• The Journal of the Korean dental association
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• v.56 no.5
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• pp.263-276
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• 2018

Long-term survival and prognosis of narrow-diameter implants have been reported to be adequate to consider them a safe method for treating a deficient alveolar ridge. The objective of this study was to perform case report of narrow-diameter implants with a trapezoid-shape in anterior teeth alveolar bone. A 50-year-old male patient presented with discomfort due to mobility of all of the maxillary teeth and mandibular incisors. Due to destruction of alveolar bone, four anterior mandibular teeth were extracted. Soft tissue healing was allowed for approximately 3 months after the extraction, and a new design of implant placement was planned for the mandibular incisor area, followed by clinical and radiological evaluation. Implant placement was determined using an R2GATE surgical stent. The stability of the implants was assessed by ISQ measurements at the first and second implant surgery and after prosthetic placement. At 1 and 3 months and 1 year after implantation of the prosthesis, clinical and radiological examinations were performed. Another 50-year-old male patient presented with discomfort due to mobility of the mandibular central incisors. For the same reason as in the first patient, implant placement was carried out in the same way after extraction. ISQ measurements and clinical and radiological examinations were performed as in the previous case. In these two clinical cases, 12 months of follow-up revealed that the implant remained stable without inflammation or additional bone loss, and there was no discomfort to the patient. In conclusion, computer-guided implant surgery was used to place an implant in an optimal position considering the upper prosthesis. A new design of a narrow-diameter implant with a trapezoid-shape into anterior mandibular alveolar bone is a less invasive treatment method and is based on the contour of the deficient alveolar ridge. Through all of these procedures, we were able to reduce the number of traumas during surgery, reduce the operation time and total treatment period, and provide patients with more comfortable treatment.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.359-370
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• 2011

To identify osseointegration of implants, dentists were performed the radiographic analysis. The fractal analysis methods using periapical radiographs before and after loading on implants was to evaluate whether or not significant. 30 patients who were placed implants in dental hospital of Wonkwang university were participated in this study. Total of 42 implants were analyzed. And, 14 males and 16 females aged from 22 to 73 participated in this study. The two morphologic and Fractal analysis of the one trabecular patterns in alveolar bone were done using periapical views. Two periapical views, after implant placement, and after 2 months of functional loading were analysed. The analysis was done by software, Image J(1.40s, National Institute of Health, Bethesda, USA). The data were statistically analyzed using one-way ANOVA(P<.05). Multiple comparison was done by the Tukey HSD test. The results of Fractal analysis and change in bone density around implants showed significantly different values, especially mandibles. However, in case of implants with failure, Fractal values decreased from 1.2865 to 1.1521 and 1.1135 to 1.0478.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.3
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• pp.255-265
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• 2009

Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.1
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• pp.47-57
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• 2010

An undisturbed healing process without micromotion at the implant-bone interface is essential for achievement of osseointegration of dental implant. Therefore, initial stability was advocated as prerequisite for successful clinical outcome. Adequate bone quality and quantity were important to achieve initial stability and to prevent early failures. However there were few published data available regarding the effect of design change in implant geometry on initial stability of the implants. The purpose of the current study was to assess the initial stability of various designs of implants when placed into artificial bone materials of varying qualities and shapes of insertion holes. Within the scope of this study, the following results were drawn. Bone quality was major importance to achieve initial stability. Initial stability was higher on GS II which had additional design feature of double thread. With a tapered design of implant such as GS III showed a higher initial stability than straight one. An insertion hole with the similar shape of implant would lead to reduce a compression force on cortical bone and enhance a bone anchorage on cancellous bone.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.167-174
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• 2018

Purpose: The purpose of present study was to retrospectively analyze the survival rate of implant placed after alveolar ridge preservation by initial stability and radiographic measurements. Materials and Methods: In total, 19 patients who received 21 sandblasted, large-grit, acid-etched (SLA) implants were enrolled in this retrospective study. Implants placed after alveolar ridge preservation technique (ARP) 2 - 3 months healing period, Periotest value (PTV) measured at implant placement and before placed prosthodontics. Marginal bone level (MBL) was measured at implant placement and final recall check. Results: Overall survival rate of implant was 100%. Mean PTV at implant placement was $-0.06{\pm}8.33$ and mean PTV before placed prosthodontics was $-5.75{\pm}1.7$. The range of MBL change was from -0.55 mm to 1.6 mm (Mean: $0.19{\pm}0.58mm$). Conclusion: The findings of present study suggest that the implant paced after alveolar ridge preservation appear high survival rates and stable MBL.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.4
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• pp.391-409
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• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.659-681
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• 2001

Platelet-rich plasma(PRP) has been known to increase the rate and degree of bone formation by virtue of growth factors in concentrated platelets. Although its great healing effect on bone defect or pre-implantation site preparation in conjunction with bone substitute has been reported, the effect associated with implant is unknown. The purpose of this study was to investigate the effect of PRP on rapid osseointegration of endosseous dental implants in the rabbit tibiae. Twenty two adult female New Zealand white rabbits, weighing approximately 2.7-3.3kg, were used for this study. Twelve of the 22 animals were used for histomorphometric analysis and ten of the 22 were for removal torque test. Each animal received two implants in each tibia (two treated with PRP and two as control) and was given fluorochrome intramuscularly. For histomorphometric analysis, rabbits were divided into four groups according to the healing period. At 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively, each three animals were sacrificed serially and the amount and rate of bone formation around dental implant were examined on the undecalcified sections under fluorescent microscope, polarized microscope and light microscope connected to a personal computer equipped with image analysis system. For removal torque test, rabbits were divided into two groups and removal torque tests were performed at 4 weeks, 10 weeks after implant placement. In total, 88 screw shaped, commercially pure titanium implants (Neoplant, Neobiotech, Seoul, Korea) were used in this study. Labeling pattern reflected differences of two groups in bone formation rate at each period. Histomorphometrically, PRP group showed significantly higher bone volume within threads compared to control group at 2 weeks ($70.30{\pm}4.96%$ vs. $50.68{\pm}6.33%$; P < .01) and 4 weeks ($82.59{\pm}5.94%$ vs. $72.94{\pm}4.57%$; P < .05 ). PRP group at 1, 2 and 4 weeks revealed similar degree of bone volume formation comparable to control group at 2, 4 and 8 weeks, respectively. On the other hand, while PRP group showed higher bone-implant contact ($47.37{\pm}8.09%$) than control group ($33.16{\pm}13.47%$) at 2 weeks, there were no significant differences between PRP group and control group for any experimental period. Removal torque values also showed no significant differences between PRP group and control group at any experimental period (P > .05). These findings imply that PRP could induce rapid, more bone formation around implant during early healing period and get faster secondary stability for reducing healing period, though it has not induced bone maturation enough to resist functional loading.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.1
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• pp.148-169
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• 1994

The concept of biologic attachment of load-bearing implants has developed over the past decades as an alternative to the difficulties associated with long term implantation using mechanical fixation and bone cement. The choice of implant material is also as critical an element as site preparation or insertion procedure. The properties of implants that affect host tissue responses are not limited to chemical composition alone, but also include shape, surface characteristics, site of implantation, and mechanical interaction with host tissues. Initial mechanical interlocking prevents micromotion and may be a prerequisite for direct bone apposition. A hard tightening of screws does not necessarily mean a stronger fixation and final tightening of the fixtures is dependent on the experience of the operator. Removal torque is lower than insertion torque. The purpose of this study was to investigate differences in the removal torques at the bone-implant interface of polished and sandblasted Titanium. This experiment will give insight into important factors that must be considered when interpreting in vivo screwing forces on implants during the connection of the transmucosal abutments. We evaluated the significance of different surface textures by comparison of the withdrawal forces necessary for removal of otherwise identical rough and polished implants of Titanium and also evaluated interfacial response on the light microscopic level to implant surface. And the priority of the area of insertion on osseointegration were evaluated. 9 Titanium implants - among them, 3 were for the developmental - of either a smooth or rough surface finish were inserted in the dog mandible in the right side. 3 months later Kanon Torque Gauge was used to unscrew the implants. The results were as follows : 1. No significant difference was seen in the removal torque due to variation in surface treatment, 23 Ncm for the sandblasted and 23.33 Ncm for the polished surface (p>0.05). 2. Implants in the anterior (25 Ncm) mandible showed better resistance to unscrewing in comparison to ones in the posterior (18 Ncm) region (p<0.05). 3. Developmental fixtures (22 Ncm) had similar pullout strength to the control group (p>0.05).

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.177-193
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• 2004

Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.216-221
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• 2014

Purpose: This retrospective study compares the amount of bone resorption around implants between an autogenous tooth bone graft (AutoBT) and a synthetic bone graft after a bone-added crestally approached sinus lift with simultaneous implant placements. Methods: In all, 37 patients participated in this study. Seventeen patients were grouped as group I and underwent an AutoBT-added sinus lift using the crestal approach. The remaining 20 patients were grouped as group II and underwent synthetic bone grafting. Both groups received the implant placements simultaneously. Of the 37 participating patients, only 22 patients were included in the final results: Eleven patients of group I and 11 patients of group II. Before the surgery, the distance from the alveolar crest to the sinus floor was measured using panoramic radiography. After the surgery, the distance was measured again from the neck of the implant thread to the most superior border of the added graft materials. Then, the amount of sinus lift was calculated by comparing the two panoramic radiographs. After a year, a panoramic radiograph was taken to calculate the resorption of the bone graft material from the radiograph that was taken after the surgery. The significance of the resorption amount between the two types of graft materials was statistically analyzed. Results: The bone height was increased to an average of 4.89 mm in group I and 6.22 mm in group II. The analysis of panoramic radiographs 1 year after the surgery showed an average bone resorption of 0.76 mm and 0.53 mm, respectively. However, the degree of lifting (P=0.460) and the amount of bone-grafted material resorption (P=0.570) showed no statistically significant difference. Conclusions: Based on this limited study, AutoBT can be considered a good alternative bone graft to a synthetic bone graft in a bone-added sinus lift, when extraction is necessary prior to the surgery.