• Journal of the Korean Society for Precision Engineering
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• v.25 no.2
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• pp.148-155
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• 2008

The aim of the study is to interpret the distribution of occlusal force by 3-dimensional finite element analysis of ISP(Implant Supported Prosthesis) supported by minimum number of implant to restore the edentulous patients. For this study, the Astra Tech implant system is used. Geometric modeling for 6 and 4 fixture ISP group is performed with respect to the bone, implant and one piece superstructure, respectively. Implants are arbitrarily placed according to the anatomical limit of lower jaw and for the favorable distribution of occlusal force, which is applied at the end of cantilever extension of ISP with 30mm. Element type is tetrahedral for finite element model and the typical mechanical properties, Young's modulus and Poisson's ratio of each material, cortical, cancellous bone and implant material are utilized for the finite element analysis. From this study, we can see the distribution of equivalent stress equal to real situation and speculate the difference in the stress distribution in the whole model and at each implant fixture, From the analysis, the area of maximum stress is distributed on distal contact area between bone and fixture in the crestal bone. The maximum stress is 53MPa at the 0.2mm area from the bone-implant interface in the maximum side for 300N load condition for 4 fixture case, which is slightly less than the stress calculated from allowable strain. This stress has not been deduced to directly cause the loss of crestal bone around implant fixture, but the stress can be much reduced as the old peoples may have lower chewing force. Thus, clinical trial may be performed with this treatment protocol to use 4 fixtured ISP for old patients.

• Journal of Dental Rehabilitation and Applied Science
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• v.18 no.4
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• pp.277-288
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• 2002

Seven finite element models were constructed in mandible having single screw-type implant fixture connected to the premolar superstructure, in order to evaluate how the length, diameter and platform shape of a screw-type fixture influence the stress in the supporting tissue around fixtures. Each finite element model was varied in terms of length, diameter, and platform shape of the fixture. In each model, 250N of vertical load was placed on the central pit of an occlusal plane and 250N of oblique load placed on the buccal cusp. The stress distribution in the supporting tissue and the other components was analysed using 2-dimensional finite element analysis and the maximum von Mises stress in each reference area was compared. Under lateral loading, the stress was larger at the abutment/fixture interface, and in the crestal bone, compared to the stress pattern under vertical loading. The amount of stress at the superstructure was similar regardless of the length, diameter and platform shape of a fixture. Around the longer fixture, the stress was decreased at the bone crest and subjacent cancellous bone and increased in the cancellous bone area apical to the fixture. Around the wider fixture, the stress was decreased at the abutment/fixture interface, and the bone crest and increased in the cancellous bone area apical to the fixture. Around the fixture having wider platform, less stress was produced at the abutment/fixture interface and the upper part of the cortical bone, compared to the fixture having standard platform. In conclusion, the stress distribution of the supporting tissue was affected by length, diameter, and platform shape of a fixture, and the fixture which was larger in diameter and length could reduce the stress in the supporting tissues at the bone-fixture interface and bone crest area.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.106-120
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• 2020

Purpose: A new form of porous polyethylene, characterized by higher porosity and pore interconnectivity, was developed for use as a tissue-integrated implant. This study evaluated the effectiveness of porous polyethylene blocks used as an onlay bone graft in rabbit mandible in terms of tissue reaction, bone ingrowth, fibrovascularization, and graft-bone interfacial integrity. Methods: Twelve New Zealand white rabbits were randomized into 3 treatment groups according to the study period (4, 12, or 24 weeks). Cylindrical specimens measuring 5 mm in diameter and 4.5 mm in thickness were placed directly on the body of the mandible without bone bed decortication, fixed in place with a titanium screw, and covered with a collagen membrane. Histologic and histomorphometric analyses were done using hematoxylin and eosin-stained bone slices. Interfacial shear strength was tested to quantify graft-bone interfacial integrity. Results: The porous polyethylene graft was observed to integrate with the mandibular bone and exhibited tissue-bridge connections. At all postoperative time points, it was noted that the host tissues had grown deep into the pores of the porous polyethylene in the direction from the interface to the center of the graft. Both fibrovascular tissue and bone were found within the pores, but most bone ingrowth was observed at the graft-mandibular bone interface. Bone ingrowth depth and interfacial shear strength were in the range of 2.76-3.89 mm and 1.11-1.43 MPa, respectively. No significant differences among post-implantation time points were found for tissue ingrowth percentage and interfacial shear strength (P>0.05). Conclusions: Within the limits of the study, the present study revealed that the new porous polyethylene did not provoke any adverse systemic reactions. The material promoted fibrovascularization and displayed osteoconductive and osteogenic properties within and outside the contact interface. Stable interfacial integration between the graft and bone also took place.

• The Journal of Korean Academy of Prosthodontics
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• v.37 no.5
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• pp.607-619
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• 1999

Cortical support is an important factor, as the engagement of the fixture in strong compact bone offers an increased load-carrying capacity and initial stability. Because of the poor bone quality in the posterior mandible and other anatomic considerations, it has been suggested that implant fixtures be placed in these locations with apical engagement of the lingual cortical plate for so-called bicortication. The purpose of this investigation was to determine the effect of cortical engagements and in addition polyoxymethylene(POM) intramobile connector(IMC) of IMZ implant on implant load transfer in edentulous posterior segment of mandible, using three-dimensional (3D) finite element analysis models composed of cortical and trabecular bone involving single implant. Variables such as (1) the crestal peri-implant defect, (2) the apical engagement of lingual cortical plate, (3) the occlusal contact position (a vertical load at central fossa or buccal cusp tip), and (4) POM IMC were investigated. Stress patterns were compared and interfacial stresses along the bone-implant interface were monitored specially. Within the scope of this study, the following observations were made. 1) Offset load and angulation of fixture led to increase the local interfacial stresses. 2) Stresses were concentrated toward the cortical bones, but the crestal peri-implant defect increased the interfacial stresses in trabecular bone. 3) For the model with bicortication, it was noticed that the crestal cortical bone provided more resistance to the bending moment and the lingual cortical plate provided more support for the vertical load. But Angulation problem of the fixture from the lingual cortical engagement caused the local interfacial stress concentrations. 4) It was not clear that POM IMC had the effect on stress distribution under the present experimental conditions, especially for the cases of crestal peri-implant defect.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.46 no.3
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• pp.162-173
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• 2020

Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental implants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of insertion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a comparison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I²=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.

• 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.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.151-164
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• 2007

Objective: The sinus floor elevation procedures have been used to facilitate implant placement in the severely atrophic posterior maxilla. Many variables may have an influence on the outcomes of the sinus floor elevation in combination with implant treatment. The aim of this study was to analyze survival rate of implants placed in the edentulous maxillae of patients in whom sinus floor elevation was undertaken according to variables. Materials and Methods: It consisted of 96 patients(50 male and 46 female), ranging in age from 31 to 70 years(mean 49 years), who underwent sinus floor elevation procedure(94 implants in left side and 106 implants in right side) from 2001 to 2002. A total of 200 implants were placed in the grafted sinus(73 implants in lateral approach and 127 implants in crestal approach). All implants were restored by fixed prosthesis. All patients were healthy. Follow-up periods for implants were between 48 to 60 months. Results: The cumulative survival rate of implants was 91.5%. Gender, age and operation site did not have an influence on the survival rate. There was statistically significant differences for the implants which placed in less than 4 or 5 rom residual bone height, the survival rate was 60%, 81.4% respectively (p<0.05). There was no statistically significant difference of implants survival rate ac- cording to approach technique. The survival rate for 100% autogenous bone grafts was lower with respect to composite grafts containing autogenous bone and 100% substitutes. The survival rate for hydroxyapatite-coated implants was statistically significant lower than other textured group (p<0.05). Conclusion: Residual bone height, surface texture and graft materials have an influence on the survival rate. To use autogenous bone as a part of a composite bone replacement, implant texture which leads to more favorable implant-bone interface were necessary. To determine residual bone height for initial implant stability was important.

• The Journal of the Korean dental association
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• v.46 no.8
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• pp.494-504
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• 2008

Osseointegration is a result of bone formation and bone regeneration process, which take place at the interface between bone and implant and biologic determinants such as cytokine, growth factors, bone matrix proteins play an important role in osseointegration. The purpose of this study is to compare the expressoin of TGF-$\beta$, IGF-I, BMP2, BMP4 during osseointegration. We designed an experimental group which was inserted with a RBM surface titanium implants and machined surface, and compared with a control group which had a simple bone cavity and normal bone. Titanium implants were placed into tibia of 8 rabbits. We compared the expression of TGF-$\beta$, IGF-I, BMP2, BMP4 using RT_PCR (reverse transcriptase chain reaction)analysis in day 3,7,14 and 28 of implant insertion. According to the results, growth factors of experimental groups were more expressed than control groups. Among experimental groups, expression of TGF-$\beta$, IGF-I, BMP4 of BMP group had tedency to increase more at 14th, 28th days than Machined surface group. Therefore, our results suggest that TGF-$\beta$, IGF-I, BMP4 are expressed within the bone around the implant and more increased around rough surface implants while osseointegration occurs after dental implant insertion.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.32 no.1
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• pp.52-59
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• 2006

Purpose: The purpose of this study was to evaluate the influence of apical-coronal implant position on the stress distribution after occlusal and oblique loading. Materials and Methods: The cortical and cancellous bone was assumed to be isotropic, homogeneous, and linearly elastic. The implant was apposed to cortical bone in the crestal region and to cancellous bone for the remainder of the implant-bone interface. The cancellous core was surrounded by 2-mm-thick cortical bone. An axial load of 200 N was assumed and a 200-N oblique load was applied at a buccal inclination of 30 degrees to the center of the pontic and buccal cusps. The 3-D geometry modeled in Iron CAD was interfaced with ANSYS. Results: When only the stress in the bone was compared, the minimal principal stress at load Points A and B, with a axial load applied at 90 degrees or an oblique load applied at 30 degrees, for model 5. The von Mises stress in the screw of model 5 was minimal at Points A and B, for 90- and 30-degree loads. When the von Mises stress of the abutment screw was compared at Points A and B, and a 30-degree oblique load, the maximum principal stress was seen with model 2, while the minimum principal stress was with model 5. In the case of implant, the model that received maximum von Mises stress was model 1 with the load Point A and Point B, axial load applied in 90-degree, and oblique load applied in 30-degree. Discussion and Conclusions: These results suggests that implantation should be done at the supracrestal level only when necessary, since it results in higher stress than when implantation is done at or below the alveolar bone level. Within the limited this study, we recommend the use of supracrestal apical-coronal positioning in the case of clinical indications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.455-464
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• 2004

The purpose of this study was to evaluate and compare the influence of Steroid topical irrigation and implant surface on bone healing in the irradiated rabbit tibia. Implant to bone contact surface ratio and the pattern of bone healing around hydroxyapatite(HA) coated implant and pure titanium (Ti) implant which were inserted into the irradiated rabbit tibia were compared. 16 Korean house mature male rabbits were used as experimental animal. Each rabbit received 15 Gy of irradiation. 4 weeks after the irradiation, two holes were prepared in the irradiated tibia of each rabbits, where two surface type of implants were inserted :1) HA coated type and 2) pure Ti type. Right before placing implants, one group of rabbit received steroid irrigation and the other group did saline. After the irrigation, two implants of HA coated type and pure Ti type were inserted into the tibia of each rabbits. Each rabbit were sacrificed at 2nd, 4th, and 8th week after the implantation and the specimens were observed by the light microscope. The pattern of bone healing and histomorphometric analysis of the implant-bone interface were done. The results were as follows. 1. All implants inserted into the irradiated tibia of rabbit did not show any sign of clinical mobility and the bone around implants inserted into the irradiated tibia of rabbit did not show any resorption. 2. The bone to implant contact surface ratio around HA coated implants that received steroid irrigation got more bone to implant contact surface ratio than that of the saline irrigation. This result showed statistically significant(p<0.05). There was no statistically significant difference in 8th week group. 3. Though there was no statistically significant difference HA coated implants had more bone to implant contact surface ratio than pure Ti implant in 2nd and 4th groups, and there was no difference in 8th week group. 4. All implants inserted into the irradiated tibia of rabbit had exhibited successful osseointegraion.