• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.1
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• pp.39-47
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• 2005

The purpose of this study is to review the prognosis of the TG Osseotite implant(3i Co, USA) placed in partial edentulous area of oral cavity and to suspect the possible causes leading to failure. 124 TG Osseotite implants that had been inserted between 2000 - 2002 were followed up for 2 years(avg : 9.5 months) in function. Medical records, and radiographs were evaluated and analyzed by the over all success rate, gender and age factor, general disease, implant fixture length and diameter, implant site, bone density, and various surgical methods. Chi square test was used statistically. Of the 124 TG Osseotite implants, 9 implants(7.3%) were removed in early phase and 3 implants(2.4%) were in late phase. The cumulative survival rate was 90.2%. The failure of the TG Osseotite implant was closely related with the use of bone graft techniques such as sinus elevation or immediate implantation and not with the age, sex, general disease, implant site, bone density of implanted site. The failure of the TG Osseotite implant was well developed when it was the wide type of implant and it was inserted for single tooth replacement. The developement of peri-implantitis was the most important factor in the failure of the TG Osseotite implant.

• The korean journal of orthodontics
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• v.37 no.6
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• pp.400-406
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• 2007

The purpose of this experimental study was to evaluate the effect of immediate orthodontic loading on the stability at the bone-implant interface of titanium miniscrews in a rabbit model. Methods: Forty titanium miniscrews (1.6 mm diameter, 8 mm length) were inserted in the tibiae of 10 rabbits. Twenty test group miniscrews were subjected to continuous orthodontic forces of 200g immediately after implantation for a period of 6 weeks. The remaining 20 control group miniscrews were left unloaded for the same follow-up interval. Removal torque values were recorded using a digital torque gauge. An independent t-test was performed. Results: All the miniscrews were stable, and exhibited no mobility or displacement throughout the experimental period. Histologically, miniscrews were well-integrated into bone. No statistically significant differences in removal torque data were found between the loaded test and the unloaded control groups. Conclusions: These findings suggest that titanium miniscrews can be used as anchoring units for orthodontic tooth movement immediately after insertion.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.497-507
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• 2021

All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient's inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient's requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

• Journal of Korean Dental Science
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• v.2 no.2
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• pp.12-17
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• 2009

Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.27.1-27.9
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• 2019

Background: Implants are becoming the first choice of rehabilitation for tooth loss. Even though they have a high success rate, failures still occur for many reasons. The objective of this study is to analyze the reasons for recurring failure at the same site and the results of re-implantation. Methods: Thirteen patients (11 males and 2 females, mean age 60 ± 9.9 years) who experienced implant surgery failure at the same site (same tooth extraction area) two or more times in the Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, between 2004 and 2017 were selected. The medical records on a type, sites, diameter, and length of implants; time and estimated cause of failure; and radiographs were reviewed. Data were collected and analyzed retrospectively, and the current statuses were evaluated. Results: A total of 14 implants experienced failure in the same site more than two times. Twelve implants were placed in the maxilla, while 2 implants were placed in the mandible. The maxillary molar area was the most common site of failure (57.1%), followed by the mandibular molar, anterior maxilla, and premolar areas (14.3% each). The first failure occurred most commonly after prosthetic treatment (35.7%) with an average period of failure of 3.8 months after loading. Ten cases were treated as immediate re-implantation, while the other 4 were delayed reimplantation after an average of 3.9 months. The second failure occurred most commonly after prosthetic treatment (42.9%), with an average of 31 months after loading; during the healing period (42.9%); and during the ongoing prosthetic period (14.3%). In 3 cases (21.4%), the treatment plan was altered to an implant bridge, while the other 11 cases underwent another implant placement procedure (78.6%). Finally, a total of 9 implants (64.3%) survived, with an average functioning period of 60 months. Conclusions: Implants can fail repeatedly at the same site due to overloading, infection, and other unspecified reasons. The age and sex of the patient and the location of implant placement seem to be associated with recurring failure. Type of implant, bone augmentation, and bone materials used are less relevant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.4
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• pp.219-225
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• 2003

Purpose: Platelet Rich Plasma(PRP) application is increasing with sinus inlay bone graft, but there is few research with radiographic ananlysis on effect of PRP in maxillary sinus. The author investigated the amount of bony changes of maxillary sinus for dental implantation among the patients with maxillary inlay graft. Materials and Methods: With 10 patients who were treated with sinus inlay autologous bone grafting combined with PRP technique, and with 5 patients who were treated with sinus inlay grafting only without PRP, the panoramic radiographys which were taken at preoperation, immediate postoperation, 3months postoperation, and 4 months postoperation(a month after dental implantation)periods were analysed. The films had been scanned, and then proceeded throughout image analysis system. The bone density of maxillary grafted sites was compared with adjacent tooth enamel density and remeasured according to density luminosity of each film. The density changes on PRP group and bone graft only group were analysed with non-parameteric statistics method. Results: In PRP combined patients group, bone density on postoperation periods was increased totally. The remarkable enhanced change of bone density was observed on 3 months postoperation period, thereafter the increasing rate was slightly reduced. In only bone graft patients group, bone density on postoperation periods was also increased compared with preoperation period, but the bone density of 4 months postoperation period was decreased compared with 3 months postoperation period. The amount of bone density on PRP group was significantly changed according to periods in contrast to bone graft only group. Conclusion: The bone density on PRP group was remarkably increased at 3 months postoperation compared to bone graft only group and it was seemed to be associated with more new bone formation, less grafted bone resorption at bone grafted sites with PRP.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.389-395
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• 2010

Purpose: Although it is generally accepted that patients with controlled diabetes have similar rates of success for dental implants as healthy individuals, the use of dental implants in diabetic patients is controversial. In addition, the impact of diabetes on the healing of bone associated with immediately place dental implants is not completely understood. The purpose of this study was to measure bone response to implants radiologically in uncontrolled and insulin-controlled diabetic rats. Materials and Methods: Twenty rats were divided into control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. Two titanium implants ($1.2{\times}3$ mm) were placed in the extraction socket of the maxillary first molars of the animals and were harvested at 3 days, 1, 2 and 4 weeks. The bone density was measured by digital radiography using gray-level analysis (histogram) in the regions of interest (ROI) at four points: two mesial and two distal to both sides of the implant. Results: The results showed that the osseointegration of the implants was impaired in the diabetic rats compared to the control and the insulin-treated rats. The radiographic evidence demonstrated marked destruction of bone around the implants in the diabetic group. Both the control and the insulin-treated groups had a significantly higher bone density on radiograph than the diabetic group from the 1 week of the experiment (P<0.05 for each comparison). Conclusion: The present study revealed that the immediate placement of titanium implants in the maxilla of diabetic rat lead to delay in the maturation of bone adjacent to implants. It is expected that the reduced predictability of success of immediate implantation in patient with the uncontrolled diabetes.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.1
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• pp.43-66
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• 1997

Dental implant may be immediately placed in postextraction socket which has alveolar bone defect. The purpose of this study was to compare the bone regeneration and bone quality around defects adjacent to implants that were placed into extraction sockets according to EFEB, GTAM barrier and GTAM barrier with DFDB. Mandibular P2, P3 and P4 were extracted bilaterally in dogs, and buccal defects were created about 4mm in depth and 3.3mm in width. Screwed pure titanium implants, 3.8mm in diameter and 10mm in length, were placed into the extraction sockets. The experimental groups were divided into four groups : the G group was covered with a GTAM barrier on the defective area, the D+G group was filled with DFEB and covered with a GTAM barrier, the D group was filled with DFDB only and the control group was sutured without any special treatment on the defective area. The experimental animals were killed after 12 weeks and specimens were prepared for light microscopic evaluation and fluorescent dyes were administered daily for 2 weeks after implantation, and injected on the 4th and 11th week for fluorescent microscopic examination to observe new bone formation and bone remodeling. The new Bone height of the buccal defect was measured and compared with the another for bone gain and the removal torque for the implant was measured for the comparison of bone density and bone-implant osseointegration. Results obtained were as follows : 1. Experimental groups showed bone regeneration in oder from D+G, G, D group and control. D+G and G group was significantly from D group and control(P<0.01). 2. In the defective area of control the regenerated alveolar bone showed poorly developed lamellated structure and fibrous tissue intervention into the bone-implant interface but the others showed well developed lamellated structure and osseointegration. 3. All implant groups showed no significaant difference in the removal torque for implant(P>0.05) These results suggest that immediate implants placed in defective sockets were successfully osseointegrated and utilizing placed in defective sockets were successfully osseointegrated and utilizing not only the combination of GTAM and DFDB but also only the GTAM was favorable for the predictable regeneration of the defective area.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.26 no.1
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• pp.17-23
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• 2017

Purpose: This retrospective study is to evaluate whether the timing of implant placement and the result of esthetic outcomes are related. Materials and Methods: Among the patients who had undergone single implant surgery on anterior area from 2010 to 2013 in Veterans Health Service Medical Center, 34 implants in 27 patients (24 male and 3 female) were selected and categorized into 3 groups according to the timing of placement, which are group D (Delay), group E (Early) and group I (Immediate). Aesthetic indices used included the Pink Esthetic Score (PES). It has 7 variables scores, such as mesial papilla, distal papilla, a level of soft-tissue margin, soft-tissue contour, alveolar process, soft-tissue color, and soft-tissue texture. Each variable ranges from 0 to 2, therefore total 14 points are highest. All patients were received by regular follow-up at least 1-year. One examiner measured PES on the intraoral photos. Each patient was considered as a statistical unit for statistical analysis. Statistical analyses were performed using a commercially available statistical software (SPSS Statistics 21.0, IBM Corp., Armonk, NY, USA). Kruskal-Wallis test was used for inter-group comparisons. Statistical significance was set at P<0.05. Result: Mean score in Group D, Group I, and Group E were $11.5{\pm}1.5$, $11.4{\pm}1.8$, and $11.3{\pm}1.8$ respectively. In Kruskal-Wallis test, there are no differences (P=0.989). Conclusion: In this limited study suggests that clinical aesthetic results can be achieved with all treatment protocols. Finally, various factors can be considered to produce the esthetic results.

• The korean journal of orthodontics
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• v.29 no.6 s.77
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• pp.699-706
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• 1999

Anchorage plays an important role in orthodontic treatment. Endosseous implants may be considered adequate firm anchorage. However, clinicians have hesitated to use endosseous implants as orthodontic anchorage because of limited implantation space, high cost, and long waiting period before osseointegration occurs. Recently, some clinicians have tried to use titanium miniscrews and microscrews in treatment due to their many advantages such as ease of insertion and removal, low cost, immediate loading, and the ability to place microscrews in any area of alveolar bone. The author treated a case with skeletal cortical anchorage using titanium microscrew implants. During six months of orthodontic force application from skeletal cortical anchorage, the author could get 4 mm bodily retraction and intrusion of upper anterior teeth. The most outstanding result was a 1.5 mm posterior refraction of the upper posterior teeth. The titanium microscrew implants had remained firm and stable throughout treatment. These results indicate that skeletal cortical anchorage might be a very good option.