• 대한치과기공학회지
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• 제45권4호
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• pp.124-130
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• 2023

This study aims to describe the clinical experience of single and bridge crowns fabricated using a cementless screw-retained implant prosthesis system. In the case of single crown (#37), regular link (HDL) was used, and bridge crowns (#15~#24), (#26~#27), (#17~#14) (#24~#26) were fabricated by selecting regular link and short link considering the vertical height. One abutment was hex shaped to ensure that it could be mounted while preventing insertion and prosthesis rotation. The advantages of cementless implant prosthesis include shorter chair time and periodic care, strong retention with LINK abutment, safety from inflammation, bacterial infection, and complications due to peri-implant cement, and high patient satisfaction. Dentists should double-check the position of the implant fixture and dental technicians should continuously manage the fit of the link and prosthesis with digital equipment to reduce screw loosening and fractures.

• The Journal of Advanced Prosthodontics
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• 제8권6호
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• pp.494-503
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• 2016

PURPOSE. The aim of this study was to compare the efficacies of two-implant splinting (2-IS) and single-implant restoration (1-IR) in the first and second molar regions over a mean functional loading period (FLP) of 40 months, and to propose the appropriate clinical considerations for the splinting technique. MATERIALS AND METHODS. The following clinical factors were examined in the 1-IR and 2-IS groups based on the total hospital records of the patients: sex, mean age, implant location, FLP, bone grafting, clinical crown-implant ratio, crown height space, and horizontal distance. The mechanical complications [i.e., screw loosening (SL), screw fracture, crown fracture, and repeated SL] and biological complications [i.e., peri-implant mucositis (PM) and peri-implantitis (PI)] were also evaluated for each patient. In analysis of two groups, the chi-square test and Student's t-test were used to identify the relationship between clinical factors and complication rates. The optimal cutoff value for the FLP based on complications was evaluated using receiver operating characteristics analysis. RESULTS. In total, 234 patients with 408 implants that had been placed during 2005 - 2014 were investigated. The incident rates of SL (P<.001), PM (P=.002), and PI (P=.046) differed significantly between the 1-IR and 2-IS groups. The FLP was the only meaningful clinical factor for mechanical and biological complication rates in 2-IS. CONCLUSION. The mechanical complication rates were lower for 2-IS than for 1-IR, while the biological complication rates were higher for 2-IS. FLP of 39.80 and 46.57 months were the reference follow-up periods for preventing biological and mechanical complications, respectively.

• Journal of Periodontal and Implant Science
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• 제54권2호
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• pp.108-121
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• 2024

Purpose: The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. Methods: Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. Results: Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. Conclusions: Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권1호
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• pp.60-71
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• 2008

The objective of this study is to evaluate the stress distribution according to the thread design and the marginal bone loss of a single unit dental implant under the axial and offset-axial loading by three dimensional finite element analysis. The implants used had the diameter of 5mm and 4mm with 13mm in length and prosthesis with a conical type which is 6mm in height and 12mm in diameter. The thread designs were triangular, square and buttress. In the three dimensional finite element model with $15\times15\times20mm$ hexahedron and 2mm cortical thickness, implants were placed with crown to root ratio 7:12, 10:9, 13:6 and 16:3. And additionally the axial force of 100N were applied into 0mm, 2mm and 4mm away from the center of the implants. The results were as follows 1. The maximum von-Mises stress in cortical bone was concentrated to cervical area of implant, and in cancellous bone, apical portion. 2. Comparing the von-Mises stresses in cortical bone of 2mm and 4mm offset loading with central axial loading, it were increased to 3 and 5 times in diameter 4mm implant, and 2 and 4 times, in diameter 5mm implant. 3. The square threads were more effective than the triangular and butress as the longer diameter, the offset loading, and the worse crown to root ratio. 4. The von-Mises stresses were relatively stable until crown to root ratio 13:6, but it was suddenly increased at 16:3. From the results of this study, minimum requirement of crown to root ratio of implant is 2:1, and in the respect of crown to root ratio, diameter and offset loading, square threads are more effective than triangular and buttress threads.

• 대한치과보철학회지
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• 제62권2호
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• pp.146-156
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• 2024

임플란트 보조 국소의치의 치료는 오래전부터 여러 형태로 시도되어 왔으며, 이 중 임플란트 서베이드 크라운 국소의치의 경우 점차 예지성을 얻고 있으며, 특히 경제적, 해부학적으로 불리한 부분 무치악 환자에게 한 가지 치료 방법이 될 수 있다. 이때 임플란트의 식립 위치는 치료 목적에 따라 전방 식립과 후방 식립으로 분류될 수 있는데, 이는 환자의 치조제, 잔존치 예후, 대합치 등 여러 상황을 고려하여 결정되어야 한다. 본 증례에서는 하악 Kennedy 1급 부분 무치악 환자에게 두 개의 임플란트 서베이드 크라운을 활용한 하악 임플란트 보조 국소의치를 통해 수복하였다. 본 환자에게 후방 식립이 어렵다는 점과 잔존치의 예후를 고려하여 임플란트를 잔존치에 근접한 부위에 두 개를 식립하는 것이 계획되었으며, 가이드 수술을 통해 계획한 위치, 각도, 깊이에 식립되었다. 고정성 보철물 제작 과정은 상악 무치악 치아 배열 과정과 병행하여 예지성을 높였고, 국소의치를 제작 시에는 임플란트가 최후방 지대치로서 과도한 하중이 가하지 않도록 기능 운동을 허용하는 형태로 디자인되고, 이차 인상 과정을 거쳐 제작되었다. 각 치료 과정을 계획한대로 진행하여 환자와 술자 모두 심미적, 기능적으로 만족스러운 결과를 얻었기에 이를 보고하는 바이다.

• 대한치과교정학회지
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• 제44권4호
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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 Advanced Prosthodontics
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• 제13권3호
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• pp.172-179
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• 2021

Purpose. This intra-patient retrospective study of up to 10 years evaluated the clinical success and risk factors of 6- and 8-mm long implants and their respective prostheses. Materials and Methods. The sample consisted of patients treated at a Military Polyclinic dental service, who received both 6- and 8-mm long tissue level implants in the posterior region of the same arch. Data were collected from the dental charts, clinical and radiographic exams, self-report of sleep bruxism, measurement of maximum occlusal force, and clinical crown-to-implant (C/I) ratio. Data were analyzed by descriptive and inferential statistics with univariate and hierarchical multivariate models, at the 0.05 significance level. Results. The 30 patients (27 women) had 85 implants and 83 prostheses. Two implants were lost before prosthesis installation (implant survival: 97.6%). Ten events of prosthetic complication (screw tightening loss) occurred in five patients (success rate: 87.9%) in a single moment. Only the variable C/I ratio had a significant effect for repairable prosthesis complication (P<.05). Conclusion. The results suggest that 6- and 8-mm long implants have similar long-term clinical success for implants and prostheses.

• The Journal of Advanced Prosthodontics
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• 제16권4호
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• pp.231-243
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• 2024

PURPOSE. The objective of the study was to analyze the impact of cement, bonding pretreatment, and ceramic abutment material on the overall color results of CAD-CAM ceramic crowns bonded to titanium-based hybrid abutments. MATERIALS AND METHODS. For single implant restoration of a maxillary lateral incisor a total of 51 CAD-CAM-fabricated monolithic lithium disilicate crowns were fabricated and subsequently bonded onto 24 lithium disilicate Ti-base abutments, 24 zirconia Ti-base abutments and 3 resin abutment replicas as a control group. The 48 copings were cemented with three definitive and one provisional cement on both grit-blasted and non-blasted Ti-bases. The color of each restoration and surrounding artificial gingiva was measured spectrophotometrically at predefined measuring points and the CIELAB (ΔE_ab) color scale values were recorded. RESULTS. The color outcome of ceramic crowns bonded to hybrid abutments and soft tissues was affected differently by cements of different brands. Grit-blasting of Ti-bases prior to cementing CAD-CAM copings affected the color results of allceramic crowns. There was a significant difference (P = .038) for the median ΔE value between blasted and non-blasted reconstructions at the cervical aspect of the crown. Full-ceramic crowns on zirconia Ti-base abutments exhibited significantly lower ΔE values below the threshold of visibility (ΔE 1.8). In all subcategories tested, the use of a highly opaque temporary cement demonstrated the lowest median ΔE for both the crown and the artificial gingiva. CONCLUSION. Various cements, core ceramic materials and airborne particle abrasion prior to bonding can adversely affect the color of Ti-base supported ceramic crowns and peri-implant soft tissue. However, zirconia CAD-CAM copings and an opaque cement can effectively mask this darkening.

• 대한치과보철학회지
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• 제42권2호
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• pp.226-237
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• 2004

Purpose: Four finite element models were constructed in the mandible having a single implant fixture connected to the first premolar-shaped superstructure, in order to evaluate how the shape of the fixture and the implant-abutment connection would influence the stress level of the supporting tissues fixtures, and prosthethic components. Material and methods : The superstructures were constructed using UCLA type abutment, ADA type III gold alloy was used to fabricate a crown and then connected to the fixture with an abutment screw. The models BRA, END , FRI, ITI were constructed from the mandible implanted with Branemark, Endopore, Frialit-2, I.T.I. systems respectively. In each model, 150 N of vertical load was placed on the central pit of an occlusal plane and 150 N of $40^{\circ}$ oblique load was placed on the buccal cusp. The displacement and stress distribution in the supporting tissues and the other components were analysed using a 2-dimensional finite element analysis . The maximum stress in each reference area was compared. Results : 1. Under $40^{\circ}$ oblique loading, the maximum stress was larger in the implant, superstructure and supporting tissue, compared to the stress pattern under vertical loading. 2. In the implant, prosthesis and supporting tissue, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 3. In the superstructure and implant/abutment interface, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 4. In the implant fixture, the maximum stress was smaller with the internal connection type (FRI) and the morse taper type (ITI) when compared to that of the external connection type (BRA & END). 5 The stress was more evenly distributed in the bone/implant interface through the FRI of trapezoidal step design. Especially Under $40^{\circ}$ oblique loading, The maximum stress was smallest in the bone/implant interface. 6. In the implant and superstructure and supporting tissue, the maximum stress occured at the crown loading point through the ITI. Conclusion: The stress distribution of the supporting tissue was affected by shape of a fixture and implant-abutment connection. The magnitude of maximum stress was reduced with the internal connection type (FRI) and the morse taper type (ITI) in the implant, prosthesis and supporting tissue. Trapezoidal step design of FRI showed evenly distributed the stress at the bone/implant interface.

• Journal of Periodontal and Implant Science
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• 제34권4호
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• pp.819-836
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• 2004

Nowdays, the awareness of implant treatment has grown rapidly among dentists and patients alike in Korea, as it becomes a widely accepted treatment. The reason is that unlike crown and bridge or denture treatment, implant treatment helps preserve existing bone and improve masticatory functions. So, It is needed understanding about the type, distribution of implant patient. The following results on patient type and implant distribution were compiled from 4433 implant cases of 1596 patients treated at the periodontal dept. of Y University Hospital during 1992 to 2004. 1. There are no dissimilarities between men and women, with patients in their 40, 50s accounting for 52.5% of patients and 57.5% of implant treatments; the largest share of patients and implant treatments. 2. Mn. posterior area accounted for 54.9% of implant treatments followed by Mx. posterior area(27.6%), Mx anterior area(11.9%) and Mn anterior area(5.6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 97.5% and fully edentulous patient accounted for the remaining 2.5%. 4. The major cause of tooth loss is periodontal disease, followed by dental caries, trauma and congenital missing. Also, older people are more likely to suffer from tooth loss due to periodontal disease rather than dental caries. 5. In the distribution of bone quality for maxillae, type III was most, followed by type II, r type IV and r type I. As for mandible, type II was most, followed by type III, type IV and for type I. 6. In the distribution of bone quantity for maxillae, type C was most, followed by type B, type D, type A, and for type E. As for mandible, type B was 52% most, followed by type C, type D, type A and type E. 7. The majority of implants were those of 1O-14mm in length (85.2%) and regular diameter in width (64%). The results provided us with basic data on patient type, implant distribution, bone condition, etc. We wish that our results coupled with other research data helps assist in the further study for better implant success/survival rates, etc.