• The Journal of Korean Academy of Prosthodontics
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• v.54 no.3
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• pp.239-245
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• 2016

Purpose: The purpose of this study was to identify clinical complications in removable partial denture (RPD) with implant-supported surveyed prostheses, and to analyze the factors associated with the complications such as location of the implant, splinting adjacent prostheses, the type of retentive clasps, Kennedy classification, and opposing dentition. Materials and Methods: A retrospective clinical study was carried out for 11 patients (7 male, 4 female), mean age of 67.5, who received RPD with Implant-supported surveyed prostheses between 2000 and 2016. The mechanical complications of 11 RPDs and 37 supporting implant prostheses and the state of natural teeth and peripheral soft tissue were examined. Then the factors associated with the complications were analyzed. Results: The average of 3.4 implant-supported prostheses were used for each RPD. Complications found during the follow-up period of an average of 42.1 months were in order of dislodgement of temporary cement-retained prostheses, opposing tooth fracture/mobility, screw fracture/loosening, clasp loosening, veneer porcelain fracture, marginal bone resorption and mobility of implant, artificial tooth fracture. Complications occurred more frequently in anterior region compared to posterior region, non-splinted prostheses compared to splinted prostheses, surveyed prostheses applied by wrought wire clasp compared to other clasps, and natural dentition compared to other removable prostheses as opposing dentition. There were no significant differences in complications according to the Kennedy classification. Conclusion: All implant-assisted RPD functioned successfully throughout the follow-up. However, further clinical studies are necessary because the clinical evidences are still not enough to guarantee the satisfactory prognosis of implant-assisted RPD for long-term result.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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• pp.394-404
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• 2006

Statement of problem: A conventional 3-unit fixed partial denture design with a pontic between two retainers is the most commonly used. However in cases where the mental nerve is in close proximity to the second premolar, a cantilever design can be considered. As such, logical and scientific evidence is lacking for the number and position of implants to be placed for partially edentulous patients, and no clear-cut set of treatment principles currently exist. Purpose : The purpose of this study was to evaluate prognosis of implant-supported fixed partial dentures and to compare changes in bone level which may rise due to the different factors. Material and method : The present study examined radiographical marginal bone loss in patients treated with implant-supported fixed partial dentures (87 prostheses supported by 227 implants) and evaluated the influence of the span of the pontic, type of the opposing dentition. Clinical complications were studied using a retrospective method. Within the limitation of this study. the following result were drawn Result, 1. Seven of a total of 227 implants restored with fixed prostheses failed, resulting in a 96.9% success rate. 2. Complications encountered during recall appointments included dissolution of temporary luting agent (17 cases), porcelain fracture (8 cases), loosened screws (5 cases), gingival recession (4 cases), and gingival enlargement (1 case). 3. Marginal bone loss, 1 year after prosthesis placement, was significant(P<0.05) in the group that underwent bone grafting, however no difference in annual resorption rate was observed afterwards. 4. Marginal bono loss, 1 year post-placement, was greater in cantilever-type prostheses than in centric pontic protheses (P<0.05). 5. Marginal bone loss was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. The degree of marginal bone loss was proportional to the length of the pontic (P<0.05). Conclusion: The success rate of implant-supported fixed partial dentures, including marginal bone loss, was satisfactory in the present study. Factors influencing marginal bone loss included whether bone graft was performed, location of the pontic (s), location of the surgical area in the arch pontic span. Long-term evaluation is necessary for implant-supported fixed partial dentures, as are further studies on the relationship between functional load and the number of implants to be placed.

• 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 Advanced Prosthodontics
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• v.7 no.3
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• pp.207-213
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• 2015

PURPOSE. The purpose of this study was to examine the abutment screw stability of screw- and cement-retained implant-supported dental prosthesis (SCP) after simulated cement washout as well as the stability of SCP cements after complete loosening of abutment screws. MATERIALS AND METHODS. Thirty-six titanium CAD/CAM-made implant prostheses were fabricated on two implants placed in the resin models. Each prosthesis is a two-unit SCP: one screw-retained and the other cemented. After evaluating the passive fit of each prosthesis, all implant prostheses were randomly divided into 3 groups: screwed and cemented SCP (Control), screwed and non-cemented SCP (Group 1), unscrewed and cemented SCP (Group 2). Each prosthesis in Control and Group 1 was screwed and/or cemented, and the preloading reverse torque value (RTV) was evaluated. SCP in Group 2 was screwed and cemented, and then unscrewed (RTV=0) after the cement was set. After cyclic loading was applied, the postloading RTV was measured. RTV loss and decementation ratios were calculated for statistical analysis. RESULTS. There was no significant difference in RTV loss ratio between Control and Group 1 (P=.16). No decemented prosthesis was found among Control and Group 2. CONCLUSION. Within the limits of this in vitro study, the stabilities of SCP abutment screws and cement were not significantly changed after simulated cement washout or screw loosening.

• The Journal of Advanced Prosthodontics
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• v.9 no.2
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• pp.124-129
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• 2017

PURPOSE. This study evaluated the effect of span length on the adaptation of implant-supported cobalt chromium frameworks fabricated by three techniques. MATERIALS AND METHODS. Models with two solid abutment analogs at different inter-abutment distances were digitized using a laboratory scanner. Frameworks of two-, three-, and four-unit fixed prostheses were designed by a computer. Six dots with a diameter of 0.2 mm were preset on the surface of each framework. A total of 54 implant-supported cobalt chromium frameworks were fabricated by milling, selective laser melting (SLM), and cast techniques. The frameworks were scanned and exported as Stereolithography files. Distances between two dots in X, Y, and Z coordinates were measured in both the designed and fabricated frameworks. Marginal gaps between the framework and the abutments were also evaluated by impression replica method. RESULTS. In terms of distance measurement, significant differences were found between three- and four-unit frameworks, as well as between two- and four-unit frameworks prepared by milling technique (P<.05). Significant differences were also noted between two- and three-unit frameworks, as well as between two- and four-unit frameworks prepared by cast technique (P<.05). The milling technique presented smaller differences than the SLM technique, and the SLM technique showed smaller differences than the cast technique at any unit prostheses (P<.05). Evaluation with the impression replica method indicated significant differences among the span lengths for any fabrication method (P<.05), as well as among the fabrication methods at any unit prostheses (P<.05). CONCLUSION. The adaptation of implant-supported cobalt chromium frameworks was affected by the span length and fabrication method.

• The Journal of Advanced Prosthodontics
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• v.7 no.3
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• pp.264-270
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• 2015

This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene.

• 대한치과보철학회:학술대회논문집
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• 1999.04a
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• pp.45-45
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• 1999

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.131-139
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• 2024

In a edentulous patient, various methods can be employed for prosthetic treatment using implants, such as implant-supported fixed prostheses, overdentures, hybrid prostheses, and implant assisted removable partial denture. In this case, in a patient with moderate to severe chronic periodontitis requiring full arch extractions, implants were strategically placed using computer-guided surgery. In the maxilla, due to inadequate bone quality and quantity leading to insufficient initial stability, delayed loading was implemented, and interim prosthesis was used during the osseointegration period. In the mandible, stable initial stability was achieved, allowing for immediate loading to reduce patient discomfort. Primary stability is considered the most crucial factor for obtaining immediate loading, so a thorough clinical and radiological evaluation of the remaining alveolar bone quantity and quality must be conducted before surgery.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.53-63
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• 2005

Number of fixtures supporting prosthesis for rehabilitation of partial edentulism in distal area is an important factor in distal area to the bone tissue response around dental implant. Optimal number and optimal positioning of dental implant has leaded to the stable condition of bone tissue and successful long-term treatment outcome. This clinical and radiographic study was performed to document and evaluate the short-term result of occlusal rehabilitation by means of implant-supported fixed prostheses (ISPs) especially for partial edentulism in distal area in patients treated for advanced periodontal disease and to verify the number of fixture affecting the bone tissue response. A total of 30 consecutive patients referred because of advanced periodontal disease were included. Before the implant therapy was initiated, periodontal treatment was performed and the outcome evaluated during at least a 6-month period. An individual maintenance care program was designed for each patient. All 75 implants were placed using a 2-stage surgical approach. The patients were divided into 2 groups, in one of which two fixtures were placed and in the other of which three fixtures were placed with tripodal geometry. Following installation of the ISPs, all patients underwent a baseline examination including evaluation of i) oral hygiene, and ii) periodontal/ peri-implant conditions, and iii) radiographs. These examinations were repeated annually during the 1 or 2-year observation period. The results were as follows: 1.No single implant was lost during the observation follow-up period. 1.The percentage of plaque harboring surfaces and bleeding units upon probing were found to be low (<10%), and no soft tissue complications were recorded. 1.Two-fixture group showed bone destruction ranged from 0.0mm to 1.5mm and the mean was 0.31mm. Three-fixture group showed more bone destruction of 0.51mm. There was no statistically difference between two groups. These results suggested that the factor for success is not the number of fixture but the strict maintenance of peri-implant tissue health and initial stability of fixture.

• The Journal of the Korean dental association
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• v.53 no.5
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• pp.307-317
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• 2015

Although the long-term success of osseointegrated endosseous implants for the support of fixed dental prostheses has been reported, the increasingly widespread use of implant-supported prostheses has led to problems associated with their structural integrity. The most common biomechanical complications observed in dental implant treatment are fracture and screw loosening. The nature of loosening or fracture of dental implant components is complex, since it involves fatigue, fitness, and varied chewing patterns and loads. To assess the service life of the components of the prosthetic system, a knowledge of the loads transmitted through the system is necessary. Design of the final restoration and occlusion in relation to the geometry of a prosthetic restoration has a great influence on the mechanical loading of the implant. It is proposed that control of force in oral cavity may play a larger role in failures than previously believed. Based on theoretic consideration and clinical experiences with dental implant, this article gives simple guidelines for controlling these loads.