• 대한치과보철학회지
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• 제45권4호
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• pp.506-521
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• 2007

Statement of problem: The cumulative success rate of wide implant is still controversial. Some previous reports have shown high success rate, and some other reports shown high failure rate. Purpose: The aim of this study was to analyze, and compare the biomechanics in wide implant system embeded in different width of crestal bone under different occlusal forces by finite element approach. Material and methods: Three-dimensional finite element models were created based on tracing of CT image of second premolar section of mandible with one implant embedded. One standard model (6mm-crestal bone width, 4.0mm implant diameter central position) was created. Varied crestal dimension(4, 6, 8 mm), different diameter of implants(3.3, 4.0, 5.5, 6.0mm), and buccal position implant models were generated. A 100-N vertical(L1) and 30 degree oblique load from lingual(L2) and buccal(L3) direction were applied to the occlusal surface of the crown. The analysis was performed for each load by means of the ANSYS V.9.0 program. Conclusion: 1. In all cases, maximum equivalent stress that applied $30^{\circ}$ oblique load around the alveolar bone crest was larger than that of the vertical load. Especially the equivalent stress that loaded obliquely in buccal side was larger. 2. In study of implant fixture diameter, stress around alveolar bone was decreased with the increase of implant diameter. In the vertical load, as the diameter of implant increased the equivalent stress decreased, but equivalent stress increased in case of the wide implant that have a little cortical bone in the buccal side. In the lateral oblique loading condition, the diameter of implant increased the equivalent stress decreased, but in the buccal oblique load, there was not significant difference between the 5.5mm and 6.0mm as the wide diameter implant. 3. In study of alveolar bone width, equivalent stress was decreased with the increase of alveolar bone width. In the vertical and oblique loading condition, the width of alveolar bone increased 6.0mm the equivalent stress decreased. But in the oblique loading condition, there was not a difference equivalent stress at more than 6.0mm of alveolar bone width. 4. In study of insertion position of implant fixture, even though the insertion position of implant fixture move there was not a difference equivalent stress, but in the case of little cortical bone in the buccal side, value of the equivalent stress was most unfavorable. 5. In all cases, it showed high stress around the top of fixture that contact cortical bone, but there was not a portion on the bottom of fixture that concentrate highly stress and play the role of stress dispersion. These results demonstrated that obtaining the more contact from the bucco-lingual cortical bone by installing wide diameter implant plays an important role in biomechanics.

• 대한치과보철학회지
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• 제57권4호
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• pp.397-404
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• 2019

성공적인 임플란트 치료를 위해서는 식립부위의 골조직 및 연조직 상태(condition)도 중요하지만 식립 위치 또한 매우 중요하다. 잘못된 위치에 식립된 임플란트는 생물학적, 심미적, 기계적 문제점을 야기하게 된다. 올바른 위치에 임플란트를 식립하기 위해서는 최종 보철물을 고려해야 하며 이를 위해서는 진단 왁스업 과정이 필요하다. 발치 후 사용 할 임시 의치의 인공치를 진단 왁스업 형태대로 제작하면 구강내에서 진단 왁스업 형태를 평가해 볼 수 있으며, 잘 적응된 임시 의치를 복제해 제작한 임플란트 수술용 템플릿으로 계획된 위치에 임플란트를 식립하는 것이 가능하다. 본 증례에서는 진단 왁스업을 디지털 복제하여 의치용 인공치를 맞춤형으로 제작하였고, 이를 이용해 임시 의치를 제작하였다. 충분한 적응 기간을 거친 후 임시 의치를 복제하여 임플란트 수술용 템플릿을 제작한 다음, 이를 활용하여 계획된 위치에 임플란트를 식립하였다. 골유착을 위한 충분한 치유기간을 가진 다음 진단 왁스업 형태가 반영된 임플란트 지지형 고정성 보철물을 제작하였다. 최종 보철물 장착 후 6개월간의 경과 관찰 기간 동안 심미적, 기능적으로 만족할 만한 치료 결과를 보였기에 이를 보고하고자 한다.

• The Journal of Advanced Prosthodontics
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• 제4권2호
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• pp.61-71
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• 2012

PURPOSE. To compare the changes in the occlusal vertical dimension, activity of masseter muscles and biting force after insertion of immediate denture constructed with conventional, tooth-supported and Implant-supported immediate mandibular complete denture. MATERIALS AND METHODS. Patients were selected and treatment was carried out with all the three different concepts i.e, immediate denture constructed with conventional (Group A), tooth-supported (Group B) and Implant-supported (Group C) immediate mandibular complete dentures. Parameters of evaluation and comparison were occlusal vertical dimension measured by radiograph (at three different time intervals), Masseter muscle electromyographic (EMG) measurement by EMG analysis (at three different positions of jaws) and bite force measured by force transducer (at two different time intervals). The obtained data were statistically analyzed by using ANOVA-F test at 5% level of significance. If the F test was significant, Least Significant Difference test was performed to test further significant differences between variables. RESULTS. Comparison between mean differences in occlusal vertical dimension for tested groups showed that it was only statistically significant at 1 year after immediate dentures insertion. Comparison between mean differences in wavelet packet coefficients of the electromyographic signals of masseter muscles for tested groups was not significant at rest position, but significant at initial contact position and maximum voluntary clench position. Comparison between mean differences in maximum biting force for tested groups was not statistically significant at 5% level of significance. CONCLUSION. Immediate complete overdentures whether tooth or implant supported prosthesis is recommended than totally mucosal supported prosthesis.

• 구강회복응용과학지
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• 제33권4호
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• pp.291-298
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• 2017

치조골 폭이 협소한 상악 전치부의 심미적인 임플란트 수복은 임플란트 식립체의 경사각과 위치가 제한되기 때문에 단순한 임플란트 식립만으로는 심미적인 임플란트 보철물을 제작하기 어려운 일이다. 임플란트 보철물이 변연 치은과 조화로운 출현윤곽을 재현하기 위해서는 임플란트 식립체의 이상적인 치조골 내 위치와 식립각이 설정될 수 있어야 하며, 이를 위해서는 종종 임플란트 식립 전 골증대술을 선행하여야 한다. 본 증례는 구개측의 심한 골 결손을 동반한 얇은 치조골 폭을 보이는 상악 전치 상실부에 골증대술을 시행한 후, 임플란트를 식립하여 심미 보철을 시행한 증례이다. 먼저 협측에 과량의 골증대술을 선행하여 불리한 임플란트 식립 위치를 보상할 수 있는 구개측 식립 경사를 확보하였으며, 임시보철물의 외형을 조정하여 인접 치아와 조화로운 변연 치은 높이와 치간 유두를 형성하였다. 최종적으로 지르코니아 코어를 가지는 도재수복물을 이용하여 보철 수복하였고 심미적, 기능적으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• Imaging Science in Dentistry
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• 제33권2호
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• pp.79-83
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• 2003

Purpose : To assess the relationship between the direction of the indicating rod of the radiographic stent for ideal prosthetic design and the actual possible path of implant fixture placement when residual ridge resorption is considered. Materials and Methods: The study materials consisted of 326 implant sites (male 214 cases and female 112 cases) from a total of 106 patients (male 65 patients and female 41 patients) who desired implant prostheses. Computed tomography of patients were taken and reformatted using ToothPix/sup (R)/ software. Bony defects, bony sclerosis, the change of the direction of indicating rod, and root proximity of the adjacent teeth were examined on the CT-derived images. Results: The rate of the irregular crestal cortex was relatively high on premolar and molar area of maxilla. Mandibular molar area showed relatively high rate of focal sclerosis on the area of implant fixture insertion. The position of the indicating rods were relatively acceptable on the molar areas of both jaws. However, the position of the indicating rods should be shifted to buccal side with lingual rotation of the apical end on maxillary anterior teeth and premolar area. Conclusion: Clinically determined rod direction and position of the indicating rod for implant placement was not always acceptable for insertion according to the reformatted CT images. The pre-operative treatment plan for implant should be determined carefully, considering the state of the alveolar bone using the reformatted CT images.

• 대한치과보철학회지
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• 제56권4호
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• pp.354-359
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• 2018

상악 전치부의 단일 임플란트 수복 치료 시, 치은 퇴축 및 골결손 문제를 가질 경우 임플란트 보철의 심미적인 결과를 얻는 것은 쉽지 않다. 장기적으로 심미적 안정성이 유지되기 위해서는 임플란트를 이상적인 위치에 식립하는 것이 중요하며 연조직의 회복 및 보철물과의 조화가 중요하다. 이러한 심미성이 더욱 요구되는 임플란트 보철물의 제작 시 이상적인 임플란트의 위치 뿐만 아니라, 주변 연조직과의 조화 역시 중요하다. 본 증례에서는 상악 전치부에서 골결손과 치은 퇴축이 진행된 47세 남자환자에서 골유도재생술 및 치은재형성술을 통해 심미 임플란트 치료를 진행하였다.

• 대한치과기공학회지
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• 제45권4호
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• pp.124-130
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• 2023

This study aims to describe the clinical experience of single and bridge crowns fabricated using a cementless screw-retained implant prosthesis system. In the case of single crown (#37), regular link (HDL) was used, and bridge crowns (#15~#24), (#26~#27), (#17~#14) (#24~#26) were fabricated by selecting regular link and short link considering the vertical height. One abutment was hex shaped to ensure that it could be mounted while preventing insertion and prosthesis rotation. The advantages of cementless implant prosthesis include shorter chair time and periodic care, strong retention with LINK abutment, safety from inflammation, bacterial infection, and complications due to peri-implant cement, and high patient satisfaction. Dentists should double-check the position of the implant fixture and dental technicians should continuously manage the fit of the link and prosthesis with digital equipment to reduce screw loosening and fractures.

• Journal of Korean Dental Science
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• 제17권2호
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• pp.84-91
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• 2024

Achieving both esthetic and functional implant rehabilitation is crucial for the successful treatment of the anterior maxilla. Adequate peri-implant alveolar bone and soft tissue are essential for optimal rehabilitation of the esthetic area, and there is a direct association between the implant position and prosthetic outcomes. Immediate provisionalization may also be advantageous when combined with augmentation. This case report described the implant placement in a 25-year-old female patient who had lost her right maxillary lateral incisor (#12) due to trauma-induced avulsion. The treatment involved simultaneous grafting and collagenated, deproteinized bovine bone mineral, along with subepithelial connective tissue taken from the right maxillary tuberosity. A polyetheretherketone abutment and non-functional immediate provisionalization were performed by removing both the proximal and occlusal contacts on the composite resin crown. Clinical and radiographic evaluations revealed maintenance of stable ridge contour aspects for six months following surgical treatment. In summary, implant rehabilitation in the esthetic zone can be successful using simultaneous soft and hard tissue grafts. Moreover, soft tissue stabilization post-subepithelial connective tissue grafting can be achieved through early or immediate visualization, along with immediate implant placement.

• Journal of Periodontal and Implant Science
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• 제35권1호
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• pp.187-197
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• 2005

The aim of this study was to investigate the influence of peri-implant soft tissue and bone thickness on the early dimensional change of peri-implant soft tissue. Seventy-seven non-submerged implants of 39 patients which had been loaded more than 6 months were selected for the study. Following clinical parameters were measured; bucco-lingual bone width of the alveolar bone for implant placement before implant surgery; distance between implant shoulder and the first bone/implant contact at the surgery; presence of plaque, probing depth, bleeding on probing, width of keratinized mucosa, mucosa thickness, distance between implant shoulder and peri-implant mucosa, crown margin location at follow-up examination. The results showed that distance between implant shoulder and peri-implant mucosa (DIM) was correlated with probing depth and width of keratinized mucosa (p < 0.05). In addition, mucosa thickness was also correlated with probing depth (p<0.05). However, the bone width of alveolar bone and soft tissue thickness were not found to be correlated with DIM. It is important to understand the meaning of peri-implant tissue dimension in relation to dimensional changes of peri-implant soft tissue which designates appearance of implant-supported restorations. Future study is needed to elucidate the significance of the buccal bone thickness and soft tissue thickness with respect to the change of peri-implant soft tissue margin with the use of an instrument capable of measuring buccal bone thickness directly.

• 구강회복응용과학지
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• 제21권2호
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• pp.169-182
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• 2005

The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.