• The Journal of the Korean dental association
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• v.54 no.3
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• pp.198-205
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• 2016

The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.169-182
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• 2005

The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.

• The Journal of Advanced Prosthodontics
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• v.11 no.2
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• pp.112-119
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• 2019

PURPOSE. Zirconia materials have been used for implant-retained restorations, but the stress distribution of zirconia is not entirely clear. The aim of this study is to evaluate the stress distribution and risky areas caused by the different design of zirconia restorations on the atrophic bone of the posterior maxilla. MATERIALS AND METHODS. An edentulous D4-type bone model was prepared from radiography of an atrophic posterior maxilla. Monolithic zirconia and zirconia-fused porcelain implant-retained restorations were designed as splinted or non-splinted. 300-N occlusal forces were applied obliquely. Stress analyses were performed using a 3D FEA program. RESULTS. According to stress analysis, the bone between the 1) molar implant and the 2) premolar in the non-splinted monolithic zirconia restoration model was stated as the riskiest area. Similarly, the maximum von Mises stress value was detected on the bone of the non-splinted monolithic zirconia models. CONCLUSION. Splinting of implant-retained restorations can be more critical for monolithic zirconia than zirconia fused to porcelain for the longevity of the bone.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.3
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• pp.486-503
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• 1997

The purpose of this study was to evaluate the stress patterns developed in abutment and residual ridge according to removable denture design in case of remaining mandibular canines. The removable denture designs in this study were as foolows : 1. Removable partial denture with non-splinted abutment 2. Removable partial denture with splinted abutment 3. Overdenture with telescopic crown 4. Overdenture with O-Ring attachment 5. Overdenture with combination bar attachment Photoelastic stress analysis was used to record the isochromatic fringe patterns and to calculate principal stress components at measuring points. The results were as follows : 1. In case of removable partial denture with non-splinted abutment, stress of root area at the loaded side was the largest. No significant differences in stress of root area were observed between loaded side and unloaded side. 2. No significant differences in stress of residual ridge at the loaded side were observed between removable partial denture with splinted abutment and removable partial denture with non-splinted abutment. 3. In case of combination bar attachment retained overdenture, stress of root area was the largest and in case of telescopic crown retained overdenture, stress of root area was the lowest. 4. In case of attachment retained overdenture, stress of residual ridge was lower but stress of root area was larger than in case of removable partial denture.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.412-424
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• 2004

Statement of problem: Several prosthetic options are available for the restoration of multiple adjacent implants. A passively fitting prosthesis has been considered a prerequisite for the success and maintenance of osseointegration. Passivity is a particular concern with multiple implants because of documented inaccuracies in the casting and soldering process. One way to avoid this problem is to restore the implants individually, however, the restorations of individual adjacent impants requires careful adjustment of interproximal contacts. Purpose: The purpose of this study was to compare the stress distribution pattern and amount surrounding Bicon implants with individual crowns and splinted restorations. Material and method: A photoelastic model of a human partially edentulous left mandible with 3 Bicon implants($4{\times}11mm$) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 abutments ($4{\times}0.65mm,\;0^{\circ}$, 2.0 mm post, Bicon Inc., Boston, USA) After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal ($8{\mu}m$ shim stock drags without tearing), medium($40{\mu}m)$), and heavy($80{\mu}m$). Splinted 3-unit fixed partial dentures were fabricated and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions(7.5, 15, 30 lb) were analyzed with a circular polaricope. Results: 1. Stresses were distributed around the entire body of fin in Bicon implants. 2. Splinted restorations were useful for distribution of stress around implants especially with higher loads. 3. By increasing the contact tightness between the individually restored three implants, the stress increased in the coronal portion of implants. Conclusions: Ideal adjustment of the contact tightness was important to reduce the stresses around individually restored Bicon implants.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.1
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• pp.51-62
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• 2006

Purpose: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i. and Bicon implant system) Material and method: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine. For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit axed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb. 30 lb). Conclusion: The results were as follows; 1 Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system. while the other side of 3i system tended to concentrate the stress in some parts.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.425-442
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• 2004

Statement of problem: A difficulty in achieving a passive-fitting prosthesis can be overcome by individual crown restoation of multiple implants. But individualized crown has another difficulty in control of contact tightness and stress distribution. Purpose: This in vitro study is to evaluate the stress distribution and the magnitude in the supporting tissues around Endopore implants with different crown lengths, interproximal contact tightness, and the splinting effects. Material & methods: Three Endopore implants($4.1{\times}9mm$) were placed in the mandibular posterior edentulous area distal to the canine and photoelastic model was made with PL-2 resin(Measurements Group, Raleigh, USA). Restorations were fabricated in two crown lengths: 9, 13 mm. For non-splinted restorations, individual crowns were fabricated on three custom-milled titanium abutments. After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal($8{\mu}m$ shim stock drags without tearing), medium($40{\mu}m$), and heavy($80{\mu}m$). For splinted restorations, 3-unit fixed partial dentures were fabricated. This study was examined under simulated non-loaded and loaded conditions(6.8 kg). Photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure. Results: 1. When restorations were not splinted, the more interproximal contact tightness was increased among the three implants, the more stress was shown in the cervical region of each implant. When crown length was increased, stresses tended to increase in the apex of implants but there were little differences in stress fringes. 2. When nonsplinted restorations were loaded on the first or third implant, stresses were increased in the apex and cervical region of loaded implant. Regardless of interproximal contact tightness level, stresses were not distributed among the three implants. But with tighter interproximal contact, stresses were increased in the cervical region of loaded first or third implant. 3. When the nonsplinted restorations were not loaded, there were little stresses on the supporting structure of implants, but low level stresses were shown in the splinted restorations even after sectioning and soldering. 4. With splinted restorations, there were little differences in stresses between different crown lengths. When splinted restorations were loaded, stresses were increased slightly on the loaded implant, but relatively even stress distribution occurred among the three implants. Conclusions: Splinting the crowns of adjacent implants is recommended for Endopore implants under the overloading situation.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.4
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• pp.433-445
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• 2010

The aim of this study was to evaluate the fixation effect by connecting impression copings and to compare the three types of impression trays which were used in open tray impression technique. Experimental groups used 3 types of impression trays which are custom tray, plastic metal combination tray and polycarbonate stock tray. These three groups were subdivided into splinted and non-splinted impression copings group. The total number of experimental groups was six. 10 specimens were made for each group. We used 1-screw test, observing the specimen on which only one side abutment of reference framework was fixated with 20 Ncm. The gap between implant analogue and abutment of the other side was observed by stereo microscope. It was measured at 6 points in each specimen. Measuring value was selected when same result was revealed 3 times. Recorded data were statistically analyzed. Whether impression copings were splinted or not, there was no significant difference among custom tray group, plastic metal combination tray group, and polycarbonate stock tray group. Significant statistical difference in vertical fit discrepancy was found between splinted and non-splinted impression copings group with custom tray, plastic metal combination tray and polycarbonate stock tray (p<0.05).

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.5
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• pp.361-366
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• 2009

Purpose: The purpose of this retrospective report was to analyze long-term survival rate of sintered porous-surfaced dental implant ($Endopore^{(R)}$ Dental Implant system, Innova Corporation, Toronto, ON, Canada). Methods: 61 partially edentulous patients were received a total of 127 Endopore dental implants in the maxilla. Of the 127 implants, 24 implants were restored with individual (ie, non-splinted) crowns, while 103 implants were splinted to other implants. Medical records and radiographs were evaluated and analyzed by the cumulative survival rate, location of implants, implants length and diameter, crown/implant ratio and whether the implant was splinted. Chi squire test was used statistically. Result: Of the 127 implants, 8 implants (6.3%) were removed and and cumulative survival rate was 93.7%. Conclusion: Endopore implants showed satisfactory results after up to 8 years function periods in the edentulous posterior maxilla.

• The Journal of Advanced Prosthodontics
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• v.14 no.2
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• pp.108-121
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• 2022

PURPOSE. The purpose of this study was to evaluate survival rates and marginal bone loss (MBL) of implants in IC-RPDs. MATERIALS AND METHODS. Seventy implants were placed and used as surveyed crowns in 30 RPDs. The survival rates and MBL around implants based on multiple variables, e.g., position, sex, age, opposing dentitions, splinting, type of used retainer, and first year bone loss, were analyzed. Patient reported outcome measures (PROMs) regarding functional/esthetic improvement after IC-RPD treatment, and complications were also inspected. RESULTS. The 100% implant survival rates were observed, and 60 of those implants showed MBL levels less than 1.5 mm. No significant differences in MBL of implants were observed between implant positions (maxilla vs. mandible; P = .341) and type of used retainers (P = .630). The implant MBL of greater than 0.5 mm at 1 year showed significantly higher MBL after that (P < .001). Splinted implant surveyed crowns showed lower MBL in the maxilla (splinted vs. non-splinted; P = .037). There were significant esthetic/functional improvements observed after treatment, but there were no significant differences in esthetic results based on implant position (maxilla vs. mandible). Implants in mandible showed significantly greater improvement in function than implants in the maxilla (P = .002). Prosthetic complication of IC-RPD was not observed frequently. However, 2 abutment teeth among 60 were failed. The bone loss of abutment teeth was lower than MBL of implants in IC-RPDs (P = .001). CONCLUSION. Class I RPD connected to residual teeth and strategically positioned implants as surveyed crowns can be a viable treatment modality.