• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.401-408
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• 1998

Screw shaped implants of Titanium-13Zirconium-6Niobium(newly developed), Titanium-6Zirconium-6Sn-6Niobium(newly developed) and Titanium-6Aluminum-4Vanadium were machined with square top and inserted in rabbit bone for 3 months. Biomechanical tests(removal torque) showed Titanium-13Zirconium-6Niobium and Titanium-6Zirconium-6Sn-6Niobium to be more stable in the bone bed than those of Titanium-6Aluminum-4Vanadium. Titanium-13Zirconium-6Niobium implants demonstrated a mean removal torque of 31.59Ncm while Titanium-6Aluminum-4Vanadium demonstrated a mean removal torque of 25.27Ncm and Titanium-6Zirconium-6Sn-6Niobium revealed a mean removal torque of 37.44Ncm and were statistically significance in Wilcoxon Signed Rank test(P<0.05). Histomorphometrical comparisons were performed on $10\;{\mu}m$ thick undecalcified ground sections in the light microscope and Titanium-13Zirconium-6Niobium showed more mean bone-tometal contact ratio than to other twotitanium alloys but had no statistically significant differences were found among the three materials(P>0.01).

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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• pp.10-18
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• 2009

STATEMENT OF PROBLEM. Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. PURPOSE. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in early loading conditions. MATERIAL AND METHODS. A total of 36 solid screw implants(diameter 3.75 mm, length 10 mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium implants served as control. Gold crowns were inserted 4 weeks after implant placement and the dogs were immediately put on a food diet. Implants were observed for 10 weeks after loading. Radiographic assessments and stability tests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 4 weeks after loading, and 10 weeks after loading. Histological observations and morphometrical measurements were also performed. RESULTS. Of 36 implants, 33 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels(P=.46) and RFA values. The mean BIC % in the Mg-implants was $54.5{\pm}8.4%$. The mean BIC % in the turned implant was $45.3{\pm}12.2%$. These differences between the Mg-implant and control implant were statistically significant(P=.005). CONCLUSIONS. The anodized, Mg-incorporated implant demonstrated significantly more bone-to-implant contact(BIC) in early loading conditions. CLINICAL IMPLICATIONS. The results of this study in beagle dogs suggest the possibility of achieving predictable stability of early loaded free-standing dental implants with Mg-incorporated surface.

• The Journal of Korean Academy of Prosthodontics
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• v.58 no.3
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• pp.244-250
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• 2020

The labio-palatal location of the implant in the maxillary anterior region is one of the important factors affecting the aesthetics of the implant prosthesis. However, the thin labial bone of maxilla could be absorbed in significant amounts after extraction of the teeth, which makes the implant be placed on the palatal side rather than the ideal location. In fact, in the cases of maxillary central incisor loss, UCLA was used for prosthetic restoration of palatally placed implant. In addition, with multidisciplinary treatment, GBR (Guided Bone Regeneration) was performed for compensating the absorbed alveolar bone and adjacent anterior tooth were aligned. Definitive restoration was performed after confirming aesthetic recovery of the gingiva with sufficient provisional restoration period. There were satisfactory results of functional and esthetic recovery of tooth loss through implant prosthesis.

• Journal of Korean Neurosurgical Society
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• v.64 no.6
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• pp.922-932
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• 2021

Objective : It is challenging to make solid fusion by posterior screw fixation and laminectomy with posterolateral fusion (PLF) in thoracic and thoracolumbar (TL) diseases. In this study, we report our experience and follow-up results with a new surgical technique entitled posterior thoracic cage interbody fusion (PTCIF) for thoracic and TL spine in comparison with conventional PLF. Methods : After institutional review board approval, a total of 57 patients who underwent PTCIF (n=30) and conventional PLF (n=27) for decompression and fusion in thoracic and TL spine between 2004 and 2019 were analyzed. Clinical outcomes and radiological parameters, including bone fusion, regional Cobb angle, and proximal junctional Cobb angle, were evaluated. Results : In PTCIF and conventional PLF, the mean age was 61.2 and 58.2 years (p=0.46), and the numbers of levels fused were 2.8 and 3.1 (p=0.46), respectively. Every patient showed functional improvement except one case of PTCIF. Postoperative hematoma as a perioperative complication occurred in one and three cases, respectively. The mean difference in the regional Cobb angle immediately after surgery compared with that of the last follow-up was 1.4° in PTCIF and 7.6° in conventional PLF (p=0.003), respectively. The mean durations of postoperative follow-up were 35.6 months in PTCIF and 37.3 months in conventional PLF (p=0.86). Conclusion : PTCIF is an effective fusion method in decompression and fixation surgery with good clinical outcomes for various spinal diseases in the thoracic and TL spine. It provides more stable bone fusion than conventional PLF by anterior column support.

• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.12-23
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• 2021

Purpose. The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio. Materials and Methods. Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creating an excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges. Results. The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain. CONCLUSION. Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.5
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• pp.385-396
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• 2001

The purpose of this experiment was to examine the histological changes and the pattern of expression of proliferating cell nuclear antigen(PCNA) and type I collagen in the elongated bone affected by osteodistraction of the mandibular body in an adult canine model. Seven adult male mongrel dogs weighing over 20kg were used for this experiment. The author excluded 3 animals because they died before the planned time of sacrifice. The custom-made linear extraoral device and 4 bicortical fixation screws 2.3mm in diameter, 50mm in total length, 15mm in screw length were used in each animal. The distal part of the distractor produced a 0.75mm gap between proximal and distal bony segments every $360^{\circ}$ turn of the rotation rod of the device. The mandibular body of the right side from each animal was experimental side and the left side was left intact and served as control. At the experimental side, the mandibular body was osteotomized. After 5-day latency period, the segments were distracted with a rate of 1.1mm/day and a rhythm of two/day for ensuing 7 days. The animals were sacrificed at the 4th. 17th, and 32th day after the end of the distraction. The bony specimens were decalcified, embedded in paraffin, sectioned $5{\mu}m$ thick and stained with Masson trichrome and examined under the light microscope. The immunohistochemical examinations using anti-PCNA antibody and anti-type-I collagen antibody were performed to examine the pattern of the expression of PCNA and type I collagen, respectively. Results : 1. The mean increment of the distance between the proximal and distal screw-holding parts of the distractor was 6.8mm. The average elongation of the mandible in the experimental side was 5.3mm. The loss of elongation was 1.5mm in average. 2. New bone was already observed at the 4th. day after the end of distraction. But, bony union was not completed in the distraction gap at the 32th. day after the end of distraction by radiographic and microscopic examinations. 3. The expression rate of PCNA positive cells in the distraction gap had a tendency of decrease from 35.1-68.8% initially, to 49.1%, and finally to 17.6-27.2%. But at the final period, the tissue of the elongated gap still had the ability of cell proliferation. On the other hand, the expression of PCNA positive cells in the control side were negligible through the experimental period. 4. PCNA positive cells were observed primarily both at the central fibrous zone and at the region of just adjacent to CFZ which initiated new bone formation. 5. The expression pattern of the type I collagen was not zone-specific. They were observed diffusely throughout the elongation gap. 6. The predominant mechanism of new bone formation in the distraction gap was intramembranous. But, some of the regenerated bone was formed by endochondral ossification.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.199-209
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• 2011

Purpose: Osteoporosis, is a major health problem for the elderly and post-menopausal women and shown to alter the properties of bone as well as impair bone healing around titanium implants in both human and animals. The objective of this study was to examine the effect of LIPUS with adipose-derived stem cells on the healing process around a titanium implant in rats with osteoporosis. Methods: Sixteen osteoporosis-induced rats were divided into two groups: an adipose-derived stem cell injected with Low Intensity Pulsed Ultrasound (LIPUS) application group and a control group. Titanium screw implants (diameter, 2.0 mm: length, 3.5 mm, Cowell Medi, Korea) were placed into both tibia of 16 rats, on 8 rats as the control group and the other 8 rats as the experimental group. Rats were sacrificed at different intervals from 1, 2, 4 and 8 weeks after implantation for histopathologic and immunohistochemical analyses. Results: Histopathological analysis revealed newly formed bone in experimental group earlier than that in control group. Especially at 1 week after implantation, more amounts of new bone matrix and collagen around the implant in the experimental group were seen compared with the control group. Immunohistochemical analysis showed that the levels of osteoprotegerin (OPG) expression in the experimental group were increased at early stages compared with that of control group until 2 weeks after implantation. But after 2 weeks, the expression level of OPG similar in both groups. The expression levels of receptor activator of nuclear factor kB ligand (RANKL) were stronger in the experimental group than the control group until 2 weeks after implantation. After 4 weeks, expression of RANKL in experimental group was similar to the control group. Conclusion: The results of this study suggest that LIPUS with Adipose-Derived Stem Cells in implantation could promote bone healing around titanium implants in rats with osteoporosis.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.5
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• pp.392-401
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• 2010

Introduction: Diabetes mellitus, as a major health problem for the elderly has been shown to alter the properties of the bone and impair bone healing around a titanium implant in both humans and animals. The aim of this study was to examine the effect of adipose-derived stem cells on the healing process around a titanium implant in streptozotocin-induced diabetic rats. Materials and Methods: Thirteen rats were divided into two groups: adipose-derived stem cells injected group and a control group. A titanium screw implant (diameter: 2.0 mm, length: 3.5 mm) was placed into both tibia of 13 rats: 13 right tibia as the control group and 13 left tibia as the experimental group. The rats were sacrificed at different intervals (1, 2, and 4 weeks) after implantation for histopathology observations and immunohistochemistric analysis. Results: The histopathological findings revealed earlier new formed bone in the experimental group than the control group. In particular, at 1 week after implantation, the experimental group showed more newly formed bone and collagen around the implant than the control group. In immunohistochemistric analysis, osteoprotegerin (OPG) expression in the experimental group increased early compared to that of the control group until 2 weeks after implantation. However, after 2 weeks, OPG expression in the experimental group was similar to OPG expression in the control group. The receptor activator of nuclear factor ${\kappa}B$ ligand (RANKL) expression in the experimental group increased early compared to that of the control group, and then decreased at 2 weeks. After 2 weeks, the level of RANKL expression was similar in both groups. Conclusion: These results suggest that adipose-derived stem cells in implantation can promote bone healing around titanium, particularly in diabetes mellitus induced animals.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.457-464
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• 2008

Purpose: The aim of this study was to evaluate the clinical results of implants which were installed with maxillary sinus elevation by using lateral window technique. Materials and methods: We performed the maxillary sinus elevation by lateral window technique to 87 patients who visited Dept. of Oral & Maxillofacial Surgery, Chonnam National University Hospital from January, 2003 to January, 2007. When the residual bone height was from 3 mm to 7 mm, the sinus elevation and simultaneous implant installation was mostly performed. When the residual bone height was less than 3 mm, the sinus elevation was performed and the delayed implant installation was done after 5 or 6 months. No artificial membranes were used for coverage of the lateral bony window site and freeze dried fibrin sealant was applied to the grafted bone. The mean follow-up period was 28.5 months (ranged from 10 months to 48 months) Results: 1. Unilateral sinus elevations were performed in 51 patients and bilateral sinus elevations were performed in 36 patients. And the total number of sinus elevation procedure was 123 cases. 2. The sinus elevation and simultaneous implant installation was performed in 89 sinuses and 249 implants were installed. The sinus elevation and delayed implant installation was performed in 44 sinuses and 141 implants were installed. The total number of implants were 390 in 133 sinuses. The average healing period after sinus elevations was 6.1 months in delayed implant installation. 3. Only autogenous bone, autogenous bone mixing with allografts or autogenous bone mixing with xenografts were used as graft materials. 4. The average period from first surgery to second surgery was about 7.2 months. 5. Some patients complications, such as perforation of sinus membrane, swelling, infection and exposure of cover screw. Two implants were removed in the infected sinus. 6. The survival rate of implants with maxillary sinus elevation by lateral window technique was 99.5% and the success rate of implants was 95.1%. Conclusions: These results indicated that the implants which were installed with maxillary sinus elevation by lateral window technique showed high survival and success rates.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.4
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• pp.780-806
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• 1995

The purpose of this study was to describe the application of 3D finite element analysis to determine resultant stresses on the bone anchored fixed prosthesis, implants and supporting bone of the mandible according to fixture numbers and load conditions. 4 or 6 fixtures and the bone anchored fixed prosthesis were placed in 3D finite element mandibular arch model which represents an actual mandibular skull. A $45^{\circ}$ diagonal load of 10㎏ was labiolingually applied in the center of the prosthesis(P1). A $45^{\circ}$ diagonal load of 20㎏ was buccolingually applied at the location of the 10mm or 20mm cantilever posterior to the most distal implant(P2 or P3). The vertical distribution loads were applied to the superior surfaces of both the right and the left 20mm cantilevers(P4). In order that the boundary conditions of the structure were located to the mandibular ramus and angle, the distal bone plane was to totally fixed to prevent rigid body motion of the entire model. 3D finite element analysis was perfomed for stress distribution and deflection on implants and supporting bone using commercial software(ABAQUS program. for Sun-SPARC Workstation. The results were as follows : 1. In all conditions of load, the hightest tensile stresses were observed at the metal lates of prostheses. 2. The higher tensile stresses were observed at the diagonal loads rather than the vertical loads 3. 6-implants cases were more stable than 4-implants cases for decreasing bending and torque under diagonal load on the anterior of prosthesis. 4. From a biomechanical perspective, high stress developed at the metal plate of cantilever-to-the most distal implant junctions as a consequence of loads applied to the cantilever extension. 5. Under diagonal load on cantilever extension, the 6-implants cases had a tendency to reduce displacement and to increase the reaction force of supporting point due to increasing the bendign stiffness of the prosthesis than 4-implants cases. 6. Under diagonal load on cantilever extension, the case of 10mm long cantilever was more stable than that of 20mm long cnatilever in respect of stress distribution and displacement. 7. When the ends of 10mm or 20mm long cantilever were loaded, the higher tensile stress was observed at the second most distal implant rather than the first most distal implant. 8. The 6-implants cases were more favorable about prevention of screw loosening under repeated loadings because 6-implants cases had smaller deformation and 4-implants cases had larger deformation.