Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.47
no.3
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pp.153-174
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2021
Dental implants are popular for dental rehabilitation after tooth loss. The goal of this systematic review was to assess bone changes around bone-level and tissue-level implants and the possible causes. Electronic searches of PubMed, Google Scholar, Scopus, and Web of Science, and a hand search limited to English language clinical trials were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines up to September 2020. Studies that stated the type of implants used, and that reported bone-level changes after insertion met the inclusion criteria. The risk of bias was also evaluated. A total of 38 studies were included. Eighteen studies only used bone-level implants, 10 utilized tissue-level designs and 10 observed bone-level changes in both types of implants. Based on bias assessments, evaluating the risk of bias was not applicable in most studies. There are vast differences in methodologies, follow-ups, and multifactorial characteristics of bone loss around implants, which makes direct comparison impossible. Therefore, further well-structured studies are needed.
Purpose: This study was to identify the influencing factors of the compliance level to a therapeutic regimen after a bone mineral densitometry test. Method: The sample for the study was 95 people who took the bone mineral densitometry test from March, 2002 to July, 2002. Data was collected by mail using aself reporting questionnaire on the selected variables such as the compliance level, self efficacy, health locus of control, susceptibility, severity, usefulness, barrier, and self esteem. Results: The average compliance level was 63.93. Through multiple regression, three independent variables including chance health locus of control on personality, the result of bone mineral density and self-efficacy were entered in the model as the significant determinants of the compliance level after a bone mineral densitometry test. The coefficients of determination of each variable were 10.9%, 8.3% and 8.1% respectively. Conclusion: The identification of the determinants of the compliance level to the therapeutic regimen after bone mineral densitometry is expected to contribute to the development of an intervention program to improve the compliance level to the therapeutic regimen in osteoporosis patients.
This study was done to evaluate the effect of dietary calcium level (a diet which met 100% or twice the calcium level in AIN-76 diet) on preventing bone loss in ovariectomized rats. Forty Sprauge-Dawley female rats(body weight 200$\pm$5g)were divided into two groups. One group were ovariecotomized (Ovx) while the others received sham operation(Sham). Thereafter, each rat group was further divided into normal calcium diet(0.52%) and high calcium diet(1.04%) subgroups. All rats were fed on experimental diet and deionized water ad libitum for 8 weeks. The total body, spine and femur bone mineral densities and bone mineral contents were measured by Dual Energy X-ray Absorptiometry, Eight weeks following operation, ovariectomized rats fed a high calcium diet had a significantly higher total bone mineral content, total bone calcium content, spine bone mineral density, spine bone mineral content and femur bone mineral content than ovariectomized rats fed control calcium diet. The correlation between dietary calcium intake level and spine bone mineral density were positive, but there was no correlation between dietary calcium intake and femur bone mineral density. The findings from the present study demonstrated that bone loss due to ovarian hormonal deficiency can be partially prevented by a high calcium diet. Futhermore, these findings support the strategy of the use of a high calcium diet in the prevention of estrogen depleted bone loss(postmenopausal osteoporosis)
To study the effects of the age and the dietary protein content on Ca metabolism male rats of 1 month 6 month 12 month of age were fed experimental diets containing 5%, 15% or 50% casein for 4 weeks. Food and ca intake were higher in old rats and in high protein groups. The weight ash and Ca contents of femur and tibia were higher in old rats. The higher dietary protein level resulted in higher skeletal weigh ash and Ca contents. But high protein diet(50% casein) lead to reduced bone mineral density(ash/dry bone weight) and Ca density(Ca/dry bone weight) in 1 month old rats. Low protein diet(5% casein) on the other hand reduced the bone growth even though the bone density was higher in this group. The ill effect of low protein diet was not evident in 12 month old rats. Glomerular filteration rate(GFR) and urinary Ca excretionincreased with age and with dietary protein level especially in 12 month old rats. Serum immunoreactive parathyroid hormone(iPTH) level tended to be higher in aged rats but was not affected by dietary protein level except 1 month old rats where 50% protein group showed significantly higher value. This study showed that the dietary protein level seemed to have different effect on Ca metabo-lism in rats of different age., The low bone density in the high protein group of growing rats may be due to the higher iPTH level and increased urinary Ca. The dietary protein level however had no effects on the bone composition in aged rats even though the higher urinary Ca excretion. In conclusion this study suggests that high protein intake from young may lead to less peak bone mass and to increase the bone loss in later years, which would increase the risk for osteporosis.
Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.
Purpose : This study was peformed to evaluate the effect of Kamijoaguiem(JGE) on the bone mass and its related factors. Methods : We used ovariectomized rat as an estrogen-deficient animal model. The model rats of osteoporosis showed a significant decrease in bone density, bone ash density, calcium content of femur bone. At the 7th day after operating ovariectomy, rats were administered with JGE per orally, and continued for 10 weeks. And osteoporosis related parameters were determined to investigate the effect of JGE. Results : Bone density, bone ash density, bone calcium, magnesium and phosphorus was decreased in osteoporotic rats. JGE improved the decreased bone density, bone ash density and the decreased bone magnesium, but JGE didn't improve the decreased bone calcium and phosphorus in osteoporotic rats. Osteocalcin in serum and hydroxy-proline excretion in urine were increased in osteoporotic rats. Their levels were decreased when JGE was administered. ALP activity in serum was increased in osteoporotic rats. JGE didn't induce any significant changes. JGE showed significant increase in serum calcium level, total protein level, albumin level, BUN level, serum LDH activity. JGE didn't show significant increase in serum T-cholesterol density, triglyceride density, HDL-cholesterol density. JGE didn't show significant increase in RBC number, hemoglobin level, platelet number, hematocrit level. JGE showed inhibitory effect on the degradation of bone-matrix in osteoporotic rats, in histological examination to Hematoxylin-eosin stain. Conclusion : JGE might improve bone density due to inhibition of bone resolution in osteoporotic rats. It suggest that JGE may be useful prescription in osteoporosis.
This study was designed to investigate the effects of dietary calcium. serum estrogen level and physical activity on the bone status of 116 healthy elderly women living in urban area. Current calcium intake was assessed by convenient method(refered to as Ca intake) and calcium containing food frequency method(refered to as Ca index) Daily activity record was used for the estimation of physical activity level, and serum estrogen level was measured from fasting blood of subjects. The rate of bone resorption was evaluated by the determination of hydroxyproline(Hpr) in fasting urine with correction for creatinine excretion. The results of this study are summarized as follows : 1) Average daily Ca intake of subjects was 621.4$\pm$155.8mg, which is above the Korean recommended dietary allowances. However 44.8% of the subjects consumed Ca below RDA level. Ca index score was significantly correlated with the bone status(P<0.05), Ca intake did not show significant correlation with the bone status although a positive trend of influence was evident. 2) Average serum estrogen level of subjects was 18.7$\pm$9.8pg Contrary to our anticipation. estrogen level did not show any significant relation to age and bone status. 3) Daily physical activity was classified into four categories by activity intensity : sedentary. moderate, active and severe. The average physical activity of subjects belong to moderate level. and the bone status was significantly related to the physical activity(P<0.01) 4) Among other influential factors such as age, pocket-money. family type. drinking, smoking and BMI, there was a significant difference between bone status and BMI(P<0.05). 5) Multiple regression analysis of variables showed that physical activity has greater effect than other variables when the entire subjects were taken into account. However. eliminating the subjects whose bone status rated as excellent(Hpr/cr<0.009), Ca index showed higher correlation than physical activity. These results have demonstrated that dietary calcium intake is the primary important factor for keeping good bone health and that bone status of subjects with a sufficient calcium intake is affected by various factors such as physical activity, age, smoking. BMI and others.
Purpose: Implant wall thickness and the height of the implant-abutment interface are known as factors that affect the distribution of stress on the marginal bone around the implant. The goal of this study was to evaluate the long-term effects of supracrestal implant placement and implant wall thickness on maintenance of the marginal bone level. Methods: In this retrospective study, 101 patients with a single implant were divided into the following 4 groups according to the thickness of the implant wall and the initial implant placement level immediately after surgery: 0.75 mm wall thickness, epicrestal position; 0.95 mm wall thickness, epicrestal position; 0.75 mm wall thickness, supracrestal position; 0.95 mm wall thickness, supracrestal position. The marginal bone level change was assessed 1 day after implant placement, immediately after functional loading, and 1 to 5 years after prosthesis delivery. To compare the marginal bone level change, repeated-measures analysis of variance was used to evaluate the statistical significance of differences within groups and between groups over time. Pearson correlation coefficients were also calculated to analyze the correlation between implant placement level and bone loss. Results: Statistically significant differences in bone loss among the 4 groups (P<0.01) and within each group over time (P<0.01) were observed. There was no significant difference between the groups with a wall thickness of 0.75 mm and 0.95 mm. In a multiple comparison, the groups with a supracrestal placement level showed greater bone loss than the epicrestal placement groups. In addition, a significant correlation between implant placement level and marginal bone loss was observed. Conclusions: The degree of bone resorption was significantly higher for implants with a supracrestal placement compared to those with an epicrestal placement.
PURPOSE. This study evaluated the initial stability of different implants placed above the bone level in different types of bone. MATERIALS AND METHODS. As described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Br${\aa}$nemark System$^{(R)}$ Mk III TiUnite$^{TM}$, Straumann Standard Implant SLA$^{(R)}$, and Astra Tech Microthread$^{TM}$-OsseoSpeed$^{TM}$) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis. RESULTS. In the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Br${\aa}$nemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants. CONCLUSION. The initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.
Journal of Dental Rehabilitation and Applied Science
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v.18
no.4
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pp.301-311
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2002
The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different vertical bone level of implant fixture. The two kinds of finite element models were designed according to vertical bone level around fixture ($4.0mm{\times}11.5mm$). The cemented crowns for mandibular first and second molars were made. Three- dimensional finite element model was created with the components of the implant and surrounding bone. Vertical loads were applied with force of 200N distributed within 0.5mm radius circle from the center of central fossa and distance 2mm and 4 mm apart from the center of central fossa. Von-Mises stresses were recorded and compared in the supporting bone, fixtures, abutment screws, and crown. The results were as following : (1) In vertical loading at the center circle of central fossa on model 1 and 2, the difference from vertical bone in implant placement did not affect the stress pattern on all components of implant except for crown. (2) With offset distance incerasing and the bone level of implant decreasing, the concentration of stress occured in the buccal side of long crown, around the buccal crestal bone, and on the fixture- abutment interface. As a conclusion, the research showed a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the vertical level of bone around fixture was different. Since the same vertical bone bed has more benefits than the different bone bed around fixtures, it is important to prepare a same vertical level of bone bed for the success of implants under occlusal loads.
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