• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.4
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• pp.301-311
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• 2002

The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different vertical bone level of implant fixture. The two kinds of finite element models were designed according to vertical bone level around fixture ($4.0mm{\times}11.5mm$). The cemented crowns for mandibular first and second molars were made. Three- dimensional finite element model was created with the components of the implant and surrounding bone. Vertical loads were applied with force of 200N distributed within 0.5mm radius circle from the center of central fossa and distance 2mm and 4 mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the supporting bone, fixtures, abutment screws, and crown. The results were as following : (1) In vertical loading at the center circle of central fossa on model 1 and 2, the difference from vertical bone in implant placement did not affect the stress pattern on all components of implant except for crown. (2) With offset distance incerasing and the bone level of implant decreasing, the concentration of stress occured in the buccal side of long crown, around the buccal crestal bone, and on the fixture- abutment interface. As a conclusion, the research showed a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the vertical level of bone around fixture was different. Since the same vertical bone bed has more benefits than the different bone bed around fixtures, it is important to prepare a same vertical level of bone bed for the success of implants under occlusal loads.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.4
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• pp.374-385
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• 2002

A total of 605 implant fixture prosthesis delivered by 3 clinics and 2 laboratories were examined in this study, The object of this study was to determine the proper length of screw head. The depth of access hole were measured and compared to the type of fixture, abutment, gold screw and prosthesis. The results were as follows : 1 The average number of fixtures per patient were 2.97. 2. The number of fixture installed in the upper posterior area are 327(55.56 %), the upper posterior area 171 (28.25%). 3. The depth of access hole is 4.23 mm in shallow area, and 5.46 mm in deep area and the differences were 1.23 mm. 4. The average depth of the aceess hole of the UCLA abutment were 5.02 mm. 5. The number of 4-5 mm access hole depth were 60(22.39%) in abutment screw level and the number of 4-5 mm depth in fixture level were 101 (29.19%). 6. In the shape of screw head, hexed type were 576(95.21%), slotted type were 29(4.79%).

• Journal of Periodontal and Implant Science
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• v.40 no.5
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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.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.169-182
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• 2005

The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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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.

• Journal of the Korean Society of Manufacturing Process Engineers
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• v.13 no.3
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• pp.89-95
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• 2014

The increasing level of demand for multi-tasking machines requires a saddle with an ultra-precise machining accuracy level of $15{\mu}m$, as such a saddle is one of the main components of these machines. The manner of achieving ultra-precise machining accuracy mainly depends on the fixed forces. In this paper, we optimized the number of contact points and the contact positions to reduce the deformation of the saddle while it is machined. The performance levels of the proposed optimal jig and fixture are determined by measuring the flatness, parallelism and perpendicularity of a machined saddle. The machining accuracy is found to be lower than $15{\mu}m$ at all measured points.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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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.

• 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.44 no.1
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• pp.63-72
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• 2006

Purpose: The purpose of this study was to compare the accuracy of master cast fabricated by using different impression methods at the different impression levels. Material and Method: The master model used in this study was resin block having low implant analogs. Impression method studied were 1) direct method on future level (Group FIX-D), 2) Indirect method on fixture level(Group FIX-I), 3) Modified indirect method on fixture level(Group FD(-M), 4) Direct method on abutment level(Group AB-D) and 5) Indirect method on abutment level(Group AB-I). Each of the five groups took 10 impressions. Fifty impressions were made for master cast by using Impregum $F^(R)$ impression material loaded on individual tray. Three dimensional measuring microscope was used to measure the inter-implant distance. Error rate of each inter-implant distance were calculated and evaluated. Results: The results were as follows. 1. Group FIX exhibited higher accuracy than group AB. 2 In group FIX, modified indirect method showed the highest accuracy, while indirect method showed the lowest accuracy. In group Ab, indirect method showed the higher accuracy than direct method. 3. Group FIX showed larger horizontal error than group AB. But, group AB showed the larger vertical error than group FIX. 4. Group Fix-M showed smallest vertical and horizontal error.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.424-434
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• 2009

Statement of problem: Problems such as loosening and fractures of retained screws and fracture of implant fixture have been frequently reported in implant prosthesis. Purpose: Implant has weak mechanical properties against lateral loading compared to vertical occlusal loading, and therefore, stress analysis of implant fixture depending on its material and geometric features is needed. Material and methods: Total 28 of external hexed implants were divided into 7 of 4 groups; Group A (3i, FULL $OSSEOTITE^{(R)}$Implant), Group B (Nobelbiocare, $Br{\aa}nemark$ $System^{(R)}$Mk III Groovy RP), Group C (Neobiotec, $SinusQuick^{TM}$ EB), Group D (Osstem, US-II). The type III gold alloy prostheses were fabricated using adequate UCLA gold abutments. Fixture, abutment screw, and abutment were connected and cross-sectioned vertically. Hardness test was conducted using MXT-$\alpha$. For fatigue fracture test, with MTS 810, the specimens were loaded to the extent of 60-600 N until fracture occurred. The fracture pattern of abutment screw and fixture was observed under scanning electron microscope. A comparative study of stress distribution and fracture area of abutment screw and fixture was carried out through finite element analysis Results: 1. In Vicker's hardness test of abutment screw, the highest value was measured in group A and lowest value was measured in group D. 2. In all implant groups, implant fixture fractures occurred mainly at the 3-4th fixture thread valley where tensile stress was concentrated. When the fatigue life was compared, significant difference was found between the group A, B, C and D (P<.05). 3. The fracture patterns of group B and group D showed complex failure type, a fracture behavior including transverse and longitudinal failure patterns in both fixture and abutment screw. In Group A and C, however, the transverse failure of fixture was only observed. 4. The finite element analysis infers that a fatigue crack started at the fixture surface. Conclusion: The maximum tensile stress was found in the implant fixture at the level of cortical bone. The fatigue fracture occurred when the dead space of implant fixture coincides with jig surface where the maximum tensile stress was generated. To increase implant durability, prevention of surrounding bone resorption is important. However, if the bone resorption progresses to the level of dead space, the frequency of implant fracture would increase. Thus, proper management is needed.