• The Journal of Korean Academy of Prosthodontics
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• v.33 no.2
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• pp.335-353
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• 1995

The purpose of this study was to the determine the optimal torques values to tighten the retaining screw. 3-different implant system tested were as follows : Branemark implant system$(3.75mmD{\times}100mm)$, Steri-Oss implant system$(3.8mmD{\times}10mm)$. One fixtures of each implant system was mounted into the epoxy resin block and abutment/superstructure complex was constructed. Eighty dental college students(male : 40, female : 40) of Chosun University were selected and were asked to tighten the retaining screws. Abutment/superstructure complex of each implant system was tightened to the maximum torque by use of hand-held screw driver, and then torque value was measured with torque value was measured with torque driver(Tohnichi torque driver, model 20 FTD, Tohnichi MFG, Co., LTD., Tokyo, Japan). Abutment/superstructure complex of each implant system was titghtened to each torque of 10 N-cm, 20 N-cm and 30 N-cm, and then the dynamic load(vertical & diagonal load) was applied to the abutment / superstructure complex. The gap between abutment/superstrure in each implant system was measured with 3-dimensional measuring microscope(model No. 850, Germany). The results were as follow : 1. Torque values according to the individual subjects showed wide range. 2. Torque values according to sex showed statistical significant difference. Those are as follows : in case of male, $9.38{\pm}2.93$ N-cm ; incase of female, $7.80{\pm}2.25$ N-cm. 3. Torque values according t implant systems showed statistical significant difference. Those are as follows : in ase of Branemark implant system, $6.54{\pm}1.54$ N-cm : in ase of Steri-Oss implant system, $10.1{\pm}2.88$ N-cm ; in case of IMZ implant system, $9.18{\pm}2.17$ N-cm. 4. The more torque value of tightening screw was increased, the less the gap was after the vertical and diagonal loading. 5. The gap after the diagonal loading was greater than that after the vertical loading. 6. The magnitude of gap between abutment/superstructure in order of IMZ, Steri-Oss, Branemark implant system after the verical and diagonal loading. 7. The gap under the diagonal loading after applying 30 N-cm torque showed no statistical significant difference in cases of the Branemark system and the Steri-Oss implant system but it showed significant different in case of the IMZ implant system.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.724-743
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• 2000

One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.1
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• pp.17-25
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• 2003

Treatment with implants of single tooth missing cases is both functional and esthetic. Although the success rate of single-tooth implant treatments is increasing, sometimes it makes some problems. Problems with single-tooth implant treatments include soft tissue complications, abutment screw fracture, and most commonly, abutment screw loosening, and these involve the instability of the dental implant-superstructure interface. This study investigated and compared dental implant screw joint micromotion of various implant system with external connection or internal connection when tested under simulated clinical loading, Six groups (N=5) were assessed: (1) Branemark AurAdapt (Nobel Biocare, Goteborg, Sweden), (2) Branemark EsthetiCone (Nobel Biocare, Goteborg, Sweden), (3) Neoplant Conical (Neobiotec, Korea), (4) Neoplant UCLA (Neobiotec, Korea), (5) Neoplant 5.5mm Solid (Neobiotec, Korea), and (6) ITI SynOcta (Institute Straumann, Waldenburg, Switzerland). Six identical frameworks were fabricated. Abutment screws were tightened to 32-35 Ncm and occlusal screw were tightened to 15-20 Ncm with an electronic torque controller. A mechanical testing machine applied a compressive cyclic load of 20kg at 10Hz to a contact point on each implant crown. Strain gauge recorded the micromotion of the screw joint interface once a second. Data were selected at 1, 500, 5,000, 10,000, 20,000, 30,000, 40,000 and 50,000 cycle and 2-way ANOVA test was performed to assess the statistical significance. The results of this study were as follows; The micromotion of the implant-superstructure in the interface increased gradually through 50,000 cycles for all implant systems. In the case of the micromotion according to cycle increase, Neoplant Conical and Neoplant UCLA system exhibited significantly increasing micromotion at the implant-superstructure interface (p<0.05), but others not significant. In the case of the micromotion of the implant-superstructure interface at 50,000 cycle, the largest micromotion were recorded in the Branemark EsthetiCone, sequently followed by Neoplant Conical, Neoplant UCLA, Branemark AurAdapt, ITI SynOcta and Neplant Solid. Internal connection system showed smaller micromotion than external connection system. Specially, Neoplant Solid with internal connection system exhibited significantly smaller micromotion than other implant systems except ITI SynOcta with same internal connection system (p<0.05). In the case of external connection, Branemark EsthetiCone and Neoplant Conical system with abutment showed significantly larger micromotion than Branemark AurAdapt without abutment (p<0.05).

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.3
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• pp.273-283
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• 2010

This study evaluated the effect of 3 different compatible screws on the detorque values in a multiple implant-supported superstructure and single implant abutments. An implant superstructure directly connected to 4 implants was screwed to 6 experimental dental stone casts made by acrylic resin splinted impressions, using 20 Ncm. The detorque values of screws were measured twice. Three compatible abutment screws used in this study were TorqTite screw, Gold-Tite screw, and, Titanium screw. And, using single implant abutments (GoldAdapt Engaging abutments), the detorque values of 3 different screws were measured twice on 2 implants of 5 experimental casts. According to statistical analysis of detorque values using mixed model at a .05 level of significance, no statistically significant differences among 3 different compatible screws were found in a multiple implant-supported superstructure (p>0.05). But, in single implant abutments, statistically significant differences among 3 different compatible screws were found (p=0.0175). The detorque values of TorqTite(p=0.0462) and Titanium(p=0.0348) screws were significantly higher than those of Gold-Tite screw, but no statisticantly significantlydifferences were found between TorqTite and Titanium screws(p>0.05). Therefore, various compatible screws showed significant effects on the detorque values for single implant abutment, but, showed no significant effects for a multiple implant-supported superstructure.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.2
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• pp.226-237
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• 2004

Purpose: Four finite element models were constructed in the mandible having a single implant fixture connected to the first premolar-shaped superstructure, in order to evaluate how the shape of the fixture and the implant-abutment connection would influence the stress level of the supporting tissues fixtures, and prosthethic components. Material and methods : The superstructures were constructed using UCLA type abutment, ADA type III gold alloy was used to fabricate a crown and then connected to the fixture with an abutment screw. The models BRA, END , FRI, ITI were constructed from the mandible implanted with Branemark, Endopore, Frialit-2, I.T.I. systems respectively. In each model, 150 N of vertical load was placed on the central pit of an occlusal plane and 150 N of $40^{\circ}$ oblique load was placed on the buccal cusp. The displacement and stress distribution in the supporting tissues and the other components were analysed using a 2-dimensional finite element analysis . The maximum stress in each reference area was compared. Results : 1. Under $40^{\circ}$ oblique loading, the maximum stress was larger in the implant, superstructure and supporting tissue, compared to the stress pattern under vertical loading. 2. In the implant, prosthesis and supporting tissue, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 3. In the superstructure and implant/abutment interface, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 4. In the implant fixture, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 5 The stress was more evenly distributed in the bone/implant interface through the FRI of trapezoidal step design. Especially Under $40^{\circ}$ oblique loading, The maximum stress was smallest in the bone/implant interface. 6. In the implant and superstructure and supporting tissue, the maximum stress occured at the crown loading point through the ITI. Conclusion: The stress distribution of the supporting tissue was affected by shape of a fixture and implant-abutment connection. The magnitude of maximum stress was reduced with the internal connection type (FRI) and the morse taper type (ITI) in the implant, prosthesis and supporting tissue. Trapezoidal step design of FRI showed evenly distributed the stress at the bone/implant interface.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.3
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• pp.438-447
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• 1996

This study was performed to determine the failure strength and pattern of implant prosthesis luted with resin cement between gold cylinder and superstructure, and to evaluate the bonding strength of resin cement. To evaluate failure strength and pattern, the groups were divided into 2. Group 1 : Casted gold cylinder Group 2 : Luted with resin cement between gold cylinder ans superstructure. To evaluate effects of the bonding strength of the implant prosthesis luted with resin cement according to storage condition, the groups were divided into 3 : Group A : Stored in waste at $37^{\circ}C$ for 24 hours. Group B : 1000 cycles thermocycled between $5^{\circ}C\;and\;55^{\circ}C$ in water. Group C : Stored in water at $37^{\circ}C$ for 30 days. The results were as follows. 1. Failure was found at gold screw in all specimens of group 1 & 2. 2. The bond strength in group 1 and 2 was 189.86 and 188.14kgf. There was no statistically significant difference between group 1 and 2(P>0.05). 3. The bond strength of group A, B and C was 53.28, 45,86 and 39.29Kgf. There result suggest the advantage of an improved fit of superstructure to the abutment and a simple procedure. But there was a measurable decrease of the bond strength according to storage condition. So, Further research is necessary to evaluate of the implant prosthesis luted with resin cement between gold cylinder and superstructure.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.1
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• pp.70-81
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• 2009

Statement of problem: The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever-rest-implant" and Malo reported "All-on-Four" in 2003. Purpose: Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and All-on-$Four^{TM}$ implant prostheses. Material and method: The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0. Results: 1. The rest implant and "All-on-Four" implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.653-664
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• 2007

Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.5
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• pp.463-476
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• 2001

Since the treatment of edentulous patients with osseointegrated implant was first introduced more than 30 years ago, implant therapy has become one of the most important dental treatment modalities today. Based on the previous experience and knowledge, $Br{\aa}nemark\;Novum^{(R)}$ protocol was introduced with the concept of simplifying surgical and prosthetic technique and reducing healing time recently. This protocol recommends the installation of three 5mm wide diameter futures in anterior mandible and the prefabricated titanium bars for superstructure fabrication. This study was designed to analyze the stress distribution at fixture and superstructure area according to changes of fixture number, diameter and superstructure materials. Four 3-dimensional finite element models were fabricated. Model 1 - 5 standard fixtures (13mm long and 3.75mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 2- 3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 3-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and resin Model 4-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and porcelain A 150N occlusal force was applied on the 1st molar of each model in 3 directions - vertical($90^{\circ}$), horizontal($0^{\circ}$) and oblique($120^{\circ}$). After analyzing the stresses and displacements, following results were obtained. 1. There were no significant difference in stress distribution among experimental models. 2. Model 2, 3, 4 showed less amount of compressive stress than that of model 1. However, tensile stress was similar. 3. Veneer material with a high modulus of elasticity demonstrated less stress accumulation in the superstructure. Within the limites of this study, $Br{\aa}nemark\;Novum^{(R)}$ protocol demonstrated comparable biomechanical properties to conventional protocol.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.1
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• pp.53-67
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• 2002

This study was aimed to analyze the stress distribution of implant and supporting tissue in single tooth implant restoration using Branemark $system^{(R)}$(Nobel Biocare, Gothenberg, Sweden) and Bicon system(Bicon Dental Implants, Boston, MA). Two dimensional finite element analysis model was made at mandibular first premolar area As a crown materials porcelain, ceromer, ADA type III gold alloy were used. Tests have been performed at 25Kgf vertical load on central fossa of crown portion and at 10Kgf load with $45^{\circ}$ lateral direction on cusp inclination. The displacement and stresses of implant and supporting structures were analyzed to investigate the influence of the crown material and the type of implant systems by finite element analysis. The results were obtained as follows : 1. The type of crown material influenced the stress distribution of superstructure, but did not influence that of the supporting alveolar bone. 2. The stress distribution of ceromer and type III gold alloy and porcelain is similar. 3. Stress under lateral load was about twice higher than that of vertical load in all occlusal restorative materials. 4. In Bicon system, stress concentration is similar in supporting bone area but CerOne system generated about 1.5times eater stress more in superstructure material. 5. In Branemark models, if severe occlusal overload is loaded in superstvucture. gold screw or abutment will be fractured or loosened to buffer the occlusal overload but in Bicon models such buffering effect is not expected, so in Bicon model, load can be concentrated in alveolar bone area.