• 대한치과보철학회지
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• 제53권4호
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• pp.301-309
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• 2015

목적: 이 연구의 목적은 지대주 나사 잔여 전부하 비율과 시멘트 파손유무 평가를 통해 나사 시멘트 유지형 임플란트 보철물(screw- and cement-retained implant prosthesis: SCP)의 임상적 수행 능력을 알아보는 것이다. 재료 및 방법: 구치부 부분 무치악 환자들을 대상으로 임플란트가 식립되었으며 3 - 6개월의 치유기간 후 SCP임플란트 보철물이 장착되었다. 추적관찰을 통해 임플란트의 생존율이 평가되고 보철물 성공률도 평가되었다. SCP 보철물의 나사 잔여 전부하 비율 및 시멘트 파손 비율이 측정되었다. 결과: 20명의 환자로부터 21개의 SCP보철물(43개의 임플란트)이 최대 64개월까지 관찰되었다. 관찰기간(평균 34개월) 동안 골융합에 실패한 임플란트는 하나도 없었다. 지대주, 나사, 도재 혹은 보철물 프레임 파절이나 나사 풀림 등은 없었으므로 보철물 성공율은 100%였다. SCP 보철물의 나사 잔여 전부하 비율은 97.61% (${\pm}16.29$), 그리고 시멘트 파손비율은 9.5%이었다. 결론: 본 실험의 한계 내에서, 나사 풀림과 시멘트 파손이란 관점에서 SCP 디자인의 임플란트 보철물은 양호한 단기 임상 결과를 보였다.

• 대한치과보철학회지
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• 제55권1호
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• pp.61-70
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• 2017

본 증례에서는 기존의 총의치 사용 환자에서 의치의 이장된 인상면을 스캔하고 이를 삼차원적으로 반전하여 잔존 치조제의 형태를 재현하고, 의치에 방사선 불투과성 마커를 부착한 상태로 스캔 및 CT 촬영을 진행하여 스캔 이미지와 CT 영상이 중첩된 데이터 상에서 임플란트 식립을 계획하였다. 수술 당일에는 치은 형태에 맞게 제작된 맞춤형 지대주와 임시 수복물을 장착하였다. 임플란트 고정체의 골유착이 완료된 이후 최종 보철물을 제작하는 과정에서는 임플란트 식립 전 미리 스캔하여 저장된 임플란트 지대주 이미지 파일과 구강 내 지대주 상태에서 채득된 구강 스캔 이미지를 중첩하였다. 중첩을 통해 얻어진 정확한 지대주 형태 상에서 최종 보철물을 제작함으로써 최종 보철물의 변연 적합도를 높이고 임상 과정을 간소화 할 수 있었다.

• 대한치과보철학회지
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• 제39권6호
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• pp.625-632
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• 2001

Statement of Problem. Objective and quantitative measurement of implant stability is very important from implant installation to long-lasting maintenance period thereafter. Purpose of study. This study was to evaluate and compare two ISQ and PTVs on the implant stability measurements according to the increased effective implant length. Materials and methods. Twenty self-tapping fixtures were installed in the bovine scapula and in 10 of those for group I, ISQ and PTVs were obtained in the vertical/horizontal directions according to the increased effective implant length using $Osstell^{TM}$ and $Periotest^{(R)}$. After stability measurement, removal torques were measured between the after installation and after thread exposure group. Results. ISQ and PTVs showed decreased and increased values according to the increased abutment length. Apart from PTVs, ISQ values were shown higher in horizontal direction to the long axis of bone in both the after installation and the after thread exposure groups. Removal torque values were shown higher in after installation group. Conclusion. From the results of this study, implant stability measurement using resonance frequency analysis was more sensitive and discriminative than PTVs measurement.

• 대한치과의사협회지
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• 제54권3호
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• pp.198-205
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• 2016

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

• 구강회복응용과학지
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• 제26권3호
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• pp.273-283
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• 2010

이 연구는 다수의 임플란트에 의해 지지되는 보철물과 단일 임플란트 보철물에서 호환 가능한 세 가지 종류의 나사의 풀림토크값을 측정하여 나사 결합부 안정성에 차이가 있는지를 알아보고자 하였다. 이를 위해, 네 개의 외부 육각 임플란트에 직접 연결되는 임플란트 상부구조물을, 아크릴릭 레진을 이용한 연결인상법으로 얻은 총 6개의 실험모형에 20 Ncm의 힘으로 조인 후, 각 나사의 풀림토크값을 총 2회 측정하였다. 사용한 지대주 나사는 토크타이트(TorqTite), 골드타이트(Gold-Tite), 그리고, 티타늄(Titanium) 나사였다. 또한, 단일 임플란트 수복의 경우 를 가정하여 총 5개의 실험모형 상의 2개의 임플란트에, 한 개의 지대주(GoldAdapt Engaging)를 다시 세 종류의 나사로 연결한 후, 각 나사의 풀림토크값을 총 2회 측정하였다. 나사의 풀림토크값의 비교를 위한 통계적 분석을 혼합모형(mixed model)을 이용하여 유의수준 .05에서 실시한 결과, 다수 임플란트 지지 상부구조물의 경우, 나사의 종류에 따른 풀림토크값은 통계적으로 유의성 있는 차이를 보이지 않았다(p>0.05). 그러나 단일 임플란트 지대주의 경우에는 통계적으로 유의성 있는 차이를 보였으며(p=0.0175), 토크타이트 나사(p=0.0462)와 티타늄 나사(p=0.0348)는 각각, 골드타이트 나사보다 유의성 있게 큰 풀림토크값을 보였으나, 두 나사 간에는 유의성 있는 차이가 없었다(p>0.05). 이상의 연구 결과로 보아, 서로 다른 종류의 나사가 나사 결합부의 초기 안정성에 미치는 영향은, 단일 임플란트 보철물의 경우에서와는 달리, 다수의 임플란트에 의해 지지되는 보철물의 경우에는 미미하다고 할 수 있다.

• 대한치과보철학회지
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• 제59권4호
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• pp.515-522
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• 2021

소수의 잔존치가 존재하는 경우 소수의 임플란트를 추가적으로 식립하여 의치의 유지, 지지, 안정을 확보하는 임플란트 융합 국소의치 및 피개의치의 성공적인 증례가 보고되고 있다. 임플란트 융합 국소의치는 임플란트를 포함한 지대치에 가해지는 측방력을 최소화할 경우 의치의 수평적, 회전적 움직임이 현저하게 줄어들고 의치의 탈락 및 안정의 불편감을 호소하는 환자에서 주소를 크게 개선할 수 있는 효과적인 치료법으로 제안되고 있다. 본 증례는 소수의 임플란트를 식립하여 상악에 임플란트 지지 서베이드 금관을 제작하고 하악에 Locator^® attachment를 통해 의치의 유지, 안정, 지지를 개선하였다. 임상 관찰에서 환자가 최종 의치 장착 후 기능적, 심미적 면에서 모두 만족하였기에 보고하는 바이다.

• 대한심미치과학회지
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• 제23권2호
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• pp.70-76
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• 2014

After extraction of tooth, alveolar ridge resorption is inevitable in most cases. Clinicians confront with horizontal and vertical resorption of alveolar bone. Without massive amount of bone and soft tissue graft, dental implant will be placed apically to gain stability. In those cases, not only white esthetic part, but also pink esthetic part should be restored with pink porcelain. The margin of prosthesis should be located apically to reproduce natural look with adjacent teeth. However, when the margin is located apically, it is always hard to remove remaining cement, thus complications may arise. In this report, a novel design of implant prosthesis is introduced to solve those issues. The novel design is consisted of zirconia framework with pink porcelain and separate crowns on top of the framework. It eliminates the possibility of cement remnants by bringing the crown margin coronally. Pink esthetic part is incorporated in abutment part instead of crown part and the screw hole is covered with separate crowns.

• Journal of Korean Dental Science
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• 제15권1호
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• pp.75-83
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• 2022

Crown-type implant-assisted removable partial dentures (CIRPDs) can be a feasible treatment option for partially edentulous patients. Here we report a case with remaining unilateral mandibular teeth. Two implants were placed in the posterior portion of the mandible using a surgical guide, and a distal-extension removable partial denture with implant-supported surveyed crowns was fabricated. After 12 months, both the abutment teeth and implants were in good condition. The treatment outcomes were satisfactory in terms of masticatory function and esthetics. The advantages of CIRPDs and considerations for obtaining successful clinical outcomes with these dentures are also discussed.

• The Journal of Advanced Prosthodontics
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• 제9권2호
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• pp.124-129
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• 2017

PURPOSE. This study evaluated the effect of span length on the adaptation of implant-supported cobalt chromium frameworks fabricated by three techniques. MATERIALS AND METHODS. Models with two solid abutment analogs at different inter-abutment distances were digitized using a laboratory scanner. Frameworks of two-, three-, and four-unit fixed prostheses were designed by a computer. Six dots with a diameter of 0.2 mm were preset on the surface of each framework. A total of 54 implant-supported cobalt chromium frameworks were fabricated by milling, selective laser melting (SLM), and cast techniques. The frameworks were scanned and exported as Stereolithography files. Distances between two dots in X, Y, and Z coordinates were measured in both the designed and fabricated frameworks. Marginal gaps between the framework and the abutments were also evaluated by impression replica method. RESULTS. In terms of distance measurement, significant differences were found between three- and four-unit frameworks, as well as between two- and four-unit frameworks prepared by milling technique (P<.05). Significant differences were also noted between two- and three-unit frameworks, as well as between two- and four-unit frameworks prepared by cast technique (P<.05). The milling technique presented smaller differences than the SLM technique, and the SLM technique showed smaller differences than the cast technique at any unit prostheses (P<.05). Evaluation with the impression replica method indicated significant differences among the span lengths for any fabrication method (P<.05), as well as among the fabrication methods at any unit prostheses (P<.05). CONCLUSION. The adaptation of implant-supported cobalt chromium frameworks was affected by the span length and fabrication method.

• 대한치과보철학회지
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• 제29권3호
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• pp.55-74
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• 1991

The purpose of this study was to investigate the influence of early functional load around osseointegrated titanium implants. 24 titanium plasma spray coated implants (ITI HS-type) were placed into the previously extracted site in the mandible of six adult dogs. The implants were divided into three groups : the control group was the implants without abutment during the experimental period; the experimental group I was loaded by connecting the contoured abutment after 6 weeks of healing; the experimental group II was loaded after 12 weeks of healing: and the mandibular second premolar and surrounding tissues were selected for natural tooth group to compare the implanted group. All dogs were injected intravenously tetracycline, alizarin red S, and calcein for bone labeling. After the experimental period of 18 weeks, the dogs were sacrificed and longitudinal sections of the bone-implant interface were cut and observed using light microscope, scanning electron microscope, and fluorescence microscope. The results of the study were as follows: 1. Light and scanning electron microscopically, all implant surfaces were well contact with bone tissue at the cortical layer, but some areas of cancellous bone were not contact directly. 2. Fluorescence microscopically, number and size of the new secondary osteons around the implant were increased than those of the natural tooth. 3. Fluorescence microscopically, linear and concentrical fluorescence was observed at or near the surface of all implants, and the bone formation and remodeling of the implants loaded after 6 week of healing were great, and unloaded implants were worst. 4. Fluorescence microscopically, endosteal bone formation was greater than periosteal bone formation at or near the implants. 5. Fluorescence microscopically, number and size of linear and concentric fluorescence was increased at the lingual side than the buccal side of the loaded implants. The result of the study indicate the possibility of the early load to the implant via a prosthesis.