• The Journal of Korean Academy of Prosthodontics
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• v.59 no.3
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• pp.359-369
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• 2021

Implant prostheses and removable partial dentures are mainly used as treatment methods for partial edentulous patients who have lost a number of teeth. The implant-assisted removable partial denture (IARPD) is strategically selected. The defect in maxillofacial structure due to osteomyelitis, a type of facial bone infection, causes dysfunction such as mastication, swallowing, and pronunciation, as well as social and psychological effects, so a removable restoration is required to restore the supporting tissue. Design of abutment and partial dentures is an essential factor in the success of treatment. In this case, IARPD, which has superior retention and stability compared to traditional removable partial dentures, can have a good prognosis. In a partial edentulous patient with bone defects due to osteomyelitis treatment, the stability of the denture was secured with IARPD restoration. Moreover, maintenance problem that may occur in the future was minimized by providing an appropriate denture design and occlusal scheme through several provisional restorations. This case can be expected to have a favorable prognosis in the long term.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.3
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• pp.269-281
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• 2008

Fatigue or overload can result in mechanical problems of implant components. The mechanical strength in the implant system is dependent on several factors, such as screw and fixture diameters, material, and design of the fixture-abutment connection and abutment. In these factors, the last rules the strength and stability of the fixture-abutment assembly. There have been some previous reports on the mechanical strength of the fixture-abutment assembly with the compressive bending test or short-term cyclic loading test. However, it is restrictive to predict the long-term stability of the implant system with them. The purpose of this study was to evaluate the influence of the design of the fixture-abutment connection and abutment on the mechanical strength and failure mode by conducting the endurance limit test as well as the compressive bending strength test. Tests were performed according to a specified test(ISO/FDIS 14801) in 4 fixture-abutment assemblies of the Osstem implant system: an external butt joint with Cemented abutment (group BJT), an external butt joint with Safe abutment (group BJS), an internal conical joint with Solid abutment (group CJO), and an internal conical joint with ComOcta abutment (group CJT). The following conclusions were drawn within the limitation of this study. Compressive bending strengths were decreased in order of group BJS(1392.0N), group CJO(1261.8N), group BJT(1153.2N), and group CJT(1110.2N). There were no significant differences in compressive bending strengths between group BJT and group CJT(P>.05). Endurance limits were decreased in order of group CJO(600N), group CJT(453N), group BJS(360N), and group BJT(300N). 3. Compressive bending strengths were influenced by the connection and abutment design of the implant system, however endurance limits were affected more considerably by the connection design.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.2
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• pp.136-142
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• 2009

Bone density in the recipient implant site seems to be an important factor for long term success of endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify suitable implant sites, thereby improving the success rate of the procedure. Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively with computerized tomography and histologically measured bone density by bone biopsy. Patients and methods; Twenty seven patients were selected. All the patients were in good health, with no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery 2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and insertion torque values were recorded. Results; The highest histomorphometric values was found in the posterior mandible $32.3{\pm}3.8$, followed by $29.9{\pm}2.6$ for the posterior maxilla, $29.4{\pm}2.6$ for the anterior maxilla, $28.6{\pm}2.3$ for the anterior mandible(p=0.214). The hounsfield unit was $989.2{\pm}258.1$ in the posterior mandible, $845.0{\pm}241.5$ in the anterior maxilla, $744.5{\pm}92.6$ in the anterior mandible, $697.3{\pm}136.9$ in the posterior maxilla(p=0.045). This results may suggest that there are strong correlation between the histomorphometric values and hounsfield unit(r=0.760, p<0.05). The RF measurements were $81.9{\pm}2.4$ ISQ in the posterior mandible, $79.0{\pm}1.4$ ISQ in the anterior mandible, $78.3{\pm}4.6$ ISQ in the posterior maxilla, $76.5{\pm}5.0$ ISQ in the anterior maxilla(p=0.048). The insertion torque values was $43.2{\pm}4.2\;Ncm$ in the posterior mandible, $42.0{\pm}0.0\;Ncm$ in the anterior mandible, $41.3{\pm}4.1\;Ncm$ in the posterior maxilla, $40.8{\pm}3.8\;Ncm$ in the anterior maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield unit and the insertion torque values(r=0.494, p<0.05), the histomorphometric values and the insertion torque values(r=0.689, p<0.05). But there was no correlation between histomorphometric values and ISQ. There was no statistical significance in age and gender effect on parameters. Conclusions; There was significant correlations between bone density and implant stability parameters. The bone density measurements using preoperative CT may help clinicians to predict primary stability before implant insertion, which is associated with implant survival rates.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2007.11a
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• pp.52-52
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• 2007

치과 임플란트는 주로 Ti 합금으로 이루어지며 구강내 또는 체내에 매식되기 때문에 다양한 신체용액에 노출될 수 있다. 본 연구에서는 국내에서 제조된 티타늄 임플란트를 이용하여 수종의 신체유사용액에서 전기화학적인 방법을 통해 각각의 부식 안정성을 평가하였다.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.65-69
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• 2023

The surgical approach for humeral implant failure can be challenging due to neurovascular anatomy and the possible necessity of osteosynthesis removal. We present a rare case of humeral nail bending after secondary trauma in a patient with preexistent nonunion of the humerus after intramedullary nailing. During revision surgery, the nail was sawed in half and the distal part was removed, followed by plate osteosynthesis with cable fixation to achieve absolute stability. The patient regained a full range of motion 1 year after surgery, and complete healing of the fracture was seen on imaging.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.3
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• pp.163-172
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• 2012

Purpose: Diabetes mellitus (DM) has been shown to alter the properties of the bone and impair bone healing around a titanium implant. The aim of this study is to investigate whether the low-intensity pulsed ultrasound (LIPUS), which has been known to stimulate the bone healing, improve the osseointegration of the titanium implant in tibia of DM-induced rats. Methods: 16 rats were received streptozotocin (60 mg/kg) for inducing diabetes. A total number of 32 titanium implants were placed bilaterally into both tibiae of these rats. The right tibia of each rat received LIPUS application (10 min/day) during 7 days post-operation, while the left side received no treatment. The study was carried on for six weeks and the rats were sacrificed at 1, 2, 4, and 6 weaks postoperatively (4 rats for each week) for histomorphometric and histologic analysis. Bone-implant contact and bone area were measured. Comparisons between the groups were made using statistical analysis on histomorphometric analysis. Results: The histomorphometry parameters showed that the bone-implant contact and the bone area values have decreased in the late osseointegration periods (4, 6 weeks) compared to the early osseointegration periods (1, 2 weeks) in both two groups. The bone-implant contact values of the LIPUS group were somewhat higher than those of controls at 1, 2 weeks, but the difference was not statistically significant. The bone area values of the LIPUS group were also higher than those of controls at 1, 2 weeks, but the difference was not statistically significant as well. Conclusion: Results of this study indicate that LIPUS may have positive effects on early osseointegration but could not improve the long term stability of dental implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.405-413
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• 2011

It was proposed that technologies derived from CAD-CAM and computed tomography may be useful for flapless implant treatment procedures. The aims of this study were to validate the reliability of this concept in a prospective 12-month clinical study. Twelve patients with fully edentulous areas in their mandibles were included in this study. A total of 71 implants were inserted in interforaminal regions by use of a CAD/CAM drill template($NobelGuide^{TM}$), specially designed for flapless implant surgery. To assess the degree of pain and discomfort, the patients were examined at 2 days and 1 week after surgery. Patient satisfaction and implant functionality were further evaluated at follow-up intervals of 1, 3, 6, and 12 months postoperatively. One implant failed early in 1 patient. All of the other implants were in a good functional state throughout the study. The mean marginal bone loss after 1 year of follow-up was 0.3 mm (SD, 0.1) at center, 0.5 mm (SD, 0.1) at canine and 0.7 mm (SD, 0.2) at distal fixtures, respectively. Statistically, there was not significant differences among each sites(P>.05)The mean ISQ change after 1 year of follow-up was -1.05 (SD, 2.76) at center, -0.85 (SD, 2.59) at canine and -1.27 (SD, 2.18) at distal fixtures, respectively. This prospective pilot study showed that the use of CAD/CAM technology and flapless implant surgery may be considered reliable for fully edentulous mandible of patients.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.653-664
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• 2007

Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.259-271
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• 2013

The purpose of this study was to make the stress distribution produced by simulated different load under two types of internal connection implant system (stepped and tapered type) by means of 3D finite element analysis, The finite element model was designed with the parallel placement of the one fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st molar. Two models were loaded with 200 N magnitude in the vertical direction on the central position of the crown, the 1.5 mm and 3 mm buccal offset point from the central position of the fixture. The oblique load was applied at the angle of $30^{\circ}$ on the crown surface. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual dimension. The results were as follows; 1. The loading conditions of two internal connection implant systems (stepped and tapered type) were the main factor affecting the equivalent bone strain, followed by the type of internal connections. 2. The stepped model had more mechanical stability with the reduced max. stress compared to $11^{\circ}$ tapered models under the distributed oblique loading. 3. The more the contact of implant-abutment interface to the inner wall of implant fixture, the less stress concentration was reduced.