• The Journal of Advanced Prosthodontics
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• 제1권1호
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• pp.19-25
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• 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.

• Journal of Plant Biology
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• 제38권2호
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• pp.159-164
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• 1995

The taxonomic note was given to the species of Ceramium from Ullungdo Island. Five species, Ceramium aduncum Nakamura, C. codii (Rhichards) G. Mazoyer, C. flaccidum (Harvey exK tzing) Ardissone, C. paniculatum Okamura, and C. tenerrimum (Martense) Okamura were collected during this study. C. aduncum was collected in the intertidal and upper subtidal zones from December to Feburary. They had a narrow internodal space showing 1/3-1/5 times as large as nodal band. C. codii had the spermatangial mother cells developed on abaxial cortical cells of cortical band C. paniculatum collected in summer and winter had a creeping thallus and alternative branching type in gross morphology. The axial cell of C. flaccidum showed 2.3-2.8 L/B ratio, smaller than those of plants from Chejudo Island.

• Journal of Periodontal and Implant Science
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• 제31권3호
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• pp.581-595
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• 2001

In performing implant procedures in the anterior portion of the maxilla, many difficulties exist because of anatomical reasons, such as the proximity of the nasal floor, lateral extension of the incisive canal, and labial concavity. On the other hand, in the posterior region of the maxilla, there is often insufficient recipient bone between the maxillary sinus and alveolar ridge due to alveolar ridge resorption and pneumatization of the maxillary sinus. In order to perform implants in such regions, ridge augmentation procedures such as onlay bone graft, guided bone regeneration, and maxillary sinus grafting are performed. In studies of Caucasians, use of autograft from mandibular symphysis has been reported to be highly successful in maxillary sinus grafting. However, in a clinical study of Koreans, autograft of mandibular symphysis has been reported to have significantly low success rate. It has been hypothesized that this is because of insufficient cancellous bone due to thick cortical bone. In order to test this hypothesis, bone quality and morphology of Koreans can be compared with those of Caucasians. In this study, the bone density and morphology of the cortical bone and cancellous bone in the mandibular symphysis of 35 Korean cadavers were evaluated. The following results were obtained: 1. In terms of bone density, type I, type II, and type III consisted of 1.4%(3/213), 72.3%(154/213), and 26.3%(56/213) of the cross-sectioned specimens, respectively. In general, the bone density tended to change from type II to type III, as cross-sectioned specimens were evaluated from the midline to the canine. Type IV wasn't observed in this study. 2. The distance between the root apex and the lower border of the cancellous bone was 18.34mm-20.59mm. Considering that the bone has to be cut 5mm below the root apex during the procedure, autografts with about 15mm of vertical thickness can be obtained. 3. The thickness of cortical bone on the labial side increased from the root apex to the lower border of the mandible. The average values ranged from 1.43mm to 2.36mm. 4. The labio-lingual thickness of cancellous bone ranged from 3.43mm to 6.51mm. The thickness tended to increase from the apex to the lower border of the mandible and decrease around the lower border of cancellous bone. From the above results, the anatomic factors of the mandibular symphysis (bone density, thickness, quantity and length of the cortical bone and cancellous bone) didn't show any difference from Caucasians, and it cannot be viewed as the cause of failure in autografts in the maxillary sinus for implants.

• 대한치과보철학회지
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• 제33권3호
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• pp.517-538
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• 1995

Dental implantation is a method restoring missing teeth, especially in the case of severely resorbed edentulous patient. But the direct contact between bone and implant surface, induces stress concentration to the bone and eventually becomes a cause. The purpose of this study was to compare the stress distribution patterns between following two cylindrical implant models. One group has implant apex located in the inferior cortical bone and the other in the cancellous bone. Anterior edentulous mandible was modeled with two dimensional 953,878 nodes, 995,918 elements and compared the deflection and stress distribution under the 70 N,4 load cases for 26 models having variant mandibular height and length. The result were as follows; 1. The stress concentration was more affected by the height of the mandible than implant length. 2. Bicortication mitigates the stress of upper cortical and cancellous bone area at the same height of the mandible 3. Perforation of the inferior mandibular cortex significant stress concentration. 4. Stud type porstheses induced less stress concentration to the cortical and cancellous bone than bar type prostheses. 5. Stress of implant apex for stud type was larger than that of bar type.

• 대한치과보철학회지
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• 제37권5호
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• pp.687-697
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• 1999

A finite element analysis has been utilized to analyze stress and strain fields and design a new configuration in orthopedics and implant dentistry. Load transfer and stress analysis at implant bone interface are important factors from treatment planning to long term success. Bone configuration and quality are different according te anatomy of expecting implantation site. The purpose of this study was to compare the stress distribution in maxilla and mandible accord-ing to implant length and bone engagement types. A three dimensional axi-symmetric implant model(Nobel Biocare, Gothenburg, Sweden) with surrounding cortical and cancellous bone were designed to analyze the effects of bone engagement and implant length on stress distribution. ANSYS 5.5 finite element program was utilized as an interpreting toot. Three cases of unicortical anchorage model with 7, 10, 13 mm length and four cases of bicortical anchorage model with 5, 7, 10 and 13 mm length were compared both maxillary and mandibular single implant situation. Within the limits of study, following conclusions were drawn. 1. There is a difference in stress distribution according to cortical and cancellous bone thickness and shape. 2. Maximum stress was shown at the top of cortical bone area regardless of bone engagement types. 3. Bicortical engagement showed less stress accumulation when compared to unicortical case overall. 4. Longer the implant future length, less the stress on cortical bone area, however there is no difference in mandibular bicortical engagement case.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제40권1호
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• pp.11-16
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• 2014

Objectives: The aim of this study was to evaluate the pattern of lingual split line when performing a bilateral sagittal split osteotomy (BSSO) for asymmetric prognathism. This was accomplished with the use of cone-beam computed tomography (CBCT) and three-dimensional (3D) software program. Materials and Methods: The study group was comprised of 40 patients (20 males and 20 females) with asymmetric prognathism, who underwent BSSO (80 splits; n=80) from January 2012 through June 2013. We observed the pattern of lingual split line using CBCT data and image analysis program. The deviated side was compared to the contralateral side in each patient. To analyze the contributing factors to the split pattern, we observed the position of the lateral cortical bone cut end and measured the thickness of the ramus that surrounds the mandibular lingula. Results: The lingual split patterns were classified into five types. The true "Hunsuck" line was 60.00% (n=48), and the bad split was 7.50% (n=6). Ramal thickness surrounding the lingual was $5.55{\pm}1.07$ mm (deviated) and $5.66{\pm}1.34$ mm (contralateral) (P =0.409). The position of the lateral cortical bone cut end was classified into three types: A, lingual; B, inferior; C, buccal. Type A comprised 66.25% (n=53), Type B comprised 22.50% (n=18), and Type C comprised 11.25% (n=9). Conclusion: In asymmetric prognathism patients, there were no differences in the ramal thickness between the deviated side and the contralateral side. Furthermore, no differences were found in the lingual split pattern. The lingual split pattern correlated with the position of the lateral cortical bone cut end. In addition, the 3D-CT reformation was a useful tool for evaluating the surgical results of BSSO of the mandible.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.413-417
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• 2022

The authors present a unique case of osteonecrosis of a cortical half of a fibula free flap that has not been reported in the literature yet. This complication was associated with the impairment of the vascularization of periosteum in the cortical half of fibula that was fixated with a nonlocking reconstructive 2.0-mm plate and screws but other factors could have been involved. The patient was submitted to excision of a cemento-ossifying fibroma that resulted in a left hemimaxilectomy mesoinfrastructure defect classified as the Cordeiro type 2B. The 42-year-old female patient was submitted to reconstruction with an osteomusculocutaneous fibula free flap plus a segment of fibula graft. The two bone segments of the free flap used to reconstruct the anterior and left alveolar crest were fixated with a reconstructive 2.0-mm plate of matrixMANDIBLE system. The only reported complication was an oronasal fistula that healed with conservative treatment and the referred osteonecrosis of the external cortical half of the fibula free flap with plate exposure at 2.5 years postoperatively. Surgical excision of the osteonecrosed cortical half of the fibula with the plate and screws was performed, while the other cortical underwent bone union as corroborated by computed tomography scans.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권2호
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• pp.166-179
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• 2008

Excessive concentration of stress which is occurred in occlusion around the implant in case of the implant supported fixed partial denture has been known to be the main cause of the crestal bone destruction. Therefore, it is essential to evaluate the stress analysis on supporting tissue to get higher success rates of implant. The purpose of this study was to evaluate the effects of stress distribution and deformation in 3 different types of three-unit fixed partial denture sup-ported by two implants, using a three dimensional finite element analysis in a three dimensional model of a whole mandible. A mechanical model of an edentulous mandible was generated from 3D scan, assuming two implants were placed in the left premolars area. According to the position of pontic, the experiments groups were divided into three types. Type I had a pontic in the middle position between two implants, type II in the anterior posi-tion, and type III in the posterior position. A 100-N axial load was applied to sites such as the central fossa of anterior and posterior implant abutment, central fossa of pontic, the connector of pontic or the connector between two implants, the mandibular boundary conditions were modeled considering the real geometry of its four-masticatory muscular supporting system. The results obtained from this study were as follows; 1. The mandible deformed in a way that the condyles converged medially in all types under muscular actions. In comparison with types, the deformations in the type II and type III were greater by 2-2.5 times than in the type I regardless of the loading location. 2. The values of von Mises stresses in cortical and cancellous bone were relatively stable in all types, but slightly increased as the loading position was changed more posteriorly. 3. In comparison with type I, the values of von Mises stress in the implant increased by 73% in Type II and by 77% in Type III when the load was applied anterior and posterior respectively, but when the load was applied to the middle, the values were similar in all types. 4. When the load was applied to the centric fossa of pontic, the values of von Mises stress were nearly $30{\sim}35%$ higher in the type III than type I or II in the cortical and cancellous bone. Also, in the implant, the values of von Mises stress of the type II or III were $160{\sim}170%$ higher than in the type I. 5. When the load was applied to the centric fossa of implant abutment, the values of von Mises stress in the cortical and cancellous bone were relatively $20{\sim}25%$ higher in the type III than in the other types, but in the implant they were 40-45% higher in the type I or II than in the type III. According to the results of this study, musculature modeling is important to the finite element analysis for stress distribution and deformation as the muscular action causes stress concentration. And the type I model is the most stable from a view of biomechanics. Type II is also a clinically accept-able design when the implant is stiff sufficiently and mandibular deformation is considered. Considering the high values of von Mises stress in the cortical bone, type III is not thought as an useful design.

• 대한치과보철학회지
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• 제38권3호
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• pp.348-357
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• 2000

The purpose of this study is to examine the effect of partial osseointegration situation on bone loading patterns around two different free-standing screw shaped implants (Nobel Biocare, Gothenburg, Sweden and Degussa-Huls, Hanau, German). Two dimensional axisymmetric Finite element models of two implants(10mm length and 4mm diameter) were created according to different bone quantity, quality and osseointegration ratio in maxilla and mandible bone. At the same time uni-cortical and hi-cortical fixation were analyzed. Generally, full bond case showed less stress than partial bond case in overall area and mandibular model showed less amount of stress than that of maxilla model. Maximum stress of the Branemark implant is higher than that of ANKYLOS regardless of bonding ratio at crestal and apex region. However, more stress concentration was noted in ANKYLOS implant at screw body area especially in mandible. The effect of bicortical fixation on crestal bone stress reduction is dramatical in mandible however, there was no significant effect in maxillary case. The effect of partial bond on stress distribution was more significant at screw body and apex region than in crestal region. Partial bond cases demonstrated greater stress accumulation in trabecular bone than cortical bone. It is concluded that the more accurate model of implant and bone which affects stress and strain distribution is needed to mimic in vivo behavior of implants.

• Advances in biomechanics and applications
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• 제1권1호
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• pp.67-76
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• 2014

Bone properties are one of the key components when constructing models that can simulate the mechanical behavior of a mandible. Due to the complexity of the structure, the tooth, ligaments, different bones etc., some simplifications are often considered and bone properties are one of them. The objective of this study is to understand if a simplification of the problem is possible and assess its influence on mandible behavior. A cadaveric toothless mandible was used to build three computational models from CT scan information: a full cortical bone model; a cortical and cancellous bone model, and a model where the Young's modulus was obtained as function of the pixel value in a CT scan. Twelve muscle forces were applied on the mandible. Results showed that although all the models presented the same type of global behavior and proximity in some locations, the influence of cancellous bone can be seen in strain distribution. The different Young's modulus defined by the CT scan gray scale influenced the maximum and minimum strains. For modeling general behavior, a full cortical bone model can be effective. However, when cancellous bone is included, maximum values in thin regions increase the strain distribution. Results revealed that when properties are assigned to the gray scale some peaks could occur which did not represent the real situation.