• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제42권6호
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• pp.345-351
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• 2016

Objectives: This study compared the impact of implant surface treatment on the stability and osseointegration of implants in dog mandibles. Materials and Methods: Six adult dogs received a total of 48 implants that were prepared using four different surface treatments; resorbable blast media (RBM), hydroxyapatite (HA), hydrothermal-treated HA, and sand blasting and acid etching (SLA). Implants were installed, and dogs were separated into 2- and 4-week groups. Implant stability was evaluated via Periotest M, Osstell Mentor, and removal torque analyzers. A histomorphometric analysis was also performed. Results: The stability evaluation showed that all groups generally had satisfactory values. The histomorphometric evaluation via a light microscope revealed that the HA surface implant group had the highest ratio of new bone formation on the entire fixture. The hydrothermal-treated HA surface implant group showed a high ratio of bone-to-implant contact in the upper half of the implant area. Conclusion: The hydrothermal-treated HA implant improved the bone-to-implant contact ratio on the upper fixture, which increased the implant stability.

• 한국재료학회지
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• 제22권6호
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• pp.292-297
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• 2012

In order to improve osseointegration of dental implants with bone we studied an implant with holes inside its body to deliver bioactive materials based on a proposed patent. Bioactive materials can be selectively applied through holes to a patient according to diagnosis and the integration progress. After the bioactive material is applied, bone can grow into the holes to increase implant bonding and also enhance surface integration. In order to improve the concept and study the effect of bioactive material injection on implant integration, design optimization and integration research were undertaken utilizing the finite element method. A 2-dimensional simulation study showed that when bone grew into the holes after the bioactive material was injected, stress vertically distributed in the upper part of the implant was relieved and mild stress appeared at the opening of the injection holes. This confirmed the effect of the bioactive material and the contribution of the injection holes, but the maximum stress increased ten-fold at the opening. In order to reduce the maximum stress, the size, location, and the number of holes were varied and the effects were studied. When bioactive materials formed an interface layer between the implant and the mandible and four holes were filled with cortical and cancellous bones all the stress concentrated opposite to the loading side without holes disappeared. The stresses at the four outlets of the holes was mildly elevated but the maximum stress value was ten-fold greater compared to the case without the bioactive material.

• 대한임상검사과학회지
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• 제37권1호
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• pp.35-40
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• 2005

This paper reports the morphological nature of the remodelled interface process between implants and surrounding bone after 1, 4, 6, 8 and 12 weeks of implantation of smooth machined implants into rat tibias. After 4 weeks of implantation, histochemical analysis showed that the new bone was growing in direct contact with the implant. In the forming process, the activatived osteoblast cells migrated toward the interface and colonized the surface at the contact areas. This immature woven bone, rich in osteocyte lacunae, was deposited directly onto the implant surface. Osteoblast activity was found to continue ill 12 weeks of implantation The osteoblasts in lacunar areas developed numerous processes and synthesized bone matrix, after all, surrounded by secreting matrix. At the 12th week, the amount of newly formed bone matrix between bone and implant increased in mineralization. The mineralized mature bone contained well organized collagen fibers with characteristic banding pattern bone tissue formation around the implant.

• Journal of Korean Neurosurgical Society
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• 제43권3호
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• pp.139-142
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• 2008

Objective: The purpose of this study was to evaluate the efficacy of spinal implant removal and to determine the possible mechanisms of pain relief. Methods: Fourteen patient~with an average of 42 years (from 22 to 67 years) were retrospectively evaluated. All patients had posterior spinal instrumentation and fusion, who later developed recurrent back pain or persistent back pain despite a solid fusion mass. Patients' clinical charts, operative notes, and preoperative x-rays were evaluated. Relief of pain was evaluated by the Visual Analog Scale (VAS) pain change after implant removal. Clinical outcome using VAS and modified MacNab's criteria was assessed on before implant removal, 1 month after implant removal and at the last clinical follow-up. Radiological analysis of sagittal alignment was also assessed. Results: Average follow-up period was 18 months (from 12 to 25 months). There were 4 patients who had persistent back pain at the surgical site and 10 patients who had recurrent back pain. The median time after the first fusion operation and the recurrence of pain was 6.5 months (from 3 to 13 months). All patients except one had palpation pain at operative site. The mean blood loss was less than 100ml and there were no major complications. The mean pain score before screw removal and at final follow up was 6.4 and 2.9, respectively (p<0.005). Thirteen of the 14 patients were graded as excellent and good according to modified MacNab's criteria. Overall 5.9 degrees of sagittal correction loss was observed at final follow up, but was not statistically significant. Conclusion: For the patients with persistent or recurrent back pain after spinal instrumentation, removal of the spinal implant may be safe and an efficient procedure for carefully selected patients who have palpation pain and are unresponsive to conservative treatment.

• Journal of Periodontal and Implant Science
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• 제40권6호
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• pp.276-282
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• 2010

Purpose: The present study was performed to evaluate the effect of erbium:yttrium-aluminium-garnet (Er:YAG) laser irradiation on the change of hydroxyapatite (HA)-coated implant surface microstructure according to the laser energy and the application time. Methods: The implant surface was irradiated by Er:YAG laser under combination condition using the laser energy of 100 mJ/pulse, 140 mJ/pulse and 180 mJ/pulse and application time of 1 minute, 1.5 minutes and 2 minutes. The specimens were examined by surface roughness evaluation and scanning electron microscopic observation. Results: In scanning electron microscope, HA-coated implant surface was not altered by Er:YAG laser irradiation under experimental condition on 100 mJ/pulse, 1 minute. Local areas with surface melting and cracks were founded on 100 mJ/pulse, 1.5 minutes and 2 minutes. One hundred forty mJ/pulse and 180 mJ/pulse group had surface melting and peeling area of HA particles, which condition was more severe depending on the increase of application time. Under all experimental condition, the difference of surface roughness value on implant surface was not statistically significant. Conclusions: Er:YAG laser on HA-coated implant surface is recommended to be irradiated below 100 mJ/pulse, 1 minute for detoxification of implant surface without surface alteration.

• 대한치과보철학회지
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• 제38권5호
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• pp.724-743
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• 2000

One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.325-337
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• 2022

Purpose: The aim of this study was to investigate the effect of (1) the size of the bony access window and (2) collagen membrane coverage over the window in sinus floor elevation in a rabbit sinus model. Methods: Small bony access windows (SW; ø 2.8 mm) were made in 6 rabbits and large windows (LW; ø 6 mm) in 6 other rabbits. Both sinuses in each rabbit were allocated to groups with or without coverage of a collagen membrane (CM) on the window, resulting in 4 groups: SW, LW, SW+CM, and LW+CM. After 4 weeks of healing, micro-computed tomographic, histologic, and histomorphometric analyses were performed. Results: Bony healing in the window area was incomplete in all groups, but most bone graft particles were well confined in the augmented cavity. Histologically, the pattern of new bone formation was similar in all groups. Histomorphometrically, the percentage of newly formed bone was greater in the groups with CM than in the groups without CM, and in the groups with SW than in the groups with LW (12.92%±6.40% in the SW+CM group, 4.21%±7.73% in the SW group, 10.45%±4.81% in the LW+CM group, 11.77%±3.83% in the LW group). The above differences were not statistically significant (P>0.05). Conclusions: The combination of a small bony access window and the use of a collagen membrane over the window favored new bone formation compared to other groups, but this result should be further investigated due to the limitations of the present animal model.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권6호
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• pp.437-441
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• 2009

Purpose: In many cases, the erroneous placement of a dental implant brings about undesirable results. Here, the effect of dental implant placement on the success of the final prosthesis was evaluated from the point of view of the prosthodontist. Materials and Methods: All surgical operations were performed by the same oral surgeon with the same surgical protocol and all prosthodontic procedures were performed by the same prosthodontist. The problems faced by the prosthodontist, their causes, and their effect on prosthesis success were identified. The success of the final prostheses was evaluated by the same prosthodontist. Results: Only 53% (238 implants in 105 patients) of dental implants were not associated with prosthodontic problems. Multiple implant placement (more than three implants) was associated more frequently with prosthodontic problems. Conclusions: The data indicate that the satisfactory construction of a prosthesis is highly dependent on the placement of the dental implant in the best possible position. It is strongly recommended that the oral surgeon and the prosthodontist engage in pre-operative discussions to establish a top-down treatment plan, as this will improve implant placement and ultimately the success of the prosthesis.

• 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.

• 대한치과보철학회지
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• 제45권1호
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• pp.98-106
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• 2007

Statement of problem: Current tendencies of the implant macrodesign are tapered shapes for improved primary stability, but there are lack of studies regarding the relationship between the implant macrodesign and primary stability. Purpose: The purpose is to investigate the effect of implant macrodesign on the implant primary stability by way of resonance frequency analysis in the bovine rib bones with different kinds of quality. Material and method: Fifty implants of 6 different kinds from two Korean implant systems were used for the test. Bovine rib bones were cut into one hundred pieces with the length of 5 cm. Among them forty pieces of rib bones with similar qualities were again selected. For the experimental group 1, the thickness of cortical part was measured and 20 pieces of rib bones with the mean thickness of 1.0mm were selected for implant placement. For the experimental group 2, the cortical parts of the remaining 20 pieces of rib bones were totally removed and then implants were placed on the pure cancellous bone according to the surgical manual. After placement of all implants, the implant stability quotient(ISQ) was measured by three times, and its statistical analysis was done. Results: There are statistically significant differences in ISQ values among 4 different kinds of Avana system implants in the experimental group 2. For the experimental group 1, Avana system implants showed significantly different ISQ values, but when differences in the thickness of cortical parts were statistically considered, did not show any significant differences in ISQ values. Among Oneplant system implants, there are no significant differences in ISQ values for the experimental group 2 as well as for the experimental group 1. Conclusion: Within the limits of this study, bone quality and implant design have some influences on the primary stability of implants. Especially in the bone of poor quality, tapered shape of implants are more favorable for the primary stability of implants.