• The Journal of Advanced Prosthodontics
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• v.7 no.5
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• pp.375-379
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• 2015

PURPOSE. The purpose of this study was to evaluate the influence of tightening technique and the screw coating on the loosening torque of screws used for Universal Abutment fixation after cyclic loading. MATERIALS AND METHODS. Forty implants (Titamax Ti Cortical, HE, Neodent) (n=10) were submerged in acrylic resin and four tightening techniques for Universal Abutment fixation were evaluated: A - torque with 32 Ncm (control); B - torque with 32 Ncm holding the torque meter for 20 seconds; C - torque with 32 Ncm and retorque after 10 minutes; D - torque (32 Ncm) holding the torque meter for 20 seconds and retorque after 10 minutes as initially. Samples were divided into subgroups according to the screw used: conventional titanium screw or diamond like carbon-coated (DLC) screw. Metallic crowns were fabricated for each abutment. Samples were submitted to cyclic loading at $10^6$ cycles and 130 N of force. Data were analyzed by two-way ANOVA and Tukey's test (5%). RESULTS. The tightening technique did not show significant influence on the loosening torque of screws (P=.509). Conventional titanium screws showed significant higher loosening torque values than DLC (P=.000). CONCLUSION. The use of conventional titanium screw is more important than the tightening techniques employed in this study to provide long-term stability to Universal Abutment screws.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.1
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• pp.129-150
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• 1993

Since the restoration or masticatory function is the most important aim of implants, it should be substituted for the role of natural teeth and deliver the stress to the bone under the continous load during function. In natural teeth, stress distribution can be obtained through enamel, dentin and cementum and the elasticity of the periodontal ligament play a role of buffering action. In contrast, implant prosthesis has a very unique characteristics that it delvers the load directly to bone through the implant and superstructure. This fact arise the needs to evaluate the stress distribution of the implant in the mechnical aspects, which has a similar role of natural teeth but different pathway of stress. With 3 kinds of implant in prevalent use, 2 types of experimental PEA implant models were made, axisymmetric and 2-dimensional type. In axisymmetric model, the stiffness of the part including the prosthesis and implant which extrude out of bony surface could be calculated with displacement of the superstructure un er 100N vertical load and then damping effects could be determined through this stiffness. In axisymmetric FEA model, load to the bone could be deduced by evaluation the stress distribution of the designed surface under the 100N vertical force and in 2-dimensional model, 100N eccentric vertical load and 20N horizontal loda. The result are as follows. 1. In every implant, stress to the bone tends to be concenturated on the cortical bone. 2. Though the stress of the cancellous bone is larger at the apex of implants, it is less compared with cortical bone. 3. Under 20N horizontal load, stress of the left and right sides of implant shows a symmetrical pattern. But under 100N eccentric vertical load, loaded side shows much larger stress value. 4. In the 1mm interface, stress distribution among implants tend to have a similar pattern. But under 20N horizontal load apposite side of being loaded shows less stress in IMZ. 5. In the case of screw type implant, stress tends to vary along with screw shape. 6. According to the result determined with microstrain, cancellous bone id generally under the condition of overload, while cortical bone is usually within the limitation of physiologic load. 7. In the Branemark implant, maximum stress to the cortical bone is larger than any other implant except for the condition of 20N horizontal force and 0.05mm interface. 8. Damping effects of implants is maximum in IMZ.

• The korean journal of orthodontics
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• v.41 no.6
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• pp.423-430
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• 2011

Objective: To evaluate the extent and aspect of stress to the cortical bone after application of a lateral force to a two-component orthodontic mini-implant (OMI, mini-implant) by using three-dimensional finite element analysis (FEA). Methods: The 3D-finite element models consisted of the maxilla, maxillary first molars, second premolars, and OMIs. The screw part of the OMI had a diameter of 1.8 mm and length of 8.5 mm and was placed between the roots of the upper second premolar and the first molar. The cortical bone thickness was set to 1 mm. The head part of the OMI was available in 3 sizes: 1 mm, 2 mm, and 3 mm. After a 2 N lateral force was applied to the center of the head part, the stress distribution and magnitude were analyzed using FEA. Results: When the head part of the OMI was friction fitted (tapped into place) into the inserted screw part, the stress was uniformly distributed over the surface where the head part was inserted. The extent of the minimum principal stress suggested that the length of the head part was proportionate with the amount of stress to the cortical bone; the stress varied between 10.84 and 15.33 MPa. Conclusions: These results suggest that the stress level at the cortical bone around the OMI does not have a detrimental influence on physiologic bone remodeling.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.365-375
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• 2009

Statement of problems: Stress analysis on implant components of the combined screw- and cement-retained implant prosthesis has not investigated yet. Purpose: The purpose of this study was to assess the load distribution characteristics of implant prostheses with the different prosthodontic retention types, such as cement-type, screw-type and combined type by using 3-dimensional finite element analysis. Material and methods: A 3-dimensional finite element model was created in which two SS II implants (Osstem Co. Ltd.) were placed in the areas of the first premolar and the first molar in the mandible, and three-unit fixed partial dentures with four different retention types were fabricated on the two SS II implants. Model 1 was a cement-retained implant restoration made on two cement-retained type abutments (Comocta abutment; Osstem Co. Ltd.), and Model 2 was a screw-retained implant restoration made on the screw-retained type abutments (Octa abutment; Osstem Co. Ltd.). Model 3 was a combined type implant restoration made on the cement-retained type abutment (Comocta abutment) for the first molar and the screw-retained type abutment (Octa abutment) for the first premolar. Lastly, Model 4 was a combined type implant restoration made on the screw-retained type abutment (Octa abutment) for the first molar and the cement-retained type abutment (Comocta abutment) for the first premolar. Average masticatory force was applied on the central fossa in a vertical direction, and on the buccal cusp in a vertical and oblique direction for each model. Von-Mises stress patterns on alveolar bone, implant body, abutment, abutment screw, and prosthetic screw around implant prostheses were evaluated through 3-dimensional finite element analysis. Results: Model 2 showed the lowest von Mises stress. In all models, the von Mises stress distribution of cortical bone, cancellous bone and implant body showed the similar pattern. Regardless of loading conditions and type of abutment system, the stress of bone was concentrated on the cortical bone. The von-Mises stress on abutment, abutment screw, and prosthetic screw showed the lower values for the screw-retained type abutment than for the cement-retained type abutment regardless of the model type. There was little reciprocal effect of the abutment system between the molar and the premolar position. For all models, buccal cusp oblique loading caused the largest stress, followed by buccal cusp vertical loading and center vertical loading. Conclusion: Within the limitation of the FEA study, the combined type implant prosthesis did not demonstrate more stress around implant components than the cement type implant prosthesis. Under the assumption of ideal passive fit, the screw-type implant prosthesis showed the east stress around implant components.

• The korean journal of orthodontics
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• v.39 no.4
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• pp.203-212
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• 2009

Objective: The aim of this study was to evaluate the strain induced in the cortical bone surrounding an orthodontic microimplant during insertion in a self-drilling manner. Methods: A 3D finite element method was used to simulate the insertion of a microimplant (AbsoAnchor SH1312-7, Dentos Co., Daegu, Korea) into 1 mm thick cortical bone. The shape and dimension of thread groove in the center of the cortical bone produced by the cutting flute at the apical of the microimplant was obtained from animal test using rabbit tibias. A total of 3,600 analysis steps was used to calculate the 10 turns and 5 mm advancement of the microimplant. A series of remesh in the cortical bone was allowed to accommodate the change in the geometry accompanied by the implant insertion. Results: Bone strains of well higher than 4,000 microstrain, the reported upper limit for normal bone remodeling, were observed in the peri-implant bone along the whole length of the microimplant. Level of strains in the vicinity of either the screw tip or the valley part were similar. Conclusions: Bone strains from a microimplant insertion in a self-drilling manner might have a negative impact on the physiological remodeling of cortical bone.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.4
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• pp.257-268
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• 2003

The purpose of this study was to assess the loading distributing characteristics of implant prosthesis according to position and direction of load, under vertical and inclined loading using FEA analysis. The finite element model was designed according to standard fixture (4.1mm restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction (loading condition B), 200N at the centric usp in a $15^{\circ}$ inward oblique direction (loading condition C), 200N at the in a $30^{\circ}$ inward oblique direction (loading condition D) or 200N at the centric cusp in a $30^{\circ}$ outward oblique direction (loading condition E) individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant in both vertical and oblique loading but stresses in the cancellous bone were low in both vertical and oblique loading. 2. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading than with the vertical loading. 3. An offset of the vertical occlusal force in the buccolingual direction relative to the implant axis gave rise to increased bending of the implant. 4. The relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 5. The magnitude of the stress in the supporting bone, fixture and abutment screw was greater with the outward oblique loading than with the inward oblique loading and was the greatest under loading at the centric cusp in a $30^{\circ}$ outward oblique direction. Conclusively, this study provides evidence that bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. But it seems to be more important that how long is the distance from center of rotation of the implant itself to the resultant line of force from occlusal contact(leverage). The goal of improving implants should be to avoid bending of the implant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.6
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• pp.472-479
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• 2002

Since $Br^{\circ}anemark$ introduced the osseointegrated implants, they have been granted for useful methods for the restoration of oral function. The original $Br^{\circ}anemark$ protocol recommended long stress-free healing periods to achieve the osseointegration of dental implants. However, many clinical and experimental studies have shown that the osseointegration is no wonder in almost cases and that early and immediate loading may lead to predictable osseointegration. So we are willing to introduce the Satellite Abutment newly invented for immediate loading. We think that it will make the occlusal forces dispersed to surrounding bone and that we can restore the oral function immediately after implant installation not disturbing osseointegration. In case of using Satellite abutment, stress concentrated to bone contact area of implant was distributed not only fixation plate and screws but also superior, middle portion of implant and cortical layer of jaw bone. It was clearly decreased on the bone contact surfaces around dental implants. 1. Stress was decreased more than 76.5% when satellite straight abutment was used. 2. Stress was decreased more than 50% when satellite angled abutment was used. 3. The stress around dental implant was well distributed along the cortical bone surface and the fixation plate and screw. This study concludes that satellite abutment can be used as all immediate loading implant prothesis because it was possible to distribute periimplant occlusal stress through implant contact bone surface and cortical layer of jaw bone.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.116-126
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• 2009

The use of short implants has been accepted risky from biomechanical point of view. However, short implants appear to be a long term viable solution according to recent clinical reports. The purpose of this study was to investigate the effect of different diameter and length of implant size to the different type of bone on the load distribution pattern. Stress analysis was performed using 3-dimensional finite element analysis(3D-FEA). A three-dimensional linear elastic model was generated. All implants modeled were of the various diameter(${\phi}4.0$, 4.5, 5.0 and 6.0 mm) and varied in length, at 7.0, 8.5 and 10.0 mm. Each implant was modeled with a titanium abutment screw and abutment. The implants were seated in a supporting D2 and D4 bone structure consisting of cortical and cancellous bone. An amount of 100 N occlusal load of vertical and $30^{\circ}$ angle to axis of implant and to buccolingual plane were applied. As a result, the maximum equivalent stress of D2 and D4 bones has been concentrated upper region of cortical bone. As the width of implant is increased, the equivalent stress is decreased in cancellous bone and stress was more homogeneously distributed along the implants in all types of bone. The short implant of diameter 5.0mm, 6.0mm showed effective stress distribution in D2 and D4 bone. The oblique force of 100N generated more concentrated stress on the D2 cortical bone. Within the limitations of this study, the use of short implant may offer a predictable treatment method in the vertically restricted sites.

• Journal of Periodontal and Implant Science
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• v.37 no.4
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• pp.681-690
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• 2007

Mini implants had been used provisionally for the healing period of implants in the beginning. But it becomes used for the on-going purpose, because it is simple to use, economic and especially suitable for the overdenture. But there is few studies about the stability of mini implants, that is most important factor for the on-going purpose, and particularly the implant parameters affecting the initial stability. The purpose of this study was to evaluate the stress and the strain distribution pattern of immediate-loaded screw type orthodontic mini-implant and the parameters affecting the initial stability of immediate-loaded mini-implant. Two dimensional finite element models were made and contact non-linear finite element analysis was performed. The magnitude and distribution of Von Mises stresses were evaluated. The obtained results were as follows: 1. The stress was concentrated on the thread tip of an implant in the cortical bone. 2. The direction of load is the most important factor for the stress distribution in cortical bone. 3. The diameter of an implant is the most important factor for the stress distribution in the trabecular bone. In conclusion, if the horizontal load vector is successfully controlled, mini-implants, which diameter is under 3mm, can be used for the on-going purpose.

• Journal of Korean Foot and Ankle Society
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• v.20 no.2
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• pp.67-72
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• 2016

Purpose: The purpose of this study was to assess the 2-year follow-up results of patients with a trimalleolar fracture, who had undergone an anterior incision cannulated screw fixation of the posterior malleolar fragment, which had more than 25% of articular involvement or had no cortical continuity with the distal tibia. Materials and Methods: Among 28 patients with a trimalleolar fracture who had undergone fixation of the posterior malleolar fragment between February 2005 and February 2010, 14 patients, who underwent an anterior incision cannulated screw fixation of posterior malleolar fragment and were followed-up for more than 2 years, were selected. The postoperative clinical and radiological findings immediately and at the 1- and 2-year follow-up were compared. The clinical findings were evaluated as American Orthopaedic Foot and Ankle Society (AOFAS) score. The radiological assessment was evaluated as the maintenance of reduction, period to bone union, and the presence of nonunion, malunion, and complications. Results: The clinical outcome by mean AOFAS score revealed 83.0 points in the group with preoperative displacement below 2 mm and 80.7 points in the group with preoperative displacement above 2 mm postoperatively. The mean AOFAS score was 91.7 and 93.1 points in the group with preoperative displacement below 2 mm on 1- and 2-year follow-up, respectively, and 89.8 and 91.7 points in group with the preoperative displacement above 2 mm on 1- and 2-year follow-up, respectively. After a 2-year follow-up among 14 cases selected for this study, 13 cases showed an excellent reduction state and only 1 case (7.1%) showed a displacement of more than 2 mm. No complication were encountered in the group with preoperative displacement below 2 mm. On the other hand, among 8 patients in the group with preoperative displacement above 2 mm, there were 3 with limitations of the range of motion of the ankle joint (37.5%) and 1 post-traumatic arthritis (12.5%) at the 2-year follow-up. Conclusion: Anterior incision cannulated screw fixation of the posterior malleolar fragment could be a valuable method for the treatment of trimalleolar fractures that provides satisfactory results.