• The Journal of Advanced Prosthodontics
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• 제11권2호
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• pp.105-111
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• 2019

PURPOSE. Limited data is available regarding the differences for possible microleakage problems and fitting accuracy of zirconia versus titanium abutments with various connection designs. The purpose of this in vitro study was to investigate the effect of connection design and abutment material on the sealing capability and fitting accuracy of abutments. MATERIALS AND METHODS. A total of 42 abutments with different connection designs [internal conical (IC), internal tri-channel (IT), and external hexagonal (EH)] and abutment materials [titanium (Ti) and zirconia (Zr)] were evaluated. The inner parts of implants were inoculated with $0.7{\mu}L$ of polymicrobial culture (P. gingivalis, T. forsythia, T. denticola and F. nucleatum) and connected with their respective abutments under sterile conditions. The penetration of bacteria into the surrounding media was assessed by the visual evaluation of turbidity at each time point and the number of colony forming units (CFUs) was counted. The marginal gap at the implant- abutment interface (IAI) was measured by scanning electron microscope. The data sets were statistically analyzed using Kruskal-Wallis followed by Mann-Whitney U tests with the Bonferroni-Holm correction (${\alpha}=.05$). RESULTS. Statistically significant difference was found among the groups based on the results of leaked colonies (P<.05). The EH-Ti group characterized by an external hexagonal connection were less resistant to bacterial leakage than the groups EH-Zr, IT-Zr, IT-Ti, IC-Zr, and IC-Ti (P<.05). The marginal misfit (in ${\mu}m$) of the groups were in the range of 2.7-4.0 (IC-Zr), 1.8-5.3 (IC-Ti), 6.5-17.1 (IT-Zr), 5.4-12.0 (IT-Ti), 16.8-22.7 (EH-Zr), and 10.3-15.4 (EH-Ti). CONCLUSION. The sealing capability and marginal fit of abutments were affected by the type of abutment material and connection design.

• 구강회복응용과학지
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• 제29권3호
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• pp.259-271
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• 2013

임플란트 고정체-지대주 결합구조체의 형태에 따른 교합부하의 반응이 다양하여 본 연구에서는 하중위치 및 결합구조체 접촉 비율에 따라 3단 계단형 결합구조체와 경사형에서 어떠한 차이가 있는 지를 3차원 유한요소분석을 시행하였다. 2종의 임플란트-지대주 결합 구조체에 연결된 상부 치관을 제작하여 각 치관에 설정된 하중위치에 200 N의 하중을 부여하였다. 임플란트 중심 부위에서 하중조건이 멀어질수록 피질골정에 가해지는 응력이 증가되기에 하중조건은 응력발생에 영향을 미치는 주요 요소이며 다음으로 결합구조형태에도 영향을 받았다. 또한 수직 하중에 비해 빗금 경사 하중이 부여된 경우 계단형은 경사형에 비해 유리한 응력 분포를 보였다. 그리고 지대주 결합구조체가 고정체의 내벽에 대해 접촉이 많아 질수록 골질에 대한 응력분산이 유리한 것으로 나타났다. 결론적으로 고정체 폭경에서 벗어난 빗김 수직 및 경사 하중은 결합구조체의 종류와 관계없이 피질골정에 응력을 집중시키므로 저작기능시 교합접촉면을 고정체의 폭경 내에 위치하도록 하는 것이 생체역학적으로 바람직 할 것으로 사료되었다.

• 구강회복응용과학지
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• 제24권1호
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• pp.77-89
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• 2008

이 연구의 목적은 원추형 내측 연결 임플랜트 시스템에서 하중조건에 따른 지대주의 침하 및 적합도를 평가하는 것이다. 본 연구에서는 내부 원추형 연결방식의 Alloden implant system (Nei Corp. Korea)의 고정체와 2종류(conventional, FDI)의 지대주를 사용하였다. 임상에서 Alloden 임플랜트는 지대주와 고정체 연결시 처음에 손으로 지긋이 눌러 고정시킨 후 mallet을 이용하여 약 3회정도 타격을 가하여 고정한다. 이때 타격시의 정확한 힘을 측정하여 각 실험군에 적용시켰다. 적용 횟수는 손가락으로 누르는 힘을 1회, mallet으로 타격하는 힘을 3회, 저작력으로 가정한 20kg의 힘을 지대주의 침하가 생기지 않을때까지 각각의 표본에 적용하였다. 그 후 각 단계에 대한 지대주의 침하량을 Vernier caliper를 이용하여 측정하였다. 임플랜트는 불포화 폴리에스터(Epovia, Cray Valley Inc. Korea)에 매몰하여 중합시켰고 모든 표본을 절삭한 후 연마하여 주사전자현미경을 통하여 분석, 평가하였다.

• Journal of Periodontal and Implant Science
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• 제36권2호
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• pp.473-488
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• 2006

Adequate bone quality and stress distribution to the bone are of decisive importance for implant success. Even though the success rates of dental implants have been high, implant failures do occur. Overloading has been identified as a primary factor behind dental implant failure. The purpose of this study was to theoretically investigate the effect of two types of implants on the stress distribution in poor bone quality. Employing the finite element method, the study modeled a 4.1 mm diameter, 12.0 mm length implant placed in cortical or spongeous bone. A static loading of lOON was applied at the occlusal surface at 0, 30 degrees angle to the vertical axis of the implant. von Mises stresses concentrations in the supporting bone were analyzed with finite element analysis program. The results were as follows; 1. The stresses at the marginal bone were higher under buccal oblique load(30 degrees off of the long axis) than under vertical load. 2. Under buccal oblique load, the stresses were higher at the lingual marginal bone than at the buccal marginal bone, and the differences were almost the same. 3, Under vertical and oblique load, the stress was the highest at the marginal bone and lowest at the bone around apical portions of implant in cortical bone. 4, Under vertical load, Model 1 showed more effective stress distribution than Model 2 irrespective of bone types. On the other hand, Model 2 showed lower stress concentration than Model 1 under buccal oblique load.

• The Journal of Advanced Prosthodontics
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• 제10권2호
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• pp.155-162
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• 2018

PURPOSE. The aim of this study was to compare the fracture of implant component behavior of external and internal type of implants to suggest directions for successful implant treatment. MATERIALS AND METHODS. Data were collected from the clinical records of all patients who received WARANTEC implants at Seoul National University Dental Hospital from February 2002 to January 2014 for 12 years. Total number of implants was 1,289 and an average of 3.2 implants was installed per patient. Information about abutment connection type, implant locations, platform sizes was collected with presence of implant component fractures and their managements. SPSS statistics software (version 24.0, IBM) was used for the statistical analysis. RESULTS. Overall fracture was significantly more frequent in internal type. The most frequently fractured component was abutment in internal type implants, and screw fracture occurred most frequently in external type. Analyzing by fractured components, screw fracture was the most frequent in the maxillary anterior region and the most abutment fracture occurred in the maxillary posterior region and screw fractures occurred more frequently in NP (narrow platform) and abutment fractures occurred more frequently in RP (regular platform). CONCLUSION. In external type, screw fracture occurred most frequently, especially in the maxillary anterior region, and in internal type, abutment fracture occurred frequently in the posterior region. placement of an external type implant rather than an internal type is recommended for the posterior region where abutment fractures frequently occur.

• The Journal of Advanced Prosthodontics
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• 제5권3호
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• pp.312-318
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• 2013

PURPOSE. The aim of this study was to compare the passivity of implant superstructures by assessing the strain development around the internal tapered connection implants with strain gauges. MATERIALS AND METHODS. A polyurethane resin block in which two implants were embedded served as a measurement model. Two groups of implant restorations utilized cement-retained design and internal surface of the first group was adjusted until premature contact between the restoration and the abutment completely disappeared. In the second group, only nodules detectable to the naked eye were removed. The third group employed screw-retained design and specimens were generated by computer-aided design/computer-aided manufacturing system (n=10). Four strain gauges were fixed on the measurement model mesially and distally to the implants. The strains developed in each strain gauge were recorded during fixation of specimens. To compare the difference among groups, repeated measures 2-factor analysis was performed at a level of significance of ${\alpha}$=.05. RESULTS. The absolute strain values were measured to analyze the magnitude of strain. The mean absolute strain value ranged from 29.53 to 412.94 ${\mu}m/m$ at the different strain gauge locations. According to the result of overall comparison, the cement-retained prosthesis groups exhibited significant difference. No significant difference was detected between milled screw-retained prostheses group and cement-retained prosthesis groups. CONCLUSION. Within the limitations of the study, it was concluded that the cement-retained designs do not always exhibit lower levels of stress than screw-retained designs. The internal adjustment of a cement-retained implant restoration is essential to achieve passive fit.

• 대한치과보철학회지
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• 제51권4호
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• pp.315-322
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• 2013

연구 목적: 내측연결형 임플란트와 지대주의 연결체에 반복하중을 부여하였을 때 수직 침하를 평가하고자 하였다. 연구 재료 및 방법: 외측연결형 임플란트와 내측연결형 임플란트에 세 종류의 시멘트유지형 지대주를 각각 장착하였다. 즉, 외측연결형 지대주(Ext 그룹), 내측연결형 1-piece 지대주(Int-1 그룹), 내측연결형 2-piece 지대주(Int-2 그룹)를 사용하였으며, 각 그룹마다 7개의 시편을 준비하였다. 임플란트-지대주 연결체에 수직하중을 적용하기 위하여 임플란트 받침대에 고정한 후, 4 Hz의 빈도로 $150{\pm}10N$의 반복하중을 가하였다. 수직침하량은 0, 5, 10, 50, 100, 1,000, 5,000, 10,000회의 반복하중 후에 각각 측정하였다. 반복측정분산분석(RM-ANOVA)를 이용하여 반복하중의 영향을 분석하였으며, 패턴변화를 관찰하기 위하여 선형혼합모형(linear mixed model)을 사용하였다. 유의수준은5% 로 설정하였다. 결과: 10,000회 반복하중 후 수직침하량은, Ext 그룹에서 $0.714{\pm}0.488{\mu}m$, Int-1그룹에서 $5.286{\pm}1.604{\mu}m$, Int-2 그룹에서 $11.429{\pm}1.902{\mu}m$를 나타내었다. 패턴분석에서는, Int-1 그룹 및 Int-2 그룹에서 지속적인 수직침하가 관찰되었으며, Ext그룹에서는 수직침하현상이 관찰되지 않았다. 결론:10,000회 반복하중 후의 선형혼합모형을 통한 분석에서, Ext그룹은 수직침하현상을 보이지 않았으나, Int-1 및 Int-2 그룹은 지속적인 수직침하현상을 나타내었다. 또한, Int-2그룹에서 Int-1그룹보다 더 많은 수직침하량이 관찰되었다.

• Journal of Periodontal and Implant Science
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• 제48권2호
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• pp.103-113
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• 2018

Purpose: The purpose of this retrospective study with 4-12 years of follow-up was to compare the marginal bone loss (MBL) between external-connection (EC) and internal-connection (IC) dental implants in posterior areas without periodontal or peri-implant disease on the adjacent teeth or implants. Additional factors influencing MBL were also evaluated. Methods: This retrospective study was performed using dental records and radiographic data obtained from patients who had undergone dental implant treatment in the posterior area from March 2006 to March 2007. All the implants that were included had follow-up periods of more than 4 years after loading and satisfied the implant success criteria, without any peri-implant or periodontal disease on the adjacent implants or teeth. They were divided into 2 groups: EC and IC. Subgroup comparisons were conducted according to splinting and the use of cement in the restorations. A statistical analysis was performed using the Mann-Whitney U test for comparisons between 2 groups and the Kruskal-Wallis test for comparisons among more than 2 groups. Results: A total of 355 implants in 170 patients (206 EC and 149 IC) fulfilled the inclusion criteria and were analyzed in this study. The mean MBL was 0.47 mm and 0.15 mm in the EC and IC implants, respectively, which was a statistically significant difference (P<0.001). Comparisons according to splinting (MBL of single implants: 0.34 mm, MBL of splinted implants: 0.31 mm, P=0.676) and cement use (MBL of cemented implants: 0.27 mm, MBL of non-cemented implants: 0.35 mm, P=0.178) showed no statistically significant differences in MBL, regardless of the implant connection type. Conclusions: IC implants showed a more favorable bone response regarding MBL in posterior areas without peri-implantitis or periodontal disease.

• Journal of Periodontal and Implant Science
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• 제45권1호
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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.

• 구강회복응용과학지
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• 제39권1호
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• pp.32-44
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• 2023

목적: 이번 연구는 상·하악 제1대구치 부위에 식립 된 단일 임플란트를 통해 임플란트-지대주 연결 유형이 임플란트의 변연골 소실 (MBL)에 영향을 주는지, 그리고 MBL에 영향을 끼치는 요인들을 알아보기 위해 분석하였다. 연구 재료 및 방법: 5년 이상의 추적 기간 동안, 상·하악 제1대구치 부위에 단일 임플란트를 식립하여 수복한 68명의 환자(남: 38명, 여: 30명)의 87 임플란트(external connection type (EC) 임플란트: 57개, internal connection type (IC) 임플란트: 30개)를 대상으로 추적 조사하였다. 최대 5년 후의 구내 방사선 영상에서 MBL과 보철물의 출현 각도(EA)를 측정하였다. 60 - 79세에 해당하는 환자의 비율이 52.9%로 가장 높았고 상악 구치부에 임플란트가 가장 많이 식립되었다. 결과: GBR을 하지 않은 경우 EC (-0.065 ± 0.859 mm)와 IC (-0.627 ± 0.639 mm)에서 유의한 차이가 있었고, 또한 당뇨병이 없는 환자들 사이에서 EC (-0.131 ± 1.002 mm)와 IC (-0.792 ± 0.762 mm)에서 유의한 차이가 존재하였다. 임플란트 매식체의 직경, 길이, 보철물 연결 방법, 임플란트 제조업체, 보철물의 emergence angle (EA)로 구분하였을 때 각군 간에 유의미한 차이가 없었다. 다중회귀분석을 이용하여 MBL에 영향을 주는 요인분석 결과 회귀계수의 유의성 검증에서 임플란트-지대주 체결 방식(β = -0.303), 당뇨병의 유무(β = -0.113), EA의 차이(β = -0.234), 나이(β = -0.776)에서 MBL에 통계학적으로 유의한 음의 상관관계를 보였다. 결론: IC가 EC보다 GBR을 하지 않은 경우와 당뇨병이 없는 환자들 사이에서 MBL이 작다는 것을 알 수 있었다. 또한 보철물의 EA가 30°보다 큰 보철물의 형태를 가진 임플란트가 30°보다 작은 보철물의 형태를 가진 임플란트 보다 MBL이 컸으며 나이가 많을수록 MBL이 크다는 것을 알 수 있었다. 임플란트의 MBL을 최소화하고 임플란트 안정성을 확보하기 위해서 임플란트 보철물의 EA와 임플란트-지대주 연결 유형을 세심하게 고려해야 할 것이다.