• 대한치과보철학회지
• /
• 제36권1호
• /
• pp.183-198
• /
• 1998

This study was designed to investigate the peri-implant tissue reaction in ovariectomized osteoporotic female rats, and to evaluate effects of estrogen, calcitonin, parathyroid hormone on the bone - implant interface in osteoporotic rats. 120 Sprague - Dawley rats were used in this experiments. Osteoporosis was induced by bilateral ovariectomy. They were divided 5 groups : sham-operated control group(Sham), ovariectomized group (OVX), OVX and estrogen treated group (OVX+E), OVX and PTH treated group (OVX+PTH), and OVX and calcitonin treated group (OVX+CT). Eight weeks after ovariectomy, two titanium screw implants were inserted into the left tibia of each rat. Eight weeks after the insertion of the implants, the periotest values (PTV) of implant were examined, and the rats were sacrificed, and examined the reaction of bone tissue surrounding the implant both histologically and histomorphometrically. The bone density and ash weight of opposite right tibia were examined. Over 40 rats were fractured on left tibia that was implant inserted. On histologically finding, all groups were osseointegrated well, especially in OVX+PTH group. In OVX group, tibial cortical bone showed many large harversian canal and microfracture lines. The OVX+PTH group showed the lowest mean PTV (-2.33) (p<0.05), and the hightest mean bone - implant contact percentage (89%) (p>0.05). But the OVX+CT group showed the highest mean bone density ($5.45mg/cm^3$) and ash weight (56.12%) (p<0.05). The results indicate that PTH treatment enhances osseointegration of implant in OVX rats, and CT treatment depresses bone turnover and prevent the development of osteopenia in OVX rats.

• 대한치과교정학회지
• /
• 제47권4호
• /
• pp.238-247
• /
• 2017

Objective: The aim of this study was to compare recycled and unused orthodontic miniscrews to determine the feasibility of reuse. The comparisons included both miniscrews with machined surfaces (MS), and those with etched surfaces (ES). Methods: Retrieved MS and ES were further divided into three subgroups according to the assigned recycling procedure: group A, air-water spray; group B, mechanical cleaning; and group C, mechanical and chemical cleaning. Unused screws were used as controls. Scanning electron microscopy, energy-dispersive X-ray spectrometry, insertion time and maximum insertion torque measurements in artificial bone, and biological responses in the form of periotest values (PTV), bone-implant contact ratio (BIC), and bone volume ratio (BV) were assessed. Results: Morphological changes after recycling mainly occurred at the screw tip, and the cortical bone penetration success rate of recycled screws was lower than that of unused screws. Retrieved ES needed more thorough cleaning than retrieved MS to produce a surface composition similar to that of unused screws. There were no significant differences in PTV or BIC between recycled and unused screws, while the BV of the former was significantly lower than that of the latter (p < 0.05). Conclusions: These results indicate that reuse of recycled orthodontic miniscrews may not be feasible from the biomechanical aspect.

• 대한치과기공학회지
• /
• 제40권1호
• /
• pp.41-47
• /
• 2018

Purpose: The purpose of this study was to analyze the biomechanical properties of the dental implants on the supporting bone using three-dimensional finite element method when three different abutment materials were applied to the implant system. Methods: Three different dental implant models were fabricated by applying Ti, PEEK, and CRE-PEEK (60% carbon-reinforced PEEK) to abutment material. The abutment and connecting screw from the fixture was applied with a tightening torque of 20 Ncm. And then, total loads of 150 N were applied in an $30^{\circ}oblique$ direction (to the vertical). The structural stability of dental implants on the supporting bone was analyzed using Von Mises stress and principal stress values. Results: The maximum tensile stress of the cortical bone was highest at 12.6 MPa in the PEEK abutment (Model-B). Ti abutment (Model-A) and CRE-PEEK abutment (Model-C) showed similar stress distributions (10.6 and 10.3 MPa, respectively). And the maximum compressive principal stress was similar in all models. The Von Mises stress value delivered to the bone around the implant was highest at 16.5 MPa in Model-B. On the other hand, Model-A and C showed similar stress distributions (14.0 and 13.8 MPa, respectively). In addition, the maximum equivalent stress applied to the abutment was highest at 629.8 MPa in Model-A. The stress distribution in Model-C was 573.9 MPa. Whereas, Model-B showed the lowest value at 165.6 MPa. Conclusion : The dental implant supporting bone system using PEEK material seems to have the possibility of supporting bone fracture. It was found that the CRE-PEEK abutment can reduce the elastic deformation and reduce the stress value of the interfacial bone.

• 구강회복응용과학지
• /
• 제18권4호
• /
• pp.321-329
• /
• 2002

Bending moments results from offset overloading of dental implant, which may cause stress concentrations to exceed the physiological capacity of cortical bone and lead to various kinds of mechanical failures. The purpose of this study was to compare the distributing pattern of stress on the finite element models with the different angulated placement of dental implant in mandibular posterior missing areas. The three kinds of finite element model, were designed according to 3 main configurations: Model 1(parallel typed placement of 2 fixtures), Model 2(15. distal angulated placement of one fixture on second molar area), Model 3(15. mesial angulated placement of one fixture on second molar area). The cemented crowns for mandibular first and second molars were made on the two fixtures (4mm 11.5). Three-dimensional finite element models by two fixtures were constructed with the components of the implant and surrounding bone. A 200N vertical static load were applied to the center of central fossa and the point 2mm apart from the center of central fossa on each model. The preprocessing, solving and postprocessing procedures were done by using FEM analysis software NISA/DISPLAY IV Version 10.0((Engineering Mechanics Research Corporation, USA). Von Mises stresses were evaluated and compared in the supporting bone, fixtures, and abutment. The results were as following : (1) Under the point loading at the central fossa, the direction of angulated fixture affected the stress pattern of implants. (2) Under the offset loading, the position of loading affected more on the stress concentration of implants compare to the angulated direction of implants. The results had a tendency to increase the stress on the supporting bone, fixture and screw under the offset loads when the placement angulation of implant fixture is placed toward mesial or distal direction. In designing of the occlusal scheme for angulated placement, placing the occlusal contacts axially during chewing appears to have advantages in a biomechanical viewpoint.

• 대한심미치과학회지
• /
• 제28권2호
• /
• pp.64-73
• /
• 2019

심한 치조골의 위축과 흡수로 인한 형태학적 변화는 임플란트의 성공적인 식립과 임플란트의 골유착에 영향을 미친다. 이를 극복하기 위한 다양한 골증대술 중 치조제분할술은 좁은 치조골 폭을 성공적으로 증대시키는 수술방법으로 보고되었다. 또한 다양하게 개발되는 임플란트 디자인과 치조제 팽창 기구 등은 심하게 흡수된 위축된 하악부위에서도 협측골 파절을 최소화할 수 있다. 가철성 부분의치의 사용으로 심하게 흡수된 하악 구치부에 치조제 분할술과 최소 크기의 블록형 골이식술을 이용해 한개의 스크류로 수용부의 고정을 획득한 후 동시적 접근법을 이용한 골이식 증례를 보고 하고자 한다. 보철과와 치주과의 협업으로 환자의 기능과 심미를 회복해준 증례로 사료된다.

• The Journal of Advanced Prosthodontics
• /
• 제13권1호
• /
• pp.12-23
• /
• 2021

Purpose. The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio. Materials and Methods. Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creating an excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges. Results. The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain. CONCLUSION. Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.

• The Journal of Advanced Prosthodontics
• /
• 제13권6호
• /
• pp.396-407
• /
• 2021

PURPOSE. Zirconia has exceptional biocompatibility and good mechanical properties in clinical situations. However, finite element analysis (FEA) studies on the biomechanical stability of two-piece zirconia implant systems are limited. Therefore, the aim of this study was to compare the biomechanical properties of the two-piece zirconia and titanium implants using FEA. MATERIALS AND METHODS. Two groups of finite element (FE) models, the zirconia (Zircon) and titanium (Titan) models, were generated for the exam. Oblique (175 N) and vertical (175 N) loads were applied to the FE model generated for FEA simulation, and the stress levels and distributions were investigated. RESULTS. In oblique loading, von Mises stress values were the highest in the abutment of the Zircon model. The von Mises stress values of the Titan model for the abutment screw and implant fixture were slightly higher than those of the Zircon model. Minimum principal stress in the cortical bone was higher in the Titan model than Zircon model under oblique and vertical loading. Under both vertical and oblique loads, stress concentrations in the implant components and bone occurred in the same area. Because the material itself has high stiffness and elastic modulus, the Zircon model exhibited a higher von Mises stress value in the abutments than the Titan model, but at a level lower than the fracture strength of the material. CONCLUSION. Owing to the good esthetics and stress controllability of the Zircon model, it can be considered for clinical use.

• 대한치과보철학회지
• /
• 제48권3호
• /
• pp.209-214
• /
• 2010

연구 목적: 본 연구의 목적은 골 유착된 임플란트에 인위적 비틀림을 가한 후 골 유착이 다시 일어나는지, 혹은 일어나지 않는지, 일어난다면 이전의 골유착보다 강화되는지, 약화되는지에 대해 알아보기 위함이다. 연구 재료 및 방법:상업적으로 순수한 티타늄 (commercial pure titanium 99%)으로 직경 3.75 mm, 길이 4 mm의 표면처리 없는 실험용 임플란트를 제작하였다. 3.0 kg이상의 뉴질랜드산 흰색 암컷 토끼 7마리의 좌우 경골에 제작한 임플란트를 2개씩 식립 후, 6주의 골유착 유도 기간 부여 후 비틀림 제거력을 측정한 경우를 I군으로, 다시 임플란트 고정체를 재위치시키고 봉합하여 4주간의 치유기간을 더 두고 측정한 경우를 II군으로 분류하였다. 광학현미경을 이용한 조직 형태학적 분석을 위하여, 1차 비틀림 제거력 측정 직후 1마리의 토끼를 희생시키고, 2차 비틀림 제거력 측정 직후 2마리의 토끼를 희생시켜 각각 4개, 7개의 시편을 제작하여, 광학현미경 (${\times}20$) 분석에서 골-임플란트 접촉 (Bone-Implant contact, BIC, %)비율과 치밀골 부위에 위치하는 임플란트의 나사산 수를 측정하여 CBa (Bone area in the cortical passage)비율을 측정하였다. 비틀림 제거력과 BIC및 CBa비율에서의 I군과 II군의 통계적 유의성 ($\alpha$=.05)을 평가하였다. 결과: 비틀림 제거력 측정에서 I군은 $10.8{\pm}3.6$ NCm로 측정되었으며, II군은 $20.2{\pm}9.7$ NCm로 측정되었으며, I군보다II군의 비틀림 제거력이 평균 98.1% 증가되었다 (P<.05). 조직 형태학적 분석에서 BIC와 CBa 비율은 I군과 II군 사이에 통계적 유의성을 나타내지 않았고 (P>.05), RT/BIC와 RT/CBa 값은 I군과 II군 사이에 통계적 유의성을 나타냈다 (P<.05). 결론: 임플란트 고정체에 의원성 비틀림 동요가 발생한 경우에 초기 골유착을 얻기 위해 필요로 했던 치유기간보다 짧은 기간 내에 이전보다 견고한 골유착을 얻을 수 있을 것으로 생각된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제35권6호
• /
• pp.451-458
• /
• 2009

Metallic bone plates and screws have been commonly used in oral and maxillofacial surgery for internal fixation. However, there are several disadvantages such as atrophy of cortical bone inherent to excessive rigid fixation systems, growth disturbance in growing individual, allergy reaction, interference with radiographic imaging, palpability, thermal sensitibity and the need for subsequent removal. To overcome these disadvantages and avoid additional surgery of removal of plates and screws, there have been many studies of biodegradable plates and screws. But, It also has complication such as foreign body reactions. We have undertaken a clinical and retrospective study on 140 patients in Dept. of Oral and Maxillofacial Surgery, Inha University Hospital from February 2006 to March 2009. The purpose of this study is to report the clinical cases and review of the literatures with biodegradable plates and screws. And we concluded following results. 1. 6 cases(3.4%) of the 177 operation sites(140 patients) experienced complications. 1 case(0.6%) was a failure of initial fixation, 1 case(0.6%) was a postoperative infection, 4 cases(2.3%) were inflammations or foreign body reaction. 2. Postoperative infections, inflammations and foreign body reactions were completely recovered with incision and drainage, supporative care with antibiotic coverage and removal of biodegradable plates. 3. Biodegradable plates and screws provide acceptable rigidity and stability clinically. But, long-term observation is required for the tissue reactions around the biodegradable plates and screws because of long resorption periods of the biodegradable materials.

• Journal of Korean Neurosurgical Society
• /
• 제60권6호
• /
• pp.611-619
• /
• 2017

Objective : In addition to bone bridging inside a cage or graft (intragraft bone bridging, InGBB), extragraft bone bridging (ExGBB) is commonly observed after anterior cervical discectomy and fusion (ACDF) with a stand-alone cage. However, solid bony fusion without the formation of ExGBB might be a desirable condition. We hypothesized that an insufficient contact area for InGBB might be a causative factor for ExGBB. The objective was to determine the minimal area of InGBB by finite element analysis. Methods : A validated 3-dimensional, nonlinear ligamentous cervical segment (C3-7) finite element model was used. This study simulated a single-level ACDF at C5-6 with a cylindroid interbody graft. The variables were the properties of the incorporated interbody graft (cancellous bone [Young's modulus of 100 or 300 MPa] to cortical bone [10000 MPa]) and the contact area between the vertebra and interbody graft (Graft-area, from 10 to $200mm^2$). Interspinous motion between the flexion and extension models of less than 2 mm was considered solid fusion. Results : The minimal Graft-areas for solid fusion were $190mm^2$, $140mm^2$, and $100mm^2$ with graft properties of 100, 300, and 10000 MPa, respectively. The minimal Graft-areas were generally unobtainable with only the formation of InGBB after the use of a commercial stand-alone cage. Conclusion : ExGBB may be formed to compensate for insufficient InGBB. Although various factors may be involved, solid fusion with less formation of ExGBB may be achieved with refinements in biomaterials, such as the use of osteoinductive cage materials; changes in cage design, such as increasing the area of polyetheretherketone or the inside cage area for bone grafts; or surgical techniques, such as the use of plate/screw systems.