• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.346-350
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• 2014

PURPOSE. Impact forces in implant supported FDP (fixed dental prosthesis) are higher than that of tooth supported FDPs and the compositions used in frameworks also has a paramount role for biomechanical reasons. The aim of this study was to evaluate the flexural strength of two different zirconia frameworks. MATERIALS AND METHODS. Two implant abutments with 3.8 mm and 4.5 mm platform were used as premolar and molar. They were mounted vertically in an acrylic resin block. A model with steel retainers and removable abutments was fabricated by milling machine; and 10 FDP frameworks were fabricated for each Biodenta and Cercon systems. All samples were thermo-cycled for 2000 times in $5-55^{\circ}C$ temperature and embedded in $37^{\circ}C$ artificial saliva for one week. The flexural test was done by a rod with 2 mm ending diameter which was applied to the multi-electromechanical machine. The force was inserted until observing fracture. The collected data were analyzed with SPSS software ver.15, using Weibull modulus and independent t-test with the level of significance at ${\alpha}=.05$. RESULTS. The mean load bearing capacity values were higher in Biodenta but with no significant differences (P>.05). The Biodenta frameworks showed higher load bearing capacity ($F_0=1700$) than Cercon frameworks ($F_0=1520$) but the reliability (m) was higher in Cercon (m=7.5). CONCLUSION. There was no significant difference between flexural strengths of both zirconia based framework systems; and both Biodenta and Cercon systems are capable to withstand biting force (even parafunctions) in posterior implant-supported bridges with no significant differences.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.290-297
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• 2008

STATEMENT OF PROBLEM: Implant-supported fixed cantilever prostheses are influenced by various biomechanical factors. The information that shows the effect of implant number and position of cantilever on stress in the supporting bone is limited. PURPOSE: The purpose of this study was to investigate the effect of implant number variation and the effect of 2 different cantilever types on stress distribution in the supporting bone, using 3-dimensional finite element analysis. MATERIAL AND METHODS: A 3-D FE model of a mandibular section of bone with a missing second premolar, first molar, and second molar was developed. $4.1{\times}10$ mm screw-type dental implant was selected. 4.0 mm height solid abutments were fixed over all implant fixtures. Type III gold alloy was selected for implant-supported fixed prostheses. For mesial cantilever test, model 1-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 1-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 1-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with mesial cantilever were simulated. And then, 155N oblique force was applied to the buccal cusp of second premolar. For distal cantilever test, model 2-1 which has three $4.1{\times}10$ mm implants and fixed prosthesis with no pontic, model 2-2 which has two $4.1{\times}10$ mm implants and fixed prosthesis with a central pontic and model 2-3 which has two $4.1{\times}10$ mm implants and fixed prosthesis with distal cantilever were simulated. And then, 206N oblique force was applied to the buccal cusp of second premolar. The implant and superstructure were simulated in finite element software(Pro/Engineer wildfire 2.0). The stress values were observed with the maximum von Mises stresses. RESULTS: Among the models without a cantilever, model 1-1 and 2-1 which had three implants, showed lower stress than model 1-2 and 2-2 which had two implants. Although model 2-1 was applied with 206N, it showed lower stress than model 1-2 which was applied with 155N. In models that implant positions of models were same, the amount of applied occlusal load largely influenced the maximum von Mises stress. Model 1-1, 1-2 and 1-3, which were loaded with 155N, showed less stress than corresponding model 2-1, 2-2 and 2- 3 which were loaded with 206N. For the same number of implants, the existence of a cantilever induced the obvious increase of maximum stress. Model 1-3 and 2-3 which had a cantilever, showed much higher stress than the others which had no cantilever. In all models, the von Mises stresses were concentrated at the cortical bone around the cervical region of the implants. Meanwhile, in model 1-1, 1-2 and 1-3, which were loaded on second premolar position, the first premolar participated in stress distribution. First premolars of model 2-1, 2-2 and 2-3 did not participate in stress distribution. CONCLUSION: 1. The more implants supported, the less stress was induced, regardless of applied occlusal loads. 2. The maximum von Mises stress in the bone of the implant-supported three unit fixed dental prosthesis with a mesial cantilever was 1.38 times that with a central pontic. The maximum von Mises stress in the bone of the implant-supported three-unit fixed dental prosthesis with a distal cantilever was 1.59 times that with a central pontic. 3. A distal cantilever induced larger stress in the bone than a mesial cantilever. 4. A adjacent tooth which contacts implant-supported fixed prosthesis participated in the stress distribution.

• Journal of Korean Dental Science
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• v.15 no.2
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• pp.152-161
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• 2022

Mandibular implant overdenture is a good treatment option for complete edentulous patients with restoring removable prosthesis. Mandibular implant overdenture with two implants and locator attachments is widely used. It is tissue-supported overdenture that is made with the concept of conventional complete denture fabrication. There are two patients who provided impressions by open mouth technique and closed mouth technique in each case. In both cases, mandibular implant overdentures were restored with functionally and aesthetically satisfying results.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.214-220
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• 2013

Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported- overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

• The Journal of Advanced Prosthodontics
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• v.14 no.4
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• pp.223-235
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• 2022

PURPOSE. To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS. The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS. Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION. The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.

• The Journal of Advanced Prosthodontics
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• v.12 no.4
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• pp.233-238
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• 2020

PURPOSE. This study aims to compare the marginal fitness of two types of implant-supported fixed dental prosthesis, i.e., cementless fixation (CL.F) system and cement-retained type. MATERIALS AND METHODS. In each group, ten specimens were assessed. Each specimen comprised implant lab analog, titanium abutment fabricated with a 2-degree tapered axial wall, and zirconia crown. The crown of the CL.F system was retained by frictional force between abutment and relined composite resin. In the cement-retained type, zinc oxide eugenol cement was used to set crown and abutment. All specimens were sterilized with ethylene oxide, immersed in Prevotella intermedia culture in a 50 mL tube, and incubated with rotation. After 48 h, the specimens were washed thoroughly before separating the crown and abutment. The bacteria that penetrated into the crown-abutment interface were collected by washing with 500 µL of sterile saline. The bacterial cell number was quantified using the agar plate count technique. The BacTiter-Glo Microbial Cell Viability Assay Kit was used to measure bacterial adenosine triphosphate (ATP)-bioluminescence, which reflects the bacterial viability. The t-test was performed, and the significance level was set at 5%. RESULTS. The number of penetrating bacterial cells assessed by colony-forming units was approximately 33% lower in the CL.F system than in the cement-retained type (P<.05). ATP-bioluminescence was approximately 41% lower in the CL.F system than in the cement-retained type (P<.05). CONCLUSION. The CL.F system is more resistant to bacterial penetration into the abutment-crown interface than the cement-retained type, thereby indicating a precise marginal fit.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.2
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• pp.173-178
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• 2018

The direct metal laser sintering (DMLS) technique would be promising for the full-arch implant-supported restorations due to reduced cost and manufacturing time without potential human errors and casting defects. The aims of this case report were to describe the successful outcome of an implant-supported fixed dental prosthesis in the edentulous maxilla by using the DMLS technology and computer-aided design and computer-aided manufacturing (CAD/CAM) monolithic zirconia crowns, and to describe its clinical implications. A healthy 51-year-old Korean woman visited Seoul National University Dental Hospital and she was in need of a rehabilitation of her entire maxilla due to severe tooth mobility. In this case, all maxillary teeth were extracted and an implant-supported fixed dental prosthesis was fabricated that involved a cobalt-chromium (Co-Cr) framework with the DMLS technique and CAD/CAM monolithic zirconia crowns. Six months after delivery, no distinct mechanical and biological complications were detected and the prosthesis exhibited satisfactory esthetics and function. In this case report, with the DMLS system, the three-dimensional printed prosthesis was created without additional manual tooling and thus, reliable accuracy and passive fit were obtained.

• Journal of Technologic Dentistry
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• v.43 no.4
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• pp.202-209
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• 2021

By classifying temporary denture production for surgical guides, digital guide-based surgery, and final prosthesis production, the problems of each process were assessed in advance and the factors that could be improved were confirmed in this study. The manufacturing process of fusion dental prosthesis uses virtual programs and computed tomography images to manufacture devices using the latest technologies of computer-aided design/computer-aided manufacturing and three-dimensional printing, which enables implants to be placed in the desired location in advance. Moreover, implant placement is not dependent on the skill and condition of the dentist, and because it uses a computer system, it can always be performed at a constant and optimal position. This can reduce the remanufacturing rate compared with the general method, shorten the treatment period, and eliminate patient discomfort. Unlike the traditional method of using impression materials and plaster models, digital fusion dental prostheses would be evaluated as a technology for producing prosthesis through professional design technology and communication.

• The Journal of Advanced Prosthodontics
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• v.13 no.2
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• pp.79-88
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• 2021

Purpose. To assess peri-implant stress distribution using finite element analysis in implant supported fixed partial denture with occlusal schemes of cuspally loaded occlusion and implant protected occlusion. Materials and methods. A 3-D finite element model of mandible with D2 bone with partially edentulism with unilateral distal extension was made. Two Ti alloy identical implants with 4.2 mm diameter and 10 mm length were placed in the mandibular second premolar and the mandibular second molar region and prosthesis was given with the mandibular first molar pontic. Vertical load of 100 N and and oblique load of 70 N was applied on occlusal surface of prosthesis. Group 1 was cuspally loaded occlusion with total 8 contact points and Group 2 was implant protected occlusion with 3 contact points. Results. In Group 1 for vertical load, maximum stress was generated over implant having 14.3552 Mpa. While for oblique load, overall stress generated was 28.0732 Mpa. In Group 2 for vertical load, maximum stress was generated over crown and overall stress was 16.7682 Mpa. But for oblique load, crown stress and overall stress was maximum 22.7561 Mpa. When Group 1 is compared to Group 2, harmful oblique load caused maximum overall stress 28.0732 Mpa in Group 1. Conclusion. In Group 1, vertical load generated high implant stress, and oblique load generated high overall stresses, cortical stresses and crown stresses compared to vertical load. In Group 2, oblique load generated more overall stresses, cortical stresses, and crown stresses compared to vertical load. Implant protected occlusion generated lesser harmful oblique implant, crown, bone and overall stresses compared to cuspally loaded occlusion.

• Journal of Technologic Dentistry
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• v.44 no.3
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• pp.67-75
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• 2022

Purpose: This study aimed to comparatively evaluate the stress distribution of bones surrounding the implant system to which both titanium and polyetheretherketone (PEEK) abutments are applied using a three-dimensional finite element analysis. Methods: The three-dimensional implant system was designed by the computer-aided design program (CATIA; Dassault Systemes). The discretization process for setting nodes and elements was conducted using the HyperMesh program (Altair), after finishing the design of each structure for the customized abutment implant system. The results of the stress analysis were drawn from the Abaqus program (Dassault Systèmes). This study applied 200 N of vertical load and 100 N of oblique load to the occlusal surface of a mandibular first molar. Results: Under external load application, the PEEK-modeled dental implant showed the highest von Mises stress (VMS). The lowest VMS was observed in the Ti-modeled abutment screws. In all groups, the VMS was observed in the crestal regions or necks of implants. Conclusion: The bones surrounding the implant system to which the PEEK abutment was applied, such as the cortical and trabecular bones, showed stress distribution similar to that of the titanium implant system. This finding suggests that the difference in the abutment materials had no effect on the stress distribution of the bones surrounding implants. However, the PEEK abutments require mechanical and physical properties improved for clinical application, and the clinical application is thought to be limited.