• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.2
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• pp.154-166
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• 2004

Statement of problem: In distal extension removable partial denture, the preservation of health of abutment teeth are very important, but they are always subjected to unfavorable stress. Purpose: The purpose of this study was performed to investigate the effects of abutment splinting and design of direct retainer on the stress distribution of abutments in unilateral distal extension removable partial dentures. Material and method: Abutments were splinted by different method. In group 1, autment teeth were not splinted, in group 2, canine and 1st premolar were splinted, and in group 3, canine, 1st and 2nd premolars were all splinted. Three different types of direct retainer such as Akers clasp, RPI clasp, and wrought wire clasp were designed. Strain was measured with Switch & Balance Unit(SB-10, Measurement Group Instruments Division, Raleigh USA) and Strain Indicator(P-3500, Measurement Group Instruments Division, Raleigh, USA) 15kg of vertical and oblique loads was applied at central fossa of missing 2nd molar area. Results : The strain on lingual side of 2nd premolar was the greatest, and abutment splinting induced decrease of strain on buccolingual side of 2nd premolar. The strain of loaded area was decreased by abutment splinting and there was no statistical difference of strain between Group2 and Group 3, and strain on 2nd premolar in wrought wire clasp was the least. Conclusion: Within the limitations of this study, splinting of two distal abutment teeth is enough for stress distribution widely, and wrought wire clasp was more benefitable than others.

• 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 Advanced Prosthodontics
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• v.10 no.2
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• pp.138-146
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• 2018

PURPOSE. The purpose of this study was to analyze the effects of the splinted implant prosthesis in a reconstructed mandible using three-dimensional finite element analysis. MATERIALS AND METHODS. Three-dimensional finite element models were generated from a patient's computed tomography data. The patient had undergone partial resection of the mandible that covered the area from the left canine to the right condyle. The mandible was reconstructed using a fibula bone graft and dental implants. The left mandibular premolars and molars remained intact. Three types of models were created. The implant-supported prosthesis was splinted and segmented into two or three pieces. Each of these models was further subcategorized into two situations to compare the stress distribution around normal teeth and implants. Oblique loading of 300 N was applied on both sides of the mandible unilaterally. The maximum von Mises stress and displacement of the models were analyzed. RESULTS. The stress distribution of the natural mandible was more uniform than that of the reconstructed fibula. When the loading was applied to the implant prosthesis of reconstructed fibula, stress was concentrated at the cortical bone around the neck of the implants. The three-piece prosthesis model showed less uniform stress distribution compared to the others. Displacement of the components was positively correlated with the distance from areas of muscle attachment. The three-piece prosthesis model showed the greatest displacement. CONCLUSION. The splinted implant prosthesis showed a more favorable stress distribution and less displacement than the separated models in the reconstructed mandible.

• 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.

• 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.

• 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).

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.201-208
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• 2008

Statement of problem: A new implant impression technique which use abutments as impression coping, and use resin cement as a splinting material was described. Accuracy of this technique was compared with conventional closed tray and resin splinted open tray technique for a $15^{\circ}$ angled 3-implant model Material and methods: A dental stone master model with 3 linearly positioned implant analogue and a reference framework which was passively fitted to it were fabricated. The center analogue was perpendicular to the plane of model and the outer analogues had a $15^{\circ}$angulation forward or backward. 10 closed tray impressions, 10 resin splinted open tray impressions, 10 abutment-resin framework cementation impressions and 10 abutment-metal framework cementation impressions were made with additional silicone material and poured with dental stone. A light microscope with image processing was used to record the vertical gap dimension between reference framework and analogue of duplicated cast made with each 4 impression techniques. Statistical analysis used one-way ANOVA with post-hoc tests Tukey test of .05 level of significance Results: Significant difference in the vertical gap dimension was found between closed tray technique; 74.3 (${\pm}33.4$)${\mu}m$ and resin splinted open tray technique, and two other new technique. (P<.05) Abutment-metal framework cementation technique;42.5 (${\pm}11.9$)${\mu}m$ was significantly different from resin splinted open tray technique. (P<.05) Abutmentresin framework cementation technique;51.0 (${\pm}14.1$)${\mu}m$ did not differ significantly from resin splinted open tray technique;50.3 (${\pm}16.9$)${\mu}m$. (P>.05) Conclusion: Within limitations of this study, the accuracy of implant level impressions of resin splinted open tray technique was superior to that of closed tray technique. A new technique using abutment and metal framework cementation was more accurate than resin splinted open tray technique.

• 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.

• The Journal of Advanced Prosthodontics
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• v.15 no.6
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• pp.290-301
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• 2023

PURPOSE. The study aimed to determine the influence of implant angulation on the trueness of multi-unit implant impressions taken through different techniques and strategies. MATERIALS AND METHODS. As reference models, three partially edentulous mandibular models (Model 1: No angulation; Model 2: No angulation for #33, 15-degree distal angulation for #35 and #37; Model 3: No angulation for #33, 25-degree distal angulation for #35 and #37) were created by modifying the angulations of implant analogues. Using a lab scanner, these reference models were scanned. The obtained data were preserved and utilized as virtual references. Three intraoral scanning (IOS) strategies: IOS-Omnicam, ISO-Quadrant, and IOS-Consecutive, as well as two traaditional techniques: splinted open tray (OT) and closed tray (CT), were used to create impressions from each reference model. The best-fit alignment approach was used to sequentially superimpose the reference and test scan data. Computations and statistical analysis of angular (AD), linear (LD), and 3D deviations (RMS) were performed. RESULTS. Model type, impression technique, as well as interaction factor, all demonstrated a significant influence on AD and LD values for all implant locations (P < .05). The Model 1 and SOT techniques displayed the lowest mean AD and LD values across all implant locations. When considering interaction factors, CT-Model 3 and SOT-Model 1 exhibited the highest and lowest mean AD and LD values, respectively. Model type, impression technique, and interaction factor all revealed significant effects on RMS values (P ≤ .001). CT-Model 3 and SOT-Model 1 presented the highest and lowest mean RMS values, respectively. CONCLUSION. Splinted-OT and IOS-Omnicam are recommended for multi-unit implant impressions to enhance trueness, potentially benefiting subsequent manufacturing stages.