• Title/Summary/Keyword: implant prosthesis

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A FINITE ELEMENT STRESS ANALYSIS OF THE STRESS DISTRIBUTION AND THE SHOCK ABSORPTION IN AN OSSEOINTEGRATED IMPLANT-NATURAL TOOTH SUPPORTED FIXED PARTIAL DENTURE (골유착성 임프란트와 자연치를 이용한 고정성 국소의치에서 응력분산 및 충격흡수에 관한 유한요소법적 응력분석)

  • Jeong Chang-Mo;Lee Ho-Yong
    • The Journal of Korean Academy of Prosthodontics
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    • v.30 no.4
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    • pp.582-610
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    • 1992
  • The long-term success of any dental implant is dependent upon the optimization of stresses which occur during oral function and parafunction. Especially, it has been suggested that there is an unique set of problems associated with joining an osseointegrated implant and a natural tooth with a fixed partial denture. For this particular case, although many literatures suggest different ways to avoid high stress concentrations on the bone surrounding the implant under static and dynamic loading conditions, but few studies on the biomechanical efficacy of each assertion have been reported. The purpose of this investigation was to evaluate the efficacies of clinically suggested methods on stress distribution under static load and shock absorption under dynamic load, using two dimensional finite element method. In FEM models of osseointegrated implant-natural tooth supported fixed partial dentures, calculations were made on the stresses in surrounding bone and on the deflections of abutments and superstructure, first, to compare the difference in stress distribution effects under static load by the flexure of fastening screw or prosthesis, or intramobile connector, and second, to compare the difference in the shock absorption effects under dynamic load by intramobile connector or occlusal veneering with composite resin. The results of this analysis suggest that : 1. Under static load condition, using an implant design with fastenign screw connecting implant abutment and prosthesis or increasing the flexibility of fastening screw, or increasing the flexibility of prosthesis led to the .increase in height of peak stresses in cortical bone surrounding the implant, and has little effect on stress change in bone around the natural tooth. 2. Under static load condition, intramobile connector caused the substantial decrease in stress concentration in cortical bone surrounding the implant and the slight increase in stress in bone around the natural tooth. 3. Under dynamic load condition, both intramobile connector and composite resin veneering showed shock absorption effect on bone surrounding the implant and composite resin veneering had a greater shock absorption effect than intramobile connector.

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Three-dimensional finite element analysis of buccally cantilevered implant-supported prostheses in a severely resorbed mandible

  • Alom, Ghaith;Kwon, Ho-Beom;Lim, Young-Jun;Kim, Myung-Joo
    • The Journal of Advanced Prosthodontics
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    • v.13 no.1
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    • pp.12-23
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    • 2021
  • Purpose. The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio. Materials and Methods. Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creating an excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges. Results. The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain. CONCLUSION. Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.

Implant-supported fixed prosthesis restoration of fully edentulous patient using computer-guided implant surgery and immediate loading: A case report (Computer guided implant surgery와 immediate loading을 활용한 무치악 환자의 전악 임플란트 고정성 보철물 수복 증례)

  • Hyeon-Me Sung;Kyoung-Hee Sul;Sun-Woo Kang;Jung-Han Kim
    • The Journal of Korean Academy of Prosthodontics
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    • v.62 no.2
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    • pp.131-139
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    • 2024
  • In a edentulous patient, various methods can be employed for prosthetic treatment using implants, such as implant-supported fixed prostheses, overdentures, hybrid prostheses, and implant assisted removable partial denture. In this case, in a patient with moderate to severe chronic periodontitis requiring full arch extractions, implants were strategically placed using computer-guided surgery. In the maxilla, due to inadequate bone quality and quantity leading to insufficient initial stability, delayed loading was implemented, and interim prosthesis was used during the osseointegration period. In the mandible, stable initial stability was achieved, allowing for immediate loading to reduce patient discomfort. Primary stability is considered the most crucial factor for obtaining immediate loading, so a thorough clinical and radiological evaluation of the remaining alveolar bone quantity and quality must be conducted before surgery.

Pontic site development with an implant submergence technique for unaesthetic implant in the anterior maxilla (상악 전치부 임플란트의 비심미성 개선을 위한 임플란트 침수(submergence)를 동반한 치조제 증대술)

  • Song, Yujeong;Lee, Ju-Youn
    • Journal of Dental Rehabilitation and Applied Science
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    • v.36 no.4
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    • pp.289-295
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    • 2020
  • Improving implant esthetics is very difficult, especially in cases where unaesthetic problems are related to implants in the maxillary anterior dentition. A 69-year old male patient was referred by a prosthodontist for periodic pus discharge and an unaesthetic implant prosthesis (maxillary right lateral incisor). The implant was placed too deeply and showed soft tissue volume deficiency and a long clinical crown. After a clinical and radiographic examination, implant submergence and alveolar ridge augmentation were performed to enhance the aesthetics instead of an explantation. The treatment plan was as follows: extraction the adjacent teeth with tooth mobility, secondary caries, and poor prognosis; placement an additional dental implant with hard and soft tissue grafting; fabrication a fixed bridge using implant abutments. A fixed esthetic prosthesis using implants was fabricated, and the patient was satisfied with the prosthesis. A ridge augmentation with implant submergence may be an alternative for solving the problems of unaesthetic implant restorations in the esthetic zone.

Rehabilitation of a patient by converting poorly maintained fixed implant prosthesis into implant overdenture: a case report (기존 임플란트 보철물의 불량한 유지관리를 개선하기 위해 임플란트 피개의치로의 상부 보철물 전환 증례)

  • Kim, Yeong-Kyu;Jeong, Chang-Mo;Yun, Mi-Jung;Lee, So-Hyoun;Huh, Jung-Bo
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.1
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    • pp.127-134
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    • 2022
  • Among many contributing factors of implant failure, excessive loading and inflammation contribute mainly to increasing implant failure rate. Especially, poor oral hygiene around implants is one of the most common reasons for implant failure. When implant prosthesis fails to function, the clinician should re-diagnose and plan treatment using the remaining implants. Additional implantation may be needed to make a new type of prosthesis or either implant-assisted RPD and implant overdenture treatment may be performed using the remaining implants. In this article, a patient whose fixed implant prosthesis in the maxilla had failed of poor oral hygiene maintenance was reported to be recovered with removable implant overdenture by using remaining implant abutments and a milled bar with additional retentive elements. Through this treatment, the clinical results were satisfactory in terms of esthetics, masticatory function recovery and oral hygiene management.

A STUDY ON THE DEGREE OF OCCLUSAL CONTACT UNDER THE FIXEDIMPLANT PROSTHESIS OF PARTIALLY DENTULOUS PATIENTS (부분 무치악 고정성 임플랜트 보철하에서 교합접촉정도에 관한 연구)

  • Song, Keum-Young;Kay, Kee-Sung;Cjung, Chae-Heon
    • The Journal of Korean Academy of Prosthodontics
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    • v.33 no.2
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    • pp.281-299
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    • 1995
  • The purpose of this study was to evaluate the degree of occlusal contact under the fixed implant prosthesis of partially edentulous patients which was hased on occlusal concept of implant prosthesis. From the patients who have free-standing implant supported prosthesis of unilateral partially edentulous area, occlusal and occlusal contact point of th enatural tooth side and implant side of light closure and heavy closure were analyzed by T-scan system throuht pre-and post-adjustment and the degree of occlusal contact was estimated by Shimstock. The following results were obtained : 1. The occlusal force of natural tooth side(NF) from mid-sagittal axis was relatively constant at light and heavy closure through pre-and post-adjustment, but the occlusal force of implant side(IF) was decreased significantly at light closure(P<0.01) and heavy closure(P<0.05) of post-adjustment. 2. Natural tooth side-implant side moment(MIMoment) fo occlusal force from mid-sagittal axis was significant(p<0.05) through pre-and post-adjustment and the deviation from mid-sagittal axis was increased at light closure of post-adjustment, but was decreased at heavy closure of post-adjustment. 3. Comparing the NF and IF, IF was greater at heavy closure of pre-adjustment, and NF was greater at light closure of post-adjustment, and the NF and IF was relatively equally distributed at light closure of pre-adjustment and at heavy closure of post-adjustment. 4. The number of occlusal contact point of natural tooth side(NC) was relatively constant through pre-and post-adjustment, but the number of occlusal contact point of implant side(IC) was significantly decreased(P<0.05) at light closure of post-adjustment, and was not significant but was lesser at heavy closure of post-adjustment. 5. Difference of the NC and IC was greater at light closure of post-adjustment, but it was less at heavy closure of post-adjustment, and therefore occlusal contact point of natural tooth side and implant side was relatively equally distributed at heavy closure of postadjustment. 6. When bilaterally distribution of occlusal force and occlusal contact point was established, degree of occlusal contact of implant suporoted prosthesis with opoosing teeth at light clousre was $34.13{\pm}21.69{\mu}m$.

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Effect of repetitive firing on passive fit of metal substructure produced by the laser sintering in implant-supported fixed prosthesis

  • Altintas, Musa Aykut;Akin, Hakan
    • The Journal of Advanced Prosthodontics
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    • v.12 no.3
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    • pp.167-172
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    • 2020
  • PURPOSE. The aim of the present study was to investigate the passive fit of metal substructure after repetitive firing processes in implant-supposed prosthesis. MATERIALS AND METHODS. Five implants (4 mm diameter and 10 mm length) were placed into the resin-based mandibular model and 1-piece of screw-retained metal substructure was produced with the direct metal laser sintering (DMSL) method using Co-Cr compound (n = 10). The distance between the marked points on the multiunit supports and the marginal end of the substructure was measured using a scanning electron microscope (SEM) at each stage (metal, opaque, dentin, and glaze). 15 measurements were taken from each prosthesis, and 150 measurements from 10 samples were obtained. In total, 600 measurements were carried out at 4 stages. One-way ANOVA test was used for statistical evaluation of the data. RESULTS. When the obtained marginal range values were examined, differences between groups were found to be statistically significant (P<.001). The lowest values were found in the metal stage (172.4 ± 76.5 ㎛) and the highest values (238.03 ± 118.92 ㎛) were determined after glaze application. When the interval values for groups are compared with pairs, the differences between metal with dentin, metal with glaze, opaque with dentin, opaque with glaze, and dentin with glaze were found to be significant (P<.05), whereas the difference between opaque with metal was found to be insignificant (P=.992). CONCLUSION. Passive fit of 1-piece designed implant-retained fixed prosthesis that is supported by multiple implants is negatively affected by repetitive firing processes.

Implant-supported fixed prosthesis in patient with severe defects using staged GBR via 2-step augmentations: A case report (심한 결손부의 단계적 골증대술을 통한 임플란트 지지 고정성 보철 수복 증례 보고)

  • Oh, SaeEun;Jun, Ji Hoon;Park, YoungBum
    • The Journal of Korean Academy of Prosthodontics
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    • v.60 no.4
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    • pp.382-394
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    • 2022
  • The treatment of patients with severe periodontitis should be proceeded step-bystep through an accurate diagnosis of each patients' individual tooth and with a strategic treatment plan. Implant-supported fixed prosthetic restoration has the advantage of high patient satisfaction and stable vertical dimension compared to the removable partial denture. However, multiple teeth defect areas lacking hard tissue may be disadvantageous in aesthetic failure and longer treatment time. In addition, it takes a certain period of time to manufacture and install a conventional fixed prosthesis, and during this process, the provisional prosthesis must satisfy the mechanical, biological, and aesthetic requirements of teeth. The purpose of this article is to describe the fabrication of implant-supported fixed prosthesis through a step-by-step approach in a partially edentulous patient.