• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.261-281
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• 2022

Purpose: Short implants are a potential alternative to long implants for use with bone augmentation in atrophic jaws. This meta-analysis investigated the survival rate and marginal bone level (MBL) of surface-modified short vs. long implants. Methods: Electronic and manual searches were performed for articles published between January 2010 and June 2021. Twenty-two randomized controlled trials (RCTs) comparing surface-modified short and long implants that reported the survival rate with at least 1 year of follow-up were selected. Two reviewers independently extracted the data, and the risk of bias and quality of evidence were evaluated. A quantitative meta-analysis was performed regarding survival rate and MBL. Results: The failure rates of surface-modified short and long implants differed significantly (risk ratio, 2.28; 95% confidence interval [CI], 1.46, 3.57; P<0.000). Long implants exhibited a higher survival rate than short implants (mean follow-up, 1-10 years). A significant difference was observed in mean MBL (mean difference=-0.43, 95% CI, -0.63, -0.23; P<0.000), favoring the short implants. Regarding the impact of surface treatment in short and long implants, for hydrophilic sandblasted acid-etched (P=0.020) and titanium oxide fluoride-modified (P=0.050) surfaces, the survival rate differed significantly between short and long implants. The MBL differences for novel nanostructured calcium-incorporated, hydrophilic sandblasted acid-etched, and dual acid-etched with nanometer-scale calcium phosphate crystal surfaces (P=0.050, P=0.020, and P<0.000, respectively) differed significantly for short vs. long implants. Conclusions: Short surface-modified implants are a potential alternative to longer implants in atrophic ridges. Long fluoride-modified and hydrophilic sandblasted acid-etched implants have higher survival rates than short implants. Short implants with novel nanostructured calcium-incorporated titanium surfaces, hydrophilic sandblasted acid-etched surfaces, and dual acid-etched surfaces with nanometer-scale calcium phosphate crystals showed less marginal bone loss than longer implants. Due to high heterogeneity, the MBL results should be interpreted cautiously, and better-designed RCTs should be assessed in the future.

• 대한치과보철학회지
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• 제51권3호
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• pp.190-198
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• 2013

연구 목적: 최근 지르코니아 임플란트가 크게 향상된 물리적 성질, 자연치와 유사한 색조, 뛰어난 생체 적합성으로 주목 받고 있다. 이에 본 연구에서는 국내에서 시판되고 있는 상용 타이타늄 임플란트와 개발 단계인 지르코니아 임플란트의 골유착을 비교 연구하였다. 연구 재료 및 방법: 상용 타이타늄 임플란트(T 군)와 기계 절삭된 나사형 지르코니아 임플란트(Z 군), 기계 절삭 후 알루미나 샌드 블라스팅으로 표면 처리된 나사형 지르코니아 임플란트(ZS 군)의 표면 거칠기를 측정한 후 6마리 돼지의 좌, 우측 하지 경골에 식립하여 1주, 4주, 12주에 각각 희생하여 Periotest values (PTVs) 측정, 조직학적 측정 및 조직 계측학적 측정, 주사 전자 현미경 관찰을 시행하였다. 평균 표면 거칠기와 PTVs, 조직계측학적 측정 결과는 일원분산분석을 통해 통계 처리되었다(${\alpha}=.05$). 결과:각 군 임플란트의 표면 거칠기를 측정한 결과 T 군이 Z 군, ZS 군에 비해 더 유의하게 높은 평균 표면 거칠기 값을 보였다. PTVs는 측정 시기 모두에서 T 군이 상대적으로 낮은 값을 보였으나 각 군에 따라, 시기에 따라 모두 통계적으로 유의하지는 않았다. 식립 1주차 골접촉율 측정 결과 Z 군이 T 군, ZS 군에 비해 유의성 있게 높았고, 골면적율은 T 군, Z 군이 ZS 군에 비해 유의성 있게 높았다. 식립 4주차 골접촉율 측정에서 T 군이 Z 군, ZS 군에 비해 유의성 있게 높았고, 골면적율은 군간 유의한 차가 없었다. 식립 12주차 골접촉율은 T 군, ZS 군, Z 군 순으로 낮아졌고 모든 군간 통계적으로 유의한 차이가 존재하였다. 골면적율은 T 군, ZS 군이 Z 군에 비해 유의성 있게 높았다. 결론: 이상의 결과는 지르코니아 임플란트의 골유착이 타이타늄 임플란트에 비해 부족하며, 상용화를 위해서는 지르코니아 임플란트의 표면 변형에 관한 연구가 더 필요함을 시사한다.

• 구강회복응용과학지
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• 제28권2호
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• pp.119-126
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• 2012

시멘트 유지 임플란트 지지 수복물은 치과 치료에 일상적으로 사용된다. 임플란트와 지대주 나사연결의 안정적인 견고함과 골유합 임플란트의 높은 생존율로 인해 높은 강도를 가진 시멘트의 사용이 점차 늘어나고 있다. 그러나 CAD/CAM을 이용하여 제작한 금속 코핑의 유지력에 대해 이용할 수 있는 임상 자료가 없다. 네 종류의 시멘트를 이용하여 티타늄 지대주와 CAD/CAM을 이용하여 제작한 금속 코핑의 유지력을 평가하는 것과 시멘트 유지력에 대한 sandblasting의 효과를 알아보고자 함이다. 40개의 티타늄 지대주 블록(Innovium, 세라젬바이오시스, 대한민국)을 제작하여 네 그룹으로 나누었다. 40개의 금속 코핑을 CAD/CAM을 이용하여 제작하고 금속 코핑의 교합면 상방부에 유지력 테스트를 위해 구멍을 형성하였다. 네 종류의 시멘트는 Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan), Superbond C&B(Sunmedical, Japan)이다. 금속 코핑과 티타늄 지대주를 제조사의 지시대로 시멘트 혼합하여 합착하고 100% 습도 하에 37도에서 24시간 동안 보관 후 유지력 테스트하였다. 유지 실패가 발생하는 힘을 newton으로 기록하고 실패의 양상 또한 기록하였다. 유지력의 평균과 표준 편차를 ANOVA와 Paired t-test 로 통계분석하였다. Panavia F2.0이 Fujicem과 Maxcem Elite보다 통계적으로 유의하게 높은 유지력을 보였다(p<0.05). Sandblasting이 모든 시멘트에서 유의하게 유지력을 증가시켰다(p<0.05). 유지력 실패의 양상은 대부분의 시멘트가 금속 코핑 내부에 남아있는 접착성 실패였다. 본 연구의 한계 내에서 Panavia F2.0이 Fujicem이나 Maxcem Elite보다 통계적으로 유의하게 큰 유지력을 보였고(p<0.05), Fujicem과 Maxcem Elite는 유지력의 차이를 보이지 않았다. Sandblasting처리는 모든 실험군에서 유지력의 향상을 보였다. 따라서 임플란트 지대주에 합착된 금속 코핑의 유지력은 표면 거칠기와 시멘트의 종류에 영향을 받는다.

• 구강회복응용과학지
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• 제31권4호
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• pp.340-348
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• 2015

임플란트주위염(peri-implantitis)은 기능중인 골유착 임플란트 주위의 조직에서 생기는 사이트 별 감염성 질환이며 임플란트 후기 실패(late failure)의 원인으로 가장 높은 비율을 차지한다. 여러 연구들을 통해 미생물 침착이 임플란트주위염에 미치는 영향이 보고된 바 있으며 세균막의 제거는 임플란트주위염의 치료 시 필수조건이 된다. 최근에 여러 연구들을 통해 티타늄 임플란트에 레이저를 사용하여 표면을 살균, 정화 시키는 방법에 대한 실험이 많이 보고되고 있다. 본 논문에서는 임플란트주위염 처치에 있어 레이저가 갖는 효능에 대한 최근 연구 결과들을 문헌고찰을 통해 되짚어보고자 한다.

• 대한치과보철학회지
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• 제50권1호
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• pp.67-73
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• 2012

최근 디지털 인상채득 시스템이 개발되면서 이를 기존의 CAD/CAM 시스템과 접목한 인레이, 온레이, 크라운이나 간단한 계속가공의치 등의 고정성 보철물의 제작이 활발히 소개되고 있다. 그러나 임플란트 보철에서는 주로 기존의 아날로그식 인상채득 후 이를 스캔하여 제작하는 방법이 사용되어 왔으나, 구강 내 디지털 스캔한 데이터를 이용하여 나사형 보철물을 제작하는 술식은 아직 활발히 이루어지지 않았다. 이에 본 증례보고에서는 6명의 환자를 대상으로 구강 내 스캐너인 iTero를 사용하여 디지털 스캔을시행한후그중다섯명은맞춤형지대주와 시멘트 합착 후 나사형 임플란트 보철물(screw-retained implant prosthesis after cementation, or SCRP)을 제작하였고, 임상적으로 기능과 심미적인 측면으로 만족할 만한 결과를 얻었기에 이를 보고하고자 한다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제41권
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• pp.36.1-36.8
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• 2019

Background: This study aims to examine the outcome of simultaneous maxillary sinus lifting, bone grafting, and vertical ridge augmentation through retrospective studies. Methods: From 2005 to 2010, patients with exhibited severe alveolar bone loss received simultaneous sinus lifting, bone grafting, and vertical ridge augmentations were selected. Fifteen patients who visited in Seoul National University Bundang Hospital were analyzed according to clinical records and radiography. Postoperative complications; success and survival rate of implants; complications of prosthesis; implant stability quotient (ISQ); vertical resorption of grafted bone after 1, 2, and 3 years after surgery; and final observation and marginal bone loss were evaluated. Results: The average age of the patients was 54.2 years. Among the 33 implants, six failed to survive and succeed, resulting in an 81.8% survival rate and an 81.8% success rate. Postoperative complications were characterized by eight cases of ecchymosis, four cases of exposure of the titanium mesh or membrane, three cases of periimplantitis, three cases of hematoma, two cases of sinusitis, two cases of fixture fracture, one case of bleeding, one case of numbness, one case of trismus, and one case of fixture loss. Prosthetic complications involved two instances of screw loosening, one case of abutment fracture, and one case of food impaction. Resorption of grafted bone material was 0.23 mm after 1 year, 0.47 mm after 2 years, 0.41 mm after 3 years, and 0.37 mm at the final observation. Loss of marginal bone was 0.12 mm after 1 year, and 0.20 mm at final observation. Conclusions: When sinus lifting, bone grafting, and vertical ridge augmentation were performed simultaneously, postoperative complications increased, and survival rates were lower. For positive long-term prognosis, it is recommended that a sufficient recovery period be needed before implant placement to ensure good bone formation, and implant placement be delayed.

• Journal of Periodontal and Implant Science
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• 제42권4호
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• pp.136-143
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• 2012

Purpose: The osseointegration around titanium mini-implants installed in macroporous biphasic calcium phosphate (MBCP) blocks was evaluated after incubation with recombinant human bone morphogenetic protein-2 (rhBMP-2) in an ectopic subcutaneous rat model. Methods: Mini-implants (${\varphi}1.8{\times}12$ mm) were installed in MBCP blocks (bMBCPs, $4{\times}5{\times}15$ mm) loaded with rhBMP-2 at 0.1 mg/mL, and then implanted for 8 weeks into subcutaneous pockets of male Sprague-Dawley rats (n=10). A histomorphometric analysis was performed, and the bone-to-implant contact (BIC) and bone density were evaluated. Results: Significant osteoinductive activity was induced in the rhBMP-2/bMBCP group. The percentage of BIC was $41.23{\pm}4.13%$ (mean${\pm}$standard deviation), while bone density was $33.47{\pm}5.73%$. In contrast, no bone formation was observed in the bMBCP only group. Conclusions: This model represents a more standardized tool for analyzing osseointegration and bone healing along the implant surface and in bMBCPs that excludes various healing factors derived from selected animals and defect models.

• Journal of Periodontal and Implant Science
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• 제43권6호
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• pp.291-300
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• 2013

Purpose: Calcium phosphate (CaP)-coated implants promote osseointegration and survival rate. The aim of this study was to (1) analyze the dissolution behavior of the residual CaP particles of removed implants and (2) evaluate bone apposition of CaP-coated machined surface implants at the early healing phase. Methods: Mandibular premolars were extracted from five dogs. After eight weeks, the implants were placed according to drilling protocols: a nonmobile implant (NI) group and rotational implant (RI) group. For CaP dissolution behavior analysis, 8 implants were removed after 0, 1, 2, and 4 weeks. The surface morphology and deposition of the coatings were observed. For bone apposition analysis, block sections were obtained after 1-, 2-, and 4-week healing periods and the specimens were analyzed. Results: Calcium and phosphorus were detected in the implants that were removed immediately after insertion, and the other implants were composed mainly of titanium. There were no notable differences between the NI and RI groups in terms of the healing process. The bone-to-implant contact and bone density in the RI group showed a remarkable increase after 2 weeks of healing. Conclusions: It can be speculated that the CaP coating dissolves early in the healing phase and chemically induces early bone formation regardless of the primary stability.

• 대한치과보철학회지
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• 제45권1호
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• pp.107-118
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• 2007

Statement of problem: Implant-type distractor uses a removable distraction device that has an appearance similar to that of a dental implant and utilizes many of the same techniques for placement as are used for dental implants. Material and method: In this study, 48 implant type titanium distractors were inserted into the osteotomized alveolar bone of 12 beagle dogs. After a 7-day latency period, the alveolar bone was augmented by 5mm vertically at a rate of 1.0 mm/day. The dogs were sacrificed after 4weeks, 8weeks and 12 weeks for radiographic, histologic, and histomorphometric analysis. Result: Copper equivalent value showed significant difference between 4 weeks and the other weeks(8, 12 weeks)(p<0.05). But there was no significant difference between maxillary and mandibular groups. In the bone to metal contact analysis, there was a significant difference between 4 weeks and 12 weeks(p<0.05). On the contrary, there was no significant difference between maxilla and mandible. The bone area showed significantly higher values in 12 weeks compared to 4 weeks(p<0.05). Histologically mineralization began at the host bone margins. At 12 weeks, increasing accumulation of $Ca^{++}$ element was confirmed. Conclusion: From the results above, the new bone formation was increased according to consolidation period. Especially there was significant difference between 4 weeks and 12 weeks(p<0.05). Implant type distractors used in this study to augment vertical ridge defect may prove to be a clinically useful treatment option in selected cases.

• 한국산업융합학회 논문집
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• 제20권2호
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• pp.169-176
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• 2017

Dental implants are required to have biomechanical functions and biostability in order to perform authoring, pronunciation, and aesthetic functions in the oral cavity. In terms of biostability, pure titanium for medical have good biostability and no rejection in the alveolar bone. with appropriate strength in terms of strength as well as biocompatibility. In recent years, various surgical methods and devices have been developed to improve the convenience and safety of the procedure. However, as the number of procedures increases, the screw loosening of the abutment screw connecting the artificial root and the abutment There are many reports of artificial root and abutment fracture. Fig. 1 is an example of a case where the upper part of the abutment screw is arbitrarily modified to remove the abutment by the abutment fracture due to the loosening of the abutment screw. The fundamental cause of abduction of the abutment screw is caused by the slight movement due to the lowering of the retention force of the abutment screw. It is necessary to minimize loosening of the abutment screw to avoid problems such as fracture during the period of using the implant. The purpose of this study is to investigate the structure of the abutment screw to prevent the loosening of the abutment screw by forming 0.5mm slot.