• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.125-137
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• 2003

The use of screw-retaind prosthesis on an osseointegrated implant is a popular treatment modality offering relative ease in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and lab technician. This article offers pratical solutions to minimize this clinical problem and describes the factors involved in maintaining a stable screw joint assembly. To avoid joint failure, adherence to specific clinical, as well as mechanical, parameters is critical. With respect to hardware, optimal tolerance and fit, minimal rotational play, best physical properties, a predictable interface, and optimal torque application are mandatory. In the clinical arena, optimal implant distribution; load in line with implant axis; optimal number, diameter, and length of implants; elimination of cantilevers; optimal prosthesis fit; and occlusal load control are equally important.

• Journal of Technologic Dentistry
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• v.30 no.2
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• pp.57-63
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• 2008

Statement of problem: Conventional techniques for implant framework fabrication produce significant error that is inconsistent with passive-fit requirement for osseointegrated implants. One of the etiologic factors which cause the errors is a sprue which may deform the framework during solidification and contraction. Purpose: This study was aimed to evaluate objectively effect of the sprue design on the accuracy of fit of implant prosthesis. Materials and method: Three different designs were considered relative to effect of casting accuracy. The first design had straight sprues and a button of excess alloy at the non-casting end of the sprues. The second was runner bar design(with the button). The last was straight sprues design(without the button). Gold cylinder and laboratory analogue had been used to diminish variables affecting to casting accuracy. Gold alloy and pressure-vacuum casting machine had been used. Marginal gap had been measured by SEM. One-way ANOVA and Duncan test had been used for statistical analysis. Results: The first design showed $79.87{\pm}13.95{\mu}m$ marginal gap. The second and third were $40.17{\pm}15.8{\mu}m$ and $35.17{\pm}9.95{\mu}m$ respectively. Conclusion: Straight sprues without button and runner bar designs were more accurate than straight sprues with button design(P<.05).

• Journal of Korean Dental Science
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• v.6 no.1
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• pp.27-33
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• 2013

The introduction of osseointegrated dental implants in dentistry brought about a new era in everyday dental practice. For the past 50 years, prosthetic restoration with implant-supported prosthesis has developed into a viable and predictable treatment option. Alongside the increasing use of dental implants is the occurrence of many complications during implant placement (surgery), in the mechanical or prosthetic problem, and in the biological aspect. In particular, abutment or screw fracture as one of the mechanical complications can put the dentist in a tight spot in a clinical situation. It is hard to remove the fractured abutment and screw to restore it properly. Therefore, it is very important that clinicians consider possible complications in advance and make an appropriate treatment plan. We discuss cases of abutment fracture and mechanical/prosthetic complications together with the causes and solutions.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.3
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• pp.55-74
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• 1991

The purpose of this study was to investigate the influence of early functional load around osseointegrated titanium implants. 24 titanium plasma spray coated implants (ITI HS-type) were placed into the previously extracted site in the mandible of six adult dogs. The implants were divided into three groups : the control group was the implants without abutment during the experimental period; the experimental group I was loaded by connecting the contoured abutment after 6 weeks of healing; the experimental group II was loaded after 12 weeks of healing: and the mandibular second premolar and surrounding tissues were selected for natural tooth group to compare the implanted group. All dogs were injected intravenously tetracycline, alizarin red S, and calcein for bone labeling. After the experimental period of 18 weeks, the dogs were sacrificed and longitudinal sections of the bone-implant interface were cut and observed using light microscope, scanning electron microscope, and fluorescence microscope. The results of the study were as follows: 1. Light and scanning electron microscopically, all implant surfaces were well contact with bone tissue at the cortical layer, but some areas of cancellous bone were not contact directly. 2. Fluorescence microscopically, number and size of the new secondary osteons around the implant were increased than those of the natural tooth. 3. Fluorescence microscopically, linear and concentrical fluorescence was observed at or near the surface of all implants, and the bone formation and remodeling of the implants loaded after 6 week of healing were great, and unloaded implants were worst. 4. Fluorescence microscopically, endosteal bone formation was greater than periosteal bone formation at or near the implants. 5. Fluorescence microscopically, number and size of linear and concentric fluorescence was increased at the lingual side than the buccal side of the loaded implants. The result of the study indicate the possibility of the early load to the implant via a prosthesis.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.349-357
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• 2015

Edentulous patients with a severely resorbed mandible or maxilla often experience problems with conventional dentures, such as insufficient stability and retention, together with a decrease in chewing ability. Because of the good prognosis of dental implants, these patients can be successfully treated with implant-retained or implant-supported prosthesis. Ideally, a maximum number of implants of maximum length are placed in appropriate surgically prepared sites that are surrounded by a maximum amount of bone of favorable quality. The implants are favorably aligned faciolingually and mesiodistally to enhance optimal prosthodontic design. This article describes the clinical problems and complications encountered when treating a consecutive number of edentulous patients with osseointegrated implant-supported prostheses.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.1
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• pp.57-70
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• 2004

The significance of occlusion has regained its popularity in dentistry with the introduction of implant therapy. Literature has reported that the clinical success and longevity of dental implants can be achieved by biomechanically controlled occlusion. Occlusal overload is known to be one of the main causes for implant failure. Evidences have suggested that occlusal overload contribute to early implant bone loss as well as deosseointegration of successfully integrated implants. Unlike natural teeth, osseointegrated implants are ankylosed to surrounding bone without the periodontal ligament (PDL) which provides mechanoreceptors as well as shock-absorbing function. Moreover, the crestal bone around dental implants may act as a fulcrum point for lever action when a force (bending moment) is applied, indicating that implants/implant prosthesis could be more susceptible to crestal bone loss by applying force. Hence, it is essential for clinicians to understand inherent differences between teeth and implants and how force, either normal or excessive force, may influence on implants under occlusal loading. The purposes of this paper are to review the importance of implant occlusion, to establish the optimum implant occlusion with biomechanical rationale, to provide clinical guidelines of implant occlusion and to discuss how to manage complications related to implant occlusion.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.1
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• pp.43-48
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• 2003

During the past several years, significant advances have occurred in the utilization of osseointegrated implants for the treatment of partially edentulous patients. One of the biggest purposes for treating of these patients is the high demand for improved esthetics, especially in the anterior region. For this esthetics, the new trend in dental implants is the immediate placement and immediate superstructure fabrication. The refined surgical technique, the skillful soft tissue management, and the proper prosthetic coordination are the main factors to achieve natural looking of implant supported prosthesis. The customized provisional restoration and the customized impression coping are recommended for the optimal peri-implant soft tissue contour. The basic concept of Frialit 2 system was the immediate replacement of a tooth with root-analog fixture after extraction. This system guarantees an ideal result in function and esthetics. The ceramic abutment system offers improved quality in the respect of esthetics, fitness, translucency, and biocompatibility. In this clinical report, the final restoration made with IPS Empress 2 crown on the CeraBase abutmen of Frialit 2 system allowed the reproduction of the natural vitality of tooth and adjacent gingiva.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.1
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• pp.83-93
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• 2004

Statement of problem : Since the concept of osseointegrated dental implant by $Br{\aa}nemark$ et al was first applied to mandibular full edentulous patients. Recently it is considerated the first treatment option on missing teeth. A common problem associated with dental implant restorations is loosening of screws that retain the prosthesis to the abutment and the abutment to the implant fixture. Purpose : This study is to examine the influence on screw loosening of implant-abutment designs. Material and methods : External hex, cone screw, beveled hex, cam cylinder, cylinder hex by means of evaluating the loosening torques, with respect to a range of tightening torques after repeated loading. Result : 1. Cone screw, beveled hex groups are the highest initial tightening rate and cylinder hex, external hex groups are the lowest initial tightening rate (p < 0.05). 2. Cone screw groups are the highest after repeated loading tightening rate and cylinder hex groups are lowest after repeated loading tightening rate(p < 0.05). 3. Cone screw groups have the highest initial stability and anal stability. 4. All groups are decreased tightening rate after repeated loading.

• The Journal of the Korean dental association
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• v.58 no.8
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• pp.496-504
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• 2020

The osseointegrated implants react biomechanically in a different pattern to occlusal force, due to lack of the periodontal ligament unlike the natural teeth. The implants show markedly less movement and limited tactile sensitivity compared with the natural teeth. The implant occlusion concept aims to avoid overloading on the implants and to direct occlusal loads along the longitudinal axis of the implants, in order to compensate for the different biomechanics of the implants. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Moreover, the outcome of treatment often quite successful in spite of different concepts of occlusion and there is an increasing tendency to doubt about the strict theoretical implant-specific occlusion concept. The purpose of this article is to review the previous reports about the concept of implant occlusion and discuss clinical occlusal considerations in implant rehabilitations.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.23 no.5
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• pp.396-405
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• 2001

Osseointegrated implants are used for the fixation of dental prosthesis with good long-term clinical results. In an attempt to improve the quantity and quality of the bone-implant interface, numerous implant modification have been used. Implants surface modifications have been used such as titanium-plasma sprayed, hydroxyapatite-coating, sandblasted, sandblasted and acid-etched, acid-etched. Rough surface implants have greater implant surface area and enhance the bone-implant interface and improve stabilization. The purpose of present study was to evaluate light microscopic and scanning microscopic examinations and removal torque value of newly developed calcium phosphate blast and acid-etched implant in the femur of rabbits. Titanium plasma sprayed(TPS) implant served as controls. After 12 weeks of healing of the femurs of 12 rabitts, the implant-containing segments of femur were removed on bloc and bone block including sections. Histologic examination and histomorphometric and removal torque values comparision were made for two implants. Obtained results are follows: 1. Newly developed calcium phosphate blasted and acid-etched implants were in close contact with bone under light microscopic examinations. 2. New implants showed mean bone-to implant contact 59.8%, whereas TPS implants showed mean bone-to implant contact 54.5% (statistically no difference p<0.05). 3. New implants showed mean bone density 56.7%, whereas TPS implants showed mean bone density 49.2% (statistically difference p<0.05). 4. New implants demonstrated mean removal torque values 40.5Ncm, whereas the mean removal torque values of TPS implants ranged 39.3Ncm. No statistical differences(p<0.05) were observed between two groups of implants nor was there any difference between the two implants at the clinical level.