• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.396-405
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• 2001

Osseointegrated implants are used for the fixation of dental prosthesis with good long-term clinical results. In an attempt to improve the quantity and quality of the bone-implant interface, numerous implant modification have been used. Implants surface modifications have been used such as titanium-plasma sprayed, hydroxyapatite-coating, sandblasted, sandblasted and acid-etched, acid-etched. Rough surface implants have greater implant surface area and enhance the bone-implant interface and improve stabilization. The purpose of present study was to evaluate light microscopic and scanning microscopic examinations and removal torque value of newly developed calcium phosphate blast and acid-etched implant in the femur of rabbits. Titanium plasma sprayed(TPS) implant served as controls. After 12 weeks of healing of the femurs of 12 rabitts, the implant-containing segments of femur were removed on bloc and bone block including sections. Histologic examination and histomorphometric and removal torque values comparision were made for two implants. Obtained results are follows: 1. Newly developed calcium phosphate blasted and acid-etched implants were in close contact with bone under light microscopic examinations. 2. New implants showed mean bone-to implant contact 59.8%, whereas TPS implants showed mean bone-to implant contact 54.5% (statistically no difference p<0.05). 3. New implants showed mean bone density 56.7%, whereas TPS implants showed mean bone density 49.2% (statistically difference p<0.05). 4. New implants demonstrated mean removal torque values 40.5Ncm, whereas the mean removal torque values of TPS implants ranged 39.3Ncm. No statistical differences(p<0.05) were observed between two groups of implants nor was there any difference between the two implants at the clinical level.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.71-76
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• 2009

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 Journal of Korean Academy of Prosthodontics
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• v.35 no.1
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• pp.165-180
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• 1997

The purpose of this study was to observe bone apposition and marginal bone loss and to check the possibility of success on titanium implant, HA coated implant and the implant with natural coral that were place immediately after teeth extraction in dogs. Experimental subjects were divided into 4 groups ; the 1st group is the titanium implant, second the HA coated implant, third the implant with natural coral, and the last the control group that was prepared in the extraction sockets. After 12 weeks, the dogs were sacrificed for visual observation and microscopic examination approaching histologic and histomorphometric analysis. The results were as follows : 1. Neither the infection nor the exposure of implant was found at the sites of all implant. 2. In a histomorphometric analysis, mean percentage of direct bone contact with the titanium implant was 80.7% and the HA coated implant showed 81.5% apposition, but the implant with natural coral showed 64.9% apposition(P<0.05). 3. In a microscopic examination, mature lamellated bone was found around the immediate implants and control group, while unabsorbed natural coral around the immediate implants with natural coral was found. 4. All immediate implant groups showed the loss of marginal bone in order from implant with natural coral, titanium implant, and HA coated implant. 5. Implant with natural coral that was placed by the type I interface of the Barzilay's classification immediately after teeth extraction showed low percentage of direct bone contact area, low success rate and a lot of marginal bone loss. Above results suggested that the immediate implants are osseointegrated successfully, although slightly marginal bone was loss.

• The Journal of Advanced Prosthodontics
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• v.3 no.2
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• pp.76-80
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• 2011

PURPOSE. Implant stability quotient (ISQ) values have been supposed to predict implant stability. However, the relationship between ISQ values and bone-to-implant contact ratio (BIC%) which is one of the predictors of implant stability is still unclear. The aim of the present study was to evaluate initial ISQ values in relation to BIC% using rabbit model. MATERIALS AND METHODS. Four New Zealand white rabbits received a total of 16 implants in their tibia. Immediately after implant placement ISQ values were assessed. The measurements were repeated at the time of sacrifice of the rabbits after 4 weeks. Peri-implant bone regeneration was assessed histomorphometrically by measuring BIC% and bone volume to total volume values (bone volume %). The relationships between ISQ values and the histomorphometric output were assessed, and then, the osseointegration prediction model via the initial ISQ values was processed. RESULTS. Initial ISQ values showed significant correlation with the BIC%. The bone volume % did not show any significant association with the ISQ values. CONCLUSION. In the limitation of this study, resonance frequency analysis is a useful clinical method to predict the BIC% values and examine the implant stability.

• Journal of Periodontal and Implant Science
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• v.29 no.2
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• pp.415-433
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• 1999

Implant stability is the key to long-term successful outcome for osseointegrated implants. To evaluate the initial healing response of bone around HA-coated implants without primary bone contact. 21 HA-coated thread type implants(STERI-OSS?) were placed in the femurs of 5 mongrel dogs, about 1-year old. Implants, 8 mm in length and 3.8mm(experimental 1group), 5.0mm(experimental 2group) and 6.0mm(control group) in diameter, were inserted after 3 holes of 6.0mm in diameter and 10mm in depth were prepared in the surgical sites each dog. Implants were supported by only nonresorbable membrane($Teflon^{(R)}$), in order to prevent the ingrowth of upper soft tissue into the gap between bone and implant, and to maintain each implant to be positioned in the center of the drilled hole. 9 implants with different diameters were inserted in 3 dogs for histologic observation, and 12 implants were inserted in 2 dogs for mobility test and removal torque test. Fluorescent dyes were injected for the observation of new bone formation in order of $Terramycin^{(R)}$, Arizarin $Red^{(R)}$, and $Calcein^{(R)}$ at an interval of 2 weeks. 3 dogs were sacrificed for histologic observation at 4, 8, and 12-week after placement. Light microscopy and confocal laser scanning microscopy were used to qualitatively characterize the bone around HA-coated implant. 2 dogs were sacrificed for mobility test($Periotest^{(R)}$, Simens AG, Bensheim, Germany) and removal torque test($Autograph^{(R)}$ AGS-1000D series, Japan) at 8 and 12-week after placement The results were as follows: 1. Histologic observation showed that osseointegration occurred to both control and experimental groups as time lapse, but delayed bone healing was revealed in 3.8mm group (experimental 1group), compared to contrtol group and 5.0mm group (experimental 2group). 2. The mobility test showed that the experimental groups had no distinguishable movement during experimental periods of 8 and 12-week, and there was no difference in mobility depending on the gap between bone and implant, and time lapse. 3. The removal torque forces were increased depended on the gaps decreasing between bone and implant, and time lapse. The results suggest that HA-coated implant without primary bone contact, based on guided bone regeneration could obtain its stability in all experimental groups as time lapse, but bone healing was delayed in experimental group of 3.8mm. And the results suggested that studies on correlationship between mobility test and removal torque test for implant stability would be necessary.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.233-249
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• 1999

Primary fixation is one of the most important factor in establishing adequate osseointegration between implant and bone. To evaluate the initial healing response of bone around implants without primary bone contact, this study was designed to create considerable space between implant and bone in 5 mongrel dogs, about 1-year old. After 3 holes of 6.0mm in diameter were prepared at the femur neck of the dogs, commercially pure titanium thread type implants(STERI-$OSS^{(R)}$), 8mm in length and 3.8mm, 5.0mm and 6.0mm in diameter, were inserted. Implants were supported by only nonresorbable membrane($Teflon^{(R)}$), and the penetration of upper soft tissue into the gap was inhibited by it. The each implant was positioned in the center of the drilled hole. 9 implants with different diameters were inserted in 3 dogs for histologic observation, and 12 were inserted in 2 dogs for mobility test and removal torque test.Fluorescent dyes were injected in order of Doxycycline, Alizarin Red S, and Calcein at intervals of 2 weeks. At 4-, 8-, and 12-week after placement, 3 dogs were sacrificed for histologic observation, and at 8- and 12-week after placement, 2 dogs were sacrificed for mobility test using $Periotest^{(R)}$ (Simens AG, Bensheim, Germany) and torque test using Autograph AGS-1000D $series^{(R)}$(Japan). The result were as follows: 1. The wider the gap between bone and implant was, the less bone maturity was, and the later osseointegration was occurred. Trabecular direction of new bone around implant was changed from parallel to perpendicular to the implant, and the gap was filled with new bone, over time. 2. There was a decreasing tendency over time in the mobility of all implants, but the wider gap between bone and implant was, the smaller decrease of the mobility was. 3. There was a increasing tendency over time in the removal torque gauge of all implants, and the wider gap was, the smaller increase of the removal torque gauge was. The results suggest that osseointegration in case of implant without primary bone contact may be obtained by guided bone regeneration technique with prolonged healing period, but the time of second surgery should be considered carefully.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.35-48
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• 2004

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.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.455-464
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• 2004

The purpose of this study was to evaluate and compare the influence of Steroid topical irrigation and implant surface on bone healing in the irradiated rabbit tibia. Implant to bone contact surface ratio and the pattern of bone healing around hydroxyapatite(HA) coated implant and pure titanium (Ti) implant which were inserted into the irradiated rabbit tibia were compared. 16 Korean house mature male rabbits were used as experimental animal. Each rabbit received 15 Gy of irradiation. 4 weeks after the irradiation, two holes were prepared in the irradiated tibia of each rabbits, where two surface type of implants were inserted :1) HA coated type and 2) pure Ti type. Right before placing implants, one group of rabbit received steroid irrigation and the other group did saline. After the irrigation, two implants of HA coated type and pure Ti type were inserted into the tibia of each rabbits. Each rabbit were sacrificed at 2nd, 4th, and 8th week after the implantation and the specimens were observed by the light microscope. The pattern of bone healing and histomorphometric analysis of the implant-bone interface were done. The results were as follows. 1. All implants inserted into the irradiated tibia of rabbit did not show any sign of clinical mobility and the bone around implants inserted into the irradiated tibia of rabbit did not show any resorption. 2. The bone to implant contact surface ratio around HA coated implants that received steroid irrigation got more bone to implant contact surface ratio than that of the saline irrigation. This result showed statistically significant(p<0.05). There was no statistically significant difference in 8th week group. 3. Though there was no statistically significant difference HA coated implants had more bone to implant contact surface ratio than pure Ti implant in 2nd and 4th groups, and there was no difference in 8th week group. 4. All implants inserted into the irradiated tibia of rabbit had exhibited successful osseointegraion.

• Journal of Periodontal and Implant Science
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• v.35 no.3
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• pp.789-798
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• 2005

Primary stability is a fundamental criteria of implant success. There has been various trials to increase initial stability and bone to implant contact. The objective of osteotome technique is to preserve all the existing bone by minimizing or even eliminating the drilling sequence of the surgical protocol. The bone layer adjacent to the osteotomy site is progressively compacted with various bone condensers(osteotomes) this will result in a denser bone to implant contact. This improved bone density helps to optimize primary implant stability in low density bone. The use of wide implant is one of methods to increse primary stability. They can be used in special situations in which they can increase the surface area available for implant anchorage and improve their primary stability The aim of this study was to evaluate the influence of the osteotome technique and implant width on primary stability. Osteotome technique was compared with conventional drilling method by resonance frequency measurments according to the implant fixtures diameter. The results were as follows: 1. The average of ISQ value was sightly higher in osteotome technique, but there was not statistically significant in regular and narrow implant(p <0.05). 2. Either osteotome technique or conventional technique. ISQ value was significantly higer as increasing of implant diameter(p <0.05). 3. ISQ value of drilling technique was higer than those of osteotome technique in wide implant. It was assumed to be caused by difference in final preparation diameter.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.535-541
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• 2004

The aims of the present study are firstly to investigate the amount of bone loss around non-submerged implants placed in the posterior region and secondly to investigate the relationship between inter-implant and implant-tooth distance and peri-implant bone loss. Thirty-one subjects with 60 implants were selected consecutively from the implant patient pool at the department of Chonbuk National University Hospital. To be included in the study subject, the implant should have been functioned more than 6 months after loading. Inter-implant and implant-tooth distance, distance between implant shoulder and the first bone contact with the implant(DIB) were measured from the scanning image of the radiograph of each implant. The result showed that; 1. inter-implant distance has a statistically significant relationship with DIB in Pearson correlation analysis. 2. the DIB at the implant facing surface of the implant was greater than that of tooth facing surface of the implant. Within limitation of this study, it is suggested to place an implant not too closely to adjacent implants, and the presence of a tooth adjacent to an implant may keep the level of tooth-facing surface of the implant. Further studies with a prospective design are needed to elucidate the relationship between bone changes and various dimensions around implants.