• 구강회복응용과학지
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• 제25권3호
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• pp.255-265
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• 2009

즉시 하중에 대한 관심과 시도가 증가되고 있지만, 명확한 술식이 정립되어 있지는 않다. 본 연구에서는 상악 전치부 임플란트에서 즉시 하중시에 골과 임플란트에 나타나는 응력분포 양상을 3차원 유한요소법을 이용하여 알아보고자 하였다. 골질이 D3인 상악 전치부의 골모형을 구성하고, 서로 다른 길이(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm)의 직경 4.0 mm 나사형 임플란트를 식립한 모형을 제작하였다. 해석 절차의 간소화를 위하여 모든 물성은 등방성, 선형탄성, 균질성으로 가정하였다. 골-임플란트 계면은 접촉 요소법으로 처리하여 골유착이 일어나기 전 상태로 구성하였다. 지대주 장축에 120도의 각도로 지대주의 구개 절단각 중앙부에 176 N의 정하중을 가하고 응력분포를 관찰하였다. von Mises stress를 이용하여 응력을 분석한 결과 모든 모형에서 순측 피질골에 응력이 집중되었으며 피질골과 망상골의 경계부에서 최대 응력값을 나타내었다. 길이에 따른 비교시 8.5 mm 모형에서 가장 큰 최대 응력값을 나타냈으며, 임플란트 길이가 증가될수록 좀 더 양호한 응력 분포를 나타내었다. 상악 전치부 즉시 하중시에 피질골의 존재 유무는 매우 중요하며, 길이가 긴 임플란트를 식립하는 것이 유리하며, 가능하면 13.0 mm 이상의 임플란트를 식립하는 것이 즉시하중을 시행할 때 응력 분산에 유리한 것으로 판단된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권3호
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• pp.248-254
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• 2005

The purpose of this study was to investigate the distribution of stress within the regenerated bone surrounding the implant using three dimensional finite element stress analysis method. Using ANSYS software revision 6.0 (IronCAD LLC, USA), a program was written to generate a model simulating a cylindrical block section of the mandible 20 mm in height and 10 mm in diameter. The $5.0{\times}11.5-mm$ screw implant (3i, USA) was used for this study, and was assumed to be 100% osseointegrated. And it was restored with gold crown with resin filling at the central fossa area. The implant was surrounded by the regenerated type IV bone, with 4 mm in width and 7 mm apical to the platform of implant in length. And the regenerated bone was surrounded by type I, type II, and type III bone, respectively. The present study used a fine grid model incorporating elements between 250,820 and 352,494 and nodal points between 47,978 and 67,471. A load of 200N was applied at the 3 points on occlusal surfaces of the restoration, the central fossa, outside point of the central fossa with resin filling into screw hole, and the functional cusp, at a 0 degree angle to the vertical axis of the implant, respectively. The results were as follows: 1. The stress distribution in the regenerated bone-implant interface was highly dependent on both the density of the native bone surrounding the regenerated bone and the loading point. 2. A load of 200N at the buccal cusp produced 5-fold increase in the stress concentration at the neck of the implant and apex of regenerated bone irrespective of surrounding bone density compared to a load of 200N at the central fossa. 3. It was found that stress was more homogeneously distributed along the side of implant when the implant was surrounded by both regenerated bone and native type III bone. In summary, these data indicate that concentration of stress on the implant-regenerated bone interface depends on both the native bone quality surrounding the regenerated bone adjacent to implant and the load direction applied on the prosthesis.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권6호
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• pp.440-448
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• 2012

Purpose: The purpose of this study was to evaluate marginal bone loss of the alveolar crest on implants with or without guided bone regeneration and variables that have influenced. Methods: The clinical evaluation were performed for survival rate and marginal bone loss of 161 endosseous implants installed with guided bone regeneration (GBR) in 83 patients from September 2009 to October 2010 in relation to sex and age of patients, position of implant, implant system, length and diameter of implant. Study group (n=42) implant with GBR procedure, control group (n=41) implant without GBR technique. Simultaneous GBR approach using resorbable membranes combined with autogenous bone graft or freeze-dried bone allograft or combination. Radiographic examinations were conducted at healing abutment connection and latest visit. Marginal bone level was measured. Results: Mean marginal bone loss was 0.73 mm in study group, 0.63 mm in control group. Implants in maxillary anterior area (1.21 mm) were statistically significant in study group (P<0.05), maxillary posterior area (0.81 mm) in control group (P<0.05). Mean marginal bone loss 1.47 mm for implants with diameter 3.4 mm, 0.83 mm for implants of control group with diameter 4.0 mm (P<0.05). Some graft materials showed an increased marginal bone loss but no statistically significant influence of sex, implant type or length. Conclusion: According to these findings, this study demonstrated the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods. We conclude that implants with GBR had similar survival rate and crestal bone level compared with implants in native bone.

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.209-231
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• 1999

Even though titanium(Ti) and its alloys are the most used dental implant materials, there are some problems that Ti wears easily and interferes normal osteogenesis due to the metal ions. Ti coated with bioactive ceramics such as hydroxyapatite has also such problems as the exfoliation or resorption of the coated layer, Recent studies on implant materials have been proceeding to improve physical properties of the implant substrate and biocompatibility of the implant surfaces. The purpose of the present study was to examine the physical property and bone tissue compatibility of bioinert nitrides ion plated Ti, Button type specimens(14mm in diameter, 2.32rrun in height) for the abrasion test and cytotoxicity test and thread type implants(3.75mm in diameter, 6mm in length) for the animal experiments were made from Ti(grade 2) and 316LVM stainless steel. Ti specimens were ion plated with TiN, ZrN by the low temperature arc vapor deposition, and the depth profile of the TiN/Ti, ZrN/Ti ion plated surface was examined by Auger Electron Spectroscopy. Three kind of button type specimens .of TiN/Ti, ZrN/Ti and Ti were used for abrasion test, and HEPAlClC7 cells and CCD cells were cultivated for 4 days with the specimens for cytotoxicity test. Thread type implants of TiN/Ti, ZrN/Ti, Ti, 316LVM were implanted on the femur of 6 adult dogs weighing 10kg-13kg. Two dogs were sacrified for histological examination after 45 days and 90 days, and four dogs were sacrified for the removal torque test of the implant') after 90 days. The removal torque force was measured by Autograph (Shimadzu Co., AGS-1000D series, Japan). Abrasion resistance of TiN/Ti was the highest, and that of ZrN/Ti and Ti were followed. The bioinert nitride ion plated Ti had much better abrasion resistance, compared with Ti, In the cytotoxicity test, the number of both cells were increased in all specimens, and there were no significant difference in cytotoxic reaction among all groups (p>0.1), In histological examination, 316LVM showed the soft tissue engagement in interface between the implant and bone, but the other materials after 45 days noted immature new bone formation in the medullary portion along the implant surface, and those after 90 days showed implant support by new bone formation in both the cortical and the medullary portion, The removal torque force of Tilv/Ti showed significantly higher than that of Ti(p(O,05). The difference in removal torque force between TiN/Ti and ZrN/Ti was not significant(p>0.05), and that of 316LVM was lowest among all groups(p<0.05). These results suggest that bioinert nitrides ion plated Ti can resolve the existing problems of Ti and bioactive ceramics, and it may be clinically applicable to human.

• 대한치과보철학회지
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• 제50권4호
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• pp.292-298
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• 2012

연구 목적: 이 연구의 목적은 임플란트의 직경, 길이 및 디자인의 변화가 임플란트 안정성 지수에 미치는 영향을 비교하는 것이다. 연구 재료 및 방법: 골질차이에 의한 변수를 제거하기 위해 상악골 평균밀도와 유사한 균일한(0.48g /$cm^3$) 밀도를 가진 Polyuretane foam blocks (Sawbones$^{(R)}$, Pacific Research Laboratories Inc, Vashon, Washington)을 이용, 임플란트(Implantium$^{(R)}$, Dentium, Seoul, Korea)를 다양한 직경(${\phi}3.8$, ${\phi}4.3$ 및 ${\phi}4.8$)과 길이(8, 10 및 12 mm)로 식립하여 그 변화가 임플란트 안정성 지수(Implant Stability Quotient, ISQ)에 미치는 영향을 비교하였다. 또 같은 직경과 길이(${\phi}4.3{\times}10mm$)에서 submerged와 non-submerged (SimplelineII$^{(R)}$, Dentium, Seoul, Korea) 디자인이 ISQ 에 미치는 영향을 비교하였다. 식립 회전력의 영향을 배제하기 위해 동일한 35 N의 Torque로 각 실험군당 10개씩 총 60개의 임플란트를 식립하였다. Osstell$^{TM}$ mentor(Integration Diagnostic AB, Sweden)를 이용하여 공진주파수를 측정한 후 ISQ 값으로 기록하였고, 그 결과를 one-way ANOVA와 Tukey HSD test로 분석하였다(${\alpha}$=.05). 결과: 1. 임플란트 직경의 변화는 ISQ에 영향을 미치지 않았으나(P>.05), 임플란트 길이가 증가함에 따라 ISQ도 증가하였다(P<.001). 2. 임플란트 디자인의 변화는 ISQ와 유의한 상관관계를 보여 Submerged 디자인의 ISQ가 non-submerged 디자인보다 높게 나타났다(P<.05). 결론: 임플란트 안정성을 높이기 위해서는 가능한 길이가 긴 임플란트를 식립하는 것이 유리하며, 같은 길이의 임플란트에서 볼 때 Non-submerged 디자인보다 submerged 디자인이 더 높은 ISQ를 얻을 수 있을 것으로 생각된다.

• 대한치과보철학회지
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• 제44권2호
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• pp.185-196
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• 2006

Statement of problem: The researches on the influence of design variables on the stress distribution in cortical and trabecular bones and on optimal design for implant system were limited. Purpose: The purpose of this study is to identify the sensitivities of design parameters and to suggest the optimal parameters for designing the onebody type implant system. Material and methods: Stresses arising in the implant system were obtained by finite element analysis using a three dimensional model. An onebody type implant system[Oneplant (Warrantec. Co. Ltd., Korea)] was considered in this study. Vortical load(150 N) was applied on the top of the abutment along the axial direction. The initial design variables set for sensitivity analysis were radius of fixture, numbers of micro thread, numbers of power thread, height of micro thread, future length, tapered angle of future, inclined angle of thread, width of micro thread and width of power thread. The statistical technique of Design of Experiments(DOE) was applied tn the simulation model to deduce effective design parameters on stress distributions in bones. The deduced design parameters were incorporated into a fully automated design tool which is coupled with the finite element analysis and numerical optimization to determine the optimal design parameters. Results: 1. The result of sensitivity analysis showed six design variables - radius of future, tapered angle of fixture, inclined angle of thread, numbers of power thread, numbers of micro thread and height of micro thread - were more influential than the others. 2. The optimal values of design variables can be deduced by coupling finite element analysis (FEA) and design optimization tool(DOT).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제34권3호
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• pp.186-199
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• 2012

Purpose: Single implants, of which screw loosening has been observed frequently, presents problems such as fixtures fractures, marginal bone loss, and inflammation of the soft tissue around the implant. However, the single implant is more conservative, cost effective, and predictable compared to the 3 unit bridge with respect to the long-term outcome. This study evaluated the survival rate as well as future methods aimed at increasing the survival rate in single implants in posterior teeth. Methods: Among the implants placed in the Dankook University Dental Hospital department of Oral & Maxillofacial surgery from January 2001 to June 2008, 599 implants placed in the maxillar and mandibular posterior were evaluated retrospectively. Survival rates were investigated according to implant location, cause of tooth loss, gender, age, general disease, fixture diameter and length, surface texture, implant type and shape, presence of bone graft, surgery stage, surgeons, bone quality and opposite teeth. Results: Out of 599 single implants in posterior teeth, 580 implants survived and the survival rate was 96.8%. The difference in survival rate was statistically significant according to the implant location. The survival rate was low (84.2%) in implants exhibiting a wide diameter (${\geq}5.1mm$) and the surface treated by the acid etching group demonstrated a significantly lower survival rate (91.1%). One stage surgical procedure, which implemented a relatively better bone quality survival rate (100%), was higher than the two stage surgical procedure (96.1%). The survival rate of type IV bone quality (75%) was significantly lower than the other bone quality. Conclusion: Single posterior teeth implant treatments should use an improved surface finishing fixture as well as careful and safe procedures when performing implant surgery in the maxilla premolar and molar regions since bone quality is poor.

• 대한치과보철학회지
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• 제48권1호
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• pp.28-40
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• 2010

연구 목적: 임플란트의 성공과 실패는 숙주 관련 요인, 위치 관련 요인, 수술 관련 요인, 임플란트 관련 요인, 수복물 관련 요인 등 다양한 인자에 의해 결정된다. 본 연구는 그 중 임플란트의 식립 위치, 골질, 임플란트 표면, 길이 및 직경, 초기 안정성, 보철물 유형이 생존율에 미치는 영향을 평가하여, 임플란트의 예후를 예측하는데 도움을 주고자 한다. 연구 재료 및 방법: 1991년 2월부터 2009년 5월 사이에 연세대학교 치과대학병원에서 5인의 외과의가 임플란트 수술을 시행하고, 1인의 보철 전문의에 의해 보철 수복이 이루어져 적어도 6개월 이상 보철물에 대한 주기적인 검사가 이루어진 879명환자, 2796개의 임플란트에 대한 후향적 연구를 시행하였다. 진료 기록부 및 방사선 사진을 통해 환자의 식립 당시 나이와 성별, 임플란트의 제조회사, 표면, 직경 및 길이, 식립 부위 및 골질, 초기 안정성, 보철물의 유형, 생존 기간에 관한 자료를 수집하였다. 이를 통해, 임플란트의 성공과 실패에 영향을 미치는 국소 인자의 유형, 분포 및 국소 인자와 생존율 간의 관계를 연구하였다. 생존율 분석은 Kaplan-Meier 생존 분석법을 이용하였으며, 평가 인자 내 항목들의 생존율 비교는 Chi-square test를 사용하였다. 또한, 임플란트의 실패 위험성을 평가하기 위해 오즈비 (odds ratio)를 구하였다. 결과: 1. 총 879명에게 식립된 2796개의 임플란트 중 150개가 실패하여 누적 생존율은 94.64%로 나타났다. 그 중 기계 절삭 표면 임플란트의 누적 생존율은 91.76%, 거친 표면 임플란트의 누적 생존율은 96.02% 이었다. 2. 식립위치, 임플란트의 표면 특성, 기계 절삭 표면 임플란트의 직경, 초기 안정성, 보철물 유형, 환자의 연령 및 성별이 생존율에 미치는 영향은 통계학적으로 유의하였다 (P<.05). 3. 식립 부위의 골질, 임플란트 제조사별 거친 표면 특성, 임플란트의 길이 및 기계 절삭 표면을 제외한 거친 표면 임플란트의 직경이 생존율에 미치는 영향은 통계학적으로 유의하지 않았다 (P>.05). 4. 특히, 실패율이 높은 경우는 상악 구치부에 식립 시 (8.84%), 기계 절삭 표면의 임플란트 식립 시 (8.24%), 기계 절삭 표면 임플란트 중 wide 직경을 사용하는 경우 (14.47%), 초기 고정이 불량한 경우 (28.95%), 상악에 implant retained overdenture (기계 절삭 표면 26.69%; 거친 표면 10%) 및 telescopic denture (기계 절삭 표면 100%; 거친 표면 27.27%)로 수복하는 경우, 60-79세 환자에게 식립하는 경우 (6.90%), 남성에게 식립하는 경우 (6.36%) 이었다.

• Journal of Periodontal and Implant Science
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• 제52권6호
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• pp.496-508
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• 2022

Purpose: This study aimed to compare the long-term survival rate and peri-implant marginal bone loss between different types of dental implant-abutment connections. Methods: Implants with external or internal abutment connections, which were fitted at Gangneung-Wonju National University Dental Hospital from November 2011 to December 2015 and followed up for >5 years, were retrospectively investigated. Cumulative survival rates were evaluated for >5 years, and peri-implant marginal bone loss was evaluated at 1- and 5-year follow-up examinations after functional loading. Results: The 8-year cumulative survival rates were 93.3% and 90.7% in the external and internal connection types, respectively (P=0.353). The mean values of marginal bone loss were 1.23 mm (external) and 0.72 mm (internal) (P<0.001) after 1 year of loading, and 1.20 mm and 1.00 mm for external and internal abutment connections, respectively (P=0.137) after 5 years. Implant length (longer, P=0.018), smoking status (heavy, P=0.001), and prosthetic type (bridge, P=0.004) were associated with significantly greater marginal bone loss, and the use of screw-cement-retained prosthesis was significantly associated (P=0.027) with less marginal bone loss. Conclusions: There was no significant difference in the cumulative survival rate between implants with external and internal abutment connections. After 1 year of loading, marginal bone loss was greater around the implants with an external abutment connection. However, no significant difference between the external and internal connection groups was found after 5 years. Both types of abutment connections are viable treatment options for the reconstruction of partially edentulous ridges.

• 대한치과보철학회지
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• 제40권4호
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• pp.374-385
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• 2002

A total of 605 implant fixture prosthesis delivered by 3 clinics and 2 laboratories were examined in this study, The object of this study was to determine the proper length of screw head. The depth of access hole were measured and compared to the type of fixture, abutment, gold screw and prosthesis. The results were as follows : 1 The average number of fixtures per patient were 2.97. 2. The number of fixture installed in the upper posterior area are 327(55.56 %), the upper posterior area 171 (28.25%). 3. The depth of access hole is 4.23 mm in shallow area, and 5.46 mm in deep area and the differences were 1.23 mm. 4. The average depth of the aceess hole of the UCLA abutment were 5.02 mm. 5. The number of 4-5 mm access hole depth were 60(22.39%) in abutment screw level and the number of 4-5 mm depth in fixture level were 101 (29.19%). 6. In the shape of screw head, hexed type were 576(95.21%), slotted type were 29(4.79%).