• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.13.1-13.6
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• 2020

Background: The aim of this study was to evaluate the factors that may affect implant fixture fractures. Methods: Patients who experienced implant fixture removal at Seoul National University Bundang Hospital from 2007 to 2015 due to implant fixture fracture were included. Implant/crown ratio, time of implant fracture, clinical symptoms before implant fracture, treatment of fractured implants, and the success and survival rate of the replaced implants were evaluated retrospectively. Results: Thirteen implants were fractured in 12 patients. Patient mean age at the time of fracture was 59.3 years. Of the 13 implants, 7 implants were placed at our hospital, and 6 were placed at a local clinic. The mean crown/implant ratio was 0.83:1. The clinical symptoms before fracture were screw loosening in five implants, marginal bone loss in five implants, and the presence of peri-implant diseases in five implants. All the fractured implants were removed, and 12 out of the 13 sites were re-implanted. Parafunctions were observed in two patients: one with bruxism and one with attrition due to a strong chewing habit. Conclusions: Several clinical symptoms before the fracture of an implant can predict implant fixture failure. Therefore, if these clinical symptoms are observed, appropriate treatments can be taken before more serious complications result.

• 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.

• 대한치과보철학회지
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• 제47권4호
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• pp.424-434
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• 2009

연구목적: 임플란트는 수직교합 하중에는 비교적 잘 견디나 측방하중에 대해서는 약한 역학적 성질을 갖고 있으므로 임플란트의 재료 특성과 기하학적 형태에 따른 응력 분석 연구의 필요성이 제기되고 있다. 연구재료 및 방법: 외부육각구조를 갖는 28개의 임플란트를 7개씩 4군으로 나누어 그 제품에 적합한 UCLA gold abutment를 이용해, 제3형 금합금으로 보철 물을 제작하였고, A군 (3i, FULL $OSSEOTITE^{(R)}$-Implant), B군 (Nobelbiocare, Branemark $System^{(R)}$Mk III Groovy RP), C군 (Neobiotec, $SinusQuick^{(TM)}$ EB), D군 (Osstem, US-II)으로 분류하였다. 고정체와 지대주나사, 지대주를 연결한 후 수직적으로 절단하여 연마한 후 미세경도계를 이용하여 10군데에서 경도측정을 실시하였고, 동적하중 피로시험기를 이용하여 60-600 N범위로 파절시까지 동적 하중을 가하였다. 주사전자현미경을 이용하여 지대주나사 및 고정체의 파절 양상과 파절 위치 등을 관찰하였고, 유한요소분석을 통해 고정체와 지대주 나사에 나타나는 응력 분포와 파절면을 비교 분석하였다. 결과: 1.고정체 경도는 A, B, C, D군에서 각각 245.3, 289.7, 281.3, 300.4 Hv로 D군이 가장 높았고, A군이 가장 낮았다. 지대주 나사의 경도는 A, B, C, D군에서 각각 340.00, 317.62, 306.5, 306.2 Hv로 A군이 가장 높고, D군이 가장 낮았다. 2. 모든 실험군에서 임플란트 고정체의 파절은 응력이 집중되는 고정체 3-4번째 나사산 홈 (valley) 부위 또는 내면의 사공간부와 일치하는 부위에서 발생되었고, 피로수명은 A, B, C, D군에서 각각 31585, 47311, 30141, 105371로 D군이 가장 높았으며, A, B, C군과는 유의한 차이가 있었다(P<.05). 3. 파절양상은 B군과D군에서는 고정체와 나사 모두에서 수직 (longitudinal)파절과 수평 (transverse)파절이 동시에 일어나는 복합 (complex mode) 파절이 관찰 되었고, A와 C군에서는 고정체에서 수평 (transverse mode) 파절만이 관찰되었다. 4. 유한요소분석 결과 인장응력이 가장 높은 고정체 표면부에서 피로 균열이 시발되어 압축응력이 가장 높은 반대편 부위로 피로균열이 전파되었으며, 최대 유효 응력값은 C군이 가장 높았고, B군에서 가장 낮았다. 결론: 피질골 높이와 일치하는 임플란트 고정체 부위에서 최대 인장 주응력이 발생되며, 고정체 사공간부 (dead space)가 최대 인장 주응력이 작용하는 지그 표면과 일치할 때 피로파절이 발생되었다. 따라서 악골에 식립된 임플란트의 신뢰성을 향상시키고 수명을 증대시키기 위해서는 가능한 임플란트 주위의 골소실이 일어나지 않도록 해야 할 것이나 골흡수가 일어나 사공간부 수준까지 진행된다면 임플란트의 파절 빈도가 증가될 수 있으므로 이에 대한 대처가 필요할 것으로 사료된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제49권1호
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• pp.43-48
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• 2023

The biocompatibility and durability of implant fixtures are major concerns for dentists and patients. Mechanical complications of the implant include abutment screw loosening, screw fracture, loss of implant prostheses, and implant fracture. This case report aims to describe management of a case of fixture damage that occurred after screw fracture in a tissue level, internal connection implant and microscopic evaluation of the fractured fixture. A trephine bur was used to remove the fixture, and the socket was grafted using allogeneic bone material. The failed implant was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), which revealed a fractured fixture with both normal and irregular bone patterns. The SEM and EDS results give an enlightenment of the failed fixture surface micromorphology with microfracture and contaminated chemical compositions. Noticeably, the significantly high level of gold (Au) on the implant surface and the trace amounts of Au and titanium (Ti) in the bone tissue were recorded, which might have resulted from instability and micro-movement of the implant-abutment connection over an extended period of time. Further study with larger number of patient and different types of implants is needed for further conclusion.

• 대한치과의사협회지
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• 제53권5호
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• pp.360-367
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• 2015

Purpose : The purpose of this study was to evaluate the effect of amount of cantilever in intra-crown according to implant fixture position on mechanical strength of internal conical joint type implant. Materials and Methods : Internal conical joint type implant fixture, abutment screw, abutment was connected and gold alloy prostheses were fabricated and cemented on abutment. For fatigue fracture test, the specimens were loaded to the 350 N, 2,000,000 cycle on 3, 4, 5, and 6 mm off-center of gold alloy prostheses. The fracture pattern of implant component was observed. Results : No fatigue fracture found on 3 and 4 mm group. But initial crack pattern found on 3 specimens of 4 mm group. Fatigue fracture found on all specimens of 5 mm group. But complete fracture was not observed. One specimen of 6 mm group fracture completely. Implant fixture fracture wax not observed. Conclusion : The mechanical failure of implant prostheses increased with the loading area farther from center of implant fixture. To reduce mechanical problem of internal joint type implant, surgical and prosthetic consideration is needed.

• 구강회복응용과학지
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• 제26권3호
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• pp.297-309
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• 2010

보철물의 실패는 파절로 인해 다수 발생하게 되지만 파절 발생시 그 원인을 파악하는 것은 어렵다. 보철물의 실패를 예방하고 예후를 예측하기 위해 보철물의 원인을 분석하는 것이 중요하며, 원인을 밝히기 위해 파절면 분석을 시행하게 된다. 파절면 분석은 파절면 뿐 아니라 주위 환경(응력 상황)에 대한 분석이 동반되며, 이를 이용하여 균열 진행, 파절 양상, 파절 원인 등을 파악하게 된다. 이 연구의 목적은 임상적으로 기능 후 파절된 임플란트 고정체의 파절면 분석을 시행하여 파절 기전 및 파절 원인(하중 양상)을 밝히는 것이다. 파절된 임플란트 고정체는 3년간 강릉-원주 대학교에 임플란트 고정체의 파절을 주소로 내원한 환자를 대상으로 수집하였다. 먼저 임상 및 방사선 사진 분석을 하였으며, 시편 세척 과정을 거쳐 주사 전자 현미경을 이용한 파절면 분석을 시행하였다. 임플란트 파절면 분석 시 피로 줄무늬, 벽개 파절 등의 파절 지표를 통해 피로 파절로 인해 파절이 발생되었음을 확인할 수 있었다.

• 한국정밀공학회지
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• 제33권9호
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• pp.769-775
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• 2016

Currently, dental implants are widely used as artificial teeth due to their good chewing performance and long life cycle. Generally, a dental implant consists of an abutment as the upper part and a fixture as the lower part. When chewing forces are repeatedly applied to a dental implant, a gap is often generated at the interfacial surface between the abutment and the fixture, and it results in some deterioration such as loosening of the fastening screw, dental retraction and fixture fracture. To enhance the sealing performance for coping with such problems, this study proposes a new sealing-type abutment having a number of grooves along the conical surface circumference, and it carries out finite element analysis in consideration of the external chewing force and pretension between the abutment and the fixture. The result shows that the proposed sealing-type abutment shows an enhanced sealing performance in terms of the contact pressure in comparison with a conventional abutment.

• 대한치과보철학회지
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• 제43권3호
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• pp.338-351
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• 2005

Statement of problem. Accurate fit between the implant components is important because the misfit of the implant components results in frequent screw loosening, irreversible screw fracture, plaque accumulation, poor soft tissue reaction, and destruction of osseointegration. Purpose. This study is to evaluate the machining accuracy and consistency of the implant fixture/ abutment/screw interfaces of the internal connection system by using a Stereoscopic Zoom microscope and FE-SEM(field emission scanning electron microscope) Materials and methods. The implant systems selected in this study were internal connection type implants from AVANA(Osstem^{\circledR}), Bioplant(Cowell-Medi^{\circledR}), Dio(DIO^{\circledR}), Neoplant(Neobiotech 􀋓), Implantium(Dentium􀋓)systems. Each group was acquired 2 fixtures at random. Two piece type abutment and one piece type abutment for use with each implant system were acquired. Screw were respectively used to hold a two piece type abutment to a implant fixture. The implant fixtures were perpendiculary mounted in acrylic resin block. Each two piece abutment was secured to the implant fixture by screw and one piece abutment also secured to the implant fixture. Abutment/fixture assembly were mounted in liquid unsaturated polyester. All samples were cross-sectioned with grinder-polisher unit. Finally all specimens were analysed the fit between implant fixture/abutment/screw interfaces Results and conclusions. 1. Implant fixture/abutment/screw connection interfaces of internal connection systems made in Korea were in good condition. 2. The results of the above study showed that materials and mechanical properties and quality of milling differed depending on their manufacturing companies.

• The Journal of Advanced Prosthodontics
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• 제8권5호
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• pp.388-395
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• 2016

PURPOSE. The purpose of this study was to evaluate the resistance to deformation under static overloading by measuring yield and fracture strength, and to analyze the failure characteristics of implant assemblies made of different titanium grades and connections. MATERIALS AND METHODS. Six groups of implant assemblies were fabricated according to ISO 14801 (n=10). These consisted of the combinations of 3 platform connections (external, internal, and morse tapered) and 2 materials (titanium grade 2 and titanium grade 4). Yield strength and fracture strength were evaluated with a computer-controlled Universal Testing Machine, and failed implant assemblies were classified and analyzed by optical microscopy. The data were analyzed using the One-way analysis of variance (ANOVA) and Student's t-test with the level of significance at P=.05. RESULTS. The group $IT4_S$ had the significantly highest values and group IT2 the lowest, for both yield strength and fracture strength. Groups $IT4_N$ and ET4 had similar yield and fracture strengths despite having different connection designs. Group MT2 and group IT2 had significant differences in yield and fracture strength although they were made by the same material as titanium grade 2. The implant system of the similar fixture-abutment interfaces and the same materials showed the similar characteristics of deformation. CONCLUSION. A longer internal connection and titanium grade 4 of the implant system is advantageous for static overloading condition. However, it is not only the connection design that affects the stability. The strength of the titanium grade as material is also important since it affects the implant stability. When using the implant system made of titanium grade 2, a larger diameter fixture should be selected in order to provide enough strength to withstand overloading.

• 한국표면공학회:학술대회논문집
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• 한국표면공학회 2012년도 추계총회 및 학술대회 논문집
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• pp.115-116
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• 2012

In this study, fitness and fatigue test were performed to estimate the coating effects of abutment screw for implant system after fatigue test. The purpose of this study was to investigate fatigue fracture phenomena of dental implant fixture used titanium nitride coated abutment screw under cyclic load.