• The Journal of Advanced Prosthodontics
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• 제10권6호
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• pp.415-421
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• 2018

PURPOSE. This study investigated the effects of abutment screw lengths on screw loosening and removal torque in external connection implants after oblique cyclic loading. MATERIALS AND METHODS. External connection implants were secured with abutment screws to straight abutments. The abutment-implant assemblies were classified into seven groups based on the abutment screw length, with each group consisting of five assemblies. A cyclic load of 300 N was applied at a $30^{\circ}$ angle to the loading axis until one million cycles were achieved. Removal torque values (RTVs) before and after loading, and RTV differences were evaluated. The measured values were analyzed using repeated measures of analysis of variance with the Student-Newman-Keuls multiple comparisons. RESULTS. All assemblies survived the oblique cyclic loading test without screw loosening. There was a significant decrease in the RTVs throughout the observed abutment screw lengths when the abutment-implant assemblies were loaded repeatedly (P<.001). However, the abutment screw length did not show significant difference on the RTVs before and after the experiment when the abutment screw length ranged from 1.4 to 3.8 mm (P=.647). CONCLUSION. Within the limit of this experiment, our results indicate that the abutment screw length did not significantly affect RTV differences after oblique cyclic loading when a minimum length of 1.4 mm (3.5 threads) was engaged. These findings suggest that short abutment screws may yield stable clinical outcomes comparable to long screws in terms of load resistance.

• 대한치과기공학회지
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• 제43권2호
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• pp.42-47
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• 2021

Purpose: The purpose of this study was to evaluate the stability of abutment screws used with the zirconia fixture-based implant system and compare them with those used with the existing titanium fixture system via the finite element method. Methods: A single implant-supported restoration was designed for the finite element analysis. A universal analysis program was used to set 8 occlusal points along the direction to the long axis of the implant, and an occlusal load of 700 N was applied. Results: In all models (Zir and Ti-fixture model), the screw threads presented with the highest von Mises stress (VMS) values, whereas the head and end presented with the lowest VMS values. The VMS of the screw used in the zirconia-fixture model was 5.97% lower than that used in the titanium-fixture model (261.258 vs. 276.911 MPa, respectively) despite statistical significance. Furthermore, the zirconia fixture (352.912 MPa) had a higher stress value (8.42%) than the titanium fixture (332.331 MPa). In a completely tightened titanium fixture implant system, the stress was concentrated in the implant-abutment connection interface, the zirconia fixture presented with a stable stress distribution. Conclusion: Although the zirconia fixture demonstrated a high VMS value, owing to the stiffness and elasticity coefficients of the material, the stress generated in the abutment screws was similar in all models. In conclusion, the zirconia fixture-based implant system presented with a more stable stress distribution in the abutment screws than the titanium fixture-based implant system.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권2호
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• pp.133-142
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• 2020

Objectives: In this study, we determined the incidence and pattern of screw loosening in patients who received dental implants. Materials and Methods: Patients who received implants between January 2008 and October 2013 and completed their prosthetic rehabilitation were evaluated for the incidence, frequency, and onset of screw loosening using dental charts and radiographs. The association between each factor and screw loosening was analyzed using the chi-square test and a multivariate analysis with binary logistic regression models (P<0.05). Results: Total 1,928 implants were placed in 837 patients (448 males, 389 females), whose follow-up period after loading varied from 0.25 to 70 months (mean period, 31.5 months). Screw loosening occurred in 7.2% of implants. Most cases occurred less than six months after loading. Among those, 22.3% experienced recurrent screw loosening. Screw loosening was most common in the molar region (8.5%) and frequently associated with an implant diameter of ≥5 mm (14.2%). External implant-abutment connections (8.9%) and screw-retained implant prostheses (10.1%) showed higher incidence of problems than internal implant-abutment connections and cement-retained implants, respectively. Screw loosening was most common in implant prostheses with single crowns (14.0%). Conclusion: Within the limits of the current study, we conclude that the incidence of screw loosening differs significantly according to the position of implant placement, the type of implant and manufacturer, implant diameter, the type of implant-abutment connection, the type of retention in the implant prosthesis, and the type of implant prosthesis.

• 대한치과의사협회지
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• 제53권9호
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• pp.644-655
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• 2015

Purpose: This study was conducted to evaluate the effect of the fixture abutment connection type and diameter on the screw joint stability in external butt joint for 2nd surgery and internal cone connected type implant system for 1st and 2nd surgery using ultimate fracture strength. Materials and Methods: USII system, SSII system and GSII system of Osstem Implant were used. Each system used the fixture with two different diameters and cement-retained abutments, and tungsten carbide / carbon coated abutment screws were used. Disc shaped stainless steel metal tube was attached using resin-based temporary cement. The experimental group was divided into seven subgroups, including the platform switching shaped specimen that uses a regular abutment in the fixture with a wide diameter in USII system. A static load was increased to the metal tube at 5mm deviated point from the implant central axis until it reached the compression bending strength at a rate of 1mm/min. Then the deformations and patterns of fracture in threaded connection were compared. Results and Conclusion: 1. In the comparison between the Regular diameter, compression bending strength of SSII system was higher than USII system and GSII system. There was no significant difference between USII system and GSII system. 2. In the comparison between wide diameter, compression bending strength was increased in the order of GSII system, USII system, and SSII system. 3. In comparison between the implant diameter, compression bending strength of the wide diameter was greater than the regular diameter in any system(P<0.05). 4. There was no significant difference between the platform switching (III group) and the regular diameter (I group) in USII system. 5. In USII system, fracture of abutment screw and deformation of both fixture and abutment were observed in I, II and III subgroups. 6. Failure pattern of SSII system, which was the fracture of abutment screw and deformation of the abutment and fixture, was observed in both IV and V subgroups. Fracture of some fixtures was observed in subgroup V. 7. Failure pattern of GSII system, which was the fracture of the abutment screw and deformation of the fixture and the abutment, was observed in both VI and VII subgroups. Apart from other subgroups, subgroup VII demonstrated no bending neither the fracture at the top of the fixture. The compressive deformation of internal slope in the fixture was the only thing observed in subgroup VII.

• The Journal of Advanced Prosthodontics
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• 제14권1호
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• pp.22-31
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• 2022

PURPOSE. The purpose of this study was to investigate the misfit and screw preload at the implant abutment connection of implant supported fixed dental prosthesis with cantilever (ICFDP) manufactured using different digital manufacturing techniques and to compare the screw preload before and after cyclic loading. MATERIALS AND METHODS. Mandibular jaw model with four intra-foraminal implants was scanned using digital scanner. Stereolithography file was used to design a framework with nonengaging (NE) abutments and 10 mm cantilever distal to one terminal implant. Five frameworks were constructed using combined digital-conventional techniques (CAD-cast), and five frameworks were constructed using three-dimensional printing (3DP). Additional CAD-cast framework was constructed in a way that ensures passive fit (PF) to use as control. Scanning electron microscope (SEM) measured the implant abutment connection misfit. Sixty screws were used on the corresponding frameworks. Screws were torqued and pre-cyclic loading reverse torque value (RTV) was recorded. Frameworks were subjected to 200,000 loading cycles with a loading point 9 mm from the center of terminal implants adjacent to the cantilever and post-cyclic loading RTVs were recorded. RESULTS. Microscopic readings showed significant differences between frameworks. PF demonstrated the lowest measurements of 16.04 (2.6) ㎛ while CAD-cast demonstrated the highest measurements of 29.2 (3.1) ㎛. In all groups, RTVs were significantly lower than the applied torque. Post-cyclic loading RTV was significantly lower than pre-cyclic loading RTV in PF and 3DP frameworks. Differences in RTVs between the three manufacturing techniques were insignificant. CONCLUSION. Although CAD-cast and three-dimensionally printed (3DP) both produce frameworks with clinically acceptable misfit, 3DP might not be the technique of choice for maintaining screw's preload stability under an aggressive loading situation.

• The Journal of Advanced Prosthodontics
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• 제11권2호
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• pp.105-111
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• 2019

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with $0.7{\mu}L$ of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (${\alpha}=.05$). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in ${\mu}m$) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.

• 구강회복응용과학지
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• 제24권1호
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• pp.77-89
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• 2008

이 연구의 목적은 원추형 내측 연결 임플랜트 시스템에서 하중조건에 따른 지대주의 침하 및 적합도를 평가하는 것이다. 본 연구에서는 내부 원추형 연결방식의 Alloden implant system (Nei Corp. Korea)의 고정체와 2종류(conventional, FDI)의 지대주를 사용하였다. 임상에서 Alloden 임플랜트는 지대주와 고정체 연결시 처음에 손으로 지긋이 눌러 고정시킨 후 mallet을 이용하여 약 3회정도 타격을 가하여 고정한다. 이때 타격시의 정확한 힘을 측정하여 각 실험군에 적용시켰다. 적용 횟수는 손가락으로 누르는 힘을 1회, mallet으로 타격하는 힘을 3회, 저작력으로 가정한 20kg의 힘을 지대주의 침하가 생기지 않을때까지 각각의 표본에 적용하였다. 그 후 각 단계에 대한 지대주의 침하량을 Vernier caliper를 이용하여 측정하였다. 임플랜트는 불포화 폴리에스터(Epovia, Cray Valley Inc. Korea)에 매몰하여 중합시켰고 모든 표본을 절삭한 후 연마하여 주사전자현미경을 통하여 분석, 평가하였다.

• 대한치과의사협회지
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• 제53권11호
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• pp.804-816
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• 2015

PURPOSE: The aim of this study was to evaluate the influence of the oxide layer removal process in the Co-Cr-Mo (CCM) abutment after casting procedure on the prosthesis settlement and screw stability. MATERIALS AND METHODS: CCM abutments of four different interface conditions (CCM-M; machined, CCM-O; oxide layer formed, CCM-B; blasted, CCM-P; polished after blasted) and gold abutment (Gold-C; Cast with type III Gold alloy) were used. The initial settling values of abutments were evaluated according to the difference of implant-abutment length when the tightening torques were applied at 5 Ncm and 30 Ncm, and the settling values of abutments caused by loading were evaluated according to the difference of implant-abutment length before and after loading with 250 N, 100000 cycle. The loss ratios of removal torque for abutment screws were evaluated according to the difference in value of removal torques under 30 Ncm tightening torque applied before and after cyclic loading. RESULTS: The CCM-P and CCM-B group showed a higher initial settling value compared with the Gold-C group (P<.05), while the Gold-C group showed the highest settling values caused by loading (P<.05) and no significant differences were observed for between CCM groups (P>.05). The loss ratio of removal torque values for the CCM-B, CCM-P groups did not differ significantly from that of the Gold-C group (P>.05). CONCLUSION: Even though the oxide layer was removed by different methods, CCM abutment with internal conical connection structure showed lower abutment settling and similar screw loosening after cyclic loading compared with gold abutment.

• 대한치과의사협회지
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• 제54권3호
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• pp.198-205
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• 2016

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

• The Journal of Advanced Prosthodontics
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• 제13권1호
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• pp.46-54
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• 2021

Purpose. The design of the implant-abutment complex is thought to be responsible for marginal bone loss (MBL) and might affect the condition of the peri-implant tissues. This the present study aimed to evaluate the influence of the implant-abutment complex on MBL and the peri-implant tissues in partially edentulous patients treated with dental implants and determine the most advantageous design. Materials and Methods. A total of ninety-one endosseous implants with different designs of implant-abutment complex [tissue level-TL (n = 30), platform switch-PS (n = 18), and platform match-PM (n = 43)] were reviewed for MBL, Probing Pocket Depth (PPD) and Bleeding on Probing (BoP). MBL was calculated for first year of the insertion and the following years. Results. The median MBL for the PM implants (2.66 ± 1.67 mm; n = 43) in the first year was significantly higher than those for the other types (P=.033). The lowest rate of MBL (0.61 ± 0.44 mm; n = 18) was observed with PS implants (P=.000). The position of the crown-abutment border showed a statistically significant influence (P=.019) and a negative correlation (r=-0.395) on MBL. BoP was found significantly higher in PM implants (P=.006). The lowest BoP scores were detected in PS implants, but the difference was not significant (P=.523). The relation between PPD and connection type revealed no statistically significant influence (P>.05). Conclusion. Within the limitations of the present study, it may be concluded that PS implants seem to show better peri-implant soft tissue conditions and cause less MBL.