• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.4
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• pp.329-340
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• 2006

Statement of problem: Damping of the peak force transmitted to implants has been reported by in vitro studies using impact forces on resin-veneered superstructures. Theoretical assumptions suggest that use of acrylic resin for the occlusal surfaces of a prosthesis would protect the connection between implant and bone. Therefore, the relationship between prosthesis materials and the force transmitted through the implant system also needs to be investigated under conditions that resemble the intraoral mechanical environment. Purpose: The purpose of this study was to analyze the fracture strength and modes of temporary prosthesis when a flange or occlusally extended structure were connected on the top of the abutment. Material and method: Modified abutments of winged and bulk design were made by casting the desired wax pattern which is made on the UCLA type plastic cylinder. Temporary crowns were made using templates on the modified abutments, and its fracture toughness and strain were compared to the traditional temporary prosthesis. To evaluate the effect of aging, 5.000 times of thermocycling were performed, and their result was compared to the 24hours specimen result. Results: The following conclusions were drawn from this study: 1. In the fracture toughness test, temporary crown's fracture line located next to the screw hole while modified designs with metal support showed fracture line on the metal and its propagation along the metal-resin interface. 2. Wing and bulk structure didn't show significant difference in the fracture toughness (p>0.05), but wing structure showed stress concentration on the screw hole area compared to bulk structure which showed even stress distribution. 3. In the fracture toughness test after thermocycling, wing and bulk structure showed increased or similar results in metal supported area while off-metal area and temporary crown showed decreased results. 4. In the strain measurement after thermocycling, its value increased in the temporary and bulk structure. However, wing structure showed decreased value in the loading point while increased value in the screw hole area. Conclusion: Wing type design showed compatible result to the bulk type that its application with composite resin prosthesis to the implant dentistry is considered promising.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.6
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• pp.440-448
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• 2012

Purpose: The purpose of this study was to evaluate marginal bone loss of the alveolar crest on implants with or without guided bone regeneration and variables that have influenced. Methods: The clinical evaluation were performed for survival rate and marginal bone loss of 161 endosseous implants installed with guided bone regeneration (GBR) in 83 patients from September 2009 to October 2010 in relation to sex and age of patients, position of implant, implant system, length and diameter of implant. Study group (n=42) implant with GBR procedure, control group (n=41) implant without GBR technique. Simultaneous GBR approach using resorbable membranes combined with autogenous bone graft or freeze-dried bone allograft or combination. Radiographic examinations were conducted at healing abutment connection and latest visit. Marginal bone level was measured. Results: Mean marginal bone loss was 0.73 mm in study group, 0.63 mm in control group. Implants in maxillary anterior area (1.21 mm) were statistically significant in study group (P<0.05), maxillary posterior area (0.81 mm) in control group (P<0.05). Mean marginal bone loss 1.47 mm for implants with diameter 3.4 mm, 0.83 mm for implants of control group with diameter 4.0 mm (P<0.05). Some graft materials showed an increased marginal bone loss but no statistically significant influence of sex, implant type or length. Conclusion: According to these findings, this study demonstrated the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods. We conclude that implants with GBR had similar survival rate and crestal bone level compared with implants in native bone.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.259-271
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• 2013

The purpose of this study was to make the stress distribution produced by simulated different load under two types of internal connection implant system (stepped and tapered type) by means of 3D finite element analysis, The finite element model was designed with the parallel placement of the one fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st molar. Two models were loaded with 200 N magnitude in the vertical direction on the central position of the crown, the 1.5 mm and 3 mm buccal offset point from the central position of the fixture. The oblique load was applied at the angle of $30^{\circ}$ on the crown surface. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual dimension. The results were as follows; 1. The loading conditions of two internal connection implant systems (stepped and tapered type) were the main factor affecting the equivalent bone strain, followed by the type of internal connections. 2. The stepped model had more mechanical stability with the reduced max. stress compared to $11^{\circ}$ tapered models under the distributed oblique loading. 3. The more the contact of implant-abutment interface to the inner wall of implant fixture, the less stress concentration was reduced.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.211-221
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• 2020

The typical biomechanical properties of an internal conical connection (ICC) are axial displacement and loss of preload. The axial displacement of an ICC without a vertical stop can cause the loss of preload and a lowered occlusion. The stress of an ICC is concentrated on the contact interface of the abutment and not on the screw, and during placement, it is important to choose a wider coronal wall thickness as much as possible. The ICC should also be placed below the level of the bone crest. During the restoration of an ICC, care should be taken to ensure an appropriate abutment shape and an accurate connection. To get the best clinical results, it is important to select its wall thickness and place it in the appropriate position to restore it adequately.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.206-214
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• 2014

This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.3
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• pp.352-362
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• 2005

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 techniques in internal connection implant systems. Purpose. The purpose of this study was to compare the accuracy of two fixture-level impression techniques in two conditions (parallel and divergent) and to assess the effect of tightening sequences and forces on stresses generated on superstructures in internal connection implant system (Astra Tech). Material and methods. Two metal master frameworks made from two abutments (Cast-to Abutment ST) each and a corresponding, passively fitting, dental stone master cast with four fixture replicas (Fixture Replica ST) were fabricated. Ten dental stone casts for each impression techniques (direct unsplinted & splinted technique) were made with vinyl polysiloxane impressions from the master cast. Strain gauges for each framework were fixed midway between abutments to measure the degree of framework deformation on each stone cast. Pairs of strain gauges placed opposite each other constituted one channel (half Wheatstone bridge) to read deformation in four directions (superior, inferior, anterior, and posterior). Deformation data were analyzed using one-way ANOVA and the Tukey test at the .01 level of significance. And the effect of tightening sequences (right-to-left and left-to-right) and forces (10 Ncm and 20 Ncm) were assessed with ten stone casts made from parallel condition by the splinted technique. Deformation data were analyzed using paired t-test at the .01 level of significance. Conclusions. Within the limitations of this study, the following conclusions could be drawn. 1. Frameworks bent toward the inferior side on all casts made by both direct unsplinted and splinted impression techniques in both parallel and divergent conditions. 2. There was no statistically significant difference of accuracy between the direct unsplinted and splinted impression techniques in both parallel and divergent conditions (P>.01). 3. There was no statistically significant difference of stress according to screw tightening sequences in casts made by the splinted impression technique in parallel condition (P>.01). 4. Greater tightening force resulted in greater stress in casts made by the splinted impression technique in parallel condition (P<.01).

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.125-135
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• 2009

Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.36-43
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• 2012

Purpose: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. Materials and methods: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type ${\phi}4.0mm{\times}11.5mm$ Osstem$^{(R)}$ USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. Results: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2mm, there was no significant influence on the stress distribution. Conclusion: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.119-126
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• 2012

State of problem: Cement-retained implant-supported prostheses are routinely used in dentistry. The use of high strength cements has become more popular with the increasing confidence in the stability of the implant-abutment screw connection and the high survival rates of osseointegrated implants. No clinical data on retention of metal copings using CAD/CAM. To evaluate retention of metal copings using CAD/CAM system bonded to short titanium abutment with four different cements and compare retentive strength of metal copings with sandblasting or without sandblasting before cementation. Forty titanium abutment blocks were fabricated and divided into 4 groups of 10 samples each. Forty metal copings with occlusal hole to allow for retention testing were fabricated using CAD/CAM technology. The four cements were Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan) and Superbond C&B(Sunmedical, Japan). The copings were cemented on the titanium abutment according to manufacture's recommendation. All samples were stored for 24h at 37oC in 100% humidity and tested for retention using universal testing machine(Instron) at a crosshead speed of 1.0mm/min. Force at retentive failure was recorded in Newton. The mode of failure was also recorded. Means and standard deviations of loads at failure were analyzed using ANOVA and Paired t-test. Statistical significance was set at P<0.05. Panavia F2.0 provided significantly higher retentive strength than Fujicem, Maxcem Elite(P<0.05). Sandblasting significantly increased bond strength(P<0.05). The mode of failure was cement remaining principally on metal copings. Within the limitation of this study, Panavia F2.0 showed significantly stronger retentive strength than Fujicem, Maxcem Elite(p<0.05). The Ranking order of the cements to retain the copings was Panavia F2.0, Fujicem = Maxcem Elite. Sandblasting significantly increased bond strength(P<0.05). The retentive strength of metal copings on implant abutment were influenced by surface roughness and type of cements.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.113-124
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• 2023

Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.