• 구강회복응용과학지
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• 제26권1호
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• pp.59-68
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• 2010

최근 무치악 부위를 대신하여 광범위하게 식립되고 있는 치과용 임플란트는 높은 임상 성공률을 보이고 있으나 실패 가능성은 늘 존재하며 이는 예기치 않은 경우가 많다. 임플란트의 실패과 관련하여 여러 가지 요인들이 거론되고 있으나, 아직 논란의 여지가 있다. 본연구에서는 서울 보훈병원에서 2005-2006년에 하악 구치부위에 임플란트를 식립한 212명의 환자, 총 358개의 임플란트를 대상으로 환자의 연령, 임플란트 식립 부위, 시스템, 직경과 길이, 골이식 유무에 따른 생존율을 비교하였다. 각 요소에 따른 생존율을 SPSS chi-square test를 이용한 multi-variable analysis를 시행하여 관련성을 검증하였다. 연구 결과 3년간 98.3%의 누적 생존율을 보였으며, 조사한 요인 중 임플란트 직경만이 임플란트 생존율과 관련성이 있는 것으로 나타났다. 이는 넓은 직경의 임플란트가 주로 대체(rescue) 임플란트 혹은 골질이 좋지 않은 부위에 사용되는 경우가 많은 것이 원인으로 작용한 것으로 사료된다. 향후 임플란트의 성공과 관련하여 명확한 지표를 제공할 수 있는 지속적인 연구가 필요할 것이다.

• Journal of Periodontal and Implant Science
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• 제45권3호
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• pp.120-126
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• 2015

Purpose: With the significance of stable adhesion of alveolar bone and peri-implant soft tissue on the surface of titanium for successful dental implantation procedure, the purpose of this study was to apply microgrooves on the titanium surface and investigate their effects on peri-implant cells and tissues. Methods: Three types of commercially pure titanium discs were prepared; machined-surface discs (A), sandblasted, large-grit, acid-etched (SLA)-treated discs (B), SLA and microgroove-formed discs (C). After surface topography of the discs was examined by confocal laser scanning electron microscopy, water contact angle and surface energy were measured. Human gingival fibroblasts (hGFs) and murine osteoblastic cells (MC3T3-E1) were seeded onto the titanium discs for immunofluorescence assay of adhesion proteins. Commercially pure titanium implants with microgrooves on the coronal microthreads design were inserted into the edentulous mandible of beagle dogs. After 2 weeks and 6 weeks of implant insertion, the animal subjects were euthanized to confirm peri-implant tissue healing pattern in histologic specimens. Results: Group C presented the lowest water contact angle ($62.89{\pm}5.66{\theta}$), highest surface energy ($45{\pm}1.2mN/m$), and highest surface roughness ($Ra=22.351{\pm}2.766{\mu}m$). The expression of adhesion molecules of hGFs and MC3T30E1 cells was prominent in group C. Titanium implants with microgrooves on the coronal portion showed firm adhesion to peri-implant soft tissue. Conclusions: Microgrooves on the titanium surface promoted the adhesion of gingival fibroblasts and osteoblastic cells, as well as favorable peri-implant soft tissue sealing.

• Imaging Science in Dentistry
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• 제34권1호
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• pp.7-12
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• 2004

Purpose: To investigate the anatomical structure of the incisive canal radiographically by a cone beam computed tomography. Materials and Methods: 38 persons (male 26, female 12) were chosen to take images of maxillary anterior region in dental CT mode using a cone beam computed tomography. The tube voltage were 65, 67, and 70kVp, the tube current was 7 mA, and the exposure time was 13.3 seconds. The FH plane of each person was parallel to the floor. The images were analysed on the CRT display. Results: The mean length of incisive canal was 15.87 mm±2.92. The mean diameter at the side of palate and nasal fossa were 3.49 mm±0.76 and 3.89 mm± 1.06, respectively. In the cross-sectional shape of incisive canal, 50% were round, 34.2% were ovoid, and 15.8% were lobulated. 87% of incisive canal at the side of nasal fossa have one canal, 10.4% have two canals, and 2.6% have three canals, but these canals were merged into one canal in the middle portion of palate. The mean angles of the long axis of incisive canal and central incisor to the FH plane were 110.3°±6.96 and 117.45°±7.41, respectively. The angles of the long axis of incisive canal and central incisor to the FH plane were least correlated (r= 0.258). Conclusion : This experiment suggests that a cone beam computed radiography will be helpful in surgery or implantation on the maxillary incisive area.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.273-278
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• 2008

Purpose: The most widely accepted protocol for alveolar cleft reconstruction is to repair it during the mixed dentition stage. There were lower resorption rate (about 88%) at this stage. However we found some cases that need repeated bone grafting. Therefore we sought to analyze the cause of repeated alveolar bone grafting in connection with other factors. Methods: From January 2000 to January 2006, thirty-nine secondary alveolar bone grafts with iliac crest spongiosa were carried out. In 39 patients, 5 patients who had significant bone graft resorption received repeated alveolar bone graft. In all the cases, the causes of repeated bone grafts were dental root exposure(angulation), and the deficiency of the bony support for lateral incisor or canine eruption. In 3 cases, there was deficiency of the alveolar bone at the cleft side. There was the need of repeated bone grafts for orthodontic treatment in 2 cases and for application of dental implants in 1 case. Results: During the follow-up period, the clinical and radiologic examinations showed that repeated alveolar bone grafts were maintained successfully without any complications. The volume of the repeated bone graft was sufficient for orthodontic treatment and implantation. Conclusion: The essential conditions for successful alveolar bone grafting includes the status of cleft sided teeth, further treatment and planed schedule, as well as canine eruption. Alveolar bone grafting has to be performed with difference of each case in mind.

• Journal of Periodontal and Implant Science
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• 제41권2호
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• pp.86-91
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• 2011

Purpose: The aim of this study was to analyze the short-term predictability and reliability of Astra Tech implants according to the demographical distribution of patients and condition of implant sites and location of implants. Methods: Among patients treated with Astra Tech implant (Astra Tech AB) in the Department of Periodontology at the Dental Hospital of Yonsei University of College of Dentisry and K Dental Clinic from May 2004 to March 2009, 195 implants in 98 patients which had been restored more than 6 months ago were reviewed in this study. Following data were reviewed from patient charts and implants success rate was examined: 1) patient type and implant location, 2) bone status at the implant site, 3) diameter and length of the placed implants, 4) presence or absence of bone augmentation and types of the augmentation. Results: The results from this study are as follows: 1) most implants were placed in the molar area, especially 1st molar area of maxilla, 2) most implants were placed at $D_2$ and $D_3$ bone type, 3) most implants were placed in areas of B and C bone quantity, 4) autogenous and alloplastic bone graft and artificial membrane were used for placement of 74 implants. Conclusions: Short-term survival rate of Astra Tech implants was 100%.

• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.169-176
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• 2003

Background: Although dental implantation has become widespread and acceptable treatment for dental prosthodontics, maxillary posterior jaw region is often complicated by the pneumatization of the maxillary sinus and physiological resorption of the alveolar bone. When this occurs, the residual bone between the floor of the sinus and the crestal ridge is inadequate for the placement of implants. The sinus elevation procedure provides a way to increase the amount of available bone and to allow the placement of longer implants. Materials & methods: We studied 11 patients requiring the implant placements and the maxillary sinus elevation simultaneously from 1996 to 2003 in our clinic. Nine patients were males and two patients were females, aged from 39 to 72(mean=51.6). Four patients had medical compromised states; angina pectoris, diabetes, hypertension, hepatitis. Patients didn't show any pathologic findings clinically or radiographically. We studied the success and survival rate of implants, factors increasing the osseointegrating capacity of implants. Results: The success rate of osseointegration of implants was 93%. At least 6 months after loading on implants, the survival rate of implants was 78.5%. Autogenous bone graft and adequate residual bone height(>6mm) increased survival rate of implants. Conclusion: Successful implant placement with maxillary sinus elevation mainly depends on sufficient residual bone height, healthy maxillary sinus, autogenous bone graft.

• Journal of Periodontal and Implant Science
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• 제44권1호
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• pp.39-47
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• 2014

Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.

• Journal of Periodontal and Implant Science
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• 제42권1호
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• pp.25-29
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• 2012

Purpose: There has been no attempt to establish an objective implant surgical evaluation protocol to assess residents' surgical competence and improve their surgical outcomes. The present study presents a newly developed assessment and rating system and simulation model that can assist the teaching staffs to evaluate the surgical events and surgical skills of residents objectively. Methods: Articles published in peer-reviewed English journals were selected using several scientific databases and subsequently reviewed regarding surgical competence and assessment tools. Particularly, medical journals reporting rating and evaluation protocols for various types of medical surgeries were thoroughly analyzed. Based on these studies, an implant surgical technique assessment and rating system (iSTAR) has been developed. Also, a specialized dental typodont was developed for the valid and reliable assessment of surgery. Results: The iSTAR consists of two parts including surgical information and task-specific checklists. Specialized simulation model was subsequently produced and can be used in combination with iSTAR. Conclusions: The assessment and rating system provided may serve as a reference guide for teaching staffs to evaluate the residents' implant surgical techniques.

• 한국표면공학회:학술대회논문집
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• 한국표면공학회 2017년도 춘계학술대회 논문집
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• pp.155-155
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• 2017

Surface modifications are commonly utilized to adjust the properties of the titanium and its alloy surface to the specific needs of the medical applications, but there are disadvantages such as poor osteoconductive properties and low adhesion of bone cell to implant surface. In order to improve these disadvantages, changes in surface properties have an important effect on osseointegration during implantation. In this paper we applied new technological method for improving a unique surface modification using the characteristic of an electrolytic Solution. Thus, in the electrolyte containing NaF in Na2SO4, TiO2 nanoporous was uniformly formed, and HAp nanoparticles were electrodeposited around the TiO2 nanopores, but in the electrolyte containing NH4F in (NH4)H2PO4, the coarse protrusions including HAp nano particles were regularly deposited onto the TiO2 barrier layer. The surface characteristics and the distributed elements and have been investigated by EDS analysis, and ultra-fine structure of surface are carried out using FE-SEM. To investigate the behavior of the anion, the analysis of chemical states was performed by XPS, and the narrow spectrums for Ti2P, Ca 2p, and P 2p seems to be almost similar depending on the characteristics of the electrolyte solution respectively. In addition, Ca 2p spectrum could be resolved into two peaks for Ca 2p3/2 and 2p1/2 at 347.4 and 351.3 eV, which are related to hydroxyapatite. And, the P peak can also be deconvoluted into two peaks for P1/2 and P3/2 levels with binding energy 134.2 and 133.4 eV, respectively. From the result of soaking test, the apatite morphologys were well-formed onto the modified surface according to the different conditions.

• 한국표면공학회:학술대회논문집
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• 한국표면공학회 2017년도 춘계학술대회 논문집
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• pp.153-153
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• 2017

The application of the coating supports the mechanical characteristics of the implant, and various materials and coatings are currently being used in the implant in a way to accelerate adhesion. Especially, plasma electrolytic oxidation (PEO) coating has been proposed continually with good surface treatment of titanium alloys. Also, the PEO process can incorporate Ca and P ions on the titanium surface through variables varied factor. PEO process for bioactive surface has carried out in electrolytes containing Ca and P ions. Natural bone is composed of mineral elements such as Mg, Si, Zn, Sr, and Mn, etc. Especially, Mg and Si of these elements play role in bone formation and growth after clinical implantation of bio-implants. In this study, corrosion charateristics of PEO-treated Ti-6Al-4V alloy in solution containing Si and Mg ions has been investigated using several experimental techniques. The PEO-treated surfaces were identified by X-ray diffraction, using a diffractometer (XRD, Philips X' pert PRO, Netherlands) with Cu $K{\alpha}$ radiation. The morphology was observed by field-emission scanning electron microscopy (FE-SEM, Hitachi 4800, Japan) and energy-dispersive X-ray spectroscopy (EDX, Oxford ISIS 310, England). The potentiodynamic polarization and AC impedance tests for electrochemical degradations were carried out in 0.9% NaCl solution at similar body temperature using a potentiostat with a scan rate of 1.67mV/s and potential range from -1500mV to + 2000mV.