• The Journal of Korean Academy of Prosthodontics
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• v.36 no.3
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• pp.468-482
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• 1998

Since the concept of osseointegration was introduced by Branemark of Sweden, dental implants have been used for various dental prosthetic treatments. The survival rate of dental implant is likely to be closely related to the total biomechanical role of each component of implant system. The use of interchangeable component is very attractive for dental practitioners because such an approach would save treatment cost, flexibility of prosthetic treatment options as well as conveniences. Therefore, the use of interchangeable implant system has been increasing without scientific assessment of safety and efficacy of various interchangeable implant system. The purpose of this study, therefore, were to compare the geometric characteristic of four interchangeable dental implant screws and the loosening torque of these screws. Four types of dental implant screws tested in this study were Nobelpharma, 3i, Impla-med, Restore. Four screws each of the test specimens were subjected for scanning electron microscopic examinations under the same condition and a 35x magnified standard SEM picture was objected from each test specimen using JSM-5200 scanning microscope. From each of the SEM pictures, eight parameters. i.e., diameter of screw head. screw length, thread pitch, major diameter. neck diameter, neck length, crest width and root width were determined using a caliper. The measurement for each parameters were then corrected for their magnification factor. The loosening torque were also determined by using a torque gauge. All of the measurements were statistically analyzed by ANOVA test and multiple range test. Statistical significance was set in advance at the probability level of less than 0.05. All analyses were done with SPSS software for the personal computer. The conclusion obtained from this studies were summarized as the following; 1. No statistically significances were noted in the thread pitch. and crest width in the four screws, and in the case of major diameter, the Impla-med screw was significantly smaller than the other three screws (p<0.05). Therefore, four implant bolts could be physically inserted in a abutment nuts. 2. The diameter of screw head was decreased in the order of Restore, 3i, Nobelpharma, Impla-med screws and the length of screws were decreased in the order of 3i, Restore, Nobelpharma and Impla-med. The diameter of neck was decreased in the order of Impla-med, Restore. Nobelpharma, 3i screws. The differences of each of these parameters were statistically significant (p<0.05). The width of root of screws were decreased in the order of Nobelpharma, Impla-med, Restore and 3i. The differences among Nobelpharma and Impla-med. Restore and 3i were statistically significant (p<0.05). 3. When the screws were loosening 1, 3, 4 and 5 times, the loosening torque for Impla-med and 3i screws were significantly higher than that of Nobelpharma or Restore screws (p<0.05). However, when statistically smaller than that of 3i, Restore or Nobelpharma screws(p<0.05).

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.229-235
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• 2011

PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.

• The Journal of the Korea Contents Association
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• v.14 no.9
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• pp.343-349
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• 2014

The dental osseointegration implant should be enough to endure occlusion load and it's required to have efficient design and use of implant to disperse the stress into bones properly. Solidworks as a finite element analysis program for modeling and analysis of stress distribution was used for the research. The simple crown model was designed on applying conjoined condition with tightening torque of 20 Ncm of a abutment screw between a cement retained implant abutment and a fixture. A $45^{\circ}$ oblique loading from lingual to buccal side on buccal cusps of crown and performed finite element analysis by 100 N of external load. The results by a analysis for stress distribution of supporting bones of fixture were as below. The von Mises stress was concentrated on the upper side of supporting compact bone regardless of the diameters and lengths of fixture, and the efficiency result of stress reduction was increase of fixture's diameter than it's length. Therefore, it's effective to use wider fixture as possible to the conditions of supporting jaw bone.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.4
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• pp.793-800
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• 1997

Periotest(Siemens, Germany) has been used to test mobility of the implants clinically, however the effects of target materials and connection methods on the PTVs(Periotest Values) have not been evaluated. Periotest has been regarded as a reliable and objective tool to test implant and natural teeth mobility clinically, however this instrument showed different PTVs under various test conditions. This in vitro study was designed to compare PTVs of different veneering materials and prosthodontic designs (single and bridge restorations). To compare the effects of veneering materials on PTVs, 1 mm thickness of five different testing materials (porcelain, type III gold alloy, pure titanium, composite resin, acrylic resin) were placed on the resin block. Three full length of 13 mm Mark II implant fixtures were embedded into autopolymerizing resin block to fabricate single and bridge restorations. To evaluate effects of the connection method in single restorations, PTVs of screw retained(UCLA type) and cementation type(Cera-One system) were compared. Finally, to test reliability of PTVs of the final restorations, screw retained three unit short span PFM bridges were fabricated on the standard and Estheti-Cone abutments. All testing components were tightened with torque controller and PTVs of all specimens were measured 15 times for statistical analysis with SAS program. Following conclusions were made within the limit of this in vitro study. 1. PTVs of type III gold alloy, grade II titanium, composite resin veneering materials showed no significant differences, however acrylic resin and porcelain showed significant differences (P<0.05). 2. Single tooth restorations showed consistent PTVs as long as proper torque force was applied. 3. PTVs of bridge type prostheses was inconsistent regardless of abutment types. 4. PTVs of the prostheses showed higher scores and standard deviations than those of abutments regardless types of connection (P<0.05).

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.153-167
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• 2005

The purpose of this study was to compare the v-shape thread with the square shape thread of fixture in the view of stress distribution pattern using finite element stress analysis. The finite element model was designed with the parallel placement of two standard fixtures(4.0 mm diameter ${\times}$ 11.5 mm length) on the region of mandibular 1st and 2nd molars. Three dimensional finite element model was created with the components of the implant and surrounding bone. This study simulated loads of 200 N at the central fossa in a axial direction (load A), 200 N at the buccal offset load that is 2 mm apart from central fossa in a axial direction (load B), 200 N at the buccal offset load that was 4 mm apart from central fossa in a axial direction (load C). These forces of load A',B',C' were applied to a $15^{\circ}$ inward oblique direction at that same site with 200 N. Von Mises stress values were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study : 1. The highest stress concentration occurred at the cervical region of the implant fixture. 2. Von Mises stress value of off-site region was higher than that of central fossa region. 3. Square shape thread type showed more even stress distribution in the vertical and oblique force than V-shape thread type. 4. Stress distribution was the most effective in the case of buccal offset load (2, 4 mm distance from central fossa) in the square shape thread type. 5. V-shape thread type revealed higher von Mises stress value than square shape thread type in all environmental condition. The results from numerical analyses concluded that square shape thread type had the lower destructive stress and more stress distribution between the fixture and bone interface than V-shape thread type. Therefore, square shape thread type was regarded as optimal thread configuration in biomechanical concepts.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.6
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• pp.717-723
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• 2007

Statement of problem. Unreasonable distal cantilevered implant-supported prosthesis can mask functional problems of reconstruction temporarily, but it can cause serious strain and stress around its supported implant and surrounding alveolar bone. Purpose. The purpose of this study was to evaluate strain of implants supporting distal cantilevered fixed prosthesis with two different cantilevered length under distal cantilevered static load. Material and methods. A partially edentulous mandibular test model was fabricated with auto-polymerizing resin (POLYUROCK; Metalor technologies, Stuttgart, Swiss) and artificial denture teeth (Endura; Shofu inc., Kyoto, Japan). Two implants-supported 5-unit screw-retained cantilevered fixed prosthesis was made using standard methods with Type III gold alloy (Harmony C&B55; Ivoclar-vivadent, Liechtenstein, Germany) for superstructure and reinforced hard resin (Tescera; Ivoclar-vivadent, Liechtenstein, Germany) for occlusal material. Two strain gauges (KFG-1-120-C1-11L1M2R; KYOWA electronic instruments, Tokyo, Japan) were then attached to the mesial and the distal surface of each standard abutment with adhesive (M-bond 200; Tokuyama, Tokyo, Japan). Total four strain gauges were attached to test model and connected to dynamic signal conditioning strain amplifier (CTA1000; Curiotech inc., Paju, Korea). The stepped $20{\sim}100$ N in 25 N increments, cantilevered static load 8mm apart (Group I) or 16mm apart (Group II), were applied using digital push-pull gauge (Push-Pull Scale & Digital Force Gauge, Axis inc., Seoul, Korea). Each step was performed ten times and every strain signal was monitored and recorded. Results. In case of Group I, the strain values were surveyed by $80.7{\sim}353.8{\mu}m$ in Ch1, $7.5{\sim}47.9{\mu}m/m$ in Ch2, $45.7{\sim}278.6{\mu}m/m$ in Ch3 and $-212.2{\sim}718.7{\mu}m/m$ in Ch4 depending on increasing cantilevered static load. On the other hand, the strain values of Group II were surveyed by $149.9{\sim}612.8{\mu}m/m$ in Ch1, $26.0{\sim}168.5{\mu}m/m$ in Ch2, $114.3{\sim}632.3{\mu}m/m$ in Ch3, and $-323.2{\sim}-894.7{\mu}m/m$ in Ch4. Conclusion. A comparative statistical analysis using paired sample t-test about Group I Vs Group II under distal cantilevered load shows that there are statistical significant differences for all 4 channels (P<0.05).

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.157-168
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• 2008

Statement of problem: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. Purpose: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or non-splinting crowns by performing finite element analysis. Materials and methods: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: $Br{{\aa}}nemark$ length 8.5mm 13mm splinting type Group 2: $Br{{\aa}}nemark$ length 8.5mm 13mm Non-splinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. Results: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.61-66
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• 2012

Purpose: This study was to compare the cumulative survival rate (CSR) of Br${\aa}$nemark machined surface implants and TiUnite$^{TM}$ imlants and to analyze association between risk factors and the CSR of the implants. Materials and methods: A retrospective study design was used to collect long-term follow-up clinical data from dental records of 156 patients treated with 541 Br${\aa}$nemark machined and TiUnite$^{TM}$ implants at Korea University Guro hospital in South Korea from 1993 through 2008. Machined implant and TiUnite$^{TM}$ implant were compared by CSR. Exposure variables such as gender, systemic disease, location, implant length, diameter, prosthesis type, opposing occlusion type, date of implant placement, type of edentulous space, abutment type, existence of splinting with natural teeth, and existence of cantilever were collected. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR (${\alpha}$=.05). Results: Patient ages ranged from 16 to 75 years old (mean age, 51 years old). Implants were more frequently placed in men than women (94 men versus 63 women). Since 1993, 264 Br${\aa}$nemark machined implants were inserted in 79 patients and since 2001, 277 TiUnite$^{TM}$ implants were inserted in 77 patients. A total survival rate of 86.07% was observed in Br${\aa}$nemark and Nobel Biocare TiUnite$^{TM}$ during 15 years. A survival rate of machined implant during 15 years was 82.89% and that of TiUnite$^{TM}$ implant during 5 years was 98.74%. The implant CSR revealed lower rates association with several risk factors such as, systemic disease, other accompanied surgery, implant location, and Kennedy classification. Conclusion: Clinical performance of Br${\aa}$nemark machined and TiUnite$^{TM}$ implant demonstrated a high level of predictability. In this study, TiUnite$^{TM}$ implant was more successful than machined implant. The implant CSR was associated with several risk factors.