• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.97-105
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• 2020

Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.440-448
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• 2012

Purpose: The purpose of this study was to evaluate marginal bone loss of the alveolar crest on implants with or without guided bone regeneration and variables that have influenced. Methods: The clinical evaluation were performed for survival rate and marginal bone loss of 161 endosseous implants installed with guided bone regeneration (GBR) in 83 patients from September 2009 to October 2010 in relation to sex and age of patients, position of implant, implant system, length and diameter of implant. Study group (n=42) implant with GBR procedure, control group (n=41) implant without GBR technique. Simultaneous GBR approach using resorbable membranes combined with autogenous bone graft or freeze-dried bone allograft or combination. Radiographic examinations were conducted at healing abutment connection and latest visit. Marginal bone level was measured. Results: Mean marginal bone loss was 0.73 mm in study group, 0.63 mm in control group. Implants in maxillary anterior area (1.21 mm) were statistically significant in study group (P<0.05), maxillary posterior area (0.81 mm) in control group (P<0.05). Mean marginal bone loss 1.47 mm for implants with diameter 3.4 mm, 0.83 mm for implants of control group with diameter 4.0 mm (P<0.05). Some graft materials showed an increased marginal bone loss but no statistically significant influence of sex, implant type or length. Conclusion: According to these findings, this study demonstrated the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods. We conclude that implants with GBR had similar survival rate and crestal bone level compared with implants in native bone.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.3
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• pp.296-305
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• 2002

The main disadvantage of cement-retained implant restorations is their difficulty in retrievability. Advocates of cemented implant restorations frequently state that retrievability of the restoration can be maintained if a provisional cement is used. The purpose of this study was to find the optimal properties of provisional luting cements and the surface treatment of abutments in single implant abutment system. 30 prefabricated implant abutments, height 8mm, diameter 6mm, 3-degree taper per side, with light chamfer margins were obtained. Three commercially available provisional luting agents which were all zinc oxide eugenol type ; Cavitec, TempBond and TempBond NE were evaluated. No cement served as the control. TempBond along with vaseline, a kind of petrolatum (2:1 ratio) was also evaluated. Ten out of thirty abutments were randomly selected and abutment surfaces were sandblasted with $50{\mu}m$ aluminum oxide. Another ten abutments were sandblasted with $250{\mu}m$ aluminum oxide. A vertical groove, 1 mm deep and 5mm long was cut in each twenty abutments. Ten of them were sandblasted with $50{\mu}m$ aluminum oxide. The full coverage casting crowns were cemented to the abutments with the designated provisional luting agent. Specimens were stored in distilled water at $37^{\circ}C$ for 24 hours. Each specimen was attached to a universal testing machine. A crosshead speed of 0.5mm/min was used to apply a tensile force to each specimen. Within the limitations of this in vitro study, the following conclusions were drawn: 1. Tensile bond strength of provisional luting cements in no surface treatment decreased with the sequence of TempBond NE, TempBond, Cavitec, TempBond with vaseline, no cement. 2. Tensile bond strength more increased by surface treatment. Sandblasting with $250{\mu}m$ aluminum oxide exhibited the highest tensile bond strength in the abutment cemented with TempBond NE and sandblasting with $50{\mu}m$ aluminum oxide exhibited the highest tensile bond strength in cemented with TempBond. 3. In the aspect of a groove formation, tensile bond strength significantly increased in TempBond with vaseline only and the others had no significant effect on tensile bond strength.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.5
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• pp.674-688
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• 2003

Statement of Problem : With increasing demand of the implant-supported prosthesis, it is advantageous to use the different platform width of the fixture according to bone quantity and quality of the patients. Purpose : The purpose of this study was to assess the loading distributing characteristics of two implant designs according to each platform width of fixture, under vertical and inclined loading using finite element analysis. Material and method : The two kinds of finite element models were designed according to each platform width of future (4.1mm restorative component x 11.5mm length, 5.0mm wide-diameter restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction, 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction and 200N at the buccal cusp in a 300 transverse direction individually Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. Results : The stresses were concentrated mainly at the cortex in both vertical and oblique load ing but the stresses in the cancellous bone were low in both vertical and oblique loading. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading. Increasing the platform width of the implant fixture decreased the stress in the supporting bone, future and abutment screw. Increased the platform width of fixture decreased the stress in the crown and platform. Conclusion : Conclusively, this investigation provides evidence that the platform width of the implant fixture directly affects periimplant stress. By increasing the platform width of the implant fixture, it showed tendency to decreased the supporting bone, future and screw. But, further clinical studies are necessary to determine the ideal protocol for the successful placement of wide platform implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.2
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• pp.80-88
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• 2018

Purpose: Implant surface modification and implant design are the principle targets for achieving successful primary stability. The aim of this study was to measure implant stability quotient (ISQ) values of sandblasted, large-grit, acid-etched (SLA) implants with tapered straight body design during the healing period, and to determine the various factors affecting implant stability. Materials and Methods: To measure implant stability, resonance frequency analysis (RFA) was performed in 26 patients (13 women and 13 men) with 44 SLA implants with tapered straight body design. Implant stability (ISQ values) was evaluated at baseline and healing abutment connection (12 weeks), and the correlations between RFA and insertion torque (IT), bone quality, and jawbone were determined. Results: The mean ISQ value of the implants was $69.4{\pm}10.2$ at the time of implant placement (baseline) and $81.4{\pm}6.9$ at the time of healing abutment connection (P < 0.05). Significant differences were found between RFA and bone quality and between RFA and jawbone (P < 0.05). No significant differences were found between RFA and IT, insertion area, fixture diameter, and implant length (P > 0.05). Conclusion: ISQ values of SLA implants with tapered straight body design were high at baseline and healing abutment connection. It was concluded that SLA implants with tapered straight body design show improved primary and secondary stability, and that immediate or early loading may be applicable.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.6
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• pp.740-750
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• 2006

Statement of problems. In an attempt to reduce screw loosening, dry lubricant coatings such as pure gold or tefron have been applied to the abutment screw. However, under repeated tightening and loosening procedures, low wear resistance and adhesion strength of coating material produced free particles on the surface of abutment screw and increased frictional resistance resulting in screw tightening problems. Purpose. The aim of this study was to compare friction coefficient, adhesion strength, vickers hardness and evaluate coating surface of titanium alloy specimens coated with TiN(titanium nitride), ZrN(zirconium nitride) and WC(tungsten carbide). Material and method. Titanium alloy(Ti-6Al-4V) discs of 12mm in diameter and 1mm in thickness divided into 4 groups. TiN, ZrN and WC was coated for the specimens of 3 groups respectively, and those of 1 group were not coated. Each group was made up of 4 specimens. In this study, sputtering method was used among the PVD(Physical Vapor Deposition) techniques available for TiN, ZrN and WC coatings. Friction coefficient, adhesion strength, vickers hardness and coating surface of 4 groups were measured. Results. 1. For all three coating conditions, friction coefficient was significantly decreased. Especially, ZrN coated surface showed the lowest value. $TiN(0.39{\pm}0.02)$, $ZrN(0.24{\pm}0.01)$, $WC(0.31{\pm}0.03)$. 2. TiN coating showed the highest adhesion strength, however ZrN coating had the lowest value. $TiN(25.3N{\pm}1.6)$, $ZrN(14.8N{\pm}0.6)$, $ WC(18.4N{\pm}0.7)$. 3. Vickers hardness of all three coatings was remarkably increased as compared with that of none coated specimen. TiN coating had the highest Vickers hardness, however WC coating showed the lowest value. $TiN(1865.2{\pm}33.8)$, $ZrN(1814.4{\pm}18.6)$, $WC(1008.5{\pm}35.9)$. 4. The ZrN or WC coated specimen showed a homogeneous and smooth surface, however the rough surface with defects was observed for TiN coating. Conclusions. When TiN, ZrN and WC coating applied to the abutment screw, frictional resistance would be reduced, as a result, the greater preload and prevention of the screw loosening could be expected.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.2
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• pp.119-127
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• 2012

Purpose: This study was performed to compare the stress distribution pattern of abutment-fixture connection area using 3-dimensional finite element model analysis when 5 different implant systems which have internal connection. Materials and methods: For the analysis, a finite element model of implant was designed to locate at first molar area. Stress distribution was observed when vertical load of 200 N was applied at several points on the occlusal surfaces of the implants, including center, points 1.5 mm, 3.0 mm away from center and oblique load of 200 N was applied $30^{\circ}$ inclined to the implant axis. The finite element model was analyzed by using of 3G. Author (PlassoTech, California, USA). Results: The DAS tech implant (internal step with no taper) showed more favorable stress distribution than other internally connected implants. AS compare to the situations when the loading was applied within the boundary of implants and an oblique loading was applied, it showed higher equivalent stress and equivalent elastic strain when the loading was applied beyond the boundary of implants. Regardless of loading condition, the abutments showed higher equivalent stress and equivalent elastic strain than the fixtures. Conclusion: When the occlusal contact is afforded, the distribution of stress varies depending on the design of connection area and the location of loading. More favorable stress distribution is expected when the contact load was applied within the diameter of fixtures and the DAS tech implant (internal step with no tapering) has more benefits than the other design of internally connected implants.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.531-554
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• 2006

Oral implants must fulfill certain criteria arising from special demands of function, which include biocompatibility, adequate mechanical strength, optimum soft and hard tissue integration, and transmission of functional forces to bone within physiological limits. And one of the critical elements influencing the long-term uncompromise functioning of oral implants is load distribution at the implant- bone interface, Factors that affect the load transfer at the bone-implant interface include the type of loading, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface. To understand the biomechanical behavior of dental implants, validation of stress and strain measurements is required. The finite element analysis (FEA) has been applied to the dental implant field to predict stress distribution patterns in the implant-bone interface by comparison of various implant designs. This method offers the advantage of solving complex structural problems by dividing them into smaller and simpler interrelated sections by using mathematical techniques. The purpose of this study was to evaluate the stresses induced around the implants in bone using FEA, A 3D FEA computer software (SOLIDWORKS 2004, DASSO SYSTEM, France) was used for the analysis of clinical simulations. Two types (external and internal) of implants of 4.1 mm diameter, 12.0 mm length were buried in 4 types of bone modeled. Vertical and oblique forces of lOON were applied on the center of the abutment, and the values of von Mises equivalent stress at the implant-bone interface were computed. The results showed that von Mises stresses at the marginal. bone were higher under oblique load than under vertical load, and the stresses were higher at the lingual marginal bone than at the buccal marginal bone under oblique load. Under vertical and oblique load, the stress in type I, II, III bone was found to be the highest at the marginal bone and the lowest at the bone around apical portions of implant. Higher stresses occurred at the top of the crestal region and lower stresses occurred near the tip of the implant with greater thickness of the cortical shell while high stresses surrounded the fixture apex for type N. The stresses in the crestal region were higher in Model 2 than in Model 1, the stresses near the tip of the implant were higher in Model 1 than Model 2, and Model 2 showed more effective stress distribution than Model.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.1
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• pp.22-28
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• 2011

Purpose: This article attempted to examine how teeth for restoration is made in a clinical practice and utilize it as future educational material of teeth formation and basic data for additional research. Materials and methods: This experiment investigated the models sent to milling center for production of zirconia crowns. After scanned with Lava CAD/CAM System (3M ESPE, Seefeld, Germany), they are measured on 'ImageJ (version 1.32j, National Institutes of Health, USA)' program and compared and analyzed. Convergence angle from mesio-distal surfaces and bucco-lingual surfaces of each teeth are measured. Also, bucco-lingual diameter of the region lowered as much as 0.4 mm from incisal edge in anterior teeth except canines.(This measure is defined as the Peak 0.4) The analysis of data between each group was conducted by Windows SPSS statistic program, and was proved significant on 95% confidence level by independent t-test, one-way ANOVA and multiple analysis (Sheff${\'{e}}$ test). Results: The mean value of convergence angle was $18.67^{\circ}$ It is ranked as molar ($26.70^{\circ}$) > premolar ($16.87^{\circ}$) > anterior teeth ($14.81^{\circ}$) in the order of mesio-distal convergence angle; anterior teeth ($22.32^{\circ}$) > molar ($20.93^{\circ}$) > premolar ($15.41^{\circ}$) in the order of bucco-lingual convergence angle. The mean value of Peak 0.4 was 1.18 mm. Conclusion: Convergence angle of abutment of zirconia all ceramic crown has difference depending on the location in the arch. Due to the nature of production of zirconia all ceramic crown, convergence angle of abutment and line angle finishing degree can have an effect on internal suitability of restoration.