• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.412-424
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• 2004

Statement of problem: Several prosthetic options are available for the restoration of multiple adjacent implants. A passively fitting prosthesis has been considered a prerequisite for the success and maintenance of osseointegration. Passivity is a particular concern with multiple implants because of documented inaccuracies in the casting and soldering process. One way to avoid this problem is to restore the implants individually, however, the restorations of individual adjacent impants requires careful adjustment of interproximal contacts. Purpose: The purpose of this study was to compare the stress distribution pattern and amount surrounding Bicon implants with individual crowns and splinted restorations. Material and method: A photoelastic model of a human partially edentulous left mandible with 3 Bicon implants($4{\times}11mm$) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 abutments ($4{\times}0.65mm,\;0^{\circ}$, 2.0 mm post, Bicon Inc., Boston, USA) After the units were cemented, 4 levels of interproximal contact tightness were evaluated: open, ideal ($8{\mu}m$ shim stock drags without tearing), medium($40{\mu}m)$), and heavy($80{\mu}m$). Splinted 3-unit fixed partial dentures were fabricated and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions(7.5, 15, 30 lb) were analyzed with a circular polaricope. Results: 1. Stresses were distributed around the entire body of fin in Bicon implants. 2. Splinted restorations were useful for distribution of stress around implants especially with higher loads. 3. By increasing the contact tightness between the individually restored three implants, the stress increased in the coronal portion of implants. Conclusions: Ideal adjustment of the contact tightness was important to reduce the stresses around individually restored Bicon implants.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.5
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• pp.617-627
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• 2006

Statement of problem: HA has been used as a coating material on Ti implants to improve osteoconductivity. However. it is difficult to form uniform HA coatings on implants with complex surface geometries using a plasma spraying technique. Purpose : To determine if Ti6Al4V sintered porous-surfaced implants coated with HA sol-gel coated and hydrothermal treated would accelerate osseointegration. Materials and Methods : Porous implants which were made by electric discharge were used in this study. Implants were anodized and hydrothermal treatment or HA sol-gel coating was performed. Hydrothermal treatment was conducted by high pressure steam at $300^{\circ}C$ for 2 hours using a autoclave. To make a HA sol, triethyl phosphite and calcium nitrate were diluted and dissolved in anhydrous ethanol and mixed. Then anodized implant were spin-coated with the prepared HA sols and heat treated. Samples were soaked in the Hanks solution with pH 7.4 at $37^{\circ}C$ for 6 weeks. The microstructure of the specimens was observed with a scanning electron microscope (SEM), and the composition of the surface layer was analyzed with an energy dispersive spectroscope (EDS). Results : The scanning electron micrographs of HA sol-gel coated and hydrothermal treated surface did not show any significant change in the size or shape of the pores. After immersion in Hanks' solution the precipitated HA crystals covered macro- and micro-pores The precipitated Ca and P increased in Hanks' solution that surface treatment caused increased activity. Conclusion : This study shows that sol-gel coated HA and hydrothermal treatment significantly enhance the rate of HA formation due to the altered surface chemistry.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.5
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• pp.549-560
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• 2006

Purpose : This experiment examined the effects of anodization on commercially pure titanium implant fixtures. Material & methods : The implant fixtures were anodized at three different voltage levels, producing three different levels of oxidation on the surface of the fixure. Implant were divided into four groups according to the level of oxidation. Group 1 consist of the control group of machined surface implants, Group 2 implants were treated by anodizing to 100 voltage, Group 3 implants were treated by anodizing oxidation to 200 voltage Group 4 implants were treated by anodizing oxidation to 350 voltage. Surface morphology was observed by Scanning Electron Microscope(SEM) and the surface roughness was measured using NanoScan $E-1000^{\circledR}$. Implantation of the fixtures were performed using New Zealand white rabbits. $Periotest^{\circledR}$ value(PTV) resonance frequency analysis(RFA), and removal torque were measured in 0, 2, 4, 8, 12 weeks after implantation. Results : The results of the study were as follows: 1. Values for the measured surface roughness indicate statistically significant differences in Ra, Rq, and Rt values among group 1, 2, 3, and 4 at the top portion of the thread,(p<0.05) while values at the base of the threads indicated no significant difference in these values. 2. A direct correlation between the firming voltage, and surface roughness and irregularities were observed using scanning electron microscope. 3. No statistically significant differences were found between test groups regarding $Periotest^{\circledR}$ values. 4. Analysis of the data produced by RFA, significant differences were found between group 1 and group 4 at 12 weeks after implantation.(p<0.05) Conclusions : In conclusion, no significant differences could be found among test groups up to a certain level of forming voltage threshold, beyond this firming voltage threshold, statistically significant differences occurred as the surface area of the oxide layer increased with the increase in surface porosity, resulting in enhanced bone response and osseointegration.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.35-48
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• 2004

Since the occlusal loading is transmitted to the surrounding bone, the success of an implant treatment is closely related to the distribution of the stress on the implant. The finite element analysis method is often used in order to produce a model for dispersion of stress. Assessment of the success of the implant is usually based on the degree of osseointegration which is a bone and implant surface interface. Implant used in this research was designed through the method of shape optimization after the stress on implant was anaylzed by the finite element analysis method. This study was pertinently assessed by a clinical, histologic, histomorphometric analysis after the shape optimized implant was installed on beagle dog tibia. The results are as follows 1. It clinically showed a good result without mobility and imflammatory reaction. 2. Implant was supported by dense bone and bone remodeling showed on the surrounding area of the implant 3. The average percentage of bone-implant contact was 58.1%.The percentage of bone density was 57.6%. Having above results, shape optimized implant showed the pertinence through clinical and histologic aspects. However, to use the shape optimized implant, the further experiment is required for finding problems, improvement.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.2
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• pp.199-215
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• 1990

This study was to analyze the stress distribution of implant and supporting tissue in $Br{\aa}nemark$ osseointegration implant. The analysis has been conducted by using the axisymmetric finite element method and type of model according to crown material. Tests have been performed at 1 kg load on central fossa of crown portion. Each type of model was designed differently according to crown material. 1) Porcelain fused to metal crown(Model A) 2) Composite resin veneered crown(Model B) 3) Acrylic resin veneered crown(Model C) 4) Type III gold crown(Model D) The displacements and stresses of implant and supporting structures were analyzed to investigate the influence of the type of crown material. The results were obtained as follows : 1. Displacement of implant was shown uniformly downward displacement in all models and abutments were observed distally downward displacement. 2. In supporting tissues, stress was concentrated on the crest of compact bone and the spongy bone below implant. 3. The PFM and the type III gold crown showed the largest concentration of stress at the crest of compact bone and the spongy bone below implant, respectively. Acrylic resin artificial teeth and composite resin veneered crown indicated almost the same distribution of stress. 4. The gold screw, the abutment screw and the top of abutment showed the concentration of stress in implants of every model.

• Journal of Periodontal and Implant Science
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• v.46 no.5
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• pp.291-302
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• 2016

Purpose: The aim of the present study was to evaluate the effectiveness of using a mineralized bone cortical allograft (MBCA), with or without a resorbable collagenous membrane derived from bovine pericardium, on alveolar bone remodeling after immediate implant placement in a dog model. Methods: Six mongrel dogs were included. The test and control sites were randomly selected. Four biradicular premolars were extracted from the mandible. In control sites, implants without an allograft or membrane were placed immediately in the fresh extraction sockets. In the test sites, an MBCA was placed to fill the gap between the bone socket wall and implant, with or without a resorbable collagenous membrane. Specimens were collected after 1 and 3 months. The amount of residual particles and new bone quality were evaluated by histomorphometry. Results: Few residual graft particles were observed to be closely embedded in the new bone without any contact with the implant surface. The allograft combined with a resorbable collagen membrane limited the resorption of the buccal wall in height and width. The histological quality of the new bone was equivalent to that of the original bone. The MBCA improved the quality of new bone formation, with few residual particles observed at 3 months. Conclusions: The preliminary results of this animal study indicate a real benefit in obtaining new bone as well as in enhancing osseointegration due to the high resorbability of cortical allograft particles, in comparison to the results of xenografts or other biomaterials (mineralized or demineralized cancellous allografts) that have been presented in the literature. Furthermore, the use of an MBCA combined with a collagen membrane in extraction and immediate implant placement limited the extent of post-extraction resorption.

• Journal of Periodontal and Implant Science
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• v.46 no.5
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• pp.337-349
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• 2016

Purpose: The aim of this study was to compare and analyze the peri-implant tissue conditions and prospective clinical outcomes associated with 2 types of hydroxyapatite (HA)-coated implants: (1) fully HA-coated implants and (2) partially HA-coated implants with resorbable blast medium on the coronal portion of the threads. Methods: Forty-four partially edentulous patients were randomly assigned to undergo the placement of 62 HA-coated implants, and were classified as the control group (partially HA-coated, n=30) and the test group (fully HA-coated, n=32). All patients had chronic periodontitis with moderate crestal bone loss around the edentulous area. The stability and clinical outcomes of the implants were evaluated using the primary and secondary implant stability quotient (ISQ), as well as radiographic, mobility, and peri-implant soft tissue assessments around the implants. The Wilcoxon signed-rank test and the Mann-Whitney test were used to evaluate differences between and within the 2 groups, with P values <0.05 considered to indicate statistical significance. Results: The fully HA-coated implants displayed good retention of crestal bone, and insignificant differences were found in annual marginal bone loss between the 2 types of HA-coated implants (P>0.05). No significant differences were found in the survival rate (group I, 100%; group II, 100%) or the success rate (group I, 93.3%; group II, 93.8%). The fully HA-coated implants also did not significantly increase the risk of peri-implantitis (P>0.05). Conclusions: The fully HA-coated implants did not lead to an increased risk of peri-implantitis and showed good retention of the crestal bone, as well as good survival and success rates. Our study suggests that fully HA-coated implants could become a reliable treatment alternative for edentulous posterior sites and are capable of providing good retention of the crestal bone.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.150-156
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• 2017

Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.

• The Journal of the Korean dental association
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• v.47 no.9
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• pp.585-595
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• 2009

Purpose : The aim of this study was to compare surgical complications between simple implant placement and implant placement combined with complicated surgical procedures. We also evaluated prosthetic complications according to the specific types of prosthesis. Material and Method : A retrospective analysis of dental chart of patients who was performed implant therapy during the period from June 2003 to December 2005 was carried out. This study was performed on 408 patients (208 male, 200 female). In addition, 1671 implants were performed. Based on their medical record and radiographs, the authors evaluated surgical and prosthetic complications, surgical procedures accompanied at the time of implant, risk factors of implant failure etc. Result : Surgical complications were developed on 358 implants(21.4% on total placed implants) and wound dehiscence was most prevalent complication. On maxillary posterior area, surgical complications developed more frequently on implants with major surgery and showed a significant difference. And complication rate of implants accompanied with GBR was higher than that of simple implants placement and also showed significant difference. The implant supported prosthesis showed no statistical difference in the occurrence of complications according to the types of prosthesis, and food retention was the most common post-prosthetic complication. Also we speculated that length and width of implant showed significant correlation to the failure of implant primary osseointegration. Conclusion : Based on the result, clinician should provide more careful maintenance for patients with implant placement accompanied by complicated surgical procedure. And periodic maintenance for the patient is requested for long-term survival of implant therapy.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.1-16
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• 1991

In order to see the possible effect of the functional load-bearing after osseointegration of the titanium root form implant in dog a histologic study was conducted. One side of lower jaw was surgically prepared edentulousness and titanium implants were inserted. Some implants were functionally loaded through fixed detachable prosthesis and some are isolated and unloaded. The dog was sacrificed four months later and bone sections with implants were processed for histologic evaluation and the results were as follows ; (1) The bone to implant interface after four months of load bearing presented no mobility and no marginal bone loss radiographically and histologically. (2) The interface zone between compact bone and implant revealed a direct bone to implant contact and in some areas marrow tissue contacts were examined at the light microscopic level. (3) At the ultrastructural level the interface of surrounding compact bone matrix and implant, three types of superficial layers were found ; one with moderate electron dense amorphous granular substance layer, other with high electron dense fine granular substance layer, and another type of amorphous granular substance covered with high electron dense line of minute granules. (4) The osteoblasts in the marrow tissue neighboring implants and osteocytes in compact bone showed typical normal characteristics and in the marrow tissues some of lymphocytes and mast cells were observed. (5) The abscence of abnormal tissue reactions at a cellular level indicates a high degree of biocompatibility for the experimental titanium implant and basically no difference was found between functionally loaded and unloaded implants.