• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.136-147
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• 2009

Statement of problem: Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved. Though the use of dental implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. Purpose: The aim of this retrospective study was to provide long-term data on the $Implantium^{(R)}$ implant, which features a sandblasted and acid-etched surface and internal connection with microthreads. Material and methods: 106 $Implantium^{(R)}$ implants placed in 38 patients at Yonsei University Hospital were examined to determine the effect of various factors on implant success and marginal bone loss, through clinical and radiographic results during a 6 to 30 month period. Results: 1. Out of a total of 106 implants placed in 38 patients, one fixture was lost, resulting in a 99.1% cumulative survival rate. 2. Among the 96 implants which were observed throughout the study period, the survival rates were 97.0% in the maxilla and 100% in the mandible. The survival rate in the posterior regions was 98.9% and 100% in the anterior regions. 3. The mean bone loss during the first year after prosthesis placement was 0.17 mm, while the mean annual bone loss after the first year was 0.04 mm, which was statistically less than during the first year(P<.05). 4. There was no significant difference in marginal bone loss according to age during the first year(P>.05), but after the first year, the mean annual bone loss in patients above 50 years was significantly greater(P<.05) compared with patients under 50 years. 5. No significant difference in marginal bone loss was found according to the following factors: gender, jaw, location in the arch, type of implant(submerged or non-submerged), presence of bone grafts, type of prostheses, and type of opposing dentition(P<.05). Conclusion: Based on these results, the sole factor influencing marginal bone loss was age, while factors such as gender, jaw, location in the arch, type of implant, presence of bone grafts, type of prostheses and type of opposing dentition had no significant effect on bone loss. In the present study, the success rate of the $Implantium^{(R)}$ implant with a SLA surface and internal connection with microthreads was satisfactory up to a maximum 30 month period, and the marginal bone loss was in accord with the success criteria of dental implants.

• Journal of the Korean Society of Radiology
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• v.14 no.3
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• pp.253-259
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• 2020

Mammography has the advantage of being economical, simple and effective in detecting microcalcification, but breast is a highly sensitive organ and is accompanied by the risk of an over-exposure. While accurate dose assessments are important to prevent this, current breast dose assessments are limited to breast implant patients. This purpose of this study was to identify dose variations due to tube voltages by forming a mock-up with breast implants for an accurate dosimetric assessment on breast implant patients. As a result, doses from the presence of breast implants were smaller than those from the absence of the mammal. As the result of the change of the voltage to 26, 28, 30, and 32 kV, the imcreased tube voltage included larger dose regardless of the presence of Breast implant. Therefore, it is believed that diagnosis recommendations for breast implants will be possible if further studies on internal and external bioretical imaging and quality assessment are carried out as the basis for this study.

• The Journal of Advanced Prosthodontics
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• v.6 no.1
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• pp.46-52
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• 2014

PURPOSE. The aim of this study was to evaluate the interface accuracy of computer-assisted designed and manufactured (CAD/CAM) titanium abutments and implant fixture compared to gold-cast UCLA abutments. MATERIALS AND METHODS. An external connection implant system (Mark III, n=10) and an internal connection implant system (Replace Select, n=10) were used, 5 of each group were connected to milled titanium abutment and the rest were connected to the gold-cast UCLA abutments. The implant fixture and abutment were tightened to torque of 35 Ncm using a digital torque gauge, and initial detorque values were measured 10 minutes after tightening. To mimic the mastication, a cyclic loading was applied at 14 Hz for one million cycles, with the stress amplitude range being within 0 N to 100 N. After the cyclic loading, detorque values were measured again. The fixture-abutment gaps were measured under a microscope and recorded with an accuracy of ${\pm}0.1{\mu}m$ at 50 points. RESULTS. Initial detorque values of milled abutment were significantly higher than those of cast abutment (P<.05). Detorque values after one million dynamic cyclic loadings were not significantly different (P>.05). After cyclic loading, detorque values of cast abutment increased, but those of milled abutment decreased (P<.05). There was no significant difference of gap dimension between the milled abutment group and the cast abutment group after cyclic loading. CONCLUSION. In conclusion, CAD/CAM milled titanium abutment can be fabricated with sufficient accuracy to permit screw joint stability between abutment and fixture comparable to that of the traditional gold cast UCLA abutment.

• Archives of Plastic Surgery
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• v.48 no.2
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• pp.165-174
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• 2021

Background In recent years, implant-based breast reconstruction has been performed because of its simplicity, short operation time, and rapid recovery of patients. Several studies have reported treatment methods for implant surgery-related infection, which is a serious complication. The aim of this study was to introduce our strategy for salvaging infected implants and to evaluate its effectiveness. Methods The authors performed a retrospective study of 145 cases from 132 patients who underwent implant-based breast reconstruction from January 2012 to December 2018. Empirical antibiotics were immediately administered to patients with suspected infections. The patients then underwent salvage treatment including appropriate antibiotics, ultrasonography-guided aspiration, debridement, antibiotic lavage, and implant exchange through a multidisciplinary approach. Patient demographics, operative data, duration until drain removal, adjuvant treatment, and complications were analyzed. Results The total infection rate was 5.5% (8/145). A longer indwelling catheter period and adjuvant treatment were significantly associated with infection. The salvage treatment showed a success rate of 87.5% (7/8). Seven patients who received early aggressive salvage treatment recovered from infection. One patient with methicillin-resistant Staphylococcus aureus, who received salvage treatment 11 days after symptom onset, did not respond to drainage and antibiotic treatment. That patient subsequently underwent explantation. Conclusions In implant-based breast reconstruction, prevention of infection is of the utmost importance. However, if an infection is suspected, proactive empirical antibiotic therapy and collaboration with the necessary departments are required. Through a multidisciplinary approach and proactive early management, swift and appropriate salvage should be performed.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.93-106
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• 2023

Reverse total shoulder arthroplasty (RTSA) emerged as a new concept of arthroplasty that does not restore normal anatomy but does restore function. It enables the function of the torn rotator cuff to be performed by the deltoid and shows encouraging clinical outcomes. Since its introduction, various modifications have been designed to improve the outcome of the RTSA. From the original cemented baseplate with peg or keel, a cementless baseplate was designed that could be fixed with central and peripheral screws. In addition, a modular-type glenoid component enabled easier revision options. For the humeral component, the initial design was an inlay type of long stem with cemented fixation. However, loss of bone stock from the cemented stem hindered revision surgery. Therefore, a cementless design was introduced with a firm metaphyseal fixation. Furthermore, to prevent complications such as scapular notching, the concept of lateralization emerged. Lateralization helped to maintain normal shoulder contour and better rotator cuff function for improved external/internal rotation power, but excessive lateralization yielded problems such as subacromial notching. Therefore, for patients with pseudoparalysis or with risk of subacromial notching, a medial eccentric tray option can be used for distalization and reduced lateralization of the center of rotation. In summary, it is important that surgeons understand the characteristics of each implant in the various options for RTSA. Furthermore, through preoperative evaluation of patients, surgeons can choose the implant option that will lead to the best outcomes after RTSA.

• The Journal of the Korean dental association
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• v.53 no.9
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• pp.644-655
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• 2015

Purpose: This study was conducted to evaluate the effect of the fixture abutment connection type and diameter on the screw joint stability in external butt joint for 2nd surgery and internal cone connected type implant system for 1st and 2nd surgery using ultimate fracture strength. Materials and Methods: USII system, SSII system and GSII system of Osstem Implant were used. Each system used the fixture with two different diameters and cement-retained abutments, and tungsten carbide / carbon coated abutment screws were used. Disc shaped stainless steel metal tube was attached using resin-based temporary cement. The experimental group was divided into seven subgroups, including the platform switching shaped specimen that uses a regular abutment in the fixture with a wide diameter in USII system. A static load was increased to the metal tube at 5mm deviated point from the implant central axis until it reached the compression bending strength at a rate of 1mm/min. Then the deformations and patterns of fracture in threaded connection were compared. Results and Conclusion: 1. In the comparison between the Regular diameter, compression bending strength of SSII system was higher than USII system and GSII system. There was no significant difference between USII system and GSII system. 2. In the comparison between wide diameter, compression bending strength was increased in the order of GSII system, USII system, and SSII system. 3. In comparison between the implant diameter, compression bending strength of the wide diameter was greater than the regular diameter in any system(P<0.05). 4. There was no significant difference between the platform switching (III group) and the regular diameter (I group) in USII system. 5. In USII system, fracture of abutment screw and deformation of both fixture and abutment were observed in I, II and III subgroups. 6. Failure pattern of SSII system, which was the fracture of abutment screw and deformation of the abutment and fixture, was observed in both IV and V subgroups. Fracture of some fixtures was observed in subgroup V. 7. Failure pattern of GSII system, which was the fracture of the abutment screw and deformation of the fixture and the abutment, was observed in both VI and VII subgroups. Apart from other subgroups, subgroup VII demonstrated no bending neither the fracture at the top of the fixture. The compressive deformation of internal slope in the fixture was the only thing observed in subgroup VII.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.3
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• pp.352-362
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• 2005

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 techniques in internal connection implant systems. Purpose. The purpose of this study was to compare the accuracy of two fixture-level impression techniques in two conditions (parallel and divergent) and to assess the effect of tightening sequences and forces on stresses generated on superstructures in internal connection implant system (Astra Tech). Material and methods. Two metal master frameworks made from two abutments (Cast-to Abutment ST) each and a corresponding, passively fitting, dental stone master cast with four fixture replicas (Fixture Replica ST) were fabricated. Ten dental stone casts for each impression techniques (direct unsplinted & splinted technique) were made with vinyl polysiloxane impressions from the master cast. Strain gauges for each framework were fixed midway between abutments to measure the degree of framework deformation on each stone cast. Pairs of strain gauges placed opposite each other constituted one channel (half Wheatstone bridge) to read deformation in four directions (superior, inferior, anterior, and posterior). Deformation data were analyzed using one-way ANOVA and the Tukey test at the .01 level of significance. And the effect of tightening sequences (right-to-left and left-to-right) and forces (10 Ncm and 20 Ncm) were assessed with ten stone casts made from parallel condition by the splinted technique. Deformation data were analyzed using paired t-test at the .01 level of significance. Conclusions. Within the limitations of this study, the following conclusions could be drawn. 1. Frameworks bent toward the inferior side on all casts made by both direct unsplinted and splinted impression techniques in both parallel and divergent conditions. 2. There was no statistically significant difference of accuracy between the direct unsplinted and splinted impression techniques in both parallel and divergent conditions (P>.01). 3. There was no statistically significant difference of stress according to screw tightening sequences in casts made by the splinted impression technique in parallel condition (P>.01). 4. Greater tightening force resulted in greater stress in casts made by the splinted impression technique in parallel condition (P<.01).

• Journal of Technologic Dentistry
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• v.41 no.2
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• pp.63-69
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• 2019

Purpose: The purpose of this study is to evaluate the effect of CAD/CAM system milling tool wear on the marginal and internal fit of PMMA implant interim prosthesis three-dimensional manner. Methods: A total of 20 crowns were fabricated with CAD/CAM method. Their designs were unified to first molar of the left maxilla. The Customized abutments were prepared and scanned with on optical model scanner. Five crowns were milled by the newly replaced tool (1st milling), and 15 crowns were milled by 2nd, 3rd, 4th milling tool. The marginal and internal fit of 20 interim crowns were measured using the triple-scan protocol. Results: Statistically significant difference was found between the $1^{st}$ milling group ($51.8{\pm}14.6{\mu}m$) and the $3^{rd}$, $4^{th}$ milling group ($128.6{\pm}43.8{\mu}m$, $146.2{\pm}38.1{\mu}m$, respectively) at the distal margins. In the mesial margins, There was a statistically significant difference between the $1^{st}$ milling group ($63.6{\pm}25.9{\mu}m$) and the $3^{rd}$, $4^{th}$ milling group ($137.2{\pm}25.9{\mu}m$, $186.8{\pm}70.6{\mu}m$, respectively). In the distal line angle, significant difference was found between the $1^{st}$, $2^{nd}$, $3^{rd}$ milling groups and the $4^{th}$ milling group. In the mesial axial wall, significant difference was found between the $1^{st}$ milling group ($52.2{\pm}20.3{\mu}m$) and the $3^{rd}$, $4^{th}$ milling groups ($22.8{\pm}8.8{\mu}m$, $7.8{\pm}5.7{\mu}m$). Conclusion: As a result of the experiment, decrease of the marginal and internal fit was statistically significant as the number of machining cycles increased. In order to produce clinically excellent restorations, it is recommandable to consider the condition of the milling tool wear, when designing the restoration with CAD program.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.164-173
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• 2009

Purpose: The purpose of this study was to evaluate the effect of abutment material on screw-loosening before and after cyclic loading. Among the different materials of abutments, zirconia and metal abutment were used. Material and methods: Two types of implant systems: external butt joint(US II, Osstem Implant, Korea) and internal conical joint(GS II, Osstem Implant, Korea) were used. In each type, specimens were divided into two different kinds of abutments: zirconia and metal(n=5). The implant was rigidly held in a special holding to device ensure fixation. Abutment was connected to 30 Ncm with digital torque gauge, and was retightened in 30 Ncm after 10 minutes. The initial removal torque values were measured. The same specimens were tightened in 30 Ncm again and held in the cycling loading simulator(Instron, USA) according to ISO/FPIS 1480. Cycling loading tests were performed at loads 10 to 250 N, for 1 million cycles, at 14 Hz,(by subjecting sinusoidal wave from 10 to 250 N at a frequency of 14 Hz for 1 million cycles,) and then postload removal torque values were evaluated. Results: 1. In all samples, the removal values of abutment screw were lower than tightening torque values(30 Ncm), but the phenomenon of the screw loosening was not observed. 2. In both of the implant systems, initial and postload removal torque of zirconia abutment were significantly higher than those of metal abutment(P<.05). 3. In both of the implant systems, the difference in removal torque ratio between zirconia abutment and metal abutment was not significant(P>.05). 4. In metal abutments, the removal torque ratio of GS II system(internal conical joint system) was lower than that of US II system(external butt joint system)(P<.05). 5. In zirconia abutments, the difference in removal torque ratio between the two implant systems was not significant(P>.05). Conclusion: Zirconia abutment had a good screw joint stability in the condition of one million cycling loading.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.6
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• pp.561-568
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• 2008

STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a $30^{\circ}$ inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group $1{\times}10^6$, $5{\times}10^6$ cyclic loading; second group $3{\times}10^6$, $3{\times}10^6$ for a total cyclic loading of $6{\times}10^6$) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with ${\alpha}$=0.05. RESULTS: In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after $1{\tims}10^6$ cyclic loading, and the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was not significant. The difference between the removal torque value after $3{\times}10^6$ cyclic loading and after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after $1{\times}10^6$ cyclic loading was not significant, but the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after $3{\times}10^6$ cyclic loading and the value after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. CONCLUSION: The external hexagonal connection was more stable than the internal hexagonal connection after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after $3{\times}10^6$, and additional $3{\times}10^6$ cycles.