• The Journal of Korean Academy of Prosthodontics
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• v.42 no.3
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• pp.261-266
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• 2004

Statement of problem. The effects of surface roughness have not or insufficiently been analyzed on earlier events such as cell adhesion though cell behavior most germane to implant performance is cell adhesion. Purpose. The purpose of this study was to evaluate cell adhesion of osteoblast-like cells (MG63) onto three types of titanium disks with varying roughness using the Elisa assay. Materials and methods. Representative disks from each group (SLA, HA, machined) were subjected to surface analysis and surface roughness was measured by the optical interferometer (Accura 2000, Intekplus Co., Seoul, Korea). Following this, MG63 cells were cultured on the titanium disks and released. Cell adhesion measurements using the Elisa assay were performed specifically at three points: after 24, 48, and 72 hours of culture. Results. Among the 3 types of surface analyzed, the SLA surface was the roughest with a Ra value of $1.114{\mu}m$ followed by HA coated surface and machined surface, consecutively. The optical density values for the SLA surface group was significantly higher than that of the machined and HA coated surface groups following 24 and 48 hours of culture. The cell culture on HA coated surface showed significantly higher values compared to the machined surface following 24, 48 and 72 hours of culture. Conclusion. The results suggest that surface treatment of titanium surfaces enhanced cell adhesion of human osteoblast-like cells (MG63).

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.177-193
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• 2004

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.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.

• 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 Journal of Korean Academy of Prosthodontics
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• v.39 no.5
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• pp.463-476
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• 2001

Since the treatment of edentulous patients with osseointegrated implant was first introduced more than 30 years ago, implant therapy has become one of the most important dental treatment modalities today. Based on the previous experience and knowledge, $Br{\aa}nemark\;Novum^{(R)}$ protocol was introduced with the concept of simplifying surgical and prosthetic technique and reducing healing time recently. This protocol recommends the installation of three 5mm wide diameter futures in anterior mandible and the prefabricated titanium bars for superstructure fabrication. This study was designed to analyze the stress distribution at fixture and superstructure area according to changes of fixture number, diameter and superstructure materials. Four 3-dimensional finite element models were fabricated. Model 1 - 5 standard fixtures (13mm long and 3.75mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 2- 3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of type IV gold alloy and resin Model 3-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and resin Model 4-3 wide diameter fixtures (13mm long and 5.0mm in diameter) & superstructure consisted of titanium and porcelain A 150N occlusal force was applied on the 1st molar of each model in 3 directions - vertical($90^{\circ}$), horizontal($0^{\circ}$) and oblique($120^{\circ}$). After analyzing the stresses and displacements, following results were obtained. 1. There were no significant difference in stress distribution among experimental models. 2. Model 2, 3, 4 showed less amount of compressive stress than that of model 1. However, tensile stress was similar. 3. Veneer material with a high modulus of elasticity demonstrated less stress accumulation in the superstructure. Within the limites of this study, $Br{\aa}nemark\;Novum^{(R)}$ protocol demonstrated comparable biomechanical properties to conventional protocol.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.49 no.1
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• pp.43-48
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• 2023

The biocompatibility and durability of implant fixtures are major concerns for dentists and patients. Mechanical complications of the implant include abutment screw loosening, screw fracture, loss of implant prostheses, and implant fracture. This case report aims to describe management of a case of fixture damage that occurred after screw fracture in a tissue level, internal connection implant and microscopic evaluation of the fractured fixture. A trephine bur was used to remove the fixture, and the socket was grafted using allogeneic bone material. The failed implant was examined by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDS), which revealed a fractured fixture with both normal and irregular bone patterns. The SEM and EDS results give an enlightenment of the failed fixture surface micromorphology with microfracture and contaminated chemical compositions. Noticeably, the significantly high level of gold (Au) on the implant surface and the trace amounts of Au and titanium (Ti) in the bone tissue were recorded, which might have resulted from instability and micro-movement of the implant-abutment connection over an extended period of time. Further study with larger number of patient and different types of implants is needed for further conclusion.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.3
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• pp.492-516
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• 1995

This study evaluated the responses of mandibular bones of mongrel dogs to loaded hydro xylapatite(HA) and titanium plasma spray(TPS) coated endosseous dental implants, using unloaded ones as the control group. after HA and TPS coated implants were implanted, their bone reactions with vital bones have been observed with light and scanning electron microscope(SEM) at the three periods of the 4th, 12th and 20th week. These reactions have been also compared in a histomorphometric method. The elemental distribution state of implants and the interface neighboring bone tissues have been measured with the energy dispersive analysis of X-rays(EDAX). The following results were obtained ; 1. The light microscopic analysis showed osseointegration in both the control group and the occlusal force loaded group ; Its degree was shown to be higher in the long-maintained and occlusal force groups. 2. The SEM analysis showed that both groups had osseointegration, In the case of TPS-coated implants, the coated layer was divided on the bone interface. In the case of HA-coated implants, there appeared a division between the metal and coated interface. 3. In the histomorphometric analysis, the measured ratio contaction bone of TPS-coated implants was $70{\pm}19$% in the case of no occlusal force ; it was $84{\pm}13$% in the case of occlusal force. The measured ratio contacting bone of HA-coated implants was $75{\pm}18$% in the case of no occlusal force ; it was $94{\pm}9$% in the case of occlusal force. However, there was no significant difference statistically(p>0.05). 4. Both groups showed that the ratio of calcium and phosphorous increased more in the bone tissues than on the bone to implant interface.

• Journal of Ginseng Research
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• v.44 no.6
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• pp.823-832
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• 2020

Background: The formation of a nanotube layer on a titanium nanotube (N-Ti) plate facilitates an active reaction between bone cells and the material surface via efficient delivery of the surface materials of the dental implant into the tissues. Studies have reported that Korean Red Ginseng extracts (KRGEs) are involved in a variety of pharmacological activities: we investigated whether implantation with a KRGE-loaded N-Ti miniimplant affects osteogenesis and osseointegration. Methods: KRGE-loaded nanotubes were constructed by fabrication on pure Ti via anodization, and MC3T3-E1 cells were cultured on the N-Ti. N-Ti implants were subsequently placed on a rat's edentulous mandibular site. New bone formation and bone mineral density were measured to analyze osteogenesis and osseointegration. Results: KRGE-loaded N-Ti significantly increased the proliferation and differentiation of MC3T3-E1 cells compared with cells on pure Ti without any KRGE loading. After 1-4 weeks, the periimplant tissue in the edentulous mandibular of the healed rat showed a remarkable increase in new bone formation and bone mineral density. In addition, high levels of the bone morphogenesis protein-2 and bone morphogenesis protein-7, besides collagen, were expressed in the periimplant tissues. Conclusion: Our findings suggest that KRGE-induced osteogenesis and osseointegration around the miniimplant may facilitate the clinical application of dental implants.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.227-237
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• 2008

STATEMENT OF PROBLEM: Zirconium oxide can be a substitute to titanium as implant materials to solve the esthetic problems of dark color in the gingival portion of implant restorations. PURPOSE: This study was performed to define attachment and growth behavior of osteoblast- like cells cultured on grooved surfaces of zirconium oxide and evaluate the genetic effect of zirconium oxide surfaces using the reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIAL AND METHODS: MC3T3-E1 cells were cultured on (1) commercially pure titanium discs with smooth surface (T group), (2) yttrium-stabilized tetragonal zirconia polycrystal (Y-TZP) with machined surface (ZS group), and (3) Y-TZP with $100{\mu}m$ grooves (ZG group). Cell proliferation activity was evaluated through MTT assay and cell morphology was examined by SEM. The mRNA expression of Runx2, alkaline phosphatase, osteocalcin, TGF-${\beta}1$, IGF-1, G3PDH in E1 cells were evaluated by RT-PCR. RESULTS: From the MTT assay, after 48 hours of adhesion of MC3T3-E1 cells, the mean optical density value of T group and ZG group significantly increased compared to the ZS group. SEM images of osteoblast-like cells showed that significantly more cells were observed to attach to the grooves and appeared to follow the direction of the grooves. After 24 hours of cell adhesion, more spreading and flattening of cells with active filopodia formation occurred. Results of RT-PCR suggest that T group, ZS group, and ZG group showed comparable osteoblast-specific gene expression after 24 hours of cell incubation. CONCLUSION: Surface topography and material of implants can play an important role in expression of osteoblast phenotype markers. Zirconia ceramic showed comparable biological responses of osteoblast-like cells with titanium during a short-time cell culture period. Also, grooves influence cell spreading and guide the cells to be aligned within surface grooves.

• The Journal of Advanced Prosthodontics
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• v.7 no.5
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• pp.375-379
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• 2015

PURPOSE. The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS. Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at $10^6$ cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS. The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION. The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws.