Even though titanium(Ti) and its alloys are the most used dental implant materials, there are some problems that Ti wears easily and interferes normal osteogenesis due to the metal ions. Ti coated with bioactive ceramics such as hydroxyapatite has also such problems as the exfoliation or resorption of the coated layer, Recent studies on implant materials have been proceeding to improve physical properties of the implant substrate and biocompatibility of the implant surfaces. The purpose of the present study was to examine the physical property and bone tissue compatibility of bioinert nitrides ion plated Ti, Button type specimens(14mm in diameter, 2.32rrun in height) for the abrasion test and cytotoxicity test and thread type implants(3.75mm in diameter, 6mm in length) for the animal experiments were made from Ti(grade 2) and 316LVM stainless steel. Ti specimens were ion plated with TiN, ZrN by the low temperature arc vapor deposition, and the depth profile of the TiN/Ti, ZrN/Ti ion plated surface was examined by Auger Electron Spectroscopy. Three kind of button type specimens .of TiN/Ti, ZrN/Ti and Ti were used for abrasion test, and HEPAlClC7 cells and CCD cells were cultivated for 4 days with the specimens for cytotoxicity test. Thread type implants of TiN/Ti, ZrN/Ti, Ti, 316LVM were implanted on the femur of 6 adult dogs weighing 10kg-13kg. Two dogs were sacrified for histological examination after 45 days and 90 days, and four dogs were sacrified for the removal torque test of the implant') after 90 days. The removal torque force was measured by Autograph (Shimadzu Co., AGS-1000D series, Japan). Abrasion resistance of TiN/Ti was the highest, and that of ZrN/Ti and Ti were followed. The bioinert nitride ion plated Ti had much better abrasion resistance, compared with Ti, In the cytotoxicity test, the number of both cells were increased in all specimens, and there were no significant difference in cytotoxic reaction among all groups (p>0.1), In histological examination, 316LVM showed the soft tissue engagement in interface between the implant and bone, but the other materials after 45 days noted immature new bone formation in the medullary portion along the implant surface, and those after 90 days showed implant support by new bone formation in both the cortical and the medullary portion, The removal torque force of Tilv/Ti showed significantly higher than that of Ti(p(O,05). The difference in removal torque force between TiN/Ti and ZrN/Ti was not significant(p>0.05), and that of 316LVM was lowest among all groups(p<0.05). These results suggest that bioinert nitrides ion plated Ti can resolve the existing problems of Ti and bioactive ceramics, and it may be clinically applicable to human.
Kim, Min-Ho;Yeo, In-Sung;Kim, Sung-Hun;Han, Jung-Seok;Lee, Jai-Bong;Yang, Jae-Ho
The Journal of Korean Academy of Prosthodontics
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v.49
no.2
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pp.168-176
/
2011
Purpose: This study aims at investigating the influence of various insertion torques on thermal changes of bone. A proper insertion torque is derived based on the thermal analysis with two different implant designs. Materials and methods: For implant materials, bovine scapula bone of 15 - 20 mm thickness was cut into 35 mm by 40 - 50 mm pieces. Of these, the pieces having 2 - 3 mm thickness cortical bone were used as samples. Then, the half of the sample was immersed in a bath of $36.5^{\circ}C$ and the other half was exposed to ambient temperature of $25^{\circ}C$, so that the inner and surface temperatures reached $36.5^{\circ}C$ and $28^{\circ}C$, respectively. Two types of implants ($4.5{\times}10\;mm$ Br${\aa}$nemark type, $4.8{\times}10\;mm$ Microthread type) were inserted into bovine scapula bone and the temperature was measured by a thermocouple at 0.2 mm from the measuring point. Finite element method (FEM) was used to analyze the thermal changes at contacting surface assuming that the sample is a cube of $4\;cm{\times}4\;cm{\times}2\;cm$ and a layer up to 2 mm from the top is cortical bone and below is a cancellous bone. Boundary conditions were set on the basis of the shape of cavity after implants. SolidWorks was used as a CAD program with the help of Abaqus 6.9-1. Results: In the in-vitro experiment, the Microhead type implant gives a higher maximum temperature than that of the Br${\aa}$nemark type, which is attributed to high frictional heat that is associated with the implant shape. In both types, an Eriksson threshold was observed at torques of 50 Ncm (Br${\aa}$nemark) and 35 Ncm (Microthread type), respectively. Based on these findings, the Microthread type implant is more affected by insertion torques. Conclusion: This study demonstrate that a proper choice of insertion torque is important when using a specific type of implant. In particular, for the Microthread type implant, possible bone damage may be expected as a result of frictional heat, which compensates for initial high success rate of fixation. Therefore, the insertion torque should be adjusted for each implant design. Furthermore, the operation skills should be carefully chosen for each implant type and insertion torque.
Kim, Seong-Beom;Yun, Pil-Young;Kim, Sang-Yun;Yi, Yang-Jin;Kim, Ji-Yun;Kim, Young-Kyun
The Journal of Advanced Prosthodontics
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v.8
no.5
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pp.396-403
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2016
PURPOSE. Early loading of implant can be determined by excellent primary stability and characteristic of implant surface. The implant system with recently improved surface can have load application 4-6 weeks after installing in maxilla and mandible. This study evaluated the effect of healing period to the stability of hydrophilic tapered-type implant at maxillary posterior area. MATERIALS AND METHODS. This study included 30 patients treated by hydrophilic tapered-type implants (total 41 implants at maxilla) and classified by two groups depending on healing period. Group 1 (11 patients, 15 implants) was a control group and the healing period was 12 weeks, and Group 2 (19 patients, 26 implants) was test group and the healing period was 6 weeks. Immediately after implant placement, at the first impression taking, implant stability was measured using Osstell Mentor. The patients also took periapical radiographs after restoration delivery, 12 months after restoration and final followup period. The marginal bone loss around the implants was measured using the periapical radiographs. RESULTS. All implants were survived and success rate was 97.56%. The marginal bone loss was less than 1mm after 1 year postoperatively except the one implant. The stabilities of the implants were not correlated with age, healing period until loading, insertion torque (IT), the diameter of fixture and the location of implant. Only the quality of bone in group 2 (6 week) was correlated with the stability of implant. CONCLUSION. Healing period of 6 weeks can make the similar clinical prognosis of implants to that of healing period of 12 weeks if bone quality is carefully considered in case of early loading.
This clinical study was conducted to evaluate the clinical effects of a concave neck of external connection type implant fixture designed for platform switching on the peri-implant tissue responses. Two types of implants with different neck designs were implanted in 20 patients. For the experimental group, the bioseal(BS) implant fixtures with 's' shaped concave profile on the neck were used, and non-bioseal(NBS) implant fixtures with a straight profile on the neck were used as control(Total of 40 implants, NBS: n = 19, BS: n=21). During the one-year period after implant placement, implant survival rate, marginal bone resorption, bleeding, plaque, and complications were evaluated. The survival rate of NBS and BS group was 94.74% and 90.48%, respectively. There was no significant difference on marginal bone resorption, bleeding and plaque between the two groups (P>.05). Within the limits of the present study, implants with a concave neck design showed similar clinical results to implants with a straight neck design on the peri-implant tissue responses. Longitudinal clinical studies are necessary to confirm more effective clinical results.
Purpose: This study aimed to evaluate the clinical outcomes of a single type of narrow-diameter implant (NDI) by investigating its survival rate and peri-implant marginal bone loss (MBL). In addition, variables possibly related to implant survival and MBL were investigated to identify potential risk factors. Methods: The study was conducted as a retrospective study involving 49 patients who had received 3.0-mm diameter TSIII implants (Osstem Implant Co.) at Seoul National University Dental Hospital. In total, 64 implants were included, and dental records and radiographic data were collected from 2017 to 2022. Kaplan-Meier survival curves and a Cox proportional hazard model were used to estimate the implant survival rate and to investigate the effects of age, sex, jaw, implant location, implant length, the stage of surgery, guided bone regeneration, type of implant placement, and the surgeon's proficiency (resident or professor) on implant survival. The MBL of the NDIs was measured, and the factors influencing MBL were evaluated. Results: The mean observation period was 30.5 months (interquartile range, 26.75-45 months), and 6 out of 64 implants failed. The survival rate of the NDIs was 90.6%, and the multivariate Cox regression analysis showed that age was associated with implant failure (hazard ratio, 1.17; 95% confidence interval, 1.04-1.31, P=0.01). The mean MBL was 0.44±0.75 mm, and no factors showed statistically significant associations with greater MBL. Conclusions: NDIs can be considered a primary alternative when standard-diameter implants are unsuitable. However, further studies are required to confirm their long-term stability.
This study was performed for the purpose of evaluating the stress distribution around threaded type implants, cylindrical type implants and teeth connected with rigid or non-rigid connector. The stress distribution around the surrounding bone was analyzed by three-dimensional photoelastic method. Twelve mandibular photoelastic epoxy resin models and a circular polariscope were used to record the isochromatic fringes. After the stress distribution around the implant and tooth was observed, the results were as follows ; 1. In threaded type implants, stress concentrated patterns were observed at the neck either vertical or 25 degree lateral force. 2. The stress concentrated patterns were observed at the tooth apical portion and neck portions of the implant and tooth when a threaded implant was connected with the tooth by either a rigid or non-rigid connector. More force was generated at the tooth neck portion by a rigid connector and more force at the implant neck portion by a non-rigid connector. 3. The stress concentrated patterns were observed at the apical portion of the implant and tooth when a cylindrical type ,implant was connected with the tooth either by a rigid or non-rigid connector. More force was generated at the tooth apical portion by a rigid connector and more force at the neck portion of the tooth and implant by a non-rigid connector. 4. The stress around the tooth was more equally distributed in a threaded type implant than in a cylindrical implant when the tooth was connected with either a rigid or non-rigid connector. 5. The stress around a threaded type implant was progressively more equally distributed in the following order : 1) when used a single implant, 2) a non-rigid connection with the implant and tooth, 3) a rigid connection with the implant and tooth, 4) a rigid connection with two implant fixtures.
Purpose: The change of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. The purpose of this study was to investigate the load transfer of internal conical joint type implant according to marginal bone resorption by using the three-dimensional finite element analysis model. Materials and methods: The internal conical joint type system was selected as an experimental model. Finite element models of bone/implant/prosthesis complex were constructed. A load of 300 N was applied vertically beside 3 mm of implant axis. Results: The pattern of stress distribution according to marginal bone resorption was similar. The maximum equivalent stress of implant was increase according to marginal bone resorption and the largest maximum equivalent stress was shown at model of 1 mm marginal bone resorption. Although marginal bone loss more than 1mm was occurred increasing of stress, the width of the stress increase was decreasing. Conclusion: According to these results, the exposure of thin neck portion of internal conical joint type implant is most important factor in stress increasing.
This paper presents the loosening behavior that occurs after the application of an external load to internal and external connection types of dental implants using the finite element method. We use fastening force between an abutment and a fixture to clamp the dental implant system; however, loosening and breakage may occur owing to cyclic external loads. In this study, we considered the initial fastening condition in the pre-load analysis and then investigated the change in stress and contact surface status when applying external loads. After the application of the initial fastening load, we verified that the internal connection-type model exhibited a relatively lower stress distribution than that of the external connection-type one. Moreover, we found that the former model showed a lower stress concentration after the application of the external load. In addition, after the application of this load, we found that the higher the shear load acting on the implant system, the higher the possibility of loosening. The study results showed the change in stress distribution and contact surface according to the connection type of the dental implants and the phenomenon of loosening by cyclic loads. We expect that the results of this study will be useful for the study of reliability and design of dental implant systems.
The aim of this study was to analyze various data of 120 non-submerged ITI implants placed in 64 korean adults. The data were retrieved from patients' charts and registered in the computer and coded for a statistical analysis. The results revealed that the most common type of edentulism was a distal extension case, and the largest number of implants were placed in the mandibular first molar position. Implants were placed more frequently in mandibular, posterior position than maxillary, anterior position, respectively. With respect to the implant diameter and length, an implant with 4.1mm in diameter and more than 10mm in length was the most common. Since a molar position was the most prevalent position for implant placement in korean patients, clinicians should be careful about implant diameter which can resist a strong occlusal force expected in the molar position. In addition, the distance to the mandibular canal and the floor of maxillary sinus should be considered to avoid possible damages, such as nerve injury and sinus perforation in selecting a proper implant length.
Journal of Dental Rehabilitation and Applied Science
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v.21
no.2
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pp.191-204
/
2005
Traditionally, the implant treatment require load-free healing period of at least 3 months in the mandible and 6 months in the maxilla. But this long healing period provides patients with the discomfort and economical trouble. Many experiments has been attempted for the outcome of such disadvantage, so recently the immediate loaded implant is getting popularity. Several literature has been published for clinical success of immediate loaded implant. The studies for the success rate of immediate loaded implant in multi-way has been reporting, nevertheless, we don't have yet a probable success. Various studies have been practiced that the advantages and disadvantages associated with immediate loaded implant, and factors that may influence the success of immediate implant, including patient selection, type of bone quality, required implant length, structure of the implant, surgical skill, need for achieving primary stability, control of occlusal force, peri-implant bone activity. The objective of this study is to review the literature related to immediate loading of implants and to discuss factors that may influence this treatment modality, based on scientific evidence.
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