• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.417-429
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• 2009

Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved and accepted as viable option for the treatment of fully and partially edentulous patients. Although the use of domestic implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. 96 endosseous implants placed in 31 patients at Wonkwang University Sanbon Dental Hospital were examined to determine the effect of various factors on implant survival rate and marginal bone loss, through clinical and radiographic results. The design of endosseous implant used to this study is straight with the microthread.(GS II RBM Fixture) 1. 3 fixtures were lost, resulting in 96.9% cumulative survival rate. 2. Survival rate in fifties was significantly lower (93.6%) and no significant difference in marginal bone loss was found according to gender. 3. Survival rates were 95.6% in the maxillary molar area and 97.3% in the mandible molar area. 4. No significant difference in survival rate was found according to presence of bone grafts, type of prostheses, implant position, and length and diameter of implant. 5. A factor influencing marginal bone loss was presence of type of prostheses, while facters such a length, diameter of fixture and bone grafts had no statistically significant effect on crestal bone loss. This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.419-432
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• 2010

Various torque generating devices have been developed and employed to apply a proper torque. These devices are usually calibrated by the manufacturer to apply appropriate torque levels for their specific implants and attachments. The purpose of this investigation was to determine and compare the accuracy of the torque controllers. In this study, 4 types of torque controllers were used; torque limiting device(TLD), torque indicating device(TID) and contra angle torque driver(CA), electronic torque controller(ETC). Digital torque gauge was employed to measure the de-torque value. Thirty cycles of tightening and loosening were repeated with each torque controller. All implant torque controllers have shown slight errors and deviations. The contra angle torque driver exhibited the most accurate data. In the limitation of this study, it would be recommended that the implant torque controllers should be checked whether uniformed and precise torque can be generated and a measuring error should be corrected.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.205-220
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• 2010

Purpose : To analyze the effect of implant designs on insertion torque and stress by performing a comparative study on von Mises stress, torque and normal force through a three-dimensional finite element analysis. Materials and methods : Models of the screw type implant were used to model the implant as a form placed in the mandibular premolar region applying a three-dimensional finite element method. Screw type implant designs were classified into 4 types of parallel ones and 7 types of tapered ones. Other factors were simulated to represent clinical environment. Results : In parallel implant designs, higher and wider threads resulted in higher insertion torques and higher stress distributions. In tapered implant designs, changes in the taper led to remarkable differences in the insertion torques. It was difficult to determine a certain tendency of stress distribution around the implants since the stress level was too high around them. In tapered implant designs, smaller implants demonstrated lower insertion torques than the original type and were relatively less dependent on the degree of taper. Tapered implants showed higher insertion torques and higher stress distributions than parallel implants. Conclusion : According to this study, although the tapered implant demonstrated a higher insertion torque than the parallel implant, stress tended to be concentrated in the entire fixture of the tapered implant due to the inefficient stress distribution.

• Journal of Periodontal and Implant Science
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• v.36 no.1
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• pp.167-177
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• 2006

연구배경 임플란트에 관한 전통적인 연구들은 주로 임플란트 매식체와 골조직간의 결합에 중점을 두어왔다. 최근 임플란트의 심미적 관점에 대한 관심이 높아지면서 임플란트 주위 연조직의 재건 및 유지에 대한 연구들이 많이 이루어지고 있다. 이번 연구는 임플란트 주위 연조직이 임플란트 지대주의 모양에 따라 어떻게 반응하는지 알아보고자 한다. 연구방법 및 재료 2 마리의 성견을 대상으로, 먼저 하악의 모든 소구치를 발치하고, 3개월의 치유 기간 후에 각 4분악에 실험에 사용된 3개의 다른 모양의 지대주를 가진 임플란트를 식립하였다: (1) 위로 벌어진 모양의 지대주 (2) 안쪽으로 오목하게 좁아진 지대주 (3) 평행한 모양의 지대주. 식립 순서는 무작위로 하였으며, 3개월 후 실험동물을 희생하고 조직 표본을 얻었다. 조직 표본은 광학 현미경을 통해 관찰하고, 상피, 결합조직, 전체 연조직의 수직적 거리를 측정하여 비교하였다. 연구 결과 이번 연구에서 임플란트 주위의 연조직을 측정한 결과, 접합 상피는 1.21 ${\pm}$ 0.47 mm, 결합조직은 1.16 ${\pm}$ 0.39 mm, 전체 연조직 두께는 2.37 ${\pm}$ 0.47 mm로 이전의 연구들과 비슷한 결과를 보였다. 지대주 주위의 연조직 중 결합조직이 많은 부위에서는 여러 주행 방향의 교원 섬유들이 관찰되었다. 그 중에서 결합조직이 차단막으로써의 역할을 할 수 있도록 하는 원형으로 주행하는 교원 섬유들이 모든 지대주 모양에서 관찰되었다. 특히 오목하게 좁아진 모양을 가진 지대주에서는 오목하게 파인 부분으로 많은 원형으로 주행하는 교원 섬유들이 관찰되었다. 오목한 모양의 지대주는 다른 모양의 지대주에 비해서 측면 방향의 연조직 두께가 두꺼웠다. 특히 위로 벌어진 모양의 지대주에 비해서 두꺼운 연조직을 확보할 수 있었으며, 내부에 많은 결합조직 교원 섬유들을 관찰할 수 있었다. 결론 이번 연구에서 오목한 모양의 지대주가 연조직을 두껍게 유지하고, 많은 원형으로 주행하는 교원 섬유들을 확보할 수 있었다. 이를 통해 오목한 여태의 지대주가 연조직 유지에 더 유리하고, 따라서 심미적인 부위에서 연조직의 퇴축을 예방하는데 더 유리하다고 할 수 있다.

• Journal of Periodontal and Implant Science
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• v.35 no.2
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• pp.383-399
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• 2005

The successful implantation necessitate tissue regeneration m site of future implant placement, there being severe bone defect. Therapeutic approaches to tissue regeneration in the site have used bone grafts, root surface treatments, barrier membranes, and growth factors, the same way being applied to periodontal tissue regeneration. Great interest in periodontal tissue regeneration has lead to research in bone graft, guided-tissue regeneration, and the administration of growth factors as possible means of regenerating lost periodontal tissue. The blood component separated by centrifuging the blood is the platelet-rich plasma. There are growth factors, PDGF, $TGF{beta}1$, $TGF{beta}2$ and IGF in the platelet-rich plasma. The purpose of this study was to study the histopathological correlation between the use of platelet-rich plasma and the healing of bone defect around implant fixture site. Implant fixtures were inserted and graft materials were placed into the left femur of in the experimental group, while the control group received only implant fixtures. In the first experimental group, platelet-rich plasma and BBP xenograft were placed at the implant fixture site, and the second experimental group had platelet-rich plasma, BBP xenograft, and the e-PTFE membrane placed at the fixture site. The degree of bone regeneration adjacent to the implant fixture was observed and compared histopathologically at 2, 4, and 8 weeks after implant fixture insertion. The results of the experiment were as follows: 1. Bone remodeling in acid etched surface near the implant fixture of all experimental groups was found to be greater than new bone formation. 2. Bone remodeling in acid etched surface distant to the implant fixture of all experimental groups was decreased and new bone formation was not changed. 3. Significant new bone formation in machined surface near the implant fixture of bothl experimental groups was observed in 2 weeks. 4. New bone formation in machined surface distant to the implant fixture of both experimental groups was observed. Bone remodeling was significant in near the implant fixture and not in distant to the implant fixture. The results of the experiment suggested that the change of bone formation around implant. Remodeling in machined surface distant to the implant fixture of both experimental groups, and new bone formation and remodeling near the implant fixture were significant.

• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.741-755
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• 1995

Currently titanium is the material of choice for implants because of its biological acceptance. This high degree of biocompatibility is thought to result, in part, from the protective and stable oxide layer that presumably aids in the bonding of the extracellular matrix at the implant-tissue interface. Endosseous dental implants are interfaced with bone, connective tissue, and epithelium when implanted into the jaw bone. The soft tissue interface including connective tissue and epithelium is one of the most critical factors in the determination of implant maintenance and prognosis. For maintenance of failing or failed implants, it is essential to treat the implant fixture surface to remove bacterial endotoxins and make a surface tolerated by surrounding soft and hard tissues. In this study, the effect of mechanical treatment on titanium plasma sprayed implant on adhesiveness and proliferation of human gingival fibroblasts and changed surface characteristics were studied. titanium plasma sprayed discs manufactured by Friedrichsfeld company were treated with loaw speed stone bur, a rubber point and a jetpolisher. Its surface components were analyzed with Energy dispersive X-ray spectroscopy to evaluate whether the surface characteristics were altered or not. To observe the spreading pattern of the human gingival fibroblasts which attached to the all specimens author used the scanning electron microscope. The results were as follows : Pure titanium and plasma sprayed titanium, stone polished titanium showed titanium peak and small amout of aluminum, so there was no alteration on surface characteristics. Under the scanning electron microscopic examination in the initial attachment of human gingival fibroblast, there was a slight enhancement in pure titanium, stone polished titanium than plasma sprayed titanium. After 6 hours, the pure titanium and stone polished titanium showed human gingival fibroblasts were elongated and connected with numerous processes. Human gingival fibroblasts were more intimately attached on the pure titanium discs than on the other discs. The human gingival fibroblasts attached on the plasma sprayed titanium by thin and elongated processes. After 24 hours, the human gingival fibroblasts connected with each other via numerous processes and compeletly covered the pure titanium and stone polshed titanium discs. Human gingival fibroblasts had multiple point contacts with more long and thin lamellopodia and showed a little bare surface on plasma sprayed titanium discs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.406-414
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• 2001

In recent decade, there has been a very rapid development in technical possibilities to provide patients with maxillofacial prostheses. Dr. Brenemark first introduced possibility of use of maxillofacial interosseous implant in patients with ablative tumor surgery in 1979. He did introduce the new type of maxillofacial implants system which widen the fixture flange on top of the bone. The advantages of fixed prostheses with implants were well known to various ways, easy to attach, keep clean prostheses, and not to disturb recipient bed. But there are some problems to install implants on maxillofacial regions, because mostly facial bone has very thin cortical bone and poor bone quality. It needs more retention between implant and bone which overcome that fault with fixture flange. To make maxillofacial prostheses, it should be understood general procedure of maxillofacial laboratory work. Ear and midface maxillofacial fabrication which include nose and eye defects will be described step by step.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.1
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• pp.7-23
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• 1990

The success or failure of endosseous dental implants is related to the cellular activity at the implant surface. Success seems to be associated with the enclosure of the implant in a non-inflammed connective tissue or the formation of a direct bone implant interface. The purpose of this study was to examine the tissue reactions to the various implants at the submergible state in dog mandible. The $Br\"{a}nemark$, Core-Vent, Intergral, Bone spiral were selected for evaluation and also the Kimplant, Nephrite were used for the experimental study. After 4 months the animals were sacrificed. The interface zone between bone and implant was investigated using x-rays, light microscope, scanning electron microscope, transmission electron microscope. The following results were obtained from this study. 1. $Br\"{a}nemark$, Core-Vent, Kimplant, Integral showed no mobility and bone growth over the healing screws of the implants. Histologically most of the implant surface were covered by remodelled lamellar bone, and partly by a cellular layer or the thin fibrous tissue layer. 2. The Bone spiral showed no mobility and partially radiolucent line around the implant. The upper part of the implant was surrounded by a thin fibrous connective tissue and the middle, apical part of it were contacted with bone directly. 3. The Nephrite implant showed severe mobility and a radiolucent line around the implant. Histologically it showed mild inflammation and was surrounded by a fibrous connective tissue. 4. Scanning electron microscope showed that there was no amorphous ground substance in the Nephrite implant but the formation of ground substance over the collagen filaments in other implants. 5. Transmission electron microscope showed that collagen filaments were approached irregularly to the surface of all implants and in the $Br\"{a}nemark$, Core-Vent, Kimplant, Integral there was amorphous layer between the implant and the collagen filaments. It seemed to be ground substances.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.4
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• pp.321-329
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• 2002

Bending moments results from offset overloading of dental implant, which may cause stress concentrations to exceed the physiological capacity of cortical bone and lead to various kinds of mechanical failures. The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different angulated placement of dental implant in mandibular posterior missing areas. The three kinds of finite element model, were designed according to 3 main configurations: Model 1(parallel typed placement of 2 fixtures), Model 2(15. distal angulated placement of one fixture on second molar area), Model 3(15. mesial angulated placement of one fixture on second molar area). The cemented crowns for mandibular first and second molars were made on the two fixtures (4mm 11.5). Three-dimensional finite element models by two fixtures were constructed with the components of the implant and surrounding bone. A 200N vertical static load were applied to the center of central fossa and the point 2mm apart from the center of central fossa on each model. The preprocessing, solving and postprocessing procedures were done by using FEM analysis software NISA/DISPLAY IV Version 10.0((Engineering Mechanics Research Corporation, USA). Von Mises stresses were evaluated and compared in the supporting bone, fixtures, and abutment. The results were as following : (1) Under the point loading at the central fossa, the direction of angulated fixture affected the stress pattern of implants. (2) Under the offset loading, the position of loading affected more on the stress concentration of implants compare to the angulated direction of implants. The results had a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the placement angulation of implant fixture is placed toward mesial or distal direction. In designing of the occlusal scheme for angulated placement, placing the occlusal contacts axially during chewing appears to have advantages in a biomechanical viewpoint.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.164-173
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• 2009

Purpose: The purpose of this study was to evaluate the effect of abutment material on screw-loosening before and after cyclic loading. Among the different materials of abutments, zirconia and metal abutment were used. Material and methods: Two types of implant systems: external butt joint(US II, Osstem Implant, Korea) and internal conical joint(GS II, Osstem Implant, Korea) were used. In each type, specimens were divided into two different kinds of abutments: zirconia and metal(n=5). The implant was rigidly held in a special holding to device ensure fixation. Abutment was connected to 30 Ncm with digital torque gauge, and was retightened in 30 Ncm after 10 minutes. The initial removal torque values were measured. The same specimens were tightened in 30 Ncm again and held in the cycling loading simulator(Instron, USA) according to ISO/FPIS 1480. Cycling loading tests were performed at loads 10 to 250 N, for 1 million cycles, at 14 Hz,(by subjecting sinusoidal wave from 10 to 250 N at a frequency of 14 Hz for 1 million cycles,) and then postload removal torque values were evaluated. Results: 1. In all samples, the removal values of abutment screw were lower than tightening torque values(30 Ncm), but the phenomenon of the screw loosening was not observed. 2. In both of the implant systems, initial and postload removal torque of zirconia abutment were significantly higher than those of metal abutment(P<.05). 3. In both of the implant systems, the difference in removal torque ratio between zirconia abutment and metal abutment was not significant(P>.05). 4. In metal abutments, the removal torque ratio of GS II system(internal conical joint system) was lower than that of US II system(external butt joint system)(P<.05). 5. In zirconia abutments, the difference in removal torque ratio between the two implant systems was not significant(P>.05). Conclusion: Zirconia abutment had a good screw joint stability in the condition of one million cycling loading.