하고, 위험 요소와의 상관관계를 밝히고자 하였다. 연구 재료 및 방법: 본 연구는 1993년부터 2008년까지 고려대 구로병원 임플란트클리닉에서 임플란트 치료를 받은 환자를 대상으로 하여, 환자의 임상기록을 토대로 조사하였고, 임플란트 일차수술 후 즉시 부하를 가한 경우와 임플란트 보철물이 다른 임플란트 시스템과 결합한 경우는 제외하였다. 15년 간 총 155명의 환자에게 541개의 Br${\aa}$nemark 임플란트 중, 264개의 machined 임플란트와 277개의 TiUnite$^{TM}$ 임플란트를 식립하였고, 임플란트 수술 및 보철수복 술식은 Adell 등이 제안한 방법에 따랐다. 6개월에서 1년 간격으로 Follow-up을 위한 재내원 기간 동안 임플란트에 대한 임상검사를 실시하였다. 본 연구의 관찰 기간은 1차 수술일로부터 2008년 12월 이내의 최종 내원일까지였고, 임상검사시 동요도, 타진, screw loosening, 그리고 환자의 불편감 등을 관찰하고, Zarb와 Albreksson에 의한 임플란트 생존 범주를 근거로 누적생존률을 평가하였다. 임플란트 누적생존율(CSR)이 Kaplan Meier estimate를 이용하여 얻었으며, 각각의 위험요소가 누적생존율에 미치는 영향을 Cox proportional hazards regression을 이용하여 분석하였다(${\alpha}$=.05). 결과: 전체 Br${\aa}$nemark 임플란트의 15년 누적생존율은 86.07%이었고, machined 임플란트의 경우 15년 누적생존율은 82.89%, 5년 누적생존율은 89.21%였으나 Tiunite$^{TM}$ 임플란트의 5년 누적생존율은 98.74%로 machined surface가 Tiunite$^{TM}$ 임플란트에 비해 실패율이 4.6배 정도 더 높았다. 전신질환을 가진 환자의 경우 실패율이 32% 더 증가하였고, 상악동 거상술 또는 골이식을 동반한 수술 등 부가적인 수술을 받은 경우 임플란트 실패율이 40% 더 증가하여 위험 요소와 임플란트의 생존율은 상관 관계가 있었다. Kennedy 분류에 따른 부분 무치악부의 위치에 따라 임플란트 실패율이 통계적으로 유의하게 달랐으며, 소구치와 구치부가구치부가 전치부에 비해 임플란트 실패율이 높게 나타났다. 결론: Br${\aa}$nemark machined 임플란트와 TiUnite$^{TM}$ 임플란트는 모두 우수한 임상적 결과를 보였으나, TiUnite$^{TM}$ 임플란트가 더 성공적이었으며, 임플란트의 누적 생존율은 위험요소와 연관성이 있었다.

• 대한치과보철학회지
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• 제45권3호
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• pp.339-344
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• 2007

Statement of problem. Various anodic oxidation techniques can be applied to dental implant surfaces. But the condition for optimal anodized surfaces has not been described yet. Purpose. The purpose of this investigation was to compare an implant that was oxidized by another method with $TiUnite^{TM}$ through resonance frequency analysis and histomorphometry. Material and methods. Turned (control), $TiUnite^{TM}$ and another oxidized fixtures, which used $Ca^{2+}$ solution for anodic oxidation, were placed in the tibiae of 5 New Zealand White rabbits. The bone responses were evaluated and compared by consecutive resonance frequency analysis once a week for 6 weeks and histomorphometry after a healing period of 6 weeks. Results. At the first week, both oxidized implants showed significantly higher implant stability quotient (ISQ) values than the control. No significant differences in resonance frequency analysis were found between the two oxidized groups for 6 weeks. The means and standard deviations of bone-to-implant contact (BIC) ratios were $71.0{\pm}4.2$ for $TiUnite^{TM}$, $67.5{\pm}10.3$ for the $Ca^{2+}$-based oxidation fixture, $22.8{\pm}6.5$ for the control. Both oxidized implants were significantly superior in osseointegration to the turned one. There was, however, no statistically significant difference between the two oxidized implants. Conclusion. $TiUnite^{TM}$ and the $Ca^{2+}$-based oxidation fixture showed superior early bone response than the control with respect to resonance frequency analysis and histomorphometry. No significant differences between the oxidized groups, however, were found in this investigation using the rabbit tibia model.

• Journal of Korean Dental Science
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• 제1권1호
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• pp.4-9
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• 2008

Purpose : This study sought to examine the aspects of crestal bone resorption and to evaluate the clinical outcomes of the TiUnite$^{(R)}$ (Nobel Biocare, Sweden) anodized implant system. Materials and Methods : Among the 67 patients (211 fixtures) who were treated using TiUnite(r) implants at Seoul National University Bundang Hospital between March 2004 and January 2007, 26 (91 fixtures) were considered in this study. Initial and secondary stabilities were measured using Periotest$^{(R)}$ and Ostell(tm) Mentor. The radiographic evaluation of crestal bone resorption was carried out by measuring the change in crestal bone level at the time of surgery compared to that 1 year after loading. Panoramic radiograph and periapical radiograph were used. Based on the radiographic findings, the shapes of crestal bone resorption were classified. Results : The average amount of crestal bone resorption after 1 year of functional implant loading was 0.30 mm. There was no saucerization in 40 implant fixtures (43.9%), although more than 1 thread were exposed in 51 implant fixtures (56.6%). The success rate of the implants was 94.5%, and the survival rate was 100%. Conclusions : Good clinical outcomes and minor crestal bone resorption were noted in this study. Saucerization for the establishment of biological width was not a general finding in the TiUnite$^{(R)}$ anodized implant system.

• The Journal of Advanced Prosthodontics
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• 제3권4호
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• pp.190-195
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• 2011

PURPOSE. This study evaluated the initial stability of different implants placed above the bone level in different types of bone. MATERIALS AND METHODS. As described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Br${\aa}$nemark System$^{(R)}$ Mk III TiUnite$^{TM}$, Straumann Standard Implant SLA$^{(R)}$, and Astra Tech Microthread$^{TM}$-OsseoSpeed$^{TM}$) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis. RESULTS. In the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Br${\aa}$nemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants. CONCLUSION. The initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.

• 대한치과보철학회지
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• 제44권1호
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• pp.40-50
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• 2006

Statement of problem: $Periotest^(R)\;and\;Osstell^{TM}$ were known as the most objective and quantitative mobility tests available for evaluating stability of implant in vivo. Although a correlation between PTV widely used and ISQ recently introduced exist, a PTV was corresponded to various ISQ. A correct evaluation of implant stability could be obtained only after one has a thorough understanding of the limitations of devices and factors that affect measurements. Purpose: The purpose of this study was to investigate the causes of variables in the values obtained with these two tests. Material and method: A total of 333 implants 134 $Br{\aa}nemark$, 5 Silhouette and 194 ITI implants were investigated. Result: 1. There was a correlation between PTV and ISQ (Spearman correlation =0.39, p<0.0001) 2. The factors that affected ISQ were diameter of implant future, location of implant and implant system (submerged type vs non-submerged type). 3. The factors that affected W were dimeter of implant future, location of implant, and elapsed time after implant placement. 4. There was no significant difference between different surface treatments of RBM, smooth surface and ti-unite on PTY and ISQ. 5. In radiographic finding, no saucerization or bone resorption has been detected in implants with ISQ values that were above the average level of each PTV. These higher values had higher bone densities around the implant fixture. Saucerization was observed in the most impants with ISQ values that were below the average level of each PTV. Conclusion: There was a correlation between ISQ and PTV. However, each measuring methods had factors influencing the measured values. PTV were less sensitive to marginal bone resorption and influenced with the striking point on an implant to the level of bone. With ISQ, the height of implant from bone level to transducer should be considered.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.535-542
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• 2007

Background : Repeated dis/re-connection of implant abutment caused bone loss around implant fixtures due to the new formation of biologic width of the mucosal-implant barrier. The aim of this clinical study was to evaluate whether the repeated dis/re-connection of implant abutment cause bone loss clinically and the effect of cleansing methods on a bone loss during the early healing period. Methods : A total 50 implants were installed in 20 patients and repeated dis/re-connection of abutment was performed at the time of surgery and once per week for 12 weeks. 0.9% normal saline solution as group1 and 0.1% chlorhexidine solution as group 2 was used to clean abutments. All patients had radiographs taken at the placement of implant and 4, 8, and 12 weeks postoperatively. The data for bone loss around implant were analyzed. Results: The marginal bone loss at 12 weeks were $1.28{\pm}0.51mm$, $1,32{\pm}0,57mm$ in the mesial and distal sides in group1, $1.94{\pm}0.75mm$, $1.81{\pm}0.84mm$ in group 2, respectively. In view of marginal bone loss, there was not a significant statistical difference between groups. Conclusions : Repeated dis/re-connection of implant abutment may not cause marginal bone loss around implant fixture although limited samples and short-term observation period. In spite of more bone loss in group 2, there was no statistical significant difference between groups. In context of those results, the clinical significance of the repeated dis/re-connection of implant abutment and the cleansing method of abutments is debatable when it comes to marginal bone loss during early healing period.

• 대한치과보철학회지
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• 제43권6호
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• pp.745-750
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• 2005

Statement of problem. Resonance frequency analysis has been increasingly served as a non-invasive and objective method for clinical monitoring of implant stability. Many clinical studies must be required for standardized data using RFA. Purpose. This study was performed to evaluate RFA value changes in two anodized implant groups. Material and method. Among a total of 24 implants, twelve screw shaped implants as a test group (H2-R8.5) were manufactured, which had a pitch-height of 0.4 mm, an outer diameter of 4.3 mm, a length of 8.5 mm, and external hexa-headed, were turned from 5 mm rods of commercially pure titanium (ASTM Grade IV, Warantec Co., Seoul, Korea), and another twelve implants as a control group were $Br{\aa}nemark$ Ti-Unite MK4 (diameter 4.0 mm, length 8.5 mm). Each group was installed in tibia of rabbit. Two implants were placed in each tibia (four implants per rabbit). Test two implants were inserted in right side and control two in left side. ISQ values were measured using $Osstell^{TM}$ (Integration Diagnostics Ltd. Sweden) during fixture installation, and 12 weeks later and evaluated the RFA changes. Results. Mean and SD of baseline ISQ values of test group were $75.0{\pm}3.4$ and $68.7{\pm}8.1$ for control group. Mean and SO of ISQ values 12 weeks after implant insertion were $73.2{\pm}4.7$ for test group and $72.6{\pm}3.9$ for control group. There were no statistically significant differences between groups in ISQ values after 3 months (P>0.05). From the data, RFA gains after 3 months were calculated, and there was statistically significant difference between groups (P<0.05). Conclusion. Although there were RFA changes between groups, implant stability after experimental period shows alike tendency and good bone responses.

• Journal of Periodontal and Implant Science
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• 제35권4호
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• pp.891-905
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• 2005

The present study was performed to evaluate the effect of tetracycline-HCL on the change of implant surface microstructure according to application time. Implant with pure titanium machined surface. HA-coated surface and TiUniteTM surface were utilized. Implant surface was rubbed with 50mg/ml tetracycline-HCL solution for $\frac{1}{2}min.$, 1min., $1\frac{1}{2}min.$, 2min., and $2\frac{1}{2}min.$ respectively in the test group. Then, specimens were processed for scanning electron microscopic observation. The results of this study were as follows. 1. Both test and control group showed a few shallow grooves and ridges in pure titanium machined surface implants. There were not significant differences between two groups. 2. In HA-coated surfaces, round particles were deposited irregularly. The roughness of surfaces conditioned with tetracycline-HCL was lessened and the cracks were increased relative to the application time. 3. The anodic oxidized surfaces showed the craterous structures. The surface conditioning with tetracycline-HCl didn't influence on its micro-morphology. In conclusion, the detoxification with 50mg/ml tetracycline-HCL must be applied respectively with different time according to various implant surfaces.