• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.267-275
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• 2011

This prospective study was designed to compare clinical outcomes of immediately loaded implant with delayed loaded implant in partially posterior edentulous patients. For test group, 42 GS III (Osstem, Korea) implants in 17 patients were loaded within 48 hours after the placement. Control group was 27 implants in 15 patients loaded at $2.6{\pm}1.7months$ from the placement surgery. Before loading, primary stability was evaluated by ISQ value. Clinical symptoms, mobility, soft tissue state was evaluated at baseline, 3 months, 6 months and 12 months of loading. Marginal bone level change was also measured with periapical radiographs. Mann-Whitney test (${\alpha}$=0.05) and repeated measured ANOVA (${\alpha}$=0.05) was used for marginal bone level change between two groups. At the baseline, mean ISQ value of test group and control group was $80.3{\pm}7.1$ and $69{\pm}17$ respectively. Test group showed 95.23% of success rate and 100% of control group was successful. At 3 and 6months of loading, significantly more bone resorption was observed in test group than in control group (p<0.05). However, there was no significant difference in the bone level change at 12months of loading between two groups (p>0.05). Marginal bone level change showed no significant difference with gender and location (p>0.05). Within the limitation of this study, when primary stability was obtained, immediate loading of GS III implant at posterior region could be predictable treatment option.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.136-142
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• 2009

Bone density in the recipient implant site seems to be an important factor for long term success of endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify suitable implant sites, thereby improving the success rate of the procedure. Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively with computerized tomography and histologically measured bone density by bone biopsy. Patients and methods; Twenty seven patients were selected. All the patients were in good health, with no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery 2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and insertion torque values were recorded. Results; The highest histomorphometric values was found in the posterior mandible $32.3{\pm}3.8$, followed by $29.9{\pm}2.6$ for the posterior maxilla, $29.4{\pm}2.6$ for the anterior maxilla, $28.6{\pm}2.3$ for the anterior mandible(p=0.214). The hounsfield unit was $989.2{\pm}258.1$ in the posterior mandible, $845.0{\pm}241.5$ in the anterior maxilla, $744.5{\pm}92.6$ in the anterior mandible, $697.3{\pm}136.9$ in the posterior maxilla(p=0.045). This results may suggest that there are strong correlation between the histomorphometric values and hounsfield unit(r=0.760, p<0.05). The RF measurements were $81.9{\pm}2.4$ ISQ in the posterior mandible, $79.0{\pm}1.4$ ISQ in the anterior mandible, $78.3{\pm}4.6$ ISQ in the posterior maxilla, $76.5{\pm}5.0$ ISQ in the anterior maxilla(p=0.048). The insertion torque values was $43.2{\pm}4.2\;Ncm$ in the posterior mandible, $42.0{\pm}0.0\;Ncm$ in the anterior mandible, $41.3{\pm}4.1\;Ncm$ in the posterior maxilla, $40.8{\pm}3.8\;Ncm$ in the anterior maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield unit and the insertion torque values(r=0.494, p<0.05), the histomorphometric values and the insertion torque values(r=0.689, p<0.05). But there was no correlation between histomorphometric values and ISQ. There was no statistical significance in age and gender effect on parameters. Conclusions; There was significant correlations between bone density and implant stability parameters. The bone density measurements using preoperative CT may help clinicians to predict primary stability before implant insertion, which is associated with implant survival rates.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.2
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• pp.82-89
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• 2013

Purpose: The present study is aimed to evaluate the combined effect of recombinant human bone morphogenetic protein 2 (rhBMP-2) and recombinant human vascular endothelial growth factor (rhVEGF) coated onto anodized implants on osseointeration. Materials and methods: Six New Zealand white rabbit were used in this study. Each animal received 4 implants that were either coated with rhBMP-2 and rhVEGF (Study group) or anodized implant (Control group) in both tibia. This was performed using a randomized split-mouth design. A total 24 implants were used. The implant stability quotient (ISQ) value using resonance frequency analyser and removal torque (RTQ) measurement were investigated at 2 and 8 weeks. The t-test was used for statistical analysis (${\alpha}$=.05). Results: Control and study group showed good osseointegration at 8 weeks. The ISQ and RTQ values of study group were significant compared with the control group at 8 weeks (P<.05). However, No statistical significance was observed at 2 weeks (P>.05). Conclusion: It was concluded that rhBMP-2 with rhVEGF coated onto anodized implants can induce better osseointegration at late healing period.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.405-413
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• 2011

It was proposed that technologies derived from CAD-CAM and computed tomography may be useful for flapless implant treatment procedures. The aims of this study were to validate the reliability of this concept in a prospective 12-month clinical study. Twelve patients with fully edentulous areas in their mandibles were included in this study. A total of 71 implants were inserted in interforaminal regions by use of a CAD/CAM drill template($NobelGuide^{TM}$), specially designed for flapless implant surgery. To assess the degree of pain and discomfort, the patients were examined at 2 days and 1 week after surgery. Patient satisfaction and implant functionality were further evaluated at follow-up intervals of 1, 3, 6, and 12 months postoperatively. One implant failed early in 1 patient. All of the other implants were in a good functional state throughout the study. The mean marginal bone loss after 1 year of follow-up was 0.3 mm (SD, 0.1) at center, 0.5 mm (SD, 0.1) at canine and 0.7 mm (SD, 0.2) at distal fixtures, respectively. Statistically, there was not significant differences among each sites(P>.05)The mean ISQ change after 1 year of follow-up was -1.05 (SD, 2.76) at center, -0.85 (SD, 2.59) at canine and -1.27 (SD, 2.18) at distal fixtures, respectively. This prospective pilot study showed that the use of CAD/CAM technology and flapless implant surgery may be considered reliable for fully edentulous mandible of patients.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.176-183
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• 2012

Purpose: This study examined the clinical success rate of Mg titanate implants (M Implant system, Shinhung, Korea), which employ a Mg coating method, by evaluating the marginal bone loss and implant stability using radiographs and Osstell$^{(R)}$, over a 1 year. Materials and methods: The locations of the implants placement were divided into 4 areas; the maxillary and mandibular premolars and molars. In the maxilla, 8 and 9 implants were inserted in the premolar and molar areas, respectively. In the mandible, 11 and 51 implants were inserted in the premolar and molar areas. Marginal bone loss and ISQ of all implants (79) were measured after insertion, mounting the prosthetic appliance, and 1, 3, 6, and 12 months after loading. The marginal bone loss was measured from the radiograph using XCP bite, which was customized, and the implant stability measured using Osstell$^{(R)}$. Fisher's exact test (${\alpha}$=.05) was used to compare the success rates of each region. Results: The mean marginal bone loss for the upper and lower jaws were 1.537 mm and 1.172 mm. The mobility showed a non-significant reduction or increase according with time. The success rates were accounted for 94.12% and 98.39% in the upper and lower jaws; the premolars and molars were accounted for 100% and 96.67%. The two cases of early failure resulted from failure of primary stability during implant insertion. The late failures were not observed for 1 year after adding a loading to the implants. Conclusion: The Mg titanate implant showed good primary stability and good clinical results in both healing and function.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.391-401
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• 2009

The successful outcome of dental implants is mainly the result of intial implant stability following placement. The aim of this study was to investigate the effect of a self-tapping blades and implant design on initial stability of two tapered implant systems in poor bone quality. The two different implant systems included one with self-tapping blades and one without self-tapping blades. D4 bone model using Solid Rigid Polyurethane Form was used to simulate poor bone densities. The insertion torque during implant placement was recorded. Resonance frequency Analysis (RFA), measured as the implant stability quotient (ISQ), was assessed immediately after insertion. Finally, the implant-bone specimen was transferred to an Universal Testing Machine to measure the axial pull-out force. Insertion torque values and maximum pull-out torque value of the non self-tapping implants were significantly higher than those in the self-tapping group (P = 0.008). No statistically differences were noted between the two implant designs in RFA. Within the each implant system, no correlation among insertion torque, maximum pull-out torque and RFA value could be determined. Higher insertion torque of the non-self-tapping implants appeared to confirm higher clinical initial stability. In conclusion, implants without self-tapping blades have higher initial stability than implants with self-tapping blades in poor bone quality.

• The Journal of Advanced Prosthodontics
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• v.1 no.2
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• pp.107-112
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• 2009

STATEMENT OF PROBLEM. Macroscopic and especially microscopic properties of implant surfaces play a major role in the osseous healing of dental implants. Dental implants with modified surfaces have shown stronger osseointegration than implants which are only turned (machined). Advanced surface modification techniques such as anodic oxidation and Ca-P application have been developed to achieve faster and stronger bonding between the host bone and the implant. PURPOSE. The purpose of this study was to investigate the effect of surface treatment of titanium dental implant on implant stability after insertion using the rabbit tibia model. MATERIAL AND METHODS. Three test groups were prepared: sandblasted, large-grit and acid-etched (SLA) implants, anodic oxidized implants, and anodized implants with Ca-P immersion. The turned implants served as control. Twenty rabbits received 80 implants in the tibia. Resonance frequencies were measured at the time of implant insertion, 2 weeks and 4 weeks of healing. Removal torque values (RTV) were measured 2 and 4 weeks after insertion. RESULTS. The implant stability quotient (ISQ) values of implants for resonance frequency analysis (RFA) increased significantly (P <. 05) during 2 weeks of healing period although there were no significant differences among the test and control groups (P >. 05). The test and control implants also showed significantly higher ISQ values during 4 weeks of healing period (P < .05). No significant differences, however, were found among all the groups. All the groups showed no significant differences in ISQ values between 2 and 4 weeks after implant insertion (P >. 05). The SLA, anodized and Ca-P immersed implants showed higher RTVs at 2 and 4 weeks of healing than the machined one (P < .05). However, there was no significant difference among the experimental groups. CONCLUSION. The surface-modified implants appear to provide superior implant stability to the turned one. Under the limitation of this study, however, we suggest that neither anodic oxidation nor Ca-P immersion techniques have any advantage over the conventional SLA technique with respect to implant stability.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.47 no.3
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• pp.175-182
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• 2021

Objectives: In this prospective randomized controlled trial, we measured the primary and secondary stability of two surface-treated implants placed in the posterior maxilla, applied 3-month loading protocols, and compared and analyzed the short-term outcomes of the implants. Patients and Methods: From June 2018 to June 2019, patients with a residual bone height of 4 mm in the posterior maxilla were enrolled and randomly divided into two groups to place SA implants (Osstem Implants, Korea) in Group A and NH implants (Hiossen, USA) in Group B. Finally, 14 implants placed in 13 patients in Group A and 17 implants placed in 14 patients in Group B were analyzed. The measured primary and secondary stability of each implant was represented by implant stability quotient (ISQ), and treatment outcomes were evaluated. Results: Group A consisted of patients with an average age of 62.2 years (range, 48-80 years), and Group B consisted of patients with an average age of 58.1 years (range, 35-82 years). Primary stability was 73.86±6.40 and 71.24±5.32 in Groups A and B, respectively (P=0.222). Secondary stability was 79.07±5.21 in Group A and 78.29±4.74 in Group B (P=0.667). A steep increase in ISQ during the healing period was observed in Group B, though it was not significant (P=0.265). The mean follow-up period was 378.5±164.6 days in Group A and 385.3±167.9 days in Group B. All implants in each group met the success criteria, and the success rate was 100%. Conclusion: Two surface-treated implants placed in the posterior maxilla with greater than 4 mm alveolar bone height exhibited successful one-year treatment outcomes if a primary stability of 65 or higher ISQ was obtained and a 3-month early loading protocol was applied.

• The Journal of the Korean dental association
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• v.53 no.5
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• pp.368-376
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• 2015

Purpose : The objective of this research was to develop a more simplified drilling procedure with an enhanced implant drill. Materials and Methods : The drill enhanced design factors enabled implantation of Dia. 5.0mm fixture with only 2 times drilling which is more simplified drilling procedure. The enhanced drill was designed with 2 flutes, 2-phase or 3-phase formed drill tip and 25 degrees of helix angle. The proposed drilling procedure (2 times) was compared with a general drilling process (4 times) in terms of temperature changes, cutting time and ISQ value. Results : The simplified drilling procedure indicated less heat than a conventional drilling procedure (p<0.05). The enhanced drill showed significantly shorter drilling time than a conventional drill (p<0.05). On the other hand, higher insertion torque and ISQ value were observed on the the suggested drilling procedure than the conventional drilling procedure (p<0.05). Conclusion : A simplified drilling procedure with the newly designed drill could provide higher effectiveness and safety of dental implant operations under properly controlled external conditions, such as irrigation and RPM of drilling.

• Journal of Periodontal and Implant Science
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• v.39 no.3
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• pp.339-348
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• 2009

Purpose: The purpose of the present study was to analyze the implant stability quotient(ISQ) values for Korean non-submerged type implant and determine the factors that affect implant stability. Methods: A total of 49 Korean non-submerged type implants were installed in 24 patients, and their stability was measured by resonance frequency analysis(RFA) at the time of surgery, and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data for implant site, age, sex, implant length and diameter, graft performing, bone type, and insertion torque were analyzed. Results: The lowest mean stability measurement was at 3 weeks. There was significant difference between implant placement and 12 weeks. There was significant difference between implant placement and 12 weeks in diameters of 4.1 mm and 4.8 mm. Also, there were significant differences between diameters of 4.1 mm and 4.8 mm at implant placement and 12 weeks after surgery. This result suggests that the factor related to implant diameter may affect the level of implant stability. No statistically significant relationship was found between the resonance frequency analysis and the variables of maxilla/mandible, sex, anterior/posterior, implant length, age of patient, graft performing, bone type, insertion torque during initial healing period. Conclusions: These findings suggest that the factor related to implant diameter may affect the variance of implant stability, and ISQ value of implant was stable enough for proved stability level during initial healing period.