• Title/Summary/Keyword: Screw placement

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Improvement of fibrosed scar tissue elongation using self-inflatable expander

  • Jung, Gyu-Un;Kim, Jin-Woo;Pang, Eun-Kyoung;Kim, Sun-Jong
    • The Journal of the Korean dental association
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    • v.54 no.7
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    • pp.501-512
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    • 2016
  • We evaluated a self-inflatable osmotic tissue expander for its utility in creating sufficient soft tissue elongation for primary closure after bone grafting. Six patients with alveolar defects who required vertical augmentation of >6 mm before implant placement were enrolled. All had more than three prior surgeries, and flap advancement for primary coverage was restricted by severely fibrosed scars. Expanders were inserted beneath the flap and fixed with a screw. After 4 weeks, expander removal and bone grafting were performed simultaneously. A vertical block autograft and guided bone regeneration and distraction osteogenesis were performed. Expansion was sufficient to cover the grafted area without additional periosteal incision. Complications included mucosal perforation and displacement of the expander. All augmentation procedures healed uneventfully and the osseous implants were successfully placed. The tissue expander may facilitate primary closure by increasing soft tissue volume. In our experience, this device is effective, rapid, and minimally invasive, especially in fibrous scar tissue.

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THE MANAGEMENT OF A COMPLEX IMPLANT CASE USING CAD-CAM TECHNOLOGY: A CLINICAL REPORT

  • Park, Eun-Jin
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.634-638
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    • 2008
  • PURPOSE: The application of computer-aided technology to implant dentistry has created new opportunities for treatment planning, surgery and prosthodontic treatment, but the correct selection and combination of available methods may be challenging in times. Hence, the purpose of this case report is to present a combination of several computer-aided tools as approaches to manage complicated implant case. MATERIAL AND METHODS: A 47 year-old female patient with severe dental anxiety, high expectations, financial restrictions and poor compliance presented for a fixed rehabilitation. A CT scan with a radiographic template obtained with software (SimPlant, Materialize, Leuven, Belgium) was used for treatment planning. The surgical plan was created and converted into a stereolithographic model of the maxilla with bone-supported surgical templates (SurgiGuide, Materialise, Leuven, Belgium), that allowed for the precise placement of 7 implants in a severely resorbed edentulous maxilla. After successful osseointegration, an accurate scan model served as the basis for the fabrication of a one-piece milled titanium framework using the Procera (Nobel Biocare, Gothenburg, Sweden) technology. The final rehabilitation of the edentulous maxilla was rendered in the form of a screw-retained maxillary metal-reinforced resin-based complete prosthesis. RESULTS: Despite challenging circumstances, 7 implants could be placed without bone augmentation in a severely resorbed maxilla using the SimPlant software for pre-implant analysis and the SurgiGuide-system as the surgical template. The patient was successfully restored with a fixed full arch restoration, utilizing the Procera system for the fabrication of a milled titanium framework.

Retrospective Study of Sandblasted, Large-grit and Acid-etched Implant (Sandblasted, Large-grit and Acid-etched Implant에 대한 후향적 임상 연구)

  • Jo, Ji-Ho;Kim, Su-Gwan;Moon, Seong-Yong;Oh, Ji-Su;Park, Jin-Ju;Jung, Jong-Won;Yoon, Dae-Woong;Yang, Seong-Su;Jeong, Mi-Ae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.33 no.4
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    • pp.352-358
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    • 2011
  • Purpose: This study evaluated the prognosis and survival rate of SLA (Sandblasted, Large-grit and Acid-etched) implants and it also evaluated the prosthodontic complications and the associated factors. Methods: Twenty seven patients (14 men and 13 women, mean age: 54.9) who visited Chosun University Hospital Implant Center with the chief desire for placement of an implant in an edentulous area from March, 2008 to December 2008 and who received placement of a SLA implant ($Implantium^{(R)}$, Dentium Co., Korea) were selected for this study. Results: The average follow-up period was 15 months and the study was based on the treatment records, radiographs and clinical examinations. A total of 69 implant cases were retrospectively assessed for the width and length of the implant, the primary and secondary stability, the combined surgery, the employed bone graft material and barrier membrane, the status of the opposing tooth, implant failure and the prosthetic complications. During the follow-up period (average: 15 months), the accumulative survival rate of the 69 implants in 27 patients was 100%. Complications such as infection, sinusitis and fixture exposure after surgery were seen for 5 implants in 4 patients. Complications such as screw loosening, contact loosening and peri-implant gingivitis after prosthodontic treatment occurred in 7 cases (10.14%). Conclusion: This study reports placement of SLA implants may cause various complications, yet the final accumulative survival rate was 100%. The SLA implant ($Implantium^{(R)}$) has an excellent clinical survival rate and outcome.

EFFECTS OF DIFFERENT OXIDIZED SURFACES OF IMPLANT ON OSSEOINTEGRATION; RESONANCE FREQUENCY AND HISTOMORPHOMETRIC ANALYSIS STUDY IN MINI-PIGS (다양한 양극산화막 처리방법이 임플란트 골유착에 미치는 영향)

  • Kwon, Kyung-Hwan;Min, Seung-Ki;Sung, Dae-Hyuk;Choi, Jae-Young;Choi, Seung-Lim;Cha, Su-Ryeon;Oh, Hee-Kyun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.5
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    • pp.383-393
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    • 2007
  • The aim of the present study is to investigate the effect of anodized surface of osseointegration implants by using of resonance frequency analysis (RFA) and histomorphometric analysis. A total of 96 screw-shaped implants were devided into 4 groups. Seventy-two implants were prepared by electrochemical oxidation with 3 different ways; Group 1 (n=24) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid, Group 2 (n=24) were prepared at galvanostatic mode in calcium glycerophosphate and calcium acetate, and Group 3 (n=24) were prepared at galvanostatic mode in 0.25M sulfuric acid and phosphoric acid followed by Calcium metaphosphate(CMP) coating. Control group (n=24) were the RBM surfaced implants. The implants were placed in the mandibles of 12 mini pigs. Bone tissue responses were evaluated by resonance frequency analysis(RFA) and histomorphometric analysis that were undertaken at 2, 4 and 6weeks after implant placement. The following result were obtained. 1. Twenty-two of 96 implants (4 in control group, 5 in group 1, 7 in group 2, and 6 in group 3) were failed due to faliure of osseoitegration. The failure rate of osseointegration was 22.9%. 2. The mean values of RFA in control, group 2 and groups 3 showed the similar values, but there was no significant difference among groups. 3. Histomorphometric evaluation demonstrated significantly higher bone-to-implant contact ratio in group 2 at 3 and 4 weeks after implant placement than other groups (p<0.05), but there was no significant difference among groups at 6weeks after implant placement.

Concept and application of implant connection systems: Part I. Placement and restoration of internal conical connection implant (임플란트 연결부의 개념과 적용: Part 1. 원추형 내부연결 임플란트의 식립과 보철)

  • Ko, Kyung-Ho;Kang, Hyeon-Goo;Huh, Yoon-Hyuk;Park, Chan-Jin;Cho, Lee-Ra
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.211-221
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    • 2020
  • The typical biomechanical properties of an internal conical connection (ICC) are axial displacement and loss of preload. The axial displacement of an ICC without a vertical stop can cause the loss of preload and a lowered occlusion. The stress of an ICC is concentrated on the contact interface of the abutment and not on the screw, and during placement, it is important to choose a wider coronal wall thickness as much as possible. The ICC should also be placed below the level of the bone crest. During the restoration of an ICC, care should be taken to ensure an appropriate abutment shape and an accurate connection. To get the best clinical results, it is important to select its wall thickness and place it in the appropriate position to restore it adequately.

Full mouth rehabilitation of edentulous patient with fixed implant prosthesis (고정성 임플란트 보철물을 이용한 완전 무치악 환자의 구강회복 증례)

  • Shi, Hee-Hyun;Kim, Jong-Jin;Baik, Jin;Cha, Hyun-Suk;Lee, Joo-Hee
    • Journal of Dental Rehabilitation and Applied Science
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    • v.37 no.3
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    • pp.147-156
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    • 2021
  • There are various treatment options such as conventional complete denture, hybrid prosthesis and implant-supported fixed prosthesis for fully edentulous patients. In case of implant-supported fixed prosthesis, compared to removable prosthesis, it is difficult to place the implant in the correct position considering the anatomical contours of the final prosthesis. In this case, a full mouth rehabilitation with implant-supported fixed prosthesis was performed for a patient who required extraction of all remaining teeth due to dental caries and chronic periodontitis. In the implant placement stage, the implant was placed in the desired position using a surgical guide fabricated considering the anatomical contours of the final prosthesis, and the function and esthetics were evaluated through correction and re-fabrication of the fixed provisional restoration. A final restoration of porcelain fused to gold prosthesis was delivered to the patient based on the provisional restoration. To cope with complications such as loosening of screws and fracture of porcelain, a screw-retained type prosthesis was fabricated for the posterior part and a screw-cement-retained type prosthesis for the anterior part. As a result, the patient showed an improved prognosis in terms of functional and esthetics after the final prosthesis was delivered.

Finite element analysis of cortical bone strain induced by self-drilling placement of orthodontic microimplant (Self-drilling 방식의 마이크로임플란트 식립에 의해 발생하는 피질골 스트레인의 유한요소해석)

  • Park, Jin-Seo;Yu, Won-Jae;Kyung, Hee-Moon;Kwon, Oh-Won
    • The korean journal of orthodontics
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    • v.39 no.4
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    • pp.203-212
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    • 2009
  • Objective: The aim of this study was to evaluate the strain induced in the cortical bone surrounding an orthodontic microimplant during insertion in a self-drilling manner. Methods: A 3D finite element method was used to simulate the insertion of a microimplant (AbsoAnchor SH1312-7, Dentos Co., Daegu, Korea) into 1 mm thick cortical bone. The shape and dimension of thread groove in the center of the cortical bone produced by the cutting flute at the apical of the microimplant was obtained from animal test using rabbit tibias. A total of 3,600 analysis steps was used to calculate the 10 turns and 5 mm advancement of the microimplant. A series of remesh in the cortical bone was allowed to accommodate the change in the geometry accompanied by the implant insertion. Results: Bone strains of well higher than 4,000 microstrain, the reported upper limit for normal bone remodeling, were observed in the peri-implant bone along the whole length of the microimplant. Level of strains in the vicinity of either the screw tip or the valley part were similar. Conclusions: Bone strains from a microimplant insertion in a self-drilling manner might have a negative impact on the physiological remodeling of cortical bone.

Bone-to-Implant Contact according to the Surface Roughness of the Implants (임플란트의 표면조도가 골융합에 미치는 영향)

  • Choi, Kwi-Hyun;Herr, Yeek;Lee, Man-Sub;Kwon, Young-Hyuk
    • Journal of Periodontal and Implant Science
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    • v.33 no.4
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    • pp.717-728
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    • 2003
  • This study was performed to evaluate the difference of the bone-to-implant contact according to the surface roughness of the implants. Two beagles were used in the experiment. Extraction of the all premolars was performed in the mandible. In 3 months of healing, screw-shaped pure titanium machined surface implants (Implantium(R), Dentium Co. Korea), implants blasted with 45${\mu}m$ $TiO_2$ particles, (Implantium(R), Dentium Co. Korea) and implants blasted with 100${\mu}m$ $TiO_2$ particles (Implantium(R), Dentium Co. Korea) in diameter 3.4mm and length 6mm were installed in the edentulous mandible. Each dog was sacrificed at 4, 12 weeks after placement and then nondecalcified specimens were prepared for histologic analysis. The results of this study were as follows. 1. At 4 , 12 weeks after the surgery, bone-to-implant contact in the surface blasted with $TiO_2$ particles was higher than that in the pure titanium machined surface respectively. 2. Osseointegration in the surface blasted with 45${\mu}m$ $TiO_2$ particles was more increased than that in the surface blasted with 100${\mu}m$ $TiO_2$ particles. 3. Bone-to-implant contact was increased with time independent of surface roughness. 4. Bone formation was in the outfolded area more than inside the threads independent of surface roughness. From the above results, we were able t o find the most bone-to-implant contact in 45${\mu}m$ $TiO_2$ blasted implant.

New Technical Tip for Anterior Cervical Plating : Make Hole First and Choose the Proper Plate Size Later

  • Park, Jeong-Yoon;Zhang, Ho-Yeol;Oh, Min-Chul
    • Journal of Korean Neurosurgical Society
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    • v.49 no.4
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    • pp.212-216
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    • 2011
  • Objective : It is well known that plate-to-disc distance (POD) is closely related to adjacent-level ossification following anterior cervical plate placement. The study was undertaken to compare the outcomes of two different anterior cervical plating methods for degenerative cervical condition. Specifically, the new method involves making holes for plate screws first with an air drill and then choosing a plate size. The other method was standard, that is, decide on the plate size first, locate the plate on the anterior vertebral body, and then drilling the screw holes. Our hypothesis was that the new technical tip may increase POD as compared with the standard anterior cervical plating procedure. Methods : We retrospectively reviewed 49 patients who had a solid fusion after anterior cervical arthrodesis with a plate for the treatment of cervical disc degeneration. Twenty-three patients underwent the new anterior cervical plating technique (Group A) and 26 patients underwent the standard technique (Group B). POD and ratios between POD to anterior body heights (ABH) were measured using postoperative lateral radiographs. In addition, operating times and clinical results were reviewed in all cases. Results : The mean durations of follow-up were $16.42{\pm}5.99$ (Group A) and $19.83{\pm}6.71$ (Group B) months, range 12 to 35 months. Of these parameters mentioned above, cephalad POD (5.43 versus 3.46 mm, p=0.005) and cephalad POD/ABH (0.36 versus 0.23, p=0.004) were significantly greater in the Group A, whereas operation time for two segment arthrodesis (141.9 versus 170.6 minutes, p=0.047) was significantly lower in the Group A. There were no significant difference between the two groups in caudal POD (5.92 versus 5.06 mm), caudal POO/ABH (0.37 versus 0.32) and clinical results. Conclusion : The new anterior cervical plating method represents an improvement over the standard method in terms of cephalad plate-to-disc distance and operating time.

Is Titanium Mesh Cage Safe in Surgical Management of Pyogenic Spondylitis?

  • Heo, Won;Kang, Dong-Ho;Park, Kyung-Bum;Hwang, Soo-Hyun;Park, In-Sung;Han, Jong-Woo
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.357-362
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    • 2011
  • Objective : To report our experience with pyogenic spondylitis treated with anterior radical debridement and insertion of a titanium mesh cage and to demonstrate the effectiveness and safety of the use of a titanium mesh cage in the surgical management of pyogenic spondylitis. Methods : We retrospectively analyzed the clinical characteristics of 19 patients who underwent surgical treatment in our department between January 2004 and December 2008. The average follow-up period was 11.16 months (range, 6-64 months). We evaluated risk factors, cultured organisms, lab data, clinical outcomes, and radiographic results. Surgical techniques for patients with pyogenic spondylitis were anterior radical debridement and reconstruction with titanium mesh cage insertion and screw fixation. All patients received intravenous antibiotics for at least 6 weeks postoperatively, and some patients received oral antibiotics. Results : The infections resolved in all of the patients as noted by normalization of their erythrocyte sedimentation rates and C-reactive protein levels. The mean pain score on a Visual Analog Scale was 7.8 (range, 4-10) before surgery and 2.4 (range, 1-5) after surgery. The Frankel grade was improved by one grade in seven patients. After surgery, the average difference of the angle was improved about $6.96^{\circ}$ in all patients. At the last follow-up, the mean loss of correction was $4.86^{\circ}$. Conclusion : Anterior radical debridement followed by the placement of instrumentation with a titanium mesh cage may be a safe and effective treatment for selected patients with pyogenic spondylitis. This surgical therapy does not lead to recurrent pyogenic spondylitis.