• The Journal of Korean Academy of Prosthodontics
• /
• v.43 no.3
• /
• pp.379-392
• /
• 2005

Statement of problem. One of the common problems of dental implant prosthesis is the loosening of the screw that connects each component, and this problem is more common in single implant-supported prostheses with external connection, and in molars. Purpose. The purposes of this study were: (1) to compare the initial abutment screw detorque values of the six different implant-abutment interface designs, (2) to compare the detorque values of the six different implant-abutment interface designs after cyclic loading, (3) to compare the detorque values of regular and wide diameter implants and (4) to compare the initial detorque values with the detorque values after cyclic loading. Material and methods. Six different implant-abutment connection systems were used. The cement retained abutment and titanium screw of each system were assembled and tightened to 32Ncm with digital torque gauge. After 10 minutes, initial detorque values were measured. The custom titanium crown were cemented temporarily and a cyclic sine curve load(20 to 320N, 14Hz) was applied. The detorque values were measured after cyclic loading of one million times by loading machine. One-way ANOVA test, scheffe’s test and Mann-Whitney U test were used. Results. The results were as follows : 1. The initial detorque values of six different implant-abutment connections were not significantly different(p>0.05). 2. The detorque values after one million dynamic cyclic loading were significantly different (p<0.05). 3. The SS-II regular and wide implant both recorded the higher detorque values than other groups after cyclic loading(p<0.05). 4. Of the wide implants, the initial detorque values of Avana Self Tapping Implant, MIS and Tapered Screw Vent, and the detorque values of MIS implant after cyclic loading were higher than their regular counterparts(p<0.05). 5. After cyclic loading, SS-II regular and wide implants showed higher detorque values than before(p<0.05).

• The Journal of Korean Academy of Prosthodontics
• /
• v.40 no.3
• /
• pp.275-286
• /
• 2002

Statement of problem. Surface alteration of the implant screws after function may be associated with mechanical failure. Theses metal fatigue appears to be the most common cause of structural failure. Purpose. The purpose of this study was to evaluate surface alteration of the implant screws after function through the examination of used and unused implant screws in SEM(scanning electron microscope). Materials and methods. In this study, abutment screws(Steri-oss, 3i), gold retaining screw(3i) and titanium retaining screw(3i) were retrieved from patients. New, unused abutment and retaining screws were prepared for control group. Each of the old, used screws was retrieved with a screwdriver. And retrieved implant complex of Steri-oss system was prepared for this study. Then, SEM investigation and EDS analysis of abutment and retaining screws were performed. And SEM investigation of cross-sectioned sample of retrieved implant complex was performed. Results. In the case of new, unused implant screws, as maunfactured circumferential grooves are regularly examined and screw thread are sharply remained. Before ultrasonic cleansing of old, used implant screw, a lot of accumulation and corrosion products were existed. After ultrasonic cleansing of old, used implant screws, circumferential grooves as examined before function were randomly deepened and scratches increased. Also, dull screw thread was examined. More surface alterations after function were examined in titanium screw than gold screw. And more surface alteration was examined when retrieved with driver than retrieved without driver. Conclusions. These surface alteration after function may result in the screw instability. Regularly cleansing and exchange of screws was recommended. We recommend the use of gold screw rather than titanium screw, and careful manipulation of the driver.

• The Journal of the Korean dental association
• /
• v.48 no.4
• /
• pp.280-287
• /
• 2010

Objective: In spite of increasing dental treatment for the disabled, there was a few collected data on dental treatment status and dentists' perception in Korea. The purpose of this' study is to research the current dental treatment status for the disabled in Korea and to suggest public health policies for the disabled. Material and methods: Total of 68 dentists who have treated the disabled regularly were asked to fill questionnaires regarding dental treatments for the disabled. Results: 1. It is necessary to set up public dental center for the disabled in rural area. 2. In case of dental treatments relating to cerebral palsy, ADHD, autism, the compensation for treatment time and extra investment is needed. 3. Only 39.7% of dentists charged treatment fees to the disabled as same as normal patients. Moreover 38.2% of dentists answered that they didn't charge treatment fees at all when their patient are disabled. 4.23.5% of dentists provided all of dental treatments including dental implant and orthodontic appliances in Korea. However, 54.3% of dentists reported the improvement of access to dental implant, orthodontic and esthetic treatment is needed. 5. It is imperative for the government to improve the support system for the disabled. Conclusions: Through this research only 26.5% of dentists answered that they had received the fund from the government and 11.1% of them were satisfied with the support for the disabled in Korea. This indicated the improvement of government financial support system for the disabled is needed.

• The Journal of Korean Academy of Prosthodontics
• /
• v.44 no.4
• /
• pp.421-431
• /
• 2006

Statement of problem : Accurate impression is essential to success of implant prostheses. But there have been few studies about the accuracy of fixture-level impression technique in internal connection implant system. Purpose: This study evaluated the accuracy of splinted fixture-level impression technique using clinical methods and the effect of internal hex on fit of superstructure in internal connection implant system (Astra Tech). Material and method : Two metal master frameworks made from two abutments (Cast-to Abutment ST) each for parallel and divergent conditions and a corresponding. passively fitting, dental stone master cast with four future replicas (Fixture Replica ST) were fabricated. Ten dental stone casts were made with vinyl polysiloxane impressions from the master cast by acrylic resin splinted fixture-level impression technique. To evaluate the accuracy of impression technique, the fit of master frameworks for test models was evaluated using screw resistance test (SRT) and one-screw test. The results of SRT were recorded as SRT values from grade 1 to grade 5 by 1/4 turn. And to evaluate the effect of hex on fit of superstructure, the same tests were performed after removing hexes of master frameworks. Results: 1. There was only one case (2.5%) showing SRT value of test model below ade 2 in total before and after removing hexes of master frameworks. And, by removing hexes. SRT values decreased in only one test model (5%) and did not change in 17 test models (85%). 2. SRT values of the 1$^{st}$ screws were grade 2 in 80% of cases before, and grade 1 in 80% of cases after removing hexes. And, by removing hexes, SRT values decreased in 72.5% of cases. 3. SRT values of the 2$^{nd}$ screws were grade 3 in 85% of cases before, and grade 3 in 95% of cases after removing hexes. And, by removing hexes, SRT values did not change in 85% of cases. 4. There were only 2 cases regarded as acceptable fit by one-screw test, and SRT values of 2$^{nd}$ screws of both cases were grade 2. Conclusion. Within the limitations of this study, future-level impression of internal connection implant system is considered to obtain inaccurate working cast, even using acrylic resin splinted impression technique. And, it is considered to be unable improve the fit to remove the hexes of implant restoration.

• Journal of Periodontal and Implant Science
• /
• v.46 no.2
• /
• pp.96-106
• /
• 2016

Purpose: Stress distribution and mandible distortion during lateral movements are known to be closely linked to bruxism, dental implant placement, and temporomandibular joint disorder. The present study was performed to determine stress distribution and distortion patterns of the mandible during lateral movements in Class I, II, and III relationships. Methods: Five Korean volunteers (one normal, two Class II, and two Class III occlusion cases) were selected. Finite element (FE) modeling was performed using information from cone-beam computed tomographic (CBCT) scans of the subjects' skulls, scanned images of dental casts, and incisor movement captured by an optical motion-capture system. Results: In the Class I and II cases, maximum stress load occurred at the condyle of the balancing side, but, in the Class III cases, the maximum stress was loaded on the condyle of the working side. Maximum distortion was observed on the menton at the midline in every case, regardless of loading force. The distortion was greatest in Class III cases and smallest in Class II cases. Conclusions: The stress distribution along and accompanying distortion of a mandible seems to be affected by the anteroposterior position of the mandible. Additionally, 3-D modeling of the craniofacial skeleton using CBCT and an optical laser scanner and reproduction of mandibular movement by way of the optical motion-capture technique used in this study are reliable techniques for investigating the masticatory system.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.18 no.2
• /
• pp.81-91
• /
• 2002

Dental implant systems have shown many post-surgical problems and One of the most frequent problem is screw loosening. To reduce screw loosening, a number of methods have been tried and recently fundamental modification of fixture-abutment connection structure was developed and used the most frequently. Former implant system structure, such as Br${\aa}$nemark, had external hex with the height of 0.7 mm and later, fixture with external hex of 1.0 mm height and internal hex structure were developed. In addition, the method of morse taper application was introduced to reduce screw loosening. In this study, the level of screw loosening of each implant systems was compared based on the vibration loosening measurement of abutment screw of each implant systems. Analysis of measured value was performed using 3 kinds of methods, (i) Percentage of average of initial 3 times loosening-torque value(initial loosening value) to tightening-torque of 30 Ncm, (ii) Percentage of loosening-torque value after 200 N strength loaded(experimental value) to initial loosening value and (iii) Percentage of experimental value to 30 Ncm of tightening-torque. Each result of analyses shows the value of initial loosening, loosening by repetitive load and final loosening level. The results of this study were as follows. (1) Percentage of initial loosening value to tightening-torque was increased in order of 0.7 mm external hex, 1.0 mm external hex, internal hex and internal taper and all values between each groups showed statistical significance (p<0.05). (2) Percentage of experimental value to initial loosening value was increased in order of internal hex, 0.7 mm external hex, 1.0 mm external hex and internal taper. Value of internal taper showed significant difference with that of 0.7 mm external hex and internal hex (p<0.05). (3) Percentage of experimental value to tightening torque was increased in order of 0.7 mm external hex, 1.0 mm external hex, internal hex and internal taper. Values of all groups showed statistical significance (p<0.05) except between the groups of 1.0 mm external hex and internal hex. Based on those results, there was no significant difference of loosening-torque by repetitive loading except internal taper. It is supposed that implant system with high resistant capability against initial loosening could be recommended for clinical use. In addition, in case of single implant restoration, 1.0 mm external hex or internal hex could be recommended rather than 0.7 mm external hex, and the use of internal taper would be the most useful way to reduce screw loosening.

• Journal of Periodontal and Implant Science
• /
• v.42 no.6
• /
• pp.231-236
• /
• 2012

Purpose: The aim of this study was to evaluate the influence of the crown-to-implant (C/I) ratio on the change in marginal bone level around the implant and to determine the site-related factors influencing the relationship between the C/I ratio and periimplant marginal bone loss. Methods: A total of 259 implants from 175 patients were evaluated at a mean follow-up of five years. Implants were divided into two groups according to their C/I ratios: ${\leq}$ 1, and >1. Site-related factors having an influence on the relationship between C/I ratio and periimplant marginal bone loss were analyzed according to the implant location, implant diameter, implant manufacturer, prosthesis type, and guided bone regeneration (GBR) procedure. Results: It was found that 1) implants with a C/I ratio below 1 exhibited greater periimplant marginal bone loss than implants with a C/I ratio more than 1, 2) site-related factors had an effect on periimplant marginal bone loss, except for the implant system used, 3) the C/I ratio was the factor having more dominant influence on periimplant marginal bone loss, compared with implant diameter, prosthesis type, implant location, and GBR procedure, 4) implants with a C/I ratio below 1 showed greater periimplant marginal bone loss than implants with a C/I ratio greater than 1 in the maxilla, but not in the mandible, 5) and periimplant marginal bone loss was more affected by the implant system than the C/I ratio. Conclusions: Within the limitations of this study, implants with a higher C/I ratio exhibited less marginal bone loss than implants with a lower C/I ratio in the posterior regions. The C/I ratio was a more dominant factor affecting periimplant marginal bone loss in the maxilla than the mandible. Meanwhile, the implant system was a more dominant factor influencing periimplant marginal bone loss than the C/I ratio.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.26 no.1
• /
• pp.59-68
• /
• 2010

Recently, dental implants extensively inserted on edentulous area show highly clinical success rate. However, clinicians cannot exclude the possibility of failure and it often unexpectively occures. Many possible factors associated with failure of dental implants have been reported but controversy exists over the extent to them. In this study, we collected 212 patients who had been inserted 358 dental implants on mandibular premolar and molar area from 2005 to 2006. The survival rate of fixtures was recorded according to age of patients, implantation site, implant system, diameter and length of fixtures. Multi-variable analysis using SPSS chi-square test was operated to verify relation of each factors and survival rates. Accumulative survival rate was 98.3% for 3 years. Only diameter of fixtures was related to the implant survival rate. This may be thought that wider fixtures had been chosen to rescue implants or used in sites of poor bone quality. Further continuous study will be needed for direct guidance associated with survival rate of implants.

• The Journal of Korean Academy of Prosthodontics
• /
• v.59 no.4
• /
• pp.478-486
• /
• 2021

This report demonstrates a method of generating a chair-side and computer-aided template for implant surgery based on the Top-Down and restoration-driven concept. Compared to the traditional CAD-CAM process which requires multiple steps to be taken between dental clinic and laboratory, this alternative procedure, VARO guide system (VARO Guide, CAD, Pre-Guide, VARO-mill, NeoBiotech, Seoul, South Korea) enables accurate and patient-friendly implant surgery as well as immediate provisional restoration in a single visit. First, bite-registration at centric jaw relation and CBCT were taken using the Pre-Guide. The CBCT data was then reorganized directly through the chair-side CAD, and we could determine the most appropriate 3-dimensional position of implant. The STL file was extracted and put into the chair-side CAM (VARO-mill) to fabricate a VARO. This surgical guide allowed the implants to be accurately positioned into the planned sites within an hour.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.24 no.1
• /
• pp.57-65
• /
• 2008

Purpose: Misfit of implant components was very important in terms of prosthodontics. they has been linked to prosthetic complications such as screw loosening and fracture. Although there are many results about rotational freedom or machining tolerance between fixture and abutments, the data about domestic implant systems are lacking. The aim of this in vitro study was to evaluate the rotational freedom of domestic external and internal connection implant systems between their fixtures/anlaogs and abutments comparing imported systems. Materials and Methods: Rotational freedom between abutments and fixtures/analogs was investigated by using digitalized rotational angle measuring device. (1) 1 domestic external connection system(Neobiotec) and 2 imported external connection systems(Nobel Biocare, Anthorgyr), (2) 1 domestic internal connection system(Dentium) and 4 imported external connection systems(Nobel Biocare, Anthorgyr, Straumann, Frident Dentsply), and (3) 1 domestic zirconia external connection abutment(ZirAce) were evaluated. Each group has 3 samples. Mean values for each group were analyzed. Results: The differences relative to rotational freedom between domestic and imported implant systems were observed but domestic external connection implant system showed about 2.67 degrees(in case of fixture) and internal connection system showed about 4.3 degrees(in case of fixture). Domestic zirconia abutment showed less than 3 degrees of rotational freedom in a situation where the abutment was connected to an implant fixture egardless of domestic or imported systems. Conclusion: Newly developed digitalized rotational angle measuring device has high measuring resolution. The rotational freedom of domestic implant systems were similar to imported implant systems.