• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.371-380
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• 2017

PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.1
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• pp.148-169
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• 1994

The concept of biologic attachment of load-bearing implants has developed over the past decades as an alternative to the difficulties associated with long term implantation using mechanical fixation and bone cement. The choice of implant material is also as critical an element as site preparation or insertion procedure. The properties of implants that affect host tissue responses are not limited to chemical composition alone, but also include shape, surface characteristics, site of implantation, and mechanical interaction with host tissues. Initial mechanical interlocking prevents micromotion and may be a prerequisite for direct bone apposition. A hard tightening of screws does not necessarily mean a stronger fixation and final tightening of the fixtures is dependent on the experience of the operator. Removal torque is lower than insertion torque. The purpose of this study was to investigate differences in the removal torques at the bone-implant interface of polished and sandblasted Titanium. This experiment will give insight into important factors that must be considered when interpreting in vivo screwing forces on implants during the connection of the transmucosal abutments. We evaluated the significance of different surface textures by comparison of the withdrawal forces necessary for removal of otherwise identical rough and polished implants of Titanium and also evaluated interfacial response on the light microscopic level to implant surface. And the priority of the area of insertion on osseointegration were evaluated. 9 Titanium implants - among them, 3 were for the developmental - of either a smooth or rough surface finish were inserted in the dog mandible in the right side. 3 months later Kanon Torque Gauge was used to unscrew the implants. The results were as follows : 1. No significant difference was seen in the removal torque due to variation in surface treatment, 23 Ncm for the sandblasted and 23.33 Ncm for the polished surface (p>0.05). 2. Implants in the anterior (25 Ncm) mandible showed better resistance to unscrewing in comparison to ones in the posterior (18 Ncm) region (p<0.05). 3. Developmental fixtures (22 Ncm) had similar pullout strength to the control group (p>0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.6
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• pp.379-391
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• 2003

The present study was undertaken to evaluate bone regenerative capacity around titanium screw implants placed in irradiated rat's tibiae. At one week after single 15-Gy dose irradiation, miniaturized titanium screw implants were inserted into anterior aspect of the upper tibia of rats weighing 200-250g. Seventy rats were involved: 35 rats were control and 35 rats radiation group. The rats were killed at different intervals as 1, 2, 3, 4, 6, 8, 12 weeks after implantation for histologic observation, histomorphometric analysis and immunohistochemical study with fibronectin and CD34 antibody. 1. Histologically, various stages of bone maturation and ossification can be seen at 4 weeks and regenerated bone close to edges demonstrates more advanced calcification, and network of new bone are well formed at 12 weeks in non-irradiated group. In contrast, active bone formation with increased contact of newly formed bone to implant surface was noted at 4 weeks and a significant amount of new bone formation and bone-implant contact is oberved at 12 weeks in irradiated group. 2. Histomorphometrical analysis confirmed these histologic findings. A significant difference in implant-bone contact and bone density was measured between the control and radiation group. Mean MBD was 62.2% in control group and 27.5% in radiation group, mean MBIC was 86.6% in control group and 47.7% in radiation group, and mean TBIC was 87.3% in control group and 45.6% in radiation group at 12 weeks after implantation. 3. In immunohistochemical study with fibronectin and CD34, radiation reduced hematopoietic progenitor cells severely and disturbed differentiation of osteoblast in bone marrow. The results of this study revealed bone healing capacity around implant after radiation therapy was severely impaired and irradiation reduces the capacity for osseointegration of titanium implants. Many factors including radiation dose, period between radiation and implantation, bone quality, time elapse between first and second surgery, type of prosthetics and hyperbaric oxygen therapy must be considered carefully in postradiation implantation.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.224-235
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• 2013

A passively fitting prosthesis is an essential prerequisite to attain long-lasting success and maintenance of osseointegration. However, true "passive fit" can not be achieved with the present implant-supported prosthesis fabrication protocol. Many clinical situations are suitably treated with cantilevered implant-supported fixed restorations. The purpose of this study was to compare the stress distribution pattern and magnitude in supporting tissues around ITI implants with cantilevered, implant-supported, screw-retained fixed prosthesis according to the fitness of superstructures. Photoelastic model was made with PL-2 resin (Measurements, Raleigh, USA) and three ITI implants (${\phi}4.1{\times}10mm$) were placed in the mandibular posterior edentulous area distal to the canine. Anterior and posterior extended 4-unit cantilevered FPDs were made with different misfit in the superstructures. 4 types of prosthesis were made by placing a $100{\mu}m$ gap between the abutment and the crown on the second premolar and/or the first molar. Photoelastic stress analysis were carried out to measure the fringe order around the implant supporting structure under simulated loading conditions (30 lb).

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.1
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• pp.112-123
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• 2006

Purpose: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. Materials and Methods: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. Results: The results were obtained as fellows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05) but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs , the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. Conclusions: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.44-54
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• 2022

Without proper treatment on the multiple tooth missing area, the lack of posterior support and the supra-eruption of the teeth cause many severe complications of occlusion, vertical dimension and masticatory function. This report is a case of full-mouth rehabilitation of a patient with loss of posterior support and collapsed occlusion due to missing teeth area left untreated for a long time. The patient who is 68-year old male patient had some teeth fallen out while removing his old maxillary denture and was complaining about pain in the region of anterior teeth due to traumatic contact. The vertical dimension was corrected by 4 mm from the top cervical point of the canine through various evaluations and the edentulous area was treated with the implant fixed prostheses through computer guided implant surgery based on the diagnosis and treatment plan for definitive prostheses supported by computed tomography (CT) data analysis and CAD-CAM (Computer-aided design/computer-aided manufacturing) technique. After full mouth rehabilitation, the patient was very satisfied with remarkable improvements in mastication, function, and aesthetics.

• The korean journal of orthodontics
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• v.36 no.5
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• pp.339-348
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• 2006

Objective: With development of the skeletal anchorage system, orthodontic mini-implant (OMI) assisted on masse sliding retraction has become part of general orthodontic treatment. But compared to the emphasis on successful anchorage preparation, the control of anterior teeth axis has not been emphasized enough. Methods: A 3-D finite element Base model of maxillary dental arch and a Lingual tipping model with lingually inclined anterior teeth were constructed. To evaluate factors influencing the axis of anterior teeth when OMI was used as anchorage, models were simulated with 2 mm or 5 mm retraction hooks and/or by the addition of 4 mm of compensating curve (CC) on the main archwire. The stress distribution on the roots and a 25000 times enlarged axis graph were evaluated. Results: Intrusive component of retraction force directed postero-superiorly from the 2 mm height hook did not reduce the lingual tipping of anterior teeth. When hook height was increased to 5 mm, lateral incisor showed crown-labial and root-lingual torque and uncontrolled tipping of the canine was increased.4 mm of CC added to the main archwire also induced crown-labial and root-lingual torque of the lateral incisor but uncontrolled tipping of the canine was decreased. Lingual tipping model showed very similar results compared with the Base model. Conclusion: The results of this study showed that height of the hook and compensating curve on the main archwire can influence the axis of anterior teeth. These data can be used as guidelines for clinical application.

• 대한치주과학회:학술대회논문집
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• 2006.11a
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• pp.149-149
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• 2006

• The Journal of the Korean dental association
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• v.51 no.1
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• pp.6-11
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• 2013

Dental ceramics is well known to have excellent esthetics, biocompatibility as well as high compressive strength. However, the fragility of ceramics against tensile and shear loads leading to the delayed fracture of micro crack on ceramic surface and the backwardness of ceramic fabrication technique limit the usage of ceramic materials in dentistry. Among all ceramic materials, zirconia has been introduced to overcome the drawback of conventional dental ceramics in the field of dentistry due to the nature of zirconia featuring proper opalescence and high fracture toughness. Also, novel manufacturing techniques enable ceramic materials to prepare high esthetic anterior and posterior all ceramic system. In this paper, it is introduced and discussed that novel techniques characterizing the bond strength between zirconia core and veneering ceramics and analyzing the fluorescence of dental ceramics in order to overcome the gap between the results of basic research and the feasibility of the results in the field of dental clinics.

• Restorative Dentistry and Endodontics
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• v.40 no.3
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• pp.236-240
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• 2015

Traumatic dental injury can result in avulsion of anterior teeth. In young patients, it is a challenge to the dental professional because after replantation, late complications such as ankylosis require tooth extraction. Although prosthetic and orthodontic treatment, and implant placement have been described as the options for intervention, autogenous tooth transplantation could be an effective procedure in growing patients if there is a suitable donor tooth available. This case presents the treatment of a patient who suffered a traumatic injury at 9 years old with avulsion of tooth 21, which had been replanted, and intrusion of tooth 11. Both teeth ankylosed; thus they were removed and autotransplantation of premolars was carried out. After transplantation, the tooth underwent root canal treatment because of pulpal necrosis. Orthodontic treatment began 3 months after transplantation and during 7 years' follow-up the aesthetics and function were maintained without signs of resorption.