• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.215-223
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• 2010

Purpose: The present study was aimed to evaluate the level of cortical bone strain during the placement of an implant. The primary concern was to investigate if the extent of overloading area near the marginal bone could be affected by microthread fabricated at the cervical 1/3 of an implant. Materials and methods: Three dimensional finite element analysis was used to simulate the insertion of 3 implants. Control model was $4.1{\times}10$ mm implant (Submerged model, Dentis Co,, Daegu, Korea) equipped with a main thread only. Type I was with main thread and microthread, and Type II had similar thread pattern but was of tapered body. A PC-based finite element software (DEFORM 3D ver 5, SFTC, Columbus, OH, USA) was used to calculate a total of 3,600 steps of analysis, which simulated the whole insertion. Results: Results showed that the strain field in the marginal bone within 1 mm of the implant wall was higher than 4,000 micro-strain in the control model. The size of bone overloading was 1-1.5 mm in Type I, and greater than 2 mm in Type II implants. Conclusion: These results indicate that the marginal bone may be at the risk of resorption on receiving the implant for all 3 implant models studied. Yet, the risk was greater for Type I and Type II implants, which had microthread at the cervical 1/3.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.2
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• pp.168-176
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• 2011

Purpose: This study aims at investigating the influence of various insertion torques on thermal changes of bone. A proper insertion torque is derived based on the thermal analysis with two different implant designs. Materials and methods: For implant materials, bovine scapula bone of 15 - 20 mm thickness was cut into 35 mm by 40 - 50 mm pieces. Of these, the pieces having 2 - 3 mm thickness cortical bone were used as samples. Then, the half of the sample was immersed in a bath of $36.5^{\circ}C$ and the other half was exposed to ambient temperature of $25^{\circ}C$, so that the inner and surface temperatures reached $36.5^{\circ}C$ and $28^{\circ}C$, respectively. Two types of implants ($4.5{\times}10\;mm$ Br${\aa}$nemark type, $4.8{\times}10\;mm$ Microthread type) were inserted into bovine scapula bone and the temperature was measured by a thermocouple at 0.2 mm from the measuring point. Finite element method (FEM) was used to analyze the thermal changes at contacting surface assuming that the sample is a cube of $4\;cm{\times}4\;cm{\times}2\;cm$ and a layer up to 2 mm from the top is cortical bone and below is a cancellous bone. Boundary conditions were set on the basis of the shape of cavity after implants. SolidWorks was used as a CAD program with the help of Abaqus 6.9-1. Results: In the in-vitro experiment, the Microhead type implant gives a higher maximum temperature than that of the Br${\aa}$nemark type, which is attributed to high frictional heat that is associated with the implant shape. In both types, an Eriksson threshold was observed at torques of 50 Ncm (Br${\aa}$nemark) and 35 Ncm (Microthread type), respectively. Based on these findings, the Microthread type implant is more affected by insertion torques. Conclusion: This study demonstrate that a proper choice of insertion torque is important when using a specific type of implant. In particular, for the Microthread type implant, possible bone damage may be expected as a result of frictional heat, which compensates for initial high success rate of fixation. Therefore, the insertion torque should be adjusted for each implant design. Furthermore, the operation skills should be carefully chosen for each implant type and insertion torque.

• Journal of Periodontal and Implant Science
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• v.39 no.1
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• pp.27-36
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• 2009

Purpose: The stability of periodontal condition and marginal bone level were important to achieve long-term success of dental implant treatment. The aim of this study was to evaluate periodontal conditions and marginal bone loss around 67 GSII(OSSTEM, Seoul, Korea) dental implants with dual-microthread at the neck portion, 1 year after prosthetic loading. Materials and methods: Sixty-seven GS II dental implants in 27 patients(mean age; $47.4{\pm}14.0$ years) who received implant treatments at Pusan National University Hospital, were included in this study. Thirteen US II(OSSTEM, Seoul, Korea) implants with smooth neck design were selected for the control group. Periodontal and radiographic evaluations were carried out at baseline, 6 months and 12 months after prosthetic loading. Results: In the GS II group, plaque index(PI), gingival index(GI) and probing depth(PD) increased as time passed. In the US II group, GI and PD increased. Although marginal bone level was lower in the US II group in all evaluation periods, the changes between the periods were not statistically significant(p>0.05). In each period, periodontal parameters were not statistically significant between groups. Conclusion: One year after prosthetic loading, GS II and US II dental implants showed similar periodontal conditions and marginal bone response, and were within the criteria of success.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.4
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• pp.240-247
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• 2009

Purpose: The purpose of this study was to evaluate marginal bone loss to the bone crest functionally loaded for up to eighteen months and also with regard to other variables of interest. Material and Methods: 135 endosseous implants(GS II, Osstem, South Korea) were placed in 35 patients. The design of GS II implant is straight with the microthread. Radiographic examinations were conducted at baseline (implant loading) and 3, 6, 9, 12 and 18 months after loading. Marginal bone level measurement was made from the reference point to the lowest observed point of contact of the marginal bone with the fixture. The reference point of the fixture was the border between the blasted surface and machined surface of the fixture. Results: Implants were on function for a mean 12.7 months(range, 3?18 months). For the 56 maxillary and 79 mandibular implants, mean marginal bone loss was 0.68 mm and 0.70 mm. Implants placed maxillary posterior area displayed more crestal bone loss than the other position. The difference between mesial and distal bone levels was statistically significant (p<0.05) with respective means of 0.51 mm and 0.62 mm. Also, The difference between bone graft group and no-bone graft group was statistically significant(p<0.05) with respective means of 0.38 mm and 0.66 mm. But no statistically significant influence of sex, type of surgery(one or two stage surgery), the implant length was observed(p>0.05). Conclusion: This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.

• Journal of Periodontal and Implant Science
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• v.41 no.5
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• pp.211-217
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• 2011

Purpose: The marginal bone levels around implants following restoration are used as a reference for evaluating implant success and survival. Two design concepts that can reduce crestal bone resorption are the microthread and platform-switching concepts. The aims of this study were to analyze the placement of microthreaded and platform-switched implants and their short-term survival rate, as well as the level of bone around the implants. Methods: The subjects of this study were 27 patients (79 implants) undergoing treatment with microthreaded and platform-switched implants between October 2008 and July 2009 in the Dental Hospital of Yonsei University Department of Periodon-tology. The patients received follow-up care more than 6 months after the final setting of the prosthesis, at which time periapical radiographs were taken. The marginal bone level was measured from the reference point to the lowest observed point of contact between the marginal bone and the fixture. Comparisons were made between radiographs taken at the time of fixture installation and those taken at the follow-up visit. Results: During the study period (average of 11.8 months after fixture installation and 7.4 months after the prosthesis delivery), the short-term survival rate of microthreaded and platform-switched implants was 100% and the marginal bone loss around implants was $0.16{\pm}0.08$ mm, the latter of which is lower than the previously reported values. Conclusions: This short-term clinical study has demonstrated the successful survival rates of a microthread and platform-switched implant system, and that this system is associated with reduced marginal bone loss.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.3
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• pp.224-231
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• 2010

Purpose: This study was to investigate how the crestal module design could affect the level of marginal bone stress around dental implant. Materials and methods: A submerged implant of 4.1 mm in diameter and 10 mm in length was selected as baseline model (Dentis Co., Daegu,Korea).A total of 5 experimental implants of different crestal modules were designed (Type I model : with microthread at the cervical 3 mm, Type II model : the same thread pattern as Type I but with a trans-gingival module, Type III model: the same thread pattern as the control model but with a trans-gingival module, Type IV model: one piece system with concave transgingival part, Type V model: equipped with beveled platform). Stress analysis was conducted with the use of axisy mmetric finite element modeling scheme. A force of 100 N was applied at 30 degrees from the implant axis. Results: Stress analysis has shown no stress concentration around the marginal bone for the control model. As compared to the control model, the stress levels of 0.2 mm areas away from the recorded implant were slightly lower in Type I and Type IV models, but higher in Type II, Type III and Type V models. As compared to 15.09 MPa around for the control model, the stress levels were 14.78 MPa, 18.39 MPa, 21.11 MPa, 14.63 MPa, 17.88 MPa in the cases of Type I, II, III, IV and V models. Conclusion: From these results, the conclusion was drawn that the microthread and the concavity with either crestal or trans-gingival modules maybe used in standard size dental implants to reduce marginal bone stress.

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.190-195
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• 2011

PURPOSE. This study evaluated the initial stability of different implants placed above the bone level in different types of bone. MATERIALS AND METHODS. As described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Br${\aa}$nemark System$^{(R)}$ Mk III TiUnite$^{TM}$, Straumann Standard Implant SLA$^{(R)}$, and Astra Tech Microthread$^{TM}$-OsseoSpeed$^{TM}$) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis. RESULTS. In the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Br${\aa}$nemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants. CONCLUSION. The initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.

• The Journal of the Korean dental association
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• v.54 no.7
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• pp.529-540
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• 2016

Objective: The objective of this study was to evaluate the osseointegration of narrow-diameter implant with trapezoid-shape and to evaluate the effect of coronal microthreads on trapezoid-shape narrow-diameter implant. Materials and Methods: The experimental narrow-diameter implants were classified into two groups according to absence or presence of coronal microthreads: trapezoid-shape narrow diameter implant (TN group) and trapezoid-shape narrow-diameter implant with microthreads (TNM group). They were installed alternately in bilateral mandible in three dogs. After 8 weeks, the animals were sacrificed. Resonance frequency analysis, removal torque test, and histometric analysis were performed. Results: Statistically higher implant stability quotient (ISQ) values were observed in TNM group than in TN group at the time of implant installation. However, significant ISQ values difference was not observed between groups at 8 weeks. Both groups showed significantly increased ISQ values at 8 weeks, compared to the time of implant installation. There was no significant difference between groups in removal torque test. Bone-implant contact ratio also showed no significant difference between groups in total and coronal part. Conclusion: Within the limitation of this study, it could be concluded that the trapezoid-shape design on narrow-diameter implant showed successful ossointegration, and the microthreads on coronal part did not result in significant bone-implant contact and biomechanical stability at 8 weeks.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.169-174
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• 2008

Statement of problem: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. Purpose: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. Material and methods: Twenty-four patients were included and randomly assigned to treatment with $Br{{\aa}}nemark$ system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. Results: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of $0.83{\pm}0.31mm$; Group 2 had a mean crestal bone level changes of $0.44{\pm}0.36mm$. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. Conclusion: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.417-429
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• 2009

Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved and accepted as viable option for the treatment of fully and partially edentulous patients. Although the use of domestic implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. 96 endosseous implants placed in 31 patients at Wonkwang University Sanbon Dental Hospital were examined to determine the effect of various factors on implant survival rate and marginal bone loss, through clinical and radiographic results. The design of endosseous implant used to this study is straight with the microthread.(GS II RBM Fixture) 1. 3 fixtures were lost, resulting in 96.9% cumulative survival rate. 2. Survival rate in fifties was significantly lower (93.6%) and no significant difference in marginal bone loss was found according to gender. 3. Survival rates were 95.6% in the maxillary molar area and 97.3% in the mandible molar area. 4. No significant difference in survival rate was found according to presence of bone grafts, type of prostheses, implant position, and length and diameter of implant. 5. A factor influencing marginal bone loss was presence of type of prostheses, while facters such a length, diameter of fixture and bone grafts had no statistically significant effect on crestal bone loss. This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.