• 대한치과보철학회지
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• 제34권3호
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• pp.501-532
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• 1996

This study investigated the effects of cantilever length, location and load condition on stress distribution developed in the implants, prostheses and supporting tissues. The osseointegrated prostheses with two 10mm Branemark implants at 2nd premolar and 1st molar sites with cantilever extensions at 1st premolar, 2nd and 3rd molar sites were constructed. Under 100N, 200N of vertical and $45^{\circ}$ oblique loads at the cantilever pontics, stress distribution patterns and displacement were analyzed with three dimensional finite element method. The results were as follows : 1. The stress was concentrated at the joint of the cantilever pontic and implant superstructure, the neck of implant and the ridge crest near the cantilever But there was little load transfer to the lower supporting tissues of implants. 2. The implant near the cantilever was displaced inferiorly while the implant far from the cantilever was displaced superiorly. In horizontal direction the implants were displaced to the direction where the loads were applied, except the apexes of the implants. 3. In case of anterior cantilever, the stress and displacement were higher than the prosthesis connected with natural tooth. 4. The stress developed in the posterior cantilevered type was higher than in the anterior cantilevered type. The greastest stress was concentrated at the ridge crest near the posterior cantilever. 5. The longer the cantilever, the more the stress was developed and was concentrated at the joint of the cantilever pontic and implant superstructure. 6. Under oblique load, the stress was concentrated at the necks of implants and the ridge crests, but decreased at the joint of the cantilever pontic and implant superstructure than under vertical load.

• 대한치과기공학회지
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• 제40권2호
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• pp.63-69
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• 2018

Purpose: The purpose of this study is to investigate the non-precious metal core materials used in the dental laboratory to fabricate the implant superstructure by CAD / CAM method. And to observe and compare the morphology and distribution of the osteoblasts in relation to implant osseointegration. Methods: In this study, the mandibular right first molar tooth model was selected as an international standard to produce a single core. Using this model, the impression was made with the silicone rubber, the tooth model was scanned, and a single core was designed and 5-axis milling was performed. The materials used were Cobalt-Chromium and Nickel-Chromium, and the cores for dental implant top structures were fabricated according to the procedures of the dental labs. After the fabrication, the marginal area of the core was separated and cell culture experiment was performed. The osteoblast cells used MC3T3-E1, which is currently widely used. For morphological analysis of osteoblasts, cells were posttreated and observed using CLSM (Confocal Laser Scanning Microscope) and compared. Results: The cell adhesion behavior of the specimen surface measured by CLSM was uniformly distributed in specimen A (Cobalt-Chromium) than in specimen B (Nickel-Chromium). The distribution and changes of the cells were different in the two specimens. Conclusion : It is possible to confirm that specimen A (Cobalt-Chromium) is suitable for the living body through adhesion and proliferation of osteoblasts related to implant osseointegration in the non-precious metal superstructure used after implantation. It is considered that it is preferable to use Co-Cr when fabricating the superstructure.

• 대한치과보철학회:학술대회논문집
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• 대한치과보철학회 2000년도 춘계학술대회
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• pp.43-43
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• 2000

• 대한치과보철학회지
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• 제36권2호
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• pp.203-244
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• 1998

The human mandible is always under the condition of loading by the various forces extorted by the attached muscles. The loading is an important condition of the stomatognathic system. This condition is composed of the direction and amount of forces of the masticatory muscles, which are controlled by the neuromuscular system, and always influenced by the movement of both opening and closing. Mandible is a strong foundation for the teeth or various prostheses, nevetheless it is a elastic body which accompanies deformation by the external forces on it. The elastic properties of the mandible is influenced by the various procedures such as conventional restorative treatments, osseointegrated implant treatments, reconstructive surgical procedures and so forth. Among the treatments the osseointegrated implant has no periodontal ligaments, which exist around the natural teeth to allow physiologic mobility in the alveolar socket. And so around the osseointegrated implant, there is almost no damping effect during the transmission of occlusal stress and displacements. If the osseointegrated implants are connected by the superstructure for the stabilization and effective distribution of occlusal stresses, the elastic properties of mandible is restricted according to the extent of 'splinting' by the superstructure and implants. To investigate the change of elastic behaviour of the mandible which has osseointegrated implant prosthesis of various numbers of implant installment and span of superstructre, a three dimensional finite element model was developed and analyzed with conditions mentioned above. The conclusions are as follows : 1. The displacements are primarily developed at the area of muscle attachment and distributed all around the mandible according to the various properties of bone. 2. The segmentation in the superstructure has few influence on the distribution of stress and displacement. 3. In the load case of ICP, the concentration of tensional stress was observed at the anterior portion of the ramus($9.22E+6N/m^2$) and at the lingual portion of the symphysis menti($8.36E+6N/m^2$). 4. In the load case of INC, the concentration of tensional stress was observed at the anterior portion of the ramus($9.90E+6N/m^2$) and the concentration of tensional stress was observed at the lingual portion of the symphysis menti($2.38E+6N/m^2$)). 5. In the load case of UTCP, the relatively high concentration of tensional stress($3.66E+7N/m^2$) was observed at the internal surface of the condylar neck.

• 대한치과보철학회지
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• 제35권3호
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• pp.435-444
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• 1997

Transmandibular implant system은 하악골이 심하게 흡수된 환자에게 특히 유용하게 사용할 수 있다. 또한 여러 문헌에서도 높은 성공률을 보이고 있다. 저자가 시행한 증례에서도 환자는 높은 만족감과 의치의 안정성 및 저작효율의 증대를 보였다. 하지만 성공적인 보철물의 제작을 위해서는 신중한 진단과 치료계획 및 위에서 열거한 여러 가지 고려사항들을 참고해야 한다.

• 대한치과보철학회지
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• 제46권4호
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• pp.359-371
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• 2008

연구목적: 본 연구에서는 하악의 동일한 부위에 4개의 임플랜트를 식립하여 임플랜트 피개의치를 설계하는 경우, 바 구조와 이중관 구조 간의 응력분포에 대해 비교 분석하고자 하였다. 연구재료 및 방법: 하악골, 하악골에 식립한 4개의 임플랜트, 일차고정의 바 연결 상부구조, 이차고정의 이중관 상부구조를 삼차원 유한요소 모델링하였고, 상부 구조물에 최대 교두 감합위를 재현하는 수직하중과 측방운동시 작업측의 군기능을 재현하는 경사하중을 가하고, 최대 응력과 응력분포를 하악골, 임플랜트 지대주, 임플랜트 상부 구조물에서 분석하였다. 결과: 1. 악골에서의 최대 응력값은 경사하중을 제외하고 수직하중과 작업측 경사하중에서 이중관 구조가 바 구조에 비해 다소 적은 응력값을 보였다. 이중관 구조가 바 구조에 비해 비교적 악골 전체에 고르게 응력이 분포되었다. 2. 지대주에서는 모든 하중 조건에서 이중관 구조가 바 구조에 비해 낮은 응력값을 보였다. 응력 분포 양상은 두 구조에서 모두 비슷한 양상을 나타내었으며, 최후방 지대주의 원심면에 응력이 집중되었다. 3. 상부구조물에서는 모든 하중 조건에서 이중관 구조가 바 구조에 비해 높은 응력값을 나타냈다. 그러나, 바 구조에서는 바의 각 중심부와 지대주와의 연결부위, 지대주의 치경부에 응력이 집중된 반면, 이중관 구조에서는 상부 구조물 전체에 비교적 고른 응력 분포를 보였다. 결론: 본 연구 결과 이중관 구조가 바 구조보다 악골과 지대주에서는 더 낮은 응력을, 상부 구조물에서는 더 큰 응력을 나타냈다. 상부 구조물에 비교적 크게 전달되는 응력을 견딜 수 있는 상부구조물의 설계와 재료 선택만 이루진다면, 응력분포 면에서 이차고정을 하는 이중관 구조가 일차 고정하는 바 구조에 비해 유리하리라 생각된다.

• 대한치과보철학회지
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• 제31권1호
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• pp.129-150
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• 1993

Since the restoration or masticatory function is the most important aim of implants, it should be substituted for the role of natural teeth and deliver the stress to the bone under the continous load during function. In natural teeth, stress distribution can be obtained through enamel, dentin and cementum and the elasticity of the periodontal ligament play a role of buffering action. In contrast, implant prosthesis has a very unique characteristics that it delvers the load directly to bone through the implant and superstructure. This fact arise the needs to evaluate the stress distribution of the implant in the mechnical aspects, which has a similar role of natural teeth but different pathway of stress. With 3 kinds of implant in prevalent use, 2 types of experimental PEA implant models were made, axisymmetric and 2-dimensional type. In axisymmetric model, the stiffness of the part including the prosthesis and implant which extrude out of bony surface could be calculated with displacement of the superstructure un er 100N vertical load and then damping effects could be determined through this stiffness. In axisymmetric FEA model, load to the bone could be deduced by evaluation the stress distribution of the designed surface under the 100N vertical force and in 2-dimensional model, 100N eccentric vertical load and 20N horizontal loda. The result are as follows. 1. In every implant, stress to the bone tends to be concenturated on the cortical bone. 2. Though the stress of the cancellous bone is larger at the apex of implants, it is less compared with cortical bone. 3. Under 20N horizontal load, stress of the left and right sides of implant shows a symmetrical pattern. But under 100N eccentric vertical load, loaded side shows much larger stress value. 4. In the 1mm interface, stress distribution among implants tend to have a similar pattern. But under 20N horizontal load apposite side of being loaded shows less stress in IMZ. 5. In the case of screw type implant, stress tends to vary along with screw shape. 6. According to the result determined with microstrain, cancellous bone id generally under the condition of overload, while cortical bone is usually within the limitation of physiologic load. 7. In the Branemark implant, maximum stress to the cortical bone is larger than any other implant except for the condition of 20N horizontal force and 0.05mm interface. 8. Damping effects of implants is maximum in IMZ.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권2호
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• pp.108-118
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• 2010

Introduction: Maxillary posterior region, compared to the mandible or maxillary anterior region, has a thin cortical bone layer and is largely composed of cancellous bone, and therefore, it is often difficult to achieve primary stability. In such cases, sinus elevation with bone graft is necessary. Materials and Methods: In this research, 121 patients who had implant placement after bone graft were subjected to a follow-up study of 5 years from the moment of the initial surgery. The total survival rate, 5-year cumulative survival rate and the influence of the following factors on implant survival were evaluated; the condition of the patient (sex, age, general body condition), the site of implant placement, diameter and length of the implant, sinus elevation technique, closure method for osseous window, type of prosthesis and opposing teeth. Results: 1. The 5-year cumulative survival rate of total implants was 90.5%, there was no significant difference between sex, age, the site of implant placement, diameter and length of the implant, sinus elevation technique, and the type of opposing teeth. 2. Patients with diabetes mellitus < osteoporosis and smooth-surfaced machined group < hydroxyapatite (HA)-treated group and homogenous demineralized freeze dried allogenic bone (DFDB) bone graft only group had significantly lower survival rate. 3. With less than 4 mm of residual alveolar ridge height, lateral approach without closing the osseous window resulted in a significantly lower survival rate. 4. Restoration of a single implant showed a significantly lower survival rate, compared to cases where the superstructure was joined with several implants in the area. Conclusion: Patients with diabetes or osteoporosis need longer period of time for osseointegration compared to the normal, and the dentists must be prudent when choosing a surface treatment type and the bone graft material. Also, as the vertical dimension of the residual alveolar ridge can influence the result, staged implant placement should be considered when it seems difficult for the implant to gain primary stability from the residual bone with less than 4 mm of vertical dimension. It is recommended to obdurate the bone window and that the superstructure be connected with several impants in the peripheral area.

• 구강회복응용과학지
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• 제24권3호
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• pp.253-267
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• 2008

이 연구의 목적은 임플란트 고정체와 지대주간의 직경 차이가 임플란트 지지조직에 발생하는 응력에 미치는 영향을 평가 하는 것이다. 본 연구에는 세 가지 직경(4.0, 5.0, 6.0㎜)의 3i 임플란트 고정체에 지대주의 직경을 달리하여 수복하고, 하중 조건(15, 30 lb)에 따라 임플란트 지지조직에 발생한 응력의 정도와 분포를 광탄성 응력 분석법을 이용하여 비교, 분석하였다. 연구결과 고정체의 직경이 증가할수록, 상부 보철물에 가해지는 하중에 대하여 고정체 변연부의 응력집중이 높게 나타났으며, 상부 보철물의 근원심 폭경을 증가시키는 것이나, 임플란트 고정체의 직경에 비해 작은 지대주를 사용하는 것은 고정체 주위의 응력양상에 영향을 주지 않았다.

• 대한치과보철학회지
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• 제36권4호
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• pp.587-597
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• 1998

In this study, the Periotest value was measured with Periotest to evaluate precision fit of the 2-unit and 3-unit implant-supported prosthesis by modifying the size and location of ill-fitted conditions. The 2-unit prosthesis was fabricated with the right implant fitted incorrectly and the 3-unit prosthesis with the right and center implant fitted incorrectly. To evaluate the effects of the ill-fitted sizes, 4 groups were divided.:The control group being the accurately fabricated sample group fitted properly. Group 1 was constructed with $40{\mu}m$ ill-fitted conditions, group 2 with $70{\mu}m$ and group 3 with $100{\mu}m$ ill-fitted conditions. The Periotest value was measured at each implant site after tightening 10Ncm. The result was follows : 1. The PTV on the ill-fitted area in the 2-unit implant-supported prosthesis increased as the ill-fitted conditions increased. There was a statistically significant difference among groups(p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated a statistically significant difference (p<0.05) 2. The PTV on the ill-fitted area of the 3-unit implant-supported with an ill-fitted condition in the right implant increased as the ill-fitted conditions increased. There was a significant difference among groups (p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated a statistically significant difference (p<0.05). 3. In the 3-unit implant-supported prosthesis with ill fitting conditions in the center implant, the PTV on the ill-fitted area demonstrated a statistically significant difference between the control group, group 1 and group 2 (p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated significant difference between the gap side and the adjacent side with over $70{\mu}m$ ill-fitted conditions (p<0.05). The results suggest that Periotest is a valuable objective method for evaluating the precision fit of an implant superstructure.