• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.250-263
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• 2006

Statement of problem: Ti-alloy has been used widely since it was produced in the United States in 1947 because it has high biocompatibility and anticorrosive characteristics. Purpose: The pure titanium, however, was used limitedly due to insufficient mechanical charateristics and difficult manufacturing process. Our previous study was focused on the development of a new titanium alloy. In the previous study we found that the Ti-Ta-Nb alloy had better mechanical characteristics and similar anticorrosive characteristics to Ti-6Al-4V Material and methods: In this study, the cytotoxicity of the Ti-Ta-Nb alloy was evaluated by MTT assay using MSCs(Mesenchaimal stem cells) and L929 cells(fibroblast cell line). The biocompatibility of the Ti-Ta-Nb alloy was performed by inserting the alloy into the femur of the rabbits and observing the radiological and histological changes surrounding the alloy implant. Results: 1. In the cytotoxicity test using MSCs, the 60% survival rate was observed in pure titanium, 84% in Ti-6Al-4V alloy and 95% in Ti-10Ta-10Nb alloy. 2. In the animal study, the serial follow-up of the radiographs showed no separation or migration revealing gradual bone ingrowth surrounding the implants. Similar radiographic results were obtained among three implant groups pure titanium, Ti-6Al-4V alloy and Ti-10Ta-10Nb alloy. 3. In the histologic examination of the bone block containing the implants. the bone ingrowth was prominent around the implants with the lapse of time. There was no signs of any tissue rejection, degeneration, or inflammation. Active bone ingrowth was observed around the implants. In the comparison of the three groups, the rate of bone ingrowth was better in the Ti-10Ta-10Nb alloy group than those in pure titanium group or Ti-6Al-4V alloy group. In conclusion, Ti-10Ta-10Nb alloy revealed better biocompatibility in survival rate of the cells and bone ingrowth around the implants. Therefore we believe a newly developed Ti-10Ta-10Nb alloy can replace currently used Ti-6Al-4V alloy to increase biocompatibility and to decrease side effects. Conclusion: In conclusion, Ti-10Ta-10Nb alloy revealed better biocompatibility in survival rate of the cells and bone ingrowth around the implants. Therefore we believe a newly developed Ti-10Ta-10Nb alloy can replace currently used Ti-6Al-4V alloy to increase biocompatibility and to decrease side effects.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.380-384
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• 2010

Purpose: Distinguishing different types of implants and assessing the position and size of implants by radiologic exam after orbital wall reconstruction is important in determining the surgery outcome and forecasting prognosis. We observed time-dependent density changes in three types of implants (porous polyethylene, resorbing plate and titanium mesh plate) by performing facial bone CT after orbital wall reconstructions. Methods: A total of 32 patients, who had underwent orbital wall fracture surgery from October 2006 to March 2009 and received facial bone CT as outpatients at 1 postoperative year were included in the study. Follow-up facial bone CT was performed on the patients pre- operatively, 1 month post-operatively, and 1 year post-operatively to observe the status of the orbital implants. Medpor $^{(R)}$ (Porex Surgical, Inc., Newnan, Ga.) was used as porous polyethylene and followed-up in 14 cases; for resorbing plate, Synthes mesh plate (Synthes, Oberdorf, Switzerland) was used in the reconstruction, and followed-up in 11 cases; and titanium mesh plate usage was followed-up in 7 cases. Computed tomographic scan (CT) and water's view were done for radiography, and hounsfield unit (HU) was used to compare density of those facial bone CT. Wilcoxon signed rank test was applied to statistically verify measurement difference in each group of hounsfield units. Results: Facial bone CT examination performed in 1 month post-operative showed that the density of porous polyethylene, resorbing plate and titanium mesh plate were -42.07, 105.67 and 539.48 on average, respectively. Among the three types of implants, titanium mesh plate showed the highest density due to its radiopaque feature. Following up the density of three types of implants in CT during 1 year after the orbital wall fracture surgery, the density of porous polyethylene increased in 10.52 House Field Units and the resorbing plate was decreased in 26.87 HouseField Units. There were no significant differences between densities in 1 month post-operatively and 1 year post-operatively in each group ($p{\geq}0.05$). Conclusion: We performed facial bone CT on patients with orbital fractures during follow-up period, distinguishing the types of implants by the different concentration of implant density, and the densities showed little change even at 1 year post-operative. To observe how implant densities change in facial bone CT, further studies with longer follow-up periods should be carried out.

• Journal of Veterinary Clinics
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• v.20 no.2
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• pp.207-211
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• 2003

This investigation aimed to determine the relative merit of osseointegration in immediate and delayed implantation in the dog mandible using radiography and bone scintigraphy. five adult mongrel dogs with a mean weight of 8.5 kg were used in this investigation. During the entire study period. all dogs were fed with a soft commercial diet and water ad libitum to minimize functional loading of the implant. Twenty titanium alloy systems 4 mm in diameter and 10 mm in length blasted with calcium phosphate were prepared for insertion. The second and third left mandibular premolars in each dog were extracted for the delayed implant insertion. Twelve weeks later, the second and third right mandibular premolars were extracted for the immediate implant insertion. Before the delayed and immediate implantation procedures and 0, 4, 8, and 12 weeks after the insertions, radiography and bone scintigraphy were conducted. Bone scans were obtained using a large field of view gamma camera equipped with a collimator about 3 hours after intravenous injection of Tc-99m-MDP to the dogs. All the dogs were evaluated weekly for inflammation, necrosis, and other of the bone or sort tissue. Significant macroscopic lesions were not detected. Radioisotope scintigraphy with Tc-99m-MDP hat proved to be a reliable method for measuring increased bone activity at specific skeleton tissue sites. In conclusion, osseointegration in peri-implant bone did not differ significantly between the immediate and delayed implant procedures during the experimental period. The immediate implant may be an alternative treatment of implant insertion in animals.

• Journal of Periodontal and Implant Science
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• v.31 no.1
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• pp.57-74
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• 2001

The purpose of this study was to evaluate the adjunctive combined effect of demineralized freeze-dried bone allograft(DFDB) in guided bone regeneration on supra-alveo-lar peri-implant defect. Supra-alveolar perio-implant defects, 3mm in height, each including 4 IMZ titanium plasma-sprayed implants were surgically created in two mongrel dogs. Subsequently, the defects were treated with 1 of the following 3 modalities: Control) no membrane or graft application, Group1) DFDB application, Group2) guided bone regeneration using an expanded polytetra-fluoroethylene membrane, Group3) guided bone regeneration using membrane and DFDB. After a healing period of 12-week, the animals were sacrificed, tissue blocks were harvested and prepared for histological analysis. Histologic examination were as follows; 1. New bon formation was minimal in control and Group 1, but considerable new bone formation was observed in Group 2 and Group 3. 2. There was no osteointegration at the implant-bone interface in the high-polished area of group2 and Group 3. 3. In fluorescent microscopic examination, remodeling of new bone was most active during week 4 and week 8. There was no significant difference in remodeling rate between group 2 and group 3. 4. DFDB particles were observed, invested in a connective tissue matrix. Osteoblast activity in the area was minimal. The results suggest that guided bone regeneration shows promising results in supra-alveolar peri-implant defects during the 12 week healing period although it has a limited potential in promoting alveolar bone regeneration in the high-polished area. There seems to be no significant adjunctive effect when DFDB is combined with GBR.

• Korean Journal of Veterinary Research
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• v.44 no.1
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• pp.131-136
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• 2004

Osseointegration involves anchoring dental implants to stable bone rather than to soft-tissue. Clinical osseointegration is currently defined as the process whereby alloplastic material is asymptomatically and rigidly fixed and maintained in bone during functional loading. Full osseointegration is necessary for the success of long-term dental implants. Recent developments in computer assisted measurement of bone formation have improved maxillofacial examination and osseointegration. Computer assisted examination has also proved effective in dental implantology. This investigation was aimed to determine osseointegration in immediate and delayed implantation in the dog mandible using dental computed tomography (CT) and bone scintigraphy. Five adult (mean age of 2 years) mongrel dogs with a mean weight of 9.1 kg were used in this investigation. Titanium alloy implant systems with 4 mm in diameter and 10 mm in length were chosen for insertion. The second and third left mandibular premolars in each dog were extracted for the delayed implant insertion. Twelve weeks later, the second and third right mandibular premolars were extracted for the immediate implant insertion. Before the delayed and immediate implantation procedures and 0, 4, 8, and 12 weeks after the insertions, dental CT and scintigraphy were conducted. The CT and scintigraphic images indicate that reconstruction of bone surrounding of the immediate implant can be as successful as reconstruction of bone surrounding of the delayed implant.

• Journal of Periodontal and Implant Science
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• v.47 no.3
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• pp.182-192
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• 2017

Purpose: Contact and distance osteogenesis occur around all endosseous dental implants. However, the mechanisms underlying these processes have not been fully elucidated. We hypothesized that these processes occur independently of each other. To test this, we used titanium (Ti) tubes to physically separate contact and distance osteogenesis, thus allowing contact osteogenesis to be measured in the absence of possible triggers from distance osteogenesis. Methods: Sandblasted and acid-etched (SLA) and modified SLA (modSLA) implants were used. Both types had been sandblasted with large grit and then etched with acid. The modSLA implants then underwent additional treatment to increase hydrophilicity. The implants were implanted into rabbit tibiae, and half were implanted within Ti tubes. The bone-to-implant contact (BIC) ratio was calculated for each implant. Immunohistochemical analyses of bone morphogenetic protein (BMP)-2 expression and new bone formation (Masson trichrome stain) were performed. Results: The implants outside of Ti tubes were associated with good bone formation along the implant surface. Implantation within a Ti tube significantly reduced the BIC ratio (P<0.001). Compared with the modSLA implants, the SLA implants were associated with significantly higher BIC ratios, regardless of the presence or absence of Ti tubes (P=0.043). In the absence of Ti tubes, the bone adjacent to the implant had areas of new bone formation that expressed BMP-2 at high levels. Conclusions: This study disproved the null hypothesis and suggested that contact osteogenesis is initiated by signals from the old bone that undergoes distance osteogenesis after drilling. This signal may be BMP-2.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2016.11a
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• pp.198-198
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• 2016

An ideal orthopedic implant should provide an excellent bone-implant connection, less implant loosening and minimum adverse reactions. Commercial pure titanium (CP-Ti) and Ti alloys have been widely utilized for biomedical applications such as orthopedic and dental implants. However, being bioinert, the integration of such implant in bone was not in good condition to achieve improved osseointegraiton, there have been many efforts to modify the composition and topography of implant surface. These processes are generally classified as physical, chemical, and electrochemical methods. Plasma electrolytic oxidation (PEO) as an electrochemical route has been recently utilized to produce this kind of composite coatings. Mg ion plays a key role in bone metabolism, since it influences osteoblast and osteoclast activity. From previous studies, it has been found that Mg ions improve the bone formation on Ti alloys. PEO is a promising technology to produce porous and firmly adherent inorganic Mg containing $TiO_2$($Mg-TiO_2$ ) coatings on Ti surface, and the amount of Mg introduced into the coatings can be optimized by altering the electrolyte composition. In this study, a series of $Mg-TiO_2$ coatings are produced on Ti-6Al-4V ELI dental implant using PEO, with the substitution degree, respectively, at 0, 5, 10 and 20%. Based on the preliminary analysis of the coating structure, composition and morphology, a bone like apatite formation model is used to evaluate the in vitro biological responses at the bone-implant interface. The enhancement of the bone like apatite forming ability arises from $Mg-TiO_2$ surface, which has formed the reduction of the Mg ions. The promising results successfully demonstrate the immense potential of $Mg-TiO_2$ coatings in dental and biomaterials applications.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.116-126
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• 2009

The use of short implants has been accepted risky from biomechanical point of view. However, short implants appear to be a long term viable solution according to recent clinical reports. The purpose of this study was to investigate the effect of different diameter and length of implant size to the different type of bone on the load distribution pattern. Stress analysis was performed using 3-dimensional finite element analysis(3D-FEA). A three-dimensional linear elastic model was generated. All implants modeled were of the various diameter(${\phi}4.0$, 4.5, 5.0 and 6.0 mm) and varied in length, at 7.0, 8.5 and 10.0 mm. Each implant was modeled with a titanium abutment screw and abutment. The implants were seated in a supporting D2 and D4 bone structure consisting of cortical and cancellous bone. An amount of 100 N occlusal load of vertical and $30^{\circ}$ angle to axis of implant and to buccolingual plane were applied. As a result, the maximum equivalent stress of D2 and D4 bones has been concentrated upper region of cortical bone. As the width of implant is increased, the equivalent stress is decreased in cancellous bone and stress was more homogeneously distributed along the implants in all types of bone. The short implant of diameter 5.0mm, 6.0mm showed effective stress distribution in D2 and D4 bone. The oblique force of 100N generated more concentrated stress on the D2 cortical bone. Within the limitations of this study, the use of short implant may offer a predictable treatment method in the vertically restricted sites.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.2
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• pp.256-268
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• 1999

Submerged implants require secondary surgical uncovering of implants after healing period of 3-6 months. In surgical methods, there are surgical scalpel, tissue punch, electro-surgical, and laser-used uncovering, and so forth The objectives of this study are investigation and assessment of 1) thermal change in clinical application for uncovering of HA-coated implant and pure titanium implant irradiated by pulsed Nd-YAG, $CO_2$, and Er-YAG laser. 2) surface change of cover screws aaer irradiation using laser energy. The temperature of apex & side wall of implants were recorded at 10sec, 20sec, 30sec after 30sec irradiation to implant healing screw; 1) pulsed Nd-YAG laser; 2W, 20pps, contact mode 2) $CO_2$ laser; water-infused & non-water infused state, 2.5-3.5W, contibuous mode, noncontact mode 3) $CO_2$ laser ; non-water infused state, 3W, superpulse, noncontact. mode 4) Er-YAG laser; (1) non-water infused state, 10pps, 60mj, contact mode (2) water-infused state, 10pps, 60mj, 80mj, 101mj, contact mode. According to the results of this study, pulsed Nd-YAG laser is not indicated because of increased thermal change and pitting of metal surface of implant cover screw. By contrast, $CO_2$ laser & Er-YAG laser are presumed to indicate because of narrow range of thermal change & near abscence of thermal damage of metal surface. Dental laser is thought to be much helpful to surgical procedure when it is used as optimal power and time condition considering characteristics and indications of each laser. Further research is needed to verify that these techniques are safe and beneficial to implant success.

• The Journal of Advanced Prosthodontics
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• v.1 no.1
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• pp.10-18
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• 2009

STATEMENT OF PROBLEM. Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. PURPOSE. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in early loading conditions. MATERIAL AND METHODS. A total of 36 solid screw implants(diameter 3.75 mm, length 10 mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium implants served as control. Gold crowns were inserted 4 weeks after implant placement and the dogs were immediately put on a food diet. Implants were observed for 10 weeks after loading. Radiographic assessments and stability tests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 4 weeks after loading, and 10 weeks after loading. Histological observations and morphometrical measurements were also performed. RESULTS. Of 36 implants, 33 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels(P=.46) and RFA values. The mean BIC % in the Mg-implants was $54.5{\pm}8.4%$. The mean BIC % in the turned implant was $45.3{\pm}12.2%$. These differences between the Mg-implant and control implant were statistically significant(P=.005). CONCLUSIONS. The anodized, Mg-incorporated implant demonstrated significantly more bone-to-implant contact(BIC) in early loading conditions. CLINICAL IMPLICATIONS. The results of this study in beagle dogs suggest the possibility of achieving predictable stability of early loaded free-standing dental implants with Mg-incorporated surface.