• 대한치과보철학회지
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• 제55권2호
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• pp.218-224
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• 2017

방사선치료를 받은 상악에 임플란트 지지 고정성 보철물을 이용하여 수복하는 것은 골치유능력이 낮기 때문에 상세한 치료계획이 필요하다. All-on-4 개념에 의한 임플란트 식립은 골이식을 피하면서 임플란트를 매식할 수 있어 유리하다. 일반적으로 경사된 임플란트에는 기성 경사형 지대주를 사용해왔다. 본 임상증례에서는 computer-aided design and computer-aided manufacturing (CAD/CAM)으로 제작된 지대주를 사용하였다. 본 증례는 all-on-4 개념에 의해 임플란트를 매식하고 CAD/CAM titanium 지대주를 제작한 다음 CAD/CAM zirconia 고정성 보철물로 수복하여 좋은 결과를 얻었기에 보고하고자 한다.

• 대한치과보철학회지
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• 제46권3호
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• pp.280-289
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• 2008

STATEMENT OF THE PROBLEM: Recent data regarding the effects the cement type and abutment heights on the retentive force of a prosthetic crown are inconsistent and unable to suggest clinical guidelines. PURPOSE OF THE STUDY: This study evaluated the effects of different types of temporary cements and abutment heights on the retentive strength of cement-retained implant-supported prostheses. MATERIALS AND METHODS: Prefabricated implant abutments, 4 mm in diameter, $8^{\circ}$taper per side, and light chamfer margins, were used. The abutment heights of the implants were 4 mm, 5.5 mm and 7 mm. Seven specimens of a single crown similar to a first premolar were fabricated. Six commercially available temporary cements, TempBond, TempBond NE, Cavitec, Procem, Dycal, and IRM, were used in this study. Twenty-four hours after cementation, the retentive strengths were measured using a universal testing machine with a crosshead speed of 0.5 mm/min. The cementation procedures were repeated 3 times. The data was analyzed using two-way analysis of variance and a Tukey test (${\alpha}$=0.05). RESULTS: The tensile bond strength ranged from 1.76 kg to 19.98 kg. The lowest tensile strengths were similar in the TempBond and Cavitec agents. Dycal showed the highest tensile bond strength (P<0.01). More force was required to remove the crowns cemented to the long abutments (P<0.05). CONCLUSION: TempBond and Cavitec agents showed the lowest mean tensile bond strength. The Dycal agent showed more than double the tensile bond strength of the TempBond agent.

• 한국표면공학회지
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• 제42권1호
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• pp.41-46
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• 2009

The fit between dental implant fixture and zirconia abutment is affected by many variables during the fabrication process by CAD/CAM program and milling working. The purpose of this study was to evaluate the surface compatibility and electrochemical behaviors of zirconia abutment for prosthodontics. Zirconia abutments were prepared and fabricated using zirconia block and milling machine. For stabilization of zirconia abutments, sintering was carried out at $1500^{\circ}F$ for 7 hrs. The specimens were cut and polished for gap observation. The gap between dental implant fixture and zirconia abutment was observed using field-emission scanning electron microscopy (FE-SEM). The hardness and corrosion resistance of zirconia abutments were observed with vickers hardness tester and potentiostat. The gap between dental implant fixture and zirconia abutment was $5{\sim}12{\mu}m$ for small gap, and $40{\sim}60{\mu}m$ for large gap. The hardness of zirconia surface was 1275.5 Hv and showed micro-machined scratch on the surface. The corrosion potentials of zirconia abutment/fixture was .290 mV and metal abutment/fixture was .280 mV, whereas $|E_{pit}-E_{corr}|$ of zirconia abutment/fixture (172 mV) was higher than that of metal abutment/fixture (150 mV). The corrosion morphology of metal abutment/fixture showed the many pit on the surface in compared with zirconia abutment/fixture.

• 대한치과의사협회지
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• 제53권11호
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• pp.804-816
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• 2015

PURPOSE: The aim of this study was to evaluate the influence of the oxide layer removal process in the Co-Cr-Mo (CCM) abutment after casting procedure on the prosthesis settlement and screw stability. MATERIALS AND METHODS: CCM abutments of four different interface conditions (CCM-M; machined, CCM-O; oxide layer formed, CCM-B; blasted, CCM-P; polished after blasted) and gold abutment (Gold-C; Cast with type III Gold alloy) were used. The initial settling values of abutments were evaluated according to the difference of implant-abutment length when the tightening torques were applied at 5 Ncm and 30 Ncm, and the settling values of abutments caused by loading were evaluated according to the difference of implant-abutment length before and after loading with 250 N, 100000 cycle. The loss ratios of removal torque for abutment screws were evaluated according to the difference in value of removal torques under 30 Ncm tightening torque applied before and after cyclic loading. RESULTS: The CCM-P and CCM-B group showed a higher initial settling value compared with the Gold-C group (P<.05), while the Gold-C group showed the highest settling values caused by loading (P<.05) and no significant differences were observed for between CCM groups (P>.05). The loss ratio of removal torque values for the CCM-B, CCM-P groups did not differ significantly from that of the Gold-C group (P>.05). CONCLUSION: Even though the oxide layer was removed by different methods, CCM abutment with internal conical connection structure showed lower abutment settling and similar screw loosening after cyclic loading compared with gold abutment.

• 구강회복응용과학지
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• 제31권4호
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• pp.364-370
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• 2015

최근 구치부 부분 무치악 환자의 임플란트 보철 수복은 기능적뿐만 아니라 심미적으로도 환자의 만족을 이끌어내야 하는 과제를 안고 있다. 이렇게 환자의 요구가 높아지면서 상실된 자연치아와 유사한 형태의 임플란트 보철을 사용한 구강회복이 보철수복의 중요한 이슈가 되고 있다. 이를 위해서는 기성 지대주 보다는 더 넓은 customized CAD/CAM 지대주를 사용함으로써 자연스러운 출현윤곽을 재현할 수 있다. 넓은 지대주를 지지해주기 위해서는 충분한 폭과 높이를 가지는 각화치은이 존재해야 하는데, 만약 긴 치아상실기간이나 골이식술 등으로 인해 임플란트 주위에 각화치은이 부족한 경우에는 연조직 증대술을 시행하는 것이 추천된다. 이러한 과정을 통해 심미적이고 기능적인 임플란트 보철 제작이 가능하며 구강위생관리를 용이하게 하고 향후 임플란트 주위염의 발생 가능성을 감소시킨다. 본 증례는 구치부 부분 무치악 환자에서 골이식술, 상악동 이식술, 임플란트 식립술 및 연조직 이식술을 사용하여 부족한 치조골과 각화치은 및 협측전정을 회복하였으며, customized CAD/CAM 지대주와 지르코니아 보철물을 이용하여 수복한 증례로 주기적인 내원 및 검사를 통해 기능적, 심미적으로 만족할만한 결과를 얻었기에 이 사례를 보고하고자 한다.

• Journal of Periodontal and Implant Science
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• 제46권6호
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• pp.362-371
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• 2016

Purpose: The increasing demand for esthetically pleasing results has contributed to the use of ceramics for dental implant abutments. The aim of this study was to compare the biological response of epithelial tissue cultivated on lithium disilicate ($LS_2$) and zirconium oxide ($ZrO_2$) ceramics. Understanding the relevant physicochemical and mechanical properties of these ceramics will help identify the optimal material for facilitating gingival wound closure. Methods: Both biomaterials were prepared with 2 different surface treatments: raw and polished. Their physicochemical characteristics were analyzed by contact angle measurements, scanning white-light interferometry, and scanning electron microscopy. An organotypic culture was then performed using a chicken epithelium model to simulate peri-implant soft tissue. We measured the contact angle, hydrophobicity, and roughness of the materials as well as the tissue behavior at their surfaces (cell migration and cell adhesion). Results: The best cell migration was observed on $ZrO_2$ ceramic. Cell adhesion was also drastically lower on the polished $ZrO_2$ ceramic than on both the raw and polished $LS_2$. Evaluating various surface topographies of $LS_2$ showed that increasing surface roughness improved cell adhesion, leading to an increase of up to 13%. Conclusions: Our results demonstrate that a biomaterial, here $LS_2$, can be modified using simple surface changes in order to finely modulate soft tissue adhesion. Strong adhesion at the abutment associated with weak migration assists in gingival wound healing. On the same material, polishing can reduce cell adhesion without drastically modifying cell migration. A comparison of $LS_2$ and $ZrO_2$ ceramic showed that $LS_2$ was more conducive to creating varying tissue reactions. Our results can help dental surgeons to choose, especially for esthetic implant abutments, the most appropriate biomaterial as well as the most appropriate surface treatment to use in accordance with specific clinical dental applications.

• The Journal of Advanced Prosthodontics
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• 제6권5호
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• pp.346-350
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• 2014

PURPOSE. Impact forces in implant supported FDP (fixed dental prosthesis) are higher than that of tooth supported FDPs and the compositions used in frameworks also has a paramount role for biomechanical reasons. The aim of this study was to evaluate the flexural strength of two different zirconia frameworks. MATERIALS AND METHODS. Two implant abutments with 3.8 mm and 4.5 mm platform were used as premolar and molar. They were mounted vertically in an acrylic resin block. A model with steel retainers and removable abutments was fabricated by milling machine; and 10 FDP frameworks were fabricated for each Biodenta and Cercon systems. All samples were thermo-cycled for 2000 times in $5-55^{\circ}C$ temperature and embedded in $37^{\circ}C$ artificial saliva for one week. The flexural test was done by a rod with 2 mm ending diameter which was applied to the multi-electromechanical machine. The force was inserted until observing fracture. The collected data were analyzed with SPSS software ver.15, using Weibull modulus and independent t-test with the level of significance at ${\alpha}=.05$. RESULTS. The mean load bearing capacity values were higher in Biodenta but with no significant differences (P>.05). The Biodenta frameworks showed higher load bearing capacity ($F_0=1700$) than Cercon frameworks ($F_0=1520$) but the reliability (m) was higher in Cercon (m=7.5). CONCLUSION. There was no significant difference between flexural strengths of both zirconia based framework systems; and both Biodenta and Cercon systems are capable to withstand biting force (even parafunctions) in posterior implant-supported bridges with no significant differences.

• The Journal of Advanced Prosthodontics
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• 제10권5호
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• pp.381-387
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• 2018

PURPOSE. Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS). MATERIALS AND METHODS. We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles ($8^{\circ}$, $10^{\circ}$, and $12^{\circ}$), a sloped shoulder margin (0.6 mm depth), a rectangular shape ($6mm{\times}6.5mm$) with rounded edges, and a rectangular ledge ($2mm{\times}1mm$) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque ($N{\cdot}cm$) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (${\alpha}=.05$). RESULTS. Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186). CONCLUSION. Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.

• The Journal of Advanced Prosthodontics
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• 제2권1호
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• pp.25-31
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• 2010

PURPOSE. This study compared the accuracy of an abutment-framework (A-F) taken with open tray impression technique combining cement-on crown abutments, a metal framework and resin cement to closed tray and resin-splinted open tray impression techniques for the 3-implant definitive casts. The effect of angulation on the accuracy of these 3 techniques was also evaluated. MATERIAL AND METHODS. Three definitive casts, each with 3 linearly positioned implant analogs at relative angulations 0, 30, and 40 degrees, were fabricated with passively fitted corresponding reference frameworks. Ten impressions were made and poured, using each of the 3 techniques on each of the 3 definitive casts. To record the vertical gap between reference frameworks and analogs in duplicate casts, a light microscope with image processing was used. Data were analyzed by two-way analysis of variance and the Tukey test. RESULTS. The open tray techniques showed significantly smaller vertical gaps compare to closed tray technique (P < .05). The closed tray and the resin-splinted open tray technique showed significantly different vertical gaps according to the angulation of implant (P < .05), but the A-F impression technique did not (P > .05). CONCLUSION. The accuracy of the A-F impression technique was superior to that of conventional techniques, and was not affected by the angulation of the implants.

• 대한치과보철학회지
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• 제44권1호
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• pp.73-84
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• 2006

The importance of soft tissue response to implant abutments has become one of the major issues in current implant dentistry. To date, numerous studies have emphasized on maintaining connective tissue barriers in quantity, as well as in quality fir the long term success of dental implants. The cells mainly consisting the soft tissue around dental implants are fibroblasts and epithelial cells. The mechanism of the fibroblasts adhesions to certain substrata can be explained by the 'focal adhesion' theory. On the other hand, epithelial cells adhere tn the substratum via hemidesmosomes. The typical integrin-mediated adhesions of cells to certain matrix are called 'cell-matrix adhsions'. The focal adhesion complex of fibroblasts, in relation to the cell-matrix adhsions, consists of the extracellular matrix(ECM) such as fibronectin, the transmembrane proteins such as integrins, the intracellular cytoplasmic proteins such as vinculin, talin, and more, and the cytoskeletal structures such as filamentous actin and microtubules. The mechanosensory function of integrins and focal adhesion complexes are considered to play a major role in the cells adhesion, migration, proliferation, differentiation, division, and even apoptosis. The '3-D matrix adhesions' defined by Cukierman et al. makes a promising future for the verification of the actual process of the cell-matrix adhesions in vivo and can be applied to the field of implant dentistry in relation to obtaining strong soft tissue attachment to the implant abutments.