• 대한치과보철학회지
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• 제42권2호
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• pp.226-237
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• 2004

Purpose: Four finite element models were constructed in the mandible having a single implant fixture connected to the first premolar-shaped superstructure, in order to evaluate how the shape of the fixture and the implant-abutment connection would influence the stress level of the supporting tissues fixtures, and prosthethic components. Material and methods : The superstructures were constructed using UCLA type abutment, ADA type III gold alloy was used to fabricate a crown and then connected to the fixture with an abutment screw. The models BRA, END , FRI, ITI were constructed from the mandible implanted with Branemark, Endopore, Frialit-2, I.T.I. systems respectively. In each model, 150 N of vertical load was placed on the central pit of an occlusal plane and 150 N of $40^{\circ}$ oblique load was placed on the buccal cusp. The displacement and stress distribution in the supporting tissues and the other components were analysed using a 2-dimensional finite element analysis . The maximum stress in each reference area was compared. Results : 1. Under $40^{\circ}$ oblique loading, the maximum stress was larger in the implant, superstructure and supporting tissue, compared to the stress pattern under vertical loading. 2. In the implant, prosthesis and supporting tissue, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 3. In the superstructure and implant/abutment interface, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 4. In the implant fixture, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 5 The stress was more evenly distributed in the bone/implant interface through the FRI of trapezoidal step design. Especially Under $40^{\circ}$ oblique loading, The maximum stress was smallest in the bone/implant interface. 6. In the implant and superstructure and supporting tissue, the maximum stress occured at the crown loading point through the ITI. Conclusion: The stress distribution of the supporting tissue was affected by shape of a fixture and implant-abutment connection. The magnitude of maximum stress was reduced with the internal connection type (FRI) and the morse taper type (ITI) in the implant, prosthesis and supporting tissue. Trapezoidal step design of FRI showed evenly distributed the stress at the bone/implant interface.

• 대한치과기공학회지
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• 제42권2호
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• pp.99-105
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• 2020

Purpose: A study analysed the stress distribution of abutment screw and supporting bone of fixture by the tightening torque force of the abutment screw within clinical treatment situation for the stability of the dental implant prosthesis. Methods: The finite element analysis was targeted to the mandibular molar crown model, and the implant was internal type 4.0 mm diameter, 10.0 mm length fixture and abutment screw and supporting bone. The occlusal surface was modeled in 4 cusps and loaded 100 N to the buccal cusps. The connection between the abutment and the fixture was achieved by combining three abutment tightening torque forces of 20, 25, and 30 Ncm. Results: The results showed that the maximum stress value of the supporting bone was found in the buccal cortical bone region of the fixture in all models. The von Mises stress value of each model showed 184.5 MPa at the 20 Ncm model, 195.3 MPa in the 25 Ncm model, and 216.5 MPa in the 30 Ncm model. The contact stress between the abutment and the abutment screw showed the stress value in the 20 Ncm model was 201.2 MPa, and the 245.5 MPa in the 25 Ncm model and 314.0 MPa in the 30 Ncm model. Conclusion: The increase of tightening force within the clinical range of the abutment screw of the implant dental prosthesis was found to have no problem with the stability of the supporting bone and the abutment screw.

• The Journal of Advanced Prosthodontics
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• 제10권6호
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• pp.415-421
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• 2018

PURPOSE. This study investigated the effects of abutment screw lengths on screw loosening and removal torque in external connection implants after oblique cyclic loading. MATERIALS AND METHODS. External connection implants were secured with abutment screws to straight abutments. The abutment-implant assemblies were classified into seven groups based on the abutment screw length, with each group consisting of five assemblies. A cyclic load of 300 N was applied at a $30^{\circ}$ angle to the loading axis until one million cycles were achieved. Removal torque values (RTVs) before and after loading, and RTV differences were evaluated. The measured values were analyzed using repeated measures of analysis of variance with the Student-Newman-Keuls multiple comparisons. RESULTS. All assemblies survived the oblique cyclic loading test without screw loosening. There was a significant decrease in the RTVs throughout the observed abutment screw lengths when the abutment-implant assemblies were loaded repeatedly (P<.001). However, the abutment screw length did not show significant difference on the RTVs before and after the experiment when the abutment screw length ranged from 1.4 to 3.8 mm (P=.647). CONCLUSION. Within the limit of this experiment, our results indicate that the abutment screw length did not significantly affect RTV differences after oblique cyclic loading when a minimum length of 1.4 mm (3.5 threads) was engaged. These findings suggest that short abutment screws may yield stable clinical outcomes comparable to long screws in terms of load resistance.

• 대한치과보철학회지
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• 제41권5호
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• pp.617-625
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• 2003

Statement of problem : There are many studies focused on the effect of shape of futures on stress distribution in the mandibular bone. However, there are no studies focused on the effect of the abutment types on stress distribution in mandibular bone. Purpose : The purpose of this study is to investigate the effect of three different abutment types on the stress distributions in the mandibular bone due to various loads by performing finite element analysis. Material and method : Three different implant systems produced by Warantec (Seoul, Korea), were modeled to study the effect of abutment types on the stress distribution in the mandibular bone. The three implant systems are classified into oneplant (Oneplant, OP-TH-S11.5). internal implant (Inplant, IO-S11.5) and external implant (Hexplant, EH-S11.5). All abutments were made of titanium grade ELI. and all fixtures were made of titanium grade IV. The mandibular bone used in this study is constituted of compact and spongeous bone assumed to be homogeneous, isotropic and linearly elastic. A comparative study of stress distributions in the mandibular bone with three different types of abutment was conducted. Results : It was found that the types of abutments have significant influence on the stress distribution in the mandibular bone. It was due to difference in the load transfer mechanism and the size of contact area between abutment and fixture. Also the maximum effective stress in the mandibular bone was increased with the increase of inclination angle of load. Conclusion : It was concluded that the maximum effective stress in the bone by the internal implant was the lowest among the maximum effective stresses by other two types.

• 대한치과보철학회지
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• 제43권4호
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• pp.528-543
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• 2005

Statement of problem: Repeated delivery and removal of abutment cause some changes such as wear, scratch or defect of hexagonal structure. It may increase the value of rotational freedom(RF) between hexagonal structures. Purpose: The purpose of this study was to evaluate surface changes and rotational freedom between the external hexagon of the implant fixture and internal hexagon of abutment after repeated delivery and removal under SEM and toolmaker's microscope. Materials and methods: Implant systems used for this study were 3i and Avana. Seven pail's of implant fixture, abutment and abutment screws for each system were selected and all fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. Each one was embedded beneath the platform of fixture. Surfaces of hexagonal structure before repeated closing and opening of abutment were observed using SEM and rotational freedom was measured by using toolmaker's microscope. Each abutment was secured to the implant future by each abutment screw with recommended torque value using a digital torque controller and was repeatedly delivered and removed by 20 times respectively. After experiment, evaluation for the change of hexagonal structures and measurement of rotational freedom were performed. Result : The results were as follows; 1. Wear of contact area between implant fixture and abutment was considerable in both 3i and Avana system. Scratches and defects were frequently observed at the line-angle of hexagonal structures of implant fixture and abutment. 2. In the SEM view of the external hexagon of implant fixture, the point-angle areas at the corner edge of hexagon were severely worn out in both systems. It was more notable in the case of 3i systems than in that of Avana systems. 3. In the SEM view of the internal hexagon of abutment, Gingi-Hue abutment of 3i systems showed severe wear in micro-stop contacts that were machined into the corners to prevent rotation and cemented abutment of Avana systems showed wear in both surface area adjacent to the corner mating with external hexagon of implant fixture. 4 The mean values of rotational freedom between the external hexagon of the implant fixture and internal hexagon of abutment were 0.48$\pm$0.04$^{\circ}$ in pre-tested 3i systems and 1.18$\pm$0.25$^{\circ}$ after test, and 1.80$\pm$0.04$^{\circ}$ in pre-tested Avana systems and 2.61$\pm$0.16$^{\circ}$ after test. 5. Changes of rotational freedom after test shouted statistical)y a significant increase in both 3i and Avana systems(P<0.05, paired t-test). 6. Statistically, there was no significant difference between amount of increase in the rotational freedom of 3i systems and amount of increase in that of Avana ones(P>0.05, unpaired t-test). Conclusion: Conclusively, it was considered that repeated delivery and remove of abutment by 20 times would not have influence on screw joint stability. However, it caused statistically the significant change of rotational freedom in tested systems. Therefore, it is suggested that repeated delivery and remove of abutment should be minimal as possible as it could be and be done carefully Additionally, it is suggested that the means or treatment to prevent the wear of mating components should be devised.

• 대한치과보철학회지
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• 제58권1호
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• pp.58-66
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• 2020

완전무치악환자의 보철 치료를 위한 방법 중에서 임플란트 지지 상부보철물을 서베이드 금관의 형태로 제작하여 국소의치의 지대치로 활용하는 임플란트 융합 국소의치(Implant-Assisted Removable Partial Denture, IARPD) 치료가 많은 관심을 받고 있다. 이 치료 방법에서 지대치로 사용되는 임플란트 상부보철물은 유지 형태에 따라 전통적으로 나사 유지형과 시멘트 유지형으로 분류되며 각각 장, 단점이 존재한다. 시멘트 제거, 수리의 어려움, 나사구멍(screw hole)으로 인한 비심미성 등을 극복하기 위해 최근에 새로운 유지 형태의 임플란트 보철 시스템인 EZ crown system (Samwon DMP, Yangsan, Korea)이 소개되었다. 이 시스템은 fixture에 체결되는 나사 일체형의 특수 abutment와 니켈-티타늄 스프링과 지르코니아 볼이 포함된 cylinder 구조물을 microlocking 방식으로 연결하여 유지력을 얻는다. 이번 증례의 환자는 하악 피개의치의 지대치가 발거되어 새로운 의치를 제작하고 싶다는 주소로 내원하였다. 환자 맞춤형의 진단 과정을 통해 전방부의 임플란트 서베이드 보철물을 이용한 임플란트 융합 국소의치를 계획하였다. 특히, 전통적인 방식의 임플란트 상부 보철물들의 단점을 보완하고자 EZ crown system을 적용한 임플란트 서베이드 보철물을 제작하여 기능적, 심미적으로 양호한 결과를 얻을 수 있었기에 이를 보고하는 바이다.

• 대한치과보철학회지
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• 제46권3호
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• pp.246-254
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• 2008

STATEMENT OF PROBLEM: The cast abutment has advantages of overcoming angulation problem and esthetic problem. However, when a gold-machined UCLA abutment undergoes casting, the abutment surfaces in contact with the implant may change. PURPOSE: The purpose of this study was to compare the detorque values of prefabricated machined abutments with gold-premachined cast-on UCLA abutments before and after casting in two types of internal implant-abutment connection systems: (1) internal hexagonal joint, (2) internal octagonal joint. Furthermore, the detorque values of two implant-abutment connection systems were compared. MATERIALS AND METHODS: Twenty internal hexagonal implants with an 11-degree taper and twenty internal octagonal implants with an 8-degree taper were acquired. Ten prefabricated titanium abutments and ten gold-premachined UCLA abutments were used for each systems. Each abutment was torqued to 30 N㎝ according to the manufacturer's instructions and detorque value was recorded. The detorque values were measured once more, after casting with gold alloy for UCLA abutment, and preparation for titanium abutments. Group means were calculated and compared using independent t-test and paired t-test (${\alpha}$=0.05). RESULTS: The results were as follows: 1. The detorque values between titanium abutments and UCLA-type abutments showed significant differences in internal octagonal implants (P<0.05), not in internal hexagonal implants (P>0.05). 2. In comparison of internal hexagonal and octagonal implants, the detorque values of titanium abutments had significant differences between two connection systems on the initial analysis (P<0.05), not on the second analysis (P>0.05) and the detorque values of UCLA-type abutments were not significantly different between two connection systems (P>0.05). 3. The detorque values of titanium abutments and UCLA-type abutments decreased significantly on the second analysis than the initial analysis in internal hexagonal implants (P<0.05), not in internal octagonal implants (P>0.05). CONCLUSION: Casting procedures of UCLA-type abutments had no significant effect on screw loosening in internal implant-abutment connection systems, and UCLA-type abutments showed higher detorque values than titanium abutments in internal octagonal implants.

• The Journal of Advanced Prosthodontics
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• 제7권6호
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• pp.423-430
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• 2015

PURPOSE. To evaluate the cumulative survival rate (CSR) and mechanical complications of single-tooth $Ankylos^{(R)}$ implants. MATERIALS AND METHODS. This was a retrospective clinical study that analyzed 450 single $Ankylos^{(R)}$ implants installed in 275 patients between December 2005 and December 2012. The main outcomes were survival results CSR and implant failure) and mechanical complications (screw loosening, fracture, and cumulative fracture rate [CFR]). The main outcomes were analyzed according to age, sex, implant length or diameter, bone graft, arch, and position. RESULTS. The 8-year CSR was 96.9%. Thirteen (2.9%) implants failed because of early osseointegration failure in 3, marginal bone loss in 6, and abutment fracture in 4. Screw loosening occurred in 10 implants (2.2%), and 10 abutment fractures occurred. All abutment fractures were located in the neck, and concurrent screw fractures were observed. The CSR and rate of screw loosening did not differ significantly according to factors. The CFR was higher in middle-aged patients (5.3% vs 0.0% in younger and older patients); for teeth in a molar position (5.8% vs 0.0% for premolar or 1.1% for anterior position); and for larger-diameter implants (4.5% for 4.5 mm and 6.7% for 5.5 mm diameter vs 0.5% for 3.5 mm diameter) (all P<.05). CONCLUSION. The $Ankylos^{(R)}$ implant is suitable for single-tooth restoration in Koreans. However, relatively frequent abutment fractures (2.2%) were observed and some fractures resulted in implant failures. Middle-aged patients, the molar position, and a large implant diameter were associated with a high incidence of abutment fracture.

• 대한치과의사협회지
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• 제58권9호
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• pp.583-589
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• 2020

If the implant is planted in the wrong position or direction, it is disadvantageous for stress distribution, and it is easy to cause complications such as screw loosening, abutment fracture, and implant fracture. If the position or orientation of the implant is not good, efforts should be made to minimize the problem through proper implant prosthetic treatment. In this article, the prosthetic method for facilitating future maintenance in cases with poor implant placement or orientation will be presented.

• Journal of Periodontal and Implant Science
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• 제53권3호
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• pp.233-244
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• 2023

Purpose: An implant-supported prosthesis consists of an implant fixture, an abutment, an internal screw that connects the abutment to the implant fixture, and the upper prosthesis. Numerous studies have investigated the microorganisms present on the implant surface, surrounding tissues, and the subgingival microflora associated with peri-implantitis. However, there is limited information regarding the microbiome within the internal screw space. In this study, microbial samples were collected from the supragingival surfaces of natural teeth, the peri-implant sulcus, and the implant-abutment screw hole, in order to characterize the microbiome of the internal screw space in healthy subjects. Methods: Samples were obtained from the supragingival region of natural teeth, the peri-implant sulcus, and the implant screw hole in 20 healthy subjects. DNA was extracted, and the V3-V4 region of the 16S ribosomal RNA was sequenced for microbiome analysis. Alpha diversity, beta diversity, linear discriminant analysis effect size (LEfSe), and network analysis were employed to compare the characteristics of the microbiomes. Results: We observed significant differences in beta diversity among the samples. Upon analyzing the significant taxa using LEfSe, the microbial composition of the implant-abutment screw hole's microbiome was found to be similar to that of the other sampling sites' microbiomes. Moreover, the microbiome network analysis revealed a unique network complexity in samples obtained from the implant screw hole compared to those from the other sampling sites. Conclusions: The bacterial composition of the biofilm collected from the implant-abutment screw hole exhibited significant differences compared to the supra-structure of the implant. Therefore, long-term monitoring and management of not only the peri-implant tissue but also the implant screw are necessary.