• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.13.1-13.6
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• 2020

Background: The aim of this study was to evaluate the factors that may affect implant fixture fractures. Methods: Patients who experienced implant fixture removal at Seoul National University Bundang Hospital from 2007 to 2015 due to implant fixture fracture were included. Implant/crown ratio, time of implant fracture, clinical symptoms before implant fracture, treatment of fractured implants, and the success and survival rate of the replaced implants were evaluated retrospectively. Results: Thirteen implants were fractured in 12 patients. Patient mean age at the time of fracture was 59.3 years. Of the 13 implants, 7 implants were placed at our hospital, and 6 were placed at a local clinic. The mean crown/implant ratio was 0.83:1. The clinical symptoms before fracture were screw loosening in five implants, marginal bone loss in five implants, and the presence of peri-implant diseases in five implants. All the fractured implants were removed, and 12 out of the 13 sites were re-implanted. Parafunctions were observed in two patients: one with bruxism and one with attrition due to a strong chewing habit. Conclusions: Several clinical symptoms before the fracture of an implant can predict implant fixture failure. Therefore, if these clinical symptoms are observed, appropriate treatments can be taken before more serious complications result.

• 대한치과보철학회지
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• 제44권1호
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• pp.85-102
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• 2006

Statement of problem: Currently, there are some 20 different geometric variations in implant/abutment interface available. The geometry is important because it is one of the primary determinants of joint strength, joint stability, locational and rotational stability. Purpose: As the effects of the various implant-abutment connections and the prosthesis height variation on stress distribution are not yet examined this study is to focus on the different types of implant-abutment connection and the prosthesis height using three dimensional finite element analysis. Material and method. The models were constructed with ITI, 3i TG, Bicon, Frialit-2 fixtures and solid abutment, TG post, Bicon post, EstheticBase abutment respectively. And the super structures were constructed as mandibular second premolar shapes with 8.5 mm, 11 mm, 13.5 mm of crown height. In each model, 244 N of vertical load and 244 N of $30^{\circ}$ oblique load were placed on the central pit of an occlusal surface. von Mises stresses were recorded and compared in the crowns, abutments, fixtures. Results: 1. Under the oblique loading, von Mises stresses were larger in the crown, abutment, fixture compared to the vertical loading condition. 2. The stresses were increased proportionally to the crown height under oblique loading but showed little differences with three different crown heights under vertical loading. 3. In the crown, the highest stress areas were loading points under vertical loading, and the finish lines under oblique loading. 4. Under the oblique loading, the higher stresses were located in the fixture/abutment interface of the Bicon and Frialit-2 systems compared to the ITI and TG systems. Conclusions: The stress distribution patterns of each implant-abutment system had difference among them and adequate crown height/implant ratio was important to reduce the stresses around the implants.

• 대한치과보철학회지
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• 제46권5호
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• pp.479-489
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• 2008

목적: 상악 구치부에서 자연치와 임플란트 보철시, 보철치관/고정체 비율에 따른 응력분포 양상을 비교하고자 했다. 재료 및 방법: 자연치 모델의 경우는 획득한 3차원 인체모델을 상악 좌측 제2소구치 및 제 1대구치가 포함된 상악골을 Box 형태의 3차원 유한요소모델로 변환하였고, 임플란트 모델은 3차원 인체모델에서 치아 부분을 제거하고 동일 부위에 임플란트 모델을 연결하는 과정을 거쳐서 임플란트가 삽입된 유한요소모델을 구성하였다. 치관/고정체 비율을 0.7:1, 1:1, 1.25:1이 되도록 골수준 (bone level)을 조정하였으며 각 모델의 치관 부위에 300 N의 수직 하중과 수평하중을 각각 가했다. 결과: 1. 모든 하중 조건하에서 자연치와 임플란트 모두에서 피질골과 인접하는 경부에 응력이 집중되는 양상을 보였다. 2. 치관/치근 (고정체) 비가 증가함에 따라 자연치와 임플란트 모두에서 교합면에 수직적 하중을 가한 경우에는 응력의 변화가 뚜렷하지 않았으나, 수평적 하중을 가한 경우에서는 응력이 증가하는 양상을 보였다. 3. 자연치의 경우에 치관/치근비가 증가함에 따라 splinting이 응력감소 효과를 보였고, 임플란트의 경우에는, 치관/고정체 비가 증가함에 따라 splinting이 수직 하중조건에 응력감소효과를 보였으나, 중심에서 벗어난 하중조건에는 최대응력이 오히려 증가하는 양상을 보였다. 4. 임플란트의 경우, 치관/고정체 비가 증가함에 따라 splinting이 수평하중조건 4에서 뚜렷한 응력감소 효과를 보이나, 수평 하중조건 5에서는 응력감소 효과가 감소되고, 특히 치관/고정체 비가 1.25:1인 경우에서는 오히려 응력의 증가를 보였다. 결론: 임플란트 보철물은 치관/고정체 비가 커질수록 더 큰 응력을 받게 되고, splinting의 효과도 감소하게 된다. 또한 교합하중이 임플란트의 장축을 벗어나거나 중심에서 벗어난 경우 응력이 커지는 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권5호
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• pp.224-229
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• 2014

The maxillary posterior area is the most challenging site for the dental implant. Although the sinus graft is a predictable and successful technique for rehabilitation of atrophic and pneumatized posterior maxilla, when there is severe destruction of alveolar bone, a very long crown length remains challenging after successful dental implants installation with sinus graft. We performed vertical augmentation of the maxillary posterior alveolar ridge using the allogenic block bone graft with a simultaneous sinus graft using allogenic and heterogenic bone chips. After about six months, we installed the dental implant. After this procedure, we achieved a more favorable crown-implant fixture ratio and better results clinically and biomechanically. This is a preliminary report of vertical augmentation of maxillary posterior alveolar ridge using allogenic block bone graft and simultaneous maxillary sinus graft. Further research requires longer observation and more patients.