• The Journal of Advanced Prosthodontics
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• v.13 no.6
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• pp.343-350
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• 2021

PURPOSE. The success of an implant-prosthetic rehabilitation is influenced by good implant health and an excellent implant-prosthetic coupling. The stability of implant-prosthetic connection is influenced by the rotational tolerance between anti-rotational features on the implant and those on the prosthetic component. The aim of this study is to investigate the rotational tolerance of a conical connection implant system and its titanium abutment counterpart, in various conditions. MATERIAL AND METHODS. 10 preparable titanium abutments, having zero-degree angulation (MegaGen, Daegu, Korea) with an internal 5-degree conical connection, and 10 implants (MegaGen, Daegu, Korea) were used. Rotational tolerance between the connection of implant and titanium abutments was measured through the use of a tridimensional optics measuring system (Quick Scope QS250Z, Mitutoyo, Kawasaki, Japan) in the as-received condition (Time 0), after securing with a titanium screw tightening at 35 Ncm (Time 1), after tightening 4 times at 35 Ncm (Time 2), after tightening one more time at 45 Ncm (Time 3), and after tightening another 4 times at 45 Ncm (Time 4). RESULTS. The group "Time 0" had the lowest values of rotational freedom (0.22 ± 0.76 degrees), followed by the group Time 1 (0.46 ± 0.83 degrees), the group Time 2 (1.01 ± 0.20 degrees), the group Time 3 (1.30 ± 0.85 degrees), and the group Time 4 (1.49 ± 0.17 degrees). CONCLUSION. The rotational tolerance of a conical connection is low in the "as received" condition but increases with repetitive tightening and with application of a torque greater than 35 Ncm.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.4
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• pp.302-309
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• 2002

In order to improve the success rate of implants, various implant designs have been developed. Although there have been enough efforts to handle the surface of the implant with careful choice of material and mechanics so that the bone and the implant can be tightly joined together, they have still failed to play the role of periodontal ligaments of the natural teeth in the past. The role of periodontal ligaments is very important since it can improve the initial stability of implant by absorbing the impacts. The purpose of this study is, thus, to test the possibility of alleviating the impact when the surface of the implant was coated with chitosan, a natural polymer, and making sure that the coated material stayed on. Then, the condition of newly developed bone formation and the degree of inflammation in response was closely observed in the surface level. In the main experiment, Chitosan coated implant ($3.3mm{\times}7mm$) was implanted on both the right and the left side of rabbit's femur. The animals were each sacrificed on the $1^{st}$, $2^{nd}$, $3^{rd}$, $7^{th}$, $14^{th}$, $21^{st}$ and 28th day. The process was observed under an light microscope after the Toluidin Blue staining. From the experiment, it was found that the chitosan was evenly distributed on the surface of the screws, and the implant was adjoined with adjacent bone. There was a sign of inflammation on the $3^{rd}$ day, but on the $14^{th}$ day, the formation of woven bone and newly formed bones were noticed. Also, chitosan filled the gap was formed between the implant and the newly formed bone. The implant, the chitosan and the newly formed bone were forming one unit as a result. Therefore, it was found that chitosan coated implant could absorbe the impact in the initial stage of implant.

• Journal of Technologic Dentistry
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• v.31 no.1
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• pp.55-61
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• 2009

Passive fitting of meso-structure and super-structures is a predominant requirement for the longevity and clinical success of osseointegrated dental implants. However, precision and passive fitting has been unpredictable with conventional methods of casting as well as for corrective techniques. Alternative to conventional techniques, electro discharge machining(EDM) is an advanced method introduced to dental technology to improve the passive fitting of implant prosthesis. In this technique material is removed by melting and vaporization in electric sparks. Regarding the efficacy of EDM, the application of this technique induces severe surface morphological and elemental alterations due to the high temperatures developed during machining, which vary between $10,000{\sim}20,000^{\circ}C$. The aim of this study was to investigate the morphological and elemental alterations induced by EDM process of casting dental gold alloy and non-precious alloy used for the production of implant-supported prosthesis. A conventional clinical dental casting alloys were used for experimental specimens patterns, which were divided in three groups, high fineness gold alloy(Au 75%, HG group), low fineness gold alloy(Au 55%, LG group) and nonprecious metal alloy(Ni-Cr, NP group). The UCLA type plastic abutment patterns were invested with conventional investment material and were cast in a centrifugal casting machine. Castings were sandblasted with $50{\mu}m\;Al_2O_3$. One casting specimen of each group was polished by conventional finishing(HGCON, LGCON, NPCON) and one specimen of each group was subjected to EDM in a system using Cu electrodes, kerosene as dielectric fluid in 10 min for gold alloy and 20 min for Ni-Cr alloy(HGEDM. LGEDM, NOEDM). The surface morphology of all specimens was studied under an energy dispersive X-ray spectrometer (EDS). The quantitative results from EDS analysis are presented on the HGEDM and LGEDM specimens a significant increase in C and Cu concentrations was found after EDM finishing. The different result was documented for C on the NPEDM with a significant uptake of O after EDM finishing, whereas Al, Si showed a significant decrease in their concentrations. EDS analysis showed a serious uptake of C and Cu after the EDM procedure in the alloys studied. The C uptake after the EDM process is a common finding and it is attributed to the decomposition of the dielectric fluid in the plasma column, probably due to the development of extremely high temperatures. The Cu uptake is readily explained from the decomposition of Cu electrodes, something which is also a common finding after the EDM procedure. However, all the aforementioned mechanisms require further research. The clinical implication of these findings is related with the biological and corrosion resistance of surfaces prepared by the EDM process.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.5
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• pp.428-433
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• 2004

Sinus floor augmentation has been proven an effective treatment procedure to increase bone volume in the posterior edentulous maxilla. Autogenous bone considered to be the best material for reconstructive bone surgery and has been successfully used as a graft material to augment posterior maxilla. However, the collection of autogenous bone required extra risks for morbidity and complaints. So, various bone graft materials included ${\beta}$-tricalcium phosphate(${\beta}$-TCP) has been introduced for replacing the autogenous bone. The objective of this clinical study was to determine the predictability of endosseous implant placed in a maxillary sinus with ${\beta}$-TCP grafting. We performed sinus elevation with ${\beta}$-TCP to install the implant in the 10 maxillary cases. The prosthetic procedure was performed 6-9 months after. The implant-prosthetics was checked about 1 year. We checked the implant and measured the maximum bite force to evaluate the function of the implant. There was not observed the specific problem and complication in dental implant and maxillary sinus in the grafted materials. The maximum bite force was 558N in case of natural tooth, 365N in implant without grafting, 318N in implant with ${\beta}$-TCP grafting. There was no significant difference between with and without sinus grafting on maximum bite force(p>0.05). As though the long term check-up is needed, the grafting of ${\beta}$-TCP as a osteoconductive materials can expand the volume and induce dense new bone formation in maxillary sinus. So, this short-term results support that ${\beta}$-TCP can be a suitable material for sinus augmentation.

• The Journal of the Korean dental association
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• v.55 no.11
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• pp.756-765
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• 2017

Purpose: The purpose of this article is to evaluate a change o bone level on the sinus floor by a bone added osteotome sinus floor elevation (BAOSFE) technique, according to the amount of deproteinized bovine bone mineral (DBBM). And Changes in augmented bone height after BAOSFE procedure were also assessed for 6 months after the implant procedure. Materials and Methods: Forty eight single implants were placed in the posterior maxilla using BAOSFE technique. The implantation sites were classified into two groups according to the amount of grafted DBBM, 0.25 group (0.25g) and 0.5 group (0.5 g). Panoramic views or cone-beam computed tomography (CBCT) were taken at the time of implant placement with BAOSFE and after at least 6 months to assess the bone level changes in the elevated sites with DBBM. Results: Alveolar bone level around all implants was stable clinically and radiographically during the follow-up. Mean augmented bone height was $5.21{\pm}0.94mm$ in 0.25 group and $6.92{\pm}1.19mm$ in 0.5 group. Statistically significant difference in augmented bone height was found in the comparison between the 0.25 group and 0.5 group at the time of surgery. There was a positive correlation between the length of the implant protruding into the maxillary sinus and the augmented bone height. After 6 months, mean reduction of augmented bone height was $0.50{\pm}0.34mm$ in 0.25 group and $0.41{\pm}0.30mm$ in 0.5group. There was no specific correlation between the reduction of augmented bone height and amount of grafted DBBM. Conclusion: Within the limit of this study, the amount of grafting materials and the protrusion length of implant into the maxillary sinus affect the amount of the augmented bone height.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.3
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• pp.246-261
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• 2002

The screw loosening is one of the complications that happen frequently in dental implant prostheses. The purpose of this study was to evaluate the changes of reverse/loosening (opening) torque of the screw according to the surface modifications by sandblasting and 24K gold electroplating as well as to determine the possibility of the clinical use of a washer in dental implant. The reverse torque of 4 experimental conditions(control, sandblasted, use of washers, electroplasted) was measured by digital torque gauge (Model MGT50Z, Mark-10 Corp., 458 West John Street Hicksville, NY 11801 USA). Electronic torque controller (Nobel Biocare DEA 020) was used in fastening the gold screws into abutment replicas. Mixed Linear Model Analysis method was used for statistical analysis. To examine the changes of screw thread surface, microphotographs were taken by Olympus PME-3 metallurgic microscope (Olympus Optical Co. Ltd., Tokyo, Japan). Within the limitations of this study, the following results were drawn: 1. The surface modifications of the gold screws and the use of a washer have significantly affected the reverse torque value compared to the control group (P<0.01). 2. Sandblasting and electroplating treatments demonstrated significantly higher reverse torque value than that of control group. 3. The use of a washer may be one of the useful clinical methods that prevent the screw loosening. However, further studies are necessary for the material selection and design of the washer.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.1
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• pp.107-118
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• 2007

Statement of problem: Implant-type distractor uses a removable distraction device that has an appearance similar to that of a dental implant and utilizes many of the same techniques for placement as are used for dental implants. Material and method: In this study, 48 implant type titanium distractors were inserted into the osteotomized alveolar bone of 12 beagle dogs. After a 7-day latency period, the alveolar bone was augmented by 5mm vertically at a rate of 1.0 mm/day. The dogs were sacrificed after 4weeks, 8weeks and 12 weeks for radiographic, histologic, and histomorphometric analysis. Result: Copper equivalent value showed significant difference between 4 weeks and the other weeks(8, 12 weeks)(p<0.05). But there was no significant difference between maxillary and mandibular groups. In the bone to metal contact analysis, there was a significant difference between 4 weeks and 12 weeks(p<0.05). On the contrary, there was no significant difference between maxilla and mandible. The bone area showed significantly higher values in 12 weeks compared to 4 weeks(p<0.05). Histologically mineralization began at the host bone margins. At 12 weeks, increasing accumulation of $Ca^{++}$ element was confirmed. Conclusion: From the results above, the new bone formation was increased according to consolidation period. Especially there was significant difference between 4 weeks and 12 weeks(p<0.05). Implant type distractors used in this study to augment vertical ridge defect may prove to be a clinically useful treatment option in selected cases.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.3
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• pp.254-262
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• 2022

When treating partial edentulous patients, it is important to use an appropriate restorative materials. Inappropriate restorative materials can adversely affect the outcome of prosthetic restorations. Zirconia and dental metal, which are currently and widely used materials, have a higher elastic modulus than cortical bone, so when an external force is generated, a harmful force can be applied to the implant and the bone around the implant. Polyetherketoneketone (PEKK), a recently introduced material, has a elastic modulus similar to that of cortical bone, and has many advantages in terms of physical properties and biocompatibility. This case report describes that implant-supported fixed prosthetic treatment using PEKK was performed, and functional and esthetic satisfactory results were obtained.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.3
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• pp.249-255
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• 2011

Purpose: Placement of endosseous implants in the atrophic maxilla is often restricted because of the lack of supporting bone. In this article, augmentation of the maxillary sinus floor with deproteinized bovine bone to enable insertion of endosseous implants is described. The technique is aimed at providing a cortical layer on top of the graft to ensure a reliable seal of the maxillary sinus and to achieve optimal stability of the bone graft in case of simultaneously placement of dental implants. Methods: The procedure was used in 200 patients (839 implants), using deproteinized bovine bone. The mean follow-up was 28.5 months. No inflammation of the bone grafts nor of the maxillary sinus occurred. The patients received implant supported overdentures or bone-anchored bridges. Results: The survival rate of implant restoration of this study was 97.6%. The total average of marginal bone loss in radiographs was $0.20{\pm}0.38$ mm. Insufficient primary stability, bony quality, and infection were thought to be associated factors in the failed cases. Conclusion: This study documented that deproteinized bovine bone, when used as a grafting material for augmentation of the sinus floor, may lead to proper osseointegration of a endosseous implant.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.6
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• pp.634-638
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• 2008

PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis. RESULTS: Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.