• Title/Summary/Keyword: 치과용임플란트

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Computer-guided implant surgery and immediate provisionalization by chair-side CAD-CAM: A case report (진료실 CAD-CAM에 의한 컴퓨터 가이드 임플란트 수술과 즉시 임시보철치료: 증례보고)

  • Hyun, Sang Woo;Lee, sungbok Richard;Lee, Suk Won;Cho, Young Eun
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.4
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    • pp.478-486
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    • 2021
  • This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour.

Biocompatibility and Surface Characteristics of (Si,Mn)-HA Coated Ti-Alloy by Plasma Electrolytic Oxidation (PEO법으로 (Si,Mn)-HA 코팅된 치과 임플란트용 Ti 합금의 생체적합성 및 표면특성)

  • Gang, Jeong-In;Son, Mi-Gyeong;Choe, Han-Cheol
    • Proceedings of the Korean Institute of Surface Engineering Conference
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    • 2017.05a
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    • pp.83-83
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    • 2017
  • 생체재료의 표면은 이식과 동시에 생체계면의 역할을 하게 되어, 일련의 생물학적 반응이 시작되고 진행되는 중요한 장소가 된다. 초기에 생체계면에서 일어나는 단백질 흡착이나 염증반응을 비롯한 생물학적 반응들은 궁극적으로 임플란트의 성패를 좌우할 만큼 중요하다. 골융합을 개선하기 위한 다른 방법으로 생체불활성의 타이타늄 (Ti)과 골조직의 능동적인 반응을 이루기 위해 생체활성 표면을 부여함으로서 계면에서의 골형성 반응을 증진시키는 방법이 이용된다. 생체불활성의 Ti과 Ti합금은 골조직과 직접적인 결합을 이루지 못하므로, 골조직과의 반응을 향상하기 위해 여러 종류의 생체활성 재료를 코팅하는 방법이 연구되어 왔고, 이 중 생체의 변화와 가장 유사한 하이드록시아파타이트 코팅이 가장 대중적인 방법으로 사용되었으며 이는 초기 골형성을 촉진하는 것으로 알려졌다. 치과용 임플란트의 표면형상과 화학조성이 골 융합에 영향을 미치는 가장 중요한 인자이므로 최근의 연구동향은 이들 두 가지 표면특성을 결합함으로서 결과적으로 최적의 골세포반응을 유도하고, 골융합 후 골조직과의 micromechanical interlocking에 의해 임플란트의 안정성에 중요한 역할을 하는 마이크론 단위의 표면조도와 표면 구조를 유지하면서, 부가적으로 골 조직 반응을 능동적으로 개선할 수 있는 생체활성 성분을 부여하여 골 융합에 상승효과를 이루기 위한 표면처리법에 관해 많은 연구가 요구되어지고 있다. 따라서 골을 구하는 원소인 망간과 실리콘으로 치환된 하이드록시아파타이트를 플라즈마 전해 산화법으로 코팅하여 세포와 잘 결합할 수 있는 표면을 제공함으로써 골 융합과 치유기간을 단축시킬 수 있을 것으로 사료된다. 실험방법은 시편은 치과 임플란트 제작 합금인 Ti-6Al-4V ELI disk (grade 5, Timet Co., USA; diameter, 10 mm, thickness, 3 mm)이며, calcium acetate monohydrate, calcium glycerophosphate, manganese(II) acetate tetrahydrate, sodium metasilicate을 설계조건에 따라 혼합 제조된 전해질 용액을 이용하여 플라즈마 전해 산화법으로 표면 코팅을 실시하였다. 각 시편의 플라즈마 전해시 전압은 280V로 인가하였고, 전류밀도는 70mA로 정전류를 공급하여 해당 인가전압 도달 후 3분 동안 정전압 방식을 유지하였다. 코팅된 피막 표면을 주사전자현미경과 X-선 회절분석을 통하여 미세구조 및 결정상을 관찰하였다. 또한 코팅된 표면의 생체활성 평가는 정량적으로 평가하기 위해 동전위시험과 AC 임피던스를 통하여 시행하였다. 분극거동을 확인하기 위해 potentiostat (Model PARSTAT 2273, EG&G, USA)을 이용하여 구강 내 환경과 유사한 $36.5{\pm}1^{\circ}C$의 0.9 wt.% NaCl에서 실시하였다. 전기화학적 부식 거동은 potentiodynamic 방법으로 조사하였고 인가전위는 -1500 mV에서 2000 mV까지 분당 1.67 mV/min 의 주사속도로 인가하여 시험을 수행하였다. 임피던스 측정은 potentiostat (Model PARSTAT 2273, EG&G, USA)을 이용하였으며, 측정에 사용한 주파수 영역은 10mHz ~ 100kHz 까지의 범위로 하여 조사하였고 ZSimWin(Princeton applied Research, USA) 소프트웨어를 사용하여 용액의 저항, 분극 저항 값을 산출하였다. 망간의 함량이 증가할수록 불규칙한 기공을 보였으며, 실리콘은 $TiO_2$ 산화막 형성을 저해하는 경향을 확인할 수 있었다. 단독으로 표면을 처리한 경우보다 두 가지 원소를 이용해 복합 표면처리를 시행한 경우가 내식성이 좋아 임플란트과의 골 유착에 긍정적인 영향을 미칠 것으로 사료된다.

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Comparative accuracy of implant impression techniques with different splinting materials (임플란트 인상채득 방법과 인상용 코핑 연결 고정에 따른 정확성 비교)

  • Ki-Yoon Hong;Soo-Yeon Shin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.39 no.1
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    • pp.9-20
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    • 2023
  • Purpose: We investigated the effect of open tray impression using pick-up impression coping and close tray impression using transfer impression coping on the accuracy of impression in edentulous patients on their mandibular parts. the effect of material types of pick-up type impression copings for splinting in open tray impression on the accuracy of impression was also evaluated. Materials and Methods: Two implant fixtures were implanted in parallel in the left molar of the mandibular in the shape of a mandibular partial edentulous model. The 40 individual trays were fabricated using 3D printer. The prepared individual trays were classified into 4 groups (i.e., PN, PG, PH, and TN groups), and a total of 40 impression-takings were conducted. A master cast was connected to a Scan Body. The converted STL file was super-imposed on the scan images of the various groups. Results: The order of standard deviation values decreased as follows: PN (0.2343 ± 0.0844 mm), TN (0.2192 ± 0.0840 mm), indicating that the high accuracy of impression for TN group. In addition, for the comparison results between the material types used in splinting the open tray impression, the PH group showed a relatively lower standard deviation (0.1910 ± 0.1176 mm) than that of the PN group (0.2343 ± 0.0844 mm), PG group (0.2556 ± 0.1082 mm). Conclusion: The acrylic resin synthesized by light-induced polymerization exhibited a higher accuracy of impression taking than that of autopolymerizing acrylic resin. Meanwhile, the accuracy of impression taking was not dependent on the implant impression taking method or the presence of connection/fixation of impression copings.

Reverse engineering technique on the evaluation of impression accuracy in angulated implants (경사진 임플란트에서 임플란트 인상의 정확도 평가를 위한 역공학 기법)

  • Jung, Hong-Taek;Lee, Ki-Sun;Song, So-Yeon;Park, Jin-Hong;Lee, Jeong-Yol
    • The Journal of Korean Academy of Prosthodontics
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    • v.59 no.3
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    • pp.261-270
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    • 2021
  • Purpose. The aim of this study was (1) to compare the reverse engineering technique with other existing measurement methods and (2) to analyze the effect of implant angulations and impression coping types on implant impression accuracy with reverse engineering technique. Materials and methods. Three different master models were fabricated and the distance between the two implant center points in parallel master model was measured with different three methods; digital caliper measurement (Group DC), optical measuring (Group OM), and reverse engineering technique (Group RE). The 90 experimental models were fabricated with three types of impression copings for the three different implant angulation and the angular and distance error rate were calculated. One-way ANOVA was used for comparison among the evaluation methods (P < .05). The error rates of experimental groups were analyzed by two-way ANOVA (P < .05). Results. While there was significant difference between Group DC and RE (P < .05), Group OM had no significant difference compared with other groups (P > .05). The standard deviations in reverse engineering were much lower than those of digital caliper and optical measurement. Hybrid groups had no significant difference from the pick-up groups in distance error rates (P > .05). Conclusion. The reverse engineering technique demonstrated its potential as an evaluation technique of 3D accuracy of impression techniques.

Customized abutment and screw-type implant prostheses after cementation based on the digital intra-oral impression technique (구강 내 디지털 인상채득을 통한 맞춤형 지대주와 시멘트 합착 후 나사형 임플란트 보철 수복 증례)

  • Hong, Yong-Shin;Park, Eun-Jin;Kim, Sun-Jong;Kim, Myung-Rae;Heo, Seong-Joo;Park, Ji-Man
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.1
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    • pp.67-73
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    • 2012
  • Fixed dental prostheses such as inlay, onlay, crown, and bridge fabricated by CAD/CAM technique combined with digital impressions is getting popular due to the recent rapid progress of digital impression taking system. For the scope of implant prosthesis, however, digital intra-oral scan hasn't been actively utilized for the fabrication of superstructures. In this case report, 6 cases of titanium-milled custom abutment based on the iTero intra-oral scan data were introduced, five of them were restored with screw-type prosthesis after cementation (SCRP) and the clinical results were satisfactory on restoring the function and esthetics.

Three-dimensional finite element analysis according to the insertion depth of an immediately loaded implant in the anterior maxilla (상악 전치부 즉시하중 임플란트의 식립 깊이에 따른 삼차원 유한요소 분석)

  • Park, Cheol-Woo;Kim, Sung-Hun;Yeo, In-Sung;Yoon, Hyung-In;Han, Jung-Suk
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.2
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    • pp.105-113
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    • 2018
  • Purpose: The purpose of this study was to investigate the effects of the insertion depth of an immediately loaded implant on the stress distribution of the surrounding bone and the micromovement of the implant using the three-dimensional finite element analysis. Materials and methods: A total of five bone models were constructed such that the implant platform was positioned at the levels of 0.00 mm, 0.25 mm, 0.50 mm, 0.75 mm, and 1.00 mm depth from the crest of the cortical bone. A frictional coefficient of 0.3 and the insertion torque of 35 Ncm were simulated on the interface between the implant and surrounding bone. A static load of 178 N was applied to the provisional prosthesis with a vertical load in the axial direction and an oblique load at $30^{\circ}$ with respect to the central axis of the implant, then a finite element analysis was performed. Results: The implant insertion depth significantly affected the stress distribution on the surrounding bone. The largest micromovement value of the implant was $39.34{\mu}m$. The oblique load contributed significantly to the stress distribution and micromovement in comparison to the vertical load. Conclusion: Increasing the implant insertion depth was advantageous in dispersing the concentrated stress in the cortical bone and did not significantly affect the micromovement associated with early osseointegration failure.

Non-surgical treatment and retention of open bite in adult patients with orthodontic mini-implants (성인 환자에서 구치부 압하를 통한 개방교합의 치료와 유지)

  • Moon, Cheol-Hyun;Lee, Joo-Sin;Lee, Hyun-Sun;Choi, Jin-Hugh
    • The korean journal of orthodontics
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    • v.39 no.6
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    • pp.402-419
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    • 2009
  • Successful treatment of the non-growing patient with an open bite of either dental skeletal pattern often presents a difficult challenge. The morphologic pattern in anterior open bite is characterized by longer vertical dimensions, an increase in development of the maxillary posterior dento-alveolar structure and a steep mandibular plane. In such cases, molar intrusion would be a good remedy for treatment. This article reports the successful treatment and retention of two anterior open-bite cases. We used orthodontic mini-implants for treatment and a circumferential retainer with posterior bite block or skeletal fixed retainer for retention. The diagnostic criteria and mechanics for appropriate treatment are discussed. Our results suggest that open bite can be reduced successfully with intrusion of molars using orthodontic mini-implants (OMI) without orthognathic surgery, and that circumferential retainer with posterior bite block and skeletal fixed retainer are effective for retention.