• 대한치과보철학회지
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• 제45권3호
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• pp.345-353
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• 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.

• Journal of Periodontal and Implant Science
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• 제35권4호
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• pp.813-822
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• 2005

The predictable outcome of implant placement in the atrophic maxilla with sinus floor elevation procedure(osteotome sinus floor elevation technique and window opening technique) is well documented. Aim of this study was to evaluate the efficacy of $Br{\aa}nemark$ Ti-Unite implant system and ITI SLA implant system placed in the atrophic posterior maxilla with sinus floor elevation procedure. Eighty patients received placement of $Br{\aa}nemark$ Ti-Unite implants(195 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(153 osteotome sinus floor elevation technique and 42 window opening procedure). Fifty patients received placement of ITI SLA implants(83 implants) in their atrophic posterior Maxilla with sinus floor elevation procedure(77 osteotome sinus floor elevation technique and 6 window opening procedure). Chart review were taken from each patient. The total failed implants were seven and the total implant survival rate was 96.4% in $Br{\aa}nemark$ Ti-Unite system. The total failed implants were one and the total implant survival rate was 98.8% in ITI SLA system. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in $Br{\aa}nemark$ Ti-Unite system. The implant survival rate with osteotome technique was 98.7% and 100% with window opening. The implant survival rate with osteotome technique was 96% and 97.6% with window opening in ITI SLA system. The results of this evaluation show that the placement of $Br{\aa}nemark$ Ti-Unite system as well as ITI SLA system is a reasonable treatment option for patients with the atrophic posterior maxillary area.

• 구강회복응용과학지
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• 제27권2호
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• pp.175-184
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• 2011

Computer-guided system은 술 전에 임플란트 위치를 계획하고 이와 일치하도록 구강 내에 임플란트를 식립할 수 있게 하는 방법이다. 하지만 이렇게 임플란트를 식립한다 할지라도 실제 매식된 임플란트의 위치는 원래 계획하였던 위치와 차이가 있을 수 있다. 이 연구의 목적은 실제 임상에서 computer guided system을 이용하여 임플란트를 식립한 환자들의 경우 계획한 위치와 실제 식립된 임플란트 사이에 발생하는 변위량의 범위를 알아보고 그 임상적 적합성을 평가하는 것이다. 'NobelGuide' system (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden)을 이용하여 Br${\aa}$nemark MK III Groovy RP (Nobel Biocare AB, G$\ddot{o}$teborg, Sweden)임플란트 식립을 시행 받은 다섯 명의 환자를 선정하였다. 수술용 형판에 지대주 유사체를 연결한 후 술 전 측정 모형을 제작하였고 최종 보철물 제작 시 최종 인상을 채득하여 술 후 측정 모형을 제작하였다. 두 측정 모형의 CT 방사선 사진을 촬영 후 3차원적으로 재현하였고 재현된 모델 상에서 식립된 임플란트 위치를 지정하였다. 각 임플란트는 임플란트 경부와 첨단의 중심점을 연결하여 임플란트 축을 설정하였으며 두 축 간의 각도가 측정되었다. 임플란트 간 거리는 각 임플란트의 경부에서, 설정된 임플란트 축이 지나가는 중심점 간의 거리를 측정하였다. 총 5명 환자의 58개 부위의 임플란트 간 술 전과 술 후 임플란트 거리와 각도 변위량이 기록되었으며 평균 및 최대 변위값을 산출하였다. 술 전과 술 후 임플란트 위치 간 거리의 변위량은 평균 0.41 mm였고 최대 1.7 mm의 범위 하에 있었다. 술 전과 술 후 임플란트 간 위치의 각도의 변위량은 평균 $1.99^{\circ}$를 나타냈으며 최대 각도 변위량은 $6.7^{\circ}$를 나타내었다. 술 전 계획된 임플란트와 술 후 식립된 임플란트 간의 길이와 각도에 따른 평균 변위량은 computer-guided implant system을 실제 임상에 적용하는 데 있어 큰 문제가 존재하지 않고 '수동적 적합(passive fit)'을 얻기에 무리가 없을 허용 가능할 만한 값을 나타냈다.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.531-554
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• 2006

Oral implants must fulfill certain criteria arising from special demands of function, which include biocompatibility, adequate mechanical strength, optimum soft and hard tissue integration, and transmission of functional forces to bone within physiological limits. And one of the critical elements influencing the long-term uncompromise functioning of oral implants is load distribution at the implant- bone interface, Factors that affect the load transfer at the bone-implant interface include the type of loading, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface. To understand the biomechanical behavior of dental implants, validation of stress and strain measurements is required. The finite element analysis (FEA) has been applied to the dental implant field to predict stress distribution patterns in the implant-bone interface by comparison of various implant designs. This method offers the advantage of solving complex structural problems by dividing them into smaller and simpler interrelated sections by using mathematical techniques. The purpose of this study was to evaluate the stresses induced around the implants in bone using FEA, A 3D FEA computer software (SOLIDWORKS 2004, DASSO SYSTEM, France) was used for the analysis of clinical simulations. Two types (external and internal) of implants of 4.1 mm diameter, 12.0 mm length were buried in 4 types of bone modeled. Vertical and oblique forces of lOON were applied on the center of the abutment, and the values of von Mises equivalent stress at the implant-bone interface were computed. The results showed that von Mises stresses at the marginal. bone were higher under oblique load than under vertical load, and the stresses were higher at the lingual marginal bone than at the buccal marginal bone under oblique load. Under vertical and oblique load, the stress in type I, II, III bone was found to be the highest at the marginal bone and the lowest at the bone around apical portions of implant. Higher stresses occurred at the top of the crestal region and lower stresses occurred near the tip of the implant with greater thickness of the cortical shell while high stresses surrounded the fixture apex for type N. The stresses in the crestal region were higher in Model 2 than in Model 1, the stresses near the tip of the implant were higher in Model 1 than Model 2, and Model 2 showed more effective stress distribution than Model.

• 대한치과보철학회지
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• 제40권1호
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• pp.53-67
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• 2002

This study was aimed to analyze the stress distribution of implant and supporting tissue in single tooth implant restoration using Branemark $system^{(R)}$(Nobel Biocare, Gothenberg, Sweden) and Bicon system(Bicon Dental Implants, Boston, MA). Two dimensional finite element analysis model was made at mandibular first premolar area As a crown materials porcelain, ceromer, ADA type III gold alloy were used. Tests have been performed at 25Kgf vertical load on central fossa of crown portion and at 10Kgf load with $45^{\circ}$ lateral direction on cusp inclination. The displacement and stresses of implant and supporting structures were analyzed to investigate the influence of the crown material and the type of implant systems by finite element analysis. The results were obtained as follows : 1. The type of crown material influenced the stress distribution of superstructure, but did not influence that of the supporting alveolar bone. 2. The stress distribution of ceromer and type III gold alloy and porcelain is similar. 3. Stress under lateral load was about twice higher than that of vertical load in all occlusal restorative materials. 4. In Bicon system, stress concentration is similar in supporting bone area but CerOne system generated about 1.5times eater stress more in superstructure material. 5. In Branemark models, if severe occlusal overload is loaded in superstvucture. gold screw or abutment will be fractured or loosened to buffer the occlusal overload but in Bicon models such buffering effect is not expected, so in Bicon model, load can be concentrated in alveolar bone area.

• 대한치과보철학회지
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• 제42권2호
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• pp.210-225
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• 2004

Statement of problem: Implant screw loosening has been remained problem in restorative practices. Surface treatment of screw plays a role of preventing screw from loosening in implant screw mechanism. Purpose : The purpose of this study was to investigate surface characteristics of TiN and ZrN film ion plated screw with titanium and gold alloy screw and to evaluate wear resistance, surface roughness, and film adhesion on screw surface using various instruments. Material and methods : GoldTite screws and titanium screws provided by 3i (Implant Innovation, USA) and TorqTite screws or titanium screws by Steri-Oss (Nobel Biocare, USA) and gold screws and titanium screws by AVANA (Osstem Implant, korea) were selected. Ion plating which is much superior to other surface modification techniques was carried out for gold screws and titanium screws using Ti and Zr coating materials with nitrogen gas. Ion nitrided surface of each abutment screw was observed with field emission scanning electron microscopy (FE-SEM, micro-diamond scratch tester, vickers hardness tester, and surface roughness tester. Results : 1) The surface of gold screw and GoldTite is more smooth than ones of other kinds of non coated screw. 2) The ZrN and TiN coated surface is the more smooth than ones of other kinds of screw. 3) The hardness of TiN and ZrN coated surface showed higher than that of non coated surface. 4) The TiN coated titanium screw and ZrN coated gold screw have a good wear resistance and adhesion on the surface. 5) The surface of ZrN coated screw showed low surface roughness compared with the surface of TiN coated screw. Conclusion : It is considered that the TiN and ZrN coated screw which would prevent a screw from loosening can be applicable to implant system and confirmed that TiN and ZrN film act as lubricant on surface of screw due to decrease of friction for recycled tightening and loosening.

• The Journal of Advanced Prosthodontics
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• 제11권6호
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• pp.350-357
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• 2019

PURPOSE. This study aims to evaluate the loosening torque on the implant fixture, and to assess the accuracy of difference electronic torque drivers. MATERIALS AND METHODS. Three electronic torque drivers were used to measure the loosening torque on the implant system (AnyOne; MegaGen). The implant fixtures were divided among the 3 electronic torque driver types (W&H, SAESHIN, and NSK group) and 9 for each group. The screws were fastened at the implant fixture by three electronic torque drivers using the tightening torques recommended by the manufacturers of the drivers. After 10 minutes, the screws were again fastened at the implant fixture with equal torque. Then, the loosening torques were measured with an MGT12 torque gauge (MARK-10, Inc.). This measurement procedure was repeated 10 times under loosening torques of 15 Ncm, 25 Ncm, and 35 Ncm. In the statistical analysis, all values of loosening torque were analyzed with the one-way ANOVA and Kruskal-Wallis test (α=.05) for comparative evaluation. RESULTS. There were significant inter-group differences at loosening torques of 15 Ncm and 25 Ncm (P<.05). The accuracy of the NSK driver was the highest, followed by SAESHIN and W&H. There was no significant difference between NSK and W&H at 35 Ncm (P>.05). The SAESHIN driver showed the closest loosening torque at 35 Ncm. CONCLUSION. The most accurate loosening torques were SAESHIN at 35 Ncm, and NSK at 15 Ncm and 25 Ncm. Since the loosening torque may vary depending on the tightening torques and electronic torque drivers, periodic calibration of the electronic torque driver is recommended.

• Journal of Periodontal and Implant Science
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• 제37권3호
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• pp.523-534
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• 2007

This study is an analysis of types of patients and distribution of implant site and survival rate of $Xive^{(R)}$ implant. The following results on patient type, implant distribution and survival rate were compiled from 324 implant cases of 140 patients treated at the periodontal dept. of Yonsei University Hospital and G dental clinic between February 2003 and April 2006. 1. There are no dissimilarities between men and women, with patients in their 30, 40, 50s accounting for 80% of patients and accounted for 82% of implant treatments; the largest share of patients and implant treatments. 2. Mn, posterior area. accounted for 57% of implant treatments followed by Mx. posterior area(29%), Mx, anterior area(8%) and Mn, anterior area(6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 96% and fully edentulous patient accounted for the remaining 4%. 4. The major cause of tooth loss is periodontal disease, followed by dental canes, trauma and congenital missing. 5, The distribution of bone quality for maxillae was 54,2% for type III, followed by 30.8% for type II, 15% for type IV and 0% for type I. As for mandible, the distribution was 63% for type II, followed by 34% for type III, 2,5% for type I and 0,5% for type IV. 6. The distribution of bone quantity for maxillae was 55% for type C, followed by 35% for type B, 8% for type D and 2% for type A. As for mandible, the distribution was 60% for type B, followed by 32% for type C, 7% for type A and 0% for type D. 7. The majority of implants were those of 9.5-13 mm in length(95%) and regular diameter in width(82%). 8. The total survival rate was 98%. The survival rate was 97% in the maxillae region and 99% in the mandible region. 9. The survival rate in type I was 83%, in type II was 99%, in type III was 97% and in type IV was 100%. As for the bone quantity, the survival rate in type A and D(100%) was most, followed by type B(99%) and type C(96%). The results showed that $Xive^{(R)}$ implant could be used satisfactorily compare for the other implant system. But we most to approach carefully in certain extreme condition especially with poor bone quality and quantity.

• The Journal of Advanced Prosthodontics
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• 제3권4호
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• pp.229-235
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• 2011

PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.

• 대한치과보철학회지
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• 제57권3호
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• pp.312-320
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• 2019

디지털 방식을 이용한 치과 임플란트 진료에서 가장 주목받는 분야 중 하나가 디지털 소프트웨어와 컴퓨터 단층촬영을 이용하여 수술용 스텐트를 제작, 임플란트를 식립하는 분야이다. 컴퓨터를 이용한 디지털 임플란트 치료계획 시스템과 이를 이용한 수술용 가이드는 예지성과 심미성, 기능성을 갖춘 임플란트의 식립과 수복을 가능하게 한다. 특히 이러한 가이드 수술은 임플란트 수복물의 형태와 기능을 고려한 임플란트의 식립 시 더욱 유리하다. 최근 여러 제조사에서 보철물 제작을 위해 치과용 스캔부터 제작방법까지 다양한 디지털 방식의 제작과정을 제시하고 있다. 이러한 방법들은 정확하고 예지성 있는 예후를 위해 여러 연구자들에 의해 연구되어지고 있으며, 점차 발전하고 있다. 이번 증례는 완전무치악의 여성 환자에서 임플란트 고정성 보철물을 이용한 수복증례이다. 하악은 all-on-four 방식을 적용하여 4개의 임플란트를 식립하였으며, 상악은 이에 기초하여 6개의 임플란트를 식립하였다. 최종보철물에 기초한 임플란트의 식립을 위해 임플란트 수술용 스텐트를 이용하였으며, 환자는 치료 결과에 만족하였으며, 5년 추적관찰 결과, 임플란트와 보철물 모두 안정적으로 유지되고 있다.