• Journal of Dental Rehabilitation and Applied Science
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• v.24 no.4
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• pp.381-388
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• 2008

Various techniques and diversely designed implants have been developed to overcome anatomic limitations of the maxillary posterior alveolar bone. The OSFE (osteotome sinus floor elevation) technique has been used for maxillary sinus augmentation. Also, $Endopore^{(R)}$ implant was designed to increase the surface area by its sintered porous surface. The purpose of this study was to evaluate the survival rate of $Endopore^{(R)}$ implants placed in the posterior maxilla in association with the elevation of the sinus membrane using OSFE technique, and examine the new bone formation in the sinus. One hundred fifteen $Endopore^{(R)}$ implants in 66 patients were placed in the posterior maxilla by OSFE technique. The implants were clinically and radiographically followed up for an average of 26.3 months. Most implants were stable and radiographs showed that the bone regenerated in contact with the implants. But, 5 implants in 4 patients were removed after the prosthetic restoration and the survival rate was 95.6% during the follow-up period. The height of new bone formed in the sinus was $3.26{\pm}1.04mm$.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.3
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• pp.128-135
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• 2018

Objectives: The role of alloplastic materials in maxillofacial reconstruction is still controversial. Determining the utility of porous, high-density, polyethylene implants as a highly stable and flexible, porous alloplast, with properties such as rapid vascularization and tissue ingrowth, is crucial in cases of maxillofacial deformities and aesthetic surgery. Materials and Methods: Thirty high-density porous polyethylene implants were implanted in 16 patients that had been referred to a private office over a three-year period. These implants were used for correcting congenital deformities, posttraumatic defects and improving the aesthetic in nasal, paranasal, malar, chin, mandibular angle, body and orbital areas. Results: The outcomes of the cases in this study showed good aesthetic and functional results. The majority of patients had no signs of discomfort, rejection or exposure. Two implants suffered complications: a complicated malar implant was managed by antibiotic therapy, and an infected mandibular angle implant was removed despite antibiotic therapy. Conclusion: Based on the results, the Medpor implant seems to be an excellent biomaterial for correcting various facial deformities. Advantages include its versatility and relatively ideal pore size that allows for excellent soft tissue ingrowth and coverage. It is strong, flexible and easy to shape.

• Journal of Technologic Dentistry
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• v.33 no.4
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• pp.307-312
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• 2011

Purpose: The purpose of this study is a porous cube mechanical analysis for the dental implant. Methods: The porous cube with a side length of 10mm was designed for dental implant. To choose proper design, porous hexagon with a side 10mm which was drilled as a regular hexagon with diameter 0.8mm, 1.0mm, 1.2mm and a side 0.4mm, 0.5mm, 0.6mm each using Computer AUTO CAD(Autodesk, 2008). Each cube was carried out in the mechanical analysis. Results: The result of mechanical analysis was observed that the H0.8 was minimum stress 0.045068MPa, maximum stress 9.4565MPa and minimum strain $0.00389{\times}10^{-4}Mpa$, maximum strain $0.816{\times}10^{-4}Mpa$, the H1.0 minimum stress 0.001147MPa, maximum stress 9.099MPa and minimum strain $0.000099{\times}10^{-4}Mpa$, the maximum strain $0.784{\times}10^{-4}Mpa$, the H1.2 minimum stress 0.099393MPa, maximum stress 13.137MPa and minimum strain $0.0112{\times}10^{-4}Mpa$, maximum strain $1.13{\times}10^{-4}Mpa$. Conclusion: The mechanical analysis of porous hexahedron was that H1.0 is the best result. It will be applicable to the porous 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.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.380-384
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• 2010

Purpose: Distinguishing different types of implants and assessing the position and size of implants by radiologic exam after orbital wall reconstruction is important in determining the surgery outcome and forecasting prognosis. We observed time-dependent density changes in three types of implants (porous polyethylene, resorbing plate and titanium mesh plate) by performing facial bone CT after orbital wall reconstructions. Methods: A total of 32 patients, who had underwent orbital wall fracture surgery from October 2006 to March 2009 and received facial bone CT as outpatients at 1 postoperative year were included in the study. Follow-up facial bone CT was performed on the patients pre- operatively, 1 month post-operatively, and 1 year post-operatively to observe the status of the orbital implants. Medpor $^{(R)}$ (Porex Surgical, Inc., Newnan, Ga.) was used as porous polyethylene and followed-up in 14 cases; for resorbing plate, Synthes mesh plate (Synthes, Oberdorf, Switzerland) was used in the reconstruction, and followed-up in 11 cases; and titanium mesh plate usage was followed-up in 7 cases. Computed tomographic scan (CT) and water's view were done for radiography, and hounsfield unit (HU) was used to compare density of those facial bone CT. Wilcoxon signed rank test was applied to statistically verify measurement difference in each group of hounsfield units. Results: Facial bone CT examination performed in 1 month post-operative showed that the density of porous polyethylene, resorbing plate and titanium mesh plate were -42.07, 105.67 and 539.48 on average, respectively. Among the three types of implants, titanium mesh plate showed the highest density due to its radiopaque feature. Following up the density of three types of implants in CT during 1 year after the orbital wall fracture surgery, the density of porous polyethylene increased in 10.52 House Field Units and the resorbing plate was decreased in 26.87 HouseField Units. There were no significant differences between densities in 1 month post-operatively and 1 year post-operatively in each group ($p{\geq}0.05$). Conclusion: We performed facial bone CT on patients with orbital fractures during follow-up period, distinguishing the types of implants by the different concentration of implant density, and the densities showed little change even at 1 year post-operative. To observe how implant densities change in facial bone CT, further studies with longer follow-up periods should be carried out.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.1
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• pp.52-59
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• 2008

The geometric design of an implant surface may play an important role in affecting early osseointegration. It is well known that the porous surfaced implant had much benefits for the osseointegration and the early stability of implant. However, the porous surfaced implant had weakness from the transgingival contamitants, and it resulted in alveolar bone loss. The other problem identified with porous surface implant is the loss of physical properties resulting from the bead sintering process. In this study, we developed the new bead coating implant to overcome the disadvantages of porous surfaced implant. Ti-6Al-4V beads were supplied from STARMET (USA). The beads were prepared by a plasma rotating electrode process (PREP) and had a nearly spherical shape with a diameter of 75-150 ${\mu}m$. Two types of titanium implants were supplied by KJ Meditech (Korea). One is an external hexa system (External type) and the other is an internal system with threads (Internal type). The implants were pasted with beads using polyvinylalcohol solution as a binder, and then sintered at 1250 $^{\circ}C$ for 2 hours in vacuum of $10^{-5}$ torr. The resulting porous structure was 400-500 ${\mu}m$ thick and consisted of three to four bead layers bonded to each other and the implant. The pore size was in the range of 50-150 ${\mu}m$ and the porosity was 30-40 % in volume. The aim of this study was to evaluate the osseointegration of the newly developed dental implant. The experimental implants (n=16) were inserted in the unilateral femur of 4 mongrel dogs. All animals were killed at 8 weeks after implantation, and samples were harvested for hitological examination. All bead coated porous implants were successfully osseointegrated with peripheral bone. The average bone-implant contact ratios were 84.6 % (External type) and 81.5 % (Internal type). In the modified Goldner's trichrome staining, new generated mature bones were observed at the implant interface at 8 weeks after implantation. Although, further studies are required, we could conclude that the newly developed vacuum sintered Ti-6Al-4V bead coating implant was strong enough to resist the implant insertion force, and it was easily osseointegrated with peripheral bone.

• Journal of Powder Materials
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• v.12 no.5 s.52
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• pp.332-335
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• 2005

Porous and porous surfaced Ti-6Al-4V implant compacts were fabricated by electro-discharge-sintering (EDS) of atomized spherical Ti-6Al-4V powders with a diameter of $100-150\;{\mu}m$, The solid core formed in the center of the compact after discharge was composed of acicular ${\alpha}+{\beta}$ Widmanstatten grains, The hardness value at the solid core was much higher than that at the particle interface or particles in the porous layer, which can be attributed to both heat treatment and work hardening effects induced from EDS, The compressive yield strength was in a range of 19 to 436 MPa which significantly depends on both input energy and capacitance, Selected porous-surfaced Ti-6Al-4V implant compacts with a solid core have much higher compressive strengths compared to the human teeth and sintered Ti dental implants.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.11-16
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• 2015

Background: Source material used to fill calvarial defects includes autologous bones and synthetic alternatives. While autologous bone is preferable to synthetic material, autologous reconstruction is not always feasible due to defect size, unacceptable donor-site morbidity, and other issues. Today, advanced three-dimensional (3D) printing techniques allow for fabrication of titanium implants customized to the exact need of individual patients with calvarial defects. In this report, we present three cases of calvarial reconstructions using 3D-printed porous titanium implants. Methods: From 2013 through 2014, three calvarial defects were repaired using custom-made 3D porous titanium implants. The defects were due either to traumatic subdural hematoma or to meningioma and were located in parieto-occipital, fronto-temporo-parietal, and parieto-temporal areas. The implants were prepared using individual 3D computed tomography (CT) data, Mimics software, and an electron beam melting machine. For each patient, several designs of the implant were evaluated against 3D-printed skull models. All three cases had a custom-made 3D porous titanium implant laid on the defect and rigid fixation was done with 8 mm screws. Results: The custom-made 3D implants fit each patient's skull defect precisely without any dead space. The operative site healed without any specific complications. Postoperative CTs revealed the implants to be in correct position. Conclusion: An autologous graft is not a feasible option in the reconstruction of large calvarial defects. Ideally, synthetic materials for calvarial reconstruction should be easily applicable, durable, and strong. In these aspects, a 3D titanium implant can be an optimal source material in calvarial reconstruction.

• Korean Journal of Materials Research
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• v.16 no.3
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• pp.173-177
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• 2006

Porous surfaced Ti implant compacts were fabricated by electro-discharging-sintering (EDS) of atomized spherical Ti powders. Powders of $50-100{\mu}m$ in diameter were vibratarily settled into a quarts tube and subject to a high voltage and high density current pulse in Ar atmosphere. Single pulse of 0.7 to 2.0 kJ/0.7 gpowder, from 150, 300, and $450{\mu}F$ capacitors was applied in less than $400{\mu}sec$ to produce twelve different porous-surfaced Ti implant compacts. The solid core formed in the center of the compact shows similar microstructure of cp Ti which was annealed and quenched in water. Hardness value at the solid core was much higher than that at the particle interface and particles in the porous layer, which can be attributed to both heat treatment and work hardening effects induced by EDS. Compression tests were made to evaluate the mechanical properties of the EDS compacts. The compressive yield strength was in a range of 12 to 304MPa which significantly depends on input energy. Selected porous-surfaced Ti-6Al-4V dental implant compacts with a solid core have much higher compressive strengths compared to the human teeth and sintered Ti dental implants fabricated by conventional sintering process.

• Journal of Powder Materials
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• v.12 no.5 s.52
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• pp.325-331
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• 2005

Implant prototypes with various porosities were fabricated by electro-discharge-sintering of atomized spherical Ti-6Al-4V powders. Single pulse of 0.75 to 2.0 kJ/0.7 g-powder, using 150, 300, and $450{\mu}F$ capacitors was applied to produce a fully porous and porous surfaced implant compact. The solid core formed in the center of the compact after discharge was composed of acicular ${\alpha}+{\beta}$ grains and porous layer consisted of particles connected in three dimensions by necks. The solid core and neck sizes increased with an increase in input energy and capacitance. On the other hand, pore volume decreased with increased capacitance and input energy due to the formation of solid core. Capacitance and input energy are the only controllable discharge parameters even though the heat generated during a discharge is the unique parameter that determines the porosity of compact. It is known that electro-discharge-sintering of spherical Ti-6Al-4V powders can efficiently produce fully-porous and porous surfaced Ti-6Al-4V implants with various porosities in a short time less then 400 isec by manipulating the discharging condition such as input energy and capacitance including powder size.