• The Journal of Korean Academy of Prosthodontics
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• v.34 no.4
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• pp.800-815
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• 1996

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.

• Journal of Periodontal and Implant Science
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• v.32 no.4
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• pp.697-709
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• 2002

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.

• Journal of Periodontal and Implant Science
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• v.30 no.4
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• pp.821-836
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• 2000

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.

• Journal of Periodontal and Implant Science
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• v.36 no.4
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• pp.879-889
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• 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).

• Journal of Periodontal and Implant Science
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• v.48 no.1
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• pp.22-33
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• 2018

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.

• The Journal of the Korean dental association
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• v.55 no.7
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• pp.457-466
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• 2017

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
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• v.31 no.2
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• pp.126-133
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• 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.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.333-344
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• 2001

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.

• Journal of Periodontal and Implant Science
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• v.49 no.5
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• pp.310-318
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• 2019

Purpose: Surface alterations of titanium discs following instrumentation with either a nylon brush or a metal brush were evaluated. Methods: A total of 27 titanium discs with 3 surface types (9 discs for each type), including machined (M) surfaces, sandblasted and acid-etched (SA) surfaces, and surfaces treated by resorbable blast media (RBM), were used. Three discs were instrumented with a nylon brush, another 3 discs were instrumented with a metal brush, and the remaining 3 discs were used as controls for each surface type. Surface properties including the arithmetic mean value of a linear profile (Ra), maximum height of a linear profile (Rz), skewness of the assessed linear profile (Rsk), arithmetic mean height of a surface (Sa), maximum height of a surface (Sz), developed interfacial area ratio (Sdr), skewness of a surface profile (Ssk), and kurtosis of a surface profile (Sku) were measured using confocal microscopy. Results: Instrumentation with the nylon brush increased the Ra, Sa, and Sdr of the M surfaces. On the SA surfaces, Ra, Sa and Sdr decreased after nylon brush use. Meanwhile, the roughness of the RBM surface was not affected by the nylon brush. The use of the metal brush also increased the Ra, Sa, and Sdr of the M surface; however, the increase in Sdr was not statistically significant (P=0.119). The decreases in the Rz, Sz, Ra, Sa, and Sdr of the SA surfaces were remarkable. On the RBM surfaces, the use of the metal brush did not cause changes in Ra and Sa, whereas Rz, Sz, and Sdr were reduced. Conclusions: Titanium surfaces were altered when instrumented either with a nylon brush or a metal brush. Hence, it is recommended that nylon or metal brushes be used with caution in order to avoid damaging the implant fixture/abutment surface.

• Journal of Periodontal and Implant Science
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• v.51 no.5
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• pp.298-315
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• 2021

Purpose: Peri-implantitis therapy and implant maintenance are fundamental practices to enhance the longevity of zirconia implants. However, the use of physical decontamination methods, including hand instruments, polishing devices, ultrasonic scalers, and laser systems, might damage the implant surfaces. The aim of this systematic review was to evaluate the effects of physical decontamination methods on zirconia implant surfaces. Methods: A systematic search was conducted using 5 electronic databases: Ovid MEDLINE, PubMed, Scopus, Web of Science, and Cochrane. Hand searching of the OpenGrey database, reference lists, and 6 selected dental journals was also performed to identify relevant studies satisfying the eligibility criteria. Results: Overall, 1049 unique studies were identified, of which 11 studies were deemed suitable for final review. Air-abrasive devices with glycine powder, prophylaxis cups, and ultrasonic scalers with non-metal tips were found to cause minimal to no damage to implantgrade zirconia surfaces. However, hand instruments and ultrasonic scalers with metal tips have the potential to cause major damage to zirconia surfaces. In terms of laser systems, diode lasers appear to be the most promising, as no surface alterations were reported following their use. Conclusion: Air-abrasive devices and prophylaxis cups are safe for zirconia implant decontamination due to preservation of the implant surface integrity. In contrast, hand instruments and ultrasonic scalers with metal tips should be used with caution. Recommendations for the use of laser systems could not be fully established due to significant heterogeneity among included studies, but diode lasers may be the best-suited system. Further research-specifically, randomised controlled trials-would further confirm the effects of physical decontamination methods in a clinical setting.