• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.181-188
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• 2010

Purpose: The purpose of this study was to compare the stress distribution characteristics of four different abutment connections on SS-$III^{(R)}$ fixture under occlusal loading, using 3-dimensional finite element method. Materials and methods: The fixture of SS-$III^{(R)}$ (Osstem, Korea) with 4 mm diameter and 11.5 mm length and 4 types of abutments were analyzed; Solid, Com-Octa, ComOcta Gold, and Octa abutment. The models were placed in the area of first molar in the mandible. The 4 loading conditions were; (1) the vertical loading of 100 N on the central fossa, (2) the vertical loading of 100 N on the buccal cusp, (3) the $30^{\circ}$ inclined loading of 100 N to lingual side on the central fossa, and (4) the $30^{\circ}$ inclined loading of 100 N to the lingual side on the buccal cusp. The 3G.Author program was used, the von-Mises stress was calculated and the stress contours were plotted on each part of the implant systems and the surrounding bone structures. Results: Regardless of abutment types and loading conditions, higher stress concentration was observed at the cortical bone. In cancellous bone, the highest stress was observed at apical portion and the maximum stress occurred at the implant neck. The higher internal stress was observed in the fixtures than in the bone. The lowest stress was observed at loading condition 1 and the stress concentration was also lower than any other loading conditions. Conclusion: Within the limitation of the result of this study, it seems that the abutment connection type does not affect much on the stress distribution of bone structure.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.321-327
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• 2020

Purpose: The purpose of this study was to measure and compare the strain value exerted on the cervical area using different screw tightening protocols in implant-supported, screw-retained 3-unit prostheses. Materials and methods: Strain gauges were attached to four implants: two external and two internal. Thereafter, two study model were designed each type using acrylic resin. CAD-CAM was used to design hex and nonhex abutments for each group (EH, ENH, IH, and INH group) and Screw-cement-retained prostheses were also designed using a nonprecious base metal. Abutment was fixed with 10 Ncm torque, and the prosthesis was cemented. Screws were fixed with 30 Ncm torque using different three protocols. After 5 min, the strain gauge level was measured, and group analysis was performed (α=.05). Results: External group showed significantly lower strain values than internal group and the EH group showed significantly lower strain values than the ENH group (P<.05). There was no difference in strain value based on the types of screw tightening protocols in same group (P>.05). The IH group exhibited significantly higher strain values than the INH group and the IH group showed a significant difference in strain values based on the types of screw tightening protocols used (P<.05). Conclusion: There was no significant effect on the external type in the implant-supported, screw-retained prostheses. However, strain values were high in the internal type, and the types of screw tightening protocol significantly affected these implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.1
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• pp.29-40
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• 2020

Purpose: The purpose of this study was to compare the accuracy of impression taking method using the encoded healing abutment, scan body and pick-up impression coping with different implant angulations. Materials and Methods: Master model was fabricated by 3D printer and three implants were placed into the model with 0°, 10° and 20° mesial angulation. The abutments were secured to each implants and master model was scanned to make a reference model. Group P model was fabricated using pick-up impression copings and model was scanned after securing the abutments. Encoded healing abutment (Group E) and scan body (Group S) were secured on the master model and digital impression was taken using intraoral scanner 15 times each. Each STL files of test groups were superimposed with reference model using best fit alignment and root mean square (RMS) value was analyzed. Results: The RMS values were lowest in Group P, followed by Group S and Group E. Group P showed significant difference with Group S and E (P < 0.05) while there was no significant difference between Group S and E. Correlation between implant angulation and RMS value was significant in Group E (P < 0.05). Conclusion: The pick-up impression coping method showed higher accuracy and there was no significant difference in accuracy between the healing abutment and the scan body. The clinical use of the encoded healing abutment is possible, but it should be used with caution in the case of angulated implant.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.234-243
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• 2015

Developing of digital technique, it is possible to fabricate implant prostheses for edentulous area using intraoral 3-dimentional information throughout implant diagnosis and treatment process. It is being changed that from the method using CAD/CAM, producing prostheses by model scanning after conventional impression and model processing, to the method of fabricating implant provisional restorations and customized abutments by digital impression after connecting digital impression copings (scanbody) and implant fixtures without models. But, this digital method has not been actively used for implant prostheses not yet. Specially, it is short of intraoral digital impression cases for immediate provisional restorations of the maxillary anterior implants. The gingival contour impression of maxillary anterior area is very important for esthetic restorations. Accordingly, in this case report, the using a digital impression coping (scanbody) and digital impression by CEREC Omnicam (Sirona, Bensheim, Germany) or Trios (3shape, Copenhagen, Denmark) were introduced for immediate provisional restorations in 3 cases needed a single implant restoration in maxillary anterior area. The clinical results were satisfactory on the convenience and accuracy of digital impression technique and the good esthetics of final restorations.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.211-221
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• 2020

The typical biomechanical properties of an internal conical connection (ICC) are axial displacement and loss of preload. The axial displacement of an ICC without a vertical stop can cause the loss of preload and a lowered occlusion. The stress of an ICC is concentrated on the contact interface of the abutment and not on the screw, and during placement, it is important to choose a wider coronal wall thickness as much as possible. The ICC should also be placed below the level of the bone crest. During the restoration of an ICC, care should be taken to ensure an appropriate abutment shape and an accurate connection. To get the best clinical results, it is important to select its wall thickness and place it in the appropriate position to restore it adequately.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.201-212
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• 2012

There are some similar aspects at histological and morphological characteristics between the peri-implant tissue and periodontal tissue and the direct attachment between the titanium and soft tissue around the implant called as "Functional ankylosis" can prevent the apical infiltration of inflammatory and bone resorption around implant. But, the repeated connection and disconnection of the abutment can destroy the mucosal barrier of soft tissue around the implant and can cause the marginal bone resorption. The amount of marginal bone resorption may reduced if the prosthetic abutment is placed at that time of surgery. Connection of the prosthetic abutment at surgery was limited because the low accuracy of conventional method, but by using of Cone Beam Computed Tomography(CBCT) and guide surgery, the 3-dimensional accuracy of implant placement became much higher than before and it became possible. This is a clinical case of immediate connection of prosthetic abutment and provisional restoration by using of precise CBCT diagnosis and pre-fabricated zirconia customized abutment at surgery and the alternative method is described in this article because of the clinically contentable results.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.263-273
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• 2016

In the implant prosthetic procedure, the soft tissue reaction was varied with the material and surface treatment of the abutment. It may be the cause of the peri-implantitis, and hence it can affect the long-term prognosis of the implant prosthesis. Titania and zirconia abutment presented superior biocompatibility and stable soft tissue reaction, while gold alloy abutment showed unfavorable reaction sometimes. A soft tissue reaction can be differed by the surface characteristics even in the same material type. Because rougher surface induces a bacterial attachment, the part contacting a soft tissue should have smooth surface. Additional surface treatment can enhance the cellular response without increasing bacterial attachment. Repeated removal and insertion of the abutment and the shape of the abutment may affect the soft tissue reaction, also. Ultrasonic cleaning and argon plasma cleaning are effective way to clean the retained micro-dust on the customized abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.36-43
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• 2012

Purpose: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. Materials and methods: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type ${\phi}4.0mm{\times}11.5mm$ Osstem$^{(R)}$ USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. Results: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2mm, there was no significant influence on the stress distribution. Conclusion: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.101-112
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• 2023

Purpose. This retrospective study was to investigate the survival and complication rates of posterior single implant according to the implant diameters, lengths and position. Materials and methods. Patients who had been restored single implant prosthesis in the posterior area by the three prosthodontists in the department of prosthodontics, Daejeon dental hospital of Wonkwang university, in the period from February 2014 to May 2018 were selected for the study. A total of 505 patients with 697 implants were observed. The survival and complications of implants were investigated using electronic medical records and radiographs. Fixture diameters, lengths, position, patient's sex and age were assessed as possible factor affecting the survival and complications of implants. Results. 3-year cumulative survival rates of posterior single implants were 98.5% and 5-year cumulative survival rates were 94.4%. 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm (97.0%) than implants with diameter ≤ 4.0 mm (89.5%), and in females (98.8%) than males (92.4%). There were statistically significant differences (P < .05). The mechanical complication rate was 20.1% and the biological complication rate was 4.7%. Complications occurred in order of abutment screw loosening (7.5%), decementation (6.3%), proximal contact loss (3.7%) and so on. Abutment screw loosening occurred more frequently in the lower molar region (10.5%), in males (9.5%) than females (5.1%), and in patients aged < 65 years (9.4%) than patients aged ≥ 65 years (5.1%). There were statistically significant differences (P < .05). Conclusion. The 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm than implants with diameter ≤ 4.0 mm and in females than males. Abutment screw loosening which was the most commonly occurring complication occurred more frequently in the lower molar region, in males than females, and in patients aged < 65 years than patients aged ≥ 65 years. There were statistically significant differences.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.2
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• pp.73-80
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• 2002

치과용 임플란트의 세라믹 지대주를 위해 개발된 지르코니아 함유 세라믹 시편의 생체 적합성을 평가하기 위하여 시험관내 세포 독성을 검사를 시행하였다. L929 섬유모세포를 $37^{\circ}C$, 90% 습도, 5% CO2 및 95% 공기의 조건을 유지하는 세포 배양기에서 배양하여 실험에 사용하였다. 배양 2일, 4일, 6일 마다 시편을 넣은 배양 접시 내의 전체 세포 수와 생존 세포 수를 세어 세포 증식과 세포 생존율 검사를 시행하였다. millipore filter test를 이용하여 succinate dehydrogenase 효소 활성을 검사하였으며, 세포막 투과성의 변화를 관찰하기 위해 agar overlay test를 시행하였다. 음성 대조군은 시편을 사용하지 않았으며, 양성 대조군은 시편과 같은 크기의 구리를 사용하여, 다음과 같은 결과를 얻었다. 1. 세포 증식과 세포 생존율 검사에서는 지르코니아 함유 세라믹을 넣은 실험군과 음성 대조군 모두에서 시간이 경과함에 따라 세포가 증식하는 양상을 보였다. 세포 생존율 검사에서도 실험군과 음성 대조군이 유사한 결과를 나타내었다. 2. millipore filter test에서는 실험 시편 모두에서 염색 정도의 변화가 없이 음성 대조군과 동일한 결과를 나타냈다. 반면에 구리 시편을 넣은 양성 대조군에서는 중등도의 세포 독성을 나타냈다. 3. agar overlay test에서도 시편을 넣지 않은 음성 대조군에서는 세포 성장에 변화가 나타나지 않았으며, 실험군에서도 시편 주위로 탈색이 관찰되지 않아서 음성대조군과 같은 결과를 나타냈다. 양성 대조군에서는 심한 세포 독성을 나타내었다. 4. 실험결과, 치과용 임플란트의 세라믹 지대주를 위해 개발된 지르코니아 함유 세라믹 시편은 시험관내 세포 독성을 나타내지 않았다.