• Journal of Korean Dental Hygiene Science
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• v.6 no.2
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• pp.25-35
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• 2023

Background: In order to emphasize the importance of clinical dental hygienists-led dental hygiene management processes for those with systemic diseases, we tried to identify systemic diseases affecting dental implants based on clinical data. Methods: In order to identify systemic diseases affecting dental implants, literature review was conducted from March 1 to May 31, 2023, and the search period was for research papers published in domestic and foreign academic journals from January 2000 to December 2020. Domestic databases used for search use RISS, Nuri Media(DBpia), and Korea Academic Information (http://www.papersearch.net ; KISS), while overseas databases searched Pubmed for dental implant failures, implants, systemic diseases, and Dental implant and system disease. Results: The cumulative survival rate of implants averaged 94.3 percent and the failure rate was 5.7 percent. Clinical analysis of systemic diseases related to implants accounted for the highest frequency with 13 (100.0%), followed by 8 (61.5%) studies on high blood pressure and smoking, 7 (53.8%) cardiovascular diseases, and 5 (38.5%). In addition, liver disease, thyroid abnormalities, blood abnormalities, organ transplants and infectious diseases were confirmed. Conclusion: Since unregulated systemic diseases are a risk factor for implant failure, clinical dental hygienists should continue to maintain healthy oral conditions by sharing information with patients during periodic preventive dental hygiene management processes such as dental hygiene assessment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.361-366
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• 2009

Purpose: The purpose of this retrospective report was to analyze long-term survival rate of sintered porous-surfaced dental implant ($Endopore^{(R)}$ Dental Implant system, Innova Corporation, Toronto, ON, Canada). Methods: 61 partially edentulous patients were received a total of 127 Endopore dental implants in the maxilla. Of the 127 implants, 24 implants were restored with individual (ie, non-splinted) crowns, while 103 implants were splinted to other implants. Medical records and radiographs were evaluated and analyzed by the cumulative survival rate, location of implants, implants length and diameter, crown/implant ratio and whether the implant was splinted. Chi squire test was used statistically. Result: Of the 127 implants, 8 implants (6.3%) were removed and and cumulative survival rate was 93.7%. Conclusion: Endopore implants showed satisfactory results after up to 8 years function periods in the edentulous posterior maxilla.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.1
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• pp.75-87
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• 2006

The purpose of this study was to investigate the effects of prostheses misfit, cantilever on the stress distribution in the implant components and surrounding bone using three dimensional finite element analysis. Two standard 3-dimensional finite element models were constructed: (1) 3 ITI implant supported, 3-unit fixed partial denture and (2) 3 ITI implant supported, 3-unit fixed partial denture with a distal cantilever. variations of the standard finite element models were made by placing a $100{\mu}m$ or $200{\mu}m$ gap between the fixture, the abutment and the crown on the second premolar and first molar. Total 14 models were constructed. In each model, 244 N of vertical load and 244 N of $30^{\circ}$ oblique load were placed on the distal marginal ridge of the distal molar. von Mises stresses were recorded and compared in the crowns, abutments, crestal compact bones, and trabecular bones. The results were obtained as follows: 1. In the ITI implant system, cement-retained prostheses showed comparatively low stress distributions on all the implant components and fixtures regardless of the misfit sizes under vertical loading. The stresses were increased twice under oblique loading especially in the prostheses with cantilever, but neither showed the effects of misfit size. 2. Under the oblique loading and posterior cantilever, the stresses were highly increased in the crestal bones around ITI implants, but effects of misfit were not shown. Although higher stresses were shown on the apical portion of trabecular bones, the effects by misfit were little and the stresses were increased by the posterior cantilever. 3. When the cement loss happened in the ITI implant supported FPD with misfit, the stresses were increased in the implant componets and supporting structures.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.39-44
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• 2020

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited disorder that presents as abnormally elevated levels of low-density lipoprotein cholesterol and premature heart disease, requiring frequent intervention through lipid apheresis for management. The risk of perioperative cardiac events is higher in patients with HoFH because of its pathophysiological manifestations in the vascular system. Careful cardiac precautions and anesthetic assessments are necessary to ensure patient safety. In the following case report, we discuss the clinical course and anesthetic considerations for a 14-year-old girl with HoFH undergoing sedation for dental extractions and mandibular molar uprighting in an outpatient oral surgery clinic. Considerations included the use of heparin in the patient's weekly plasma lipid apheresis treatment. In order to reduce the risks of peri- and postoperative bleeding and perioperative cardiac events, the operation was scheduled for 4 days after apheresis. This allowed for adequate heparin clearance, while also reducing the likelihood of possible cardiac events. A literature review revealed no results for the outpatient management of patients with HoFH undergoing sedation for noncardiac procedures. Our reported case serves as a clinical example for physicians to be utilized in the future.

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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• pp.37-40
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• 2009

STATEMENT OF PROBLEM. Implant drivers are getting popular in clinical dentistry. Unlike to implant systems with external hex connection, implant drivers directly engage the implant/abutment interface. The deformation of the implant/abutment interface can be introduced while placing an implant with its implant driver in clinical situations. PURPOSE. This study evaluated the change of rotational freedom between an implant and its abutment after application of different insertion torques. MATERIAL AND METHODS. Three kinds of internal connection implants were utilized for the current study($4.5{\times}12\;mm$ Xive, $4.3{\times}11.5\;mm$ Inplant Magicgrip, $4.3{\times}12\;mm$ Implantium MF). An EstheticBase, a 2-piece top, a Dual abutment was used for its corresponding implant system. The rotational freedom between an implant and its abutment were measured before and after applying 45, 100 Ncm insertion torque. Repeated measures ANOVA was used for statistical analysis. RESULTS. Under 45 Ncm insertion torque, the rotational freedom between an implant and its abutment was significantly increased in Xive(P = .003). However, no significant change was noted in Inplant Magicgrip and Implantium MF. Under 100 Ncm torque, both in Xive(P = .0005) and Implatium MF(P = .03) resulted in significantly increased rotational freedom between the implant and its abutment. DISCUSSION. The design of the implant/implant driver interface effectively prevented the deformation of implant/abutment interface. Little change was noted in the rotational freedom between an implant and its abutment, even though the insertion torque was far beyond clinical application. CONCLUSIONS. The implant/abutment joint of internally connecting implants were quite stable under insertion torque in clinical situation.

• The Journal of Advanced Prosthodontics
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• v.11 no.3
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• pp.169-178
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• 2019

PURPOSE. While dental implants have displayed high success rates, poor mechanical fixation is a common complication, and their biomechanical response to occlusal loading remains poorly understood. This study aimed to develop and validate a computational model of a natural first premolar and a dental implant with matching crown morphology, and quantify their mechanical response to loading at the occlusal surface. MATERIALS AND METHODS. A finite-element model of the stomatognathic system comprising the mandible, first premolar and periodontal ligament (PDL) was developed based on a natural human tooth, and a model of a dental implant of identical occlusal geometry was also created. Occlusal loading was simulated using point forces applied at seven landmarks on each crown. Model predictions were validated using strain gauge measurements acquired during loading of matched physical models of the tooth and implant assemblies. RESULTS. For the natural tooth, the maximum vonMises stress (6.4 MPa) and maximal principal strains at the mandible ($1.8m{\varepsilon}$, $-1.7m{\varepsilon}$) were lower than those observed at the prosthetic tooth (12.5 MPa, $3.2m{\varepsilon}$, and $-4.4m{\varepsilon}$, respectively). As occlusal load was applied more bucally relative to the tooth central axis, stress and strain magnitudes increased. CONCLUSION. Occlusal loading of the natural tooth results in lower stress-strain magnitudes in the underlying alveolar bone than those associated with a dental implant of matched occlusal anatomy. The PDL may function to mitigate axial and bending stress intensities resulting from off-centered occlusal loads. The findings may be useful in dental implant design, restoration material selection, and surgical planning.

• Journal of Technologic Dentistry
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• v.43 no.3
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• pp.99-105
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• 2021

Purpose: This study aims to examine the stress distribution effect of tightening torques of different abutment screws in a custom-abutment implant system on the abutment-fixture connection interface stability using finite element analysis. Methods: The custom-abutment implant system structures used in this study were designed using CATIA program. It was presumed that the abutment screws with a tightening torque of 10, 20, and 30 N·cm fixed the abutment and fixture. Furthermore, two external loadings, vertical loading and oblique loading, were applied. Results: When the screw tightening torque was 10 N·cm, the maximum stress value of the abutment screw was 287.2 MPa that is equivalent to 33% of Ti-6Al-4V yield strength. When the tightening torque was 20 N·cm, the maximum stress value of the abutment screw was 573.9 MPa that is equivalent to 65% of Ti-6Al-4V yield strength. When the tightening torque was 30 N·cm, the maximum stress value of the abutment screw was 859.6 MPa that is similar to the Ti-6Al-4V yield strength. Conclusion: As the screw preload rose when applying each tightening torque to the custom-abutment implant system, the equivalent stress increased. It was found that the tightening torque of the abutment influenced the abutment-fixture connection interface stability. The analysis results indicate that a custom-abutment implant system should closely consider the optimal tightening torque according to clinical functional loads.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.391-401
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• 2009

The successful outcome of dental implants is mainly the result of intial implant stability following placement. The aim of this study was to investigate the effect of a self-tapping blades and implant design on initial stability of two tapered implant systems in poor bone quality. The two different implant systems included one with self-tapping blades and one without self-tapping blades. D4 bone model using Solid Rigid Polyurethane Form was used to simulate poor bone densities. The insertion torque during implant placement was recorded. Resonance frequency Analysis (RFA), measured as the implant stability quotient (ISQ), was assessed immediately after insertion. Finally, the implant-bone specimen was transferred to an Universal Testing Machine to measure the axial pull-out force. Insertion torque values and maximum pull-out torque value of the non self-tapping implants were significantly higher than those in the self-tapping group (P = 0.008). No statistically differences were noted between the two implant designs in RFA. Within the each implant system, no correlation among insertion torque, maximum pull-out torque and RFA value could be determined. Higher insertion torque of the non-self-tapping implants appeared to confirm higher clinical initial stability. In conclusion, implants without self-tapping blades have higher initial stability than implants with self-tapping blades in poor bone quality.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.413-428
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• 2008

Purpose: Given the predictability of dental implant procedure from the studies of successful osseointegration, implant dentistry is often the treatment of choice to replace missing teeth in edentulous patient instead of the fixed prosthesis or removable denture. The $Renova^{(R)}$ dental implant has a RBM(Resorbable Blast Media) surface, internal hex prosthetic connection and a tapered design. At this study gives the analysis of the implant and the short term survival rate of the implant. Material and Methods: In this study, a multilateral analysis was performed on the subjects undergoing placement with $Renova^{(R)}$ implant between August 2006 and February 2008 in Yonsei University dental hospital. 96 implants were placed in 56 patients and they were surveyed for cumulative survival rate. Among them 78 implants in 44 patients were surveyed for the rest analyses. Result: 1. The cumulative survival rate was 96.88% of 96 implants in 56 patients. 2. The mean marginal bone loss was 0.803mm and the marginal bone loss in augmentation group has higher value than the marginal bone loss in non augmentation group. 3. The health scale for the implants were 87% in success group, 9% in satisfactory survival group, 1% in compromised survival group, and 3% in failure group. 4. Two implants placed in poor bone posterior area by 2-stage failed during prosthetic procedure. Conclusion: $Renova^{(R)}$ dental implant showed high cumulative survival rate in installation on partial edentulous ridge and could be a predictable implant system.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.3
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• pp.468-482
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• 1998

Since the concept of osseointegration was introduced by Branemark of Sweden, dental implants have been used for various dental prosthetic treatments. The survival rate of dental implant is likely to be closely related to the total biomechanical role of each component of implant system. The use of interchangeable component is very attractive for dental practitioners because such an approach would save treatment cost, flexibility of prosthetic treatment options as well as conveniences. Therefore, the use of interchangeable implant system has been increasing without scientific assessment of safety and efficacy of various interchangeable implant system. The purpose of this study, therefore, were to compare the geometric characteristic of four interchangeable dental implant screws and the loosening torque of these screws. Four types of dental implant screws tested in this study were Nobelpharma, 3i, Impla-med, Restore. Four screws each of the test specimens were subjected for scanning electron microscopic examinations under the same condition and a 35x magnified standard SEM picture was objected from each test specimen using JSM-5200 scanning microscope. From each of the SEM pictures, eight parameters. i.e., diameter of screw head. screw length, thread pitch, major diameter. neck diameter, neck length, crest width and root width were determined using a caliper. The measurement for each parameters were then corrected for their magnification factor. The loosening torque were also determined by using a torque gauge. All of the measurements were statistically analyzed by ANOVA test and multiple range test. Statistical significance was set in advance at the probability level of less than 0.05. All analyses were done with SPSS software for the personal computer. The conclusion obtained from this studies were summarized as the following; 1. No statistically significances were noted in the thread pitch. and crest width in the four screws, and in the case of major diameter, the Impla-med screw was significantly smaller than the other three screws (p<0.05). Therefore, four implant bolts could be physically inserted in a abutment nuts. 2. The diameter of screw head was decreased in the order of Restore, 3i, Nobelpharma, Impla-med screws and the length of screws were decreased in the order of 3i, Restore, Nobelpharma and Impla-med. The diameter of neck was decreased in the order of Impla-med, Restore. Nobelpharma, 3i screws. The differences of each of these parameters were statistically significant (p<0.05). The width of root of screws were decreased in the order of Nobelpharma, Impla-med, Restore and 3i. The differences among Nobelpharma and Impla-med. Restore and 3i were statistically significant (p<0.05). 3. When the screws were loosening 1, 3, 4 and 5 times, the loosening torque for Impla-med and 3i screws were significantly higher than that of Nobelpharma or Restore screws (p<0.05). However, when statistically smaller than that of 3i, Restore or Nobelpharma screws(p<0.05).