• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.167-173
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• 2013

Purpose: The aim of this study is to analyze the series of panoramic radiograph of implant patients using the system to measure peri-implant crestal bone loss according to the elapsed time from fixture installation time to more than three years. Methods: Choose 10 patients having 45 implant fixtures installed, which have series of panoramic radiograph in the period to be analyzed by the system. Then, calculated the crestal bone depth and statistics and selected the implant in concerned by clicking the implant of image shown on the monitor by the implemented pattern recognition system. Then, the system recognized the x, y coordination of the implant and peri-implant alveolar crest, and calculated the distance between the approximated line of implant fixture and alveolar crest. By applying pattern recognition to periodic panoramic radiographs, we attained the results and made a comparison with the results of preceded articles concerning peri-implant marginal bone loss. Analyzing peri-implant crestal bone loss in a regression analysis periodic filmed panoramic radiograph, logarithmic approximation had highest $R^2$ value, and the equation is as shown below. $y=0.245Logx{\pm}0.42$, $R^2=0.53$, unit: month (x), mm (y) Results: Panoramic radiograph is a more wide-scoped view compared with the periapical radiograph in the same resolution. Therefore, there was not enough information in the radiograph in local area. Anterior portion of many radiographs was out of the focal trough and blurred precluding the accurate recognition by the system, and many implants were overlapped with the adjacent structures, in which the alveolar crest was impossible to find. Conclusion: Considering the earlier objective and error, we expect better results from an analysis of periapical radiograph than panoramic radiograph. Implementing additional function, we expect high extensibility of pattern recognition system as a diagnostic tool to evaluate implant-bone integration, calculate length from fixture to inferior alveolar nerve, and from fixture to base of the maxillary sinus.

• 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.

• Korean Journal of Computational Design and Engineering
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• v.13 no.3
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• pp.200-208
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• 2008

Total Hip Replacement(THR) is a surgical procedure that replaces a diseased hip joint with a prosthesis. A plastic or metal cup forms the socket, and the head of the femur is replaced by a metal ball on a stem placed inside the femur. Due to the various types and shapes of human hip joint of every individual, a selected commercial implant sometimes may not be the best-fit to a patient, or it cannot be applied because of its discrepancy. Hence extracting geometry parameters of hip joint is one of the most crucial processes in designing custom-made implants. This paper describes the framework of a methodology to extract the geometric parameters of the hip joint. The parameters include anatomical axis, femoral head, head offset length, femoral neck, neck shaft angle, anteversion, acetabulum, and canal flare index. The proposed system automatically recommends the size and shape of a custom-made hip implant with respect to the patient's individual anatomy from 3D models of hip structures. The proposed procedure creating these custom-made implants with some typical examples is precisely presented and discussed in this paper.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.349-357
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• 2015

Edentulous patients with a severely resorbed mandible or maxilla often experience problems with conventional dentures, such as insufficient stability and retention, together with a decrease in chewing ability. Because of the good prognosis of dental implants, these patients can be successfully treated with implant-retained or implant-supported prosthesis. Ideally, a maximum number of implants of maximum length are placed in appropriate surgically prepared sites that are surrounded by a maximum amount of bone of favorable quality. The implants are favorably aligned faciolingually and mesiodistally to enhance optimal prosthodontic design. This article describes the clinical problems and complications encountered when treating a consecutive number of edentulous patients with osseointegrated implant-supported prostheses.

• The Journal of Advanced Prosthodontics
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• v.3 no.1
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• pp.47-50
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• 2011

Despite the greater retention and low maintenance of bar attachment system, the longer clinical time and increased number of visits were the assignments to overcome in bar attachment system. This case report describes SFI-Bar$^{(R)}$ (Cendres et Me$\'{e}$taux, Biel/Bienne, Switzerland) to be solve those problems. A 65-year-old female, who had severely absorbed mandible, hoped to wear a stable mandibular denture without pain. As soon as two implants were placed on mandible, a tube bar was connected to two adaptors connected to each implant. The length of the tube bar was adjusted considering inter implant distance, and reconnected to the adaptors. Finally a female part was seated beneath the denture. This case report showed that a satisfactory clinical result was achieved by delivering bar overdenture immediately after implant placement without laboratory procedure.

• The Journal of Advanced Prosthodontics
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• v.6 no.1
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• pp.66-70
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• 2014

A dynamic impression is a functional impression that records the functional movement of the patient's own muscle and muscle attachment. This process reduces the number of random factors. This article describes a method for making a special tray using a dynamic impression concept that was made from provisional dentures used for implant healing. The individual tray is used to make a wash-impression to record the features of the mucosa in detail. The main advantage of this technique is that it provides a functional relationship of the implant components to the supporting tissues without overextension because provisional denture had been used for 2 months and the border length of individual tray was nearly the same as that of provisional denture. The delivery of the prosthesis constructed using this impression technique is time-saving because there is no need for border molding and there are fewer post-insertion appliance adjustments.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.1
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• pp.53-64
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• 2008

Statement of problem: Peri-implant marginal bone loss is an important factor that affects the success of implants in esthetics and function. Various efforts have been made to reduce this bone loss by improving implant design and surface texture. Previous studies have shown that early marginal bone loss is affected by implant neck designs. Purpose: The purpose of this study was to examine the influence of laser microtexturing of implant collar on peri-implant marginal bone loss. Materials and methods: Radiographical marginal bone loss was examined in patients treated with implant-supported fixed partial dentures. Marginal bone level was examined with 101 implant fixtures installed in 53 patients at three periods(at the time of implantation, prosthetic treatment and 6-month after loading). Four types of implants were examined. The differences of bone loss between implants(ITI standard) with enough biologic width and implants(ITI esthetic plus, Silhouette IC, Silhouette IC Laser-$Lok^{TM}$) with insufficient biologic width have been compared. Resorption angles were examined at the time of prosthetic delivery and 6-month after loading. Results and Conclusion: Within the limitation of this study, the following results were drawn. 1. The marginal bone loss of ITI standard and Silhouette IC Laser-$Lok^{TM}$ was less than that of ITI esthetic plus and Silhouette IC(P<0.05). The marginal bone loss between ITI standard and Silhouette IC Laser-$Lok^{TM}$ had no significant statistical difference(P>0.05). There was no significant statistical difference between marginal bone loss of ITI esthetic plus and Silhouette IC(P>0.05). 2. There was no significant difference in marginal bone loss between maxilla and mandible(P>0.05). 3. There was no significant difference in resorption angle among four types of implants(P>0.05). The marginal bone of implants with supracrestal collar design of less than that of biologic width had resorbed more than those with sufficient collar length. The roughness and laser microtexturing of implant neck seem to affect these results. If an implant with collar length of biologic width, exposure of fixture is a possible complication especially in the anterior regions of dentition that demand high esthetics. Short smooth neck implant are often recommended in these areas which may lack the distance between microgap and the marginal bone level. In these cases, the preservation of marginal bone must be put into consideration. From the result of this study, it may be concluded that laser microtexturing of implant neck is helpful in the preservation of marginal bone.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.301-311
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• 2009

Statement of problem: Flapless implant surgery using a soft tissue punch device requires a circumferential excision of the mucosa at the implant site. To date, Although there have been several reports on clinical outcomes of flapless implant surgeries, there are no published reports that address the appropriate size of the soft tissue punch for peri-implant tissue healing. Purpose: In an attempt to help produce guidelines for the use of soft tissue punches, this animal study was undertaken to examine the effect of soft tissue punch size on the healing of peri-implant tissue in a canine mandible model. Material and methods: Bilateral, edentulated, flat alveolar ridges were created in the mandibles of six mongrel dogs. After a three month healing period, three fixtures (diameter, 4.0 mm) were placed on each side of the mandible using 3 mm, 4 mm, or 5 mm soft tissue punches. During subsequent healing periods, the peri-implant mucosa was evaluated using clinical, radiological, and histometric parameters, which included Gingival Index, bleeding on probing, probing pocket depth, marginal bone loss, and vertical dimension measurements of the peri-implant tissues. Results: The results showed significant differences (P <0.05) between the 3 mm, 4 mm and 5 mm tissue punch groups for the length of the junctional epithelium, probing depth, and marginal bone loss during healing periods after implant placement. When the mucosa was punched with a 3 mm tissue punch, the length of the junctional epithelium was shorter, the probing depth was shallower, and less crestal bone loss occurred than when using a tissue punch with a diameter $\geq$ 4 mm. Conclusion: Within the limit of this study, the size of the soft tissue punch plays an important role in achieving optimal healing. Our findings support the use of tissue punch that 1 mm smaller than implant itself to obtain better peri-implant tissue healing around flapless implants.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.3
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• pp.335-341
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• 2009

Statements of problem: Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the actual effect of dimensional change in implant geometry on initial stability. Purpose: The purpose of the current study was to investigate the influence of diameter and length changes on initial stability of implants. Material and methods: Four types of dummy bone (D1, D2, D3 and D4) consisted of cortical and cancellous layers with different thickness were simulated. Implants which had similar surface area to each other ($3.5{\times}13.0-mm$, $4.0{\times}11.5-mm$, $4.5{\times}10.0-mm$, $5.0{\times}8.5-mm$) were inserted in dummy bones. Implant stability as a function of peak insertion torque and resonance frequency values were recorded for each implant. Results: 1. Bone quality was a major influential factor to achieve initial stability (P <.05). 2. In D1, D2 and D3 dummy bones, implant stability quotient values were not significantly different to each other (P >.05), however insertion torques were increased with wider and shorter implants (P <.05). 3. In D4 dummy bone, implant stability quotient values and insertion torques were decreased with wider and shorter implants (P <.05). Conclusion: From a point of view of initial stability, it is suggested that use of wide and short implant may be helpful in avoiding bone augmentation procedures in area of adequate bone quality.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.1
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• pp.41-56
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• 2008

The methods of surface modification of commercial implants were various according to the manufacturer. Surface modification of implant may produce diverse physical and chemical surface characteristics resulted from the treatment method and treatment condition. As a result, the bone response might be different. Even though surface modified implants have been used clinically, most researches are focusing on the bone response of surface modified implants comparing to machined implants rather than surface modified commercial implants. This study compare and analyze bone responses of 4 surface modified commercial implants with different shapes and surfaces. Eighty surface modified commercial implants with 4 different surface characteristics were installed in the tibia of white Newzealand rabbits. Biomechanical stability tests and histomorphometric evaluation were done. The results were as follows: 1. Surface modified commercial implants showed stable osseointegration at 6 weeks after installation. 2. Histomorphometric evaluation showed that there was no significant differences in bone to implant contact among 4 different commercial titanium implants. In comparing the implants with different shape the measurement of bone growth in subcortical area would be more reliable than entire bone to implant contact length. 3. Resonance Frequency Analysis showed that there was no significant differences among 4 types of implants, even though they were significantly different in installation. 4. There was significant differences in interfacial shear strength among 4 type of implants. 5. It is difficult to observe accurate bone to implant interface using Micro-CT. However, it is possible to measure the entire contact length of the implant to the bone.