• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.179-195
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• 2010

In the internal connection system, the loading transfer mechanism within the inner surface of the implant and also the stress distribution occuring to the mandible can be changed according to the abutment form. Therefore it is thought to be imperative to study the difference of the stress distribution occuring at the mandible according to the abutment form. The purpose of this study was to assess the loading distributing characteristics of three different abutments for GS II$^{(R)}$ implant fixture(Osstem, Korea) under vertical and inclined loading using finite element analysis. Three finite element models were designed according to three abutments; 2-piece Transfer$^{TM}$ abutment made of pure titanium(GST), 2-piece GoldCast$^{TM}$ abutment made of gold alloy(GSG), 3-piece Convertible$^{TM}$ abutment with external connection(GSC). This study simulated loads of 100N in a vertical direction on the central pit(load 1), on the buccal cusp tip(load 2) and $30^{\circ}$ inward inclined direction on the central pit(load 3), and on the buccal cusp tip(load 4). The following results were obtained. 1. Without regard to the loading condition, greater stress was concentrated at the cortical bone contacting the upper part of the implant fixture and lower stress was taken at the cancellous bone. 2. When off-axis loading was applied, high stress concentration observed in cervical area. 3. GSG showed even stress distribution in crown, abutment and fixture. GST showed high stress concentration in fixture and abutment screw. GSC showed high stress concentration in fixture and abutment. 4. Maximum von Mises stress in the surrounding bone had no difference among three abutment type. In GS II$^{(R)}$ conical implant system, different stress distribution pattern was showed according to the abutment type and the stress-induced pattern at the supporting bone according to the abutment type had no difference among them.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.1
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• pp.71-78
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• 2021

Implant treatment, which was first attempted in fully edentulous patients, is now widely used in partially edentulous, and a single tooth missing patients. Moreover, implant treatment has become an essential treatment modality in modern dentistry. The material of fabricating implant prostheses has also become more diverse than before, one of which is the use of high-performance polymers. The frequency of using high-performance polymers, which have been used in the medical field, is also increased in the dental field compared to the past. In the first case, a PEKK abutment and a PFG crown (cement-screw-retaining type) were fabricated in the lower left second premolar, and in the second case, a PEKK abutment and a monolithic zirconia crown (cement-screw-retaining type) were fabricated in the missing upper left first molar, and in the third case two PEKK abutments and a splinted PFM crowns (cement-screw-retaining type) were fabricated and connected to the upper right first and second molar implants. Through these procedures the patients obtained esthetically and functionally satisfactory results after 4 years of follow-up.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.4
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• pp.306-312
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• 2020

Purpose: The aim of this study was to compare radiographic outcomes around narrow-diameter implants placed using guided flapless surgery at longer than 6 month post-placement. Materials and methods: A total of 12 implants were assessed in 12 patients for the sites where 0.5 - 1.5 mm labial bone was covering the implants, using CBCT. Results: A statistically significant preservation of crestal bone was observed in the narrow-diameter implants. Conclusion: Guided flapless implant surgery may be important in preventing bone loss around the narrow-diameter implants that are placed in narrow alveolar ridges.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.125-135
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• 2009

Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.

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

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.3
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• pp.253-267
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• 2008

The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding implant fixture with different diameter of implant fixtures(3i implant, Ø4.0, Ø5.0, Ø6.0mm and UCLA abutments(Ø4.1, Ø5.0, Ø6.0mm using photoelastic stress analysis. Photoelastic model was made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each diameter were placed in the mandibular posterior edentulous area distal to the canine. Individual crowns were fabricated using UCLA abutments. Photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure under simulated loading conditions(15 lb, 30 lb). The results were as follows; 1. The more the diameter of implant fixture was increased, the less the stress concentration on cervical area of fixture was observed under loading. 2. Increasing mesiodistal diameter of implant superstructure had no much influence on stress distribution around implant fixture. 3. The use of smaller abutment had no influence on stress distribution around implant fixture. The use of smaller abutment diameter than that of implant fixture had no favorable effect on implant supporting tissue at biomechanical consideration.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.338-344
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• 2016

Implant supported removable partial denture (ISRPD) using the implants enables favorable rehabilitation by complementing biomechanical limitations of the conventional removable partial denture (RPD). However, continuous recall check is necessary for evaluation of the mechanical and biological complications to ensure good long-term prognosis of ISRPD. This clinical report describes the complication and management in patient of Kennedy class I edentulism with ISRPD using healing abutment. The wear and fracture of healing abutment occurred at 36 months after delivery. So, healing abutment was replaced by connecting $Locator^{(R)}$ abutment for altering into the implant retained partial overdenture.

• Journal of Dental Rehabilitation and Applied Science
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• v.32 no.4
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• pp.280-292
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• 2016

Purpose: The purpose of this study was to compare the long-term survival rate and peri-implant marginal bone loss related to multiple risk factors including the clinician's experience. Materials and Methods: Four hundred twenty implants in 146 patients, who had involved a supportive periodontal therapy program every 3 to 6 months and had follow up data for at least 5 years, were selected as the study group. Peri-implant marginal bone loss, data of demographic, implant and surgical characteristics were collected from peri-apical radiographs and chart review. Implant survival was regarded as the remaining with radiographic marginal bone level in excess of 50% of the fixture length for any reason. Results: The cumulative survival rate after 5 years of loading was 94.9%. In binary logistic regression analysis, smoking status (P = 0.033) and presence of spontaneous cover screw exposure (P < 0.001) were significantly related to 5-year survival of implants. In stepwise multiple regression analysis, smoking status (P < 0.001), type of abutment connection (P < 0.001) and implant surface (P = 0.033) were significantly related to peri-implant marginal bone level. And the year of resident was not statistically related to 5-year implant survival in simple logistic regression analysis (P = 0.171). Conclusion: Smoking status, spontaneous cover screw exposure, type of abutment connection and implant surface might influence the implant success. There was no significant correlation between the year of resident and implant failure.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.2
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• pp.85-91
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• 2012

Purpose: The object of this study was to determine if the low-priced alloy and metal UCLA abutment could be available for manufacturing bar-retained framework of implant prosthesis. Materials and methods: Bar structure was classified into 4 groups, The specimen of group 1 and 2 were based on casting high noble metal alloys and noble metal alloys with gold UCLA abutment. The specimen of group 3 and 4 were based on casting noble metal alloys and base metal alloys with metal UCLA abutment. Cast bar structure was installed in an acrylic resin model and only the screw on the hexed abutment side was tightened to 20 Ncm. On the opposite side, vertical discrepancy was measured with stereo microscope from front, back, and lateral side of the implant-abutment interface. One-way ANOVA was performed to analyze the marginal fit discrepancy. Results: One-way ANOVA test showed significant differences among all groups ($P$<.05) except for Group 1 and 3. Among them, difference between Group 1 and 2 was noticeable. Measured vertical discrepancies were all below $70{\mu}m$ except to Group 2. Conclusion: Base metal alloy and metal UCLA abutment could be used as an alternative to high-priced gold alloy for implant bar-retained framework.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.206-214
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• 2014

This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.