• 대한치과보철학회지
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• 제50권4호
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• pp.243-248
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• 2012

연구 목적: 본 연구의 목적은 임플란트 지대주 연결에 사용되는 기성품 나사와 맞춤형 나사의 풀림 토크를 비교하는 것이다. 연구 재료 및 방법: 세가지 임플란트 시스템에(Osstem, Astra, Zimmer) 대해 고정체와 지대주의 연결에 기성품 나사군(대조군)과 맞춤형 나사군(실험군)으로 총 6군(n = 6)으로 나누었다. 조임 토크조절은 디지털 토크 측정기를 이용하였으며 각 임플란트 제조사가 추천한 조임 토크 값을 적용하였다. 체결 10분 후 동일한 조임 토크를 다시 적용하고 5분 후에 풀림 토크력을 측정하였다. 이 과정을 10회 반복 측정하였다. 반복 하중 실험에서는 6개 군(n = 3)에 대해 체결 10분 후 2차 조임 토크를 적용하고 $30^{\circ}$ 경사로 50 N 하중으로 총 1,000,000번 반복 하중을 가하였다. 반복 하중 적용 이후 풀림 토크값을 측정하였다. 통계 방법으로는 10회 반복 측정에서 풀림 토크값의 차이를 비교하기 위해 repeated measures of ANOVA test (${\alpha}$=.05)를 사용하였고, 반복 하중 후 풀림 토크값의 차이를 비교하기 위해서 각 시스템별 Independant t-test로 통계 처리하였다. 결과: 모든 군에서 반복 횟수가 증가할수록 풀림 토크값이 유의성 있게 감소하는 것으로 나타났다(P<.05). 10회 반복 측정 실험에서는 세 종류의 임플란트에서 대조군(기성품나사)과 실험군(맞춤형 나사) 간에 풀림 토크값은 유의차가 없었다(P>.05). 반복 하중 실험에서 세가지 시스템에서 대조군과 실험군 간의 풀림 토크력은 유의한 차이가 없었다(P>.05). 결론: 반복 측정된 풀림력 검사와 반복 하중을 적용 후 풀림력 검사에서 맞춤형 나사와 기성품 나사의 풀림력은 유의한 차이가 없었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제38권
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• pp.31.1-31.7
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• 2016

Background: The objective of this retrospective study was to show results from platform-switched narrow-diameter implants in the posterior edentulous region, which we followed up for more than 1 year after functional loading. Methods: Ninety-eight narrow implants were inserted into 66 patients. After healing, fixed implant-supported prostheses were delivered to the patients, and Periotest and radiographic examinations were performed. After the first year of loading, the implant outcome was again evaluated clinically and radiographically using the Periotest analysis. Crestal bone loss and Periotest values (PTVs) were used to evaluate the effect of surgery, prosthesis, implant, and a host-related factor. A general linear model was used to statistically detect variables statistically associated with crestal bone loss and Periotest value. Results: We followed up on the implants over 1 to 4 years after loading; their survival rate was 100 %, and pronounced differences from PTVs were noted among jaw location, bone quality, and loading period. No difference was detected in bone loss among the variables studied. Bone loss after functional loading was $0.14{\pm}0.39mm$. The stability value from the Periotest was $-3.29{\pm}0.50$. Conclusions: Within the limitations of this study, judicious use of platform-switched narrow implants with a conical connection must be considered an alternative for wide-diameter implants to restore a posterior edentulous region.

• 대한치과의사협회지
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• 제49권2호
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• pp.77-84
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• 2011

The benefits of implant supported overdenture are readily apparent for the fully edentulous patients and have been well documented, however, there is deficiency of the studies regarding the combination of implants with removable partial dentures for partially edentulous patients. The purpose of this article is to review the literature concerning implants with removable partial dentures and evaluate the evidence for this clinical approach. Through many clinical case reports and studies we have searched from a broad variety of journals, we present the six considerations needed to contemplate respecting implants with removable partial denture in partially edentulous patients. First, the connection between abutment tooth and removable partial denture has to be rigid and the link between implant and removable partial denture should be hinged. Second, a mesial rest acts better in the point of force distribution for distal extension removable partial denture and splinting between implants is also a favorable choice. Third, T bar has an advantage for implants which are used as abutments in distal extension removable partial denture. Forth, as we all known functional impression is better way to reproduce movement for distal extension removable partial denture. Fifth, indirect retainer and guiding plane on the proximal surfaces of terminal abutment teeth are important in preventing denture base lifting. Sixth, implants in conjunction with removable partial denture is superior in the esthetic and phonetic as well as cost-effective point of view. We also suggest that which place we should install implants for force distribution and which diameter and length of implants should be used. in this review article, we recommend to locate the implant near of the abutment tooth for esthetics or near of first molar position for good stress distribution. The diameter and length of implant also influence to stress distribution. When we compare to conservative partial denture, patients go for removable partial denture using implants due to convenience, better support and retention according to several studies. But it is true that we need to study more on this subject and collect long term follow up cases before we discuss on it. So it is enough to bring this subject into the surface of prosthetic treatment by this article.

• 대한치과보철학회지
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• 제44권4호
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• pp.421-431
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• 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.

• 대한치주과학회:학술대회논문집
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• 대한치주과학회 2007년도 제47회 종합학술대회 연제초록
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• pp.184-185
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• 2007

• 구강회복응용과학지
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• 제38권2호
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• pp.97-109
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• 2022

목적: 3년 이상 기능한 임플란트의 장기 추적을 통해 임플란트 실패에 기여하는 위험지표를 조사하고 변연골소실(MBL)간의 상관관계를 분석하는 것이다. 연구 재료 및 방법: 2003년부터 2017년까지 전남대학교 치과병원에서 임플란트 수술 기왕력이 있는 환자의 진료기록부를 토대로 후향적 조사 시행하였다. 환자의 인구통계학적 변수 및 임상적 변수와 임플란트 주위 변연골소실 평가를 위한 치근단 방사선 사진을 사용하여 임플란트 생존율을 분석하였다. 환자의 임상변수와 임플란트 실패의 상관관계를 규명하기 위해 후진소거법을 이용한 다중회귀분석 시행하였고, 임플란트 장기생존율과 MBL 및 초기 안정성 간의 상관관계를 규명하기위해 Pearson 상관분석 시행하였다. 결과: 다중회귀분석 결과 지대주 연결 유형(β = -.189, P < .05), SPT 유무(β = -.163, P < .05), 당뇨(β = -.164, P < .05), 골수염(β = -.211, P < .05)이 MBL과 음의 상관관계가 있었다. 임플란트 장기 성공률에 항응고제, 임플란트 2차수술 시 PTV값이 영향을 미쳤다. 결론: 임플란트 장기 성공을 위해서는 적절한 지대주 연결 유형을 선택해야 하며, 주기적 SPT가 필요하다. 당뇨병, 골다공증 같은 전신 질환과 항응고제 사용 질환을 고려해야한다. 또한 임플란트 2차 수술시 높은 PTV가 임플란트 장기 생존율과 상관관계가 있기 때문에 보철 수복 전 초기 안정성을 신중히 고려해야한다.

• 대한치과보철학회지
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• 제52권4호
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• pp.352-358
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• 2014

최근 지르코니아와 CAD/CAM을 이용하는 심미적인 임플란트 보철치료 방법들이 많이 소개되고 있다. 그러나 이러한 방법들은 치은부위와 교합면부위에서 한계점들을 가지고 있다. 이에 본 증례에서는 지르코니아와 CAD/CAM 시스템을 이용하여 고정체 1 mm 상부에서부터 형성되는 점막하지르코니아 임플란트 보철물을 제작하고 이를 타이타늄 지대주와 접착하여 시멘트 나사 유지형 보철물을 제작하였다. 임상적으로 심미적이고 기능적면에서 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• 구강회복응용과학지
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• 제18권2호
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• pp.81-91
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• 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.

• 구강회복응용과학지
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• 제31권1호
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• pp.33-44
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• 2015

목적: 본 연구는 platform matching, platform switching을 시행한 임플란트의 변연골 소실을 비교하여 platform switching 개념의 임상적 의의를 평가하고자 한다. 연구 재료 및 방법: 원광대학교 치과병원 임플란트 센터에서 치료를 진행한 환자를 대상으로 임플란트 식립 시기, 직경, 길이, 지대주 연결방법 및 보철물 연결고정 유무를 조사하였다. 변연골 소실량을 측정하기 위해서 Emago advanced v5.6 프로그램을 사용하여 임플란트 식립 시와 가장 최근 내원 시의 치근단 방사선 사진을 비교하였다. 결과: 환자 82명의 임플란트 150개를 대상으로 6 - 63개월 동안 관찰한 결과 platform matching 임플란트는 $1.16{\pm}0.54mm$, platform switching 임플란트는 $0.68{\pm}0.27mm$의 변연골 소실을 나타내었다. 결론: Platform switching을 시행함으로써 임플란트의 변연골 소실을 줄이는 효과가 있는 것으로 사료된다.

• Journal of Periodontal and Implant Science
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• 제40권5호
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• pp.244-248
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• 2010

Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.