• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.41-46
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• 2013

Purpose: The objective of this study was to evaluate the effect of microthreads on removal torque and bone-to-implant contact (BIC). Methods: Twelve miniature pigs for each experiment, a total of 24 animals, were used. In the removal torque analysis, each animal received 2 types of implants in each tibia, which were treated with sandblasting and acid etching but with or without microthreads at the marginal portion. The animals were sacrificed after 4, 8, or 12 weeks of healing. Each subgroup consisted of 4 animals, and the tibias were extracted and removal torque was measured. In the BIC analysis, each animal received 3 types of implants. Two types of implants were used for the removal torque test and another type of implant served as the control. The BIC experiment was conducted in the mandible of the animals. The $P_1-M_1$ teeth were extracted, and after a 4-month healing period, 3 each of the 2 types of implants were placed, with one type on each side of the mandible, for a total of 6 implants per animal. The animals were sacrificed after a 2-, 4-, or 8-week healing period. Each subgroup consisted of 4 animals. The mandibles were extracted, specimens were processed, and BIC was analyzed. Results: No significant difference in removal torque value or BIC was found between implants with and without microthreads. The removal torque value increased between 4 and 8 weeks of healing for both types of implants, but there was no significant difference between 8 and 12 weeks. The percentage of BIC increased between 2 and 4 weeks for all types of implants, but there was no significant difference between 4 and 8 weeks. Conclusions: The existence of microthreads was not a significant factor in mechanical and histological stability.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.2
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• pp.111-121
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• 2010

Purpose: This 3D-FEA study was performed to investigate the influence of marginal bone loss pattern around the implant to the stress distribution. Material and methods: From the right second premolar to the right second molar of the mandible was modeled according to the CT data of a dentate patient. Teeth were removed and an implant ($\Phi\;4.0{\times}10.0mm$) was placed in the first molar area. Twelve bone models were created; Studied bone loss conditions were horizontal bone loss and vertical bone loss, assumed bone loss patterns during biologic width formation, and pathologic vertical bone loss with or without cortification. Axial, buccolingual, and oblique force was applied independently to the center of the implant crown. The Maximum von Mises stress value and stress contour was observed and von Mises stresses at the measuring points were recorded. Results: The stress distribution patterns were similar in the non-resorption and horizontal resorption models, but differed from those in the vertical resorption models. Models assuming biologic width formation showed altered stress distribution, and weak bone to implant at the implant neck area seams accelerates stress generation. In case of vertical bone resorption, contact of cortical bone to the implant may positively affect the stress distribution.

• Journal of Korean Dental Science
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• v.5 no.2
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• pp.48-53
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• 2012

Various ceramic implant systems made of yttria-stabilized tetragonal zirconia polycystal (Y-TZP) have become commercially available in recent years. A search of the literature was performed to assess the clinical success of dental Y-TZP implants and whether the osseointegration of Y-TZP is comparable to that of titanium, the standard implant material. No controlled clinical studies in humans regarding clinical outcomes or osseointegration could be identified. Clinical data were restricted to case studies and case series. Only 7 animal studies were found. Osseointegration was evaluated at 4 weeks to 24 months after placement in different animal models, sites and under different loading conditions. The mean bone-implant contact percentage was above 60% in almost all experimental groups. In studies that used titanium implants as a control, Y-TZP implants were comparable to or even better than titanium implants. Surface modifications may further improve initial bone healing and resistance to removal torque. Y-TZP implants may have the potential to become an alternative to titanium implants but cannot currently be recommended for routine clinical use, as no long-term clinical data are available.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.209-214
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• 2010

Purpose: The purpose of this study was to investigate whether the re-osseointegration of the implants that had mechanical unscrewing possibly occurred or not. Furthermore, if it happened, the degree of re-osseointegration was evaluated by comparing with previous osseointegration. Materials and methods: The smooth implant (commercial pure titanium 99%) specimens, whose diameter and length was 3.75 mm, 4 mm, respectively were produced. Two implants were inserted into each tibia of 7 New Zealand female white rabbits weighing at least 3.0 kg. The torque removal force for each implant after 6 weeks of implants placement was measured and included in group I. The torque removal forces were assessed after the fixtures were re-screwed to original position and the subjects were allowed to have 4 more weeks for healing and included in group II. One rabbit was sacrificed after first measurement and produced 4 slide specimens in group I, and two rabbits were sacrificed after 2nd measurement, 7 slide specimens, in group II for histomorphologic investigations. All slide specimens were assessed based on the proportion of BIC (bone-implant contact) as well as CBa (Bone area in the cortical passage) value produced by counting the screw threads embedded in the compact bones under the optical microscopic analysis (${\times}20$). Statistical analysis was conducted to evaluate the torque removal force, BIC and CBa between group I and II. Results: As for the torque removal force, the result was $10.8{\pm}3.6$ Ncm for group I and $20.2{\pm}9.7$ Ncm for group II. Furthermore, the torque removal force of group II increased by 98.1% in average compared to group I (P<.05). On the other hand, histomorphologic analysis displayed that there was no statistical significance in BIC and CBa values between group I and the group II (P>.05), and RT/BIC and RT/CBa between group I and group II were statistically significant (P<.05). Conclusion: It is possible to obtain more substantial re-osseointegration within shorter periods than the period needed for the initial osseointegration in case of iatrogenically unscrewed implants.

• Journal of Korean Neurosurgical Society
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• v.61 no.5
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• pp.559-567
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• 2018

Objective : The aim of this study was to evaluate the effect for biodegradable screws containing bone morphogenetic protein-2 (BMP-2) in an osteoporotic rat model. Methods : Twenty-four female Wistar rat (250-300 g, 12 weeks of age) were randomized into four groups. Three groups underwent bilateral ovariectomy (OVX). Biodegradable screws with or without BMP-2 were inserted in the proximal tibia in two implantation groups. The extracted proximal metaphysis of the tibiae were scanned by exo-vivo micro-computed tomography. Evaluated parameters included bone mineral density (BMD), trabecular bone volume (BV/TV), trabecular number, trabecular thickness, and trabecular separation (Tb.Sp). The tibia samples were pathologically evaluated by staining with by Hematoxylin and Eosin, and trichrome. Results : Trabecular formation near screw insertion site was evident only in rats receiving BMP-2 screws. BMD and BV/TV significantly differed between controls and the OVX and OVX with screw groups. However, there were no significant differences between control and OVX with screw BMP groups. Tb.Sp significantly differed between control and OVX and OVX with screw groups (p<0.05), and between the OVX and OVX with screw BMP group (p<0.05), with no statistically significant difference between control and OVX with screw BMP groups. Over the 12 weeks after surgery, bone lamellae in direct contact with the screw developed more extensive and thicker trabecular bone around the implant in the OVX with screw BMP group compared to the OVX with screw group. Conclusion : Biodegradable screws containing BMP-2 improve nearby bone conditions and enhance ostoeintegration between the implant and the osteoporotic bone.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.106-120
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• 2020

Purpose: A new form of porous polyethylene, characterized by higher porosity and pore interconnectivity, was developed for use as a tissue-integrated implant. This study evaluated the effectiveness of porous polyethylene blocks used as an onlay bone graft in rabbit mandible in terms of tissue reaction, bone ingrowth, fibrovascularization, and graft-bone interfacial integrity. Methods: Twelve New Zealand white rabbits were randomized into 3 treatment groups according to the study period (4, 12, or 24 weeks). Cylindrical specimens measuring 5 mm in diameter and 4.5 mm in thickness were placed directly on the body of the mandible without bone bed decortication, fixed in place with a titanium screw, and covered with a collagen membrane. Histologic and histomorphometric analyses were done using hematoxylin and eosin-stained bone slices. Interfacial shear strength was tested to quantify graft-bone interfacial integrity. Results: The porous polyethylene graft was observed to integrate with the mandibular bone and exhibited tissue-bridge connections. At all postoperative time points, it was noted that the host tissues had grown deep into the pores of the porous polyethylene in the direction from the interface to the center of the graft. Both fibrovascular tissue and bone were found within the pores, but most bone ingrowth was observed at the graft-mandibular bone interface. Bone ingrowth depth and interfacial shear strength were in the range of 2.76-3.89 mm and 1.11-1.43 MPa, respectively. No significant differences among post-implantation time points were found for tissue ingrowth percentage and interfacial shear strength (P>0.05). Conclusions: Within the limits of the study, the present study revealed that the new porous polyethylene did not provoke any adverse systemic reactions. The material promoted fibrovascularization and displayed osteoconductive and osteogenic properties within and outside the contact interface. Stable interfacial integration between the graft and bone also took place.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.203-211
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• 2015

Purpose: The purpose of this study was to investigate the reosseointegration periods when the rough surface implants, which had complete bone-implant ankylosis, suddenly losed the osseointegration. Materials and Methods: The implants with RBM surface treatment were inserted into both tibias of 23 rabbits. Two implants were submerged into each side. After six weeks, the primary removal torque was measured by Digital torque gauge, and then the implants were replaced and submerged to estimate the level of reosseointegration. After assigned healing periods for each group, the removal torque was measured again. BIC (Bone-Implant contact, %) ratio was measured through histomorphometric analysis.Paired t-test was processed by SPSS 14.0. One-way ANOVA and Tukey's post-hoc test was processed to analyze statistically significant differences among the groups. Results: In comparison with the primary removal torque, the secondary removal torque was increased after 11 days and significantly increased from 2 weeks. In fluorochrome labeling, the origin of mineralization was observed after 7 days, which showed as fluorescent bands around the bone-implant interfaces. After 11 days, the bone formation was apparent, and it is increased continuously with the passage of the time. Conclusion: In 11 days after the implant replacement, the secondary removal torque was almost as same as the primary value, and was significantly higher from 2 weeks. The mineralized shapes were observed in 7 days after the implant replacement, and then the bone formation appeared visibly in 11 days.

• Journal of Yeungnam Medical Science
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• v.36 no.1
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• pp.43-49
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• 2019

Background: In the osseointegration of dental implants, the implant surface properties have been reported to be some of the most important critical factors. The effect of implant's surfaces created by resorbable blast media (RBM) followed by laser ablation on bone tissue reactions was examined using the removal torque test and histomorphometric analysis. Methods: Two types of dental implants, RBM-laser implants (experimental group) and RBM implants (control group) (CSM implant system, Daegu, Korea; L=6 mm, diameter=3.75 mm) were placed into the right and left distal femoral metaphysis of 17 adult rabbits. Six weeks after placement, removal torque was measured and histomorphometric analysis was performed. Results: The mean removal torque was $24.0{\pm}10.2Ncm$ and $46.6{\pm}16.4Ncm$ for the control and test specimens, respectively. The experimental RBM-laser implants had significantly higher removal torque values than the control RBM implants (p=0.013). The mean values of total and cortical bone to implant contact (BIC) were respectively $46.3{\pm}10.8%$ and $65.3{\pm}12.5%$ for the experimental group, and $41.9{\pm}18.5%$ and $57.6{\pm}10.6%$ for the control group. The experimental RBM-laser implants showed a higher degree of total and cortical BIC compared with RBM implants, but there was no statistical significance (p=0.482, 0.225). Conclusion: The removal torque and BIC of the test group were higher than those of the control group. In this study, the surface treatment created by RBM treatment followed by laser ablation appears to have a potential in improving bone tissue reactions of dental implants.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.3
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• pp.214-224
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• 2011

Objective: This study examined the potential of the in vitro osteogenesis of microtopographically modified surfaces, RBM (resorbable blasting media) surfaces, which generate hydroxyapatite grit-blasting. Methods: RBM surfaces were modified hydroxyapatite grit-blasting to produce microtopographically modified surfaces and the surface morphology, roughness or elements were examined. To investigate the potential of the in vitro osteogenesis, the osteoblastic cell adhesion, proliferation, and differentiation were examined using the human osteoblast-like cell line, MG-63 cells. Osteoblastic cell proliferation was examined as a function of time. In addition, osteoblastic cell differentiation was verified using four different methods of an ALP activity assay, a mineralization assay using alizarin red-s staining, and gene expression of osteoblastic differentiation marker using RT-PCR or ELISA. Results: Osteoblastic cell adhesion, proliferation and ALP activity was elevated on the RBM surfaces compared to the machined group. The cells exhibited a high level of gene expression of the osteoblastic differentiation makers (osteonectin, type I collagen, Runx-2, osterix). imilar data was represented in the ELISA produced similar results in that the RBM surface increased the level of osteocalcin, osteopontin, TGF-beta1 and PGE2 secretion, which was known to stimulate the osteogenesis. Moreover, alizarin red-s staining revealed significantly more mineralized nodules on the RBM surfaces than the machined discs. Conclusion: RBM surfaces modified with hydroxyapatite grit-blasting stimulate the in vitro osteogenesis of MG-63 cells and may accelerate bone formation and increase bone-implant contact.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.4
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• pp.381-388
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• 2008

Various techniques and diversely designed implants have been developed to overcome anatomic limitations of the maxillary posterior alveolar bone. The OSFE (osteotome sinus floor elevation) technique has been used for maxillary sinus augmentation. Also, $Endopore^{(R)}$ implant was designed to increase the surface area by its sintered porous surface. The purpose of this study was to evaluate the survival rate of $Endopore^{(R)}$ implants placed in the posterior maxilla in association with the elevation of the sinus membrane using OSFE technique, and examine the new bone formation in the sinus. One hundred fifteen $Endopore^{(R)}$ implants in 66 patients were placed in the posterior maxilla by OSFE technique. The implants were clinically and radiographically followed up for an average of 26.3 months. Most implants were stable and radiographs showed that the bone regenerated in contact with the implants. But, 5 implants in 4 patients were removed after the prosthetic restoration and the survival rate was 95.6% during the follow-up period. The height of new bone formed in the sinus was $3.26{\pm}1.04mm$.