Journal of the Korean Association of Oral and Maxillofacial Surgeons
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제30권4호
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pp.316-322
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2004
A low molecular weight component named bone morphogenetic protein(BMP) chemically isolated from the organic matrix of bone, induce postfetal connective tissue cells surrounding small blood vessels to differentiate into cartilage and bone. The end product of BMP is a spherical ossicle of lamella bone filled with red bone marrow for the functional loading. This is a important point that the graft material is embedded the defect site during the implant surgery. Because present knowledge of the relationship between BMP and bone regeneration arises mainly from studies of induced bone formation in heterotopic sites, it would be helpful to determine whether BMP plays any part in the process of bone healing. The BMPs have been shown to play crucial roles in normal skeletal development as well as bone healing and are able to activate transcription of genes involved in cellular migration, proliferation, and differentiation. The delivery of BMP on matrices has been efficacious in the treatment of defect bone in implant surgery. The purpose of the histologic study was to evaluate the effect of DLB(demineralized lyophilized bone) coated with purified human BMP(hBMP-I) in immediate implant surgery with bony defect to obtain the functional structure of implant asap. The ability of a graft of hBMP-I to accelerate bony defect repair provides a rationale for its use in immediate implant surgery that have large bone defect in edentulous area.
PURPOSE. Dental implant has gained clinical success over last decade with the major drawback related to osseointegration as properties of metal (Titanium) are different from human bone. Currently implant procedures include endosseous type of dental implants with nanoscale surface characteristics. The objective of this review article is to summarize the role of nanotopography on titanium dental implant surfaces in order to improve osseointegration and various techniques that can generate nanoscale topographic features to titanium implants. MATERIALS AND METHODS. A systematic electronic search of English language peer reviewed dental literature was performed for articles published between December 1987 to January 2012. Search was conducted in Medline, PubMed and Google scholar supplemented by hand searching of selected journals. 101 articles were assigned to full text analysis. Articles were selected according to inclusion and exclusion criterion. All articles were screened according to inclusion standard. 39 articles were included in the analysis. RESULTS. Out of 39 studies, seven studies demonstrated that bone implant contact increases with increase in surface roughness. Five studies showed comparative evaluation of techniques producing microtopography and nanotopography. Eight studies concluded that osteoblasts preferably adhere to nano structure as compared to smooth surface. Six studies illustrated that nanotopography modify implant surface and their properties. Thirteen studies described techniques to produce nano roughness. CONCLUSION. Modification of dental osseous implants at nanoscale level produced by various techniques can alter biological responses that may improve osseointegration and dental implant procedures.
An ideal orthopedic implant should provide an excellent bone-implant connection, less implant loosening and minimum adverse reactions. Commercial pure titanium (CP-Ti) and Ti alloys have been widely utilized for biomedical applications such as orthopedic and dental implants. However, being bioinert, the integration of such implant in bone was not in good condition to achieve improved osseointegraiton, there have been many efforts to modify the composition and topography of implant surface. These processes are generally classified as physical, chemical, and electrochemical methods. Plasma electrolytic oxidation (PEO) as an electrochemical route has been recently utilized to produce this kind of composite coatings. Mg ion plays a key role in bone metabolism, since it influences osteoblast and osteoclast activity. From previous studies, it has been found that Mg ions improve the bone formation on Ti alloys. PEO is a promising technology to produce porous and firmly adherent inorganic Mg containing $TiO_2$($Mg-TiO_2$ ) coatings on Ti surface, and the amount of Mg introduced into the coatings can be optimized by altering the electrolyte composition. In this study, a series of $Mg-TiO_2$ coatings are produced on Ti-6Al-4V ELI dental implant using PEO, with the substitution degree, respectively, at 0, 5, 10 and 20%. Based on the preliminary analysis of the coating structure, composition and morphology, a bone like apatite formation model is used to evaluate the in vitro biological responses at the bone-implant interface. The enhancement of the bone like apatite forming ability arises from $Mg-TiO_2$ surface, which has formed the reduction of the Mg ions. The promising results successfully demonstrate the immense potential of $Mg-TiO_2$ coatings in dental and biomaterials applications.
PURPOSE. The aim of this study was to investigate the shear bond strength of luting cements used with implant retained restorations on to titanium specimens after different surface treatments. MATERIALS AND METHODS. One hundred twenty disc shaped specimens were used. They were divided into three groups considering the surface treatments (no treatment, sandblasting, and oxygen plasma treatment). Water contact angle of specimens were determined. The specimens were further divided into four subgroups (n=10) according to applied cement types: polycarboxylate cement (Adhesor Carbofine-AC), temporary zinc oxide free cement (Temporary CementZOC), non eugenol provisional cement for implant retained prosthesis (Premier Implant Cement-PI), and non eugenol acrylic-urethane polymer based provisional cement for implant luting (Cem Implant Cement-CI). Shear bond strength values were evaluated. Two-way ANOVA test and Regression analysis were used to statistical analyze the results. RESULTS. Overall shear bond strength values of luting cements defined in sandblasting groups were considerably higher than other surfaces (P<.05). The cements can be ranked as AC > CI > PI > ZOC according to shear bond strength values for all surface treatment groups (P<.05). Water contact angles of surface treatments (control, sandblasting, and plasma treatment group) were 76.17° ± 3.99, 110.45° ± 1.41, and 73.80° ± 4.79, respectively. Regression analysis revealed that correlation between the contact angle of different surfaces and shear bond strength was not strong (P>.05). CONCLUSION. The retentive strength findings of all luting cements were higher in sandblasting and oxygen plasma groups than in control groups. Oxygen plasma treatment can improve the adhesion ability of titanium surfaces without any mechanical damage to titanium structure.
The use of short implants has been accepted risky from biomechanical point of view. However, short implants appear to be a long term viable solution according to recent clinical reports. The purpose of this study was to investigate the effect of different diameter and length of implant size to the different type of bone on the load distribution pattern. Stress analysis was performed using 3-dimensional finite element analysis(3D-FEA). A three-dimensional linear elastic model was generated. All implants modeled were of the various diameter(${\phi}4.0$, 4.5, 5.0 and 6.0 mm) and varied in length, at 7.0, 8.5 and 10.0 mm. Each implant was modeled with a titanium abutment screw and abutment. The implants were seated in a supporting D2 and D4 bone structure consisting of cortical and cancellous bone. An amount of 100 N occlusal load of vertical and $30^{\circ}$ angle to axis of implant and to buccolingual plane were applied. As a result, the maximum equivalent stress of D2 and D4 bones has been concentrated upper region of cortical bone. As the width of implant is increased, the equivalent stress is decreased in cancellous bone and stress was more homogeneously distributed along the implants in all types of bone. The short implant of diameter 5.0mm, 6.0mm showed effective stress distribution in D2 and D4 bone. The oblique force of 100N generated more concentrated stress on the D2 cortical bone. Within the limitations of this study, the use of short implant may offer a predictable treatment method in the vertically restricted sites.
The present study was performed to evaluate the effects of Tetracycline-HCI on the microstructure change of SLA implant surface according to application time. In the Tetracycline-HCI group, 6 implants were rubbed with sponges soaked $50mg/m{\ell}$ Tetracycline-HCI solution for O.5min., lmin., 1. 5min., 2min., 2.5min. and 3min. In the saline group. another 6 implants conditioned with sponges soaked saline using same methods. One implant wasn't conditioned anything. Then, the changes of surface roughness values were evaluated by optical interferometer & specimens were processed for scanning electron microscopic observation. The results of this study were as follows: 1. In both Tetracycline-HCI group & saline group, there are no significant differences between surface roughness values before & after surface detoxification. And in scanning electron microscopic observation. there are slightly changes of implant surface structures but this changes were not significant by comparison with no treatment implant surface. 2. In the changes of surface roughness values & the scanning electron microscopic observation, there were no significant differences between saline & Tetracycline-HCI groups. In conclusion, the detoxification with $50mg/m{\ell}$ Tetracycline-HCI within 3 minutes can be applied for treatment of peri-implantitis in SLA surface implants. without surface microstructure changes.
Purpose: The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding three different types of implants(ITI, 3i. and Bicon implant system) Material and method: Photoelastic models were made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each kind were placed in the mandibular posterior edentulous area distal to the canine. For non-splinted restorations, individual crowns were fabricated on three titanium abutments. For splinted restorations, 3-unit axed partial dentures were fabricated. Photoelastic stress analyses were carried out to measure the fringe order around the implant supporting structure under simulated loaded conditions(15 lb. 30 lb). Conclusion: The results were as follows; 1 Regardless of the implant design, stresses were increased in the apex region of loaded implant when non-splinted restorations were loaded. While relatively even stress distribution occurred with splinted restorations. Splinting was effective in the second implant. 2. Strain around Bicon implant were lower than those of other implants, which confirmed the splinting effect. The higher the load, the more the stress occurred in supporting tissue, which was most obvious in the Bicon system. 3. Stress distribution in the supporting tissue was favorable in the ITI system. while the other side of 3i system tended to concentrate the stress in some parts.
PURPOSE. This prospective clinical study was conducted to evaluate the clinical usefulness of the freely detachable zirconia ball- and spring-retained implant prosthesis (BSRP) through a comparative analysis of screw- and cement-retained implant prosthesis (SCRP). MATERIALS AND METHODS. A multi-center, randomized, prospective clinical study evaluating the clinical usefulness of the detachable zirconia ball- and spring-retained implant prostheses was conducted. Sixty-four implant prostheses in 64 patients were examined. Periodic observational studies were conducted at 0, 3, 6, and 12 months after delivery of the implant prosthesis. Factors such as implant success rate, marginal bone resorption, periodontal pocket depth, plaque and bleeding index, and prosthetic complications were evaluated, respectively. RESULTS. During the 1-year observation period, all implants survived without functional problems and clinical mobility, showing a 100% implant success rate. Marginal bone resorption was significantly higher in the SCRP group than in the BSRP group only at the time of implant prosthesis delivery (P = .043). In all observation periods, periodontal pocket depth was slightly higher in the BSRP group than in the SCRP group, but there was no significant difference (P > .05). The modified plaque index (mPI) scores of both groups were moderate. Higher ratio of a score 2 in modified sulcus bleeding index (mBI) was observed in the BSRP group in the 6- and 12-months observation. CONCLUSION. Within the limitations of this study, the newly developed zirconia ball- and spring-retained implant prosthesis could be considered as an applicable and predictable treatment method along with the existing screw- and cement-retained prosthesis.
Statement of problem: Repeated delivery and removal of abutment cause some changes such as wear, scratch or defect of hexagonal structure. It may increase the value of rotational freedom(RF) between hexagonal structures. Purpose: The purpose of this study was to evaluate surface changes and rotational freedom between the external hexagon of the implant fixture and internal hexagon of abutment after repeated delivery and removal under SEM and toolmaker's microscope. Materials and methods: Implant systems used for this study were 3i and Avana. Seven pail's of implant fixture, abutment and abutment screws for each system were selected and all fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. Each one was embedded beneath the platform of fixture. Surfaces of hexagonal structure before repeated closing and opening of abutment were observed using SEM and rotational freedom was measured by using toolmaker's microscope. Each abutment was secured to the implant future by each abutment screw with recommended torque value using a digital torque controller and was repeatedly delivered and removed by 20 times respectively. After experiment, evaluation for the change of hexagonal structures and measurement of rotational freedom were performed. Result : The results were as follows; 1. Wear of contact area between implant fixture and abutment was considerable in both 3i and Avana system. Scratches and defects were frequently observed at the line-angle of hexagonal structures of implant fixture and abutment. 2. In the SEM view of the external hexagon of implant fixture, the point-angle areas at the corner edge of hexagon were severely worn out in both systems. It was more notable in the case of 3i systems than in that of Avana systems. 3. In the SEM view of the internal hexagon of abutment, Gingi-Hue abutment of 3i systems showed severe wear in micro-stop contacts that were machined into the corners to prevent rotation and cemented abutment of Avana systems showed wear in both surface area adjacent to the corner mating with external hexagon of implant fixture. 4 The mean values of rotational freedom between the external hexagon of the implant fixture and internal hexagon of abutment were 0.48$\pm$0.04$^{\circ}$ in pre-tested 3i systems and 1.18$\pm$0.25$^{\circ}$ after test, and 1.80$\pm$0.04$^{\circ}$ in pre-tested Avana systems and 2.61$\pm$0.16$^{\circ}$ after test. 5. Changes of rotational freedom after test shouted statistical)y a significant increase in both 3i and Avana systems(P<0.05, paired t-test). 6. Statistically, there was no significant difference between amount of increase in the rotational freedom of 3i systems and amount of increase in that of Avana ones(P>0.05, unpaired t-test). Conclusion: Conclusively, it was considered that repeated delivery and remove of abutment by 20 times would not have influence on screw joint stability. However, it caused statistically the significant change of rotational freedom in tested systems. Therefore, it is suggested that repeated delivery and remove of abutment should be minimal as possible as it could be and be done carefully Additionally, it is suggested that the means or treatment to prevent the wear of mating components should be devised.
Purpose: Various studies have investigated 3-dimensional (3D)-printed implants using Ti6Al-4V powder; however, multi-root 3D-printed implants have not been fully investigated. The purpose of this study was to explore the stability of multirooted 3D-printed implants with lattice and solid structures. The secondary outcomes were comparisons between the 2 types of 3D-printed implants in micro-computed tomographic and histological analyses. Methods: Lattice- and solid-type 3D-printed implants for the left and right mandibular third premolars in beagle dogs were fabricated. Four implants in each group were placed immediately following tooth extraction. Implant stability measurement and periapical X-rays were performed every 2 weeks for 12 weeks. Peri-implant bone volume/tissue volume (BV/TV) and bone mineral density (BMD) were measured by micro-computed tomography. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were measured in histomorphometric analyses. Results: All 4 lattice-type 3D-printed implants survived. Three solid-type 3D-printed implants were removed before the planned sacrifice date due to implant mobility. A slight, gradual increase in implant stability values from implant surgery to 4 weeks after surgery was observed in the lattice-type 3D-printed implants. The marginal bone change of the surviving solid-type 3D-printed implant was approximately 5 mm, whereas the value was approximately 2 mm in the lattice-type 3D-printed implants. BV/TV and BMD in the lattice type 3D-printed implants were similar to those in the surviving solid-type implant. However, BIC and BAFO were lower in the surviving solid-type 3D-printed implant than in the lattice-type 3D-printed implants. Conclusions: Within the limits of this preclinical study, 3D-printed implants of double-rooted teeth showed high primary stability. However, 3D-printed implants with interlocking structures such as lattices might provide high secondary stability and successful osseointegration.
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