• The Journal of Korean Academy of Prosthodontics
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• v.44 no.5
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• pp.549-560
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• 2006

Purpose : This experiment examined the effects of anodization on commercially pure titanium implant fixtures. Material & methods : The implant fixtures were anodized at three different voltage levels, producing three different levels of oxidation on the surface of the fixure. Implant were divided into four groups according to the level of oxidation. Group 1 consist of the control group of machined surface implants, Group 2 implants were treated by anodizing to 100 voltage, Group 3 implants were treated by anodizing oxidation to 200 voltage Group 4 implants were treated by anodizing oxidation to 350 voltage. Surface morphology was observed by Scanning Electron Microscope(SEM) and the surface roughness was measured using NanoScan $E-1000^{\circledR}$. Implantation of the fixtures were performed using New Zealand white rabbits. $Periotest^{\circledR}$ value(PTV) resonance frequency analysis(RFA), and removal torque were measured in 0, 2, 4, 8, 12 weeks after implantation. Results : The results of the study were as follows: 1. Values for the measured surface roughness indicate statistically significant differences in Ra, Rq, and Rt values among group 1, 2, 3, and 4 at the top portion of the thread,(p<0.05) while values at the base of the threads indicated no significant difference in these values. 2. A direct correlation between the firming voltage, and surface roughness and irregularities were observed using scanning electron microscope. 3. No statistically significant differences were found between test groups regarding $Periotest^{\circledR}$ values. 4. Analysis of the data produced by RFA, significant differences were found between group 1 and group 4 at 12 weeks after implantation.(p<0.05) Conclusions : In conclusion, no significant differences could be found among test groups up to a certain level of forming voltage threshold, beyond this firming voltage threshold, statistically significant differences occurred as the surface area of the oxide layer increased with the increase in surface porosity, resulting in enhanced bone response and osseointegration.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.341-356
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• 1995

The purpose of this study was to evaluate the effect of demineralized freeze dried bone and demineralized bone gel with guided tissue regeneration treatment around titanium implants with dehisced bony defects and also evaluate space maintaining capacity of demineralized bone gel type and DFDB powder type under e-PTFE membrane. In 3 Beagle dogs, mandibular premolar was extracted and four peri-implant osteotomies were formed for dehiscence. After insertion of implants, the four peri-implant defects were treated as follows. 1) In control group. no graft material and barrier membrane were applied. 2) In experimental group.1, the site was covered only with the e-PTFE membrane. 3) In experimental group 2,received DFDB powder and covered by the e-PTFE membrane. 4) In experimental group 3, demineralized bone gel and e-PTFE membrane were used. By random selection, animals were sacrificed at 4, 8, 12 weeks. The block sectioned specimens were prepared for decalcified histologic evaluation(hematoxylin and eosin staining) and undecalcified histologic evahiation(Von Kossa's and toluidine blue staining) with light microscopy. The results of this study were as follows. 1) In control group, there was a little new bone formation and connective tissue was completely filled in the defect area. 2) Experimental group 1 showed lesser quantity of bone formation as compared to the bone grafted group. Thin vertical growth of new bone formation around implant fixture was shown. 3) Experimental group 2 showed thick bucco-lingual growth of new bone formation and grafted bone particles were almost resorbed in 12 week group. 4) In experimental group 3, most grafted bone particles were not resorbed in 12 week group and thick bucco-lingual bone formation was shown in dehisced defect base area. 5) There was no remarkable differences in space making capacity and new bone formation procedure between demineralized freeze-dried bone powder type and demineralized bone gel type.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.84-89
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• 2015

We report the eventually successful treatment of a huge bone defect and peri-implantitis following reconstruction of a previously failed intra-mobile cylinder implant system (IMZ) implant site using distraction osteogenesis (DO). In the anterior mandible, two IMZ implants failed and surgical debridement was performed in accordance to the patient's needs. Thereafter, mobility and suppuration were decreased and the patient visited the dental clinic on a regular basis for oral health maintenance. However, the inflammation did not resolve, and the bone destruction around the implants progressed for 4 years. Finally, the implants failed and a severe bone defect remained after implant removal. To reconstruct the bone defects, we attempted bone graft procedures. Titanium mesh was unsuccessfully used to obtain bone volume regeneration. However, DO subsequently was used to obtain sufficient bone volume for implant placement. The new implants were then installed, followed by prosthetic procedures. In conclusion, progression of peri-implantitis could not be arrested despite surgical intervention and repeated maintenance care for 3 years. Reconstruction of the peri-implantitis site was complicated due to its horizontal and vertical bone defects. Lesions caused by implant failure require an aggressive regenerative strategy, such as DO. DO was successful in reconstruction of a peri-implantitis site that was complicated due to horizontal and vertical bone defects.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.32 no.5
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• pp.389-395
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• 2010

Purpose: Although it is generally accepted that patients with controlled diabetes have similar rates of success for dental implants as healthy individuals, the use of dental implants in diabetic patients is controversial. In addition, the impact of diabetes on the healing of bone associated with immediately place dental implants is not completely understood. The purpose of this study was to measure bone response to implants radiologically in uncontrolled and insulin-controlled diabetic rats. Materials and Methods: Twenty rats were divided into control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. Two titanium implants ($1.2{\times}3$ mm) were placed in the extraction socket of the maxillary first molars of the animals and were harvested at 3 days, 1, 2 and 4 weeks. The bone density was measured by digital radiography using gray-level analysis (histogram) in the regions of interest (ROI) at four points: two mesial and two distal to both sides of the implant. Results: The results showed that the osseointegration of the implants was impaired in the diabetic rats compared to the control and the insulin-treated rats. The radiographic evidence demonstrated marked destruction of bone around the implants in the diabetic group. Both the control and the insulin-treated groups had a significantly higher bone density on radiograph than the diabetic group from the 1 week of the experiment (P<0.05 for each comparison). Conclusion: The present study revealed that the immediate placement of titanium implants in the maxilla of diabetic rat lead to delay in the maturation of bone adjacent to implants. It is expected that the reduced predictability of success of immediate implantation in patient with the uncontrolled diabetes.

• Journal of dental hygiene science
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• v.11 no.5
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• pp.405-410
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• 2011

The aim of this study was to evaluate antibacterial effect of Cl coated titanium. To coat the Cl on the titanium, first, the titanium was modified by blasting treatment with hydroxyapatite and alumina powder. Anodization process was completed using electrolyte solution of 0.04 M ${\beta}$-glycerol phosphate disodium salt n-hydrate, 0.4 M calcium acetate n-hydrate and 1 M NaCl on the condition of 250 voltages for 3 min. Surface morphology and elements' observation were performed with scanning electron microscopy and energy dispersive spectroscopy and surface profiler was used to analyze the surface roughness. Antibacterial effect was evaluated by film adhesion method. The anodized titanium after blasting showed dimpled surface contained the Cl. Surface average roughness of these surfaces had significantly higher compared to polished titanium. Result of antibacterial test showed that anodized titanium after blasting had an enhanced antibacterial effect compared to the polished titanium. Therefore, these results suggested that titanium contained Cl by anodization after blasting had a rough surface as well as antibacterial effect.

• Journal of Korean Dental Science
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• v.2 no.1
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• pp.28-30
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• 2009

Purpose : The purpose of this pilot experiment was to evaluate early bone response in two types of coated implants using the rabbit tibia model. Materials and Methods : Screw type titanium implants manufactured with a calcium metaphosphate (CMP) coating and hydroxyapatite (HA) coating were placed in the tibiae of 3 New Zealand White rabbits. The bone responses at 2 weeks after insertion were evaluated and compared by histomorphometry. Results : There was no significant difference in bone-to-implant contact between the groups (P>.05). However, some qualitative differences on histologic views were found. Conclusions : CMP-coating is suggested to be the preferred candidate for fast osseointegration over HAcoating.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.22 no.1
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• pp.9-21
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• 2013

Aesthetics means differ from cultures and times and also differ from each person's own thinking. But as a restorative dentist who works for esthetic areas, we need to have certain principles and rationale. Some functions in CAD/CAM looks very useful to match harmonious shape to adjacent teeth and also very effective and efficient when compare to the traditional laboratory technics. Also we will discuss about link abutment (Titanium-Zirconia abutment) which we need for dental implant placed anterior area where the soft tissue is thin.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.39 no.2
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• pp.43-54
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• 2013

In an attempt to regain function and aesthetics in the craniofacial region, different biomaterials, including titanium, hydroxyapatite, biodegradable polymers and composites, have been widely used as a result of the loss of craniofacial bone. Although these materials presented favorable success rates, osseointegration and antibacterial properties are often hard to achieve. Although bone-implant interactions are highly dependent on the implant's surface characteristics, infections following traumatic craniofacial injuries are common. As such, poor osseointegration and infections are two of the many causes of implant failure. Further, as increasingly complex dental repairs are attempted, the likelihood of infection in these implants has also been on the rise. For these reasons, the treatment of craniofacial bone defects and dental repairs for long-term success remains a challenge. Various approaches to reduce the rate of infection and improve osseointegration have been investigated. Furthermore, recent and planned tissue engineering developments are aimed at improving the implants' physical and biological properties by improving their surfaces in order to develop craniofacial bone substitutes that will restore, maintain and improve tissue function. In this review, the commonly used biomaterials for craniofacial bone restoration and dental repair, as well as surface modification techniques, antibacterial surfaces and coatings are discussed.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.6
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• pp.765-781
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• 2000

The purpose of this study was to compare the screw loosening characteristics of three avail-able cementation type abutments: one-piece cementation type abutment; two-piece cementation type abutment using titanium abutment screw; two-piece cementation type abutment using gold abutment screw. Two implant supported three-unit superstructures were fabricated using a pair of 3 kinds of abutments for each experimental model. Cyclic loading was applied on the specimen, and made to stop when the superstructure showed movement over threshold range. The loaded cycle was counted until the machine stopped. Frequency analysis was done to measure the change of natural frequency before and after the application of cyclic load and to find the effect of screw loosening on the change of natural frequency. The specimen assembly was modeled to perform the finite element analysis to see the distribution of the stress induced by the application of preload over the screw joint and to compare the pattern of the distribution of stress induced by the external force with the change of the preload condition. The following results were obtained: 1. The failure loading cycle of two-piece cementation type abutment using gold screw was significantly greater than those of the other groups. 2. One-piece cementation type abutment applied to multi-unit restoration case did not show greater resistance to screw loosening compared to two-piece cementation type abutments. 3. Frequency analysis showed decrease in natural frequency when screw loosening occured.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.2.1-2.7
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• 2018

With the development of computer-aided design/computer-aided manufacturing (CAD/CAM) technology, it has been possible to reconstruct the cranio-maxillofacial defect with more accurate preoperative planning, precise patient-specific implants (PSIs), and shorter operation times. The manufacturing processes include subtractive manufacturing and additive manufacturing and should be selected in consideration of the material type, available technology, post-processing, accuracy, lead time, properties, and surface quality. Materials such as titanium, polyethylene, polyetheretherketone (PEEK), hydroxyapatite (HA), poly-DL-lactic acid (PDLLA), polylactide-co-glycolide acid (PLGA), and calcium phosphate are used. Design methods for the reconstruction of cranio-maxillofacial defects include the use of a pre-operative model printed with pre-operative data, printing a cutting guide or template after virtual surgery, a model after virtual surgery printed with reconstructed data using a mirror image, and manufacturing PSIs by directly obtaining PSI data after reconstruction using a mirror image. By selecting the appropriate design method, manufacturing process, and implant material according to the case, it is possible to obtain a more accurate surgical procedure, reduced operation time, the prevention of various complications that can occur using the traditional method, and predictive results compared to the traditional method.