• Journal of Periodontal and Implant Science
• /
• v.36 no.2
• /
• pp.555-565
• /
• 2006

The purpose of the present study is to evaluate the biological stability of the zirconia/alumina composite abutment by histologic and radiographic examination in clinical cases. 17 partially edentulous patients (5 men and 12 women, mean age 47) were treated with 37 implants. The implants were placed following the standard two-stage protocol. After a healing period of 3 to 6 months, zirconia/alumina composite abutments were connected. All radiographs were taken using paralleling technique with individually fabricated impression bite block, following insertion of the prosthesis and at the 3-, 6-, 12 month re-examinations. After processing the obtained images, the osseous level was calculated using the digital image in the mesial and distal aspect in each implant. An ANOVA and t-test were used to test for difference between the baseline and 3-, 6-, 12 months re-examinations, and for difference between maxilla and mandible. Differences at P <0.05 were considered statistically significant. For histologic examination, sample was obtained from the palatal gingiva which implant functioned for 12 months. Sections were examined under a light microscope under various magnifications. Clinically, no abutment fracture or crack as well as periimplantitis was observed during the period of study. The mean bone level reduction(${\pm}standard$ deviation) was 0.34 rom(${\pm}\;0.26$) at 3-months, 0.4 2mm(${\pm}\;0.30$) at 6-months, 0.62 mm(${\pm}\;0.28$) at 12-months respectively. No statistically significant difference was found between baseline and 3-, 6-, 12-months re-examinations (p > 0.05). The mean bone level reduction in maxilla was 0.33(${\pm}0.25$) at 3-months, 0.36(${\pm}0.33$) at 6-months, 0.56(${\pm}0.26$) at 12-months. And the mean bone level reduction in mandible was 0.35(${\pm}0.27$) at 3-months, 0,49(${\pm}0.27$) at 6-months, 0.68(${\pm}0.30$) at 12-months. No statistical difference in bone level reduction between implants placed in the maxilla and mandible. Histologically, the height of the junctional epithelium was about 2.09 mm. And the width was about 0.51 mm. Scattered fibroblasts and inflammatory cells, and dense collagen network with few vascular structures characterized the portion of connective tissue. The inflammatory cell infiltration was observed just beneath the apical end of junctional epithelium and the area of direct in contact with zirconia/alumina abutment. These results suggest the zirconia/alumina composite abutment can be used in variable intraoral condition, in posterior segment as well as anterior segment without adverse effects.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.2
• /
• pp.93-102
• /
• 2016

Purpose: The aim of this study was to evaluate the fit accuracy of two zirconia and titanium abutments in internal hexagonal implants. Materials and methods: One titanium abutment and two zirconia abutments were tested in internal hexagonal implants (TSV, Zimmer). Prefabricated zirconia abutments (ZirAce, Acucera) and customized zirconia abutments milled by the Zirkonzahn system (Zirkonzahn Max, Zirkonzahn) were selected and prefabricated titanium abutments (Hex-Lock, Zimmer) were used as a control. Eight abutments per group were connected to implants with 30 Ncm torque. The marginal gaps at abutment-implant interface, the internal gaps at internal hex, vertical and horizontal gaps between screws and screw seats in abutments were measured after sectioning the embedded specimens using a scanning electron microscope. Data analysis included one-way analysis of variance and the Scheffe test (n=16, ${\alpha}=0.05$). Results: The mean marginal gap of customized zirconia abutment was higher than those of two prefabricated zirconia and titanium abutments. The internal gaps at internal hex showed no significant differences between customized and prefabricated abutments and were higher than those of prefabricated titanium abutments. The mean vertical and horizontal gaps at screw in prefabricated zirconia abutment were higher than those of prefabricated titanium abutment. In the case of customized zirconia abutment, the mean horizontal gap at screw was higher than those of both the prefabricated zirconia and the titanium abutment but the mean vertical gap was not even measureable. The screw seats were clearly formed but did not match with abutment screws in prefabricated zirconia abutments. They were not, however, precisely formed in the case of customized zirconia abutments. Conclusion: Within the limitations of this study, the prefabricated titanium abutments showed better fit than the zirconia abutments, regardless of customized or prefabricated. Also, the customized zirconia abutments showed significantly higher marginal gaps and the fit was less accurate between screws and screw seats than the prefabricated abutments, titanium and zirconia.

• The Journal of Korean Academy of Prosthodontics
• /
• v.37 no.5
• /
• pp.651-657
• /
• 1999

This study was performed to investigate the retrievability of the cementation type implant abutments. The cements used in this study were Cavitec, Tembond and Zinc Phosphate Cement. The types of surface conditioning were no treatment, 50 microne sandblasting, 250 microne sandblasting, fine diamond finishing point and coarse diamond point. The retention of cast crown was measured with Instron Universal Testing Machine(Instron Engineering Co., U.S.A.). The results were as fellows: 1. The Maximium retention was obtained by the group of Z.P.C. cementation and Coarse diamond point surface conditioning. 2. Z.P.C. shows maximum retention, and reduced in orders Tembond, Cavitec, No cement. 3. The value of retention of surface condition was highest in coarse diamond point, lowest in no tretment. 4. The similar results were obtained between fine diamond point and 50 microne sandblasting, coarse diamond point and 250 microne sandblasting. 5. The were no direct corelation between mechanical retention and cementation retention.

• The Journal of the Korean dental association
• /
• v.52 no.8
• /
• pp.491-505
• /
• 2014

Food impaction between the implant prostheses and adjacent teeth is the most frequently observed problem. It may be caused by the migration of the adjacent teeth. This symptom may be observed at the mesial aspect of implant prostheses especially, and related with the multiple contributing factors including teeth vitality and antagonist. Idal proximal contact with optimal strength and shape should be made for preventing the food impaction. Shape of customized abutment and prosthesis should have optimal emergence profile. Long duration from the extraction to the delivery of implant prostheses, the adjacent teeth and antagonist teeth may have possibility of occlusal interferences. Remained teeth mobility can induce the food impaction regardless of interproximal contact strength. Occlusal adjustment to remove occlusal interferences can be a method for enhancing the stability of interproximal contact.

• The Journal of Korean Academy of Prosthodontics
• /
• v.44 no.4
• /
• pp.414-420
• /
• 2006

Purpose : The purpose of this study is to use finite element analysis to predict the fatigue life of an implant system subjected to fatigue load by mastication (chewing force). The reliability and the stability of implant system can be defined in terms of the fatigue strength. Not only an implant is expensive but also it is almost impossible to correct after it is inserted. From a bio-engineering standpoint, the fatigue strength of the dental implant system must be evaluated by simulation (FEA). Material and Methods Finite element analysis and fatigue test are performed to estimate the fatigue strength of the implant system. Mesh of implant is generated with the actual shape and size. In this paper, the fatigue strength of implant system is estimated. U-fit (T. Strong, Korea, internal type). The stress field in implant is calculated by elastic-plastic finite element analysis. The equivalent fatigue stress, considering the contact and preload stretching of a screw by torque for tightening an abutment, is obtained by means of Sine's method. To evaluate the reliability of the calculated fatigue strength, fatigue test is performed. Results: A comparison of the calculated fatigue strength with experimental data showed the validity and accuracy of the proposed method. The initiation points of the fatigue failure in the implant system exist in the region of high equivalent fatigue stress values. Conclusion: The above proposed method for fatigue life estimation tan be applied to other configurations of the differently designed and improved implant. In order to prove reliability of prototype implant, fatigue test should be executed. The proposed method is economical for the prediction of fatigue life because fatigue testing, which is time consuming and precision-dependent, is not required.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.36 no.2
• /
• pp.95-103
• /
• 2020

Purpose: The purpose of this study was to compare the axial displacement of the hexagonal and conical abutment in internal conical connection implant after screw tightening and cyclic loading. Materials and Methods: Internal conical connection implants were divided into two groups (n = 10): group HEX, hexagonal abutment; and group CON, conical 2-piece abutments. The axial displacement and removal torque values were measured after 30 Ncm torque tightening and 250N loading test of 100,000 cycles. The Student t test with 5% significance level was used to evaluate the data. Results: HEX group demonstrated significantly higher axial displacement values after 30 Ncm tightening in comparison to the CON group (P < 0.05). No significant difference was found in axial displacement after cyclic loading (P = 0.052). Removal torque loss before and after the cyclic loading both revealed no significant difference between groups (P = 0.057 and P = 0.138). Removal torque value decreased after cyclic loading in both groups (P < 0.05). Conclusion: Overall, both abutment with or without hexagon index presented similar biomechanical performance except HEX group demonstrated significantly more axial displacement after applying tightening torque.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.18 no.2
• /
• pp.81-91
• /
• 2002

Dental implant systems have shown many post-surgical problems and One of the most frequent problem is screw loosening. To reduce screw loosening, a number of methods have been tried and recently fundamental modification of fixture-abutment connection structure was developed and used the most frequently. Former implant system structure, such as Br${\aa}$nemark, had external hex with the height of 0.7 mm and later, fixture with external hex of 1.0 mm height and internal hex structure were developed. In addition, the method of morse taper application was introduced to reduce screw loosening. In this study, the level of screw loosening of each implant systems was compared based on the vibration loosening measurement of abutment screw of each implant systems. Analysis of measured value was performed using 3 kinds of methods, (i) Percentage of average of initial 3 times loosening-torque value(initial loosening value) to tightening-torque of 30 Ncm, (ii) Percentage of loosening-torque value after 200 N strength loaded(experimental value) to initial loosening value and (iii) Percentage of experimental value to 30 Ncm of tightening-torque. Each result of analyses shows the value of initial loosening, loosening by repetitive load and final loosening level. The results of this study were as follows. (1) Percentage of initial loosening value to tightening-torque was increased in order of 0.7 mm external hex, 1.0 mm external hex, internal hex and internal taper and all values between each groups showed statistical significance (p<0.05). (2) Percentage of experimental value to initial loosening value was increased in order of internal hex, 0.7 mm external hex, 1.0 mm external hex and internal taper. Value of internal taper showed significant difference with that of 0.7 mm external hex and internal hex (p<0.05). (3) Percentage of experimental value to tightening torque was increased in order of 0.7 mm external hex, 1.0 mm external hex, internal hex and internal taper. Values of all groups showed statistical significance (p<0.05) except between the groups of 1.0 mm external hex and internal hex. Based on those results, there was no significant difference of loosening-torque by repetitive loading except internal taper. It is supposed that implant system with high resistant capability against initial loosening could be recommended for clinical use. In addition, in case of single implant restoration, 1.0 mm external hex or internal hex could be recommended rather than 0.7 mm external hex, and the use of internal taper would be the most useful way to reduce screw loosening.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.25 no.3
• /
• pp.255-265
• /
• 2009

Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

• The Journal of Korean Academy of Prosthodontics
• /
• v.38 no.1
• /
• pp.98-107
• /
• 2000

Three linear strain gauges (KFR-02N-120-C1-23, Kyowa, Japan) were placed around the abutment of implant future and the maximum axial loads on the mandibular implants supporting over dentures were registered in experimental model when the overdenture was removed. The overdenture attachments used in this study were Round bar Hader bar, Dolder bar with and with out spacer. The retention of bar attachment was measured using universal testing machine while being con-trolled by Activating set and Deactivator except in case of the Hader bar. Simultaneously strains were recorded with the strain smart program in strain P-6000 series (Measurement group, Raleigh, USA). The maximum axial load was calculated and compared with each other. The results were as follows: 1. The amount and the timing of the maximum axial loads were different between the right and left implant in all attachment systems. 2. The retention of bar attachment except Hader bar could be adjusted but the controllability was different among the attachment systems. 3. The more the axial load, the higher the retention with Hader bar and Dolder bar without spacer. but the tendency of increase was not shown with round bar and Dolder bar with spacer.

• Journal of Dental Rehabilitation and Applied Science
• /
• v.19 no.2
• /
• pp.125-137
• /
• 2003

The use of screw-retaind prosthesis on an osseointegrated implant is a popular treatment modality offering relative ease in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and lab technician. This article offers pratical solutions to minimize this clinical problem and describes the factors involved in maintaining a stable screw joint assembly. To avoid joint failure, adherence to specific clinical, as well as mechanical, parameters is critical. With respect to hardware, optimal tolerance and fit, minimal rotational play, best physical properties, a predictable interface, and optimal torque application are mandatory. In the clinical arena, optimal implant distribution; load in line with implant axis; optimal number, diameter, and length of implants; elimination of cantilevers; optimal prosthesis fit; and occlusal load control are equally important.