A titanium based screw shaped dental implant was first introduced by Branemark and a treatment protocol where the restoration of edentulous area by connecting abutment after the osseointegration of the titanium surface of the implant and surrounding bone structure has been proposed. Although this protocol is widely accepted as a standard up to date, the healing duration of 3-6 months as well as the need for provisional prostheses during this period present as a major drawback. Immediate loading has been accomplished through the advent of various implant designs, enforced surface treatments, diverse forms of abutment, and delicate surgical techniques together with the increase in demand from the patients. The success rate of the immediate loading technique has been first reported as 85.7% by Dr. Schnitman in 1990 which recently has been reported up to 100% in the case of immediate loading in single tooth by Dr. Kan. To ameliorate the success rate of immediate loading technique, selection of patients presenting a sound bone quality and quantity, acquiring primary stability through delicate surgical techniques and fabrication of prostheses which accounts for biological stabilities should all be taken into consideration. This presentation introduces the understanding of biological stability of immediate loading, various methods for measurement of stability and clinical cases regarding immediate loading technique.
Poly(acrylonitrile-butadiene-styrene) (ABS) composite sheets containing titanium dioxide ($TiO_2$), barium sulfate ($BaSO_4$), calcium carbonate ($CaCO_3$) were prepared by using a co-rotating twin screw extruder, and the reflectance and flexural modulus of the composite sheets were measured. The fillers were well dispersed in ABS matrix. The reflectance of composite sheet was increased with increasing $TiO_2$ and $BaSO_4$ content. Sheet having $TiO_2$ 20 wt% composition, with 5~20 wt% $BaSO_4$ resulted in more than 95% of reflectance. The flexural modulus of composite sheet was increased from 1864 MPa for $ABS/TiO_2/BaSO_4$ 85/10/5 (w/w/w) to 3134 MPa for $ABS/TiO_2/BaSO_4$ 55/20/25 (w/w/w).
PURPOSE. The marginal bone loss of implants with laser treated surface was investigated after six weeks of loading after implant installation to the mandible molar area. MATERIALS AND METHODS. A total of 23 implants were placed in the edentulous molar area of the mandible: 13 implants were immediately loaded and 10 implants were early loaded. The implants used were made of titanium grade 23, screw shaped, 4.2 mm in diameter, and 10 mm in length. Patients were evaluated with resonance frequency analysis at implant fixture installation and 1, 2 (final prosthesis installation), 3, 5, 8, and 14 months later. X-rays were taken at 2 months after fixture installation and 1, 2, 3 years after to measure the marginal bone loss. RESULTS. The mean ISQ value measured at the implant installation was over 70 at all-time points. The average of marginal bone loss was average 0.33 mm. CONCLUSION. Immediate implant loading for laser treated implants would be possible.
Hwang, Jun Ho;Kwon, Sung-Min;Choi, Sung Gi;Sung, Mi Ae;Lee, Kyu-Bok
Journal of the Korean institute of surface engineering
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v.51
no.5
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pp.309-315
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2018
The purpose of this study is to assess the mechanical properties of the ceramic abutment with washer. In this study, ceramic abutment were used, tested with $30^{\circ}$ compression load, shear fatigue, adaptation accuracy test(rotation angle, contact interval), removal torque force test, torsional breaking force test. The $30^{\circ}$ compression load was 729 N, the shear fatigue load was 275 N, adaptation accuracy test of rotation angle was within $3^{\circ}$, contact interval within $10{\mu}m$, and removal torque force test value is $18.88N{\cdot}cm$, torsional breaking force test value is $35.52N{\cdot}cm$. Ceramic abutment with a washer fitted have sufficient mechanical strength and may be substituted for titanium abutment.
Journal of the Korean Society of Manufacturing Process Engineers
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v.20
no.3
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pp.100-106
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2021
Typical implants are not specified the screw structure and the surface process according to the bone quality of the human body. The purpose of this study is to complement the shortcomings of the existing implant surface processing method. It is to propose a surface processing method that increases the adhesion between the implant and bone tissue by increasing the surface area per unit area of the implant. It is very important to establish precise and systematic process parameters when surface treatment of implants using lasers. Therefore, we intend to develop a process so that the implant can be a biocompatible structure using a Q-switching Nd:YAG laser with a wavelength of 1.06um. Implant surface treatment technology through this study will be used in the industry.
Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.26
no.1
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pp.24-39
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2000
Various methods and graft materials have been used to fill in the defect adjacent to the implants and considered as clinically acceptable. But it is not clear whether the regenerated bone increases the implant-bone contact and supports the implant. The purpose of this study is to evaluate regenerated bone surrounding implants using bone morphogenetic protein(BMP) and demineralized freeze-dried bone(DFDB), and the interfaces between implants and regenerated bone. bBMP was extracted and partially purified from the bovine bone matrix using heparine chromatography. Demineralized freeze-dried bone was made from the dog. Inactive insoluble collagenous bone matrix(IBM) of dog was used as carrier of bBMP. Interfaces of titanium coated epoxy resin implants were processed for demineralized section for transmission electron microscopy(TEM) and those of screw type implants were for nondemineralized section for light and fluoromicroscopic examination. Implants were inserted in the inferior border of mandible of adult dogs and artificial bony defects($3{\times}3{\times}4mm$) were made at the mesial and distal side of implants. Defects were filled with BMP(BMP group) and DFDB(DFDB group). For the fluoromicroscopic examination, the fluorescent dyes(oxytetracycline, calcein green, alizarin red) were injected 2, 4, 6, 8, 12 weeks after implantation. The experimental animals were sacrificed at the 6th and the 12th week and their mandible were extirpated and processed for examination with light microscopy, fluoromicroscopy and TEM. The obtained results were as follows : 1. By the light microscopic findings, the defects were filled with woven bone at the 6th week and compact bone at the 12th week, and the osseointegrations were seen in both groups. There was no histological difference between them. 2. On the basis of the histomorphometric analysis, BMP group(6th week: 40.25%, 12th week: 56.04%) had higher bony contact ratio than DFDB group(38.37%, 42.63%). There was significant difference between two groups at the 12th week(p<0.05). 3. The amount of bone formation in BMP group was more prominent than in DFDB group. Significant difference was noted among two groups at the 6th and the 8th week(p<0.05). 4. By the transmission electron microscopic findings, $0.4-2{\mu}m$ soft tissue layer was found in adjacent to the interfaces and over the collagen fibrils of bone at the 6th week. However, about 100nm amorphous layer was noted at the interface or collagen fibrils directly extended to the titanium surface at the 12th week. There was no significant difference between two groups. 5. These results suggest that BMP and DFDB can be used as good graft materials in the regeneration of bone adjacent to implant, and BMP is more valuable as a bone inducer than DFDB.
Kim, Byung-Min;Sung, Iel-Yong;Park, Bong-Soo;Shin, Sang-Hoon;Kim, Jong-Ryoul
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.29
no.6
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pp.397-406
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2003
The purpose of this study was to observe the titanium implant osseointegration in the osteoporosis-induced animal model. Seventy rats, 11 weeks of age, were divided into two groups : an ovariectomized group and a control group. Titanium screw implants(diameter, 2.0mm; length, 3.5mm) were placed into left tibias of 70 rats, 35 in the control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD34 antibody. The results obtained from this study were as follows: 1. Histopathologically findings, newly formed bone was seen at 3 weeks and became lamellar bone at 8 weeks, and mature trabecullar bone was seen at 12 weeks control group. In experimental group, thickness of regenerated bone increased till 8 weeks gradually and mature trabecullar bone was seen at 12 weeks. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 8 to 12 weeks in experimental group. 3. Fibronectin immunoreactivity was strong at 3 weeks control group and reduced after 8weeks gradually. But it was continuously strong from 3 to 8 weeks in experimental group. 4. CD34 immunoreactivity was very strong in the newly formed osteoblasts from 3 to 8 weeks control group. But it reacted minimally later. While in experimental group, it reacted continuously strong from 3 to 12 weeks. The results of this study suggest that osteoporosis is not an absolute contraindication to dental implantation if sufficient period suggested after fixture installation till second stage surgery.
Park, Kwang-Il;Lee, Jae-Yeol;Hwang, Dae-Seok;Kim, Yong-Deok;Kim, Gyoo-Cheon;Shin, Sang-Hun;Kim, Uk-Kyu;Chung, In-Kyo
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.33
no.2
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pp.131-138
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2007
The purpose of this study was to observe the effect of calcium and vitamin D to the titanium implant osseointegration in animal model. 32 rats, 10 weeks of age, were divided into two group: additional calcium and vitamin D supplementation group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm; pitch-height 0.4mm) were placed into tibia of 32 rats, 16 in the control group and 16 in the experimental group. The rats were sacrificed at different time interval(1, 2, 4, and 8 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with osteocalcin and osteopontin antibody. Histopathologically findings, newly formed bone was seen at 1 weeks and became lamellar bone at 2 weeks, and mature trabecullar bone was seen at 4 weeks experimental group. In control group, thickness of regenerated bone increased till 4 weeks gradually and trabecullar bone was seen at 8 weeks. By histomorphometric analysis, bone marrow density was increased significantly at 1 and 2 weeks in experimental group compared to control group. Osteocalcin immunoreactivity was strong at 1 week experimental group and reduced after 4 weeks gradually. But it was continuously weakly from 1 to 4 weeks in control group. Osteopontin immunoreactivity was very strong in newly formed bone from 2 to 8 weeks experimental group. And the amount of osteopontin expression was more abundant in experimental group. The results of this study suggest that calcium and vitamin D supplementation promotes bone healing around dental implants
The use of dental implants has increased tremendously in recent years and is expected to increase even more in the future. The successful outcome of any implant procedure is surely dependent on interrelationship of the various components of an equation that includes biocompatibility of implant material, macroscopic and microscopic nature of the implant surface, the status of implant bed, surgical technique, undisturbed healing phase and subsequent prosthetic design and long-term loading phase. The purpose of this study was to clarify the effects of adrenalectomy on the osseointegration of pure titanium implants. Seventy rats, 11 weeks of age, were divided into two groups : an adrenalectomized group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm) was placed into left tibia of 70 rats, 35 in control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows: 1. Histopathogically, findings, newly formed bone was seen at 3 weeks control group and became lamellar bone at 12 weeks. At 6 weeks, lipocytes were observed in bone marrow space. Thickness of regenerated trabecular bone increased till 6 weeks after then, that decreased gradually. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 4 to 12 weeks in experimental group compared to control group. 3. Fibronectin immunoreactivity was very strong at 3 and 4 weeks control group. And after that reduced gradually. But it was continuously strong from 1 to 12 weeks experimental group. 4. CD44 immunoreactivity was very strong in the newly formed osteoblasts at 3 and 4 weeks control group. But it reacted minimally later. However, it reacted continuously strong from 3 to 12 weeks experimental group. From these results, bone to implant contact ratio decreased gradually from 4 weeks in adrenalectomized group compared to control group. CD44 and fibronectin immunoreactivities were strong at all times in adrenalectomized rats. Therefore, it could be stated that immature bone remained continuously for a long time and not readily proceeded into mature status.
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