• Journal of Periodontal and Implant Science
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• 제47권5호
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• pp.312-327
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• 2017

Purpose: This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods: An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14-24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results: All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean $0.07{\pm}0.48mm$), while the crestal bone level decreased significantly, from $2.34{\pm}0.93mm$ at baseline to $1.70{\pm}1.10mm$ at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions: Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.

• 구강회복응용과학지
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• 제28권2호
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• pp.127-138
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• 2012

본 연구에서는 임플란트 고정체와 지대주 간의 전하중 크기가 임플란트 주위 변연골의 응력분포에 미치는 영향에 대해 조사하였다. 해석 모델은 하악골에 식립되는 단일 임플란트(solid형 지대주와 submerged 형 고정체)로 제작되었고, 외력 조건으로는 임플란트 지대주 상부에 100N의 기능력이 협설 방향으로 30도 경사져 협측으로 작용하도록 설정하였다. 전하중의 크기가 변연골 응력 분포에 어떠한 차이가 생기게 하는지를 조사하기 위해 다섯개의 다른 전하중의 크기(0, 200, 400, 600, 800N)를 부여하였다. 모든 분석은 선형 탄성을 가정하여 ABAQUS/CAE(ver6.10-1, HKS, Fremont, CA, USA) 프로그램을 사용하였다. 임플란트 주위 변연골 응력분포의 차이는 전하중의 크기와 관련이 있었다. 100N의 교합력 하에 전하중이 0인 경우 변연골(임플란트 벽에서 0.1mm 떨어진 부분)에서 압축 응력은 28.33MPa이었는데, 전하중을 200N 증가시킬 때마다 1.76MPa씩 증가하였다. 이런 방식으로 800N의 전하중을 가할 때 나타나는 최대 압축 응력은 35.18MPa이었다. 반면 변연골에서의 인장 응력은 전하중이 증가할 수록 감소하였다. 임플란트 고정체와 지대주 간의 전하중은 변연골에서의 압축 응력을 증가시킬 수 있으나 기능력에 비하면 그 효과는 미미할 것으로 판단된다.

• 대한치과보철학회지
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• 제44권4호
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• pp.394-404
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• 2006

Statement of problem: A conventional 3-unit fixed partial denture design with a pontic between two retainers is the most commonly used. However in cases where the mental nerve is in close proximity to the second premolar, a cantilever design can be considered. As such, logical and scientific evidence is lacking for the number and position of implants to be placed for partially edentulous patients, and no clear-cut set of treatment principles currently exist. Purpose : The purpose of this study was to evaluate prognosis of implant-supported fixed partial dentures and to compare changes in bone level which may rise due to the different factors. Material and method : The present study examined radiographical marginal bone loss in patients treated with implant-supported fixed partial dentures (87 prostheses supported by 227 implants) and evaluated the influence of the span of the pontic, type of the opposing dentition. Clinical complications were studied using a retrospective method. Within the limitation of this study. the following result were drawn Result, 1. Seven of a total of 227 implants restored with fixed prostheses failed, resulting in a 96.9% success rate. 2. Complications encountered during recall appointments included dissolution of temporary luting agent (17 cases), porcelain fracture (8 cases), loosened screws (5 cases), gingival recession (4 cases), and gingival enlargement (1 case). 3. Marginal bone loss, 1 year after prosthesis placement, was significant(P<0.05) in the group that underwent bone grafting, however no difference in annual resorption rate was observed afterwards. 4. Marginal bono loss, 1 year post-placement, was greater in cantilever-type prostheses than in centric pontic protheses (P<0.05). 5. Marginal bone loss was more pronounced in posterior regions compared to anterior regions (P<0.05). 6. The degree of marginal bone loss was proportional to the length of the pontic (P<0.05). Conclusion: The success rate of implant-supported fixed partial dentures, including marginal bone loss, was satisfactory in the present study. Factors influencing marginal bone loss included whether bone graft was performed, location of the pontic (s), location of the surgical area in the arch pontic span. Long-term evaluation is necessary for implant-supported fixed partial dentures, as are further studies on the relationship between functional load and the number of implants to be placed.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제39권4호
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• pp.161-167
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• 2013

Objectives: The objective of this study is compare the rate of marginal bone resorption around hydroxyapatite-coated implants given different loading times in order to evaluate their stability. Materials and Methods: The study was conducted retrospectively for one year, targeting 41 patients whose treatment areas were the posterior maxilla and the mandible. Osstem TS III HA (Osstem Implant Co., Busan, Korea) and Zimmer TSV-HA (Zimmer Dental, Carlsbad, CA, USA), which employ the new hydroxyapatite coating technique, were used. The patients were divided into two groups - immediate and delayed loading - and the bone level at the time of loading commencement and after one year of loading was measured using periapical radiography. Differences between the groups were evaluated using Mann-Whitney (${\alpha}$=0.05). Results: For all patients as a single group, the survival rate of the implants was 100%, and the mean marginal bone loss was $0.26{\pm}0.59mm$. In comparison of the differences by loading, mean marginal bone loss of $0.32{\pm}0.69mm$ was recorded for the immediate loading group whereas the delayed loading group had mean marginal bone loss of $0.16{\pm}0.42mm$. However, the difference was not significant (P>0.05). Conclusion: Within the limited observation period of one year, predictable survival rates can be expected when using immediately loaded hydroxyapatite-coated implants.

• Journal of Periodontal and Implant Science
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• 제36권4호
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• pp.891-900
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• 2006

Perforation of maxillary sinus is a common complication of implant placement in posterior maxilla. The purpose of this study was to evaluate the prognosis of sinus perforated implants placed in partially edentulous maxillae. Eighteen sinus perforated implants in 15 patients were examined for cumulative survival rate, radiographic preoperative bone level, and radiographic marginal bone level change. Twenty-two non-perforated implants in the same patients served as control. The results were as follows; 1. There was no statistically significant difference in cumulative survival rate between sinus perforated implants and non-perforated implants (P>0.05). 2. There was no statistically significant difference in the marginal bone level between sinus perforated implants and non-perforated implants (P>0.05). 3. There was no statistically significant difference in cumulative survival rate according to the preoperative bone level (P>0.05). These results suggests that perforation of maxillary sinus may not affect implant success in posterior maxillae.

• Journal of Periodontal and Implant Science
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• 제45권3호
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• pp.82-93
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• 2015

Purpose: This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods: Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results: Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions: Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant.

• 대한치과보철학회지
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• 제32권3호
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• pp.455-469
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• 1994

Regular radiographic examination has been considered an essential diagnositic method for osseointegrated dental implantation. This study investigated marginal bone loss through the measurement on periapical radiographs and changes in bone density through digital subtraction image radiographic method around 88 endoseous root-form dental implants in 43 human subjects. Four types of endosseous dental implants were investigated : Standard series, Mini series and Hex-lock system of Steri-Oss Dental implant system, and $Br{\aa}nemark$-type implant from 3i dental implant system, in a 3 month interval for a total period of 12 months. The results were as follows : 1. Rapid bone loss occurred in the first 3 months in all 4 groups, and the bone level stabilized at the first thread of the implant fixtures. Amount of bone loss for 12 months showed correlation with the length of the polished neck portion. 2. Most of the implant systems showed resorption of alveolar bone up to the polished neck portion although a long polished neck could delay the resolution. 3. Alveolar bone loss apical to the polished neck portion stabilized at the first thread of the fixtures with no correlation to either the time of exposure of the polished neck or types of implant systems. 4. No changes in bone density around the implant threads were observed throughout the experimental period. Bone density decreased at the marginal bone, and increased at the newly-formed alveolar crest. These results indicate that most of the alveolar bone loss occur within the first 12 months after installation of endosseous root-form dental implants resulting in the exposure of polished neck portions, and the bone level stabilizes thereafter at the first thread portions of the implant fixtures. The experimental period of 12 months seems insufficient for observing changes in bone density, and a long-term observation should be needed.

• 구강회복응용과학지
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• 제29권2호
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• pp.175-182
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• 2013

2단계 임플란트 수술법에 있어서 식립 후 골유착을 위한 치유과정 중 발생할 수 있는 덮개나사의 노출의 양상에 따른 조기 변연골 흡수 정도를 관찰하고자 하였다. 덮개나사의 노출을 보인 경우에서 선정 기준에 맞는 환자를 선택해 모집단으로 하여, 28명의 환자에서 덮개나사의 노출이 확인된 28개의 임플란트를 실험군으로 하고 노출되지 않은 나머지를 대조군으로 하였다. 총 64개의 임플란트 고정체($TiUnite^{TM}$, NobelBiocare, Sweden)가 식립되었으며 임플란트 식립 1개월 후 정기검사를 통해 덮개나사의 노출을 확인하였다. 노출의 정도에 따라 1군(대조군, 노출 없음), 2군(pin-point 노출), 3군(1/2이하의 노출), 4군(1/2 이상 노출), 5군(완전 노출)으로 하였고 2개월 정기 검진 시 치유지대주를 연결하였다. 식립 직후, 2개월 정기 검진시 치근단 방사선 촬영을 통해 변연골 흡수 변화량을 측정하고 비교하여 다음의 결과를 얻었다. 1. 덮개나사의 노출시 변연골 흡수가 관찰되었다. 2. 2군과 3군은 나머지 군에 비해 변연골 흡수 변화량이 유의하게 증가하였다(P <.05). 3. 4군과 5군은 1군에 비해 변연골 흡수 변화량이 유의하게 증가하였으나(P <.05), 그 정도는 2군과 3군에 비해 작았다(P <.05). 이상의 결과에서 임플란트 식립 후 치유과정 중 발생하는 덮개나사의 노출은 조기 변연골 흡수에 기여하므로 주기적인 검진을 통해 치유지대주를 연결하는 것이 임상적으로 적절하리라 사료된다.

• 구강회복응용과학지
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• 제32권4호
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• pp.280-292
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• 2016

목적: 이 연구의 목적은 임플란트의 생존율과 주위 변연골 수준을 후향적으로 평가하여, 술자의 임상적 경험을 포함한 요인들이 미치는 영향을 분석하고자 하였다. 연구 재료 및 방법: 2002년 1월부터 2009년 3월까지 강릉원주대학교치과병원 치주과에서 전공의가 2단계법으로 식립한 임플란트 중 5년 이상의 기록이 있는 146명의 420개 임플란트를 대상으로, 임플란트 탈락여부, 주위 골 소실량, 성별, 연령, 2형 당뇨, 흡연, 지대주 연결 형식, 표면 처리 방법, 직경, 식립 부위, 식립 당시 전공의 연차, 덮개 나사의 조기 노출, 보철학적 합병증, 동반된 골 이식 술식 등의 영향을 평가하였다. 결과: 최종 보철물 장착 후 5년간 누적생존율은 94.9% 이었다. 이원로지스틱회귀분석 결과, 흡연과 덮개 나사의 조기 노출이 실패율을 유의하게 증가시켰다. 다중회귀분석 결과, 흡연, 임플란트 지대주 연결 형식, 및 표면 처리 방법이 임플란트 주위 변연골 수준 변화에 유의한 영향을 주었다. 술자의 임상경험을 반영하기 위한 식립 당시의 전공의 수련 연차는 임플란트의 실패와 유의한 연관성은 보이지 않았다(P = 0.171). 결론: 흡연, 덮개 나사의 조기 노출, 지대주 연결 형식 및 표면 처리 방법이 임플란트의 성공과 유의한 상관관계를 보이는 것으로 생각된다.

• The Journal of Advanced Prosthodontics
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• 제2권2호
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• pp.54-57
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• 2010

PURPOSE. The aim of this study was to evaluate the periodontal and prosthodontic complications of multiple freestanding implants in the posterior jaws for up to 1 year of function. MATERIALS AND METHODS. Eight patients received 20 implants posterior to canines. Two or more implants were consecutively inserted to each patient. Single crowns were delivered onto the implants. Marginal bone loss, implant mobility, probing depth, and screw loosening were examined to evaluate the clinical success of such restorations for maximum 1 year of functional loading. RESULTS. All the implants performed well during the observation period. Neither periodontal nor prosthodontic complications were found except a slight porcelain chipping. While the marginal bone level was on average 0.09 mm lower around the implant after 6 months of loading, it was 0.15 mm higher after 1 year. CONCLUSION. Within the limits of this investigation, separate single-tooth implant restorations to replace consecutive missing teeth may clinically function well in the posterior jaw.