• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.178-183
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• 2001

Since the introduction of the concept of osseointegration, the success rate of dental implant has increased dramatically. So, the uses of dental implant in the treatment of partially or fully edentulous patients have played an important role in dental rehabilitation. Regardless of high success rate of dental implant, some amounts of fixtures cannot help failing. We can classify dental implant failure according to timing, causative factor, etc. This study is focused on dental implant fixture failure, occurring during preprosthetic stage. There are various reasons that cause implant failure on this periods, such as improper patient selection, poor bone quality, and periimplantitis, etc. We investigate the survival rate of 1058 fixtures, which installed in 306 patients in our clinic from January 1997 to December 1999, according to type, sex, location, fixture length and width, using Kaplan-Meier product-limit method and to compare each other with log-rank test. Overall survival rate was 96.80%, and 33 implants failed over the preprosthetic stage. Our survey data identified posterior location of mandible as being associated with implant failure(P<0.05).

• The Journal of the Korean dental association
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• v.47 no.9
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• pp.585-595
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• 2009

Purpose : The aim of this study was to compare surgical complications between simple implant placement and implant placement combined with complicated surgical procedures. We also evaluated prosthetic complications according to the specific types of prosthesis. Material and Method : A retrospective analysis of dental chart of patients who was performed implant therapy during the period from June 2003 to December 2005 was carried out. This study was performed on 408 patients (208 male, 200 female). In addition, 1671 implants were performed. Based on their medical record and radiographs, the authors evaluated surgical and prosthetic complications, surgical procedures accompanied at the time of implant, risk factors of implant failure etc. Result : Surgical complications were developed on 358 implants(21.4% on total placed implants) and wound dehiscence was most prevalent complication. On maxillary posterior area, surgical complications developed more frequently on implants with major surgery and showed a significant difference. And complication rate of implants accompanied with GBR was higher than that of simple implants placement and also showed significant difference. The implant supported prosthesis showed no statistical difference in the occurrence of complications according to the types of prosthesis, and food retention was the most common post-prosthetic complication. Also we speculated that length and width of implant showed significant correlation to the failure of implant primary osseointegration. Conclusion : Based on the result, clinician should provide more careful maintenance for patients with implant placement accompanied by complicated surgical procedure. And periodic maintenance for the patient is requested for long-term survival of implant therapy.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.4
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• pp.391-409
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• 2001

Since the early study about the osseointegration, lots of researches have been performed to increase the success rate and the stress around the implant in the jaw bone has been considered as one of the causes of failure. The purpose of this study was to examine the relationship between the implant failure and the stress by analysing the influence of different bone quality and bite force of some foods on the stress distribution around the implant, and to estimate the treatment result according to the bone quality and dietary pattern of patients. Bone quality was divided in 4 groups and models were drawn with the assumption that thread type implant(Nobel Biocare AB, Goteborg, Sweden) of 3.75mm diameter, 13mm length was installed to the bones. Various bite forces were applied to the occlusal surface of superstructure and the stress distributed around the implant were analysed with finite element analysis program. The results were as follows ; 1. The stress was changed proportionally to the bite forces of foods at all measuring points in all load cases. 2. The stress at the marginal bone was higher than that of the other measuring points in all load cases, and it was decreased at the first thread area. 3. The stress at the marginal bone was highest in type IV bone in all load cases. Especially it was twice those of other bone types at the bucco-lingual marginal bone and 50% higher at the mesio-distal marginal bone. 4. The stress at the bucco-lingual sides of the bone around the apical portions of implant showed little differences among the bone types, while type IV bone showed lower stress concentration than the other bone types in the mesio-distal sides. 5. Under the buccal oblique load ($15^{\circ}$ ), the stress at the lingual marginal bone was higher than that of buccal marginal bone, and the difference between the two points was almost same regardless of bone types.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.5
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• pp.556-571
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• 2004

Statement of problem: Surface texture of the implant is one of the important factors of the implant success, especially in the immediate implant loading. Many methods of the surface treatment of implant have developed and introduced. Purpose : This study was to evaluate the effects of the Ca-P coating implant crystallized the hydroxyapatite on the surface by the removal torque test and the histomorphometric analysis in vivo. Material and methods: 135 screw type implants, 4.0mm in length and 3.75mm in diameter were used in this study. Implants were divided into 3 groups and treated in the different mothods. Group I was not treated, Group II was treated in the SLA method, and Group III was treated in the Ca-P coating with the anodizing method and the hydroxyapatite was crystallized on the surface with the hydrothermal treatment. Firstly, the surface roughness of each group was measured, 45 rabbits were used in this experiment. Two implants were inserted on right tibial metaphysis and one implant was inserted on left side with the alternating order. After the healing periods of 3, 5, and 12 weeks, the rabbits were sacrificed to evaluate the osseointergration by the removal torque test and the histomorphometric analysis. Results : 1. In the analysis for the surface roughness, Group II showed the highest roughness. And Group III showed higher secondly. There was a significant difference one another statistically 2. In the removal torque test, Group III and II were significantly higher than Group I. There was no statistical difference between Group III and Group II. 3. For all Groups, the removal torque values at 12th week were significantly higher than at 3rd and 5th week. 4. In histomorphometric analysis, the bone implant contact rates of Group III and II were higher than that of Group I at 3rd and 5th week. There was a significant difference at 5th week. 5. In histomorphometric analysis, the bone implant contact rate of Group III and II increased from 3rd week to 5th week, but decreased at 12th week. In Group I, the contact rate at 12th week was significantly higher than at 3rd week and 5th week.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.225-243
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• 1991

In recent years immediate implantation has been tried by a few clinicians. This study placed IMZ implants in the rabbit femur with and without bony defects around the implant for simulating fresh extraction site. And one group with bony defects used porous hydroxyapatite ganules(HA) to fill if and the other group left the bony defects around the implant. The purpose of this study was to compare the shear bond strength and the bony contact and formation around the implant. Fifteen rabbits were divided into three groups and placed 10 IMZ implants to each group. Implant sites were surgically prepared with IMZ drills kit and implants were placed(Control), artificial bony defect was created with Apaceram drills kit around the implant sites and implants were placed(Experimental I), bony defect was filled with porous hydroxyapatite granules(Experimental II). Thereafter, rabbits were sacrificed at 8th week and specimens were prepared and pushout tested for shear bond strength of bone-implant interface immediately. Undecalcified and decalcified specimens were prepared with Vilanueva and hematoxylin-eosin stain for light microscopic finding. The results of this study were as follows. 1. In the control group, mean shear strength of bone-implant interface was $2.614{\pm}0.680$ MPa, experimental I was $0.664{\pm}0.322$ MPa, and experimental II was $2.281{\pm}0.606$ MPa. There was significant difference between control and experimental I, between experimental I and experimental II, but did not show significant difference between control and experimental II statistically. 2. In the bony formation surrounding IMZ implant of the three groups, that of cortical bone is more advanced than cancellous bone area. 3. In the histological findings of undecalcified specimens, control and experimental II showed more than 50% of bony or osteoid formation at the bony-implant interface. 4. In the histological findings of undecalcified specimens, experimental I showed less than 50% of bony or osteoid formation at the interface, and observed partial bony defect in the coronal zone. 5. In the experimental II group, were observed direct bony contact to hydroxyapatite granules, and infiltration of a few giant cells. 6. No inflammatory responses were seen around the titanium implants and the hydroxyapatite granules.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.1
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• pp.233-248
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• 1991

The purpose of this study was to qunatatively analyze the stress patterns induced in the abutment, superstructure, supporting bone and to determine the deflection of abutment and superstructure by appling occlusal force to natural teeth supported fixed prostheses and implant-supported fixed prostheses. The analysis has been conducted by using the two dimensional finite element method. The implant and natural tooth-supported bridge has a first molar pontic supported by mandibular second bicuspid and implant posterior retainer, which were rigidly(Model A) or flexible(Model B). The natural teeth-supported bridge has a first molar pontic supported by mandibular second bicuspid and second molar, which were rigidly splinted together(Model C). 63.5kg(Load P1) of localized load on central fossa of first molar pontic and 24kg(Load P2) of distributed load on each occlusal surface were applied respectively. 1. The coronal portion of premolar pontic and posterior abutment in fixed partial denture deflected inferiorly in order of Model B, Model C and Model A under Load P1 and Load P2. 2. Mesial displacement of the coronal portion of premolar showed in Model A, Model B and Model C under Load P1, but mesial displacement of that in Model B and distal displacement of that in Model A and Model C showed under Load P2. 3. Mesial displacement of the coronal portion of the pontic and distal displacement of the coronal portion of posterior abutment showed in Model A, Model B and Model C under Load P1 and Load P2. Displacement in the case of Model B was greater than that of Model A and Model C. 4. In the case Model A under Load P1 and Load P2, high stress apically was concentrated in the mesiocervical portion of the posterior abutment than in the disto-cervical portion of the premolar. 5. In the case of Model B under Load P1 and Load P2 high stress was concentrated in the case of the premolar than in that of posterior abutment and high stress especially was concentrated in the connected portion of pontic and posterior abutment. 6. In the case of Model C under Load P1 and Load P2, high stress was concentrated in the distal area of the cornal portion of premolar and the mesial area of the coronal portion of posterior abutment, and stress pattern was anteroposterially symmetric around the pontic. 7. Load P1 and Load P2 compared, stress magnitude was different but stress pattern was similar in Model A, Model B and Model C. 8. Under Load P1 and P2, stress magnitude in the mesial distal portion and the portion of root apex of the posterior abutment was in order of Model B, Model A and Model C.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.577-588
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• 2002

Osseointegrated implants have been established as the standard treatment modality for full/partial edentulous patients since the 1960's, and the long term results for full edentulous patients have proven to be successful. Based on these results osseointegrated implants are now widely used for partial edentulous patients. There has been an increased interest towards the efficacy of wide implants, despite many reports mentioning the lower success rate of wide implants compared to regular implants. Recently, mandibular molar area defects are commonly restored using 2 wide implants, but it is not determined whether which treatment modality-3 regular implants or 2 wide implants-shows superior success rate. In this study, 2 wide implants and 3 regular implants used for the restoration of mandibular molar area are used to compare the survival rate of 1-4 years, and to analyze and compare the failure factors. The following conclusions could be drawn from this study. 1. Wide implants and regular implants showed 94.5% and 97,6% of survival rate respectively. After prosthodontic work, the survival rate was 100% and 98.1% for wide implants and regular implants respectively. 2. 5 failed implants have been removed. 2 wide implants and 1 regular implant have been removed due to failure of osseointegration. 1 wide implant was removed due to abscess formation caused by over-heating, and 1 regular implant was removed due to mechanical failure caused by over-loading within the first year of function. 3. No statistically significant difference was observed with respect to the amount of marginal bone loss of wide and regular implants.(P>0.05) In conclusion, restoration of the mandibular molar area using 3 regular implants was found to be a good treatment modality, and 2 wide implants could he considered a good treatment modality when success factors are taken into account.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.707-727
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• 2000

매식된 인공치아의 성공을 위해서는 적절한 교합과 수동적 적합성을 갖는 보철물의 제작과 구강내 노출 직후부터의 세균성 치태조절이 요구된다. 본 연구는 전처리(passivation과 tridodecyl - methyl - ammonium chloride(TDMAC) 처리)가 다른 타이타늄 표 면에 chlorhexidine varnish와 테트라사이클린 을 도포시 약제의 방출역학을 알아보고 구강내 치태형성의 억제정도를 평가하기 위하여 시행 되었다. 이를 위해 방출용액으로 인산완충액 성분의 인조타액을 1일${\sim}$1개월간 매일 교환하여 약제농도를 측정하고 타이타늄 박막에 잔류한 약제 활성을 측정하였으며 항균제 도포한 타이타늄 원판을 부착한 장치를 구강내 위치시킨 1일${\sim}$3주 후 원판을 제거하여 주사전자현미경으로 세균 부착상을 관찰하였다. 테트라사이클린은 TDMAC 처리된 표면에서 $10{\sim}18$일까지 유효농도로 방출되었고 표면의 유효 항균 활성은 $3{\sim}4$주간 유지되었으며, chlorhexidine varnish 도포 시에는 TDMAC 전처리시 초기에 $3{\sim}7$일 간 증가한 유효 항균 활성을 방출하여 매식지대치 등에 이러한 항균제도포 시 매식치 주위환경에 항균활성 공급원으로 작용할 수 있음을 보였다. 주사현미경적 관찰시 모든 타이타늄 표면에서 구강내 위치 30분 후에는 세균이 부착되어 있지 않고 타액 단백질 성분에서 유래한 것으로 보이는 피막물질이 표면을 부분 또는 전면에 걸쳐 덮고 있었다. 구강내 노출 2시간 후 항균제 미도포 표본들에는 약간의 구균이 단층으로, $1{\sim}3$일 후에는 부분적으로 두꺼운 세균층을 형성하였고 7일 후에는 표면전체에 걸쳐 세균층이 덮여있었으며 주로 구균과 약간의 간균이 주종을 이루었다. 항균제 도포시 구강내 노출 1주일 이전까지는 미도포군에 비해 치태형성이 지연되는 경향을 보였지만 2주 이후에는 세균 수나 치태형성 양상이 유사하였다. 이 연구로부터 항균제 도포시 1주일 이전의 초기 치태형성을 감소시킬 수 있음을 알 수 있었으며 이러한 연구결과는 타이타늄 임프란트 지대치 표면에 항균제의 도포가 임상적으로 유용할 수 있음을 시사하였다.