• The Journal of Advanced Prosthodontics
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• v.8 no.2
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• pp.150-157
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• 2016

PURPOSE. The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS. Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS. Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION. Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.

• Journal of Periodontal and Implant Science
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• v.46 no.3
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• pp.152-165
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• 2016

Purpose: This study investigated the effects of bone density and crestal cortical bone thickness at the implant-placement site on micromotion (relative displacement between the implant and bone) and the peri-implant bone strain distribution under immediate-loading conditions. Methods: A three-dimensional finite element model of the posterior mandible with an implant was constructed. Various bone parameters were simulated, including low or high cancellous bone density, low or high crestal cortical bone density, and crestal cortical bone thicknesses ranging from 0.5 to 2.5 mm. Delayed- and immediate-loading conditions were simulated. A buccolingual oblique load of 200 N was applied to the top of the abutment. Results: The maximum extent of micromotion was approximately $100{\mu}m$ in the low-density cancellous bone models, whereas it was under $30{\mu}m$ in the high-density cancellous bone models. Crestal cortical bone thickness significantly affected the maximum micromotion in the low-density cancellous bone models. The minimum principal strain in the peri-implant cortical bone was affected by the density of the crestal cortical bone and cancellous bone to the same degree for both delayed and immediate loading. In the low-density cancellous bone models under immediate loading, the minimum principal strain in the peri-implant cortical bone decreased with an increase in crestal cortical bone thickness. Conclusions: Cancellous bone density may be a critical factor for avoiding excessive micromotion in immediately loaded implants. Crestal cortical bone thickness significantly affected the maximum extent of micromotion and peri-implant bone strain in simulations of low-density cancellous bone under immediate loading.

• The Journal of the Korean dental association
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• v.44 no.11 s.450
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• pp.739-747
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• 2006

Objectives. The standardization of connection between fixture and abutment has not been defined. The success of dental implants was not always depends on connection. However, the connection mechanism is one of the most important things for dental implant treatment success. Most implant systems are very comparable in their design and engineering. They share many common characteristics and have similar strengths and weaknesses. Their significant weaknesses are connection, microgap and the resulting micromovement allowing bacterial contamination and bone loss. In the present study, we investigated the clinical performance of Ankylos implant (conical connection implant) Patients and Methods. The clinical performance of conical connection implant was studied under well-controlled clinical conditions. A total of 133 conical connection implants were placed in 50 patients from April 2005 to March 2006. The mean follow-up loading period of implants which was considered successful was 220$\pm$29 days. We recorded the age, sex, installation site, reason of edentulous region, bone density of installation site, diameter and length of dental implants and periods from installation to uncovering surgery using patients medical chart. Results Four Ankylos implants were lost during pre-loading period. 129 implants provided excellent clinical performance during 220$\pm$29 days on an average. The short-term success rate of this conical connection implant system was 96.99%.

• The Journal of Advanced Prosthodontics
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• v.7 no.2
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• pp.115-121
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• 2015

PURPOSE. This study aimed to evaluate the effect of implant thread depth on primary stability in low density bone. MATERIALS AND METHODS. The insertion torque was measured by inserting Ti implants with different thread depths into solid rigid polyurethane blocks (Sawbones) with three different bone densities ($0.16g/cm^3$, $0.24g/cm^3$, and $0.32g/cm^3$). The insertion torque value was evaluated with a surgical engine. The static compressive strength was measured with a universal testing machine (UTM) and the Ti implants were aligned at $30^{\circ}$ against the loading direction of the UTM. After the static compressive strength test, the Ti implants were analyzed with a Measurescope. RESULTS. The Ti implants with deeper thread depth showed statistically higher mean insertion torque values (P<.001). Groups A and group B had similar maximum static compressive strengths, as did groups C and D (P>.05). After the static compressive strength, the thread shape of the Ti implants with deeper thread depth did not show any breakage but did show deformation of the implant body and abutment. CONCLUSION. The implants with deeper thread depth had higher mean insertion torque values but not lower compressive strength. The deep threads had a mechanical stability. Implants with deeper thread depth may increase the primary stability in areas of poor quality bone without decreasing mechanical strength.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.2
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• pp.182-206
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• 2003

Statement of problem : Successful osseointegration of endosseous threaded implants is dependent on many factors. These may include the surface characteristics and gross geometry of implants, the quality and quantity of bone where implants are placed, and the magnitude and direction of stress in functional occlusion. Therefore clinical quantitative measurement of primary stability at placement and functional state of implant may play a role in prediction of possible clinical symptoms and the renovation of implant geometry, types and surface characteristic according to each patients conditions. Ultimately, it may increase success rate of implants. Purpose : Many available non-invasive techniques used for the clinical measurement of implant stability and osseointegration include percussion, radiography, the $Periotest^{(R)}$, Dental Fine $Tester^{(R)}$ and so on. There is, however, relatively little research undertaken to standardize quantitative measurement of stability of implant and osseointegration due to the various clinical applications performed by each individual operator. Therefore, in order to develop non-invasive experimental method to measure stability of implant quantitatively, the resonance frequency analyzer to measure the natural frequency of specific substance was developed in the procedure of this study. Material & method : To test the stability of the resonance frequency analyzer developed in this study, following methods and materials were used : 1) In-vitro study: the implant was placed in both epoxy resin of which physical properties are similar to the bone stiffness of human and fresh cow rib bone specimen. Then the resonance frequency values of them were measured and analyzed. In an attempt to test the reliability of the data gathered with the resonance frequency analyzer, comparative analysis with the data from the Periotest was conducted. 2) In-vivo study: the implants were inserted into the tibiae of 10 New Zealand rabbits and the resonance frequency value of them with connected abutments at healing time are measured immediately after insertion and gauged every 4 weeks for 16 weeks. Results : Results from these studies were such as follows : The same length implants placed in Hot Melt showed the repetitive resonance frequency values. As the length of abutment increased, the resonance frequency value changed significantly (p<0.01). As the thickness of transducer increased in order of 0.5, 1.0 and 2.0 mm, the resonance frequency value significantly increased (p<0.05). The implants placed in PL-2 and epoxy resin with different exposure degree resulted in the increase of resonance frequency value as the exposure degree of implants and the length of abutment decreased. In comparative experiment based on physical properties, as the thickness of transducer increased, the resonance frequency value increased significantly(p<0.01). As the stiffness of substances where implants were placed increased, and the effective length of implants decreased, the resonance frequencies value increased significantly (p<0.05). In the experiment with cow rib bone specimen, the increase of the length of abutment resulted in significant difference between the results from resonance frequency analyzer and the $Periotest^{(R)}$. There was no difference with significant meaning in the comparison based on the direction of measurement between the resonance frequency value and the $Periotest^{(R)}$ value (p<0.05). In-vivo experiment resulted in repetitive patternes of resonance frequency. As the time elapsed, the resonance frequency value increased significantly with the exception of 4th and 8th week (p<0.05). Conclusion : The development of resonance frequency analyzer is an attempt to standardize the quantitative measurement of stability of implant and osseointegration and compensate for the reliability of data from other non-invasive measuring devices It is considered that further research is needed to improve the efficiency of clinical application of resonance frequency analyzer. In addition, further investigation is warranted on the standardized quantitative analysis of the stability of implant.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.19-28
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• 2022

In removable partial dentures, abutment teeth are essential for support, maintenance, and stability of partial dentures, and are an important factor in the fabrication of functional dentures. If the number of periodontally sound abutments is sufficient and they are located on both sides, it will be easy to manufacture functional dentures with good support, maintenance, and stability. But on the contrary, if the number of teeth is insufficient or if they are located on one side, it is biomechanically disadvantageous and relatively difficult to make functional denture. On the other hand, recently, implant-supported removable dentures, which reinforce the three elements of maintenance, support, and stability by using implant surveyed crown, have been frequently selected as treatment plans. In particular, by adding an implant surveyed crown when only a small number of residual teeth remain, mastication efficiency, esthetics, patient comfort, and pronunciation can be improved. In this case, bilateral posterior extension partial denture was fabricated using implant surveyed crown as abutments by placing implants in the premolars area opposite to the residual tooth unilaterally in the mandible. As a result, the asymmetry of the abutment was resolved, and the maintenance and stability of the denture was achieved.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.3
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• pp.245-256
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• 2023

When restoring with a dental digital system for implant-supported prosthesis, a double digital scanning technique is required: an intraoral scan of the three-dimensional implant location and intraoral scan after placement of temporary denture or provisional prosthesis. During the intraoral scan, the use of scan body as a stable landmark can improve the accuracy of digital impression and simplify laboratory process. In this case, a full-digital system was used to plan and fabricate a custom abutment, provisional prosthesis, and definitive prosthesis. After implant placement, the scan area of the intraoral scan body connected with implant and the intraoral scan body marked on the inside of temporary denture were superimposed. Out of the superimposed files, a custom abutment and provisional prosthesis were fabricated which match the vertical dimension of temporary denture, and definitive prosthesis was fabricated based on provisional prosthesis. We report this case because result has been functionally and esthetically satisfactory by using vertical dimension and central relation set during the fabrication of temporary denture to the definitive prosthesis.

• The Journal of the Korean dental association
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• v.50 no.3
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• pp.126-139
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• 2012

Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.2
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• pp.296-326
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• 1994

The purpose of this study was to evaluate the mechanical effects when one implant fixture was connected to the natural teeth with reduced alveolar bone height. This study also examined the effects of increasing the number of abutment teeth and the effects of the intramobile connector and the titanium connector as they were inserted between the implant superstructure and the fixture. The distribution and concentration load was applied to the fixed partial denture(FPD) supported by implant and the natural teeth with reduced alveolar bone height. The stress and displacement of each element was observed and compared by the two-dimensional finite element method. The following results were obtained : 1. The greater the loss of alveolar bone in natural teeth area, the greater the displacement of FPD and the stress concentration in alveolar bone around implant, especially at the stress concentration in the mesial alveolar bone crest around implant fixture. 2. The displacement of FPD was increased more and that of implants fixture was decreased more when intramobile connector was used than titanium connector was used. Also the stress concentration in alveolar bone around implant fixture was greater when intramobile connector than titanium connector. One implication of this finding was that the difference in stiffness of implant and the natural teeth with reduced alveolar bone height could be partially compensated in case of the POM intramobile connector. 3. The amount and direction of displacement and the stress distribution of the 4-unit FPD was better than those of the 3-unit FPD. It implied that the difference of stiffness of implant and natural teeth with reduced alveolar bone height could be partially compensated in case of the 4 unit FPD.

• Archives of Plastic Surgery
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• v.32 no.3
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• pp.293-298
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• 2005

Osseointegrated prosthetic auricular reconstruction can be classified as either direct or indirect. In the $Br{\aa}nemark $ system of direct osseointegration, implants are placed into the mastoid process of the temporal bone. In the Epitec system of indirect osseointegration, implants are inserted into a three-dimensional carrier plate that is fixed to the mastoid by means of screws. We experienced forty-four cases using the indirect system and seventeen cases using the direct system. We compared with two systems by complications, such as skin reaction, implant loosening, implant loss. There were no specific differences in the skin reaction around the implants and abutments in relation to age or system used. The degree of skin reaction was different according to the conditions around the implant: in cases of virgin microtia, a skin flap was used to cover the implant, in contrast to grafted skin coverage for failed autogenous reconstruction. In both systems, the skin reaction was more severe and frequent in skin flap than in grafted skin. Loosening of the implant was more frequent in the direct system; however, accidental detachment of the implant from the abutment was more frequent in the indirect system. To reduce complications of skin reaction in osseointegrated prosthetic auricular reconstruction, it is important for soft tissue around implant to immobilize. Therefore, grafted skin is better than skin flap as soft tissue around implant. And immobilization of soft tissue around implant by wound dressing is major facter.