• The Journal of Korean Academy of Prosthodontics
• /
• v.56 no.2
• /
• pp.114-119
• /
• 2018

Purpose: Patients who treated implant immediate loading within a week after implant placement at Wonkwang University Dental Hospital Implant Center were evaluated marginal bone resorption. These retrospective analyses are intended to reinforce the clinical evidence for the implant immediate loading. Materials and methods: Medical history and radiographic data were investigated, which were the patients' who treated implant immediate loading and restoration with provisional prostheses between January 2005 and June 2016, at Wonkwang University Dental Hospital Implant Center. Total number of implants was 70, marginal bone resorption was measured according to implant length, diameter and connection type. To measure marginal bone resorption, periapical radiographs were taken when the implants were placed and after 6 month. Statistical analysis was done in Mann-whitney U test and Kruskal-wallis test with SPSS 22.0 software (P<.05). Results: Mean marginal bone resorption around immediately loaded implants according to implant connection type was shown $1.24{\pm}0.72mm$ in internal hexagon connection type and $1.73{\pm}1.27mm$ in external hexagon connection type. There was no statically significant difference in marginal bone resorption with implant length and diameter. Conclusion: Implants with immediated loading in internal hexagon connection type showed less marginal bone resorption significantly than in external hexagon connection type.

• The Journal of Korean Academy of Prosthodontics
• /
• v.48 no.1
• /
• pp.28-40
• /
• 2010

Purpose: The aim of this retrospective study was to provide long-term data about the correlation between multifactorial local factors and the survival of implants. Material and methods: During 19 years (1991 to 2009), 2796 implants were placed in 879 patients. From dental charts and radiographs, the following data were collected: patient's age at implant placement, gender, implant system, surface, length, diameter, location of implant placement, bone quality, primary stability, type of prosthesis. The correlations between these data and implant survival were analyzed. Statistical analysis was performed using Kaplan-Meier survival analysis, Chi-square test, odds ratio. Results: 1. Among the 2796 implants, 150 implants failed that resulted in a cumulative survival rate of 94.64%. The cumulative survival rate of smooth surface implants (91.76%) was lower than rough surface implants (96.02%). 2. Anatomic location, implant surface, diameter of smooth surface implant, primary stability, type of prosthesis, patient's age and gender were significantly associated with implant survival (P < .05). 3. No significant difference in implant survival was found in relation to the following factors: implant length, bone quality, diameter of rough surface implants and type of rough surface according to implant manufacturer (P < .05). Conclusions: Local factors such as anatomic location, implant surface, diameter of smooth surface implant, primary stability and type of prosthesis have a significant effect on implant survival.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.3
• /
• pp.255-265
• /
• 2009

Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

• Journal of Periodontal and Implant Science
• /
• v.35 no.1
• /
• pp.153-161
• /
• 2005

파이브로넥틴은 세포외기질에 존재하는 당단백질로 세포의 부착, 이동, 성장 및 분화에 관여하며, 섬유아세포 성장인자는 세포의 증식 이동 및 분화에 영향을 주는 중요한 성장인자로 알려져 있다. 최근 연구에 의하면, 파이브로넥틴은 조골세포의 타이태늄 임플란트 표면으로 이주와 증식 및 골생성을 촉진하며, 섬유아세포 성장 인자는 파이브로넥틴에 상승작용을 한다고 보고된 바 있다. 이 실험의 목적은 파이브로넥틴 및 섬유아세포 성장인자의 복합 단백질을 이용하여 타이태늄 임플란트의 골 반응을 알아보는 것이다. 체중 2.5 kg 내외의 건강한 18 마리의 웅성가토를 준비하여 무균 사육하였고, 순수 타이태늄을 절삭가공하여 직경 3.5mm, 길이 6mm 의 machined surface를 지니는 screw type 의 임플란트를 준비하였다. 사람의 유전자를 기초로, 유전자 재조합법을 통해, 적절한 primer를 이용하여 얻은 섬유아세포 성장인자를 파이브로넥틴 III 형 분절의 9-10 번 도메인에 결합시켜 얻은 복합 단백질을 준비된 임플란트에 표면처리하여 실험군으로 하였고, 표면처리하지 않은 임플란트를 대조군으로 하여, 가토의 좌우 경골에 각각 2 개씩의 임플란트를 식립하였다. 4주 후, 가토를 희생시켜 각 경골 당 한 개의 임플란트에서 뒤틀림 제거력을 측정하였고 나머지 임플란트 식립 부위 에서는 경골을 포함하는 조직표본을 제작하였다. 조직표본상에서 골접촉이 가장 좋은 3 개의 나사산의 길이를 측정하고, 나사와 접촉하는 골의 길이를 측정하여 골-임플란트 접촉도를 구하고, 같은 부위에서 나사산 사이의 면적과 골이 차지하는 면적을 비교하여 골생성률을 얻었다. 실험군과 대조군의 결과는 Student t-test 를 이용하여 신뢰도 95% 수준에서 통계학적 유의성을 검정하였다. 파이브로넥틴과 섬유아세포 성장인자의 복합 단백질로 표면처리된 임플란트와 표면처리를 하지 않은 임플란트는 뒤틀림 제거력에서는 통계적 유의성이 나타나지 않았으나, 골-임플란트 접촉도와 골생성률에서 복합 단백질로 처리된 임플란트가 통계적으로 유의하게 높은 결과를 보였다. 이상의 연구결과로, 섬유아세포 성장인자와 파이브로넥틴 복합 단백질로 처리한 타이태늄 임플란트가 주변 골 형성을 촉진시켜, 골유합을 증진시킴을 알 수 있었다. 따라서, 복합 단백질이 타이태늄 임플란트의 성공률을 높이기 위한 표면개질 물질로 이용될 가능성을 확인할 수 있었다.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.4
• /
• pp.417-429
• /
• 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
• /
• v.34 no.1
• /
• pp.32-38
• /
• 2018

Purpose: The purpose of present study was to retrospectively analyze the survival rate of narrow diameter implant less than 3.6 mm by initial stability and radiographic measurements. Materials and Methods: In total, 24 patients who received 38 narrow diameter implants (${\leq}3.6mm$ in diameter, ${\geq}7mm$ in length) were enrolled in this retrospective study. The cumulative survival rate was calculated and various factors were investigated according to the implant platform diameter, body diameter, length, position, concomitant use of guided bone regeneration in implant placement and final prosthesis type. Initial stability was investigated with implant stability quotient (ISQ) value. The mesial and distal marginal bone level (MBL) change was calculated with radiography. Results: The overall survival rate was 92.11%. Mean ISQ value and MBL change of survival implants was 66.26 and $0.14{\pm}0.31mm$, respectively. None of the implants with platform diameters larger than the body diameter failed. Conclusion: In conclusion, the findings of present study suggest that narrow diameter implant could be predictable treatment in narrow alveolar ridge.

• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.3
• /
• pp.335-341
• /
• 2009

Statements of problem: Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the actual effect of dimensional change in implant geometry on initial stability. Purpose: The purpose of the current study was to investigate the influence of diameter and length changes on initial stability of implants. Material and methods: Four types of dummy bone (D1, D2, D3 and D4) consisted of cortical and cancellous layers with different thickness were simulated. Implants which had similar surface area to each other ($3.5{\times}13.0-mm$, $4.0{\times}11.5-mm$, $4.5{\times}10.0-mm$, $5.0{\times}8.5-mm$) were inserted in dummy bones. Implant stability as a function of peak insertion torque and resonance frequency values were recorded for each implant. Results: 1. Bone quality was a major influential factor to achieve initial stability (P <.05). 2. In D1, D2 and D3 dummy bones, implant stability quotient values were not significantly different to each other (P >.05), however insertion torques were increased with wider and shorter implants (P <.05). 3. In D4 dummy bone, implant stability quotient values and insertion torques were decreased with wider and shorter implants (P <.05). Conclusion: From a point of view of initial stability, it is suggested that use of wide and short implant may be helpful in avoiding bone augmentation procedures in area of adequate bone quality.

• The Journal of Korean Academy of Prosthodontics
• /
• v.55 no.3
• /
• pp.251-257
• /
• 2017

Purpose: The purpose of this study was to evaluate whether the internal abutment length affected screw stability in an internal connection implant. Materials and methods: Twenty long internal connection implants (Replus system, $4.7{\times}11.5mm$) were selected for this investigation. Abutments were assigned to four groups depending on the length of the internal connection (abutments with internal lengths of 1, 2, 3, and 4 mm, respectively). Each implant fixture specimen was embedded in resin medium and connected to an abutment with an abutment screw. A load of 100 N, applied at an angle of $30^{\circ}$ to the long axis of the implant, was repeated for $1.0{\times}10^6$ cycles. Reverse torque values (RTV) were recorded before and after loading, and the change in RTV was calculated. Data were analyzed with the Kruskal-Wallis test. Results: The change in RTV was not significantly different among the groups (P>.05). Screw loosening and fractures were not observed in any groups, and joint stability was maintained. Conclusion: The internal length of the abutment may not significantly affect the degree of screw loosening.

• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.1
• /
• pp.70-81
• /
• 2009

Statement of problem: The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever-rest-implant" and Malo reported "All-on-Four" in 2003. Purpose: Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and All-on-$Four^{TM}$ implant prostheses. Material and method: The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0. Results: 1. The rest implant and "All-on-Four" implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.2
• /
• pp.110-119
• /
• 2016

Purpose: This study is aimed to assess changes of stress distribution dependent on different connection lengths and placement of the fixture top relative to the ridge crest. Materials and methods: The internal-conical connection implant which has a hexagonal anti-rotation index was used for FEM analysis on stress distribution in accordance with connection length of fixture-abutment. Different connection lengths of 2.5 mm, 3.5 mm, and 4.5 mm were designed respectively with the top of the fixture flush with residual ridge crest level, or 2 mm above. Therefore, a total of 6 models were made for the FEM analysis. The load was 170 N and 30-degree tilted. Results: In all cases, the maximum von Mises stress was located adjacent to the top portion of the fixture and ridge crest in the bone. The longer the connection length was, the lower the maximum von Mises stress was in the fixture, abutment, screw and bone. The reduction rate of the maximum von Mises stress depending on increased connection length was greater in the case of the fixture top at 2 mm above the ridge crest versus flush with the ridge crest. Conclusion: It was found that the longer the connection length, the lower the maximum von Mises stress appears. Furthermore, it will help prevent mechanical or biological complications of implants.