• 대한치과보철학회지
• /
• 제46권6호
• /
• pp.634-638
• /
• 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.

• The Journal of Advanced Prosthodontics
• /
• 제1권2호
• /
• pp.102-106
• /
• 2009

STATEMENT OF PROBLEM. Screw loosening has been a common complication and still reported frequently. PURPOSE. The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS. Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly mounted in liquid unsaturated poly-esther with dental surveyor. After 20 times of repeated closing and opening test, the evaluation for the change of inner surface of implant and TiN-coated abutment screw, and weight loss were measured. Mann-Whitney test with SPSS statistical software for Window was applied to analyze the measurement of weight loss. RESULTS. TiN-coated abutment screws of Osstem and 3i showed lesser loss of weight than non-coated those of Osstem and 3i (P < .05, Mann-Whitney test). CONCLUSION. Conclusively, TiN coating of abutment screw showed better resistance to abrasion than titanium abutment screw. It was concluded that TiN coating of abutment screw would reduce the loss of preload with good abrasion resistance and low coefficient of friction, and help to maintain screw joint stability.

• 대한치과보철학회지
• /
• 제45권3호
• /
• pp.345-353
• /
• 2007

Statement of problem. Implant abutment screw joints tend to loosen under clinical conditions. Abutment screw loosening results in loss of preload in function. Purpose. Anti-rotational inner post screw (ARIPS) systems were compared with conventional abutment screws to reduce screw loosening. Reverse torque values were evaluated. Material and methods. 32 implant assemblies (Warentec, Co, Ltd, Seoul, Korea) were organized as the 30-Ncm-torque conventional groups and 30-Ncm-torque ARIPS groups in external and internal system. The specimens were tested to 106 cycles at a load of 200N. Preload reverse torque, postload reverse torque, and the ratio of postload reverse torque to preload reverse torque were evaluated. The data were analyzed with unpaired t-test in external and internal systems. Results. In the ratio of postload reverse torque to preload reverse torque, the ARIPS groups showed significant differences than the conventional screw group in both external and internal system. Conclusion. Within the limitations of this study, abutment screw loosening was effectively reduced using ARIPS system.

• 구강회복응용과학지
• /
• 제27권1호
• /
• pp.109-115
• /
• 2011

점차적으로 폭경이 증가하는 나사들을 이용하여 치조능확장술을 시행하고 임프란트를 식립하였다. 임상적으로 양호한 결과를 얻었으며 수술 중 협측 피질골판 골절은 발생하지 않았다. 임프란트 주변 결손부와 협측 피질골판 상방에 자가치아골이식재를 이식함으로써 부가적인 치조능 확장 효과와 동시에 협측 피질골판 흡수를 보상하였다. 치조능 폭경이 협소한 부위에 임프란트를 식립할 때 나사를 이용한 확장술은 성공적이고 예측 가능한 술식이며 자가치아골이식재는 치조능증대술과 골유도재생술을 위해 사용될 수 있다.

• 대한치과보철학회지
• /
• 제46권6호
• /
• pp.569-576
• /
• 2008

STATEMENT OF PROBLEM: While patient-centered outcomes are usually not reported, these may represent major aspects of the implant success for the patient. Use of a well-designed patient survey form can be an invaluable asset to the implant practitioners. PURPOSE: The objective of this study was to investigate patient satisfaction after implant therapy by means of a questionnaire. MATERIAL AND METHODS: South Korean patients (n = 100), who visited the dental examination center of Soon Chun Hyang university hospital, were asked to fill out the satisfaction questionnaire regarding aspects of cost, comfort, esthetics, chewing, gingival health, food impaction, phonetic aspect, screw loosening, and general satisfaction. Responses to statements were given on the Likert response scale. Four experimental groups of patients were distinguished with various location ($A_1,\;A_2,\;A_3$), year ($B_1,\;B_2,\;B_3$), number of implant replacements ($C_1,\;C_2,\;C_3$), and treatment cost ($D_1,\;D_2,\;D_3$). The reliability of the response scales was measured by calculation of its internal consistency, expressed as Cronbach's ${\alpha}$. The scales were distinguished by means of factor analysis method. Possible differences in scale scores among the groups were assessed by One-way ANOVA (${\alpha}$= 0.05). RESULTS: Patients responded to most of the statements with high satisfaction. But the mean scale score of statement about cost was low. After the verification of internal consistency and factor analysis, five components, e.g. general satisfaction, comfort, chewing efficiency, esthetics, and phonetic aspect were grouped together. These components could be explained with common meaning and the first factor was named as 'general satisfaction'. Differences in patient satisfaction on the scale with esthetics were present between patients who have been wearing the implant prosthesis less than three years and those more than seven years ($B_1<B_3$). CONCLUSION: The patients were generally satisfied with the outcome of implant treatment. But the patients' major complaint was high cost and while the statistically significant difference was not shown, the satisfaction scale about food impaction and esthetics was low. So the continuing efforts to make improvements about these problems are needed for the implant practitioners.

• 구강회복응용과학지
• /
• 제25권4호
• /
• pp.349-360
• /
• 2009

목적: 임플란트 보철 수복에서 심미적 요구도가 증진되면서 최근에는 고강도, 고인성을 지니면서 생체적합성 우수하고 치아의 색과 조화로운 지르코니아 지대주의 사용이 증가하는 추세이다. 몇몇 임상보고를 통해 지르코니아 지대주의 우수한 주위조직 반응과 단기간의 성공적인 결과가 보고 되었으나, 장기간의 안정성을 평가하는 기계적 강도에 관한 연구는 미흡한 실정이다. 이에 본 연구에서는 직경, 각도, 연결방식이 상이한 임플란트 고정체 - 지르코니아 지대주의 단순 파절강도와 반복하중에 의한 피로한계 측정을 통해 지르코니아 지대주의 기계적 안정성을 평가해 보고자 하였다. 재료와 방법: ISO규정에 따라 지르코니아 지대주-고정체를 변연골이 3mm 흡수된 조건에서 $30^{\circ}$경사하중으로 압축굽힘강도를 측정하고, 그 값의 80%를 최대하중으로 10%를 최소하중으로 하여 10Hz의 sine형 반복하중을 $5{\times}10^6$ 주기를 초과하는 조건의 내구성한계를 측정하였다. 지르코니아 지대주로는 regular diameter를 가지면서 external butt joint의 straight 지대주와 $17^{\circ}$ angled 지대주, 그리고 narrow diameter 이면서 external butt joint의 straight 지대주와 internal conical joint의 straight 지대주를 사용하였다. 압축굽힘강도 값을 일원분산분석과 사후검정으로 검증하였으며, 피로파절면을 전자주사현미경을 통해 관찰했다. 결과: 압축굽힘강도는 최소 927N 이상으로, 직경의 차이에 따른 유의한 차이를 보였으며( P<.05), 내구성 한계는 503N에서 868N까지의 번위를 보였다. 결론: 지르코니아 지대주는 구강내 기능하중을 견딜수 있는 적절한 기계적 강도를 가지는 것으로 판단된다.

• 대한치과보철학회지
• /
• 제43권4호
• /
• pp.519-527
• /
• 2005

Statement of problem : There are many articles that showed that the magnetism affected the bone formation around titanium implant. It means that a proper magnetism made the osseointegration improved around the implant. So after additional research on the other effect of magnetism on bone formation in implant therapy, we can conclude its possibility of clinical application on implant treatment. Purpose: The purposes of this study were to find out the intensity of magnetic field where magnetism in the titanium implant specimen inserted into the bone could affect the bone formation, and to discover the possibility of clinical application in the areas of dental implants and bone grafts. Material and method: Ten adult male rabbits(mean BW 2Kg) were used in this study. Titanium implant specimens were surgically implanted on the mesial side of the tibia of rabbits. Neodymium magnets(Magnedisc 500, Aichi Steel Corp. Japan) were placed into the implants of experimental group except control group, just after placement of the titanium implants. At 2, 4 and 8 weeks after the surgery, the animals were sacrificed, specimens were obtained and stained with Hematoxylin-Eosin for light microscopic evaluation and histomorphometric analysis. Conclusion : The results were as follows: 1. In radiographic findings, increased radiopacity downward from crestal bone was observed along the titanium implant specimen at experimental period passed by 2, 4, and 8 weeks in both control and experimental group. 2. In histoiogic findings, increased new bone formation was shown in both control and experimental group through the experiment performed for 2, 4, and 8 weeks. More new bone formation and bone remodeling were shown in experimental group. 3. In histomorphometric analysis, the bone contact ratios were 11.9% for control group and 38.5% for experimental group (p<0.05).

• 대한치과보철학회지
• /
• 제42권6호
• /
• pp.671-678
• /
• 2004

Statement of problem. Reducing treatment time in implant dentistry is a matter of main concern. There are so many factors affecting the success rate of immediate or early loaded implant for the initial bone response. The especially microscopic properties of implant surfaces playa major role in the osseous healing of dental implant. Purpose. The aims of this study were to perform a histologic and histomorphometric comparison of the healing characteristics anodically roughened surface, HA coated surface and RBM surface implant, and to compare of ISQ values measured by $Osstell^{TM}$ for resonance frequency analysis in dogs mandible during 2 weeks. Material and method. Bone blocks from 2 dogs were caught after covered healing for 0 day(2 h); Group I, 1 week; Group II and 2 weeks; Group III. One longitudinal section was obtained for each implant and stained with hematoxylin and eosin. Histomorphometric analysis was done with Kappa Imagebase system to calculate bone-to-implant contact and bone volumes inside the threads. ISQ values were measured in every time of surgery schedule. Conclusion. The experiment revealed that: 1. The percentages of bone-to-implant contact on the fixture in each group were not significantly different(P > 0.05). 2. The percentages of bone area inside the threads on the fixture in each group were not significantly different(P > 0.05). 3. The ISQ level showed clinical stability of each fixture during 2 weeks(all ISQ level ${\geq}71$ ).

• 대한치과보철학회지
• /
• 제39권3호
• /
• pp.273-281
• /
• 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.

• 대한치과보철학회지
• /
• 제46권3호
• /
• pp.290-297
• /
• 2008

STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.