• 구강회복응용과학지
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• 제26권4호
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• pp.389-403
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• 2010

이전부터 사용된 티타늄, 금합금 지대주 및 최근 사용이 급증한 지르코니아 지대주와 임플란트의 계면에 대한 비교 연구와 동적하중이 계면에 미치는 영향에 관한 연구가 많지 않은 실정이다. 본 연구에서 지대주 종류와 동적 하중에 따른 미세간극의 차이를 주사전자현미경 분석을 통하여 비교평가 하였다. USII ${\phi}3.75{\times}11.5mm$ (Osstem Co., Seoul, Korea) 티타늄 임플란트에 티타늄 지대주, 지르코니아 지대주, 주조 금합금 (UCLA plastic) 지대주를 각 군당 7개씩, 30Ncm의 조임회전력으로 연결하였다. 25-250N의 sine형 동적하중을 장축 방향에서 $30^{\circ}$ 경사로 $10^5$회 시행하였다. 하중 전후에 계면의 미세간극을 순측, 구개측, 근심측, 원심측 부위에서 측정하였고, 그 결과 동적 하중으로 인한 통계적 유의성은 없었다. 지대주 종류에 따른 미세간극을 비교한 결과, 동적하중 시행 전후 모두 UCLA 군과 티타늄 군, UCLA 군과 지르코니아 군 사이에 통계적으로 유의한 차이를 보였다(p<0.05). 티타늄 군과 지르코니아 군 사이에는 유의한 차이를 보이지 않았다. UCLA 지대주는 정밀 연삭된 티타늄, 지르코니아 지대주 보다 더 큰 미세간극을 보였고 $10^5$회 동적하중은 미세간극에 영향을 미치지 않았다.

• 구강회복응용과학지
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• 제17권4호
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• pp.307-314
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• 2001

To evaluate the effect of misfit in two implant-supported fixed partial dentures in the posterior of the mandible, variations of the standard finite element models were made by changing the location of the gap as follows: 1) no gap present; 2) located between the gold cylinder and the abutment on the distal implant; 3) gap located between the gold cylinder and the abutment on the mesial implant. The results of this study were as follows: 1. When the location of the gap was close to the load applied on the prosthesis, the stress in the prosthesis, implant components and surrounding bone increased. 2. The presence of cantilever increased the stress in the prosthesis, implant and surrounding bone significantly, regardless of the presence of the gap. 3. When there was a gap between the prosthesis and abutment, the stress in the bone around the implant increased. 4. When passive fit was achieved, the stress was distributed widely in each component with less peak stress in each component. 5. The inner structures of the implant components, the gold screw and the abutment screw bear more stress when the prosthesis did not exhibit passive fit with the abutments than when passive fit was present.

• Archives of Plastic Surgery
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• 제32권3호
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• pp.293-298
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• 2005

Osseointegrated prosthetic auricular reconstruction can be classified as either direct or indirect. In the $Br{\aa}nemark $ system of direct osseointegration, implants are placed into the mastoid process of the temporal bone. In the Epitec system of indirect osseointegration, implants are inserted into a three-dimensional carrier plate that is fixed to the mastoid by means of screws. We experienced forty-four cases using the indirect system and seventeen cases using the direct system. We compared with two systems by complications, such as skin reaction, implant loosening, implant loss. There were no specific differences in the skin reaction around the implants and abutments in relation to age or system used. The degree of skin reaction was different according to the conditions around the implant: in cases of virgin microtia, a skin flap was used to cover the implant, in contrast to grafted skin coverage for failed autogenous reconstruction. In both systems, the skin reaction was more severe and frequent in skin flap than in grafted skin. Loosening of the implant was more frequent in the direct system; however, accidental detachment of the implant from the abutment was more frequent in the indirect system. To reduce complications of skin reaction in osseointegrated prosthetic auricular reconstruction, it is important for soft tissue around implant to immobilize. Therefore, grafted skin is better than skin flap as soft tissue around implant. And immobilization of soft tissue around implant by wound dressing is major facter.

• 구강회복응용과학지
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• 제22권1호
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• pp.75-87
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• 2006

The purpose of this study was to investigate the effects of prostheses misfit, cantilever on the stress distribution in the implant components and surrounding bone using three dimensional finite element analysis. Two standard 3-dimensional finite element models were constructed: (1) 3 ITI implant supported, 3-unit fixed partial denture and (2) 3 ITI implant supported, 3-unit fixed partial denture with a distal cantilever. variations of the standard finite element models were made by placing a $100{\mu}m$ or $200{\mu}m$ gap between the fixture, the abutment and the crown on the second premolar and first molar. Total 14 models were constructed. In each model, 244 N of vertical load and 244 N of $30^{\circ}$ oblique load were placed on the distal marginal ridge of the distal molar. von Mises stresses were recorded and compared in the crowns, abutments, crestal compact bones, and trabecular bones. The results were obtained as follows: 1. In the ITI implant system, cement-retained prostheses showed comparatively low stress distributions on all the implant components and fixtures regardless of the misfit sizes under vertical loading. The stresses were increased twice under oblique loading especially in the prostheses with cantilever, but neither showed the effects of misfit size. 2. Under the oblique loading and posterior cantilever, the stresses were highly increased in the crestal bones around ITI implants, but effects of misfit were not shown. Although higher stresses were shown on the apical portion of trabecular bones, the effects by misfit were little and the stresses were increased by the posterior cantilever. 3. When the cement loss happened in the ITI implant supported FPD with misfit, the stresses were increased in the implant componets and supporting structures.

• 대한치과보철학회지
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• 제57권1호
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• pp.57-65
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• 2019

Computer guided implant surgery와 computer-aided design/computer-aided manufacturing, computer guided implant surgery (CAD/CAM) 기술의 발전은 수복 기반 임플란트 치료의 완성도를 한층 더 높였으며, 3D printing을 통한 국소의치의 제작도 빈도가 늘고 있다. 본 증례는 디지털 치의학의 작업 흐름을 따라서 콘빔컴퓨터단층촬영을 통한 치료 계획 수립 및 수술용 스텐트의 제작과 그를 바탕으로 한 임플란트 식립을 하였으며, 맞춤 지대주와 보철물을 제작하였다. 그 후 전자 서베잉과 3D printing을 통한 국소의치 금속 구조물 및 최종적으로 지르코니아 온레이의 제작을 통해 전악 수복을 완성하여 기능과 심미적으로 만족스러운 결과를 얻을 수 있었다.

• The Journal of Advanced Prosthodontics
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• 제1권2호
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• pp.102-106
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• 2009

STATEMENT OF PROBLEM. Screw loosening has been a common complication and still reported frequently. PURPOSE. The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS. Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly mounted in liquid unsaturated poly-esther with dental surveyor. After 20 times of repeated closing and opening test, the evaluation for the change of inner surface of implant and TiN-coated abutment screw, and weight loss were measured. Mann-Whitney test with SPSS statistical software for Window was applied to analyze the measurement of weight loss. RESULTS. TiN-coated abutment screws of Osstem and 3i showed lesser loss of weight than non-coated those of Osstem and 3i (P < .05, Mann-Whitney test). CONCLUSION. Conclusively, TiN coating of abutment screw showed better resistance to abrasion than titanium abutment screw. It was concluded that TiN coating of abutment screw would reduce the loss of preload with good abrasion resistance and low coefficient of friction, and help to maintain screw joint stability.

• 구강회복응용과학지
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• 제28권2호
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• pp.147-161
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• 2012

본 연구에서는 유한요소해석 방법을 사용하여 임플란트 지지 3본 고정성 가공 의치에 수평적인 부적합이 존재할 때 그 정도가 임플란트 인접골 응력 발생에 미치는 영향에 대해 조사하였다. 3본 고정성 가공의치, 임플란트/악골 복합체로 구성된 해석 모델은 3차원으로 연구되었다. 3본 고정성 가공의치의 체결 간격은 하악 제2 소구치와 제2 대구치에 17.9mm 거리로 식립된 임플란트 간격에 비해 0.1mm 짧거나(17.8mm), 0.1mm 길게(18.0mm) 모델링하였다. 3본 고정성 가공의치와 임플란트 지대주 간의 체결은 총 6단계로 모사되었고 각 단계별로 가공의치가 하방으로 0.1mm 씩 변위되었다. 유한요소해석에는 PC용으로 출시된 DEFORM$^{TM}$ 3D 프로그램(ver 6.1, SFTC, Columbus, OH, USA)을 사용하였다. 3본 고정성 가공의치와 임플란트 사이의 응력은 von-Mises 응력, 최대 압축 응력, 필요한 경우 방사상 응력을 평가하였다. d=18.0mm인 모델에서는 가공의치와 지대주간의 체결이 이루어지지 않은 반면, d=17.8mm 인 모델에서는 성공적으로 체결이 가능했다. 체결 여부를 떠나 과도하게 높은 응력이 체결과정과 그 이후에 발생되었는데, 17.8mm 모델의 경우 체결완료 후에도 임플란트 주위 변연골에서 잔류하는 인장 및 압축 응력이 각각 최대 186.9MPa과 114.1MPa이었다. 이 경우 임플란트로부터 2mm 떨어진 부분까지 압축 응력이 골개조 장애 임계 응력인 55MPa($4,000{\mu}{\varepsilon}$과 같은 크기)보다 크게 측정되었다. 3본 고정성 가공의치의 0.1mm 크기의 수평적 부적합은 체결 과정뿐만 아니라 완료 후에도 인접 변연골에 높은 응력을 발생시킬 수 있다.

• Journal of Periodontal and Implant Science
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• 제38권4호
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• pp.723-728
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• 2008

Purpose: During guided bone regeneration procedures for the augmentation of deficient alveolar ridge, primary closure of flap is necessary. For primary flap closure, flap is repositioned coronally and the zone of attached keratinized mucosa may decreased. The need for attached keratinized mucosa around dental implants is still controversial, but sufficient peri-implant attached keratinized mucosa would be beneficial for functional and esthetic aspects. This case report presents three cases that demonstrated free gingival graft for increasing the zone of peri-implant attached keratinized mucosa which was decreased after guided bone regeneration. Materials and Methods: In first case, maxillary incisors were extracted and guided bone regeneration was performed simultaneously. Because the membrane was exposed at 3 weeks after operation, the membrane was removed and free gingival graft was performed for primary flap closure. Free gingival graft was performed again at implant placement for the increase of attached keratinized mucosa. In second case, guided bone regeneration was performed on lower right first molar area, and implant was placed with free gingival graft. In third case, lower right molar area showed insufficient attached keratinized mucosa after implant placement with guided bone regeneration. When abutments were connected, free gingival graft with apically positioned flap was performed. Result: In these three cases, the zone of attached keratinized mucosa around dental implants was decreased after guided bone regeneration. And the increase of peri-implant attached keratinized mucosa could be obtained effectively by free gingival graft. Conclusion: Free gingival graft could be a effective treatment method increasing the zone of attached keratinized mucosa which was decreased after guided bone regeneration procedures.

• Journal of Periodontal and Implant Science
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• 제43권2호
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• pp.58-63
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• 2013

Purpose: The aim of this study was to measure the peri-implant bone length surrounding implants that penetrate the sinus membrane at the posterior maxilla and to evaluate the survival rate of these implants. Methods: Treatment records and orthopantomographs of 39 patients were reviewed and analyzed. The patients had partial edentulism at the posterior maxilla and limited vertical bone height below the maxillary sinus. Implants were inserted into the posterior maxilla, penetrating the sinus membrane. Four months after implant insertion, provisional resin restorations were temporarily cemented to the abutments and used for one month. Then, a final impression was taken at the abutment level, and final cement-retained restorations were delivered with mutually protected occlusion. The complications from the implant surgery were examined, the number of failed implants was counted, and the survival rate was calculated. The periimplant bone lengths were measured using radiographs. The changes in initial and final peri-implant bone lengths were statistically analyzed. Results: Nasal bleeding occurred after implant surgery in three patients. No other complications were found. There were no failures of the investigated implants, resulting in a survival rate of 100%. Significantly more bone gain around the implants (estimated difference=-0.6 mm, P=0.025) occurred when the initial residual bone height was less than 5 mm compared to the >5 mm groups. No significant change in peri-implant bone length was detected when the initial residual bone height was 5 mm or larger. Conclusions: This study suggests that implants penetrating the sinus membrane at the posterior maxilla in patients with limited vertical bone height may be safe and functional.

• The Journal of Advanced Prosthodontics
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• 제1권2호
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• pp.97-101
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• 2009

STATEMENT OF PROBLEM. Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE. In this study, Bicon$^{(R)}$ Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS. 10 Bicon$^{(R)}$ implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS. It was evident, that the amount of abutment sinking in Bicon$^{(R)}$ Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at $0.45{\pm}0.09\;mm$. CONCLUSION. Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location.