Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.4
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pp.240-247
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2009
Purpose: The purpose of this study was to evaluate marginal bone loss to the bone crest functionally loaded for up to eighteen months and also with regard to other variables of interest. Material and Methods: 135 endosseous implants(GS II, Osstem, South Korea) were placed in 35 patients. The design of GS II implant is straight with the microthread. Radiographic examinations were conducted at baseline (implant loading) and 3, 6, 9, 12 and 18 months after loading. Marginal bone level measurement was made from the reference point to the lowest observed point of contact of the marginal bone with the fixture. The reference point of the fixture was the border between the blasted surface and machined surface of the fixture. Results: Implants were on function for a mean 12.7 months(range, 3?18 months). For the 56 maxillary and 79 mandibular implants, mean marginal bone loss was 0.68 mm and 0.70 mm. Implants placed maxillary posterior area displayed more crestal bone loss than the other position. The difference between mesial and distal bone levels was statistically significant (p<0.05) with respective means of 0.51 mm and 0.62 mm. Also, The difference between bone graft group and no-bone graft group was statistically significant(p<0.05) with respective means of 0.38 mm and 0.66 mm. But no statistically significant influence of sex, type of surgery(one or two stage surgery), the implant length was observed(p>0.05). Conclusion: This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.
Purpose: The purpose of this study was to investigate the effect of patterning on the stress distribution in the bone tissue using the finite element analysis (FEA) model. Materials and Methods: For optimal comparison, it was assumed that the implant was axisymmetric and infinitely long. The implant was assumed to be completely embedded in the infinitely long cortical bone and to have 100% bone apposition. The implant-bone interface had completely fixed boundary conditions and received an infinitely big axial load. von Mises stress and maximal principal stress were analyzed. Conventional thread and 2 or 3 patterns on the upper and lower flank of the thread were compared. Result: The surface areas of patterned implants were increased up to 106~115%. The thread with patterns distributed stress better than conventional thread. Patterning in threads may produce more stress in the implant itself, but reduce stress in the surrounding bone. Stress patterns of von Mises stress were favorable with patterns, while the maximal principal stress was increased with patterns. Patterns in the lower flank showed favorable stress distribution. Conclusion: The patterns in implant thread reduce the stress generated in surrounding bone, but the number and position of patterns were crucial factors in stress distribution.
Lee, Sa Ya;Goh, Mi-Seon;Ko, Seok-Yeong;Yun, Jeong-Ho
The Journal of the Korean dental association
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v.56
no.5
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pp.263-276
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2018
Long-term survival and prognosis of narrow-diameter implants have been reported to be adequate to consider them a safe method for treating a deficient alveolar ridge. The objective of this study was to perform case report of narrow-diameter implants with a trapezoid-shape in anterior teeth alveolar bone. A 50-year-old male patient presented with discomfort due to mobility of all of the maxillary teeth and mandibular incisors. Due to destruction of alveolar bone, four anterior mandibular teeth were extracted. Soft tissue healing was allowed for approximately 3 months after the extraction, and a new design of implant placement was planned for the mandibular incisor area, followed by clinical and radiological evaluation. Implant placement was determined using an R2GATE surgical stent. The stability of the implants was assessed by ISQ measurements at the first and second implant surgery and after prosthetic placement. At 1 and 3 months and 1 year after implantation of the prosthesis, clinical and radiological examinations were performed. Another 50-year-old male patient presented with discomfort due to mobility of the mandibular central incisors. For the same reason as in the first patient, implant placement was carried out in the same way after extraction. ISQ measurements and clinical and radiological examinations were performed as in the previous case. In these two clinical cases, 12 months of follow-up revealed that the implant remained stable without inflammation or additional bone loss, and there was no discomfort to the patient. In conclusion, computer-guided implant surgery was used to place an implant in an optimal position considering the upper prosthesis. A new design of a narrow-diameter implant with a trapezoid-shape into anterior mandibular alveolar bone is a less invasive treatment method and is based on the contour of the deficient alveolar ridge. Through all of these procedures, we were able to reduce the number of traumas during surgery, reduce the operation time and total treatment period, and provide patients with more comfortable treatment.
The aim of this study was to evaluate Magnetic Resonance Imaging safety by measuring the translational attraction, torque and susceptibility artifact for Bone-Anchored Hearing Aid (BAHA) implant at 1.5 T and 3.0 T MRI by standard criteria. In vitro assessment tools were made of acrylic-resin by American Society for Testing and Materials (ASTM) F2052-06 and F2119-07 standard. Translational attraction of BAHA implant was measured by the maximum deflection angle at 96 cm position, where the magnetically induced deflection was the greatest. The torque was assessed by the qualitative criteria of evaluating the alignment and rotation pattern, when the BAHA implant was positioned on a line with $45^{\circ}$ intervals inside the circular container in the center of the bore. The susceptibility artifact images were obtained using the hanged test tool, which was filled with $CuSO_4$ solution. And then the artifact size was measured using Susceptibility A rtifact Measurement (SA M) software. In results, the translational attraction was 0 mm at both 1.5 T and 3.0 T and the torque was 0(no torque) at 1.5 T, and +1(mild torque) at 3.0 T. The size of susceptibility artifacts was between 13.20 mm and 38.91 mm. Therefore, The BAHA implant was safe for the patient in clinical MR environment.
Purpose: The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods. Methods: Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface. Results: At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient= 0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018). Conclusions: A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.
Park, Ji-Hyun;Kim, Sung-Hun;Han, Jung-Suk;Lee, Jai-Bong;Yang, Jae-Ho
The Journal of Korean Academy of Prosthodontics
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v.46
no.3
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pp.290-297
/
2008
STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.
Kim, Min-Ji;Park, Sun-Hyung;Kim, Hyeon-Seong;Mo, Sung-Seo;Sung, Sang-Jin;Jang, Gang-Won;Chun, Youn-Sic
The korean journal of orthodontics
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v.41
no.3
/
pp.191-199
/
2011
Objective: The purpose of this study was to investigate the stress distribution on the orthodontic mini-implant (OMI) surface and periodontal ligament of the maxillary first and second molars as well as the tooth displacement according to the OMI position in the dragon helix appliance during scissors-bite correction. Methods: OMIs were placed at two maxillary positions, between the first and the second premolars (group 1) and between the second premolar and the first molar (group 2). The stress distribution area (SDA) was analyzed by three-dimensional finite element analysis. Results: The maximal SDA of the OMI did not differ between the groups. It was located at the cervical area and palatal root apex of the maxillary first molar in groups 1 and 2, respectively, indicating less tipping in group 2. The minimal SDA was located at the root and furcation area of the maxillary second molar in groups 1 and 2, respectively, indicating greater palatal crown displacement in group 2. Conclusions: Placement of the OMI between the maxillary second premolar and the maxillary first molar to serve as an indirect anchor in the dragon helix appliance minimizes anchorage loss while maximizing the effect on scissors-bite correction.
Khavanin, Nima;Gust, Madeleine J.;Grant, David W.;Nguyen, Khang T.;Kim, John Y.S.
Archives of Plastic Surgery
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v.41
no.1
/
pp.57-62
/
2014
Background Achieving symmetry is a key goal in breast reconstruction. Anatomically shaped tabbed expanders are a new tool in the armamentarium of the breast reconstruction surgeon. Suture tabs allow for full control over the expander position and thus inframammary fold position, and, in theory, tabbed expanders mitigate many factors responsible for poor symmetry. The impact of a tabbed expander on breast symmetry, however, has not been formally reported. This study aims to evaluate breast symmetry following expander-implant reconstruction using tabbed and non-tabbed tissue expanders. Methods A chart review was performed of 188 consecutive expander-implant reconstructions that met the inclusion criteria of adequate follow-up data and postoperative photographs. Demographic, oncologic, postoperative complication, and photographic data was obtained for each patient. The photographic data was scored using a 4-point scale assessing breast symmetry by three blinded, independent reviewers. Results Of the 188 patients, 74 underwent reconstruction with tabbed expanders and 114 with non-tabbed expanders. The tabbed cohort had significantly higher symmetry scores than the non-tabbed cohort ($2.82/4{\pm}0.86$ vs. $2.55/4{\pm}0.92$, P=0.034). Conclusions The use of tabbed tissue expanders improves breast symmetry in tissue expander-implant-based breast reconstruction. Fixation of the expander to the chest wall allows for more precise control over its location and counteracts the day-to-day translational forces that may influence the shape and location of the expander pocket, mitigating many factors responsible for breast asymmetry.
Objective: The aim of this study was to analyze tooth movement and arch width changes in maxillary dentition following nonextraction treatment with orthodontic mini-implant (OMI) anchorage in Class II division 1 malocclusions. Methods: Seventeen adult patients diagnosed with Angle's Class II division 1 malocclusion were treated by nonextraction with OMIs as anchorage for distalization of whole maxillary dentition. Three-dimensional virtual maxillary models were superimposed with the best-fit method at the pretreatment and post-treatment stages. Linear, angular, and arch width variables were measured using Rapidform 2006 software, and analyzed by the paired t -test. Results: All maxillary teeth showed statistically significant movement posteriorly (p < 0.05). There were no significant changes in the vertical position of the maxillary teeth, except that the second molars were extruded (0.86 mm, p < 0.01). The maxillary first and second molars were rotated distal-in ($4.5^{\circ}$, p < 0.001; $3.0^{\circ}$, p < 0.05, respectively). The intersecond molar width increased slightly (0.1 mm, p > 0.05) and the intercanine, interfirst premolar, intersecond premolar, and interfirst molar widths increased significantly (2.2 mm, p < 0.01; 2.2 mm, p < 0.05; 1.9 mm, p < 0.01; 2.0 mm, p < 0.01; respectively). Conclusions: Nonextraction treatment with OMI anchorage for Class II division 1 malocclusions could retract the whole maxillary dentition to achieve a Class I canine and molar relationship without a change in the vertical position of the teeth; however, the second molars were significantly extruded. Simultaneously, the maxillary arch was shown to be expanded with distal-in rotation of the molars.
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