• 대한치과보철학회지
• /
• 제46권1호
• /
• pp.53-64
• /
• 2008

임플랜트 주위 변연골의 흡수는 임플랜트의 기능적 및 심미적 성공에 큰 장애가 되는 요인이다. Adell은 임플랜트에 지대주 연결 후 첫 1년간 평균적으로 1.5mm의 변연골 소실을 보이고, 이 후에는 매년 0.1mm이하의 변연골 흡수가 있었다고 하였다(Adell et al.,1981). 이러한 변연골 흡수를 막기위한 많은 노력들이 행해져 왔다. 특히 임플랜트 collar의 특징에 따라서 변연골의 흡수가 달라질 수 있다. 본 연구의 목적은 임플랜트 collar에서의 laser microtexturing(microgroove)이 변연골 흡수에 미치는 영향에 대해 알아보고자 하는 것이다. 4종류의 임플랜트 총 101개를 식립한 환자 53명에서 임플랜트 식립시부터 보철물 장착한 후 평균 6개월 후 정기 검사 시까지의 임플랜트 주위 변연골의 흡수를 측정하여 비교하였다. 생물학적 폭경을 충분히 확보한 임플랜트(ITI standard)와 생물학적 폭경이 부족한 임플랜트 (ITI esthetic plus, Silhouette IC Laser-$Lok^{TM}$, Silhouette IC)에서 변연골 흡수의 차이를 비교하였고, 임플랜트 주위 변연골의 흡수에 대한 laser를 이용한 미세나사산의(Silhouette IC Laser-$Lok^{TM}$) 영향을 알아보았다. 다음의 결과를 얻었다. 1. ITI standard와 Silhouette IC Laser-$Lok^{TM}$ 이 ITI esthetic plus 와 Silhouette IC 보다 임플랜트 주위 변연골의 흡수가 적었고 (p<0.05), ITI standard 와 Silhouette IC Laser-$Lok^{TM}$ 사이에는 변연골의 흡수가 유의차가 없었고(P>0.05), ITI esthetic plus와 Silhouette IC 사이에도 변연골의 흡수가 유의차가 없었다(P>0.05). 2. 사용된 임플랜트 전체에 대한 상하악의 비교에서는 상하악 사이에서 임플랜트 주위 변연골의 흡수는 통계학적으로 유의한 차이가 없었다(p>0.05). 3. 흡수각도에 대한 비교에서도 4종류 임플랜트 그룹 간에 통계학적으로 유의한 차이는 없었다(P>0.05). 본 연구에서 제한이 있긴 하지만, 임플랜트 디자인에서 생물학적 폭경이 부족한 경우(ITI esthetic plus, Silhouette IC)에는 생물학적 폭 경 보상을 위한 임플랜트 주위 변연골의 흡수가 있었음을 보여주고 있으나, laser를 이용한 microgroove 가 부여된 임플랜트에서는 collar의 거칠기와 laser microtexturing 등의 특징에 의해 임플랜트 주위 변연골의 흡수가 적게 일어난 것이 관찰되었다. 심미적인 요구도가 높은 전치부에서 충분한 생물학적 폭경이 확보된 임플랜트를 식립할 경우 변연골의 흡수에 따른 치은퇴축에 의해 metal collar의 노출이 우려되기에 충분한 생물학적 폭경이 부여되지 않은 임플랜트를 선정하게 되는데 이때 collar에서의 laser microtexturing은 변연골의 유지에 도움이 되었다. 이것은 조직의 단단한 부착으로 인한 안정화로 추정해 볼 수 있는데, 이에 대해서는 더 장기간의 연구와 더 많은 수의 임플랜트를 대상으로 한 연구와 조직학적인 연구도 필요할 것으로 사료된다.

• Journal of Periodontal and Implant Science
• /
• 제40권5호
• /
• pp.244-248
• /
• 2010

Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• 제37권6호
• /
• pp.483-489
• /
• 2011

Introduction: This study examined the cumulative resorption of implants placed in a severely atrophic mandible and analyzed the radiologic bone resorption in the marginal bone, after an autogenous bone graft including both block and particulates that had been harvested from the ramus and iliac crest. Materials and Methods: A retrospective study was performed on patients who had bone grafts for augmentation followed by implant installation in the mandible area from 2003 to 2008. Twelve patients (6 men and 6 women) who received 34 implants in the augmented sites were evaluated. Cumulative radiologic resorption around the implants was measured immediately, 3 months, 6 months and 12 months after implant installation surgery. Results: The installed implant in grafted bone showed 0.84 mm marginal bone resorption after 3 months and 50% total cumulative resorption after 1 year. The mean marginal bone resorption around the implant installed in the grafted bone was 0.44 mm after 3 months, 0.52 mm after 1 year, after which it stabilized. The implant survival rate was 97% (failed implant was 1/34). Marginal bone resorption of the installed implant in the autogenous onlay block bone grafts was 0.98 mm after 3 months, which was significantly higher than that of a particulated bone graft (0.74 mm) (P <0.05). Conclusion: An autogenous graft including block type and particulate type is a predictable procedure for the use of dental implants in a severely atrophic mandible. Implant placement in augmented areas show a relatively high survival and minimal bone loss, as revealed by a radiologic evaluation.

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

• Journal of Periodontal and Implant Science
• /
• 제49권3호
• /
• pp.185-192
• /
• 2019

Purpose: Implant wall thickness and the height of the implant-abutment interface are known as factors that affect the distribution of stress on the marginal bone around the implant. The goal of this study was to evaluate the long-term effects of supracrestal implant placement and implant wall thickness on maintenance of the marginal bone level. Methods: In this retrospective study, 101 patients with a single implant were divided into the following 4 groups according to the thickness of the implant wall and the initial implant placement level immediately after surgery: 0.75 mm wall thickness, epicrestal position; 0.95 mm wall thickness, epicrestal position; 0.75 mm wall thickness, supracrestal position; 0.95 mm wall thickness, supracrestal position. The marginal bone level change was assessed 1 day after implant placement, immediately after functional loading, and 1 to 5 years after prosthesis delivery. To compare the marginal bone level change, repeated-measures analysis of variance was used to evaluate the statistical significance of differences within groups and between groups over time. Pearson correlation coefficients were also calculated to analyze the correlation between implant placement level and bone loss. Results: Statistically significant differences in bone loss among the 4 groups (P<0.01) and within each group over time (P<0.01) were observed. There was no significant difference between the groups with a wall thickness of 0.75 mm and 0.95 mm. In a multiple comparison, the groups with a supracrestal placement level showed greater bone loss than the epicrestal placement groups. In addition, a significant correlation between implant placement level and marginal bone loss was observed. Conclusions: The degree of bone resorption was significantly higher for implants with a supracrestal placement compared to those with an epicrestal placement.

• 대한치과보철학회지
• /
• 제59권4호
• /
• pp.405-414
• /
• 2021

목적: 이번 연구는 최근 시판되고 있는 국내산 taper straight 타입의 SLA surface를 가진 임플란트의 변연골 흡수도와 생존율을 평가하여 임상적 유용성을 알아보기 위해 시행하였다. 대상 및 방법: 전남대학교 치과병원 치주과에서 2016년 8월부터 2019년 12월까지 KISPLANT^®가 식립된 성인남녀 83명의 125개의 임플란트 중 포함 기준을 충족시키는 19명의 40개의 임플란트를 1년 동안의 관찰 대상으로 하였다. 처음과 1년 후의 치근단 방사선 사진에서 변연골 수준을 측정하고, 이를 이용하여 임플란트 생존율과 성공률을 분석하였다. 또한 치주염 심도, SPT, 식립 부위, 치아 발거 이유, 즉시 식립 여부, 전신질환에 따라 변연골 흡수도에 유의한 차이가 있는지를 확인하기 위해 t-test를 수행하였다. 결과: 근심측 변연골 흡수도는 0.74 ± 1.07 mm, 원심측 변연골 흡수도는 0.53 ± 1.04 mm로 나타났다. 1년 동안 40개의 임플란트 중 3개의 임플란트에서 2 mm 이상의 변연골 흡수가 일어나 임플란트 성공률은 92.5%이고 생존율은 100%이었다. t-test를 수행한 결과 근심측 변연골 흡수도와 식립 부위에서 유의한 차이가 있었고 나머지 요인에서는 유의한 차이가 없었다. 결론: 이번 연구에서 변연골 흡수도와 성공률, 생존율을 평가해 본 결과 임플란트 식립 1년 후 높은 생존율과 성공률을 보였고 낮은 변연골 흡수도를 보여 taper straight 타입의 SLA surface를 가진 임플란트는 우수한 임상 결과를 보였다.

• Journal of Periodontal and Implant Science
• /
• 제41권5호
• /
• pp.211-217
• /
• 2011

Purpose: The marginal bone levels around implants following restoration are used as a reference for evaluating implant success and survival. Two design concepts that can reduce crestal bone resorption are the microthread and platform-switching concepts. The aims of this study were to analyze the placement of microthreaded and platform-switched implants and their short-term survival rate, as well as the level of bone around the implants. Methods: The subjects of this study were 27 patients (79 implants) undergoing treatment with microthreaded and platform-switched implants between October 2008 and July 2009 in the Dental Hospital of Yonsei University Department of Periodon-tology. The patients received follow-up care more than 6 months after the final setting of the prosthesis, at which time periapical radiographs were taken. The marginal bone level was measured from the reference point to the lowest observed point of contact between the marginal bone and the fixture. Comparisons were made between radiographs taken at the time of fixture installation and those taken at the follow-up visit. Results: During the study period (average of 11.8 months after fixture installation and 7.4 months after the prosthesis delivery), the short-term survival rate of microthreaded and platform-switched implants was 100% and the marginal bone loss around implants was $0.16{\pm}0.08$ mm, the latter of which is lower than the previously reported values. Conclusions: This short-term clinical study has demonstrated the successful survival rates of a microthread and platform-switched implant system, and that this system is associated with reduced marginal bone loss.

• The Journal of Advanced Prosthodontics
• /
• 제10권3호
• /
• pp.191-196
• /
• 2018

PURPOSE. The goal of this study was to evaluate the clinical outcome of single short implants, less than 8 mm in length, placed in the posterior area. MATERIALS AND METHODS. A total of 128 patients (75 male and 53 female, mean age: $52.6{\pm}11.2years$) with 154 implants participated. Implant marginal bone loss, and survival and success rates were measured. RESULTS. The mean follow-up period was $51.35{\pm}24.97months$. A total of 128 implants, 8 mm in length, were placed in patients who had mean marginal bone loss of 0.75 mm. These implants had a survival rate of 95.3%. Twenty-six implants, 7 mm in length, were placed in areas with a mean marginal bone loss of 0.78 mm and had a survival rate of 96.2%. Both marginal bone loss and survival rate were not statistically different among the groups. In the maxilla, 34 implants showed a mean marginal bone loss of 0.77 mm and a survival rate of 97.1%. In the mandible, 120 implants showed a mean marginal bone loss of 0.75 mm and a survival rate of 95.0%. The average marginal bone loss around all implants was $0.76{\pm}0.27mm$ at the last follow-up review after functional loading. The survival rate was 95.6% and success rate was 93.5%. CONCLUSION. In our study, single short implants less than 8 mm in length in the posterior areas had favorable clinical outcomes.

• Journal of Periodontal and Implant Science
• /
• 제51권6호
• /
• pp.422-432
• /
• 2021

Purpose: The aim of this study was to compare straight and tapered implant designs in terms of marginal bone loss, the modified plaque index (mPI), and the modified bleeding index (mBI) for 5 years after functional loading. Methods: Twelve patients were recruited. Two types of implants were placed adjacent to each other: 1 straight implant and 1 tapered implant. Marginal bone loss, mPI, and mBI were measured every year for 5 years after loading. Results: The straight implants showed 0.2±0.4 mm of marginal bone loss at 5 years after loading, while the tapered implants showed 0.2±0.3 mm of marginal bone loss; this difference was not statistically significant (P=0.833). Our analysis also showed no statistically significant differences in mPI (straight implants: 0.3±0.3 vs. tapered implants: 0.2±0.3; P=0.414) or in mBI (straight implants: 0.3±0.4 vs. tapered implants: 0.2±0.3; P=0.317) at 5 years after prosthesis delivery. Conclusions: Straight and tapered implants showed no significant differences with respect to marginal bone loss, mPI, and mBI for 5 years after loading.

• 대한치과보철학회지
• /
• 제39권4호
• /
• pp.391-409
• /
• 2001

Since the early study about the osseointegration, lots of researches have been performed to increase the success rate and the stress around the implant in the jaw bone has been considered as one of the causes of failure. The purpose of this study was to examine the relationship between the implant failure and the stress by analysing the influence of different bone quality and bite force of some foods on the stress distribution around the implant, and to estimate the treatment result according to the bone quality and dietary pattern of patients. Bone quality was divided in 4 groups and models were drawn with the assumption that thread type implant(Nobel Biocare AB, Goteborg, Sweden) of 3.75mm diameter, 13mm length was installed to the bones. Various bite forces were applied to the occlusal surface of superstructure and the stress distributed around the implant were analysed with finite element analysis program. The results were as follows ; 1. The stress was changed proportionally to the bite forces of foods at all measuring points in all load cases. 2. The stress at the marginal bone was higher than that of the other measuring points in all load cases, and it was decreased at the first thread area. 3. The stress at the marginal bone was highest in type IV bone in all load cases. Especially it was twice those of other bone types at the bucco-lingual marginal bone and 50% higher at the mesio-distal marginal bone. 4. The stress at the bucco-lingual sides of the bone around the apical portions of implant showed little differences among the bone types, while type IV bone showed lower stress concentration than the other bone types in the mesio-distal sides. 5. Under the buccal oblique load ($15^{\circ}$ ), the stress at the lingual marginal bone was higher than that of buccal marginal bone, and the difference between the two points was almost same regardless of bone types.