• The Journal of Advanced Prosthodontics
• /
• v.1 no.1
• /
• pp.19-25
• /
• 2009

STATEMENT OF PROBLEM. Primary stability at the time of implant placement is related to the level of primary bone contact. The level of bone contact with implant is affected by thread design, surgical procedure and bone quality, etc. PURPOSE. The aim of this study was to compare the initial stability of the various taper implants according to the thread designs, half of which were engaged to inferior cortical wall of type IV bone(Group 1) and the rest of which were not engaged to inferior cortical wall(Group 2) by measuring the implant stability quotient(ISQ) and the removal torque value(RTV). MATERIAL AND METHODS. In this study, 6 different implant fixtures with 10 mm length were installed. In order to simulate the sinus inferior wall of type IV bone, one side cortical bone of swine rib was removed. 6 different implants were installed in the same bone block following manufacturer s recommended procedures. Total 10 bone blocks were made for each group. The height of Group 1 bone block was 10 mm for engagement and that of group 2 was 13 mm. The initial stability was measured with ISQ value using Osstell $mentor^{(R)}$ and with removal torque using MGT50 torque gauge. RESULTS. In this study, we found the following results. 1. In Group 1 with fixtures engaged to the inferior cortical wall, there was no significant difference in RTV and ISQ value among the 6 types of implants. 2. In Group 2 with fixtures not engaged to the inferior cortical wall, there was significant difference in RTV and ISQ value among the 6 types of implants(P < .05). 3. There was significant difference in RTV and ISQ value according to whether fixtures were engaged to the inferior cortical wall or not(P < .05). 4. Under-drilling made RTV and ISQ value increase significantly in the NT implants which had lower RTV and ISQ value in Group 2(P < .05). CONCLUSIONS. Without being engaged to the inferior cortical wall fixtures had initial stability affected by implant types. Also in poor quality bone, under-drilling improved initial stability.

• The Journal of Korean Academy of Prosthodontics
• /
• v.37 no.5
• /
• pp.607-619
• /
• 1999

Cortical support is an important factor, as the engagement of the fixture in strong compact bone offers an increased load-carrying capacity and initial stability. Because of the poor bone quality in the posterior mandible and other anatomic considerations, it has been suggested that implant fixtures be placed in these locations with apical engagement of the lingual cortical plate for so-called bicortication. The purpose of this investigation was to determine the effect of cortical engagements and in addition polyoxymethylene(POM) intramobile connector(IMC) of IMZ implant on implant load transfer in edentulous posterior segment of mandible, using three-dimensional (3D) finite element analysis models composed of cortical and trabecular bone involving single implant. Variables such as (1) the crestal peri-implant defect, (2) the apical engagement of lingual cortical plate, (3) the occlusal contact position (a vertical load at central fossa or buccal cusp tip), and (4) POM IMC were investigated. Stress patterns were compared and interfacial stresses along the bone-implant interface were monitored specially. Within the scope of this study, the following observations were made. 1) Offset load and angulation of fixture led to increase the local interfacial stresses. 2) Stresses were concentrated toward the cortical bones, but the crestal peri-implant defect increased the interfacial stresses in trabecular bone. 3) For the model with bicortication, it was noticed that the crestal cortical bone provided more resistance to the bending moment and the lingual cortical plate provided more support for the vertical load. But Angulation problem of the fixture from the lingual cortical engagement caused the local interfacial stress concentrations. 4) It was not clear that POM IMC had the effect on stress distribution under the present experimental conditions, especially for the cases of crestal peri-implant defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.36 no.2
• /
• pp.71-77
• /
• 2010

Introduction: The purpose of this study is to evaluate the effect of platelet rich plasma in bone formation and osseointegration of implant installed in the bone marrow space. Materials and Methods: Five beagle dogs were used as experimental animals. Two implants were installed on each tibia in the dogs. Implants of the control group were installed with no additional graft. Those of the experimental group 1 were installed with autogenous bone graft from the ilium autogenous bone. Platelet rich plasma (PRP) alone was used in experimental group 2 and the mixture of PRP and autogenous bone was used in experimental group 3. The animals were sacrificed at 8 weeks after implantation. The parts of tibia containing implant were harvested and radiographs were taken for radiographic examination. The specimens were prepared for histological examination and histomorphometric analysis of implant-bone contact ratios. Results: 1. All implants showed sufficient osseointegration in the cortical bone radiographically and histologically, but osseointergration in the marrow space was not satisfactory. 2. Histomorphometrically, the implant-bone contact ratios in the bone marrow was sequentially high in the experimental group 3 (autogenous bone + PRP group), group 1 (autogenous bone group), group 2 (PRP group), and control group (non-additive). 3. It was verified that there was statistical significance between two experimental groups (group 1 and 3) and the other groups (group 2 and control group). (P<0.005) 4. However, there was no statistical significance between group 3 and group 1, also group 2 and control group respectively. Conclusion: These results suggest that platelet rich plasma is effective to osseointegration in the implant installation but there is no statistical significance.

• Journal of Periodontal and Implant Science
• /
• v.33 no.4
• /
• pp.625-641
• /
• 2003

Background: This study presents a biomechanical and histometric comparison of bone response to implants with various area of hydroxyapatite(HA) coating. Methods: The implants were placed in the tibia of 10 rabbits weighing 2.5-3.5kg. The control group had a machined surface, the experimental group 1 had 50${\mu}m$ thick HA coated in a band form, and the experimental group 2 had 50${\mu}m$ thick HA coated on the entire surface. 8 weeks after implantation, the animals were sacrificed. Removal torque was measured and histologic preparation was also performed for histologic and histometric analysis. Bone to implant contact as well as percentage of bone area inside threads were measured. ANOVA post hoc, and t-test were used for statistical analysis with p-value p<0.05. Results: 1. The removal torques were 9.36${\pm}$5.64 Ncm, 48.40 ${\pm}$ 16.66 Ncm, and 82.37${\pm}$22.56 Ncm for the control, exp. 1, and exp. 2 group respectively. Statistically significant difference were found among all the groups(p<0.05). 2. Bone to implant contact in the cortical bone were 38.94${\pm}$10.9 %, 66.90${\pm}$14.1 %, 73.00${\pm}$19.4 %, in the marrow bone, 8.30${\pm}$5.4%, 14.59${\pm}$5.9%, 18.54${\pm}$11.8%, and in total, 22.40${\pm}$10.1%, 31,17${\pm}$7.5%, 41.41${\pm}$12.2% for the control, exp. 1, and exp. 2 group respectively . In the cortical bone, exp. 1, and exp. 2 group showed statistically significantly higher contact compared to control group. Total contact and in the marrow bone, only exp. 2 group showed statistically significantly higher contact compared to control group(p<0.05). In all the groups significantly higher contact were observed in the cortical bone compared to the marrow bone(p<0.05). 3. Percentage of bone area inside threads in the cortical bone were 55.68${\pm}$7.25%, 55.19${\pm}$13.19%, 57.04${\pm}$13.33%, in the marrow bone, 12.34${\pm}$14.61%, 17.56${\pm}$20.04%, 20.26${\pm}$12.83%, and in total, 30.30${\pm}$12.46%, 31.57 ${\pm}$15.15%, 34.25${\pm}$12.56% for the control, exp.1, and exp. 2 group respectively. There was no statistical difference among the groups. In all the groups significantly higher bone area were observed in the cortical bone compared to the marrow bone(p<0.05)

• Journal of Periodontal and Implant Science
• /
• v.34 no.1
• /
• pp.177-193
• /
• 2004

Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.4
• /
• pp.295-300
• /
• 2011

Introduction: Hydroxyapatite(HA) coating implant can accelerate osseointegration, however, there are many controversies. Materials and Methods: This study examined the early osseointegration of two types of hydroxyapatite coated implants. Twelve adult male miniature pigs (Medi Kinetics Micropigs, Medi Kinetics Co., Ltd., Busan, Korea) were used in this study. In the implants placed in the mandible, a histomorphometric evaluation was performed to evaluate the bone-implant contact (BIC) ratio. Results: The BIC ratio increased with time. TS III HA and Zimmer HA were not significantly different (P>0.05). At 8 weeks, the BIC of Zimmer HA was higher than TS III HA, but there was no significant difference (P>0.05). Conclusion: HA coated implants will accelerate early osseointegration.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.32 no.6
• /
• pp.514-523
• /
• 2006

The purpose of the present study was to evaluate the effects of several implant surface treatments to the bone formation, by placing Machined implants, 75${\mu}m$ Calcium phosphate-blasted implants and $Al_2O_3$-blasted and acid-etched implants in rabbit tibia through histomorphometric study. Two animals of each group were sacrificed at 2, 4, 8 weeks. The specimens containing the implants were dehydrated and embedded into hard methylmethacrylate plastic. Thereafter, the sections were ground to 50${\mu}m$. The specimens were stained with Villanueva bone stain for a light microscopic study. The results were as follows; 1. When the surface roughness of three different implants was measured by Surfcorder, the Ra of the Machined group, the RBM group and the SLA group was 0.16${\mu}m$, 0.44${\mu}m$, and 1.08${\mu}m$. 2. When examining the surfaces of the implants in the scanning microscope, Machined implant has the smooth surface with a few scratches, RBM implant has the rough surface with curled ridges and valleys, and SLA implant has the rough surface structures such as sharp protruding parts and micropits measuring 1-2${\mu}m$ in diameter. 3. After 2 weeks of implantation, the percentage of bone-to-implant contact of the Machined group, the RBM group and the SLA group was 26.86%, 35.40% and 45.99%. However, its differences between each group decreased during the healing periods. 4. After 2 weeks of implantation, the percentage of bone area inside the threads of the Machined group, the RBM group and the SLA group were 21.55%, 30.43% and 41.18%. However, its difference of bone area between machined group and surface treatment groups was maintained but the difference within the surface treatment groups decreased during the healing periods. In summary, the amount of bone formation in RBM and SLA group was greater than Machined group in early healing stage. These results suggest that RBM and SLA implants can reduce the healing period for osseointegration and may be suitable for early function.

• The Journal of Advanced Prosthodontics
• /
• v.13 no.2
• /
• pp.79-88
• /
• 2021

Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

• 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.

• The Journal of Korean Academy of Prosthodontics
• /
• v.45 no.4
• /
• pp.506-521
• /
• 2007

Statement of problem: The cumulative success rate of wide implant is still controversial. Some previous reports have shown high success rate, and some other reports shown high failure rate. Purpose: The aim of this study was to analyze, and compare the biomechanics in wide implant system embeded in different width of crestal bone under different occlusal forces by finite element approach. Material and methods: Three-dimensional finite element models were created based on tracing of CT image of second premolar section of mandible with one implant embedded. One standard model (6mm-crestal bone width, 4.0mm implant diameter central position) was created. Varied crestal dimension(4, 6, 8 mm), different diameter of implants(3.3, 4.0, 5.5, 6.0mm), and buccal position implant models were generated. A 100-N vertical(L1) and 30 degree oblique load from lingual(L2) and buccal(L3) direction were applied to the occlusal surface of the crown. The analysis was performed for each load by means of the ANSYS V.9.0 program. Conclusion: 1. In all cases, maximum equivalent stress that applied $30^{\circ}$ oblique load around the alveolar bone crest was larger than that of the vertical load. Especially the equivalent stress that loaded obliquely in buccal side was larger. 2. In study of implant fixture diameter, stress around alveolar bone was decreased with the increase of implant diameter. In the vertical load, as the diameter of implant increased the equivalent stress decreased, but equivalent stress increased in case of the wide implant that have a little cortical bone in the buccal side. In the lateral oblique loading condition, the diameter of implant increased the equivalent stress decreased, but in the buccal oblique load, there was not significant difference between the 5.5mm and 6.0mm as the wide diameter implant. 3. In study of alveolar bone width, equivalent stress was decreased with the increase of alveolar bone width. In the vertical and oblique loading condition, the width of alveolar bone increased 6.0mm the equivalent stress decreased. But in the oblique loading condition, there was not a difference equivalent stress at more than 6.0mm of alveolar bone width. 4. In study of insertion position of implant fixture, even though the insertion position of implant fixture move there was not a difference equivalent stress, but in the case of little cortical bone in the buccal side, value of the equivalent stress was most unfavorable. 5. In all cases, it showed high stress around the top of fixture that contact cortical bone, but there was not a portion on the bottom of fixture that concentrate highly stress and play the role of stress dispersion. These results demonstrated that obtaining the more contact from the bucco-lingual cortical bone by installing wide diameter implant plays an important role in biomechanics.