• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.2
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• pp.127-144
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• 2002

There is an increasing appreciation of the vital role that biomechanics play in the performance of oral implant. The aim of this article is to provide some basic principles that will allow a clinician to formulate a biomechanically valid treatment plan. However, at this point in the history of oral implantology, the clinician should realize that we do not know enough to provide absolute biomechanical rules that will guarantee success of all implants in all situations. To examine the biomechanical questions, one must begin with an analysis of the distribution of biting forcess to implants. Related topics, such as stress transfer to surrounding tissues and interrelationships between bone biology and mechanical loading are major subjects, deserving a separate discussion. Once rigid fixation, angulation, crestal bone level, contour, and gingival health are achieved, stress beyond physiologic limits is the primary cause of initial bone loss around implants. The restoring dentist has specific responsibilities to reduce overload to the bone-implant interface. These include proper diagnosis, leading to a treatment plan designed with adequate retention and form, and progressive loading to improve the amount and density of bone and further reduce the risk of stress beyond physiologic limits. The major remaining factor is the development of occlusal concept in harmony with the rest of the stomagnetic system.

• The korean journal of orthodontics
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• v.51 no.1
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• pp.23-31
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• 2021

Objective: To evaluate the mandibular buccal shelf (MBS) in terms of the angulation and bone depth and thickness according to sex, age, and sagittal and vertical skeletal patterns in a Colombian population using cone-beam computed tomography (CBCT). Accordingly, the optimal site for miniscrew insertion in this area was determined. Methods: This descriptive, retrospective study included 64 hemi-arches of 34 patients. On CBCT images, the angulation, buccal bone depth (4 and 6 mm from the cementoenamel junction [CEJ] of MBS), and buccal bone thickness (6 and 11 mm from the CEJ of MBS) were measured at the mesial and distal roots of the mandibular first and second molars. Results: There were no statistically significant differences in the angulation, depth, and thickness of MBS between male and female patients. The values for the bone around the distal root of the mandibular second molar were significantly greater than the other values. The osseous characteristics were significantly better in participants aged 16-24 years. Class III patients exhibited the best osseous characteristics, with the bone depth at 6 mm being significantly different from that in Class I and Class II patients. Although values tended to be greater in patients with low angles, the difference was not statistically significant. Conclusions: MBS provides an optimal bone surface for miniscrew insertion, with better osseous characteristics at the distal root of the mandibular second molar, 4 mm from CEJ. Adolescent patients, Class III patients, and patients with a low angle exhibit the most favorable osseous characteristics in the MBS area.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.83-94
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• 2004

The purpose of this study was to compare the distributing pattern of stress according to the types of occlusal load on the finite element models of the splinted implant prostheses. The finite element model was designed with the parallel placement of two fixtures ($4.0mm{\times}11.5mm$) on mandibular first and second molars. The cemented crowns for mandibular first and second molars were made. Three-dimensional finite element model was created with the components of the implant, surrounding bone and cemented crowns. Two types of occlusal load, the point load and the surface load within 0.5 mm radius circle, were applied to the finite element models with 200N magnitude in axial(along the long axis of the implant and oblique(angulation of $30^{\circ}$ to the long axis) directions perpendicular to cuspal incline. Loads were positioned from the center of central fossa and to distance of 2 mm and 4 mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures and sections. The results were as following : 1. Under axial loading at the central fossa, the stress was distributed along the fixture except for the apical portion, not relative to both point & surface contacts. 2. With offset distance increasing, the highest stresses were concentrated in the neck portion of the fixture. 3. The maximum von Mises stress under the oblique load was greater than that under the axial load. 4. Under the oblique load, the highest stress were concentrated in the buccal side and lingual neck portion of the fixture with offset distance increasing. The results had a tendency to increase the stress on the neck portion of fixture with the offset and oblique loads increasing. The design of occlusal scheme should be allowed to distribute stress axially in maximum intercuspation and to decrease the angulation of cuspal incline.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.2
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• pp.71-81
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• 2004

The purpose of this study was to compare the distributing pattern of stress on the finite element models of two units implant prosthesis with one angulated placement of two implant fixtures. The two unit implant crowns simulated to mandibular first and second molars were made. The two kinds of finite element models were designed according to angulation of fixture ($4.0mm{\times}11.5mm$) : Model 1($15^{\circ}$ buccally angulated placement of one fixture on second molar area), Model 2($15^{\circ}$ lingually angulated placement of one fixture on second molar area). Axial loads of 200N were applied to the center of central fossa and to distance of 2mm and 4mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the fixtures, and buccolingual section of implants. The results were as follows: 1. Under axial loading at the central fossa, the stress was distributed along the straight fixture except apical portion, while on buccally or lingually angulated placement, the highest stresses were concentrated in the neck portion on the opposite side of the angulated fixture. 2. With offset distance increasing, the stresses were concentrated greater in buccal neck of lingually angulated fixture than in lingual neck of buccally angulated fixture. From the above results, in designing of the occlusal scheme for implant prosthesis with the angulated fixture, occlusal contacts should be placed to distribute stress axially in maximum intercuspation and to avoid offset force during eccentric movements.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.3
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• pp.293-304
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• 2011

The purpose of this study was to investigate the displacement and pattern of stress distribution on periodontal ligaments of maxillary first and second molar, and on orthodontic mini-implant (OMI) surface, according to three different insertion angles to the bone surface of OMI using Dragon helix appliance, which is a newly introduced scissors-bite correcting appliance. OMI were placed between second premolar and first molar with three different insertion angles (45, 60, 90 degrees). Displacement and maximum stress distribution area (MSDA) were analyzed by finite element analysis. When the insertion angle to the alveolar bone surface was 90 degrees, maxillary first and second molar both exhibited MSDA at the palatal root apex. Maxillary first molar did not show any significant displacement, while the second molar exhibited intrusive and palatal displacement. On the OMI, as the insertion angle decreased, the MSDA shifted towards the tip, and the amount of displacement had increased. When the OMI was inserted at a 90 degree angle, anchor loss was minimized and scissors-bite correcting effect was maximized.

• The Journal of Advanced Prosthodontics
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• v.15 no.4
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• pp.179-188
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• 2023

PURPOSE. This in vitro study aimed to evaluate the performance of digital intraoral scanners in a completely edentulous patient with angled and parallel implants. MATERIALS AND METHODS. A total of 6 implants were placed at angulations of 0°, 5°, 0°, 0°, 15°, and 0° in regions #36, #34, #32, #42, #44, and #46, respectively, in a completely edentulous mandibular polyurethane model. Then, the study model created by connecting a scan body on the implants was scanned using a model scanner, and a 3D reference model was obtained. Three different intraoral scanners were used for digital impressions (PS group, TR group, and CS group, n = 10 in each group). The distances and angles between the scan bodies in these measurement groups were measured. RESULTS. While the Primescan (PS) impression group had the highest accuracy with 38 ㎛, the values of 104 ㎛ and 171 ㎛ were obtained with Trios 4 IOSs (TR) and Carestream 3600 (CS), respectively (P = .001). The CS scanner constituted the impression group with the highest deviation in terms of accuracy. In terms of dimensional differences in the angle parameter, a statistically significant difference was revealed among the mean deviation angle values according to the scanners (P < .001). While the lowest angular deviation was obtained with the PS impression group with 0.185°, the values of 0.499° and 1.250° were obtained with TR and CS, respectively. No statistically significant difference was detected among the impression groups in terms of precision values (P > .05). CONCLUSION. A statistically significant difference was found among the three digital impression groups upon comparing the impression accuracy. Implant angulation affected the impression accuracy of the digital impression groups. The most accurate impressions in terms of both distance and angle deviation were obtained with the PS impression group.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.291-298
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• 2017

It is challenging to produce esthetic implant restoration in the narrow anterior maxilla region where insufficient volume of alveolar bone could limit the angle and position of implant fixture, if preceding bone augmentation is not considered. Ideal angle and position of implant fixture placement should be established to reproduce harmonious emergence profile with marginal gingiva of implant prosthesis, bone augmentation considered to be preceded before implant placement occasionally. In this case, preceding bone augmentation has been operated before esthetic implant prosthesis in narrow anterior maxilla region. Preceded excessive bone augmentation in buccal area allowed proper angulation of implantation, which compensates unfavorable implant position. Provisional restorations were corrected during sufficient period to make harmonious level of marginal gingiva and interdental papilla. The definite restoration was fabricated using zirconia core based glass ceramic. Functionally and esthetically satisfactory results were obtained.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.201-208
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• 2008

Statement of problem: A new implant impression technique which use abutments as impression coping, and use resin cement as a splinting material was described. Accuracy of this technique was compared with conventional closed tray and resin splinted open tray technique for a $15^{\circ}$ angled 3-implant model Material and methods: A dental stone master model with 3 linearly positioned implant analogue and a reference framework which was passively fitted to it were fabricated. The center analogue was perpendicular to the plane of model and the outer analogues had a $15^{\circ}$angulation forward or backward. 10 closed tray impressions, 10 resin splinted open tray impressions, 10 abutment-resin framework cementation impressions and 10 abutment-metal framework cementation impressions were made with additional silicone material and poured with dental stone. A light microscope with image processing was used to record the vertical gap dimension between reference framework and analogue of duplicated cast made with each 4 impression techniques. Statistical analysis used one-way ANOVA with post-hoc tests Tukey test of .05 level of significance Results: Significant difference in the vertical gap dimension was found between closed tray technique; 74.3 (${\pm}33.4$)${\mu}m$ and resin splinted open tray technique, and two other new technique. (P<.05) Abutment-metal framework cementation technique;42.5 (${\pm}11.9$)${\mu}m$ was significantly different from resin splinted open tray technique. (P<.05) Abutmentresin framework cementation technique;51.0 (${\pm}14.1$)${\mu}m$ did not differ significantly from resin splinted open tray technique;50.3 (${\pm}16.9$)${\mu}m$. (P>.05) Conclusion: Within limitations of this study, the accuracy of implant level impressions of resin splinted open tray technique was superior to that of closed tray technique. A new technique using abutment and metal framework cementation was more accurate than resin splinted open tray technique.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.246-254
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• 2008

STATEMENT OF PROBLEM: The cast abutment has advantages of overcoming angulation problem and esthetic problem. However, when a gold-machined UCLA abutment undergoes casting, the abutment surfaces in contact with the implant may change. PURPOSE: The purpose of this study was to compare the detorque values of prefabricated machined abutments with gold-premachined cast-on UCLA abutments before and after casting in two types of internal implant-abutment connection systems: (1) internal hexagonal joint, (2) internal octagonal joint. Furthermore, the detorque values of two implant-abutment connection systems were compared. MATERIALS AND METHODS: Twenty internal hexagonal implants with an 11-degree taper and twenty internal octagonal implants with an 8-degree taper were acquired. Ten prefabricated titanium abutments and ten gold-premachined UCLA abutments were used for each systems. Each abutment was torqued to 30 N㎝ according to the manufacturer's instructions and detorque value was recorded. The detorque values were measured once more, after casting with gold alloy for UCLA abutment, and preparation for titanium abutments. Group means were calculated and compared using independent t-test and paired t-test (${\alpha}$=0.05). RESULTS: The results were as follows: 1. The detorque values between titanium abutments and UCLA-type abutments showed significant differences in internal octagonal implants (P<0.05), not in internal hexagonal implants (P>0.05). 2. In comparison of internal hexagonal and octagonal implants, the detorque values of titanium abutments had significant differences between two connection systems on the initial analysis (P<0.05), not on the second analysis (P>0.05) and the detorque values of UCLA-type abutments were not significantly different between two connection systems (P>0.05). 3. The detorque values of titanium abutments and UCLA-type abutments decreased significantly on the second analysis than the initial analysis in internal hexagonal implants (P<0.05), not in internal octagonal implants (P>0.05). CONCLUSION: Casting procedures of UCLA-type abutments had no significant effect on screw loosening in internal implant-abutment connection systems, and UCLA-type abutments showed higher detorque values than titanium abutments in internal octagonal implants.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.2
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• pp.111-119
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• 2015

Purpose: The objective of this study was to evaluate the accuracy of a stereolithographic surgical guide that was made with information from intraoral digital impressions and cone beam CT (CBCT). Materials and methods: Six sets of resin maxilla and mandible models with missing teeth were used in this study. Intraoral digital impressions were made. The virtual models provided by these intraoral digital impressions and by the CBCT scan images of the resin models were used to create a surgical guide. Implant surgery was performed on the resin models using the surgical guide. After implant placement, the models were subjected to another CBCT scan to compare the planned and actual implant positions. Deviations in position, depth and axis between the planned and actual positions were measured for each implant. Results: The mean deviation of the insertion point and angulation were 0.28 mm and $0.26^{\circ}$, apex point were 0.11 mm and 0.14 mm respectively. The implants were situated at a mean of 0.44 mm coronal to the planned vertical position. Conclusion: This study demonstrates that stereolithographic surgical guides created without the use of impressions and stone models show promising accuracy in implant placement.