• Journal of Periodontal and Implant Science
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• v.40 no.3
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• pp.139-143
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• 2010

Purpose: Pink gingival esthetic especially on the anterior teeth has been an important success criterion in implant-supported restoration. Inter-implant papillae are a critical factor for implant esthetics, and various techniques for inter-implant papilla reconstruction have been introduced. The aim of this study is to suggest and evaluate a surgical technique for reconstructing inter-implant papillae. Methods: A 28-year-old man had an implant placed on the #13 and #14 area. Four months after implant placement, a second stage surgery was planned for inter-implant papilla reconstruction. At the time of the abutment connection, I-type incisions were performed on the #13i & #14i area followed by full-thickness flap elevation and connection of a healing abutment on underlying fixtures without suture. Results: Two weeks after the second stage implant surgery, soft tissue augmentation between the two implants was achieved. Conclusions: I-shaped incisions for papilla reconstruction performed during the second stage implant surgery were useful for inter-implant papilla reconstruction and showed a good esthetic result.

• The Journal of Advanced Prosthodontics
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• v.14 no.1
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• pp.22-31
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• 2022

PURPOSE. The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS. Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS. Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) ㎛ while CAD-cast demonstrated the highest measurements of 29.2 (3.1) ㎛. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION. Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw's preload stability under an aggressive loading situation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.43-48
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• 2023

The biocompatibility and durability of implant fixtures are major concerns for dentists and patients. Mechanical complications of the implant include abutment screw loosening, screw fracture, loss of implant prostheses, and implant fracture. This case report aims to describe management of a case of fixture damage that occurred after screw fracture in a tissue level, internal connection implant and microscopic evaluation of the fractured fixture. A trephine bur was used to remove the fixture, and the socket was grafted using allogeneic bone material. The failed implant was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), which revealed a fractured fixture with both normal and irregular bone patterns. The SEM and EDS results give an enlightenment of the failed fixture surface micromorphology with microfracture and contaminated chemical compositions. Noticeably, the significantly high level of gold (Au) on the implant surface and the trace amounts of Au and titanium (Ti) in the bone tissue were recorded, which might have resulted from instability and micro-movement of the implant-abutment connection over an extended period of time. Further study with larger number of patient and different types of implants is needed for further conclusion.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.2
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• pp.169-175
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• 2020

Traditionally, gingival retraction has been performed to obtain customized abutment impressions with subgingival margins of the implant supported prosthesis. However, gingival retraction may have side effects such as gingival recession and bleed, leading to an inaccurate impression. In order to prevent these problems, in this case, the new technique has been introduced; a customized abutment which is designed for superimposition is used. Before the connection of the abutment to the implant fixture, pre-scanned shape data are stored, and then the optical impression without gingival retraction is obtained after connecting to the fixture. The suprastructure is fabricated by superimposing the two data. This technique showed the clinical efficacy of fabricating the implant supported prosthesis with subgingival margin, which satisfied the aesthetics, convenience, and clinically acceptable marginal and internal fit.

• Journal of Technologic Dentistry
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• v.43 no.2
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• pp.42-47
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• 2021

Purpose: The purpose of this study was to evaluate the stability of abutment screws used with the zirconia fixture-based implant system and compare them with those used with the existing titanium fixture system via the finite element method. Methods: A single implant-supported restoration was designed for the finite element analysis. A universal analysis program was used to set 8 occlusal points along the direction to the long axis of the implant, and an occlusal load of 700 N was applied. Results: In all models (Zir and Ti-fixture model), the screw threads presented with the highest von Mises stress (VMS) values, whereas the head and end presented with the lowest VMS values. The VMS of the screw used in the zirconia-fixture model was 5.97% lower than that used in the titanium-fixture model (261.258 vs. 276.911 MPa, respectively) despite statistical significance. Furthermore, the zirconia fixture (352.912 MPa) had a higher stress value (8.42%) than the titanium fixture (332.331 MPa). In a completely tightened titanium fixture implant system, the stress was concentrated in the implant-abutment connection interface, the zirconia fixture presented with a stable stress distribution. Conclusion: Although the zirconia fixture demonstrated a high VMS value, owing to the stiffness and elasticity coefficients of the material, the stress generated in the abutment screws was similar in all models. In conclusion, the zirconia fixture-based implant system presented with a more stable stress distribution in the abutment screws than the titanium fixture-based implant system.

• The Journal of the Korean dental association
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• v.54 no.3
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• pp.198-205
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• 2016

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

• 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 the Korean dental association
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• v.51 no.11
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• pp.595-603
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• 2013

The requirements for the successful treatment of all-ceramic restorations are not so different from the ones of conventional restorations. "The provisional restoration followed by an adequate tooth reduction and the accurately fitting prostheses with corresponding to final impression" can be the examples of them. Nevertheless, the one which all-ceramic restorations are distinguished from conventional restorations is the additional procedure of so called "bonding". In addition to the application of resin cement between "inner surface of restoration and outer surface of abutment", bonding technology can be also applied to the treatment process of "Post and Core" in particular if the abutments are non-vital teeth. Core build-up for all-ceramic crown is conducted with fiber post and tooth colored composite by considering the properties of the restorations transmitting light. We know well that a vital abutment is easier than a non-vital one to get the targeted goals for clinical success in connection with esthetics and structure. The creation of "Post and Core" with bonding technique is a decisive factor for a long-term success if the abutment is non-vital tooth with dentinal collapse. I would like to share my clinical experience about "post & core build-up and all-ceramic restoration bonding" out of several success strategies of all-ceramic crown with this presentation.

• Proceedings of the KSME Conference
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• 2004.11a
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• pp.486-491
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• 2004

A comparative study on the implant screw loosening under the initial clamping force and cyclic loads was conducted. The experiments were performed to evaluate the screw loosening behavior of the internal and external implant systems. It was found that the screw loosening torques of implant systems were significantly affected by the way how the abutment and fixture were connected due to the difference in the load transfer mechanism between abutment and fixture.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.197-206
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• 2006

Statement of problem: One of common problems associated with single teeth dental implant prosthetic is the loosening of screws that retain the implants. Purpose: The maintenance of screw joint stability is considered a function of the preload achieved in the screw when the suggested initial tightening torque is applied. The purpose of this study was to investigate acquired preload after initial clamping torque for estimating screw joint stability. Material and methods: A comparative study on the effect of initial clamping of two types of implant systems with different connections was conducted Three dimensional non-linear finite element analysis is adopted to compare the characteristics of screw preloads and stress distributions between two different types of implant systems composed with abutment, screw, and fixture under the same loading and boundary conditions. Results: 1. When the initial clamping torque of 32Ncm was applied to the implant systems, all types of implants generated the maximum effective stress at the first helix region of screw. 2. Morse taper connection types of implants generate lower stress distributions compared to those by butt joint connection types or implants due to large contact surface between abutment and fixture. 3. The internal types of implant systems with friction grip type implant systems have higher resistance to screw loosening than that of the external types of implant systems since the internal types of implant systems generated larger preload than that generated by the external types for the same tightening moments.