• 구강회복응용과학지
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• 제32권3호
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• pp.240-245
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• 2016

치은 연하 변연을 갖는 임플란트 수복물 장착시 잔여 합착제의 제거는 임플란트 생물학적 합병증을 예방하기 위해 매우 중요하다. 치은 연하 잔여 합착제를 최소화하기 위해 인상용 실리콘이나 자가중합형 레진을 이용하여 복제 지대주를 제작하는 여러 방법이 소개되었다. 본 증례에서는 열가소성 접착제(hot melt adhesive material)를 이용하여 복제 임플란트 지대주(abutment replica)제작하는 방법을 소개하고자 한다. 이 방법은 간단하고 부가적인 기공과정이 필요 없어 진료실에서 쉽게 이용할 수 있어 이에 보고하는 바이다.

• 대한치과보철학회지
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• 제42권5호
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• pp.583-596
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• 2004

Statement of problem : Stress concentration on the neck bone affects the bone resorption, and finally the implant survival. Purpose: In order to examine the stress distribution on the neck bone and prosthesis abutment for implants, decreasing abutment sizes were used. Material and methods : Axisymmetric models were used to obtain the data required. These models were composed of 4mm implants with 3.4mm and 4mm abutments, 5mm implants with 3.4mm and 5mm abutments and 6mm implants with 3.4mm and 6mm abutments. All abutments were designed to received a 10mm high by 10mm diameter gold crown. Functional element analysis was used to obtain these results using data that consisted of 50 N vertical and 45 degree inclination forces. Results : 1. Changing the diameter of the abutment on the implant affects the effect of the inclination forces more than the effect of the vortical forces. 2. Changing the diameter of the abutment on the implant affect the effect of the inclination forces more than the effect of the vertical forces. 3. Experimentation showed that the larger diameter implants provided a decreased neck bone stress, whereas a larger diameter abutment provided a decrease marginal abutment stress. 4. Experimentation showed that the neck bone and abutment received more stress from inclination forces than vertical forces, Conclusions: By decreasing the size of the abutment on the implant we were able to diminishneck bone stress.

• The Journal of Advanced Prosthodontics
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• 제1권1호
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• pp.37-40
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• 2009

STATEMENT OF PROBLEM. Implant drivers are getting popular in clinical dentistry. Unlike to implant systems with external hex connection, implant drivers directly engage the implant/abutment interface. The deformation of the implant/abutment interface can be introduced while placing an implant with its implant driver in clinical situations. PURPOSE. This study evaluated the change of rotational freedom between an implant and its abutment after application of different insertion torques. MATERIAL AND METHODS. Three kinds of internal connection implants were utilized for the current study($4.5{\times}12\;mm$ Xive, $4.3{\times}11.5\;mm$ Inplant Magicgrip, $4.3{\times}12\;mm$ Implantium MF). An EstheticBase, a 2-piece top, a Dual abutment was used for its corresponding implant system. The rotational freedom between an implant and its abutment were measured before and after applying 45, 100 Ncm insertion torque. Repeated measures ANOVA was used for statistical analysis. RESULTS. Under 45 Ncm insertion torque, the rotational freedom between an implant and its abutment was significantly increased in Xive(P = .003). However, no significant change was noted in Inplant Magicgrip and Implantium MF. Under 100 Ncm torque, both in Xive(P = .0005) and Implatium MF(P = .03) resulted in significantly increased rotational freedom between the implant and its abutment. DISCUSSION. The design of the implant/implant driver interface effectively prevented the deformation of implant/abutment interface. Little change was noted in the rotational freedom between an implant and its abutment, even though the insertion torque was far beyond clinical application. CONCLUSIONS. The implant/abutment joint of internally connecting implants were quite stable under insertion torque in clinical situation.

• 대한치과보철학회지
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• 제57권4호
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• pp.432-438
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• 2019

임플란트 보철 치료의 성공에 정확한 인상 채득은 매우 중요한 과정이다. 이러한 임플란트 보철의 인상을 채득하는 방법에는 임프레션 코핑과 인상재를 이용한 전통적인 방법과 구강 스캐너와 디지털 인상 코핑(scanbody)을 이용한 디지털 인상채득법이 있다. 하지만 인상용 코핑과 scanbody는 모두 구강 내 치유 지대주(healing abutment)를 제거하고 장착해야 한다. 때문에 술자는 치유 지대주와 임프레션 코핑 또는 scanbody를 여러 번 체결하고 제거하는 과정을 반복해야 한다. 뿐만 아니라 임프레션 코핑 또는 scanbody는 교합면보다 높게 솟아 있어 환자는 지속적으로 개구 상태를 유지해야 하는 불편을 주기도 한다. 이러한 기존의 방법을 극복하고자 최근에는 치유 지대주에 scanbody의 스캔 가능 부분(scannable part)을 부여하여 치유 지대주를 제거할 필요 없이 구강 내에서 직접 구강 스캐너로 스캔이 가능한 치유지대주(scannable healing abutment)가 소개되었다. 스캔이 가능한 치유지대주를 이용하여 구치부 단일 임플란트를 수복한 증례를 소개하고자 한다.

• Journal of Periodontal and Implant Science
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• 제49권3호
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• pp.171-184
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• 2019

Purpose: To evaluate the effects of intra-alveolar socket grafting, subepithelial connective tissue grafts, and individualized abutments on peri-implant hard and soft tissue outcomes following immediate implant placement. Methods: This randomized experimental study employed 5 mongrel dogs, with 4 sites per dog (total of 20 sites). The mesial roots of P3 and P4 were extracted in each hemimandible and immediate dental implants were placed. Each site was randomly assigned to 1 of 4 different treatment groups: standardized healing abutment (control group), alloplastic bone substitute material (BSS) + standardized healing abutment (SA group), BSS + individualized healing abutment (IA group), and BSS + individualized healing abutment + a subepithelial connective tissue graft (IAG group). Clinical, histological, and profilometric analyses were performed. The intergroup differences were calculated using the Bonferroni test, setting statistical significance at P<0.05. Results: Clinically, the control and SA groups demonstrated a coronal shift in the buccal height of the mucosa ($0.88{\pm}0.48mm$ and $0.37{\pm}1.1mm$, respectively). The IA and IAG groups exhibited an apical shift of the mucosa ($-0.7{\pm}1.15mm$ and $-1.1{\pm}0.96mm$, respectively). Histologically, the SA and control groups demonstrated marginal mucosa heights of $4.1{\pm}0.28mm$ and $4.0{\pm}0.53mm$ relative to the implant shoulder, respectively. The IA and IAG groups, in contrast, only showed a height of 2.6mm. In addition, the height of the mucosa in relation to the most coronal buccal bone crest or bone substitute particles was not significantly different among the groups. Volumetrically, the IA group ($-0.73{\pm}0.46mm$) lost less volume on the buccal side than the control ($-0.93{\pm}0.44mm$), SA ($-0.97{\pm}0.73mm$), and IAG ($-0.88{\pm}0.45mm$) groups. Conclusions: The control group demonstrated the most favorable change of height of the margo mucosae and the largest dimensions of the peri-implant soft tissues. However, the addition of a bone substitute material and an individualized healing abutment resulted in slightly better preservation of the peri-implant soft tissue contour.

• 대한치과보철학회지
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• 제41권4호
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• pp.519-531
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• 2003

Statement of problem : Chronic implant screw loosening remains a problem in restorative practices. Some implant manufactureres have introduced abutment screws with treated material, surfaces and macrostructures in an effort to reduce potential loosening. Purpose : This study evaluated the materials and loading cycles on detorque value after dynamic continous fatigue test in the sinulated conditions of posterior single restoration. Material and method : Fourteen of each of the following abutment screws - titanium alloy, gold alloy, gold-tite, and titanium alloy modified - were used in test. SEM is used to verify macrostructures of each screws. $ZrO_2/Al_2O_3$ composite abutment was tightened on $4{\times}10.0mm$ titanium external implant at 30 Ncm. Cyclic loading machine delivered dynamic loading forces between 20 and 320N for 100,000, 200,000, 300,000, 500,000, and 1,000,000 cycles at frequencies 14Hz. Torque and detorque value after loading was measured. Results : All measued screws had different screw length and thread form. Titanium modified screw had greater detorque value than others before and after cyclic loadings(p<0.05). All abutment screws had no significant change in mean percentage of detorque value after loading to initial value after less than 500.000 cyclic loadings, but significant lower value after 1,000,000 cycles(p<0.05). Conclusion : Within limintations of this study all abutment screws may be loosend after about 1 year use. Annual check-up is nessasary to prevent screw loosening.

• The Journal of Advanced Prosthodontics
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• 제9권4호
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• pp.271-277
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• 2017

PURPOSE. This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS. Two regular platform dental implants, one with external connection ($Br{\aa}nemark$, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at ${\alpha}=0.05$ of significance. RESULTS. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.

• The Journal of Advanced Prosthodontics
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• 제11권2호
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• pp.105-111
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• 2019

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with $0.7{\mu}L$ of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (${\alpha}=.05$). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in ${\mu}m$) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.

• The Journal of Advanced Prosthodontics
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• 제15권1호
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• pp.33-43
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• 2023

PURPOSE. This study investigated the physical and mechanical changes in the titanium base of three different hybrid abutment materials after cyclic loading by estimating the post-load reverse torque value (RTV), compressive side fulcrum wear pattern of titanium base, and surface roughness. MATERIALS AND METHODS. A total of 24 dental implants were divided into three groups (n = 8 each): Group Z, LD, and P used zirconia, lithium disilicate, and polyetheretherketone, respectively, for hybrid abutment fabrication. RTV was evaluated after cyclic loading with 50 N for 1.2 × 10⁶ chewing cycles. The compressive sides of the titanium bases were analyzed using a scanning electron microscope, and the roughness of the affected areas was measured using an optical profilometer after loading. Datasets were analyzed using Kruskal-Wallis test followed by Mann-Whitney tests with the Bonferroni correction (α = .05). RESULTS. Twenty-three samples passed the test; one LD sample fractured after 770,474 cycles. Post-load RTV varied significantly depending on the hybridabutment material (P = .020). Group P had a significantly higher median of post-load RTVs than group Z (16.5 and 14.3 Ncm, respectively). Groups LD and P showed minor signs of wear, and group Z showed a more pronounced wear pattern. While evaluating compressive side affected area roughness of titanium bases, lower medians were shown in group LD (Ra 0.16 and Rq 0.22 ㎛) and group P (Ra 0.16 and Rq 0.23 ㎛) than in group Z (Ra 0.26 and Rq 0.34 ㎛); significant differences were found only among the unaffected surface and group Z. CONCLUSION. The hybrid abutment material influences the post-load RTV. Group Z had a more pronounced wear pattern on the compressive side of titanium base; however, the surface roughness was not statistically different among the hybridabutment groups.

• 대한치과보철학회지
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• 제43권1호
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• pp.105-119
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• 2005

Statement of problem. As the effects of the various diameters of fixture and abutment screw on stress distribution was not yet examined, this study focused on the different design of single implant restoration using three dimensional finite element analysis. Purpose. This study was to compare five different fixture-abutment combinations for single implant supported restorations with different fixture and abutment screw diameters. Material of methods. The five kinds of finite element models were designed by 3 diameter fixtures ($\oslash$3.3, 3.75, 5.0 mm) with 3 different abutment screws $\oslash$1.5, 1.7, 2.0 mm). The crown for mandibular first molar was made using UCLA abutment according to Wheeler's anatomy. 244 N was applied at the central fossa with two different loading directions, vertically and obliquely (30$^{\circ}$) and at the buccal cusp vertically. Maximum von Mises stresses were recorded and compared in the supporting bone, crowns, fixtures, and abutment screws. Results. 1. The stresses in supporting bone and implant-abutment structure under oblique loading were greater than those under vertical or offset loading. The stresses under vertical loading were the least among 3 loading conditions regardless of the implant and abutment screw diameters. 2. The stresses in the narrow implants were greater than the wider implants. The narrow implant with narrow abutment screw showed highest stresses in the lingual crest, but the narrow implant with standard abutment screw showed highest stress in abutment screw. 3. The stresses of abutment screws were influenced by the diameter of fixtures and loading conditions. The wide implants showed least difference between two different abutment screw diameters. Conclusions. The wide implants showed lesser stresses than the narrow implants and affected least by the different abutment screw diameters. The narrow implants with standard abutment screw showed highest stresses in the lingual bony crest under oblique loading.