• Archives of Plastic Surgery
• /
• v.40 no.3
• /
• pp.209-213
• /
• 2013

Background A cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia. Methods From February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework. Results The follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases. Conclusions Onlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

• Journal of Periodontal and Implant Science
• /
• v.40 no.5
• /
• pp.244-248
• /
• 2010

Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.

• The Journal of Advanced Prosthodontics
• /
• v.6 no.1
• /
• pp.14-21
• /
• 2014

PURPOSE. The purpose of this study was to evaluate bone response to anodized titanium implants coated with the extract of black cohosh, Asarum Sieboldii, and pharbitis semen. MATERIALS AND METHODS. Forty anodized titanium implants were prepared as follows: group 1 was for control; group 2 were implants soaked in a solution containing triterpenoids extracted from black cohosh for 24 hours; group 3 were implants soaked in a solution containing extracts of black cohosh and Asarum Sieboldii for 24 hours; group 4 were implants soaked in a solution containing extracts of pharbitis semen for 24 hours. The implants from these groups were randomly and surgically implanted into the tibiae of ten rabbits. After 1, 2, and 4 weeks of healing, the nondecalcified ground sections were subjected to histological observation, and the percentage of bone-to-implant contact (BIC%) was calculated. RESULTS. All groups exhibited good bone healing with the bone tissue in direct contact with the surface of the implant. Group 2 ($52.44{\pm}10.98$, $25.54{\pm}5.56$) showed a significantly greater BIC% compared to that of group 3 ($45.34{\pm}5.00$, $22.24{\pm}2.20$) with respect to the four consecutive threads and total length, respectively. The BIC% of group 1 ($25.22{\pm}6.00$) was significantly greater than that of group 3 ($22.24{\pm}2.20$) only for total length. CONCLUSION. This study did not show any remarkable effects of the extract of black coshosh and the other natural products on osseointegration of anodized titanium implants as coating agents. Further studies about the application method of the natural products on to the surface of implants are required.

• The Journal of Korean Academy of Prosthodontics
• /
• v.52 no.1
• /
• pp.9-17
• /
• 2014

Purpose: The purpose of this study was to compare zirconia implants with titanium implants from the view point of biomechanical stability and histologic response on osseointegration when those were placed with xenograft materials. Materials and methods: Specimens were divided into two groups; the control group was experimented with eighteen titanium implants which had anodized surface and the experimental group was experimented with eighteen sandblasted zirconia (Y-TZP) implants. At the tibias of six pigs, implants were installed into bone defect sites prepared surgically and treated with resorbable membranes and bovine bone. Two pigs were sacrificed after 1, 4 and 12 weeks respectively. Each implant site was sampled and processed for histologic and histomorphometric analysis. The stability of implants was evaluated with a $Periotest^{(R)}$. And the interfaces between bone and the implant were observed with a scanning electron microscope. Results: In stability analysis there was no significant difference between Periotest values of the control group and the experimental group. In histologic analysis with a light microscope after 4 weeks, there was new bone formation with the resorption of bovine bone and the active synthesis of osteoblasts in both groups. In bone-implant contact percentage there was significant difference between both groups (P<.05). In bone area percentage there was no significant difference between both groups. In analysis of both groups with a scanning electron microscope there was a gap between bone and a surface at 4 weeks and it was filled up with bone formed newly at 12 weeks. Conclusion: When accompanied by xenograft using membrane, bone to implant contact percentage of zirconia implants used in this experiment was significantly less than that of the titanium implants by surface treatment of anodic oxidation. So, it is considered that the improvement of zirconia implant is needed through ongoing research on surface treatment methods for its practical use.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.29 no.6
• /
• pp.397-406
• /
• 2003

The purpose of this study was to observe the titanium implant osseointegration in the osteoporosis-induced animal model. Seventy rats, 11 weeks of age, were divided into two groups : an ovariectomized group and a control group. Titanium screw implants(diameter, 2.0mm; length, 3.5mm) were placed into left tibias of 70 rats, 35 in the control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD34 antibody. The results obtained from this study were as follows: 1. Histopathologically findings, newly formed bone was seen at 3 weeks and became lamellar bone at 8 weeks, and mature trabecullar bone was seen at 12 weeks control group. In experimental group, thickness of regenerated bone increased till 8 weeks gradually and mature trabecullar bone was seen at 12 weeks. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 8 to 12 weeks in experimental group. 3. Fibronectin immunoreactivity was strong at 3 weeks control group and reduced after 8weeks gradually. But it was continuously strong from 3 to 8 weeks in experimental group. 4. CD34 immunoreactivity was very strong in the newly formed osteoblasts from 3 to 8 weeks control group. But it reacted minimally later. While in experimental group, it reacted continuously strong from 3 to 12 weeks. The results of this study suggest that osteoporosis is not an absolute contraindication to dental implantation if sufficient period suggested after fixture installation till second stage surgery.

• Journal of Korean Dental Science
• /
• v.11 no.1
• /
• pp.5-13
• /
• 2018

Purpose: Surface treatment with pH buffering agent has been developed to achieve higher and faster osseointegration. The aim of this study was to evaluate its influence by measuring removal torque and analyzing histological characteristics. Materials and Methods: Titanium implants with following surfaces were used in this study: sand-blasted acid-etched (SA) surface (SA group as control I group), SA surface in calcium chloride aqueous solution (CA group as control II group) and SA surface coated with pH buffering agent (pH group as test group). Removal torque test after 2 weeks and bone-to-implant contact and bone area analyses at 2 and 4 weeks were performed. Result: The rotational torque values at 2 weeks were significantly higher in pH group ($107.5{\pm}6.2Ncm$, P<0.05). The mean values of bone-to-implant contact at 2 and 4 weeks were both higher in pH group ($93.0%{\pm}6.4%$ at 2 weeks, $88.6%{\pm}5.5%$ at 4 weeks) than in SA group ($49.7%{\pm}9.7%$ at 2 weeks, $47.3%{\pm}20.1%$ at 4 weeks) and CA group ($73.7%{\pm}12.4%$ at 2 weeks, $72.5%{\pm}10.9%$ at 4 weeks) with significances (P<0.05). The means of bone area showed significantly higher numbers in pH group ($39.5%{\pm}11.3%$ at 2 weeks, $71.9%{\pm}10.9%$ at 4 weeks, P<0.05). Conclusion: Our findings demonstrated that surface modification with pH buffering agent improved early osseointegration with superior biomechanical property.

• Structural Engineering and Mechanics
• /
• v.74 no.4
• /
• pp.567-576
• /
• 2020

Considerable controversy surrounds the choice of the best abutment type for implant prosthetics. The two most common structures are hex and non-hex abutments. The non-hex abutment typically furnishes a larger contact area between itself and the implant than that provided by a hex structure. However, when a hex abutment is loaded, the position of its contact area may be deeper than that of a non-hex abutment. Hence, the purpose of this study is to determine the different biomechanical behaviors of an internal bone-level implant based on the abutment type-hex or non-hex-and clinical crown length under static and cyclic loadings using finite element analysis (FEA). The hex structure was found to increase the implant and abutment stability more than the nonhex structure among several criteria. The use of the hex structure resulted in a smaller volume of bone tissues being at risk of hypertrophy and fatigue failure. It also reduced micromovement (separation) between the implant components, which is significantly related to the pumping effect and possible inflammation. Both static and fatigue analyses, used to examine short- and long-term stability, demonstrated the advantages of the hex abutment over the non-hex type for the stability of the implant components. Moreover, although its impact was not as significant as that of the abutment type, a large crown-implant ratio (CIR) increased bone strain and stress in the implant components, particularly under oblique loading.

• The Journal of Korean Academy of Prosthodontics
• /
• v.36 no.5
• /
• pp.701-720
• /
• 1998

Research advances in dental implantology have led to the development of several different types of materials and it is anticipated that continued research will lead to advanced dental implant materials. Currently used pure titanium has relatively low hardness and strength which may limit its ability to resist functional loads as a dental implant. Ti-6Al-4V also has potential problems such as corrosion resistance. osseointegration properties and neurologic disorder due to aluminium and vanadium, known as highly toxic elements, contained in Ti-6Al-4V. Newly developed titanium based alloys(Ti-20Zr-3Nb-3Ta-0.2Pd-1In, Ti-20Zr-3Nb-3Ta-0.2Pd) which do not contain toxic metallic components were designed by the Korea Institute of Science and Technology (KIST) with alloy design techniques using Zr, Nb, Ta, Pd, and In which are known as non-toxic elements. Biocompatibility and osseointegration properties of these newly designed alloys were evaluated after implantation in rabbit femur for 3 months. The conclusions were as follows : 1. Mechanical properties of the new designed Ti based alloys(Ti-20Zr-3Nb-3Ta-0.2Pd-1In, Ti-20Zr-3Nb-3Ta-0.2Pd) demonstrated close hardness and tensile strength values to Ti-6Al-4V. 2. New desinged experimental alloys showed stable corrosion resistance similar to the pure Ti but better than Ti-6Al-4V. However, the corrosion rate was higher for the new alloys. 3. Cell culture test showed that the new alloys have similar cell response compared with pure Ti and Ti-6Al-4V with no cell adverse reaction. 4. New designed alloys showed similar bone-metal contact ratio and osseointegration properties compared to pure Ti and Ti-6Al-4V after 3 months implantation in rabbit femur. 5. Four different surface treatments of the metals did not show any statistical difference of the cell growth and bone-metal contact ratio.

• The Journal of Korean Academy of Prosthodontics
• /
• v.41 no.2
• /
• pp.169-181
• /
• 2003

Statement of problem : The survival rate of wide diameter implants was lower than of 3.75-mm implants in some clinical researches. Purpose : The purpose of this study was to investigate the influence of implant diameter on the osseointegration of implants in the rabbit femoral condyle and tibial metaphyses by means of removal torque measurements and histomorphometric analysis. Material and Method : Ten adult New Zealand White rabbits were used in this study Two 3.75-mm diameter implants were inserted through one cortical layer in the tibial metaphyses and one 3.75-mm diameter implant was inserted in the femoral condyle. 5.0-mm diameter implants were inserted in the other leg in the same manner. A total of 60 implants (3.75-mm diameter implants:30 : 5.0-mm diameter implants:30) were installed. After a healing time of 4 and 12 weeks, the peak removal torque values required to shear off the implants were recorded. From the removal torque values (Ncm) obtained, the mean shear stress ($N/mm^2$) was calculated. And the percentage of direct bone-to-implant contact and the percentage of bone area inside the thread were measured by Kappa Image Base-metreo. The Student's t-test was undertaken for statistical analysis (p<0.05). Results : The removal torque value of 5.0-mm diameter implants was higher than of 3.75-mm diameter implants (p<0.05). The difference of shear stress value between 3.75-mm and 5.0-mm diameter implants was not statistically significant (p>0.05). The percentage direct bone-to-implant contact had no statistical difference between two groups (p>0.05). The percentage of bone area inside the thread had no statistical difference between two groups (p>0.05). Conclusion It is concluded that the quality f osseointegration is not influenced by increasing implant diameter.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.45 no.2
• /
• pp.91-96
• /
• 2019

Objectives: This study aimed to investigate the effects of chronic restraint stress on the osseointegration of titanium implants. Materials and Methods: Twenty adult male Wistar albino rats were used in the study. After surgical insertion of titanium implants into the metaphyseal part of the tibial bone, rats were randomly divided into two groups: a control group (CNT group) and an experimental restraint stress group (RS group). In the CNT group, titanium implants were inserted surgically, and rats received no further treatment during the 47-day experimental period. In the RS group, restraint stress was applied for 3 hours per day for 45 days, beginning 2 days after implant surgery. Weight of the rats was measured prior to surgery and at the end of the study to analyze the effects of stress. At the end of the experimental period, rats were euthanized, and implants and surrounding bone tissues were used for undecalcified histological analysis. Serum cortisol levels were assessed in cardiac blood samples from the rats following centrifugation. Results: Average weight of rats in the RS group was lower than that of rats in the CNT group after the experimental protocol had been completed (P<0.05). Further, serum cortisol levels were higher in the RS group than in the CNT group (P<0.05). There were no significant differences in boneimplant connection levels between the two groups (P>0.05). Conclusion: The data analyzed in this study suggest that chronic restraint stress did not adversely affect rats during a 45-day osseointegration period.