• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.187-203
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• 2000

The precipitation of calcium phosphate on implant surface has been known to accelerate osseointegration and to enhance osseous adaptation. The present study was performed to examine whether the precipitation of calcium phosphate on Ti-6Al-4V alloy could be affected by the immersion in NaOH solution and heat treatment. Ti-6Al-4V alloy plates of $15{\times}3.5{\times}1mm$ in dimension were polished sequentially from #240 to #2,000 emery paper and one surface of each specimen was additionally polished with $0.1{\mu}m$ alumina paste. Polished specimens were soaked in various concentrations of NaOH solution(0.1, 1.0, 3.0, 5.0, 7.0, 10.0 M) at $60^{\circ}C$ for 24 hours for alkali treatment, and 5.0 M NaOH treated specimens were heated for 1 hour at each temperature of 400, 500, 600, 700, $800^{\circ}C$. After the alkali and heat treatments, specimens were soaked in the Hank's solution with pH 7.4 at $36.5^{\circ}C$ for 30days.The surface ingredient change of Ti-6Al-4V alloy was evaluated by thin-film X-ray diffractometer(TF-XRD) and the surface microstructure was observed by scanning electron microscope(SEM), and the elements of surface were analyzed by X-ray photoelectron spectroscopy(XPS). The results were obtained as follows ; 1. The precipitation of calcium phosphate on Ti-6Al-4V alloy was accelerated by the immersion in NaOH solution and heat treatment. 2. In Alkali treatment for the precipitation of calcium phosphate on Ti-6Al-4V alloy, the optimal concentration of NaOH solution was 5.0 M. 3. In heat treatment after alkali treatment in 5.0 M NaOH solution, the crystal formation on alloy surface was enhanced by increasing temperature. In heat treated alloys at $600^{\circ}C$, latticed structure and prominences of calcium phosphate layer were most dense. On heat treated alloy surface at the higher temperature(${\geq}700^{\circ}C$), main crystal form was titanium oxide rather than apatite. The above results suggested that the precipitation of calcium phosphate on the surface of Ti-6Al-4V alloy could be induced by alkali treatment in 5.0 M-NaOH solution and by heat treatment at $600^{\circ}C$.

• The Journal of Korean Academy of Prosthodontics
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• v.41 no.3
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• pp.300-318
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• 2003

Statement of problem: The success of implants depends on intimate and direct contact of implant material on bone tissue and on functional relationship with soft tissue contact. Creation and maintenance of osseointegration depend on the understanding of the tissue's healing, repairing, and remodeling capacity and these capacities rely on cellular behavior. Altering the surface properties can modify cellular responses such as cell adhesion, cell motility, bone deposition, Therefore, various implant surface treatment methods are being developed for the improved bone cell responses. Purpose: The purpose of this study was to evaluate the responses of osteoblast-like cells to surface-modified titanium. Materials and Methods: The experiment was composed of four groups. Group 1 represented the electropolished surface. Group 2 surfaces were machined surface. Group 3 and Group 4 were anodized surfaces. Group 3 had low roughness and Group 4 had high roughness. Physicochemical properties and microstructures of the discs were examined and the responses of osteoblast-like cells to the discs were investigated. The microtopography was observed by SEM. The roughness was measured by three-dimension roughness measuring system. The microstructure was analyzed by XRD, AES. To evaluate cell responses to modified titanium surfaces, osteoblasts isolated from calvaria of neonatal rat were cultured. Cell count, morphology, total protein measurement and alkaline phosphatase activities of the cultures were examined. Results and Conclusion: The results were as follows 1. The four groups showed specific microtopography respectively. Anodized group showed grain structure with micropores. 2. Surface roughness values were, from the lowest to the highest, electropolished group, machined group, low roughness anodized group, and high roughness anodized group. 3. Highly roughened anodized group was found to have increased surface oxide thickness and surface crystallinity. 4. The morphology of cells, flattened or spherical, were different from each other. In the electropolished group and machined group, the cells were almost flattened. In two anodized groups, some cells were spherical and other cells were flattened. And the 14 day culture cells of all of the groups were nearly flattened due to confluency. 5. The number of attached cells was highest in low roughness anodized group. And the machined group had significantly lower cell count than any other groups(P<.05). 6. Total protein contents showed no difference among groups. 7. The level of alkaline phosphatase activities was higher in the anodized groups than electropolished and machined groups(P<.05).

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.413-428
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• 2008

Purpose: Given the predictability of dental implant procedure from the studies of successful osseointegration, implant dentistry is often the treatment of choice to replace missing teeth in edentulous patient instead of the fixed prosthesis or removable denture. The $Renova^{(R)}$ dental implant has a RBM(Resorbable Blast Media) surface, internal hex prosthetic connection and a tapered design. At this study gives the analysis of the implant and the short term survival rate of the implant. Material and Methods: In this study, a multilateral analysis was performed on the subjects undergoing placement with $Renova^{(R)}$ implant between August 2006 and February 2008 in Yonsei University dental hospital. 96 implants were placed in 56 patients and they were surveyed for cumulative survival rate. Among them 78 implants in 44 patients were surveyed for the rest analyses. Result: 1. The cumulative survival rate was 96.88% of 96 implants in 56 patients. 2. The mean marginal bone loss was 0.803mm and the marginal bone loss in augmentation group has higher value than the marginal bone loss in non augmentation group. 3. The health scale for the implants were 87% in success group, 9% in satisfactory survival group, 1% in compromised survival group, and 3% in failure group. 4. Two implants placed in poor bone posterior area by 2-stage failed during prosthetic procedure. Conclusion: $Renova^{(R)}$ dental implant showed high cumulative survival rate in installation on partial edentulous ridge and could be a predictable implant system.

• Journal of Periodontal and Implant Science
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• v.37 no.2
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• pp.165-180
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• 2007

Dental Implants have been proved to be successful prosthetic modality in edentulous patients for 10 years. However, there are few reports on the survival of implant according to location in molar regions. The purpose of this study was to evaluate the $4{\sim}5$ years' cumulative survival rate and the cause of failure of dental implants in different locations for maxillary and mandibular molars. Among the implants placed in molar regions in Gwangju Mir Dental Hospital from Jan. 2001 to Jun. 2002, 473 implants from 166 patients(age range; $26{\sim}75$) were followed and evaluated retrospectively for the causes of failure. We included 417 implants in 126 periodontally compromised patients, 56 implants in 40 periodontal healthy patients, and 205 maxillary and 268 mandibular molar implants. Implant survival rates by various subject factors, surgical factors, fixture factors, and prosthetic factors at each location were compared using Chi-square test and Kaplan-Meier cumulative survival analysis was done for follow-up(FU) periods. The overall failure rate at 5 years was 1O.2%(subject level) and 5.5%(implant level). The overall survival rates of implants during the FU periods were 94.5% with 91.3% in maxillary first molar, 91.1% in maxillary second molar, 99.2% in mandibular first molar and 94,8% in mandibular second molar regions. The survival rates differed significantly between both jaws and among different implant locations(p<0.05), whereas the survival rates of functionally loaded implants were similar in different locations. The survival rates were not different according to gender, age, previous periodontal status, surgery stage, bone graft type, or the prosthetic type. The overall survival rate was low in dental implant of too wide diameter(${\geq}5.75$ mm) and the survival rate was significantly lower for wider implant diameter(p

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.56-66
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• 2020

Purpose: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device. Methods: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured. Results: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was -6.76 (-25.05 to 11.53, P<0.05). Conclusions: Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.4
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• pp.361-369
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• 2008

The purpose of this study is to make porous oxide film on the surfaces of pure Ti through anodic spark discharge in electrolytic solution containing calcium and phosphate ions, to improve osseointergration by treating fluoride agent. In addition, it is to evaluate the fluoride modified effect on the surface. Commercial pure Ti plate with $20{\times}10{\times}2mm$ and Ti wire with a diameter of 1.5mm and a total length of 15mm were used. After making titanium oxide films converted by anodic spark discharge, anodizing was performed. Fluoride was spreaded to titanium laboratory plate and maintained for 30 minutes after anodizing breakdown. Fluoride ion discharge amount was measured per 24 hours after dipping titanium plate into saline (10ml) and sustaining 90rpm in a pyrostat. Some plates and wires were dipped in Hanks solutions for a month to examine biocompatibility using SEM and XRD. $TiO_2$ film formed by anodic discharge technique showed great roughness and uniform pores which were $1{\sim}3{\mu}m$ in a diameter. Roughness of the films treated with anodic discharge after blasting were higher than the turned ones(P<0.05). Rapid surface activity was observed in the samples treated with $TiF_3$ agent, which immersed in Hanks solution for 30 days. Taking the results into consideration, the fluoride modified implant with anodic discharge demonstrates that it makes uniformly porous oxide film on the surface of implant and properly increase roughness for osseointegration. The implants will achieve greater bone integration after short healing time by improving surface activity.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.1
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• pp.112-123
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• 2006

Purpose: The biocompatibility and bio-adhesive property of a dental implant abutment are important for proper soft tissue healing and maintenance of osseointegration of implant. However, studies of soft tissue healing and mucosal attachment of various materials of implant abutment other than titanium are still needed. In this study, cell attachment, proliferation, cytotoxicity of human gingival fibroblast for ceramic, gold alloy, Ni-Cr alloy and, commercially available pure titanium as a control were evaluated, using MTS and scanning electron microscopy. Materials and Methods: Specimen was designed to disc, 4mm diameter and 1mm thickness, made of ceramic, gold alloy, Ni-Cr alloy and commercially available pure titanium. Primary culture of human gingival fibroblasts were grown in Dulbecco's modified Eagle's medium with 10% fetal bovine serum and 1% antibiotics. Cells were inoculated in the multiwell plates placed the specimen disc. Cell Titer 96 AQucous One Solution Cell Proliferation Assay were done after 1hour 3hours, 24hours, 3days, 5days of incubation. The discs were processed for scanning electron micrography to evaluate cell attachment and morphologic change. Results: The results were obtained as fellows. 1. The ceramic showed high cell attachment and proliferation and low cytotoxicity, which is as much bioadhesive and biocompatible as titanium. 2. The gold alloy represented limited proliferation of human gingival fibroblast and the highest cytotoxicity among tested materials (p<0.05). 3. The Ni-Cr alloy limited the proliferaion of the human gingival fibroblast compared to titanium(p<0.05) but cytotoxicity on the bottom of well was not so considerable, compared to titanium. 4. On the scanning electron micrographs , the ceramic showed good attachment and proliferation of human gingival fibroblast, which was similar to titanium. But gold alloy and Ni-Cr alloy showed the shrinkage of gingival fibroblast both after 24 hours and 3 days. On 5th day, small amount of the human gingival fibroblast proliferation was observed on the Ni-Cr alloy, while the shrinkage of gingival fibroblast was still observed on the gold alloy. Conclusions: These results suggest that the ceramic abutment is as biocompatible as titanium to make proper mucosal seal. The gold alloy has a high cytotoxicity to limit proliferation of gingival fibroblast, which suggest limited use on the anterior tooth where soft tissue healing is recommeded.

• The Journal of Korean Academy of Prosthodontics
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• v.57 no.4
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• pp.397-404
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• 2019

Bone and soft tissue conditions are important for successful implant treatment. But, the placement itself is also very important. Implants which is installed in the wrong position result in the biological, esthetical and mechanical problems. In order to place an implant in the correct position, the final restoration and diagnostic wax-up should be considered prior to the surgery. If the artificial teeth for the interim denture are directly transferred from the diagnostic wax-up, the operator can try the form of diagnostic wax-up in the mouth. If the surgical template is produced by duplicating the interim denture, the implant can be placed in the planned position. In this case, the polymethyl methacrylate (PMMA) artificial tooth was precisely milled by the digital duplication of diagnostic wax-up. And interim denture was fabricated by using these milled teeth. After the patient adapted for a sufficient period, the implant was placed at the planned position with surgical template produced by duplicating the interim denture. After confirming sufficient osseointegration, the final prostheses were made to reflect the shape of diagnostic wax-up. Through this procedure, the satisfactory functional and esthetic outcome could be acquired.

• Journal of dental hygiene science
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• v.20 no.4
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• pp.221-229
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• 2020

Background: The purpose of this study was to investigate the anti-oral microbial activity and anti-inflammatory effects of rosmarinic acid (RA) in lipopolysaccharide (LPS)-stimulated MC3T3-E1 osteoblastic cells on a titanium (Ti) surface during osseointegration, and to confirm the possibility of using RA as a safe natural substance for the control of peri-implantitis (PI) in Ti-based dental implants. Methods: A disk diffusion test was conducted to confirm the antimicrobial activity of RA against oral microorganisms. In order to confirm the anti-inflammatory effects of RA, inflammatory conditions were induced with 100 ng/ml of LPS in MC3T3-E1 osteoblastic cells on the Ti surface treated with or without 14 ㎍/ml of RA. The production of nitric oxide (NO) and prostaglandin E2 (PGE2) in LPS-stimulated MC3T3-E1 osteoblastic cells on the Ti surface was confirmed using an NO assay kit and PGE2 enzyme-linked immunosorbent assay kit. Reverse transcription polymerase chain reaction and western blot analysis were performed to confirm the expression of interleukin (IL)-1β and tumor necrosis factor (TNF)-α in total RNA and protein. Results: RA showed weak antimicrobial effects against Streptococcus mutans and Escherichia coli, but no antimicrobial activity against the bacteria Aggregatibacter actinomycetemcomitans and the fungus Candida albicans. RA reduced the production of pro-inflammatory mediators, NO and PGE2, and proinflammatory cytokines, TNF-α and IL-1β, in LPS-stimulated MC3T3-E1 osteoblastic cells on the Ti surface at the protein and mRNA levels. Conclusion: RA not only has anti-oral microbial activity, but also anti-inflammatory effects in LPS-stimulated MC3T3-E1 osteoblasts on the Ti surface, therefore, it can be used as a safe functional substance derived from plants for the prevention and control of PI for successful Ti-based implants.

• Journal of Dental Rehabilitation and Applied Science
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• v.37 no.4
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• pp.186-198
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• 2021

As the increased certainty of osseointegration, new parameters are now being used to assess implant success. Accordingly, patients' and clinicians' high demands and expectation for esthetics have expanded and implant-supported restorations show better esthetic outcomes. The pre-implant treatment planning process, the implant surgical steps and the post-surgery prosthetic process can affect all esthetic outcomes. Prevention of esthetic implant failures can be achieved by appropriate treatment at each stage, considering the 3 factors of alveolar bone, soft tissue, and implants. It is necessary to achieve the esthetic implant prostheses followings: minimal invasive surgery, bone augmentation, ideal 3-dimensional implant position, peri-implant soft tissue management, and provisional restorations to optimize peri-implant soft tissue architecture.