• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.2
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• pp.97-109
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• 2022

Purpose: This study aims to investigate the risk indicators contributing to implant failure, and analyze the relationship between risk indicators and marginal bone loss (MBL) through long-term follow-up over 3 years. Materials and Methods: From 2003 to 2017, patients' medical charts with a history of dental implant surgery at Chonnam National University Dental Hospital were reviewed retrospectively. The patient's demographic variables, and clinical variables were recorded. Periapical radiographs were used to evaluated the changes in MBL around implants. And we analyzed implant survival rates. Multiple regression analysis with backward elimination was conducted to correlate the patient's clinical variables and implant failure and Pearson correlation analysis was performed to the correlated between implant long-term survival rates and MBL and initial stability. Results: In multiple regression analysis, there was a statistically significant negative correlation between abutment connection type (β = -.189, P < .05), with or without SPT (β = -.163, P < .05), diabetes (β = -.164, P < .05), osteoporosis (β = -.211, P < .05) and MBL. Anticoagulant medication influenced the long-term success rate of implants. PTV values at the second implant surgery showed a statistically significant negative correlation with long-term implant survival (P < .05). Conclusion: For the long-term success of the implant, the appropriate abutment connection type must be selected and the periodic SPT is recommended. Systemic diseases such as diabetes and osteoporosis and anticoagulant medication should be considered. Furthermore, since high PTV at the second implant surgery correlated with the long-term survival rates of the implant, initial stability should be carefully considered before undergoing the prosthetic procedure.

• The korean journal of orthodontics
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• v.44 no.4
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• pp.217-225
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• 2014

Single-tooth implantation has become a common treatment solution for replacement of a root-fractured maxillary incisor in adults, but the long-term esthetic results can be unfavorable due to progressive marginal bone loss, resulting in gingival recession. In this case report, a maxillary central incisor with a root fracture in its apical one-third was orthodontically extruded and extracted in a 21-year-old female. Implant surgery was performed after a 3-month healing period, and the final crown was placed about 12 months after extraction. After 12 years, favorable osseous and gingival architectures were visible with adequate bone height and thickness at the buccal cortical plate, and no gingival recession was seen around the implant-supported crown. Although modern dentistry has been shifting toward simplified, clinical procedures and shorter treatment times, both general dentists and orthodontists should be aware of the possible long-term esthetic advantages of orthodontic extrusion of hopelessly fractured teeth for highly esthetically demanding areas and should educate and motivate patients regarding the choice of this treatment solution, if necessary.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.272-279
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• 2013

The concept of implant stability was basically originated from the relative condition of bone-implant interface and has some meanings for evaluation of that interface. In addtion, it has been used for the investigation of initial bone healing process after fixture installation because a degree of micromotion around interface can affect unfavorable clinical results. The purpose of this study is to investigate the mode of initial bone healing from fixture installation through prospective trial. Thirty fixtures were consecutively installed in mandibles of 26 patients with single tooth loss area and then healing abutment were secured for one-stage surgery meothod. Resonance frequency analysis was performed with one week interval during 12 weeks and periapical radiographs were taken at each month. Although marginal bone level change was not shown through observation period (P>0.05), statistical difference of implant stability was shown through 4 and 6 week (P<0.05) and was not shown after 6 week (P>0.05) according to the bone quality. Initial bone healing process is a successive process of bone resorption and favorable bone healing result might be postulated at 4 week interval after installation through RFA.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.3
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• pp.237-242
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• 2009

Implant-supported fixed and removable prostheses provide a proper treatment modality with reliable success. The SS $II^{(R)}$ Implants is a one-stage nonsubmerged threaded titanium implants with Resorbable Blasting Media (RBM) surface developed by Osstem company (Busan, Korea) in October of 2002. This study is to evaluate the survival rate of the SS $II^{(R)}$ Implants for 4 years using radiographic parameters and to review the retrieved implants by the cytotoxicity tests. Since September 2003, 439 SS $II^{(R)}$ implants had been used for 173 patients at Ewha Womans University Medical Center in Korea. Patients consisted of 91 females (52.6 %) and 82 males (47.4 %). The patients' mean age was $42\;{\pm}16$ years, ranging from 21 to 83 years. The follow-up period ranged from 9 to 46 months (mean F/U $24.2\;{\pm}\;10.2$ months). The results are as follows; 1. Of 439 implants, 17 implants were removed and 4-year cumulative survival rate was 96.1%. 2. 82.3% of 17 failed implants were founded during healing phase, and 94.1% of failed fixtures were removed within 5 months after implantation. 3. Crestal bone around the implants was resorbed to 1 mm in 89.0%, to 1 - 2 mm loss of the marginal bone in 8.3%, and the bone loss over 2 mm was occurred in 2.7%. 4. Microscopic examination of the retrieved implants disclosed Grade 0 cytotoxicity in 4 and Grade 1 cytotoxicity in 2 of 6 groups divided according to LOT numbers. Inhibition rate with optical density was acceptable as low as ISO standard.

• Journal of Dental Rehabilitation and Applied Science
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• v.22 no.1
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• pp.75-87
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• 2006

The purpose of this study was to investigate the effects of prostheses misfit, cantilever on the stress distribution in the implant components and surrounding bone using three dimensional finite element analysis. Two standard 3-dimensional finite element models were constructed: (1) 3 ITI implant supported, 3-unit fixed partial denture and (2) 3 ITI implant supported, 3-unit fixed partial denture with a distal cantilever. variations of the standard finite element models were made by placing a $100{\mu}m$ or $200{\mu}m$ gap between the fixture, the abutment and the crown on the second premolar and first molar. Total 14 models were constructed. In each model, 244 N of vertical load and 244 N of $30^{\circ}$ oblique load were placed on the distal marginal ridge of the distal molar. von Mises stresses were recorded and compared in the crowns, abutments, crestal compact bones, and trabecular bones. The results were obtained as follows: 1. In the ITI implant system, cement-retained prostheses showed comparatively low stress distributions on all the implant components and fixtures regardless of the misfit sizes under vertical loading. The stresses were increased twice under oblique loading especially in the prostheses with cantilever, but neither showed the effects of misfit size. 2. Under the oblique loading and posterior cantilever, the stresses were highly increased in the crestal bones around ITI implants, but effects of misfit were not shown. Although higher stresses were shown on the apical portion of trabecular bones, the effects by misfit were little and the stresses were increased by the posterior cantilever. 3. When the cement loss happened in the ITI implant supported FPD with misfit, the stresses were increased in the implant componets and supporting structures.

• Journal of Periodontal and Implant Science
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• v.53 no.4
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• pp.248-258
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• 2023

Purpose: This study aimed to characterize the early stages of periodontal disease and determine the optimal period for its evaluation in a mouse model. The association between the duration of ligation and its effect on the dentogingival area in mice was evaluated using micro-computed tomography (CT) and histological analysis. Methods: Ninety mice were allocated to an untreated control group or a ligation group in which periodontitis was induced by a 6-0 silk ligation around the left second maxillary molar. Mice were sacrificed at 1, 2, 3, 4, 5, 8, 11, and 14 days after ligature placement. Alveolar bone destruction was evaluated using micro-CT. Histological analysis was performed to assess the immune-inflammatory processes in the periodontal tissue. Results: No significant difference in alveolar bone loss was found compared to the control group until day 3 after ligature placement, and a gradual increase in alveolar bone loss was observed from 4 to 8 days following ligature placement. No significant between-group differences were observed after 8 days. The histological analysis demonstrated that the inflammatory response was evident from day 4. Conclusions: Our findings in a mouse model provide experimental evidence that ligature-induced periodontitis models offer a consistent progression of disease with marginal attachment down-growth, inflammatory infiltration, and alveolar bone loss.

• Journal of Periodontal and Implant Science
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• v.51 no.1
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• pp.63-74
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• 2021

Purpose: This study investigated the effects of hyaluronic acid (HA) on peri-implant clinical variables and crevicular concentrations of the proinflammatory biomarkers interleukin (IL)-1β and tumor necrosis factor (TNF)-α in patients with peri-implantitis. Methods: A randomized controlled trial was conducted in peri-implantitis patients. Patients were randomized to receive a 0.8% HA gel (test group), an excipient-based gel (control group 1), or no gel (control group 2). Clinical periodontal variables and marginal bone loss after 0, 45, and 90 days of treatment were assessed. IL-1β and TNF-α levels in crevicular fluid were measured by enzyme-linked immunosorbent assays at baseline and after 45 days of treatment. Clustering analysis was performed, considering the possibility of multiple implants in a single patient. Results: Sixty-one patients with 100 dental implants were assigned to the test group, control group 1, or control group 2. Probing pocket depth (PPD) was significantly lower in the test group than in both control groups at 45 days (control 1: 95% CI, -1.66, -0.40 mm; control 2: 95% CI, -1.07, -0.01 mm) and 90 days (control 1: 95% CI, -1.72, -0.54 mm; control 2: 95% CI, -1.13, -0.15 mm). There was a trend towards less bleeding on probing in the test group than in control group 2 at 90 days (P=0.07). Implants with a PPD ≥5 mm showed higher levels of IL-1β in the control group 2 at 45 days than in the test group (P=0.04). Conclusions: This study demonstrates for the first time that the topical application of a HA gel in the peri-implant pocket and around implants with peri-implantitis may reduce inflammation and crevicular fluid IL-1β levels.