Stefan P. Bienz;Edwin Ruales-Carrera;Wan-Zhen Lee;Christoph H. F. Hammerle;Ronald E. Jung;Daniel S. Thoma
Journal of Periodontal and Implant Science
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제54권2호
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pp.108-121
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2024
Purpose: The aim of this study was to compare changes in soft and hard tissue and the histologic composition following early implant placement in sites with alveolar ridge preservation or spontaneous healing (SH), as well as implant performance up to 1 year after crown insertion. Methods: Thirty-five patients with either intact buccal bone plates or dehiscence of up to 50% following single-tooth extraction of incisors, canines, or premolars were included in the study. They were randomly assigned to undergo one of three procedures: deproteinized bovine bone mineral with 10% collagen (DBBM-C) covered by a collagen matrix (DBBM-C/CM), DBBM-C alone, or SH. At 8 weeks, implant placement was carried out, and cone-beam computed tomography scans and impressions were obtained for profilometric analysis. Patients were followed up after the final crown insertion and again at 1 year post-procedure. Results: Within the first 8 weeks following tooth extraction, the median height of the buccal soft tissue contour changed by -2.11 mm for the DBBM-C/CM group, -1.62 mm for the DBBM-C group, and -1.93 mm for the SH group. The corresponding height of the buccal mineralized tissue changed by -0.27 mm for the DBBM-C/CM group, -2.73 mm for the DBBM-C group, and -1.48 mm for the SH group. The median contour changes between crown insertion and 1 year were -0.19 mm in the DBBM-C/CM group, -0.09 mm in the DBBM-C group, and -0.29 mm in the SH group. Conclusions: Major vertical and horizontal ridge contour changes occurred, irrespective of the treatment modality, up to 8 weeks following tooth extraction. The DBBM-C/CM preserved more mineralized tissue throughout this period, despite a substantial reduction in the overall contour. All 3 protocols led to stable tissues for up to 1 year.
PURPOSE. The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS. This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS. Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION. The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.
Purpose: The short dental implant is considered as possible solution in the alveolar bone height deficient cases. The aim of this study was to evaluate clinical availability of short implants by measuring the marginal bone loss of short length implants and comparing with that of conventional length implants. Materials and Methods: The groups were composed of patients who had received at least one implant. The samples of this study were selected from patients who with functional loading after prosthetic treatment for 1 year follow up period. The implants with a length of 5.7 mm and 6mm were considered short. (Bicon Dental implants, USA). The experiment group was composed of $4.5{\times}6mm$, $5{\times}6mm$, $6{\times}5.7mm$ implants (total 18 implants were placed in 14 patients, 8 on maxilla, 10 on mandible). The control group was composed of $4.5{\times}8mm$, $5{\times}8mm$, $4.5{\times}11mm$, $5{\times}11mm$. All implants were selected only by implants placed on molar area. We evaluated marginal bone loss in radiographic images at baseline (implant loading) and 3, 6, 12 months after loading. Additionally, crown-to-implant ratio was evaluated, and marginal bone loss according to crown-to-implant ratio after functional loading was analyzed. Results: The short implant group had a mean marginal bone level of $-0.52{\pm}0.69mm$; the 8mm group, $-0.22{\pm}0.82mm$; and the II mm group, $-0.10{\pm}1.09mm$ after I year of functional loading. But significant differences were not detected between three groups at every follow-up period. Crown-to-implant ratio in short implant group was $1.55{\pm}0.23$; 8mm group was $1.15{\pm}0.18$; and 11mm group was $0.92{\pm}0.15$. Additionally, significant differences between three groups were founded. (P<.0001) The greatest marginal bone loss after 1 year follow-up was founded at crown-to-implant ratio 1~1.49 range in short implant. Conclusion: The marginal bone loss of short implants was comparable to that of long implants. So, the short implants can be a clinically acceptable option.
In the anterior maxillary area, dental implants for tooth replacement are challenging due to the need to satisfy high esthetic level as well as functionality. Immediate implant placement and provisionalization can dramatically reduce the edentulous period, and then fulfill patient's demand for esthetics. The aim of present case report is to demonstrate two cases that successfully restored single tooth with immediate implant placement and provisionalization in the anterior maxillary area. A 47 years old female was scheduled to replace her maxillary right central incisor due to crown-root fracture by trauma. Another 54-year-old female was planned to place dental implant following tooth extraction of maxillary right lateral incisor owing to continuous pus discharge despite repetitive treatments including apicoectomy. In these two cases, surgical and prosthetic procedures progressed in a similar way. After minimal flap elevation, atraumatic tooth extraction was performed. Implant was placed in proper 3-dimensional position and angulation with primary stability. Bone graft or guided bone regeneration for peri-implant bone defect was conducted simultaneously. Provisionalization without occlusal loading was carried out at the same day. Each definitive crown was delivered at 7 and 5 months after the surgery. Two cases have been followed uneventfully for 2 to 5 years of loading time. In conclusion, Immediate implant placement and provisionalization could lead to esthetic outcome for single tooth replacement with dental implant under proper case selection.
Whether stress-absorbing elements are functional in an implant system has been an issue of interest in oral implantology. The unique feature of the IMZ implant system is the planned imitation of the stress-distributing function of the structural unit of the tooth, periodontium, and alveolar bone through the use of an intramobile element(IME). The purpose of this study was to compare the difference in the displacement and the stress distibutions of IMZ implant with a polyoxymethylene(POM) or a titanium IME under static load. Two dimensional finite element analysis(FEA) was applied for this study and two finite element models were created. PATRAN program(DPA Co.,USA), a software for FEA, and SUN-SPARC2GX(SUN Co., USA), a workstation computer, were used. $1Kg/mm^2$ of static load was loaded individually on each three point of crown of implant prosthesis ; central fossa(load 1), mesial cusp tip(load 2), distal cusp tip(load 3), The displacements of X- and Y-axis and total displacement were measured at mesial and distal cusp tips, mesial and distal points between crown and IME, and implant apex. The von Mises stress was measured at mesial and distal points between crown and IME, mesial and distal points between IME and TIE, mesial and distal alveolar crest, the mesial and distal midpoints of implant, and implant apex. The difference in resultant values were compared and evaluated statistically using paired t-test. The results were as follows : 1. Under the load 1, all the displacement of implant with titanium IME at 5 measuring points was larger than that of with POM IME except total and Y-axis displacement at implant apex. And the differences in stress distributions with POM and titanium were varied. 2. Under the load 2, all the displacement of implant with titanium IME at 5 measuring points was larger than that of with POM IME except X-axis displacement at distal cusp tip. And the differences in stress distributions were varied. 3. Under the load 3, all the displacement of implant with titanium IME at 5 measuring points was larger than that of with POM IME except Y-axis displacement at mesial cusp tip. And the differences in stress distributions were varied. 4. For the displacement, there was significant difference statistically only in total displacement (P<0.1), but was no significant difference in X- and Y-axis displacement(P>0.1). For the stress, there was no significant difference among the compared values.
PURPOSE. This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS. In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS. One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: $5.9{\pm}2.2years$), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION. Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required.
The objective of this finite element method study was to analyze the stress distribution induced on a supporting bone by 3.75mm, 4.0mm, 5.0mm diameter of dental implant fixture(13mm length). 3-dimensional finite element models of simplified gold alloy crown(7mm height) and dental implant structures(gold cylinder screw, gold cylinder, abutment screw, abutment, fixture and supporting bone(cortical bone, cancellous bone) designs were subjected to a simulated biting force of 100 N which was forced over occlusal plane of gold alloy crown vertically. Maximum von Mises stresses(MPa) under vertical loading were 9.693(3.75mm diameter of fixture), 8.885(4.0mm diameter of fixture), 6.301(5.0mm diameter of fixture) and the highest von Mises stresses of all models were concentrated in the surrounding crestal cortical bone. The wide diameter implant was the good choice for minimizing cortical bone-fixture interface stress.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제35권4호
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pp.248-252
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2009
Purpose: This retrospective study was performed to analyze the relationship between complications of the posterior mandibular single crowns and distance from the adjacent teeth to the implant. Subjects and Methods: Of the patients who presented Ewha Womans University Mokdong Hospital & Yonsei University Dental Hospital with missing of the posterior mandibular molar and restored with implant-supported 18 Single crowns between 1996 thru 2007, 115 patients had been followed after crown delivery. The subjects were divided into complication-followed group and a control without any problems. The distance from the most distal tooth to the implant were measured. The prosthetic & biologic complications were reviewed by the cantilever distance and analyzed by abutment type, age & gender statistically using SAS version 9.1 (SAS Inc., USA). Results and Conclusion The results were as follows; 1) The posterior mandibular single crown with cantilever showed higher incidence of follow-up complications upon logistic analysis (p<0.05). 2) The prosthetic and biologic complications are related with the cantilever distance with 2.1 odds ratio and 3.39 cut-off value of specificity & sensitivity by SPSS 12.0. 3) The complications are neither significant in abutment types nor age & gender.
Purpose : The purpose of this study was to evaluate the effect of amount of cantilever in intra-crown according to implant fixture position on mechanical strength of internal conical joint type implant. Materials and Methods : Internal conical joint type implant fixture, abutment screw, abutment was connected and gold alloy prostheses were fabricated and cemented on abutment. For fatigue fracture test, the specimens were loaded to the 350 N, 2,000,000 cycle on 3, 4, 5, and 6 mm off-center of gold alloy prostheses. The fracture pattern of implant component was observed. Results : No fatigue fracture found on 3 and 4 mm group. But initial crack pattern found on 3 specimens of 4 mm group. Fatigue fracture found on all specimens of 5 mm group. But complete fracture was not observed. One specimen of 6 mm group fracture completely. Implant fixture fracture wax not observed. Conclusion : The mechanical failure of implant prostheses increased with the loading area farther from center of implant fixture. To reduce mechanical problem of internal joint type implant, surgical and prosthetic consideration is needed.
PURPOSE. The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS. Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS. Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION. Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.
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