• 대한치과보철학회지
• /
• 제45권3호
• /
• pp.295-302
• /
• 2007

Statement of problem. Fracture of the tooth-colored superstructure material is one of the main prosthetic complications in implant-supported prostheses. Purpose. The purpose of this in vitro study was to compare the fracture strength between the cement-retained implant-supported metal-ceramic crowns and the indirect composite resinveneered metal crowns under the vertical compressive load. Material and methods. Standard implants of external type (AVANA IFR 415 Pre-mount; Osstem Co., Busan, Korea) were embedded in stainless steel blocks perpendicular to their long axis. Customized abutments were fabricated using plastic UCLA abutments (Esthetic plastic cylinder; Osstem Co., Busan, Korea). Thirty standardized copings were cast with non-precious metal (Rexillium III, Pentron, Walling ford, Conn., USA). Copings were divided into two groups of 15 specimens each (n = 15). For Group I specimens, metal-ceramic crowns were fabricated. For Group II specimens, composite resin-veneered (Sinfony, 3M-ESPE, St. Paul, MN, USA) metal crowns (Sinfony-veneered crowns) were fabricated according to manufacturer's instructions. All crowns were temporary cemented and vertically loaded with an Instron universal testing machine (Instron 3366, Instron Corp., Norwood, MA, USA). The maximum load value (N) at the moment of complete failure was recorded and all data were statistically analyzed by independent sample t-test at the significance level of 0.05. The modes of failure were also investigated with visual analysis. Results. The fracture strength of Sinfony-veneered crowns ($2292.7{\pm}576.0N$) was significantly greater than that of metal-ceramic crowns ($1150.6{\pm}268.2N$) (P < 0.05). With regard to the failure mode, Sinfony-veneered crowns exhibited adhesive failure, while metal-ceramic crowns tended to fracture in a manner that resulted in combined failure. Conclusion. Sinfony-veneered crowns demonstrated a significantly higher fracture strength than that of metal-ceramic crowns in cement-retained implant-supported prostheses.

• Journal of Periodontal and Implant Science
• /
• 제48권5호
• /
• pp.326-333
• /
• 2018

Purpose: The present study investigated the outcomes of a newly-developed, simple, and practical nonsurgical treatment modality suitable for most forms of intrabony defects around failing dental implants using intrasulcular delivery of chlorhexidine solution and minocycline hydrochloride (HCl). Methods: Forty-five dental implants in 20 patients diagnosed with peri-implantitis were included. At baseline and the study endpoint, the probing pocket depth (PPD), clinical attachment level (CAL), and the presence of bleeding on probing (BOP) at 6 sites around each implant were recorded. The radiographic osseous defect morphology at the mesial or distal proximal aspect of each implant was classified as 1) narrow or wide and 2) shallow or deep. For a comparative analysis of bone changes according to the defect morphology, the distance from the implant shoulder to the most coronal bone-to-implant contact point (DIB) at the mesial and distal aspects of each implant was measured at baseline and the endpoint. Patients were scheduled to visit the clinic every 2-4 weeks for intrasulcular irrigation of chlorhexidine and delivery of minocycline HCl. Results: We observed statistically significant decreases in PPD, CAL, and BOP after treatment. At the endpoint, bone levels increased in all defects, regardless of the osseous morphology of the intrabony defect. The mean DIB change in deep defects was significantly greater than that in shallow defects. Although the mean bone gain in narrow defects was greater than in wide defects, the difference was not statistically significant. Conclusions: We propose that significant and sustainable improvements in both clinical and radiographic parameters can be expected when intrabony defects around dental implants are managed through a simple nonsurgical approach involving combined intrasulcular chlorhexidine irrigation and local delivery of minocycline HCl.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제28권6호
• /
• pp.472-479
• /
• 2002

Since $Br^{\circ}anemark$ introduced the osseointegrated implants, they have been granted for useful methods for the restoration of oral function. The original $Br^{\circ}anemark$ protocol recommended long stress-free healing periods to achieve the osseointegration of dental implants. However, many clinical and experimental studies have shown that the osseointegration is no wonder in almost cases and that early and immediate loading may lead to predictable osseointegration. So we are willing to introduce the Satellite Abutment newly invented for immediate loading. We think that it will make the occlusal forces dispersed to surrounding bone and that we can restore the oral function immediately after implant installation not disturbing osseointegration. In case of using Satellite abutment, stress concentrated to bone contact area of implant was distributed not only fixation plate and screws but also superior, middle portion of implant and cortical layer of jaw bone. It was clearly decreased on the bone contact surfaces around dental implants. 1. Stress was decreased more than 76.5% when satellite straight abutment was used. 2. Stress was decreased more than 50% when satellite angled abutment was used. 3. The stress around dental implant was well distributed along the cortical bone surface and the fixation plate and screw. This study concludes that satellite abutment can be used as all immediate loading implant prothesis because it was possible to distribute periimplant occlusal stress through implant contact bone surface and cortical layer of jaw bone.

• Journal of Periodontal and Implant Science
• /
• 제40권2호
• /
• pp.69-75
• /
• 2010

Purpose: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. Methods: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. Results : All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. Conclusions: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.

• The Journal of Advanced Prosthodontics
• /
• 제12권2호
• /
• pp.67-74
• /
• 2020

PURPOSE. This study evaluated the influence of prosthesis weight and number of implants on the bone tissue microstrain. MATERIALS AND METHODS. Fifteen (15) fixed full-arch implant-supported prosthesis designs were created using a modeling software with different numbers of implants (4, 6, or 8) and prosthesis weights (10, 15, 20, 40, or 60 g). Each solid was imported to the computer aided engineering software and tetrahedral elements formed the mesh. The material properties were assigned to each solid with isotropic and homogeneous behavior. The friction coefficient was set as 0.3 between all the metallic interfaces, 0.65 for the cortical bone-implant interface, and 0.77 for the cancellous bone-implant interface. The standard earth gravity was defined along the Z-axis and the bone was fixed. The resulting equivalent strain was assumed as failure criteria. RESULTS. The prosthesis weight was related to the bone strain. The more implants installed, the less the amount of strain generated in the bone. The most critical situation was the use of a 60 g prosthesis supported by 4 implants with the largest calculated magnitude of 39.9 mm/mm, thereby suggesting that there was no group able to induce bone remodeling simply due to the prosthesis weight. CONCLUSION. Heavier prostheses under the effect of gravity force are related to more strain being generated around the implants. Installing more implants to support the prosthesis enables attenuating the effects observed in the bone. The simulated prostheses were not able to generate harmful values of peri-implant bone strain.

• Journal of Periodontal and Implant Science
• /
• 제49권2호
• /
• pp.127-135
• /
• 2019

Purpose: The aim of this study was to evaluate the computed tomography (CT) imaging findings and clinical symptoms of patients who complained of neurosensory disturbances after mandibular implant surgery, and to investigate the relationships of these parameters with the prognosis for recovery. Methods: CT scans were reviewed in 56 patients with nerve disturbance after mandibular implant surgery. Two oral radiologists classified the imaging findings into intrusion, contact, close, and separate groups according to the distance from the inferior border of the implant to the roof of the mandibular canal (MC). The symptoms of 56 patients were classified into 8 groups and the frequency of each group was investigated. Patients were categorized according to symptom improvement into no recovery and recovery groups, and the relationships of recovery with the CT classification and specific symptom groups were analyzed. Results: Thirty-eight of the 56 nerve disturbance cases showed improvement. The close and separate groups in the CT classification had a strong tendency for recovery (90.9% and 81.8%, respectively) (P<0.05). Although the lowest recovery rate was found in the intrusion group, it was non-negligible, at 50%. The 6 patients with a worm crawling feeling all improved, while the 8 cases with a tightening sensation showed the lowest recovery rate, at 12.5%, and the symptom of a tightening sensation occurred only in the intrusion and contact groups. Conclusions: The closer the implant fixture was to the MC on CT images, the less likely the patient was to recover. Regarding paresthesia symptoms, while a worm crawling feeling is thought to be a predictor of recovery, a tightening sensation appeared to be associated with a lower recovery rate.

• Journal of Periodontal and Implant Science
• /
• 제49권5호
• /
• pp.299-309
• /
• 2019

Purpose: To analyze the ridge profile of the anterior maxilla using cone-beam computed tomography and to assess the clinical significance of the ridge profile by performing virtual implant placement. Methods: Thirty-two cone-beam computed tomography scans of anterior maxillae were included. For each tooth, a vertical line was made along the longitudinal axis, and 3 horizontal lines at 1-, 3-, and 5-mm levels below the labial bone crest were drawn perpendicularly to the vertical reference. At these levels, the thickness of the alveolar ridge (RT), and the labial (LT) and palatal bone plate (PT) were measured. Then, virtual implant placement using standard and tapered implants was performed. A generalized linear mixed model was used for statistical analysis. Results: The teeth were located labially based on the proportion of LT and PT with respect to RT. At the 1-mm level, the value of LT was between $1.0{\pm}0.4mm$ for central incisors and $1.3{\pm}0.6mm$ for canines. A large number of teeth had area(s) with less than 1-mm-thick labial bone between the 1- and 5-mm levels below the crest. The mean PT was generally thicker than the LT in all tooth types. The greatest mean value of labial concavity was observed for canines, compared to other tooth types. Men had a greater RT than did women, but had a comparable LT. Less apical fenestration was observed when tapered implants were used. Conclusions: Most teeth in the anterior maxilla had a thin labial bone plate, with no significant difference between sexes. Tapered implants may be advantageous for the anterior maxilla.

• The Korean Journal of Pain
• /
• 제32권1호
• /
• pp.47-50
• /
• 2019

Background: It is uncommon for patients who have received a permanent implant to remove the spinal cord stimulator (SCS) after discontinuation of medication in complex regional pain syndrome (CRPS) due to their completely painless state. This study evaluated CRPS patients who successfully removed their SCSs. Methods: This 10-year retrospective study was performed on patients who had received the permanent implantation of an SCS and had removed it 6 months after discontinuation of stimulation, while halting all medications for neuropathic pain. Age, sex, duration of implantation, site and type of CRPS, and their return to work were compared between the removal and non-removal groups. Results: Five (12.5%, M/F = 4/1) of 40 patients (M/F = 33/7) successfully removed the permanent implant. The mean age was younger in the removal group ($27.2{\pm}6.4$ vs. $43.5{\pm}10.7$ years, P < 0.01). The mean duration of implantation in the removal group was $34.4{\pm}18.2$ months. Two of 15 patients (13.3%) and 3 of 25 patients (12%) who had upper and lower extremity pain, respectively, had removed the implant. The implants could be removed in 5 of 27 patients (18.5%) with CRPS type 1 (P < 0.01). All 5 patients (100%) who removed their SCS returned to work, while only 5 of 35 (14.3%) in the non-removal group did (P < 0.01). Conclusions: Even though this study had limited data, younger patients with CRPS type 1 could remove their SCSs within a 5-year period and return to work with complete pain relief.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제30권5호
• /
• pp.417-427
• /
• 2008

The aim of this study is to investigate the effect of anodizing surface to osseointegration of implant by using of resonance frequency analysis (RFA), quantitative and qualitative assessment of an anodically modified implant type with regard to osseous healing qualities. A total of 96 screw-shaped implants were prepared for this study. 72 implants were prepared by electrochemical oxidation with different ways. 24 (group 1 SP) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid. 24 (group 2GC) were prepared at galvanostatic mode in calcium glycerophosphate and calcium acetate and 24 (group 3 CMP (Calcium Metaphosphate) Coating were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid followed by CMP coating. Rest of 24 (control group were as a control group of RBM surface. Bone tissue responses were evaluated by resonance frequency analysis (RFA) that were undertaken at 2, 4 and 6 weeks after implant placement in the mandible of mini-pig. Group 1 SP (anodized with sulfuric acid and phosphoric acid implants) demonstrated slightly stronger bone responses than control Group RBM. Group 2 GC (anodized surface with calcium glycerophosphate and calcium acetate implants) demonstrated no difference which were compared with control group. Group 3 GMP (anodized and CMP coated implants) demonstrated slightly stronger and faster bone responses than any other implants. But, all observation result of RF A showed no significant differences between experimental groups with various surface type. Histomorphometric evaluation demonstrated significantly higher bone-to-implant contact for group 2 GC. Significantly more bone formation was found inside threaded area for group 2 GC. It was concluded that group 2 GC (anodized surface with calcium glycerophosphate and calcium acetate implants) showed more effects on the bone tissue responses than RBM surface in initial period of implantation. In addition, CMP showed a tendency to promote bone tissue responses.

• Archives of Plastic Surgery
• /
• 제38권2호
• /
• pp.182-188
• /
• 2011

Purpose: The buttocks region has been associated with allure and sex appeal for centuries. Gluteal implants enable buttocks remodeling in a way that is not possible in other methods. One of the reasons that render gluteal implant surgeries unpopular is the fear of complications, the main problems being seroma, wound dehiscence, extrusion, and a visible or palpable implant. The authors present the XYZ technique, which provides anatomical reference points to guide the intramuscular dissection procedure in a feasible and safe way, resulting in a lower complication rate. Methods: The XYZ procedure was done for buttock augmentation on 8 patients from December 2009 to June 2010. Patient's ages ranged from 27 to 44 with a mean age of 36. Seven patients were applied the 250cc sized Elastomer implants with one patient 290cc sized implant. Preoperative marking was done with the patients in the standing position. Bisection of the gluteus maximus muscle was done at the midpoint thickness to create a plane for implant insertion, which is called the sandwich plane. Results: The 8 cases were performed safely without major complications. However one patient had minor wound dehiscence, and was managed with conservative treatment. Another patient had a discomfort on the buttocks for a long time. The patients were followed up for average 6 months. All patients were satisfied with the aesthetic results. Conclusion: In performing the XYZ technique for gluteal augmentation, the surgeon must split the muscle into two equal halves with anatomical reference points to guide the muscle detachment in a symmetrical way at an adequate depth. This method provides a guideline for the surgeon in determining the ideal plane during intramuscular dissection and gives predictable results with low complication rates. Intramuscular gluteoplasty with gluteal implants offers predictable, aesthetically pleasing results without contour irregularities and only a low incidence of major complications.