Journal of Dental Rehabilitation and Applied Science
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v.26
no.2
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pp.179-195
/
2010
In the internal connection system, the loading transfer mechanism within the inner surface of the implant and also the stress distribution occuring to the mandible can be changed according to the abutment form. Therefore it is thought to be imperative to study the difference of the stress distribution occuring at the mandible according to the abutment form. The purpose of this study was to assess the loading distributing characteristics of three different abutments for GS II$^{(R)}$ implant fixture(Osstem, Korea) under vertical and inclined loading using finite element analysis. Three finite element models were designed according to three abutments; 2-piece Transfer$^{TM}$ abutment made of pure titanium(GST), 2-piece GoldCast$^{TM}$ abutment made of gold alloy(GSG), 3-piece Convertible$^{TM}$ abutment with external connection(GSC). This study simulated loads of 100N in a vertical direction on the central pit(load 1), on the buccal cusp tip(load 2) and $30^{\circ}$ inward inclined direction on the central pit(load 3), and on the buccal cusp tip(load 4). The following results were obtained. 1. Without regard to the loading condition, greater stress was concentrated at the cortical bone contacting the upper part of the implant fixture and lower stress was taken at the cancellous bone. 2. When off-axis loading was applied, high stress concentration observed in cervical area. 3. GSG showed even stress distribution in crown, abutment and fixture. GST showed high stress concentration in fixture and abutment screw. GSC showed high stress concentration in fixture and abutment. 4. Maximum von Mises stress in the surrounding bone had no difference among three abutment type. In GS II$^{(R)}$ conical implant system, different stress distribution pattern was showed according to the abutment type and the stress-induced pattern at the supporting bone according to the abutment type had no difference among them.
Journal of Dental Rehabilitation and Applied Science
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v.24
no.3
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pp.269-281
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2008
Fatigue or overload can result in mechanical problems of implant components. The mechanical strength in the implant system is dependent on several factors, such as screw and fixture diameters, material, and design of the fixture-abutment connection and abutment. In these factors, the last rules the strength and stability of the fixture-abutment assembly. There have been some previous reports on the mechanical strength of the fixture-abutment assembly with the compressive bending test or short-term cyclic loading test. However, it is restrictive to predict the long-term stability of the implant system with them. The purpose of this study was to evaluate the influence of the design of the fixture-abutment connection and abutment on the mechanical strength and failure mode by conducting the endurance limit test as well as the compressive bending strength test. Tests were performed according to a specified test(ISO/FDIS 14801) in 4 fixture-abutment assemblies of the Osstem implant system: an external butt joint with Cemented abutment (group BJT), an external butt joint with Safe abutment (group BJS), an internal conical joint with Solid abutment (group CJO), and an internal conical joint with ComOcta abutment (group CJT). The following conclusions were drawn within the limitation of this study. Compressive bending strengths were decreased in order of group BJS(1392.0N), group CJO(1261.8N), group BJT(1153.2N), and group CJT(1110.2N). There were no significant differences in compressive bending strengths between group BJT and group CJT(P>.05). Endurance limits were decreased in order of group CJO(600N), group CJT(453N), group BJS(360N), and group BJT(300N). 3. Compressive bending strengths were influenced by the connection and abutment design of the implant system, however endurance limits were affected more considerably by the connection design.
Several types of attachments have been used for implant supported and/or retained overdentures. Locator is one of the stud type attachments and it has been generally used. However, the colored matrix is resilient and vulnerable to wear, so frequent post-insertion maintenance is needed. To solve this problem, it is necessary to introduce innovative attachment system. Overdentures using Air Gap attachment (AGA) has improved masticatory function and facial esthetics. AGA is made of metal, so it could be more resistant to wear or friction than the other resilient attachments. Nevertheless, AGA plays a role in stress breakers because it allows movement during denture movement with predetermined gap. In addition, both pre-existing implants and natural teeth were successfully used for connection of AGA. AGA could replace other unsplinted type of attachments. Overdentures using AGA could provide satisfactory result in terms of function, esthetics and retention. However, long term follow up is needed.
Journal of Dental Rehabilitation and Applied Science
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v.25
no.3
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pp.243-253
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2009
This report described a technique utilizing a computer-aided design (CAD) /computer-aided machining (CAM) - guided surgical implant placement and prefabricated fixed complete denture for an immediately loaded restoration. A patient with an edentulous maxilla and mandible received 6 implants in maxilla and 6 implants in the mandible using CAD/CAM surgical templates. Prefabricated provisional maxillary and mandibular implant supported fixed prostheses were connected immediately after implant installation. Provisional prostheses were evaluated for aesthetics, function during 6 months. Definitive prostheses were fabricated.
Kim, Kun Min;Oh, Kyung Chul;Kim, Sang Hyun;Han, Chol Gwan;Kim, Jee Hwan
The Journal of Korean Academy of Prosthodontics
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v.59
no.4
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pp.442-450
/
2021
The CAD-CAM technique is a rapidly developing field in the dental field and is applied to various fields of prosthetic treatment. Among them, the manufacturing of dentures using the milling technique classified as subtractive manufacturing is one of the commercialized digital full denture manufacturing methods. At the same time, it is possible to more efficiently manufacture a metal framework for implant overdenture by selective laser sintering or melting technique classified as an additive manufacturing method. The purpose of this article is to describe the fabrication of CAD-CAM maxillary complete denture and mandibular implant overdenture as well as its features.
Statement of problem: Repeated delivery and removal of abutment cause some changes such as wear, scratch or defect of hexagonal structure. It may increase the value of rotational freedom(RF) between hexagonal structures. Purpose: The purpose of this study was to evaluate surface changes and rotational freedom between the external hexagon of the implant fixture and internal hexagon of abutment after repeated delivery and removal under SEM and toolmaker's microscope. Materials and methods: Implant systems used for this study were 3i and Avana. Seven pail's of implant fixture, abutment and abutment screws for each system were selected and all fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. Each one was embedded beneath the platform of fixture. Surfaces of hexagonal structure before repeated closing and opening of abutment were observed using SEM and rotational freedom was measured by using toolmaker's microscope. Each abutment was secured to the implant future by each abutment screw with recommended torque value using a digital torque controller and was repeatedly delivered and removed by 20 times respectively. After experiment, evaluation for the change of hexagonal structures and measurement of rotational freedom were performed. Result : The results were as follows; 1. Wear of contact area between implant fixture and abutment was considerable in both 3i and Avana system. Scratches and defects were frequently observed at the line-angle of hexagonal structures of implant fixture and abutment. 2. In the SEM view of the external hexagon of implant fixture, the point-angle areas at the corner edge of hexagon were severely worn out in both systems. It was more notable in the case of 3i systems than in that of Avana systems. 3. In the SEM view of the internal hexagon of abutment, Gingi-Hue abutment of 3i systems showed severe wear in micro-stop contacts that were machined into the corners to prevent rotation and cemented abutment of Avana systems showed wear in both surface area adjacent to the corner mating with external hexagon of implant fixture. 4 The mean values of rotational freedom between the external hexagon of the implant fixture and internal hexagon of abutment were 0.48$\pm$0.04$^{\circ}$ in pre-tested 3i systems and 1.18$\pm$0.25$^{\circ}$ after test, and 1.80$\pm$0.04$^{\circ}$ in pre-tested Avana systems and 2.61$\pm$0.16$^{\circ}$ after test. 5. Changes of rotational freedom after test shouted statistical)y a significant increase in both 3i and Avana systems(P<0.05, paired t-test). 6. Statistically, there was no significant difference between amount of increase in the rotational freedom of 3i systems and amount of increase in that of Avana ones(P>0.05, unpaired t-test). Conclusion: Conclusively, it was considered that repeated delivery and remove of abutment by 20 times would not have influence on screw joint stability. However, it caused statistically the significant change of rotational freedom in tested systems. Therefore, it is suggested that repeated delivery and remove of abutment should be minimal as possible as it could be and be done carefully Additionally, it is suggested that the means or treatment to prevent the wear of mating components should be devised.
Purpose: The aim of this study is to analyze and visualize the distribution of patients visiting the periodontology department at a dental college hospital, using a geographic information system (GIS) to utilize these data in patient care and treatment planning, which may help to assess the risk and prevent periodontal diseases. Methods: Basic patient information data were obtained from Dankook University Dental Hospital, including the unit number, gender, date of birth, and address, down to the dong (neighborhood) administrative district unit, of 306,656 patients who visited the hospital between 2007 and 2014. The data of only 26,457 patients who visited the periodontology department were included in this analysis. The patient distribution was visualized using GIS. Statistical analyses including multiple regression, logistic regression, and geographically weighted regression were performed using SAS 9.3 and ArcGIS 10.1. Five factors, namely proximity, accessibility, age, gender, and socioeconomic status, were investigated as the explanatory variables of the patient distribution. Results: The visualized patient data showed a nationwide scale of the patient distribution. The mean distance from each patient's regional center to the hospital was $30.94{\pm}29.62km$ and was inversely proportional to the number of patients from the respective regions. The distance from a regional center to the adjacent toll gate had various effects depending on the local distance from the hospital. The average age of the patients was $52.41{\pm}12.97years$. Further, a majority of regions showed a male dominance. Personal income had inconsistent results between analyses. Conclusions: The distribution of patients is significantly affected by the proximity, accessibility, age, gender and socioeconomic status of patients, and the patients visiting the periodontology department travelled farther distances than those visiting the other departments. The underlying reason for this needs to be analyzed further.
This study was conducted to provide with baseline data with the purpose of increasing the values of medical services. Self-administered questionnaire survey was conducted on 236 patients at a dental clinic follow-up visit in dentist clinic Gyeongnam area from June 2013 to August 2013. All statistical analyses were performed using SPSS. The motivation visiting the dental clinic is that the first one is introduction from the family and friends, the second is accessibility, the third is conspicuity and the last one is awareness of the dentist. The main variables in the process of treatment are service system, kindness, satisfaction of service, efficient of re-call system. The relief of discomfort at revisit show the highest score in the process of implant treatment and intention of revisit hereafter do in the prostheses process. In the correlation between main variables, service system and relief of discomfort at revisit (r=0.440, p<0.001), kindness and satisfaction of medical service (r=0.675, p<0.001), revisit hereafter and satisfaction of service (r=0.387, p<0.001) and efficiency of re-call system and revisit showed the highest correlation. The influence on satisfaction of dental service show meaningful level in kindness (p<0.001) and efficiency of re-call system (p<0.05). The intention of revisit is affected meaningfully by relief of uncomfort (p<0.05), service system (p<0.05), kindness (p<0.01) and efficiency of re-call system (p<0.01). In summary, the personal network of patients is most important variable at intention for revisit of dental clinic. As satisfaction of kindness and efficiency of re-call system is higher, satisfaction of medical service and intention for revisit are shown higher. Therefore further research for improvement of satisfaction for medical service and of intention of revisit at the dental clinic should be carried out.
Bone density is one of the factors in the early failure of dental implants and doctors should make a preoperative assessment of jaw bone density using patient's CT data before dental implant surgery in order to find out whether the patient has osteoporosis and osteopenia. The main goal of this study was to propose a method that based on image processing techniques in order to provide accurate information about where to drill and place an abutment screw of implants in the jaw bone for doctors and reduce human activity for the estimation of the local cancellous bone density of mandible using CT data. The experiment was performed on a computed tomography data of the jaw bone of two different individuals. We assumed that the result of the estimation of jaw bone density depends on the angle of drilling and average HU (Hounsfield Unit) values were used to evaluate the quality of local cancellous bone density of mandible. As a result of this study, we have been developed a toolbox that can be used to estimate jaw bone density automatically and found a positive correlation between the angle of the drill and time complexity but a negative correlation between the diameter of the drill and time complexity.
Purpose: The purpose of this study is to compare the removal torque between prefabricated and customized implant abutment screw. Materials and methods: Three types of implant system (Osstem, Astra, Zimmer) were used. For each system, prefabricated abutment screw (control group) and customized abutment screw (test group) were used to connect the fixture and the abutment (n = 6). Digital torque gauze was used to control the tightening torque and the screws were tightened under each manufacturer's recommendation. 10 minutes after the connection the same tightening torque was applied, and 5 minutes after the second connection, the removal torque was measured. This procedure was repeated 10 times. In the cyclic loading test, 10 minutes after the first connection to the 6 groups (n = 3), the same tightening torque was applied, and a total of 1,000,000 time loading was applied at 30 degree angle to long axis with 50 N load. Repeated measures of ANOVA test (${\alpha}$=.05) was used as statistics to evaluate the effect of repeated loading number on the removal torque. Independent t-test was used to evaluate the difference in removal torque after cyclic loading. Results: The removal torque significantly decreased as the number of loading repetition increased (P<.05). In the 10 time repetition test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Also in the cyclic loading test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Conclusion: Within the limitation of this study, there was no significant difference in the removal torque between the prefabricated abutment screw and customized abutment screws.
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