• The Journal of Korean Academy of Prosthodontics
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• v.39 no.1
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• pp.25-36
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• 2001

Among the numerous factors contributing to implant failure, the most common are infection, failure of proper healing and overload. These factors may occur combined. Implant fractures are one of the complications resulting from overload. Implant fracture is not a common feature, but once it occurs it causes very unpleasant circumstances for the patient as well as for the practitioner. Only few studies have been reported regarding this subject. Thus, little is known about its solutions. It is important that analyzing reasons for implant fracture and finding appropriate solutions. Factors leading to implant fracture are design, material defects, nonpassive fit of prosthetic framework and biomechanical overload. Previous studies have reported that implant fractures ares associated with marginal bone loss and occur mostly in the posterior regions and that most patients showing parafunctional habits also have implant fracture. Abutment and gold screw loosening or fracture were also observed in some of the cases previous to implant fracture. Similar observations were seen in our hospital as well. The following cases will present implant fracture cases which have been successfully treated regarding function and biomechanics. This was achieved by means of using increased number of futures, increasing fixture diameter and establishing proper occlusion.

• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.153-167
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• 2005

The purpose of this study was to compare the v-shape thread with the square shape thread of fixture in the view of stress distribution pattern using finite element stress analysis. The finite element model was designed with the parallel placement of two standard fixtures(4.0 mm diameter ${\times}$ 11.5 mm length) on the region of mandibular 1st and 2nd molars. Three dimensional finite element model was created with the components of the implant and surrounding bone. This study simulated loads of 200 N at the central fossa in a axial direction (load A), 200 N at the buccal offset load that is 2 mm apart from central fossa in a axial direction (load B), 200 N at the buccal offset load that was 4 mm apart from central fossa in a axial direction (load C). These forces of load A',B',C' were applied to a $15^{\circ}$ inward oblique direction at that same site with 200 N. Von Mises stress values were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study : 1. The highest stress concentration occurred at the cervical region of the implant fixture. 2. Von Mises stress value of off-site region was higher than that of central fossa region. 3. Square shape thread type showed more even stress distribution in the vertical and oblique force than V-shape thread type. 4. Stress distribution was the most effective in the case of buccal offset load (2, 4 mm distance from central fossa) in the square shape thread type. 5. V-shape thread type revealed higher von Mises stress value than square shape thread type in all environmental condition. The results from numerical analyses concluded that square shape thread type had the lower destructive stress and more stress distribution between the fixture and bone interface than V-shape thread type. Therefore, square shape thread type was regarded as optimal thread configuration in biomechanical concepts.

• Journal of Dental Rehabilitation and Applied Science
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• v.23 no.4
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• pp.327-336
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• 2007

Purpose This study was planned to compare and evaluate the stability of implant using $Osstell^{TM}$ and Osstell $Mentor^{TM}$. Material and methods Artificial bone and RBM(resorbable blasting media) surface blasted implants(Osstem US II, SS II implants - diameter: 4mm, length: 13mm) were used. To measure the stability of installed implants, $Osstell^{TM}$ and Osstell $Mentor^{TM}$ were used. In the first experiment, five implants were installed in D1(external type implants) and D3(internal type implants). In the second experiment, 4 internal type implants were divided in two groups and installed in D1 artificial bone with different depth. In the third experiment, two external implants were installed in D1 and D3 artificial bone each and two internal implants were installed in D1 and D3 artificial bone. In all groups, their stability were measured by $Osstell^{TM}$ and Osstell $Mentor^{TM}$. Results In all groups, $Osstell^{TM}$ and Osstell $Mentor^{TM}$ both showed reliable measurement values. The value difference between $Osstell^{TM}$ and Osstell $Mentor^{TM}$ was observed but the difference was small and clinically acceptable. Conclusion These results suggest that the use of Osstell $Mentor^{TM}$ has clinical relevance in the assessment of implant stability.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.417-429
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• 2009

Since the introduction of the concept of osseointegration in dental implants, high long-term success rates have been achieved and accepted as viable option for the treatment of fully and partially edentulous patients. Although the use of domestic implants have increased dramatically, there are few studies on domestic implants with clinical and objective long-term data. 96 endosseous implants placed in 31 patients at Wonkwang University Sanbon Dental Hospital were examined to determine the effect of various factors on implant survival rate and marginal bone loss, through clinical and radiographic results. The design of endosseous implant used to this study is straight with the microthread.(GS II RBM Fixture) 1. 3 fixtures were lost, resulting in 96.9% cumulative survival rate. 2. Survival rate in fifties was significantly lower (93.6%) and no significant difference in marginal bone loss was found according to gender. 3. Survival rates were 95.6% in the maxillary molar area and 97.3% in the mandible molar area. 4. No significant difference in survival rate was found according to presence of bone grafts, type of prostheses, implant position, and length and diameter of implant. 5. A factor influencing marginal bone loss was presence of type of prostheses, while facters such a length, diameter of fixture and bone grafts had no statistically significant effect on crestal bone loss. This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.6
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• pp.745-750
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• 2005

Statement of problem. Resonance frequency analysis has been increasingly served as a non-invasive and objective method for clinical monitoring of implant stability. Many clinical studies must be required for standardized data using RFA. Purpose. This study was performed to evaluate RFA value changes in two anodized implant groups. Material and method. Among a total of 24 implants, twelve screw shaped implants as a test group (H2-R8.5) were manufactured, which had a pitch-height of 0.4 mm, an outer diameter of 4.3 mm, a length of 8.5 mm, and external hexa-headed, were turned from 5 mm rods of commercially pure titanium (ASTM Grade IV, Warantec Co., Seoul, Korea), and another twelve implants as a control group were $Br{\aa}nemark$ Ti-Unite MK4 (diameter 4.0 mm, length 8.5 mm). Each group was installed in tibia of rabbit. Two implants were placed in each tibia (four implants per rabbit). Test two implants were inserted in right side and control two in left side. ISQ values were measured using $Osstell^{TM}$ (Integration Diagnostics Ltd. Sweden) during fixture installation, and 12 weeks later and evaluated the RFA changes. Results. Mean and SD of baseline ISQ values of test group were $75.0{\pm}3.4$ and $68.7{\pm}8.1$ for control group. Mean and SO of ISQ values 12 weeks after implant insertion were $73.2{\pm}4.7$ for test group and $72.6{\pm}3.9$ for control group. There were no statistically significant differences between groups in ISQ values after 3 months (P>0.05). From the data, RFA gains after 3 months were calculated, and there was statistically significant difference between groups (P<0.05). Conclusion. Although there were RFA changes between groups, implant stability after experimental period shows alike tendency and good bone responses.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.1
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• pp.120-131
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• 2005

Statement of problem. More than 70% of patients who need the implant supported restoration are parially edentulous. The principles of design for implant supported fixed partial denture in mandibular posterior region are many and varied. Jurisdiction for their use is usually based on clinical evaluation. There are several areas or interest regarding the design of implant supported fixed partial denture in mandibular posterior region. 1) Straight and tripod configuration in implant placement, 2) Two restoration types such as individualized and splinted restorations. Purpose. The purpose of this study was to compare the amount and distribution of stress around the implant fixtures placed in the mandibular posterior region with two different arrangements and to evaluate the effects of splinting using the photoelastic stress analysis. Material & methods. 1) Production of study model: Mandibular partially edentulous model was waxed-up and duplicated with silicone and two models were poured in stone. 2) Fixture installation and photoelastic model construction: Using surveyor(Ney, USh), 3 fixtures(two 4.0 $\times$13 mm, one 5.0$\times$10 mm, Lifecore, USA) were insta)led in straight & tripod configurations. Silicone molds were made and poured in photoelastic resin (PL-2. Measurements group, USA). 3) Prostheses construction: Four 3-unit bridges (Type III gold alloy, Dongmyung co., Korea) were produced with nonhexed and hexed UCLA abutments and fitted with conventional methods. The abutments were tightened with 30 Ncm torque and the static loads were applied at 12 points of the occlusal surface. 4) Photoelastic stress analysis : The polarizer analyzer system with digital camera(S-2 Pro, Fujifilm, Japan) was used to take the photoelastic fringes and analysed using computer analysis program. Results. Solitary hexed UCLA restoration developed different stress patterns between two implant arrangement configurations, but there were no stress transfer to adjacent implants from the loaded implant in both configurations. However splinted restorations showed lesser amount of stresses in the loaded implants and showed stress transfer to adjacent implants in both configurations. Solitary hexed UCLA restoration with tripod configuration developed higher stresses in anterior and middle implants under loading than implants with straight configurations. Splintied 3 unit fixed partial dentures with tripod configuration showed higher stress development in posterior implant under loading but there were no obvious differences between two configurations. Conclusions. The tripod configuration of implant arrangement didn't show any advantages over the straight configuration. Splinting of 3 unit bridges with nonhexed UCLA abutments showed less stress development around the fixtures. Solitary hexed UCLA restoration developed tilting of implant fixture under offset loads.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.1
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• pp.40-50
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• 2006

Statement of problem: $Periotest^(R)\;and\;Osstell^{TM}$ were known as the most objective and quantitative mobility tests available for evaluating stability of implant in vivo. Although a correlation between PTV widely used and ISQ recently introduced exist, a PTV was corresponded to various ISQ. A correct evaluation of implant stability could be obtained only after one has a thorough understanding of the limitations of devices and factors that affect measurements. Purpose: The purpose of this study was to investigate the causes of variables in the values obtained with these two tests. Material and method: A total of 333 implants 134 $Br{\aa}nemark$, 5 Silhouette and 194 ITI implants were investigated. Result: 1. There was a correlation between PTV and ISQ (Spearman correlation =0.39, p<0.0001) 2. The factors that affected ISQ were diameter of implant future, location of implant and implant system (submerged type vs non-submerged type). 3. The factors that affected W were dimeter of implant future, location of implant, and elapsed time after implant placement. 4. There was no significant difference between different surface treatments of RBM, smooth surface and ti-unite on PTY and ISQ. 5. In radiographic finding, no saucerization or bone resorption has been detected in implants with ISQ values that were above the average level of each PTV. These higher values had higher bone densities around the implant fixture. Saucerization was observed in the most impants with ISQ values that were below the average level of each PTV. Conclusion: There was a correlation between ISQ and PTV. However, each measuring methods had factors influencing the measured values. PTV were less sensitive to marginal bone resorption and influenced with the striking point on an implant to the level of bone. With ISQ, the height of implant from bone level to transducer should be considered.

• Journal of Periodontal and Implant Science
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• v.54 no.1
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• pp.53-62
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• 2024

Purpose: This study aimed to evaluate the long-term cumulative survival rate (CSR) of dental implants with micro-threads in the neck over a 10-year follow-up period and to examine the factors influencing the survival rate of dental implants. Methods: This retrospective study was based on radiographic and dental records. In total, 151 patients received 490 Oneplant^® dental implants with an implant neck micro-thread design during 2006-2010 in the Department of Periodontology of Seoul National University Dental Hospital. Implant survival was evaluated using Kaplan-Meier analysis. Cox proportional hazard regression analysis was used to identify the factors influencing implant failure. Results: Ten out of 490 implants (2.04%) failed due to fixture fracture. The CSR of the implants was 97.9%, and no significant difference was observed in the CSR between external-and internal-implant types (98.2% and 97.6%, respectively, P=0.670). In Cox regression analysis, 2-stage surgery significantly increased the risk of implant failure (hazard ratio: 4.769, P=0.039). There were no significant differences in influencing factors, including sex, age, implant diameter, length, fixture type, location, surgical procedure, bone grafting, and restoration type. Conclusions: Within the limitations of this retrospective study, the micro-thread design of the implant neck was found to be favorable for implant survival, with stable clinical outcomes.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.4
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• pp.331-338
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• 2004

Stress transfer to the surrounding tissues is one of the factors involved in the design of dental implants. Unfortunately, insufficient data are available for stress transfer within the regenerated bone surrounding dental implants. The purpose of this study was to investigate the concentration of stresses within the regenerated bone surrounding the implant using three-dimensional finite element stress analysis method. Stress magnitude and contours within the regenerated bone were calculated. The $3.75{\times}10-mm$ implant (3i, USA) was used for this study and was assumed to be 100% osseointegrated, and was placed in mandibular bone and restored with a cast gold crown. Using ANSYS software revision 6.0, 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 present study used a fine grid model incorporating elements between 165,148 and 253,604 and nodal points between 31,616 and 48,877. This study was simulated loads of 200N at the central fossa (A), at the outside point of the central fossa with resin filling into screw hole (B), and at the buccal cusp (C), in a vertical and $30^{\circ}$ lateral loading, respectively. The results were as follows; 1. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were increased from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, concentrated on the top of the cylindrical collar loading point B and C in vertical loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were increase from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in vertical loading. 2. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were decreased from loading point A to C in lateral loading. Stresses according to the depth of regenerated bone were concentrated on the top of the cylindrical collar in loading point A and B, distributed along the implant evenly in loading point C in lateral loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were decreased from loading point A to C in lateral loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in lateral loading. In summary, these data indicate that both bone quality surrounding the regenerated bone adjacent to implant fixture and load direction applied on the prosthesis could influence concentration of stress within the regenerated bone surrounding the cylindrical type implant fixture.

• The Journal of Advanced Prosthodontics
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• v.8 no.5
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• pp.396-403
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• 2016

PURPOSE. Early loading of implant can be determined by excellent primary stability and characteristic of implant surface. The implant system with recently improved surface can have load application 4-6 weeks after installing in maxilla and mandible. This study evaluated the effect of healing period to the stability of hydrophilic tapered-type implant at maxillary posterior area. MATERIALS AND METHODS. This study included 30 patients treated by hydrophilic tapered-type implants (total 41 implants at maxilla) and classified by two groups depending on healing period. Group 1 (11 patients, 15 implants) was a control group and the healing period was 12 weeks, and Group 2 (19 patients, 26 implants) was test group and the healing period was 6 weeks. Immediately after implant placement, at the first impression taking, implant stability was measured using Osstell Mentor. The patients also took periapical radiographs after restoration delivery, 12 months after restoration and final followup period. The marginal bone loss around the implants was measured using the periapical radiographs. RESULTS. All implants were survived and success rate was 97.56%. The marginal bone loss was less than 1mm after 1 year postoperatively except the one implant. The stabilities of the implants were not correlated with age, healing period until loading, insertion torque (IT), the diameter of fixture and the location of implant. Only the quality of bone in group 2 (6 week) was correlated with the stability of implant. CONCLUSION. Healing period of 6 weeks can make the similar clinical prognosis of implants to that of healing period of 12 weeks if bone quality is carefully considered in case of early loading.