• 대한치과기공학회지
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• 제38권3호
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• pp.151-156
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• 2016

Purpose: The dental implant should be enough to endure chewing load and it's required to have efficient design and use of implant to disperse the stress into bones properly. This study was to evaluate the stress distribution on a supporting bone by lengths and diameters of the implant fixture. Methods: The modeling and analysis of stress distribution was used for the simple molar porcelain crown model by Solidworks as FEM program. It was designed on applying with tightening torque of 20 Ncm of a abutment screw between a cement retained crown abutment and a fixture. The fixtures of experimental model used 10, 13mm by length and 4, 5mm by diameter. A external vertical loading on the two buccal cusps of crown and performed finite element analysis by 100 N. Results: The maximum von Mises stress(VMS) of all supporting bone models by fixture length and diameter were concentrated on the upper side of supporting compact bone. The maximum stress of each model under vertical load were 164.9 MPa of M410 model, and 141.2 MPa of M413 model, 54.3 MPa of M510 model, 53.6 MPa of M513 model. Conclusion: The stress reduction was increase of fixture's diameter than it's length. So it's effective to use the wider fixture as possible to the conditions of supporting bone.

• 대한치과기공학회지
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• 제40권1호
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• pp.41-47
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• 2018

Purpose: The purpose of this study was to analyze the biomechanical properties of the dental implants on the supporting bone using three-dimensional finite element method when three different abutment materials were applied to the implant system. Methods: Three different dental implant models were fabricated by applying Ti, PEEK, and CRE-PEEK (60% carbon-reinforced PEEK) to abutment material. The abutment and connecting screw from the fixture was applied with a tightening torque of 20 Ncm. And then, total loads of 150 N were applied in an $30^{\circ}oblique$ direction (to the vertical). The structural stability of dental implants on the supporting bone was analyzed using Von Mises stress and principal stress values. Results: The maximum tensile stress of the cortical bone was highest at 12.6 MPa in the PEEK abutment (Model-B). Ti abutment (Model-A) and CRE-PEEK abutment (Model-C) showed similar stress distributions (10.6 and 10.3 MPa, respectively). And the maximum compressive principal stress was similar in all models. The Von Mises stress value delivered to the bone around the implant was highest at 16.5 MPa in Model-B. On the other hand, Model-A and C showed similar stress distributions (14.0 and 13.8 MPa, respectively). In addition, the maximum equivalent stress applied to the abutment was highest at 629.8 MPa in Model-A. The stress distribution in Model-C was 573.9 MPa. Whereas, Model-B showed the lowest value at 165.6 MPa. Conclusion : The dental implant supporting bone system using PEEK material seems to have the possibility of supporting bone fracture. It was found that the CRE-PEEK abutment can reduce the elastic deformation and reduce the stress value of the interfacial bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제31권6호
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• pp.461-468
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• 2009

Purpose: Platelet derived growth factor(PDGF)-BB and bone morphogenetic protein(BMP)-2 are well-known representative growth factors. The purposes of this study were to investigate the effect of rhPDGFBB and rhBMP-2 on osseointegration of titanium implants at periimplant bone defects grafted with hydroxyapatite and to evaluate the feasibility of imaging bone structures around screw-type titanium implant with micro-CT. Materials and Methods: The first molar and all premolars in the mandible region of four beagle dogs were extracted. Following a healing period of 4 months, three $8{\times}8{\times}6mm$-sized bony defects were formed and screw-type titanium implants were placed with hydroxyapatite(HA) block and growth factors; Control group, PDGF group and BMP group. Two months post-implantation, the mandible was harvested. Bone volume(BV), bone-to-implant contact(BIC) and bone mineral density(BMD) were analyzed with micro-CT and histology. Results: According to micro-CT analysis, BV and BMD measures of PDGF and BMP group were significantly higher than control group(BV; PDGF group: $p{\fallingdotseq}0.011$, BMP group: $p{\fallingdotseq}0.006$/BMD; PDGF group: $p{\fallingdotseq}0.020$, BMP group: $p{\fallingdotseq}0.011$) and BIC measures of BMP group were significantly higher than PDGF group($p{\fallingdotseq}0.015$). In histologic evaluation, BIC measures of BMP group was significantly higher than PDGF group($p{\fallingdotseq}0.048$). The values of BV in histologic sections were higher than in micro-CT images and the values of BIC in micro-CT images were higher than in histologic sections. Conclusion: The findings of this experimental study indicates that the use of rhPDGF-BB and rhBMP-2 can increase new bone formation in a large bony defect around titanium implant, and rhBMP-2 is more effective than rhPDGF-BB. Micro-CT can be considered useful for assessment as a rapid and nondestructive method for 3-dimensional measurement of bone healing around implants. Further study is necessary, however, to remove metal artifacts around titanium implant and to standardize the method.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권3호
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• pp.258-265
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• 2008

Purpose. This multicenter retrospective study was performed to evaluate the survival and success rates of immediate placement of USII and SSII Osstem implant (Osstem implant Co, Korea) on the maxillary and mandibular anterior and premolar areas. Materials and methods. Dental records were obtained in 37 patients who were treated with immediate implantation on the maxillary and mandibular anterior and premolar areas in 6 different clinics. The 98 implants were evaluated both clinically and radiographically using predefined success criteria. Results. There was no failed implant in all patients. The mean follow up period was 24.7 months (ranged from 12 to 58 months), and 25.1 months (ranged from 16 to 35 months) in USII and SSII implants, respectively. The crestal bone loss was 3 mm in 3 USII implants during 41 months, and in 1 SSII implant during 22 months. The overall success rate was 94.2% and 97.7% in USII and SSII implants, respectively. The age, gender, diameter, or length of implants, and type of surgery were not influenced to the success rate of immediate implantation. Conclusion. These results suggest that USII and SSII Osstem implant can be used successfully in immediate implantation on the maxillary and mandibular anterior and premolar areas.

• 대한치과의사협회지
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• 제53권5호
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• pp.360-367
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• 2015

Purpose : The purpose of this study was to evaluate the effect of amount of cantilever in intra-crown according to implant fixture position on mechanical strength of internal conical joint type implant. Materials and Methods : Internal conical joint type implant fixture, abutment screw, abutment was connected and gold alloy prostheses were fabricated and cemented on abutment. For fatigue fracture test, the specimens were loaded to the 350 N, 2,000,000 cycle on 3, 4, 5, and 6 mm off-center of gold alloy prostheses. The fracture pattern of implant component was observed. Results : No fatigue fracture found on 3 and 4 mm group. But initial crack pattern found on 3 specimens of 4 mm group. Fatigue fracture found on all specimens of 5 mm group. But complete fracture was not observed. One specimen of 6 mm group fracture completely. Implant fixture fracture wax not observed. Conclusion : The mechanical failure of implant prostheses increased with the loading area farther from center of implant fixture. To reduce mechanical problem of internal joint type implant, surgical and prosthetic consideration is needed.

• 한국재료학회지
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• 제15권5호
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• pp.353-360
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• 2005

Surface treatment play an important role in nucleating calcium phosphate deposition on surgical Ti implant. Therefore, the purpose of this study is to examine whether the precipitation of apatite on cp-Ti and Ti alloys are affected by surface modification in HCl and $H_2O_2$ solution. Specimens were then chemically treated with a solution containing 0.1 M HCl and 8.8M $H_2O_2$ at $80^{\circ}C$ for 30 mins, and subsequently heat-treated at $400^{\circ}C$ for 1 hour. All specimens were immersed in the HBSS with pH 7.4 at $36.5^{\circ}C$ for 15 days, and the surface was examined with XRD, SEM, EDX ana XPS. Also, pure Ti, Ti-6Al-4V and Ti-6Al-7Nb alloy specimens with and without surface treatment were implanted in the abdominal connective tissue of mice for 4 weeks. All specimens chemically treated with HCl and $H_2O_2$ solution have the ability to form a apatite layer in the HBSS which has inorganic ion composition similar to human blood plasma. The average thickness of the fibrous capsule surrounding the specimens implanted in the connective tissue was $38.57\;{\mu}m,\;62.27\;{\mu}m\;and\;45.64\;{\mu}m$ in the cp-Ti, Ti-6Al-4V ana Ti-6Al-7Nb alloy specimens with the chemical treatment respectively, and $52.20\;{\mu}m,\;75.62\;{\mu}m\;and\;66.56\;{\mu}m$ in the commercial specimens of cp-Ti, Ti-6Al-4V and Ti-6Al-7Nb without any treatment respectively. The results of this evaluation indicate that the chemically treated cp-Ti, Ti-6Al-4V ana Ti-6Al-7Nb alloys have better bioactivity and biocompatibility compared to the other metals tested.

• 대한치과보철학회지
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• 제40권5호
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• pp.507-524
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• 2002

Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study, 1. In all experimental models. the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows: type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems. more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread. selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.325-340
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• 2008

The purpose of this study was to evaluate the artificial dental plaque by Streptococcus mutans on 4 different implant surfaces. In this study, the specimens were divided into 4 groups according to implant surface treatment. Uncoated implant group(n=5) which has an uncoated, smooth surfaced implant(Osstem, Korea), SLA implant group(n=5) which has an sandblasted large grit and acid-etched surface implant(Bicon, USA). Oxidized implant group(n=5) which has an oxidized surfaced implant (Osstem, Korea), and RBM implant group(n=5) which has resorbable blasting media(RBM) surfaced implant(Osstem, Korea). Acquired pellicle by human saliva and dental plaque by Streptococcus mutans were made on each implant surface. To analyze the plaque condition on implants surfaces, cell count and optical density were taken as a microbiologic method, and SEM(Scanning Electronic Microscope) findings was also taken for evaluation of surface condition. The following results were obtained. 1. Cell counting results of artificial dental plaque were Uncoated group($658.0{\pm}102.0$), RBM group($878.0{\pm}170.0$), SLA group ($946.0{\pm}42.0$), Oxidized group($992.0{\pm}40.0$), and there was difference between Oxidized group and Uncoated implant group(p<0.05). In case of modified cell counting results by v/w% were RBM group($197.8{\pm}45.2$), Oxidized group($207.04{\pm}8.34$), Uncoated group($261.6{\pm}40.6$), SLA group($315.4{\pm}14.0$), and there was difference between RBM group and SLA group(p<0.05). 2. Optical density results of artificial dental plaque after ultrasonic treatment was that there was difference among groups, and optical density of RBM group was higher than that of Uncoated group(p<0.05). In case of modified optical density results by v/w%, there was difference among groups, and the modified optical density of Uncoated group and SLA group was higher than those of Oxidized group and RBM group(P>0.05). 3. SEM findings of artificial dental plaque on the surfaces of implant as follows; there were artificial dental plaque on the surfaces of all test implants. Streptococcus mutans and by-product were observed at 10,000 times magnified condition on all test implants. Adhesion area of artificial dental plaque was about 1/2 of total surface after 24 hours incubate at $37^{\circ}C$. These results showed that there were differences among implant surfaces on the growth of Streptococcus mutans, and bacteria and by-product were covered about 1/2 area of total implant surfaces at 24 hours incubate at $37^{\circ}C$.

• Journal of Periodontal and Implant Science
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• 제39권1호
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• pp.71-76
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• 2009

Purpose: Many researches showed loss of alveolar bone in fresh extraction socket and even in case of immediate implant placement. The aim of this study was to evaluate the effect of non-resorbable barrier membrane on the change of buccal and lingual alveolar bone in immediate implant placement into periapically infected extraction sockets. Materials and methods: Immediate implants were placed into artificially induced periapical lesion of mandibular premolars after complete debridement using buccal bone defect made by a 6mm trephine bur in 4 mongrel dogs. Before flap repositioning, a non-resorbable barrier membrane was placed on the buccal defect in the experimental group. No membrane was placed in the control group. In 12 weeks after placement, the dogs were sacrificed and undecalcified histologic specimens were prepared. The vertical distance from the smooth-rough surface interface(SRI) to gingiva, 1st bone contact and bone crest were measured in buccal and lingual side. The horizontal thicknesses of gingiva and bone at 0, 1, 2 and 3mm below SRI were measured. Results: The buccal bone was resorbed more than lingual bone in both groups and there was statistical significance(p<0.05). The distances from SRI to 1st bone contact were $2.45{\pm}2.35\;mm$ in experimental group and $4.49{\pm}3.10\;mm$ in control group. In all vertical level, lingual bone was thicker than buccal bone(p<0.05). Conclusion: Buccal bone was reduced more than lingual bone in immediate implant placement into periapically infected extraction sockets. Placement of non-resorbable barrier membrane reduced the buccal bone resorption. However there was no statistical significance.

• 대한치과의사협회지
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• 제57권3호
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• pp.149-160
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• 2019

Atrophic alveolar ridge of maxillary anterior area is commonly observed after the extraction of teeth in patients with severely compromised periodontal disease, causing difficulties with implant placement. Successful esthetics and functional implant rehabilitation rely on sufficient bone volume, adequate bone contours, and ideal implant positioning and angulation. The present case report categorized the ridge augmentation techniques using guided bone regeneration (GBR) on the maxillary anterior site by Seibert classification. Case I patient presented for implant placement in the position of tooth #11. The alveolar ridge was considered a Seibert classification I ridge defect. Simultaneous implant placement and GBR were performed. Eight months after implantation, clinical and radiological examinations were performed. Case III patient presented with discomfort due to mobility of the upper maxillary anterior site. Due to severe destruction of alveolar bone, teeth #11 and #12 were extracted. After three months, the alveolar ridge was considered a Seibert classification III ridge defect. A GBR procedure was performed; implantation was performed 6 months later. Approximately 1-year after implantation, clinical and radiological examinations were performed. During the whole treatment period, healing was uneventful without membrane exposure, severe swelling, or infection in all cases. Radiographic and clinical examinations revealed that atrophic hard tissues and buccal bone contour were restored to the acceptable levels for implant placement and esthetic restoration. In conclusion, severely resorbed alveolar ridge of the maxillary anterior area can be reconstructed with ridge augmentation using the GBR procedure so that dental implants could be successfully placed.