• Archives of Plastic Surgery
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• v.41 no.4
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• pp.407-413
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• 2014

Background Implant malposition can produce unsatisfactory aesthetic results after breast augmentation. The goal of this article is to identify aspects of the preoperative surgical planning and intraoperative flap fixation that can prevent implant malposition. Methods This study examined 36 patients who underwent primary dual plane breast augmentation through an inframammary incision between September 1, 2012 and January 31, 2013. Before the surgery, preoperative evaluation and design using the Randquist formula were performed. Each patient was evaluated retrospectively for nipple position relative to the breast implant and breast contour, using standardized preoperative and postoperative photographs. The average follow-up period was 10 months. Results Seven of 72 breasts were identified as having implant malposition. These malpositions were divided into two groups. In relation to the new breast mound, six breasts had an inferiorly positioned and one breast had a superiorly positioned nipple-areolar complex. Two of these seven breasts were accompanied with an unsatisfactory breast contour. Conclusions We identified two main causes of implant malposition after inframammary augmentation mammaplasty. One cause was an incorrect preoperatively designed nipple to inframammary fold (N-IMF) distance. The breast skin and parenchyma quality, such as an extremely tight envelope, should be considered. If an extremely tight envelope is found, the preoperatively designed new N-IMF distance should be increased. The other main cause of malposition is failure of the fascial suture from Scarpa's fascia to the perichondrium through an inframammary incision. As well, when this fixation is performed, it should be performed directly downward to the perichondrium, rather than slanted in a cranial or caudal direction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.38 no.6
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• pp.337-342
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• 2012

Objectives: Implants connect the internal body to its external structure, and is mainly supported by alveolar bone. Stable osseointegration is therefore required when implants are inserted into bone to retain structural integrity. In this paper, we present an implant with a "wing" design on its area. This type of implant improved stress distribution patterns and promoted changes in bone remodeling. Materials and Methods: Finite element analysis was performed on two types of implants. One implant was designed to have wings on its cervical area, and the other was a general root form type. On each implant, tensile and compressive forces ($30N/m^2$, $35N/m^2$, $40N/m^2$, and $45N/m^2$) were loaded in the vertical direction. Stress distribution and displacement were subsequently measured. Results: The maximum stresses measured for the compressive forces of the wing-type implant were $21.5979N/m^2$, $25.1974N/m^2$, $29.7971N/m^2$, and $32.3967N/m^2$ when $30N/m^2$, $35N/m^2$, $40N/m^2$, and $45N/m^2$ were loaded, respectively. The maximum stresses measured for the root form type were $23.0442N/m^2$, $26.9950N/m^2$, $30.7257N/m^2$, and $34.5584N/m^2$ when $30N/m^2$, $35N/m^2$, $40N/m^2$, and $45N/m^2$ were loaded, respectively. Thus, the maximum stresses measured for the tensile force of the root form implant were significantly higher (about three times greater) than the wing-type implant. The displacement of each implant showed no significant difference. Modifying the design of cervical implants improves the strength of bone structure surrounding these implants. In this study, we used the wing-type cervical design to reduce both compressive and tensile distribution forces loaded onto the surrounding structures. In future studies, we will optimize implant length and placement to improve results. Conclusion: 1. Changing the cervical design of implants improves stress distribution to the surrounding bone. 2. The wing-type implant yielded better results, in terms of stress distribution, than the former root-type implant.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.3
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• pp.248-254
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• 2005

The purpose of this study was to investigate the distribution of stress within the regenerated bone surrounding the implant using three dimensional finite element stress analysis method. Using ANSYS software revision 6.0 (IronCAD LLC, USA), a program was written to generate a model simulating a cylindrical block section of the mandible 20 mm in height and 10 mm in diameter. The $5.0{\times}11.5-mm$ screw implant (3i, USA) was used for this study, and was assumed to be 100% osseointegrated. And it was restored with gold crown with resin filling at the central fossa area. The implant was surrounded by the regenerated type IV bone, with 4 mm in width and 7 mm apical to the platform of implant in length. And the regenerated bone was surrounded by type I, type II, and type III bone, respectively. The present study used a fine grid model incorporating elements between 250,820 and 352,494 and nodal points between 47,978 and 67,471. A load of 200N was applied at the 3 points on occlusal surfaces of the restoration, the central fossa, outside point of the central fossa with resin filling into screw hole, and the functional cusp, at a 0 degree angle to the vertical axis of the implant, respectively. The results were as follows: 1. The stress distribution in the regenerated bone-implant interface was highly dependent on both the density of the native bone surrounding the regenerated bone and the loading point. 2. A load of 200N at the buccal cusp produced 5-fold increase in the stress concentration at the neck of the implant and apex of regenerated bone irrespective of surrounding bone density compared to a load of 200N at the central fossa. 3. It was found that stress was more homogeneously distributed along the side of implant when the implant was surrounded by both regenerated bone and native type III bone. In summary, these data indicate that concentration of stress on the implant-regenerated bone interface depends on both the native bone quality surrounding the regenerated bone adjacent to implant and the load direction applied on the prosthesis.

• The Journal of the Korean dental association
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• v.50 no.1
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• pp.31-37
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• 2012

Objective : This research compared stabilities between two types of dental implant ($SLA^{TM}$, Institut Straumann AG, Waldenburg, Switzerland and $SSII^{TM}$, Osstem co, Busan, Korea) using Osstell Mentor (Integration Diagnostics AB, Goteborg, Sweden) considering surgery methods, surgery area, diameter of implant, systemic disease, and smoking for obtaining prognosis information when installing fixture of dental implant. Materials & Methods : 206 implants of 131 patients taken by resonance frequency analysis (RFA) were determined as a final sample. Dental implants were installed as protocol of supplier by a excellent dentist who had 10 years experience about dental implants. Before connecting abutments (3 months after installation of fixture), RFA were measured twice for buccal and lingual direction to obtain average value. Results : Dental implants at mandible showed significantly higher stabilities significantly than at maxilla (p<0.001). Diameter 4.8 implants had also higher stabilities than diameter 4.1 in case of $SLA^{TM}$ implants (p<0.001). $SLA^{TM}$ implants showed more excellent stabilities than $SSII^{TM}$ implants, especially at posterior area of mandible (p=0.045) and premolar area of maxilla (p=0.032). Conclusions : This research revealed higher stabilities of $SLA^{TM}$ implants than $SSII^{TM}$ implant, especially at posterior area of mandible (p=0.045) and premolar area of maxilla (p=0.032).

• Applied Microscopy
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• v.34 no.4
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• pp.277-283
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• 2004

This paper reports that the ultrastructural nature of the interface process between the implants and surrounding bone has been studied after in vivo 1, 4, 8, 12 weeks of implantation of smooth machined implants into rabbit tibias. There was no indication of the fibrous connective tissue formation around the implant that imply intolerance of the bone tissue towards the implant after 1 week of implantation. The regions showing direct bone tissue bonding to the smooth machined implant contained osteoblast activating across the interface in the direction after 4 weeks of implantation. The reaction of a smooth machined implant caused in the first instance formation of an amorphous woven bone, which transformed into a mineralized bone containing collagen fibers. After 8 weeks of implantation, the activities of osteoblast initiated osseointegration forming bone matrix at the interface. During this period, the osteoblast surrounded with a matrix consisting of collagen bundles running in various directions. In the interface area between newly formed bone tissue and implants which has been inserted in rabbit tibias for 12 weeks, the implant and mineralized bone was separated by an amorphous electron dense material layer about $1{\sim}1.5{\mu}m$ in thickness.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.4
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• pp.487-497
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• 2005

Purpose: Resonance frequency analysis (RFA) , a non-invasive technique for the clinical measurement of implant stability, was investigated. Peri-implant bony defect may contribute to implant failure. This in vitro study evaluated the resonance frequencies according to various bony defects and determined whether the directional bone defect can affect the value of frequency analysis. Material and Method: Fifteen 3.75 mm in diameter and 10 mm in length, machined self-tapping implant future were used. Twelve types of bone defects that have different horizontal and vertical dimensions were simulated. Embedded implants were attached to the dental surveyor. Then, the transducer was connected with the implant fixture and the ISQ value was measured at four different directions. Two-way analysis of variance and post hoc $Sch\`{e}ffe'$ test were performed at the 95% significance level. Results: The control group showed the highest ISQ value and 5 thread-$360^{\circ}$ group had the lowest one. As the vertical exposure of implants in each angle was increased, the ISQ value was decreased. Although the horizontal exposure in each thread was increased, the ISQ value was not significantly decreased. Conclusion : Although the simulated defect type was different from each other, the ISQ value was similar among groups.

• Journal of Technologic Dentistry
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• v.40 no.1
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• pp.41-47
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• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.2
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• pp.185-196
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• 2006

Statement of problem: The researches on the influence of design variables on the stress distribution in cortical and trabecular bones and on optimal design for implant system were limited. Purpose: The purpose of this study is to identify the sensitivities of design parameters and to suggest the optimal parameters for designing the onebody type implant system. Material and methods: Stresses arising in the implant system were obtained by finite element analysis using a three dimensional model. An onebody type implant system[Oneplant (Warrantec. Co. Ltd., Korea)] was considered in this study. Vortical load(150 N) was applied on the top of the abutment along the axial direction. The initial design variables set for sensitivity analysis were radius of fixture, numbers of micro thread, numbers of power thread, height of micro thread, future length, tapered angle of future, inclined angle of thread, width of micro thread and width of power thread. The statistical technique of Design of Experiments(DOE) was applied tn the simulation model to deduce effective design parameters on stress distributions in bones. The deduced design parameters were incorporated into a fully automated design tool which is coupled with the finite element analysis and numerical optimization to determine the optimal design parameters. Results: 1. The result of sensitivity analysis showed six design variables - radius of future, tapered angle of fixture, inclined angle of thread, numbers of power thread, numbers of micro thread and height of micro thread - were more influential than the others. 2. The optimal values of design variables can be deduced by coupling finite element analysis (FEA) and design optimization tool(DOT).

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.4
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• pp.339-346
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• 2022

Compared with traditional full dentures, mandibular implant overdentures have the advantage in that good support and retention can be obtained even with two implants. When manufacturing a mandibular implant overdenture using two implants, it is important to place the implant in the correct position. The long-term prognosis of overdenture is good when two implants are placed in the direction vertical to the occlusal plane and parallel to each other at the canine position. However, it is difficult to place two implants in the correct position in edentulous patients, and if you use surgical guides in these cases, you can get help in placing the implants in a prosthetically advantageous position. This case, a 57-year-old male patient, came to our hospital with all upper and lower teeth removed due to periodontal disease. Therefore, the maxilla was restored with a traditional full denture and the mandible was restored with an implant overdenture using two implants, which resulted in satisfactory functional and esthetic results.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.2
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• pp.105-113
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• 2018

Purpose: The purpose of this study was to investigate the effects of the insertion depth of an immediately loaded implant on the stress distribution of the surrounding bone and the micromovement of the implant using the three-dimensional finite element analysis. Materials and methods: A total of five bone models were constructed such that the implant platform was positioned at the levels of 0.00 mm, 0.25 mm, 0.50 mm, 0.75 mm, and 1.00 mm depth from the crest of the cortical bone. A frictional coefficient of 0.3 and the insertion torque of 35 Ncm were simulated on the interface between the implant and surrounding bone. A static load of 178 N was applied to the provisional prosthesis with a vertical load in the axial direction and an oblique load at $30^{\circ}$ with respect to the central axis of the implant, then a finite element analysis was performed. Results: The implant insertion depth significantly affected the stress distribution on the surrounding bone. The largest micromovement value of the implant was $39.34{\mu}m$. The oblique load contributed significantly to the stress distribution and micromovement in comparison to the vertical load. Conclusion: Increasing the implant insertion depth was advantageous in dispersing the concentrated stress in the cortical bone and did not significantly affect the micromovement associated with early osseointegration failure.