• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.29 no.1
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• pp.14-25
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• 2003

The purpose of this study was to analyze the stress pattern in different bone densities surrounding fin-type implant fixtures under the vertical and inclined loads ($30^{\circ}) of 200N. Von-Mises stress, the pricipal stress, and the displacement on the implant fixtures under the loads were calculated by using the finite element method. Four different types of bicon implant fixture were used for this study. The geometries of implant fixtures to develop the model were used by a sales brochure and profile project. Three-dimensional finite element model of the mandible was developed with 6.0 mm implant in diameter wurrounded by approximately 2.5 mm of bone. Bone densities were classified according to the elastic modulus of the tree. The finite element program MSC PATRAN (MSC, Software Corp., USA) were used for analysis of stress distribution. The value of the Von-Mises stress, the pricipal stress, and the displacement on the implant fixtures under the vertical and inclined loads were decreased when the diameter of implant fixture was increased, and increased when the elastic modulus was decreased. The stress on implant fixture under the vertical and inclined loads was distributed through the length of implant fixtures in D3 and D4. The distribution of stress was influenced by the direction of loads. In the wide diameter of implants, the stress was developed at outer surface of bone. In conclusion, this study suggest that stress developing on the peri-implant tissues might be influenced by the dimension of implant, elastic modulus of bone, and direction of loads.

• The Journal of Advanced Prosthodontics
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• v.12 no.1
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• pp.38-48
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• 2020

PURPOSE. The objective of this literature review was to analyze the cumulative survival rates (CSRs) of rigid and non-rigid double-crown-retained removable dental prostheses. MATERIALS AND METHODS. Screening of the literature published from January 1995 to December 2019 was performed by using electronic data base (Pubmed) and manual search. The CSRs of rigid and non-rigid double crown removable dental prostheses were investigated. RESULTS. A total of 403 articles were reviewed and 56 relevant articles of them were selected. Subsequently, 25 articles were included for data extraction. These articles were classified according to rigid and non-rigid type double crowns and further subdivided into teeth, implants, and teeth-implant combination types. The CSRs of rigid type double crown ranged from 68.9% to 95.1% of 5 to 10 years in tooth abutments, 94.02% to 100% over a 3-year mean observation periods in implant abutments, and 81.8% to 97.6% in tooth-implant combination. Non-rigid type double crowns had various CSR ranges from 34% to 94% maximum during 10 years observation in teeth abutment. The CSRs of non-rigid type had over 98% in implant abutments, and ranged from 85% to 100% in tooth-implant combination. CONCLUSION. The CSRs of double crowns varies according to types. With accurate evaluation of the remaining teeth and plan of the strategic implant placement, it could be successful treatment alternatives for partially or completely edentulous patients.

• The Journal of Advanced Prosthodontics
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• v.6 no.6
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• pp.491-497
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• 2014

PURPOSE. This study evaluated the influence of abutment materials on the stability of the implant-abutment joint in internal conical connection type implant systems. MATERIALS AND METHODS. Internal conical connection type implants, cement-retained abutments, and tungsten carbide-coated abutment screws were used. The abutments were fabricated with commercially pure grade 3 titanium (group T3), commercially pure grade 4 titanium (group T4), or Ti-6Al-4V (group TA) (n=5, each). In order to assess the amount of settlement after abutment fixation, a 30-Ncm tightening torque was applied, then the change in length before and after tightening the abutment screw was measured, and the preload exerted was recorded. The compressive bending strength was measured under the ISO14801 conditions. In order to determine whether there were significant changes in settlement, preload, and compressive bending strength before and after abutment fixation depending on abutment materials, one-way ANOVA and Tukey's HSD post-hoc test was performed. RESULTS. Group TA exhibited the smallest mean change in the combined length of the implant and abutment before and after fixation, and no difference was observed between groups T3 and T4 (P>.05). Group TA exhibited the highest preload and compressive bending strength values, followed by T4, then T3 (P<.001). CONCLUSION. The abutment material can influence the stability of the interface in internal conical connection type implant systems. The strength of the abutment material was inversely correlated with settlement, and positively correlated with compressive bending strength. Preload was inversely proportional to the frictional coefficient of the abutment material.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.165-180
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• 2007

Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p

• Journal of the Korean Society for Precision Engineering
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• v.22 no.3 s.168
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• pp.179-186
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• 2005

A comparative study of stress distributions in the maxillary bone with three different types of abutment was conducted. Finite element analysis was adopted to determine stress generated in the bone with the different implant systems with micro threads (Onebody type implant, Internal type implant, and External type implant). It was found that the types of abutments and the number of micro threads have significant influence on the stress distribution in the maxillary bone. They were due to the difference in the load transfer mechanism and the size of contact area between abutment and fixture. Also the maximum effective stress in the maxillary bone was increased with increasing inclination angle of load. It was concluded that the maximum effective stress in the bone was the lowest by the internal implant among the maximum effective stresses by other two types of implants and by appropriate number of micro threads, and that the specific number of micro thread was existed to decrease the maximum effective stress in the maxillary bone due to different implant systems and loading conditions.

• Journal of Periodontal and Implant Science
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• v.36 no.3
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• pp.673-682
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• 2006

Recent study shows that implant design has a great impact on initial stability in bone. The ITI $TE^{(R)}$ implant, designed originally for immediate placement has a tapered/ cylindrical form which fits the anatomical shape of the natural alvelous or tooth root. The increased diameter at the collar region coupled with more threads lead to more bone contact and enhanced stability. The aim of this retrospective study is to evaluate the clinical use and the efficacy of recently introduced ITI TE implant with a new macro-design. The following results are compiled from 139 patients who received ITl TE implant surgery at the periodontal department. of Yonsei University Hospital between July 2002 and September 2005. 1. 139 patients received 173 ITl $TE^{(R)}$ implants in their maxilla and mandible (Mx 82, Mn 91). Posterior area accounted for 84% of the whole implant surgery, 2. In the distribution of bone quality, type III(41,0%) was the most, followed by type IV(41,0%) and type II (27.7%). As for the bone quantity, type B(43.9%) was the most, followed by type C(42.2%), type D(12.2%) and type A(1.7%). 3. 125 implants(83.9%) were treated by single crown, which accounted for the majority. 4, The total implant survival rate was 100% after a mean follow-up period of 21.2 months. This preliminary data with ITl $TE^{(R)}$ implant showed excellent survival rate although the majority of implants evaluated in this study were placed in the posterior region of the jaw and compromised sites.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.174-184
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• 2006

Purpose: Current trend in implant dentistry is changing from external connection to internal connection. To evaluate the splinting of external and internal connection implant on screw loosening, 2-units prosthesis was fabricated with BioPlant $System^(R)$ of external connection type and Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. Material and Method: Experimental group is classified into three groups. 1) $G_1-EE$: 2-units prosthesis was fabricated with two Bioplant $System^(R)$ of external connection type. 2) $G_1-EI$: 2-units prosthesis was fabricated with one BioPlant $System^(R)$ of external connection type and one Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. 3) $G_1-II$: 2-units prosthesis was fabricated with two Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. In fabricating 2-units prosthesis, two hexed abutments are recommended when two implants are installed parallel, otherwise one hexed abutment is used on major occlusal force area and one nonhexed abutment is used on the other area. Since it is rare to find two implants being parallel, it is hard to fabricate prosthesis with passive adaptation using two hexed abutments. It is much more difficult to acquire passive adaptation when using hex abutment compared to nonhex abutment. To evaluate the influence of hexed and nonhexed abutment on screw loosening, 2-units prosthesis was fabricated with hexed and nonhexed abutment. Experimental group is classified into three groups. 1) $G_2-HH$: 2-units prosthesis was fabricated with two hexed abutments. 2) $G_2-HN$: 2-units prosthesis was fabricated with one hexed abutment and one nonhexed abutment. 3) $G_2-NN$: 2-units prosthesis was fabricated with two nonhexed abutments. Result: The results of comparing the detorque value after loading on a each prosthesis periodically are as follows. 1. In splinting group of external and internal connection implant, $G_1-II$ group demonstrated the biggest detorque value, followed by $G_1-EI$ group and $G_1-EE$ group. 2. There is no notable significance between external connection implant of $G_1-EI$ group and $G_1-EE$ group and also no significance between internal connection implant of $G_1-EI$ group and $G_1-II$ group. 3. $G_2-HH$ group showed higher detorque value than $G_2-HN\;and\;G_2-NN$ group. From the results, we can concluded that using both external connection and internal connection implant together is clinically acceptable and in order to acquire a good passive adaptation in fabricating 2-units implant prosthesis we can use two nonhexed abutments.

• The Journal of Advanced Prosthodontics
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• v.2 no.4
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• pp.148-153
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• 2010

PURPOSE. The aim of this study was to investigate a comparison of implant bone bed preparation with Er,Cr:YSGG laser and conventional drills on the relationship between implant stability quotient (ISQ) values and implant insertion variables. MATERIALS AND METHODS. Forty implants were inserted into two different types of pig rib bone. One group was prepared with conventional drills and a total of 20 implants were inserted into type I and type II bone. The other group was prepared with a Er,Cr:YSGG laser and a total of 20 implants were inserted into type I and type II bone. ISQ, maximum insertion torque, angular momentum, and insertion torque energy values were measured. RESULTS. The mean values for variables were significantly higher in type I bone than in type II bone (P < .01). In type I bone, the ISQ values in the drill group were significantly higher than in the laser group (P < .05). In type II bone, the ISQ values in the laser group were significantly higher than in the drill group (P < .01). In both type I and type II bone, the maximum insertion torque, total energy, and total angular momentum values between the drill and laser groups did not differ significantly (P ${\geq}$ .05). The ISQ values were correlated with maximum insertion torque (P < .01, r = .731), total energy (P < .01, r = .696), and angular momentum (P < .01, r = .696). CONCLUSION. Within the limitations of this study, the effects of bone bed preparation with Er,Cr:YSGG laser on the relationship between implant stability quotient (ISQ) values and implant insertion variables were comparable to those of drilling.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.248-254
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• 2005

The purpose of this study was to investigate the distribution of stress within the regenerated bone surrounding the implant using three dimensional finite element stress analysis method. Using ANSYS software revision 6.0 (IronCAD LLC, USA), a program was written to generate a model simulating a cylindrical block section of the mandible 20 mm in height and 10 mm in diameter. The $5.0{\times}11.5-mm$ screw implant (3i, USA) was used for this study, and was assumed to be 100% osseointegrated. And it was restored with gold crown with resin filling at the central fossa area. The implant was surrounded by the regenerated type IV bone, with 4 mm in width and 7 mm apical to the platform of implant in length. And the regenerated bone was surrounded by type I, type II, and type III bone, respectively. The present study used a fine grid model incorporating elements between 250,820 and 352,494 and nodal points between 47,978 and 67,471. A load of 200N was applied at the 3 points on occlusal surfaces of the restoration, the central fossa, outside point of the central fossa with resin filling into screw hole, and the functional cusp, at a 0 degree angle to the vertical axis of the implant, respectively. The results were as follows: 1. The stress distribution in the regenerated bone-implant interface was highly dependent on both the density of the native bone surrounding the regenerated bone and the loading point. 2. A load of 200N at the buccal cusp produced 5-fold increase in the stress concentration at the neck of the implant and apex of regenerated bone irrespective of surrounding bone density compared to a load of 200N at the central fossa. 3. It was found that stress was more homogeneously distributed along the side of implant when the implant was surrounded by both regenerated bone and native type III bone. In summary, these data indicate that concentration of stress on the implant-regenerated bone interface depends on both the native bone quality surrounding the regenerated bone adjacent to implant and the load direction applied on the prosthesis.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.2
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• pp.169-181
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• 2008

The aim of this study was to compare the retention and stability of implant overdenture according to the shape and the number of magnetic attachment. The experimental groups were designed for the number of implants(1, 2, 4) and shape of magnetic attachments(flat, cushion, dome type) resulting in 9 subgroups. 45 attachments were tested attached to $Br{\aa}nemark$ system implants which were planted on a mandibular model. Each attachment was composed of the magnet assembly embedded in a overdenture sample and the abutment keeper screwed into the implants. Dislodging tensile forces were applied to the overdenture samples using an Instron(cross-head speed 50.80mm/min) in 3 directions simulating function: vertical, oblique, and anterior-posterior. The loading was repeated 10 times in each direction for 45 samples. The values of maximum dislodging force of each subgroup were processed statistically using SPSS V. 12.0 at the 0.05 level of significance. The results of this study were as follows: 1. Flat type magnetic overdenture was the most retentive when subjected to vertically directed forces and dome type was the lest retentive when subjected to obliquely directed forces(p<0.05). 2. In case of planting one implant, flat type had a higher vertically retentive force than anterior-posteriorly retentive force. In case of planting two implants, flat type and dome type had a higher vertically retentive force and in case of planting four implants, flat type and cushion type had a higher vertically retentive force than anterior-posteriorly retentive force(p<0.05). 3. The incremental number of dental implant, without regards to the three types of magnetic attachment shapes, showed higher retention of overdenture(p<0.05). From the results, if a patient need much more retention of implant overdenture, flat type magnetic overdenture would be a good treatment. In case of the bruxism where excessive lateral forces are already present, dome type could be expected to produce better results. In case of planting one implant, flat type is more stable than the other shape of magnet and in case of two implant, flat type and dome type are more stable and in case of four implants, flat type and cushion type are more stable. Planting more than two implants and using flat type magnetic attachment would provide better retention and stability of implant overdenture