• The Journal of Korean Academy of Prosthodontics
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• v.59 no.3
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• pp.281-290
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• 2021

Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.3
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• pp.273-281
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• 2001

Digital subtraction radiography may be one of the most precise and noninvasive methods for assessing subtle density changes in peri-implant bone, providing additional diagnostic information on implant tissue integration in overall maintenance. The aims of this study were to evaluate density changes after first, second surgery of dental implant and to measure the amount of marginal bone loss 9 months after second surgery using digital subtraction radiography. Bone change around 30 screw-shaped implants in 16 patients were assessed on radiographs. 17 Branemark implants of 3.75mm in diameter(Nobel Biocare, Goteborg, Sweden), 2 Branemark implants of 5.0mm in diameter, 11 $Replace^{TM}$ implants of 4.3mm in diameter(Nobel Biocare, Goteborg, Sweden) were used. To standardize the projection geometry of serial radiographs of implants, customized bite block was fabricated using XCP film holder(Rinn Corporation, Elgin, IL.) with polyether impression material of Impregum(ESPE, Germany) and direct digital image was obtained. Qualitative and quantitative changes on radiographs were measured with Emago software(The Oral Diagnostic System, Amsterdam, Netherlands). The results were as follows: 1. The peri-implant bone density of 69.2% implants did not change and the peri-implant bone density of 30.8% implants decreased after 3 months following first surgery. 2. The crestal bone density of 53.9% implants decreased first 3 months after second surgery. The crestal bone density of 58.8% implants increased 9 months after second surgery. No density change was observed around the midportion of the implants after second surgery, 3. The amount of marginal bone loss between different kinds of implants showed no statistically significant differences (p>0.05). 4. More than 90% of total marginal bone loss recorded in a 9-month period occurred during the first 3 months.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.394-405
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• 2009

Statement of problem: Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses. Purpose: To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses. Material and methods: A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at $30^{\circ}$ with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone. Results: Base Model with straight configuration at the transgingival part created highest stresses on the crestal bone. Stress level was reduced when concavity was imposed. The greater the concavity and the closer the concavity to the crestal bone level, the less the crestal stresses. Conclusion: The transgingival part of dental implant affect the crestal bone stress. And that concavely designed one may be used to reduce bone stress.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.1
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• pp.57-70
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• 2004

The significance of occlusion has regained its popularity in dentistry with the introduction of implant therapy. Literature has reported that the clinical success and longevity of dental implants can be achieved by biomechanically controlled occlusion. Occlusal overload is known to be one of the main causes for implant failure. Evidences have suggested that occlusal overload contribute to early implant bone loss as well as deosseointegration of successfully integrated implants. Unlike natural teeth, osseointegrated implants are ankylosed to surrounding bone without the periodontal ligament (PDL) which provides mechanoreceptors as well as shock-absorbing function. Moreover, the crestal bone around dental implants may act as a fulcrum point for lever action when a force (bending moment) is applied, indicating that implants/implant prosthesis could be more susceptible to crestal bone loss by applying force. Hence, it is essential for clinicians to understand inherent differences between teeth and implants and how force, either normal or excessive force, may influence on implants under occlusal loading. The purposes of this paper are to review the importance of implant occlusion, to establish the optimum implant occlusion with biomechanical rationale, to provide clinical guidelines of implant occlusion and to discuss how to manage complications related to implant occlusion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.3
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• pp.139-143
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• 2016

Objectives: If teeth are missing, super-eruption of teeth in the opposing arch can occur in the area and can change the occlusal plane. When missing teeth are replaced with implants, the oral surgeon must determine whether or not the super-erupted teeth need to be treated in order to normalize the occlusal plane. In this study, we evaluated the clinical prognosis of dentition after implant placement and prosthetic treatment were completed in an occlusal plane altered by super-erupted teeth in the opposing arch without additional treatment of the super-erupted teeth. Materials and Methods: Twenty-two patients (9 males, 13 females) were treated with implants and prosthetics without addressing the super-erupted opposing dentition from April 2004 to August 2012 at Seoul National University Bundang Hospital. A total of 33 implants were placed. Values of crestal bone loss, survival rates, and surgical and prosthetic complications for an average of 29.6 months after prosthetic loading were recorded. Results: In one case, the cover screw was exposed after implant surgery. The mean crestal bone loss was $0.09{\pm}0.30mm$. Of the 33 implants, 31 survived, a survival rate of 93.94%. A prosthetic complication occurred in one case but functioned well after correction. Conclusion: Favorable clinical results from prosthetic complications, crestal bone loss, and implant survival rates were exhibited in implants next to a super-erupted opposing tooth.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.31.1-31.7
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• 2016

Background: The objective of this retrospective study was to show results from platform-switched narrow-diameter implants in the posterior edentulous region, which we followed up for more than 1 year after functional loading. Methods: Ninety-eight narrow implants were inserted into 66 patients. After healing, fixed implant-supported prostheses were delivered to the patients, and Periotest and radiographic examinations were performed. After the first year of loading, the implant outcome was again evaluated clinically and radiographically using the Periotest analysis. Crestal bone loss and Periotest values (PTVs) were used to evaluate the effect of surgery, prosthesis, implant, and a host-related factor. A general linear model was used to statistically detect variables statistically associated with crestal bone loss and Periotest value. Results: We followed up on the implants over 1 to 4 years after loading; their survival rate was 100 %, and pronounced differences from PTVs were noted among jaw location, bone quality, and loading period. No difference was detected in bone loss among the variables studied. Bone loss after functional loading was $0.14{\pm}0.39mm$. The stability value from the Periotest was $-3.29{\pm}0.50$. Conclusions: Within the limitations of this study, judicious use of platform-switched narrow implants with a conical connection must be considered an alternative for wide-diameter implants to restore a posterior edentulous region.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.167-173
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• 2013

Purpose: The aim of this study is to analyze the series of panoramic radiograph of implant patients using the system to measure peri-implant crestal bone loss according to the elapsed time from fixture installation time to more than three years. Methods: Choose 10 patients having 45 implant fixtures installed, which have series of panoramic radiograph in the period to be analyzed by the system. Then, calculated the crestal bone depth and statistics and selected the implant in concerned by clicking the implant of image shown on the monitor by the implemented pattern recognition system. Then, the system recognized the x, y coordination of the implant and peri-implant alveolar crest, and calculated the distance between the approximated line of implant fixture and alveolar crest. By applying pattern recognition to periodic panoramic radiographs, we attained the results and made a comparison with the results of preceded articles concerning peri-implant marginal bone loss. Analyzing peri-implant crestal bone loss in a regression analysis periodic filmed panoramic radiograph, logarithmic approximation had highest $R^2$ value, and the equation is as shown below. $y=0.245Logx{\pm}0.42$, $R^2=0.53$, unit: month (x), mm (y) Results: Panoramic radiograph is a more wide-scoped view compared with the periapical radiograph in the same resolution. Therefore, there was not enough information in the radiograph in local area. Anterior portion of many radiographs was out of the focal trough and blurred precluding the accurate recognition by the system, and many implants were overlapped with the adjacent structures, in which the alveolar crest was impossible to find. Conclusion: Considering the earlier objective and error, we expect better results from an analysis of periapical radiograph than panoramic radiograph. Implementing additional function, we expect high extensibility of pattern recognition system as a diagnostic tool to evaluate implant-bone integration, calculate length from fixture to inferior alveolar nerve, and from fixture to base of the maxillary sinus.

• The Journal of Advanced Prosthodontics
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• v.4 no.3
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• pp.134-138
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• 2012

PURPOSE. The study was conducted to evaluate the efficacy of implant supported tooth replacement in diabetic patients. MATERIALS AND METHODS. The study involved placement of implants (UNITI implants, Equinox Medical Technologies, Zeist, Holland, diameter of 3.7 mm and length 13 mm) in five diabetic patients (three females and two males) of age ranging from 35-65 years with acceptable metabolic control of plasma glucose. All patients included in the study were indicated for single tooth maxillary central incisor replacement, with the adjacent teeth intact. The survival of the restored implants was assessed for a period of three months by measurement of crestal bone heights, bleeding on probing and micro flora predominance. Paired t-test was done to find out the difference in the microbial colonization, bleeding on probing and crestal bone loss. P values of less than 0.05 were taken to indicate statistical significance. RESULTS. Results indicated that there was a significant reduction in bleeding on probing and colonization at the end of three months and the bone loss was not statistically significant. CONCLUSION. The study explores the hypothesis that patients with diabetes are appropriate candidates for implants and justifies the continued evaluation of the impact of diabetes on implant success and complications.

• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.349-358
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• 2003

The success of dental implant therapy relies mainly upon the presence and maintenance of bone adjacent to implant. An 1-year prospective study was performed, upon the patients who were diagnosed as having chronic adult periodontitis, and had been treated with dental implant. The purpose of this study was to measure the radiographic bone level changes proximal to Astra Tech Single Tooth Implants (ATST, Astra Tech AB, $M{\"{o}}lndal$, Sweden) with microthread and Astra Tech TiOblast Implant (ATTB) without microthread supporting fixed partial prosthesis. Measurements were used to determine mean marginal bone loss during the first year of loading, 17 subjects with its partial prosthesis supported by 37 implants were followed up for an 1-year period. The marginal bone loss of implants was positively correlated with the retention factor, microthread($Microthread^{TM}$) in crestal area of ATST. The results were as follows. 1. The mean marginal bone loss of ATST was 0.226${\pm}$0.395mm, while ATTB was 0.440${\pm}$0.360mm. There was a statistically significant difference between ATST and ATTB (p<0.05). 2. The mean bone loss of the upper jaw fixtures was 0.269${\pm}$0.265mm for ATST and 0.529${\pm}$0.417mm for ATTB . There was a statistically significant difference between ATST and ATTB (p<0.05). In the lower jaw the corresponding figures were 0.167${\pm}$0.231mm and 0.313${\pm}$0.214mm, respectively. There was no significant difference between ATST and ATTB (p>0.05). 3. The mean bone loss of ATST was lower than that of ATTB at all sites according to bone quality. There was a statistically significant difference between ATST and ATTB at bone quality type III(p <0.05). In conclusion, the mean bone loss of ATST was smaller than that of ATTB . Therefore, the retention factor of crestal area, microthread ($Microthread^{TM}$) was effective to maintenance of marginal bone level around fixture.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.429-436
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• 2008

Purpose: The goal of periodontal regenerative therapy is to replace bone, cementum, and periodontal ligament on a previously diseased root surface, which has suffered the loss of these supporting structures. To accomplish the regeneration, a number of surgical procedures have been advocated throughout the years. There seems to be a potential for some spontaneous periodontal tissue regeneration in the bottom of periodontal defect following open flap debridement alone. The aim of this study was to analyse the radiographic bone changes over 2-year after flap operation. Material and Methods: Patients attending the department of periodontics of Kyungpook National University Hospital were studied. Patients had clinical and radiographic evidence of infrabony defect(s). forty two sites of 33 patients aged 26 to 65 (mean age 45.5) were treated by flap operation with or without osseous surgery. Baseline and over 2-year follow-up radiographs were collected and evaluated for this study. Radiographic assessment includes a bone fill, bone crest change, defect resolution, and % of defect resolution. Pre- and post-treatment differences between variables (maxilla and mandible, gender, defect depth, defect angle) using the paired t-test were examined. Result: We observed 0.74 mm of bone fill, 0.66 mm of crestal resorption, 1.40 mm of defect resolution, and 27% of percentage of defect resolution. Mandible, women, deeper initial defect depth, narrower initial defect angle showed greater bone fill, defect resolution, and % of defect resolution. Conclusion: The results of this study suggest that the use of flap operation did enhance the outcome in terms of radiographically detectable bone fill. Both treatment resulted in some loss of crestal bone height.