• Archives of Plastic Surgery
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• v.46 no.4
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• pp.386-389
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• 2019

The development of breast implant technology continues to evolve over time, but changes in breast shape after implantation have not been fully elucidated. Thus, we performed computerized finite element analysis in order to better understand the trajectory of changes and stress variation after breast implantation. The finite element analysis of changes in breast shape involved two components: a static analysis of the position where the implant is inserted, and a dynamic analysis of the downward pressure applied in the direction of gravity during physical activity. Through this finite element analysis, in terms of extrinsic changes, it was found that the dimensions of the breast implant and the position of the top-point did not directly correspond to the trajectory of changes in the breast after implantation. In addition, in terms of internal changes, static and dynamic analysis showed that implants with a lower top-point led to an increased amount of stress applied to the lower thorax. The maximum stress values were 1.6 to 2 times larger in the dynamic analysis than in the static analysis. This finding has important implications for plastic surgeons who are concerned with long-term changes or side effects, such as bottoming-out, after anatomic implant placement.

• The Journal of Advanced Prosthodontics
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• v.2 no.4
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• pp.128-133
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• 2010

PURPOSE. The purpose of this study was to compare the accuracy of the implant master cast according to the type (pick-up, transfer) and the length (long, short) of the impression copings. MATERIALS AND METHODS. The metal master cast was fabricated with three internal connection type implant analogs (Osstem GS III analog), embedded parallel and with $10^{\circ}$ of mesial angulation to the center analog. Four types of impression coping were prepared with different combinations of types (transfer, pick-up) and lengths (long, short) of the coping. The impressions were made using vinyl polysiloxane (one step, heavy + light body) with an individual tray, and 10 impressions were made for each group. Eventually, 40 experimental casts were produced. Then, the difference in the distance between the master cast and the experimental cast were measured, and the error rate was determined. The analysis of variance was performed using the SPSS (v 12.0) program (${\alpha}$= .05), and the statistical significance was set at P < .05. RESULTS. The ANOVA showed that the pick-up type impression coping exhibited a significantly lower error rate than the transfer type. However, no significant difference was observed with respect to the length of the impression coping. Additionally, no significant difference was observed between the parallel and mesial angulated groups. CONCLUSION. Within the limitations of this study, the pick-up type impression coping exhibited a more accurate implant master cast than the transfer type in parallel group. The accuracy of the implant master cast did not differ for different lengths of impression coping of at least 11 mm. Additionally, the accuracy of the implant cast was not different for the parallel and $10^{\circ}$ mesial angulated groups.

• The Journal of Advanced Prosthodontics
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• v.1 no.2
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• pp.97-101
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• 2009

STATEMENT OF PROBLEM. Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE. In this study, Bicon$^{(R)}$ Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS. 10 Bicon$^{(R)}$ implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS. It was evident, that the amount of abutment sinking in Bicon$^{(R)}$ Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at $0.45{\pm}0.09\;mm$. CONCLUSION. Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location.

• Journal of Periodontal and Implant Science
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• v.36 no.2
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• pp.531-554
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• 2006

Oral implants must fulfill certain criteria arising from special demands of function, which include biocompatibility, adequate mechanical strength, optimum soft and hard tissue integration, and transmission of functional forces to bone within physiological limits. And one of the critical elements influencing the long-term uncompromise functioning of oral implants is load distribution at the implant- bone interface, Factors that affect the load transfer at the bone-implant interface include the type of loading, material properties of the implant and prosthesis, implant geometry, surface structure, quality and quantity of the surrounding bone, and nature of the bone-implant interface. To understand the biomechanical behavior of dental implants, validation of stress and strain measurements is required. The finite element analysis (FEA) has been applied to the dental implant field to predict stress distribution patterns in the implant-bone interface by comparison of various implant designs. This method offers the advantage of solving complex structural problems by dividing them into smaller and simpler interrelated sections by using mathematical techniques. The purpose of this study was to evaluate the stresses induced around the implants in bone using FEA, A 3D FEA computer software (SOLIDWORKS 2004, DASSO SYSTEM, France) was used for the analysis of clinical simulations. Two types (external and internal) of implants of 4.1 mm diameter, 12.0 mm length were buried in 4 types of bone modeled. Vertical and oblique forces of lOON were applied on the center of the abutment, and the values of von Mises equivalent stress at the implant-bone interface were computed. The results showed that von Mises stresses at the marginal. bone were higher under oblique load than under vertical load, and the stresses were higher at the lingual marginal bone than at the buccal marginal bone under oblique load. Under vertical and oblique load, the stress in type I, II, III bone was found to be the highest at the marginal bone and the lowest at the bone around apical portions of implant. Higher stresses occurred at the top of the crestal region and lower stresses occurred near the tip of the implant with greater thickness of the cortical shell while high stresses surrounded the fixture apex for type N. The stresses in the crestal region were higher in Model 2 than in Model 1, the stresses near the tip of the implant were higher in Model 1 than Model 2, and Model 2 showed more effective stress distribution than Model.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.554-560
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• 2008

In posterior maxilla, it is difficult to achieve primary stability of implants due to sinus pneumatization, alveolar bone loss, and low bone quality. The accurate and objective primary stability assessment is important for good prognosis of implants. Purpose: The aim of this study was to assess the primary stability of the non-submerged, internal type implants with maxillary sinus augmentation using deproteinized bovine bone mineral by a resonance frequency analyzer, when residual alveolar bone height is under 8mm Materials and methods: A total of 20 implants was placed into 5 grafted maxillary sinuses in 5 patients. Deproteinized bovine bone mineral (Bio-$Oss^{(R)}$) was used as graft material. SS II implants (diameter 4.1mm, and length 11.5mm, SLA suface)) were placed. All of the patients received maxillary sinus graft procedure by 1-step technique. Residual bone height was $1.3{\sim}7.8mm$ (mean 4.4mm) measured by panorama radiography. After implant placement, RFA was measured at 4,8,12,20 weeks. The results were divided into 2 groups; RFA value under 4mm and over 5mm of bone height. It was statistically analyzed. Results: 1. The primary stability of implants was increased with time 2. The RFA value was above 65 ISQ at 12 weeks 3. There was no correlation between RFA and residual alveolar bone height in maxillary sinus augmentation by 1-step technique. Conclusion: 1-step surgical procedure is a feasible option for patients with as little as 4mm residual alveolar bone height, when utilizing non-submerged, internal type implants with xenografts.

• Clinics in Shoulder and Elbow
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• v.27 no.1
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• pp.59-71
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• 2024

Background: Restoration of external (ER) and internal rotation (IR) after Grammont-style reverse shoulder arthroplasty (RSA) is often unreliable. The purpose of this systematic review was to evaluate the influence of RSA medio-lateral offset and subscapularis repair on axial rotation after RSA. Methods: We conducted a systematic review of studies evaluating axial rotation (ER, IR, or both) after RSA with a defined implant design. Medio-lateral implant classification was adopted from Werthel et al. Meta-analysis was conducted using a random-effects model. Results: Thirty-two studies reporting 2,233 RSAs were included (mean patient age, 72.5 years; follow-up, 43 months; 64% female). The subscapularis was repaired in 91% (n=2,032) of shoulders and did not differ based on global implant lateralization (91% for both, P=0.602). On meta-analysis, globally lateralized implants achieved greater postoperative ER (40° [36°-44°] vs. 27° [22°-32°], P<0.001) and postoperative improvement in ER (20° [15°-26°] vs. 10° [5°-15°], P<0.001). Lateralized implants with subscapularis repair or medialized implants without subscapularis repair had significantly greater postoperative ER and postoperative improvement in ER compared to globally medialized implants with subscapularis repair (P<0.001 for both). Mean postoperative IR was reported in 56% (n=18) of studies and achieved the minimum necessary IR in 51% of lateralized (n=325, 5 cohorts) versus 36% (n=177, 5 cohorts) of medialized implants. Conclusions: Lateralized RSA produces superior axial rotation compared to medialized RSA. Lateralized RSA with subscapularis repair and medialized RSA without subscapularis repair provide greater axial rotation compared to medialized RSA with subscapularis repair. Level of evidence: 2A.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.1207-1210
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• 2004

As many humans age, degenerative lumbar spinal stenosis (DLSS) becomes a major cause of lower limb discomfort and disability. By surgical treatment method of DLSS, the existing surgical treatment methods using internal fixation have showed degeneration changes of an adjacent vertebrae and loss of lumbar spine lordosis-kyphosis due to eliminating a motion. For solving the problems of internal fixation, a novel interspinous spacer has been developed to treat DLSS by surgical treatment method. In this study, we evaluated the biomechanical effects of the interspinous spacer on the kinematics of the porcine lumbar spine before and after insertion of the implant. For this purpose, a device that is capable of measuring 3-D motions were built based on direct linear transformation (DLT) algorithm written with MATLAB program. Results showed that in extension, a change of the mean angle between the intact and the implanted specimens at L4-L5 was 1.87 degree difference and the implant reduced the extension range of motion of the L4-L5 (p＆lt;0.05). But the range of motion in flexion, axial rotation and lateral bending at the adjacent segments was not statistically affected by the implant. In conclusion, we thought that interspinous spacer may have remedical value for DLSS by flexing human lumbar spine.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.4
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• pp.767-780
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• 1997

One of the most common problems of implant prosthesis is the screw loosening of abutment screws. This brings on discomfort in mastication, inflammation in the peri-implant tissue due to poor oral hygiene and fracture of prosthesis or loss of osseointegration. To prevent screw loosening, appropriate implantation to direct the occlusal force to the long axis of the implant, accurate design of the superstructure, decrease of the occlusal table, and adequate torque on the abutment screw are necessary. In this study the screw loosening torque was evaluated in implants with dimples or flutes in the internal surface of abutment screw holes. The abutments were fastened with slot type and hexagonal type abutment screws and were sealed with vinyl poly siloxane impression and bite registration material respectively. The screw loosening torque was evaluated after 1,800 and 12,600 times loading under a loading machine. The results were as follows. 1. The flute form group showed significantly higher loosening torque compared to the dimple form group and the group with no inner surface treatment (p<0.05). 2. There was no statistical difference in loosening torque according to the sealing materials. 3. The loosening torque according to the types of abutment screw showed no significant difference. 4. The loosening torque was significantly higher after 1800 times loading compared to 12600 times loading(p<0.05). From the above results. it is thought that formation of a flute in the internal surface of the screw hole decreases the chance of screw loosening, but the sealing materials and types of abutment screw did not show significant difference in prevention of screw loosening.

• Journal of Periodontal and Implant Science
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• v.45 no.1
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• pp.23-29
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• 2015

Purpose: This study was conducted to compare the cumulative survival rates (CSRs) and the incidence of postloading complications (PLCs) between a bone-level internal connection system (ICS-BL) and an external connection system (ECS). Methods: The medical records of patients treated with either a ICS-BL or ECS between 2007 and 2010 at Asan Medical Center were reviewed. PLCs were divided into two categories: biological and technical. Biological complications included >4 mm of probing pocket depth, thread exposure in radiographs, and soft tissue complications, whereas technical complications included chipping of the veneering material, fracture of the implant, fracture of the crown, loosening or fracture of the abutment or screw, loss of retention, and loss of access hole filling material. CSRs were determined by a life-table analysis and compared using the log-rank chi-square test. The incidence of PLC was compared with the Pearson chi-squared test. Results: A total of 2,651 implants in 1,074 patients (1,167 ICS-BLs in 551 patients and 1,484 ECSs in 523 patients) were analyzed. The average observation periods were 3.4 years for the ICS-BLs and 3.1 years for the ECSs. The six-year CSR of all implants was 96.1% (94.9% for the ICS-BLs and 97.1% for the ECSs, P=0.619). Soft tissue complications were more frequent with the ECSs (P=0.005) and loosening or fracture of the abutment or screw occurred more frequently with the ICS-BLs (P<0.001). Conclusions: Within the limitations of this study, the ICS-BL was more prone to technical complications while the ECS was more vulnerable to biological complications.

• Journal of Periodontal and Implant Science
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• v.38 no.2
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• pp.117-124
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• 2008

Purpose: The purpose of this study was to histomorphometrically evaluate the osteoconductivity of a new biphasic calcium phosphate ceramics with fully interconnected microporous structure. Material and Methods: Osseous defects created in the rabbit calvaria were filled with four different bone graft substitutes. Experimental sites were filled with a new fully interconnected microporous biphasic calcium phosphate with(BCP-2) or without(BCP-1) internal macropore of $4400\;{\mu}m$ in diameter. MBCP(Biomatlante, France) and Bio-Oss(Geistlich Pharma, Switzerland) were used as controls in this study. Histomorphometric evaluation was performed at 4 and 8 weeks after surgery. Result: In histologic evaluation, new bone formation and direct bony contact with the graft particles were observed in all four groups. At 4 weeks, BCP-1(15.5%) and BCP-2(15.5%) groups showed greater amount of newly formed mineralized bone area(NB%) compared to BO(11.4%) and MBCP(10.3%) groups. The amounts of NB% at 8 weeks were greater than those of 4 weeks in all four groups, but there was no statistically significant differences in NB% between the groups. Conclusion: These results indicate that new bone substitutes, BCP with interconnected microporous structure and with or without internal macroporous structures, have the osteoconductivity comparable to those of commercially available bone substitutes, MBCP and Bio-Oss.