• The Journal of Korean Academy of Prosthodontics
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• v.40 no.3
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• pp.246-261
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• 2002

The screw loosening is one of the complications that happen frequently in dental implant prostheses. The purpose of this study was to evaluate the changes of reverse/loosening (opening) torque of the screw according to the surface modifications by sandblasting and 24K gold electroplating as well as to determine the possibility of the clinical use of a washer in dental implant. The reverse torque of 4 experimental conditions(control, sandblasted, use of washers, electroplasted) was measured by digital torque gauge (Model MGT50Z, Mark-10 Corp., 458 West John Street Hicksville, NY 11801 USA). Electronic torque controller (Nobel Biocare DEA 020) was used in fastening the gold screws into abutment replicas. Mixed Linear Model Analysis method was used for statistical analysis. To examine the changes of screw thread surface, microphotographs were taken by Olympus PME-3 metallurgic microscope (Olympus Optical Co. Ltd., Tokyo, Japan). Within the limitations of this study, the following results were drawn: 1. The surface modifications of the gold screws and the use of a washer have significantly affected the reverse torque value compared to the control group (P<0.01). 2. Sandblasting and electroplating treatments demonstrated significantly higher reverse torque value than that of control group. 3. The use of a washer may be one of the useful clinical methods that prevent the screw loosening. However, further studies are necessary for the material selection and design of the washer.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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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.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.3
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• pp.445-454
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• 1994

Osseointegrated implant prostheses are to provide normal function without compromising the unique interaction between the tissue and the implant. The essential requirement for the osseointegrated implant prostheses is passive fit of abutment. Therefore, the impression must be accurate and reproduciable since the resultant master cast precisely duplicates the clinical condition. The purpose of this study was to compare the accuracy of the master casts obtained from five impression techniques. Group 1 : To take impression with indirect technique and Impregum F. Group 2 : To take impression with unsplinted direct technique and Impregum F. Group 3 : To take impression with splinted direct technique and Impregum F. Group 4 : To take impression with unsplinted direct technique and Xanthano. Group 5 : To take impression with splinted dierct technique and Xanthano. The results were as follow : 1. In taking impression of Impregum F, there was no significant difference between to use of indirect technique and unsplinted direct technique.(p<0.05) 2. Unsplinted direct technique with Impregum F is less accurate than splinted direct technique with Impregum F or Xanthano and unsplinted direct technique with Xanthano.(p<0.05). 3. There was no significant difference between splinted direct technique with Impregum F and unsplinted direct technique with Xanthano.(p<0.05) 4. Splinted direct technique reproduce more accurate than unsplinted direct technique.(p<0.05) 5. Impression plaster produced less distortion than polyether.(p<0.05) As a result, splinted direct technique with Xanthano was the most accurate technique. As a result, splinted direct technique with Xanthano was the most accurate technique in this study. In addition to dimensinal changes in the materials used, positional errors were also attributed to the mechanical components used in the transfer porocess. Although the errors measured were relatively small, this study demonstrates the potential for distortions with the transfer technique used. Further study is indicated that ?the technique will be able to reproduce the intraoral relationship of implant fixtures reliably and predictably.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.4
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• pp.444-456
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• 2007

Statement of problem: Implant inclination and cantilever loading increse loads distributed to implants, potentially causing biomechanical complications. Controversy exists regarding the effect of the intentionally distal-inclined implant for the reduction of the cantilever length. Purpose: This study investigated the stress distribution at the bone/implant interface and prostheses with 3D finite element stress analysis by using four different cantilever lengths and implant inclinations in a mandibular implant-supported bar overdenture. Material and methods: Four 3-D finite element models were created in which 4 implants were placed in the interforaminal area and had four different cantilver lengths(10, 6.9, 4 and 1.5mm) and distal implant inclinations$(0^{\circ},\;15^{\circ},\;30^{\circ}\;and\;45^{\circ})$ respectively. Vortical forces of 120N and oblique forces of 45N were applied to the molar area. Stress distribution in the bone around the implant was analysed under different distal implant inclinations. Results: Analysis of the von Mises stresses for the bone/implant interfaces and prostheses revealed that the maximum stresses occurred at the most distal bone/implant interface and the joint of bar and abutment, located on the loaded side and significantly incresed with the implant inclinations, especially over $45^{\circ}$. Conclusion: Within the limitations of this study, it was suggested that too much distal inclination over 45 degrees can put the implant at risk of overload and within the dimension of the constant sum of a anterior-posterior spread and cantilever length, a distal implant inclination compared to cantilever length had the much larger effect on the stress distribution at the bone/implant interface.

• The Journal of Advanced Prosthodontics
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• v.10 no.3
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• pp.184-190
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• 2018

PURPOSE. To analyze stress distribution in premolars restored with inlays or onlays using various materials. MATERIALS AND METHODS. Three-dimensional maxillary premolar models of abutments were designed to include the following: 1) inlay with O cavity (O group), 2) inlay with MO cavity (MO group), 3) inlay with MOD cavity (MOD group), and 4) onlay (ONLAY group). A restoration of each inlay or onlay cavity was simulated using gold alloy, e.max ceramic, or composite resin for restoration. To simulate masticatory forces, a total of 140 N static axial force was applied onto the tooth at the occlusal contact areas. A finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. RESULTS. Maximum von Mises stress values generated in the abutment teeth of the ONLAY group were ranged from 26.1 to 26.8 MPa, which were significantly lower than those of inlay groups (O group: 260.3-260.7 MPa; MO group: 252.1-262.4 MPa; MOD group: 281.4-298.8 MPa). Maximum von Mises stresses generated with ceramic, gold, and composite restorations were 280.1, 269.9, and 286.6 MPa, respectively, in the MOD group. They were 252.2, 248.0, 255.1 MPa, respectively, in the ONLAY group. CONCLUSION. The onlay design (ONLAY group) protected tooth structures more effectively than inlay designs (O, MO, and MOD groups). However, stress magnitudes in restorations with various dental materials exhibited no significant difference among groups (O, MO, MOD, ONLAY).

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.3
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• pp.259-268
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• 2007

purpose: This study was to evaluate the shear bond strength of Lithium Disilicate Glass-Ceramic by removable method of temporary cement on the abutment tooth. Material and Method: Sixty molar teeth of human with the occlusal surface up were mounted in acrylic resin blocks. The 45 specimens were prepared to exposure dentin by diamond bur and the eugenol-containing temporary cement($Cavitec^{TM}$ ($KERR^{(R)}$, U.S.A)was applied to the dentin surfaces. After initial removal of the cement with a dental explorer, the specimens were divided into 4 groups of 15 specimens each. The dentin surfaces of the specimens were treated by rotary instrument with as follow pastes: $Zircate^{(R)}$ prophy paste(Dentsply, U.S.A), Radent Prophy Paste(Pascal company,inc. U.S.A), and Dental pumice(Wip mix corporation,U.S.A). An adhesive resin luting agent(Variolink $II^{(R)}$, Ivoclar Vivadent, Leichtenstein) including Monobond-S and $Excite^{(R)}$ was applied to all specimens. The ceramic specimens were made with an A1 ingot of IPS Empress $II^{(R)}$ (Ivoclar Vivadent, Leichtenstein). After the specimens were stored in distilled water for 48hr, the shear bond strength(MPa) was measured by a Universal testing machine(Zwick 145641, Zwick, Germany) at a 1mm/min cross-head speed. The data were statistically analyzed by one-way ANOVA and Duncan's multiple range test. Results: In all group, there were no significant differences in comparison with the control group(p>0.05). The pattern of most failure showed the mixed type of cohesive and adhesive failure. Conclusion: Resin bond strength of IPS Empress $II^{(R)}$ was not affected by removal method of the temporary cement.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.4
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• pp.634-644
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• 1995

The purpose of this study is to evaluate the color differences in the In-Ceram according to coping thickness and various abutment core materials ; amalgam, precious alloy, composite resin, non-precious alloy. After the porcelain was built up on the In-Ceram coping at the thicknes of 0.3mm and 0.5mm then it was cemented with glass ionomer cement to the post & core materials. The following results were obtained. 1. There were significant differences in the $L^*$ values $a^*$ and $b^*$ values in the cementation of different cores, to the In-Ceram(P<0.01). $L^*$ values were not significantly different between the composite resin to the In-Ceram and the $a^*\;b^*$ values were not significantly different between the amalgam and the non-precious alloy. 2. All of cementations of In-Ceram to the core materisal had color difference(${\Delta}E^*ab$) compared to the In-Ceram. In the 0.3mm thickness of the In-Ceram copping non-precious alloy indicated the greatest value, while the composite resin core showed the lowest value with a thickness of 0.5mm In-Ceram copping. 3. By controlloing the In-Ceram coping thickness $L^*$ value was significatly different(P<0.01), but not in $a^*$ and $b^*$ values. 4. In an amalgam, precious & non-prcious alloys there was a 1,74 to 3.06 range color difference in the controlled thickness of In-Ceram coping at the thickness of 0.3mm and 0.5mm. The above results suggest that the requirement of the sufficient thickness of In-Ceram coping and the suitable core material in order to get an estheti restoration by In-Ceram and also to intercept the original core color.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.4
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• pp.793-800
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• 1997

Periotest(Siemens, Germany) has been used to test mobility of the implants clinically, however the effects of target materials and connection methods on the PTVs(Periotest Values) have not been evaluated. Periotest has been regarded as a reliable and objective tool to test implant and natural teeth mobility clinically, however this instrument showed different PTVs under various test conditions. This in vitro study was designed to compare PTVs of different veneering materials and prosthodontic designs (single and bridge restorations). To compare the effects of veneering materials on PTVs, 1 mm thickness of five different testing materials (porcelain, type III gold alloy, pure titanium, composite resin, acrylic resin) were placed on the resin block. Three full length of 13 mm Mark II implant fixtures were embedded into autopolymerizing resin block to fabricate single and bridge restorations. To evaluate effects of the connection method in single restorations, PTVs of screw retained(UCLA type) and cementation type(Cera-One system) were compared. Finally, to test reliability of PTVs of the final restorations, screw retained three unit short span PFM bridges were fabricated on the standard and Estheti-Cone abutments. All testing components were tightened with torque controller and PTVs of all specimens were measured 15 times for statistical analysis with SAS program. Following conclusions were made within the limit of this in vitro study. 1. PTVs of type III gold alloy, grade II titanium, composite resin veneering materials showed no significant differences, however acrylic resin and porcelain showed significant differences (P<0.05). 2. Single tooth restorations showed consistent PTVs as long as proper torque force was applied. 3. PTVs of bridge type prostheses was inconsistent regardless of abutment types. 4. PTVs of the prostheses showed higher scores and standard deviations than those of abutments regardless types of connection (P<0.05).

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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• pp.414-420
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• 2006

Purpose : The purpose of this study is to use finite element analysis to predict the fatigue life of an implant system subjected to fatigue load by mastication (chewing force). The reliability and the stability of implant system can be defined in terms of the fatigue strength. Not only an implant is expensive but also it is almost impossible to correct after it is inserted. From a bio-engineering standpoint, the fatigue strength of the dental implant system must be evaluated by simulation (FEA). Material and Methods Finite element analysis and fatigue test are performed to estimate the fatigue strength of the implant system. Mesh of implant is generated with the actual shape and size. In this paper, the fatigue strength of implant system is estimated. U-fit (T. Strong, Korea, internal type). The stress field in implant is calculated by elastic-plastic finite element analysis. The equivalent fatigue stress, considering the contact and preload stretching of a screw by torque for tightening an abutment, is obtained by means of Sine's method. To evaluate the reliability of the calculated fatigue strength, fatigue test is performed. Results: A comparison of the calculated fatigue strength with experimental data showed the validity and accuracy of the proposed method. The initiation points of the fatigue failure in the implant system exist in the region of high equivalent fatigue stress values. Conclusion: The above proposed method for fatigue life estimation tan be applied to other configurations of the differently designed and improved implant. In order to prove reliability of prototype implant, fatigue test should be executed. The proposed method is economical for the prediction of fatigue life because fatigue testing, which is time consuming and precision-dependent, is not required.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.2
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• pp.218-231
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• 2005

Statement of problem. In the partially edentulous patients, removable partial dentures have been working as a important treatment modality. Clasps, a kind of direct retainers, received some amount of stresses during the insertion and removal of partial denture on the abutment tooth. Purpose. The study is to investigate stresses of the different clasps. Material and methods. In order to investigate the degree of stresses, maxillary partial edentulism (Kennedy Class II modification I) was assumed and removable partial dentures were designed on it with three kinds of metallic materials; cobalt-chromium alloy, type IV gold alloy and commercially pure (c.p.) titanium. Aker's clasp was applied on the left second molar. RPA (mesial rest-proximal plate-Aker's) clasp was on the left first premolar and wrought wire clasp was on the right first premolar. Three dimensional, non-linear, dynamic finite element analysis method was run to solve this process. Results. 1. Cobalt-chromium alloy had the highest von Mises stress value and c.p. titanium had the lowest one irrespective of the types of clasps. 2. In the Aker's clasps, stress on the retentive tips was shown shortly after the appearance of stresses of the middle and minor connector areas. These time lag was much shorter in the RPA clasps than in the Aker's clasp. 3. In general. retentive tips of wrought wire clasps had much less amount of stress than other clasps. Conclusion. The amount of stress was the highest in the RPA clasp and the lowest in the wrought wire clasp, in general.