Since the restoration or masticatory function is the most important aim of implants, it should be substituted for the role of natural teeth and deliver the stress to the bone under the continous load during function. In natural teeth, stress distribution can be obtained through enamel, dentin and cementum and the elasticity of the periodontal ligament play a role of buffering action. In contrast, implant prosthesis has a very unique characteristics that it delvers the load directly to bone through the implant and superstructure. This fact arise the needs to evaluate the stress distribution of the implant in the mechnical aspects, which has a similar role of natural teeth but different pathway of stress. With 3 kinds of implant in prevalent use, 2 types of experimental PEA implant models were made, axisymmetric and 2-dimensional type. In axisymmetric model, the stiffness of the part including the prosthesis and implant which extrude out of bony surface could be calculated with displacement of the superstructure un er 100N vertical load and then damping effects could be determined through this stiffness. In axisymmetric FEA model, load to the bone could be deduced by evaluation the stress distribution of the designed surface under the 100N vertical force and in 2-dimensional model, 100N eccentric vertical load and 20N horizontal loda. The result are as follows. 1. In every implant, stress to the bone tends to be concenturated on the cortical bone. 2. Though the stress of the cancellous bone is larger at the apex of implants, it is less compared with cortical bone. 3. Under 20N horizontal load, stress of the left and right sides of implant shows a symmetrical pattern. But under 100N eccentric vertical load, loaded side shows much larger stress value. 4. In the 1mm interface, stress distribution among implants tend to have a similar pattern. But under 20N horizontal load apposite side of being loaded shows less stress in IMZ. 5. In the case of screw type implant, stress tends to vary along with screw shape. 6. According to the result determined with microstrain, cancellous bone id generally under the condition of overload, while cortical bone is usually within the limitation of physiologic load. 7. In the Branemark implant, maximum stress to the cortical bone is larger than any other implant except for the condition of 20N horizontal force and 0.05mm interface. 8. Damping effects of implants is maximum in IMZ.
Since the occlusal loading is transmitted to the surrounding bone, the success of an implant treatment is closely related to the distribution of the stress on the implant. The finite element analysis method is often used in order to produce a model for dispersion of stress. Assessment of the success of the implant is usually based on the degree of osseointegration which is a bone and implant surface interface. Implant used in this research was designed through the method of shape optimization after the stress on implant was anaylzed by the finite element analysis method. This study was pertinently assessed by a clinical, histologic, histomorphometric analysis after the shape optimized implant was installed on beagle dog tibia. The results are as follows 1. It clinically showed a good result without mobility and imflammatory reaction. 2. Implant was supported by dense bone and bone remodeling showed on the surrounding area of the implant 3. The average percentage of bone-implant contact was 58.1%.The percentage of bone density was 57.6%. Having above results, shape optimized implant showed the pertinence through clinical and histologic aspects. However, to use the shape optimized implant, the further experiment is required for finding problems, improvement.
Purpose: This study evaluated differences in bone healing and remodeling among 3 implants with different surfaces: sandblasting and large-grit acid etching (SLA; IS-III $Active^{(R)}$), SLA with hydroxyapatite nanocoating (IS-III $Bioactive^{(R)}$), and SLA stored in sodium chloride solution ($SLActive^{(R)}$). Methods: The mandibular second, third, and fourth premolars of 9 dogs were extracted. After 4 weeks, 9 dogs with edentulous alveolar ridges underwent surgical placement of 3 implants bilaterally and were allowed to heal for 2, 4, or 12 weeks. Histologic and histomorphometric analyses were performed on 54 stained slides based on the following parameters: vertical marginal bone loss at the buccal and lingual aspects of the implant (b-MBL and l-MBL, respectively), mineralized bone-to-implant contact (mBIC), osteoid-to-implant contact (OIC), total bone-to-implant contact (tBIC), mineralized bone area fraction occupied (mBAFO), osteoid area fraction occupied (OAFO), and total bone area fraction occupied (tBAFO) in the threads of the region of interest. Two-way analysis of variance (3 types of implant $surface{\times}3$ healing time periods) and additional analyses for simple effects were performed. Results: Statistically significant differences were observed across the implant surfaces for OIC, mBIC, tBIC, OAFO, and tBAFO. Statistically significant differences were observed over time for l-MBL, mBIC, tBIC, mBAFO, and tBAFO. In addition, an interaction effect between the implant surface and the healing time period was observed for mBIC, tBIC, and mBAFO. Conclusions: Our results suggest that implant surface wettability facilitates bone healing dynamics, which could be attributed to the improvement of early osseointegration. In addition, osteoblasts might become more activated with the use of HA-coated surface implants than with hydrophobic surface implants in the remodeling phase.
A finite element analysis has been utilized to analyze stress and strain fields and design a new configuration in orthopedics and implant dentistry. Load transfer and stress analysis at implant bone interface are important factors from treatment planning to long term success. Bone configuration and quality are different according te anatomy of expecting implantation site. The purpose of this study was to compare the stress distribution in maxilla and mandible accord-ing to implant length and bone engagement types. A three dimensional axi-symmetric implant model(Nobel Biocare, Gothenburg, Sweden) with surrounding cortical and cancellous bone were designed to analyze the effects of bone engagement and implant length on stress distribution. ANSYS 5.5 finite element program was utilized as an interpreting toot. Three cases of unicortical anchorage model with 7, 10, 13 mm length and four cases of bicortical anchorage model with 5, 7, 10 and 13 mm length were compared both maxillary and mandibular single implant situation. Within the limits of study, following conclusions were drawn. 1. There is a difference in stress distribution according to cortical and cancellous bone thickness and shape. 2. Maximum stress was shown at the top of cortical bone area regardless of bone engagement types. 3. Bicortical engagement showed less stress accumulation when compared to unicortical case overall. 4. Longer the implant future length, less the stress on cortical bone area, however there is no difference in mandibular bicortical engagement case.
Tho osseointegrated dental prosthetic treatment has develped for the edentulous patient with severely resorbed alveolar ridge, and has given us a successful clinical results to date. Nowadays the partially edentulism is included among the indications of the osseointegrated prosthetic treatment. The purpose of this study was to analyze the stress distribution at supporting bone according to the types of connection modality between implant and tooth in the superstructure. Two dimensional finite element stress analysis was applied for this study. FEM models were created using software Super SAP for MBM 16bit personal computer. Three modalities of connection were modeled and analyzed under load condition. The results were as follws: 1. The stress develped at tooth and implant in the cancellous bone was lower in the case of rigid connection than in the case of norigid connection, but higher between the two implants in the case of rigid connection than in the case of nonrigid connection. 2. The stress developed at the cortical bone and at the supporting bone interface was lower in the case of rigid connection than in the case of nonrigid connection 3. The stress developed at the supporting tissue interface of the implant nearby the tooth, was lower in the case of rigid connection than in the case of nonrigid connection. 4. The stress developed at the supporting tissue interface of posteriormost implant, was same between the cases of rigid and nonrigid connection. 5. The stress distribution related to the freestanding case was generally similar to the stress distribution pattern of nonrigid connection case. 6. The magnitude of applied load which produces deformation within elastic limit, had influence on the absolute value of stress, but had no influence on the pattern of stress distribution of the same case.
The influence of calcium phosphate (Ca-P) coating on the bone response of titanium implants was investigated two types of titanium implants, i.e. as -machined ,as -machined with Ca-P coating, were prepared. The Ca-P coating produced by OCT Inc technique. These implants were inserted into the left and right femur of beagle dog, After implantation periods of 3 days, 1weeks, weeks, 4weeks, 8weeks, 12weeks. 24weeks, the bone-implant interface was evaluated histologically, histomorphometrically , and removal torque. Histological evaluation revealed no new bone formation around different implant materials after 2weeks of implantation. After 4 weeks, Ca-P coated implants showed a higher amount of bone contact than either of the non coated implants. After 12weeks, bone healing was almost completed. And implant were removed by reverse torque rotation with torque-measuring device. Mean torque values for 4weeks control were 2.375Kgf.cm and experimental were 2.725Kgf.cm. And mean torque values for 8weeks control were 1.25Kgf.cm and experimental were 1.0Kgf.cm On the basis of these findings, we concluded that deposition of a Ca-P coating on an implant has a beneficial effect on the bone response to this implant during the healing phase. Besides implant surface conditions the bone response is also determined by local implant site condition.
PURPOSE. The aim of this study was to investigate the stress distribution of 2-short implants (2SIs) installed in a severely atrophic maxillary molar site. MATERIALS AND METHODS. Three different diameters of internal connection implants were modeled: narrow platform (NP), regular platform (RP), and wide platform (WP). The maxillary first molars were restored with one implant or two short implants. Three 2SI models (NP-oblique, NP-vertical, and NP-horizontal) and four single implant models (RP and WP in a centered or cantilevered position) were used. Axial and oblique loadings were applied on the occlusal surface of the crown. The von Mises stress values were measured at the bone-implant, peri-implant bone, and implant/abutment complex. RESULTS. The highest stress distribution at the bone-implant interface and the peri-implant bone was noticed in the RP group, and the lowest stress distribution was observed in the 2SI groups. Cantilevered position showed unfavorable stress distribution with axial loading. 2SI types did not affect the stress distribution in oblique loading. The number and installation positions of the implant, rather than the bone level, influenced the stress distribution of 2SIs. The implant/abutment complex of WP presented the highest stress concentration while that of 2SIs showed the lowest stress concentration. CONCLUSION. 2SIs may be useful for achieving stable stress distribution on the surrounding bone and implant-abutment complex in the atrophic posterior maxilla.
The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveo-lar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetra-fluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bon formation was minimal in control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.
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.
The purpose of this study was to analyze the distribution of stress in the surrounding bone around implant placed in the first and second molar region. Two different three-dimensional finite element model were designed according to vertical bone level around fixture ($4.0mm{\times}11.5mm$) on the second molar region. A mandibular segment containing two implant-abutments and a two-unit bridge system was molded as a cancellous core surrounded by a 2mm cortical layer. The mesial and distal section planes of the model were not covered by cortical bone and were constrained in all directions at the nodes. Two vertical loads and oblique loads of 200 N were applied at the center of occlusal surface (load A) or at a position of 2mm apart buccally from the center (load B). Von-Mises stresses were analyzed in the supporting bone. The results were as follows; 1. With the vertical load at the center of occlusal surface, the stress pattern on the cortical and cancellous bones around the implant on model 1 and 2 was changed, while the stress pattern on the cancellous bone with oblique load was not. 2. With the vertical load at the center of occlusal surface, the maximum von-Mises stress appeared in the outer distal side of the cortical bone on Model 1 and 2, while the maximum von-Mises stress appeared in the distal and lingual distal side of the cortical bone with oblique load. 3. With the vertical load at a position of 2 mm apart buccally from the center, there was the distribution of stress on the upper portion of the implant-bone interface and the cortical bone except for the cancellous bone, while there was a distribution of stress on the cancellous bones at the apical and lingual sides around the fixture and on the cortical bone with oblique load. 4. With the changes of the supporting bone on the second molar area, the stress pattern on the upper part of the cortical bone between two implants was changed, while the stress pattern on the cancellous bone was not. The results of this study suggest that establishing the optimum occlusal contact considering the direction and position of the load from the standpoint of stress distribution of surrounding bone will be clinically useful.
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