• 대한치과보철학회지
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• 제42권5호
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• pp.597-607
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• 2004

Purpose: This study was peformed to investigate the retrievability of the cemented crown from the cementation type implant abutment. Material and method: The cementation type implant abutments (NEOBIOTECH implant abutment regular, 3 degree taper, 10mm length, 4mm diameter, Ti grade III, machined surface. Hwasung, Kyunggi-do) and cemented crowns were divided into 3 groups, depending on their hole angles formed in the crowns for their retrievability. The abutments and crowns were luted with 4 kinds of cements and separation test using metal wedge was executed with Instron 4465 Universal Testing Machine and the maximum impact force of the modified crown ejector was measured. Results and conclusion : 1. All of the cementation type implant abutments and cemented crowns were separated with relatively small force by metal wedge. 2. The retrieving force was minimum when the metal wedge was applied perpendicular to the axis of abutment. 3. The force for retrieving crowns from abutments was maximum in resin cement group, and reduced in orders of zinc phosphate cement, glass ionomer cement and zinc oxide eugenol cement. 4. The maximum force obtained by the crown ejector was higher than the retrieval force in ZOE and GI cement and lower than that in ZPC and resin cement. 5. If it has similar conditions clinically, the cemented crowns luted with 2 types of cements (ZOE, GI cement) can be safely retrieved from the cementation type implant abutments by the modified crown ejector.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권2호
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• pp.70-76
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• 2017

The purpose of this study was to perform a literature review of short implants in the posterior maxilla and to assess the influence of different factors on implant success rate. A comprehensive search was conducted to retrieve articles published from 2004 to 2015 using short dental implants with lengths less than 10 mm in the posterior maxilla with at least one year of follow-up. Twenty-four of 253 papers were selected, reviewed, and produced the following results. (1) The initial survival rate of short implants in the posterior maxilla was not related to implant width, surface, or design; however, the cumulative success rate of rough-surface short implants was higher than that of machined-surface implants especially in performance of edentulous dental implants of length <7 mm. (2) While bone augmentation can be used for rehabilitation of the atrophic posterior maxilla, short dental implants may be an alternative approach with fewer biological complications. (3) The increased crown-to-implant (C/I) ratio and occlusal table (OT) values in short dental implants with favorable occlusal loading do not seem to cause peri-implant bone loss. Higher C/I ratio does not produce any negative influence on implant success. (4) Some approaches that decrease the stress in posterior short implants use an implant designed to increase bone-implant contact surface area, providing the patient with a mutually protected or canine guidance occlusion and splinting implants together with no cantilever load. The survival rate of short implants in the posterior edentulous maxilla is high, and applying short implants under strict clinical protocols seems to be a safe and predictable technique.

• The Journal of Advanced Prosthodontics
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• 제1권1호
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• pp.10-18
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• 2009

STATEMENT OF PROBLEM. Despite an improved bone reactions of Mg-incorporated implants in the animals, little yet has been carried out by the experimental investigations in functional loading conditions. PURPOSE. This study investigated the clinical and histologic parameters of osseointegrated Mg-incorporated implants in early loading conditions. MATERIAL AND METHODS. A total of 36 solid screw implants(diameter 3.75 mm, length 10 mm) were placed in the mandibles of 6 beagle dogs. Test groups included 18 Mg-incorporated implants. Turned titanium implants served as control. Gold crowns were inserted 4 weeks after implant placement and the dogs were immediately put on a food diet. Implants were observed for 10 weeks after loading. Radiographic assessments and stability tests were performed at the time of fixture installation, $2^{nd}$ stage surgery, 4 weeks after loading, and 10 weeks after loading. Histological observations and morphometrical measurements were also performed. RESULTS. Of 36 implants, 33 displayed no discernible mobility, corresponding to successful clinical function. There was no statistically significant difference between test implants and controls in marginal bone levels(P=.46) and RFA values. The mean BIC % in the Mg-implants was $54.5{\pm}8.4%$. The mean BIC % in the turned implant was $45.3{\pm}12.2%$. These differences between the Mg-implant and control implant were statistically significant(P=.005). CONCLUSIONS. The anodized, Mg-incorporated implant demonstrated significantly more bone-to-implant contact(BIC) in early loading conditions. CLINICAL IMPLICATIONS. The results of this study in beagle dogs suggest the possibility of achieving predictable stability of early loaded free-standing dental implants with Mg-incorporated surface.

• Journal of Periodontal and Implant Science
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• 제52권6호
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• pp.496-508
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• 2022

Purpose: This study aimed to compare the long-term survival rate and peri-implant marginal bone loss between different types of dental implant-abutment connections. Methods: Implants with external or internal abutment connections, which were fitted at Gangneung-Wonju National University Dental Hospital from November 2011 to December 2015 and followed up for >5 years, were retrospectively investigated. Cumulative survival rates were evaluated for >5 years, and peri-implant marginal bone loss was evaluated at 1- and 5-year follow-up examinations after functional loading. Results: The 8-year cumulative survival rates were 93.3% and 90.7% in the external and internal connection types, respectively (P=0.353). The mean values of marginal bone loss were 1.23 mm (external) and 0.72 mm (internal) (P<0.001) after 1 year of loading, and 1.20 mm and 1.00 mm for external and internal abutment connections, respectively (P=0.137) after 5 years. Implant length (longer, P=0.018), smoking status (heavy, P=0.001), and prosthetic type (bridge, P=0.004) were associated with significantly greater marginal bone loss, and the use of screw-cement-retained prosthesis was significantly associated (P=0.027) with less marginal bone loss. Conclusions: There was no significant difference in the cumulative survival rate between implants with external and internal abutment connections. After 1 year of loading, marginal bone loss was greater around the implants with an external abutment connection. However, no significant difference between the external and internal connection groups was found after 5 years. Both types of abutment connections are viable treatment options for the reconstruction of partially edentulous ridges.

• The Journal of Advanced Prosthodontics
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• 제15권4호
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• pp.214-226
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• 2023

PURPOSE. This study aimed to compare the bite force (BF) between complete dentures and implant overdentures (IODs) retained by two mandibular implants. Additionally, we evaluated the quality of life (QoL) and patient satisfaction among individuals using IODs. In addition, the effects of demographic parameters such as age and sex, and clinical parameters such as implant length, implant diameter, attachment height, attachment color, and interimplant distance on BF, QoL, and patient satisfaction were evaluated. MATERIALS AND METHODS. A total of 51 edentulous patients rehabilitated with the maxillary complete dentures and mandibular IODs retained by two implants were included in this study. BF was measured using a force meter pre- and post-implant in the same patients. Oral health-related quality of life (OHRQoL) was assessed with the Oral Health Impact Profile (OHIP-14) and patient satisfaction was assessed with the Visual Analog Scale (VAS) questionnaires. RESULTS. It was found that BF values were statistically higher for IODs than complete dentures (P < .001). In terms of attachment height of the OHIP scores, there was a significant difference in the psychological disability and social disability domains (P < .05). When examining the change in patient satisfaction as a function of sex, it was found that mandibular retention satisfaction differed significantly by sex (P < .05), but there was no significant difference in the other domains. CONCLUSION. Within the limitations of this study, it was observed that the BF increased after the use of IODs. Several factors, including age, interimplant distance, attachment height, and attachment color, were found to impact OHRQoL. Sex and implant diameter were identified as factors affecting patient satisfaction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제34권3호
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• pp.285-292
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• 2008

Purpose: The present study was performed to evaluate the effect of surface treatment of the cervical area of implant on bone regeneration in fresh extraction socket following implant installation. Materials and methods: The four minipigs, 18 months old and 30 kg weighted, were used. Four premolars of the left side of both the mandible and maxilla were extracted. ${\phi}$3.3 mm and 11.5 mm long US II plus implants (Osstem Implant co., Korea) with resorbable blasting media (RBM) treated surface and US II implants (Osstem Implant co., Korea) with machined surface at the top and RBM surface at lower portion were installed in the socket. Stability of the implant was measured with $Osstell^{TM}$ (Model 6 Resonance Frequency Analyser: Integration Diagnostics Ltd., Sweden). After 2 months of healing, the procedures and measurement of implant stability were repeated in the right side by same method of left side. At four months after first experiment, the animals were sacrificed after measurement of stability of all implants, and biopsies were obtained. Results: Well healed soft tissue and no mobility of the implants were observed in both groups. Histologically satisfactory osseointegration of implants was observed with RBM surface, and no foreign body reaction as well as inflammatory infiltration around implant were found. Furthermore, substantial bone formation and high degree of osseointegration were exhibited at the marginal defects around the cervical area of US II plus implants. However, healing of US II implants was characterized by the incomplete bone substitution and the presence of the connective tissue zone between the implant and newly formed bone. The distance between the implant platform (P) and the most coronal level of bone-to-implant contact (B) after 2 months of healing was $2.66{\pm}0.11$ mm at US II implants group and $1.80{\pm}0.13$mm at US II plus implant group. The P-B distance after 4 months of healing was $2.29{\pm}0.13$mm at US II implants group and $1.25{\pm}0.10$mm at US II plus implants group. The difference between both groups regarding the length of P-B distance was statistically significant(p<0.05). Concerning the resonance frequency analysis (RFA) value, the stability of US II plus implants group showed relatively higher RFA value than US II implants group. Conclusion: The current results suggest that implants with rough surface at the cervical area have an advantage in process of bone regeneration on defect around implant placed in a fresh extraction socket.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제38권6호
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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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• 제31권4호
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• pp.291-299
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• 2005

Objectives : It is well known that cigarette smoking is harzardous to the osseointegration of dental implant, due to the impaired wound healing accompanied by reduced alveolar bone density. The aim of this study is to evaluate the influence of cigarette smoke on the implant osseointegration by the time factor consideration. Materials and methods : Twenty-four male Spraque-Dawley rats (8 weeks, weighting 200 to 250g) were used in this study. In the experimental group, 13 rats were exposed to cigarette smoke, 8 minutes per day during 6 weeks, and 12 rats in the control group were not exposed at any time. RBM (Resorbed blasting media) surfaced implant (diameter 3.3mm, length 5.0mm, AVANA Co., Korea) was placed in the right femur of each rat. Each implant with surrounding bone was prepared with microtome (cutting band 0.2mm$^{(R)}$, EXAKT Co., Germany) after 1 day, 2, 4, 8 and 12 weeks and stained with toluidine blue (1%). Another clinical investigation of each implant was also done at each evaluation time. Results : Clinical investigation around implant fixture showed that there were no significant differences between the control and experimental group. Microscopic observation around implant fixture showed that there were significant differences between the control and experimental group at the initial stage after implant fixture installation. Experimental group showed a decreased bone to implant contact within 4 weeks compared to control group, but showed similar characteristics after 4 weeks. Conclusion : Smoking inhalation effect on the dental implant showed the impaired wound healing by vasoconstriction and decreased intramedullary blood flow at initial stage of osseointegration. This experimental results can be clinically useful to the implant surgery of smoking patients.

• 대한치과보철학회지
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• 제49권4호
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• pp.316-323
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• 2011

연구 목적: 본 연구의 목적은 치과용 임플란트 나사산 디자인이 변연골 응력에 미치는 영향에 정량적인 분석을 하고자 한다. 연구 재료 및 방법: 외경 4.1 mm (경부직경 3.5 mm), 매식부 길이 10 m인 표준형 ITI 임플란트 시스템(ITI Dental Implant System; Straumann AG, Waldenburg, Switzerland)을 기본모델(대조모델)로 채택하고, 그 몸체의 나사산은 다른 임플란트 시스템에 채택되고 있는 삼각형, 사각형, buttres형 디자인을 가지는 가상의 해석모델을 4종 만들었다. 해석모델은 나사산 형태와 크기에 따라 (1) 모델 A (작은 삼각형 나사산), (2) 모델 B (큰 삼각형 나사산), (3) 모델 C (buttres형 나사산), 및 (4) 모델 D (사각형 나사산)로 구분하였다. 유한요소 모델링과 해석에는 NISA II/DISPLAY III (Engineering Mechanics Research Corporation, Troy, MI, USA) 프로그램을 사용하였다. Mesh 구성에는 NKTP type 34형 solid 요소(4각형 축대칭 요소, 요소당 절점수 8개)를 사용하여 임플란트 장축과 평행한 축대칭 하중은 물론 장축과 경사각을 갖는 비축대칭 하중조건을 모두 해석할 수 있도록 하였다. 임플란트의 표면으로부터 각각 0.2, 0.4, 0.6, 0.8, 1.0 mm 떨어진 위치에 5개의 응력관찰점(stress monitoring point)을 설정 하여 기록된 응력 값으로부터 회귀분석을 통하여 변연골 응력 최대값(peak stress)을 정량화하였다. 해석에 사용한 하중 조건은 2가지로, 임플란트 축에 평행한 수직하중 100 N과 임플란트 축과 $30^{\circ}$를 이루는 경사력 100 N 조건이었다. 결과: 임플란트 경부와 접하고 있는 인접 변연골에 응력집중현상이 보이고 있었으며, 그 양상은 임플란트 나사산 디자인과 무관하게 거의 유사하게 관찰되었다. 수직력 100 N 조건에서 산출된 변연골 최대응력값은 대조모델과 실험모델 A, B, C, D에서 7.84, 6.45, 5.96, 6.85, 5.39 MPa이었고, 경사력 조건에서는 각각 29.18, 26.45, 25.12, 27.37, 23.58 MPa이었다. 결론: 임플란트 나사산의 디자인은 변연골의 응력에 영향을 미치는 중요한 요소이다.

• 대한치과보철학회지
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• 제41권4호
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• pp.421-439
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• 2003

Statement of problem : It is difficult to obtain a good titanium casting body using the traditional sprue design because of high melting point of Ti, and the low fluidity and high reactivity of molten Ti. Purpose : A new sprue design for titanium casting bodies needs more trial and error. In order to decrease the number of trial and error, computer simulation(MAGMASOFT, Magmasoft Giessereitechnologie GmbH, Achen, Germany) was used to optimize sprue design in U-shaped implant superstructures. Material and method : Five kinds of sprue were examined for the design of the sprue former for titanium casting: Sprue design A(sprue length 4 mm, rectangular shape, 4 sprues), Sprue design B(sprue length 4 mm. round shape. radius 2 mm, 7 sprues), Sprue design C (sprue length 2 mm, round shape, radius 2 mm, 7 sprues). Sprue design D (sprue length 2 mm, cone shape, large radius 3mm. small radius 2mm, 7 sprues), and Sprue design E( sprue length 2 mm. one unit channel shape). Sprue design F(sprue length 2mm, one unit channel shape) was also examined for the design of the customized sprue former in the Biotan system(Schutz Dental Gmbh, Germany). The casting bodies were taken in Sprue design A, Sprue design D, Sprue design E, and Sprue design F in the Biotan casting system. The numerically predicted defects were compared with the experimental dental castings by the radiographic and sectional view observations. Results : 1. According to the result of computer simulation, turbulence during mold filling was decreased in the sequence of Sprue design F, Sprue design E, Sprue design D, Sprue design C, Sprue design B, and Sprue design A. 2. The calculated solidification time contours indicate that hot spot was moved from the casting body to the sprue button in the sequence of Sprue design A, Sprue design B, Sprue design C, Sprue design D, and Sprue design E. The filling pattern of Sprue design F was similar to that of Sprue design E. 3 The predicted filling pattern shows that less turbulence was found in the customized sprue former than in the standard sprue former. 4. According to the results of the radiographic and cross sectional observations, casting defects less than 1mm were found at the center of a casting body with Sprue design E and Sprue design F. However, larger casting defects of 4mm were found in a casting with Sprue design A. 5. The predicted casting porosity was similar to that of the real casting. Conclusion : One unit channel-type and customized sprue former can be recommended. Further research and developement of various sprue designs using computer simulation in necessary to optimize casting design, in order to reduce the formation of casting defects in implant titanuim super-structures.