• The Journal of Korean Academy of Prosthodontics
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• v.56 no.3
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• pp.212-217
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• 2018

Purpose: This study was to assess clinically the incidence of abutment screw loosening of posterior implant-supported fixed prosthesis and its affecting factors. Materials and methods: 391 implant-supported crowns restored from January 2013 to January 2016 were included in this study. All restorations were fabricated with either a single crowns or a splinted crown, and cemented with temporary cement. The incidence of abutment screw loosening is investigated and gender, restoration position, opposing teeth, restoration type, abutment connection type were assessed as possible factors affecting abutment screw loosening. Results: During the observation period (2 - 5 years), abutment screw loosening was found in 29 restorations (7.4%). It took 3 to 48 months (means 19.5 months) to loose the screw, and three of these implants were fractured. Among the factors considered, there were statistically significant differences at abutment screw loosening rate between molar group (9.4%) and premolar group (2.6%) (P<.019). According to the type of opposing teeth, there were statistically significant differences between nature teeth (74.7%) and implant (25.0%), removable denture (3%) (P<.019). The other possible factors did not have a significant effect on loosening of the abutment. Conclusion: The incidence of abutment screw loosening in posterior restoration was 7.4%. Abutment screw loosening were more likely to occur in molars group than premolar group, and according to the opposing teeth, there were the greatest frequency in nature teeth than implant and removal denture. There was a statistically significant difference.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.1
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• pp.77-89
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• 2008

The purpose of this study was to evaluate internal conical abutment sinking and fitness according to the loading condition. In this study, Alloden implant fixture and two abutment(conventional, FDI) systems were used. Each abutment was applied 1 time of finger force, 3 times of malleting force, 5 times of 20kg and extra several times to the fixture until the amount of abutment singking showed no change. Then, the length of abutment to fixture which was binding lightly with no pressure state was measured by Vernier caliper. After loading application, the length was remeasured and the amount of sinking was calculated. The implant was buried in unsaturated polyester (Epovia, Cray Valley Inc. Korea) for making a comparison between the change of length and fitness of abutment-fixture connection part. Then All samples were cross-sectioned with high speed precision cut-off(accutom-5, Struers, Denmark). Finally, The result were observed and analyzed using FE-SEM (field emission scanning electron microscopy).

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.3
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• pp.222-227
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• 2015

Aesthetic impression is emphasized in the recent field of implant restoration. However, there is limitation of creating proper shape of soft tissue as well as cervical emergence profile due to the use of pre-existing healing abutment in the process of initial post-operative soft tissue healing period. Designing the shape of abutment into the final customized abutment instead of its original shape helped to achieve more aesthetic implant restoration by applying healing abutment which could minimize the malposition and recession of soft tissue. In this study, soft tissue healing was promoted using the post-operative customized healing abutment and thereby obtained the result of more aesthetic and functional restoration by minimizing displacement of soft tissue in the process of applying final customized abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.5
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• pp.597-607
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• 2004

Purpose: This study was peformed to investigate the retrievability of the cemented crown from the cementation type implant abutment. Material and method: The cementation type implant abutments (NEOBIOTECH implant abutment regular, 3 degree taper, 10mm length, 4mm diameter, Ti grade III, machined surface. Hwasung, Kyunggi-do) and cemented crowns were divided into 3 groups, depending on their hole angles formed in the crowns for their retrievability. The abutments and crowns were luted with 4 kinds of cements and separation test using metal wedge was executed with Instron 4465 Universal Testing Machine and the maximum impact force of the modified crown ejector was measured. Results and conclusion : 1. All of the cementation type implant abutments and cemented crowns were separated with relatively small force by metal wedge. 2. The retrieving force was minimum when the metal wedge was applied perpendicular to the axis of abutment. 3. The force for retrieving crowns from abutments was maximum in resin cement group, and reduced in orders of zinc phosphate cement, glass ionomer cement and zinc oxide eugenol cement. 4. The maximum force obtained by the crown ejector was higher than the retrieval force in ZOE and GI cement and lower than that in ZPC and resin cement. 5. If it has similar conditions clinically, the cemented crowns luted with 2 types of cements (ZOE, GI cement) can be safely retrieved from the cementation type implant abutments by the modified crown ejector.

• The Journal of Advanced Prosthodontics
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• v.14 no.6
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• pp.346-359
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• 2022

PURPOSE. Four and six implant-supported fixed full-arch prostheses with various framework materials were assessed under different loading conditions. MATERIALS AND METHODS. In the edentulous maxilla, the implants were positioned in a configuration of four to six implant modalities. CoCr, Ti, ZrO₂, and PEEK materials were used to produce the prosthetic structure. Using finite element stress analysis, the first molar was subjected to a 200 N axial and 45° oblique force. Stresses were measured on the bone, implants, abutment screw, abutment, and prosthetic screw. The Von Mises, maximum, and minimum principal stress values were calculated and compared. RESULTS. The maximum and minimum principal stresses in bone were determined as CoCr < ZrO₂ < Ti < PEEK. The Von Mises stresses on the implant, implant screw, abutment, and prosthetic screws were determined as CoCr < ZrO₂ < Ti < PEEK. The highest Von Mises stress was 9584.4 Mpa in PEEK material on the prosthetic screw under 4 implant-oblique loading. The highest maximum principal stress value in bone was found to be 120.89 Mpa, for PEEK in 4 implant-oblique loading. CONCLUSION. For four and six implant-supported structures, and depending on the loading condition, the system accumulated different stresses. The distribution of stress was reduced in materials with a high elastic modulus. When choosing materials for implant-supported fixed prostheses, it is essential to consider both the number of implants and the mechanical and physical attributes of the framework material.

• 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 Korean Academy of Prosthodontics
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• v.42 no.1
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• pp.83-93
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• 2004

Statement of problem : Since the concept of osseointegrated dental implant by $Br{\aa}nemark$ et al was first applied to mandibular full edentulous patients. Recently it is considerated the first treatment option on missing teeth. A common problem associated with dental implant restorations is loosening of screws that retain the prosthesis to the abutment and the abutment to the implant fixture. Purpose : This study is to examine the influence on screw loosening of implant-abutment designs. Material and methods : External hex, cone screw, beveled hex, cam cylinder, cylinder hex by means of evaluating the loosening torques, with respect to a range of tightening torques after repeated loading. Result : 1. Cone screw, beveled hex groups are the highest initial tightening rate and cylinder hex, external hex groups are the lowest initial tightening rate (p < 0.05). 2. Cone screw groups are the highest after repeated loading tightening rate and cylinder hex groups are lowest after repeated loading tightening rate(p < 0.05). 3. Cone screw groups have the highest initial stability and anal stability. 4. All groups are decreased tightening rate after repeated loading.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.4
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• pp.276-283
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• 2013

Purpose: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. Materials and methods: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (${\alpha}=.05$). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. Results: The pre-loading reverse torque values were $26.0{\pm}0.30Ncm$ (ready-made abutment; Transfer abutment) and $26.3{\pm}0.32Ncm$ (CAD-CAM custom-made abutment; CustomFit abutment) and $24.7{\pm}0.67Ncm$ (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. Conclusion: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

• The Journal of Advanced Prosthodontics
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• v.10 no.5
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• pp.381-387
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• 2018

PURPOSE. Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS). MATERIALS AND METHODS. We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles ($8^{\circ}$, $10^{\circ}$, and $12^{\circ}$), a sloped shoulder margin (0.6 mm depth), a rectangular shape ($6mm{\times}6.5mm$) with rounded edges, and a rectangular ledge ($2mm{\times}1mm$) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque ($N{\cdot}cm$) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (${\alpha}=.05$). RESULTS. Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186). CONCLUSION. Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.

• The Journal of Advanced Prosthodontics
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• v.12 no.4
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• pp.233-238
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• 2020

PURPOSE. This study aims to compare the marginal fitness of two types of implant-supported fixed dental prosthesis, i.e., cementless fixation (CL.F) system and cement-retained type. MATERIALS AND METHODS. In each group, ten specimens were assessed. Each specimen comprised implant lab analog, titanium abutment fabricated with a 2-degree tapered axial wall, and zirconia crown. The crown of the CL.F system was retained by frictional force between abutment and relined composite resin. In the cement-retained type, zinc oxide eugenol cement was used to set crown and abutment. All specimens were sterilized with ethylene oxide, immersed in Prevotella intermedia culture in a 50 mL tube, and incubated with rotation. After 48 h, the specimens were washed thoroughly before separating the crown and abutment. The bacteria that penetrated into the crown-abutment interface were collected by washing with 500 µL of sterile saline. The bacterial cell number was quantified using the agar plate count technique. The BacTiter-Glo Microbial Cell Viability Assay Kit was used to measure bacterial adenosine triphosphate (ATP)-bioluminescence, which reflects the bacterial viability. The t-test was performed, and the significance level was set at 5%. RESULTS. The number of penetrating bacterial cells assessed by colony-forming units was approximately 33% lower in the CL.F system than in the cement-retained type (P<.05). ATP-bioluminescence was approximately 41% lower in the CL.F system than in the cement-retained type (P<.05). CONCLUSION. The CL.F system is more resistant to bacterial penetration into the abutment-crown interface than the cement-retained type, thereby indicating a precise marginal fit.