PURPOSE. The aim of this study was to compare the retention of mini implant overdenture by the number, the type of magnetic attachment, and the directions of applied dislodging force. MATERIALS AND METHODS. The experimental groups were designed by the number and type of magnetic attachment. Twenty samples were tested with Magden implants. Each attachment was composed of the magnet assembly in overdenture sample and the abutment keeper in a mandibular model. Dislodging forces were applied to the overdenture samples (50.0 mm/min) in 3 directions. The loading was repeated 10 times in each direction. The values of dislodging force were analyzed statistically using SPSS at 95% level of confidence. RESULTS. The retentive force of group 2 was greater than that of group 1 in both types of attachment in every direction (P < .05). Oblique retentive force of flat type magnetic attachment was higher than that of cushion type attachment in both groups (P < .05). In group 1, oblique retentive force showed the highest and anterior-posterior retentive force showed the lowest value in both attachment types (P < .05). In group 2, both types of attachment showed the lowest retentive force with anterior-posterior direction of dislodging force (P <.05). CONCLUSION. Proper retentive properties for implant overdenture were obtained, regardless of the number and type of magnetic attachment. In both types of magnetic attachment, the greater retentive force was attained with more implants. Oblique retentive force of flat type magnetic attachment was greater than that of cushion type. Among all subgroups, anterior-posterior retentive force was the lowest among three different directions of dislodging force.
Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.
Periotest(Siemens, Germany) has been used to test mobility of the implants clinically, however the effects of target materials and connection methods on the PTVs(Periotest Values) have not been evaluated. Periotest has been regarded as a reliable and objective tool to test implant and natural teeth mobility clinically, however this instrument showed different PTVs under various test conditions. This in vitro study was designed to compare PTVs of different veneering materials and prosthodontic designs (single and bridge restorations). To compare the effects of veneering materials on PTVs, 1 mm thickness of five different testing materials (porcelain, type III gold alloy, pure titanium, composite resin, acrylic resin) were placed on the resin block. Three full length of 13 mm Mark II implant fixtures were embedded into autopolymerizing resin block to fabricate single and bridge restorations. To evaluate effects of the connection method in single restorations, PTVs of screw retained(UCLA type) and cementation type(Cera-One system) were compared. Finally, to test reliability of PTVs of the final restorations, screw retained three unit short span PFM bridges were fabricated on the standard and Estheti-Cone abutments. All testing components were tightened with torque controller and PTVs of all specimens were measured 15 times for statistical analysis with SAS program. Following conclusions were made within the limit of this in vitro study. 1. PTVs of type III gold alloy, grade II titanium, composite resin veneering materials showed no significant differences, however acrylic resin and porcelain showed significant differences (P<0.05). 2. Single tooth restorations showed consistent PTVs as long as proper torque force was applied. 3. PTVs of bridge type prostheses was inconsistent regardless of abutment types. 4. PTVs of the prostheses showed higher scores and standard deviations than those of abutments regardless types of connection (P<0.05).
Recently, various implant cylinders were supplied. especially received gold cylinders, cast cylinders produced from premade gold and plastic cylinders and plastic cylinders. This study measured and compared precise fit produced when using conventional gold and plastic cylinders. The comparative fit of lapped and non-lapped castings made from plastic pattern was examined. The implant/abutment interface fit was evaluated by scanning electron microscopy(SEM) for each of four cylinders. The following results were obtained: 1. The case of plastic cylinder showed $9.67{\pm}1.50{\mu}m$ gap when Steri-Oss fixture was connected. 2. The case of lapped casting made from plastic cylinder showed $3.01{\pm}2.81{\mu}m$ gap when Steri-Oss fixture was connected. 3 The case of gold/plastic cylinder showed $9.80{\pm}1.68{\mu}m$ gap when Steri-Oss fixture was connected. 4. The case of gold cylinder showed ${5.47{\pm}2.43\mu}m$ gap when Steri-Oss fixture was connected. 5. In case of each cylinder which was connected with Steri-Oss fixture, the size of gap was showed less in the order of the case of gold/plastic cylinder, the case of plastic cylinder, the case of gold cylinder and the case of lapped casting made from plastic cylinder As results of this study, the use of premade gold cylinder offers an advantage over plastic pat-terns in precise fit. When plastic patterns are used, polishing of implant cylinder components should provide precise fit.
Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.
Kim, Chang-Ho;Choi, Ah-Young;Kay, Kee-Sung;Cho, Kyu-Zong
The Journal of Korean Academy of Prosthodontics
/
v.35
no.2
/
pp.308-329
/
1997
A lot of the research paper was reported about the result of influence of IMC (Intra-mobile connector) in the IMZ implant placed solely in the alveolar bone, but reports about the effect of IMC on functional load at state of connecting with natural teeth ere rare. The major propose of this study was find the mechanical character of IMC itself by using the finite element analysis program after simulated variance of condition connected with the natural teeth and implant on funcional load. When first and second premolar was lost, IMZ implant was placed with a diameter of 3.3mm and a length of 13mm with IMC in second premolar area. Rigid connection was done and the non-figid connention was located on the female part of the canine abutment and the implant respectively and then both the infraocclusion of $30{\mu}m$ and the non-infraocclusion under the load of 40kg applied to the portion of the natural teeth, the pontic and the implant. The displacement and the stress of it was estimated and analyzed IMC itself of the rigid connection and the non-rigid connection was grouped. The following result were obtained. 1. In all groups, the displacement of Y-axis was greater than that of X-axis and the aspect of displacement showed that IMC was displaced downward and to the center. 2. There was no differences in the displacement of IMC regardless of the connection type. 3. In the displacement of IMC, I 4 was the least, I 1 and I 3 are similar and I 2 was the greatest. 4. There was no differences in the peak value of maximal stress of IMC regardless of the connection type. 5. In the peak value of maximal stress of IMC, I 4 was the least, I 1 and I 3 were similar, and I 2 was the largest.
Statement of problem : Accurate impression is essential to success of implant prostheses. But there have been few studies about the accuracy of fixture-level impression technique in internal connection implant system. Purpose: This study evaluated the accuracy of splinted fixture-level impression technique using clinical methods and the effect of internal hex on fit of superstructure in internal connection implant system (Astra Tech). Material and method : Two metal master frameworks made from two abutments (Cast-to Abutment ST) each for parallel and divergent conditions and a corresponding. passively fitting, dental stone master cast with four future replicas (Fixture Replica ST) were fabricated. Ten dental stone casts were made with vinyl polysiloxane impressions from the master cast by acrylic resin splinted fixture-level impression technique. To evaluate the accuracy of impression technique, the fit of master frameworks for test models was evaluated using screw resistance test (SRT) and one-screw test. The results of SRT were recorded as SRT values from grade 1 to grade 5 by 1/4 turn. And to evaluate the effect of hex on fit of superstructure, the same tests were performed after removing hexes of master frameworks. Results: 1. There was only one case (2.5%) showing SRT value of test model below ade 2 in total before and after removing hexes of master frameworks. And, by removing hexes. SRT values decreased in only one test model (5%) and did not change in 17 test models (85%). 2. SRT values of the 1$^{st}$ screws were grade 2 in 80% of cases before, and grade 1 in 80% of cases after removing hexes. And, by removing hexes, SRT values decreased in 72.5% of cases. 3. SRT values of the 2$^{nd}$ screws were grade 3 in 85% of cases before, and grade 3 in 95% of cases after removing hexes. And, by removing hexes, SRT values did not change in 85% of cases. 4. There were only 2 cases regarded as acceptable fit by one-screw test, and SRT values of 2$^{nd}$ screws of both cases were grade 2. Conclusion. Within the limitations of this study, future-level impression of internal connection implant system is considered to obtain inaccurate working cast, even using acrylic resin splinted impression technique. And, it is considered to be unable improve the fit to remove the hexes of implant restoration.
Purpose: There is no consensus regarding the relationship between the width of keratinized mucosa and the health of periimplant tissues, but clinicians prefer to provide enough keratinized mucosa around dental implants for long-term implant maintenance. An apically positioned flap during second stage implant surgery is the chosen method of widening the keratinized zone in simple procedures. However, the routine suture techniques used with this method tend to apply tension over the provisional abutments and decrease pre-existing keratinized mucosa. To overcome this shortcoming, a pre-fabricated implant-retained stent was designed to apply vertical pressure on the labial flap and stabilize it in a bucco-apical direction to create a wide keratinized mucous zone. Methods: During second stage implant surgery, an apically displaced, partial thickness flap with a lingualized incision was retracted. A pre-fabricated stent was clipped over the abutments after connecting to the provisional abutment. Vertical pressure was applied to displace the labial flap. No suture was required and the stent was removed after 10 days. Results: A clinically relevant amount of keratinized mucosa was achieved around the dental implants. Buccally displaced keratinized mucosa was firmly attached to the underlying periosteum. A slight shrinkage of the keratinized zone was noted after the healing period in one patient, but no discomfort during oral hygiene was reported. Clinically healthy gingiva with enough keratinized mucosa was achieved in both patients. Conclusions: The proposed technique is a simple and time-effective technique for preserving and providing keratinized tissue around dental implants.
Journal of Dental Rehabilitation and Applied Science
/
v.29
no.3
/
pp.259-271
/
2013
The purpose of this study was to make the stress distribution produced by simulated different load under two types of internal connection implant system (stepped and tapered type) by means of 3D finite element analysis, The finite element model was designed with the parallel placement of the one fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st molar. Two models were loaded with 200 N magnitude in the vertical direction on the central position of the crown, the 1.5 mm and 3 mm buccal offset point from the central position of the fixture. The oblique load was applied at the angle of $30^{\circ}$ on the crown surface. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual dimension. The results were as follows; 1. The loading conditions of two internal connection implant systems (stepped and tapered type) were the main factor affecting the equivalent bone strain, followed by the type of internal connections. 2. The stepped model had more mechanical stability with the reduced max. stress compared to $11^{\circ}$ tapered models under the distributed oblique loading. 3. The more the contact of implant-abutment interface to the inner wall of implant fixture, the less stress concentration was reduced.
In case of gingival recession or bone defect in maxillary anterior implant treatment, it is not easy to obtain satisfactory clinical results. In this case, loss of the labial alveolar plate was diagnosed in the maxillary right central incisor, so after tooth extraction, soft tissue was secured and implant placement with bone graft was planned. In addition, digital guide surgery was performed for the ideal implant position, and GBR (Guided Bone Regeneration) was accompanied with the xenogeneic bone and the autologous bone collected from the mandibular ramus since alveolar bone defects were extensive. After a sufficient period of osseointegration of the implant, a temporary prosthesis was fabricated through secondary stage surgery and impression taking, and through periodic external adjustment, the shape of soft tissue was improved. In the final prosthesis fabrication, a color tone of natural teeth was induced by an gold anodized customized abutment, and an aesthetic and functional zirconia prosthesis with reproducing the shape of the temporary prosthesis through intraoral scan was delivered.
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