PURPOSE. Cement-retained implant prostheses can lack proper retrievability during repair, and residual cement can cause peri-implantitis. The purpose of this in vitro study was to evaluate the influence of abutment height and convergence angle on the retrievability of cement-retained implant prostheses with lingual slots, known as retrievable cement-type slots (RCS). MATERIALS AND METHODS. We fabricated six types of titanium abutments (10 of each type) with two different heights (4 mm and 6 mm), three different convergence angles ($8^{\circ}$, $10^{\circ}$, and $12^{\circ}$), a sloped shoulder margin (0.6 mm depth), a rectangular shape ($6mm{\times}6.5mm$) with rounded edges, and a rectangular ledge ($2mm{\times}1mm$) for the RCS. One monolithic zirconia crown was fabricated for each abutment using a dental computer-aided design/computer-aided manufacturing system. The abutments and crowns were permanently cemented together with dual-curing resin cement, followed by 24 hours in demineralized water at room temperature. Using a custom-made device with a slot driver and torque gauge, we recorded the torque ($N{\cdot}cm$) required to remove the crowns. Statistical analysis was conducted using multiple regression analysis and Mann-Whitney U tests (${\alpha}=.05$). RESULTS. Removal torques significantly decreased as convergence angles increased. Multiple regression analysis showed no significant interaction between the abutment height and the convergence angle (Durbin-Watson ratio: 2.186). CONCLUSION. Within the limitations of this in vitro study, we suggest that the retrievability of cement-retained implant prostheses with RCS can be maintained by adjusting the abutment height and convergence angle, even when they are permanently cemented together.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
v.46
no.4
/
pp.220-227
/
2020
Objectives: Papillon-Lefèvre syndrome (PLS) is a rare autosomal recessive disorder. These patients lose their teeth at a young age and are in need of prosthetic rehabilitation. The aim of this systematic review was to assess the success of dental implant placement in these patients. Materials and Methods: An electronic search was performed in PubMed Central, Scopus, and Web of Science using the keyword "Papillon-Lefèvre syndrome" AND "dental implant" OR "prosthodontics". Articles reporting implant placement in patients with PLS until July 2019 were included. Results: Assessment of the included 11 articles reporting 15 cases showed 136 implant placements in these patients. Implant failure occurred in 3 patients (20 implants). The peri-implantitis and failure rate was higher in the maxilla. Meta-analysis showed the probability of failure to be 7% (95% confidence interval [CI] 0%-31%) for maxillary implants and 2% (95% CI 0%-9%) for mandibular implants. The follow-up time ranged between 1 and 20 years. Healing after bone graft and implant placement in these patients was uneventful. Conclusion: Dental implants may be a viable treatment option for PLS patients. Implantation can help preserve alveolar bone if the patients' immunological and growing conditions are well-considered and proper oral hygiene and compliance with the maintenance program are continued.
Pulsed Nd : YAG laser has been used to treat various soft tissue lesions. However, there have been warnings of using laser to treat peri-implantitis because the laser can alter the surface of implant and can rise its temperature so that it might be harmful to implant itself and its surrounding tissue. However, the study in vivo has not been done yet. The purpose of this study was to evaluate the biocompatibility to the pulsed Nd:YAG lased dental implant. 16 HA coated implants and 16 titanium plasma sprayed implants were used. They were divided 4 groups as unlased control, 0.3 watt, 1.0 watt and 2.0 watt lased groups after lasing. And they were implanted in the peritonial walls of 12 rabbits. The rabbits were sacrificed 6 weeks after implantation and the LM and EM specimems were made. 1. In the unlased implant group, both HA coated and titanium plasma sprayed implants were surrounded by fibroblasts and collagen fibers. No macrophages and inflammatory cells were seen. 2. In HA coated implants 0.3 watt, 1.0 watt lased group had a little inflammation, but in 2.0 watt lased group had scattered macrophages, a significantly larger number of chronic imflammatory cells were seen. 3. In titanium plasma sprayed implant 0.3 watt, 1.0 watt lased group had a little inflammation, but in 2.0 watt group had severe inflammation as in the conditions of HA coated group. 4. The inflammatory reaction of both lased HA coated and titanium plasma sprayed implant groups increased as the increase of the power of the laser.
The present study was performed to evaluate the effect of citric acid on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, titanium plasma-sprayed surface, and sand-blasted, large grit, acid etched surface were utilized. Implant surface was rubbed with pH 1 citric acid for $\frac{1}{2}$ min., 1 min., 1 $\frac{1}{2}$ min., 2 min., and 3min, respeaively in the test group and implant surface was not treated in the control group. Then, the specimens were processed for scanning electron microscopic observation. The following results were obtained. 1. Both test and control group showed a few shallow grooves and ridges in pure titanium machined surface implants. There were not significant differences between two groups. 2. In titanium plasma-sprayed surfaces, round or amorphous particles were deposited irregularly. The irregularity of titanium plasma-sprayed surfaces conditioned with pH 1 citric acid was lessened and the cracks were increased relative to the application time of pH 1 citric acid. 3. Sand-blasted, large grit, acid etched surfaces showed the macro/micro double roughness. The application of pH 1 citric acid didn't change the characteristics of the sand-blasted, large grit, acid etched surfaces. In conclusion, the application of pH 1 citric acid to titanium plasma-sprayed surface is improper. And pure titanium machined surface implants and sand-blasted, large grit, acid etched surface implants can he treated with pH 1 citric acid for peri-implantitis treatment if the detoxification of these surfaces could be evaluated.
The Peri-implantitis causes inflammation of periodontal tissue and bone loss. It contaminates surface of implants. Therefore, guided bone regeneration has been used for the treatment of this disease. For the reosseointegration of the exposed surface, various mechanical and chemical methods have been used for cleaning and detoxication of implant surface. Among these methods, air-powder abrasive and oversaturated citrate are known to be most effective. However, these treatments may deform implant surface. In this research, changes of surface roughness they were examined. 10 experimental machined titanium cylinder models were fabricated to be used for control groups. Each of them was air powder abraded for 1 minute and they were named group 1. And then, group 1 were burnished with cotton pellets soaked with citrate for 30 seconds(Group 2), 1 minute(Group 3), 3 minutes(Group 4), and 5 minutes(Group 5) burnishing were applied for grouping respectively. Each group were examined with SPM, and their surface roughness were measured and analyzed. 1. Surface roughness of titanium decreased when it was air-powder abraded for 1 minute. It was statistically significant. 2. When Air-powder abraded titanium were treated with citrate for 3 minutes, Their surface roughness was the lowest. Titanium treated for 1 minute was the second lowest and 30 seconds was the third and titanium burnished for 5 minutes was the highest. 3. Surface roughness of titanium which was treated with citrate was decreased till 3 minutes, which was statistically significant. There was no statistical significance from 30 seconds to 1 minute and from 1 minute to 3 minutes, and there was statistical significance from 30 seconds to 3 minutes. 4. Oxide layer was formed when titanium is exposed to air, and it was removed when air-powder abraded. It was made when treated with citrate. It is thought that citrate treatment is necessary after the air-powder abrasion, and 1 minute is clinically and qualitatively adequate for burnishing time of citrate.
Kim, Yong-Gun;Lee, Jae-Kwan;Chang, Beom-Seok;Um, Heung-Sik
Journal of Periodontal and Implant Science
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v.36
no.4
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pp.879-889
/
2006
The early exposure of cover screws is a common complication of 2-stage implant technique. The exposure of cover screws between stage I and IT surgery may cause inflammation in the soft tissues surrounding the implants, and lead to peri-implantitis or marginal bone loss. The purpose of this study was to evaluate the effect of the early exposure of cover screws on implants placed using 2-stage technique. Two hundred and nineteen implants in 77 patients were examined for cumulative survival rate, radiographic marginal bone level change, cause and frequency of the early exposure. The results were as follows: 1. Twenty-five implants showed early exposure of cover screws with a frequency of 11.4%. 2. Cumulative survival rate of the implants with early cover screw exposure was 88.0%, and that of the implants without cover screw exposure was 96,9%. 3. At the time of stage IT surgery and 1 year after loading, the marginal bone loss was greater around the implants with early exposure of cover screws than around the implants without cover screw exposure(p <0.05), 4, There was no statistically significant difference in the frequency of the early exposure according to the implant diameter, gender, and smoking(p >0,05).
Purpose: The purpose of this study was to evaluate the efficacy of the modified plaque score (MPS) for assessing the oral hygiene status of periodontitis patients. Methods: A total of 116 patients were included in this study. After evaluation of the $L{\ddot{o}}e$ and Silness gingival index (GI), Silness and $L{\ddot{o}}e$ plaque index (PlI), O'Leary plaque control record (PCR), and MPS, patients were randomly assigned to either a conventional tooth brushing instruction (C-TBI) group (n=56) or a professional intraoral tooth brushing instruction (P-TBI) group (n=60). The MPS and clinical parameters were re-evaluated after scaling and a series of root planing. The convergent validity of MPS with the PlI and PCR was assessed. The measurement time for MPS and PCR was compared according to the proficiency of the examiner. Results: After root planing, the GI, PlI, PCR, and MPS improved from their respective baseline values in both groups. Three different plaque indices including the MPS, showed significant differences between the C-TBI group and the P-TBI group after root planing. The MPS showed significant concurrence with the PCR and PlI. The mean time for PCR measurement was $2.76{\pm}0.71$ times longer than that for MPS measurement after 2 weeks of training. Conclusions: MPS seems to be a practical plaque scoring system compared with the PlI and PCR. These findings suggest that repetitive plaque control combined with an easily applicable plaque index (MPS) may facilitate more effective oral hygiene education and improved periodontal health.
In the case of failed fixed implant prosthesis accompanied by abutment screw fracture, fractured screw fragment must be removed to use the existing implant fixtures. A 61-year-old male patient, who had a failed maxillary fixed implant prosthesis accompanied by three abutment screw fracture, hoped to reconstruct the maxillary implant prosthesis, while maintaining the existing implant fixtures. To use the existing implant fixtures, fractured screw fragments were removed. A maxillary implant overdenture using available existing implants was planned. Bar-attachment with Locator was used for implant splinting, denture stability, and retention. Final impression was taken after treatment of peri-implantitis. Jaw relation registration was taken to evaluate available interarch space for bar-attachment. After fabricating bar-attachment, centric relation was taken. Implant overdenture using bar-attachment with Locator was delivered after wax-denture evaluation. This case report showed that a satisfactory clinical result was achieved by implant overdenture using existing implant fixtures in a maxillary edentulous patient.
Journal of Dental Rehabilitation and Applied Science
/
v.31
no.2
/
pp.126-133
/
2015
Periodontal tissue destroyed by inflammation is difficult to achieve regeneration of the tissue and esthetic restorations only by surgical methods. In particular, improvement of esthetics is more difficult if the problem is related to the implant. A 23 year old woman suffered from unesthetic anterior implant prosthesis. According to her dental history, a repeated bone graft and soft tissue graft failed at a local dental clinic. It was needed to resolve the inflammation and to improve the esthetics. A free gingival graft and ridge augmentation accompanied by guided bone regeneration and a vascularized interpositional periosteal connective tissue graft was performed. Instead of implant prosthesis, a conventional fixed bridge was adopted for better esthetic result. The patient was satisfied with the esthetic conventional fixed prosthesis. This case report introduces esthetic rehabilitation of unesthetic implant prosthetics in the maxillary anterior dentition by a combination of surgical and prosthetic approaches.
The present study was performed to evaluate the effect of tetracycline - HCl on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface and titanium plasma-sprayed surface were utilized. Implant surface was rubbed with 50mg/ml tetracycline - HCl solution for 1 min., $1\frac{1}{2}\;min$., 2 min., $2\frac{1}{2}\;min$. and 3min. respectively in the test group and with saline for 1 min. in the control group. Then, the specimens were processed for scanning electron microscopic observation. The following results were obtained. 1. Pure titanium machined surfaces conditioned with saline for 1 min., showed a few shallow grooves and ridges and were less irregular. 2. Pure titanium machined surfaces conditioned with 50mg/ml tetracycline - HCl solution showed more irregular and corrosive surfaces compared to the control group irrespective of the application time of tetracycline - HCl solution. 3. Titanium plasma-sprayed surfaces conditioned with saline for 1 min., were deposited with round amorphous particles and showed round or irregular pores that can be connected to each other. 4. The irregularity of titanium plasma-sprayed surfaces conditioned with 50mg/ml tetracycline - HCl solution was lessened and the flattened areas were wider relative to the application time of tetracycline - HCl solution. 5. Titanium plasma-sprayed surfaces conditioned with tetracycline - HCl solution for 1 min. and $1\frac{1}{2}\;min$. were very similar to that of the control group, but the surfaces conditioned for 2 min., $2\frac{1}{2}\; min$. and 3 min. were changed. In conclusion, pure titanium machined surfaces were changed irrespective of the application time of tetracycline - HCl solution. And titanium plasma-sprayed surfaces conditioned with tetracycline - HCl solution began to be changed from $1\frac{1}{2}\;min$. This results will be applicable to the regenerative procedures for peri-implantitis treatment.
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