• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.364-370
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• 2015

Fixed restoration using implants for patients with posterior partial edentulism is generalized technique. As patient demands increase, the functional and esthetic implant restoration to achieve similar results to lost natural teeth is becoming an important issue. It is inevitable to use customized CAD/CAM abutments rather than ready-made abutments for the creation of implant prosthesis which closely resembles natural teeth. Using CAD/CAM abutment made it possible to obtain natural emergency profiles for posterior implant prostheses, ensuring more comfortable, efficient management of oral hygiene. However, keratinized gingiva with sufficient width and height for a natural emergence profile is required to use a large diameter CAD/CAM abutment which ensures stability and esthetics of hard/soft tissue around the implants. In this case, for esthetical and functional implant zirconia prosthesis, soft tissue graft was performed and customized CAD/CAM abutments were used following ridge augmentation, sinus graft and implantation. Satisfactory results were obtained functionally and esthetically through periodic clinical evaluation, and I hereby report this case.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.185-195
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• 2011

In this study, titanium abutments and zirconia abutments were connected to each implant in external type implants. After that they were loaded 10000 times with 20Kg as occlusal force. The surface changes of external hexgon part and platform were observed in FESEM image. Viker's hardness of an implant, a titanium abutment and a zirconia abutment were measured respectively. 1. Viker's hardness of an implants, a titanium abutment and a zirconia abutment was $309.80{\pm}11.78$ HV, $318.40{\pm}11.82$ HV, and $1495.30{\pm}16.21$ HV respectively. There was no statistical significance between an implant and a titanium abutment (P>0.05, Anova). However, there was statistical significance between an implant and a zirconia abutment(P<0.05, Anova). 2. The wear was observed at the joint of implant and abutment in both a titanium abutment group and a zirconia abutment group after loading 10,000 times. The zirconia abutment showed more remarkable wear than the titanium one. In conclusion, the wear of external hexagon and platform was much more notable in a zirconia abutment group than a titanium one. It was suggested that it could result from the difference of surface hardness between titanium and zirconia. The wear of junction between an implant and a zirconia abutment becomes more severe, the connection of an implant and an abutment is much more unfit. This is likely to cause loosening and fracture of the abutment screw. so it is considered that the possibility of implant supra-structure failure can be increased.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.79-87
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• 2021

The digital workflow of optical impressions by the intraoral scanner and CADCAM manufacture of dental prostheses is actively developing. The complex process of traditional impression taking, definite cast fabrication, wax pattern making, and casting has been shortened, and the number of patient's visits can also be reduced. Advances in intraoral scanner technology have increased the precision and accuracy of optical impression, and its indication is progressively widened toward the long span fixed dental prosthesis. This case report describes the long span implant case, and the operator fully utilized digital workflow such as computer-guided implant surgical template and CAD-CAM produced restoration after the digital impression. The provisional restoration and customized abutments were prepared with the optical impression taken on the same day of implant surgery. Moreover, the final prosthesis was fabricated with the digital scan while utilizing the same customized abutment from the provisional restoration. During the data acquisition step, stl data of customized abutments, previously scanned at the time of provisional restoration delivery, were imported and automatically aligned with digital impression data using an 'A.I. abutment matching algorithm' the intraoral scanner software. By using this algorithm, it was possible to obtain the subgingival margin without the gingival retraction or abutment removal. Using the digital intraoral scanner's advanced functions, the operator could shorten the total treatment time. So that both the patient and the clinician could experience convenient and effective treatment, and it was possible to manufacture a prosthesis with predictability.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.19 no.1
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• pp.42-58
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• 2010

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.222-231
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• 2009

Statements of the problem: Over the past decades, conventional complete dentures were used for various patients although they have incomplete function. Overdentures using dental implants could help the improvement of denture function. Purpose: The purpose of this study was to compare the strains of abutment and bone on implant overdenture between splinted and unsplinted type of prosthesis. Additionally, the strain values of parallel placed implant model and unparallel placed implant model were compared. Material and methods: Two acrylic resin model were prepared and two implants were placed at the canine positions in each model. In the first model, two implant were placed parallel. In the second model, two implants were placed with 10 degree labiolingual divergence. Two types of abutment were connected to the fixtures alternatively. One was splint type of Hader bar, the other was unsplint type of ball abutment. Overdentures were fabricated with corresponding attachment systems and seated on abutments. Strains of abutments and labial bone simulants were measured with electric resistance strain gauges when static load from 100 N to 200 N were applied to overdentures. Results: 1. Splinted type of overdentures using bar and clip showed higher absolute strain values. But the strain was compressive and the load was shared by two implants(P<.05). 2. Unsplinted type overdentures using ball and O-ring showed low absolute strain values(P<.05). 3. Labially inclined implant showed higher tensile strain values in unsplinted type of prosthesis than in splinted type of prosthesis. Lingually inclined implant showed rather low strain values under load(P<.05). 4. Non parallel implant model showed higher absolute strain values than parallel placed implant model comprehensively(P<.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.3
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• pp.269-281
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• 2008

Fatigue or overload can result in mechanical problems of implant components. The mechanical strength in the implant system is dependent on several factors, such as screw and fixture diameters, material, and design of the fixture-abutment connection and abutment. In these factors, the last rules the strength and stability of the fixture-abutment assembly. There have been some previous reports on the mechanical strength of the fixture-abutment assembly with the compressive bending test or short-term cyclic loading test. However, it is restrictive to predict the long-term stability of the implant system with them. The purpose of this study was to evaluate the influence of the design of the fixture-abutment connection and abutment on the mechanical strength and failure mode by conducting the endurance limit test as well as the compressive bending strength test. Tests were performed according to a specified test(ISO/FDIS 14801) in 4 fixture-abutment assemblies of the Osstem implant system: an external butt joint with Cemented abutment (group BJT), an external butt joint with Safe abutment (group BJS), an internal conical joint with Solid abutment (group CJO), and an internal conical joint with ComOcta abutment (group CJT). The following conclusions were drawn within the limitation of this study. Compressive bending strengths were decreased in order of group BJS(1392.0N), group CJO(1261.8N), group BJT(1153.2N), and group CJT(1110.2N). There were no significant differences in compressive bending strengths between group BJT and group CJT(P>.05). Endurance limits were decreased in order of group CJO(600N), group CJT(453N), group BJS(360N), and group BJT(300N). 3. Compressive bending strengths were influenced by the connection and abutment design of the implant system, however endurance limits were affected more considerably by the connection design.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.389-403
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• 2010

Titanium and gold-alloy abutments have been used for a long-time in the clinical situations, but the use of zirconia abutments also increased. This study was designed to compare and evaluate the microgap differences according to types of abutment and dynamic loading. Titanium abutment, zirconia abutment and gold-alloy abutment (UCLA plastic) were connected into titanium implants of external hexagonal structure US II ${\phi}$ $3.75{\times}11.5$ mm (Osstem Co., Seoul, Korea) with the tightening torque of 30 Ncm. A sine type dynamic loading of 25-250 N and $30^{\circ}$ inclination from long axis was applied for $10^5$ times. Using the SEM both before and after the loadings, implant-abutment interfaces were analyzed on the labial, palatal, mesial and distal surface. The microgaps before and after the loading were compared, no statistically significant difference was observed caused by the dynamic loading on the labial, palatal, mesial or distal surface. Statistically significant difference was observed between UCLA and titanium group and between UCLA and zirconia group on both before and after the loading(p<0.05). No statistically significant difference was found between titanium and zirconia group. Loadings for $10^5$ times did not show significant effect to the microgaps between implants and abutments.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.222-231
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• 2020

To use the external connection implant (EXT) appropriately, the inter-implant distance should be carefully considered during placement, and the bones raised above the implants should be trimmed during the second surgery. The hex abutment is more useful than the non-hex abutment. EXT is particularly useful when the inter-arch space is limited. The tissue level (TL, internal butt connection) implant has a biomechanical advantage of coronal wall thickness and a biological advantage of an inherent transmucosal smooth surface. During TL implant restoration, an abutment can be selected using the abutment and fixture margins with considerations for the inter-arch space. Since no single type of implant can satisfy all the cases, it is necessary to select the appropriate type, considering the occlusal force and the bone condition.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.3
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• pp.132-142
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• 2019

Purpose: The purpose of this finite element analysis study is to introduce the novel Lock screw system and analyze its mechanical property to see if it can prevent abutment screw loosening. Materials and Methods: The Lock screw is a component tightened on the inside of the implant abutment which applies compressive force to the abutment screw head. To investigate the effect, modeling was done using CAD program and it was analyzed by finite element analysis under various load conditions. First, the preload was measured according to the tightening torque of the abutment screw then it was compared with the theoretical value to verify the analytical model. The validated analytical model was then divided into those with no external load and those with 178 N, and the tightening torque of the lock screw was changed to 10, 20, 30 Ncm respectively to examine the property of stress distribution on the implant components. Results: Using Lock screw under various loading conditions did not produce equivalent stresses beyond the yield strength of the implant components. In addition, the axial load was increased at the abutment-abutment screw interface. Conclusion: The use of Lock screw does not exert excessive stress on the implant components and may increase the frictional force between the abutment-abutment screw interface, thus it is considered to prevent loosening of the abutment screw.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.1
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• pp.32-44
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• 2023

Purpose: The purpose of this study was to investigate the effect of implant connection type on marginal bone loss (MBL) and to analyze the factors that affect MBL. This study focuses on single implants planted in the upper and lower first molar area. Materials and Methods: A total of 87 implants from 68 patients were tracked for a period over 5 years. There were 57 external connection type (EC) implants and 30 internal connection type (IC) implants in 38 males and 30 females. The MBL and EA were measured from intraoral radiograph images taken after 5 years at most. Results: Significant difference in MBL between EC and IC type was observed in patients without GBR or diabetes. Patients without GBR exhibited an MBL of -0.065 ± 0.859 mm in EC type and -0.627 ± 0.639 mm in IC type (P = 0.025). Using multiple regression analysis, a statistically significant negative correlation was observed between MBL and conditions including implant-abutment connection type (β = -0.303), diabetes (β = -0.113), emergence angle > 30° (β = -0.234), and age (β = -0.776). Conclusion: Within this results, IC type implants had less MBL than EC type, and implant prosthesis with emergence angle over 30° showed greater MBL. To minimize the MBL of the implant and ensure implant stability, careful consideration should be given to the EA of implant prosthesis and its connection type.