• The Journal of Korean Academy of Prosthodontics
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• v.43 no.5
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• pp.662-670
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• 2005

Statement of problem: Little is known about the effect of abutment preparation procedure on do-torque values in different implant platform and the relationship of final do-torque values with different implant platform size. Purpose: This study evaluated the effect of abutment preparation procedure on do-torque values in different implant platform and the relationship of final do-torque values with different implant platform size. Material and method: Six ITI implants (2 narrow-neck implants, 2 regular-neck implants, 2 wide-neck implants) and six Branemark implants (2 narrow platforms, 2 regular platforms, 2 wide platforms) were embedded in each acrylic resin block with epoxy resin. Eighteen $synOcta^(R)$ abutments (6 narrow-neck implant-abutments, 6 regular-neck implant-abutments, 6 wide-neck implant-abutments) and eighteen esthetic abutments (6 narrow platform-abutments, 6 regular platform-abutments, 6 wide platform-abutments) were tightened to each implant with digital torque gauge. Initial do-torque values were measured using digital torque gauge. After preparation of abutments, Final do-torque values were measured with digital torque gauge. Results and conclusion: 1. Screws loosening or abutments motion were not detected in all experimental group, but some scratches of implant-abutment joints were detected in all group 2. Reduction ratios of final do-torque values were greater than initial do-torque values in all measured group, except in narrow-neck implant-abutment group (p<0.05). 3. Reduction ratios of final do-torque values in wide-neck implant-abutment group were greater than regular-neck implant-abutment group (p<0.01). 4. The greatest standard deviation value was detected in wide platform group in both implant systems.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.1
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• pp.70-81
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• 2009

Statement of problem: The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever-rest-implant" and Malo reported "All-on-Four" in 2003. Purpose: Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and All-on-$Four^{TM}$ implant prostheses. Material and method: The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0. Results: 1. The rest implant and "All-on-Four" implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.245-252
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• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.497-507
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• 2021

All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.39
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• pp.21.1-21.6
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• 2017

Background: The purposes of the present study were to compare implant stabilities of mandibular block bone graft and bovine bone graft and to evaluate influencing factors for implant stability in mandibular block bone (MBB) graft. Methods: This retrospective study investigated 1224 cases and 389 patients treated by one surgeon in the Department of Oral and Maxillofacial Surgery of Pusan National University Dental Hospital (Yangsan, Korea) between January 2010 and December 2014. Proportions that MBB graft cases constitute in all implant restoration cases and in all bone graft cases were measured. Implant stability quotient (ISQ) values were achieved by the same surgeon before loading. The average ISQ values of the experimental groups were compared. In addition, ISQ values of influencing factors, such as age, sex, implant size, and implant placement site, were compared within the MBB group using $Osstell^{TM}$ Mentor ($Osstell^{(R)}$, $G{\ddot{o}}teborg$, Sweden). Paired t test and ANOVA were conducted for statistical analysis with a significance level of 0.05. Results: Fifty-five percent of all implant restoration cases performed bone graft while MBB cases constituted 34% of all implant restoration cases and 61% of all bone graft cases. Comparing ISQ values according to bone graft materials, the MBB group manifested sufficient implant stability by presenting comparable ISQ value to that of the experimental group without bone graft. Among the reviewed factors, females, mandibular molar regions, and implants in larger diameter displayed greater implant stabilities. Conclusions: Satisfactory implant stability was accomplished upon administration of MBB graft. Within the limitation of this study, gender, implant site, and implant diameter were speculated to influence on implant stability in MBB graft.

• The Journal of Advanced Prosthodontics
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• v.15 no.6
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• pp.290-301
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• 2023

PURPOSE. The study aimed to determine the influence of implant angulation on the trueness of multi-unit implant impressions taken through different techniques and strategies. MATERIALS AND METHODS. As reference models, three partially edentulous mandibular models (Model 1: No angulation; Model 2: No angulation for #33, 15-degree distal angulation for #35 and #37; Model 3: No angulation for #33, 25-degree distal angulation for #35 and #37) were created by modifying the angulations of implant analogues. Using a lab scanner, these reference models were scanned. The obtained data were preserved and utilized as virtual references. Three intraoral scanning (IOS) strategies: IOS-Omnicam, ISO-Quadrant, and IOS-Consecutive, as well as two traaditional techniques: splinted open tray (OT) and closed tray (CT), were used to create impressions from each reference model. The best-fit alignment approach was used to sequentially superimpose the reference and test scan data. Computations and statistical analysis of angular (AD), linear (LD), and 3D deviations (RMS) were performed. RESULTS. Model type, impression technique, as well as interaction factor, all demonstrated a significant influence on AD and LD values for all implant locations (P < .05). The Model 1 and SOT techniques displayed the lowest mean AD and LD values across all implant locations. When considering interaction factors, CT-Model 3 and SOT-Model 1 exhibited the highest and lowest mean AD and LD values, respectively. Model type, impression technique, and interaction factor all revealed significant effects on RMS values (P ≤ .001). CT-Model 3 and SOT-Model 1 presented the highest and lowest mean RMS values, respectively. CONCLUSION. Splinted-OT and IOS-Omnicam are recommended for multi-unit implant impressions to enhance trueness, potentially benefiting subsequent manufacturing stages.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.6
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• pp.317-321
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• 2015

Objectives: The purpose of this study is to evaluate five-year radiographic follow-up results of the Korean sandblasting with large grit, and acid etching (SLA)-treated implant system. Materials and Methods: The subjects of the study are 54 patients who have been followed-up to date, of the patients who underwent implant surgery from May 1, 2009 to April 30, 2011. In all, 176 implant placements were performed. Radiographs were taken before the first surgery, immediately after the first and second surgeries, immediately and six months after the final prosthesis installation, and every year after that. Bone loss was evaluated by the method suggested by Romanos and Nentwig. Results: A total of 176 implant placements were performed - 122 in men and 54 in women. These patients have been followed-up for an average of 4.9 years. In terms of prosthetic appliances, there were 156 bridges and 20 single prostheses. Nine implants installed in the maxillary molar area, three in the mandibular molar area and two in the maxillary premolar area were included in group M, with bone loss less than 2 mm at the crestal aspect of the implant. Of these, eight implants were single prostheses. In all, six implants failed - four in the mandible and two in the maxilla. All of these failures occurred in single-implant cases. The implant survival rate was 98.1% on the maxilla and 94.3% on the mandible, with an overall survival of 96.6%. Conclusion: Within the limitations of this study, implants with the SLA surface have a very superior survival rate in relatively poor bone environments such as the maxilla.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.145-156
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• 2023

Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.383-394
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• 1997

This study was done to examine adherence of oral bacteria to titanium dental implant and to know the effective prophylactic antibiotics using an in vivo model. Three samples each of the implant material were set in an acrylic resin flange and placed in the maxillary buccal sulcus of twenty volunteers. At 6- and 54-hour intervals, each sample was placed on blood agar plate (BAP) and chocolate agar, and then they were incubated and identified. Also antibiotic susceptibility test was performed. The results obtained mere as follows ; 1. The microorganisms were chain-like Gram positive cocci and staphyline Gram positive cocci, Gram positive bacilli in order of frequency were found at 6-hour and 54-hour samples by Gram staining. 2. Streptococci was found predominantly at both 6-hour and 54-hour samples, but number of streptococci was decreased as compared to 6-hour samples. 3. There was no difference in the bacterial species adherent to implant between 6-hour and 54-hour samples. 4. All the microbes were sensitive to AMC (amoxacillin clavulanic acid), chloramphenicol, quinolone and vancomycin in the antibiotic susceptibility test. Above results suggest that streptococcus are mainly adhered to titanium implant after implant was placed in the oral cavity and AMC is the most recommendable antibiotics to prevent the peri-implant inflammation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.3
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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 $37^{\circ}C$.