Lee, Shin-Eon;Yang, Sung-Eun;Lee, Cheol-Won;Lee, Won-Sup;Lee, Su Young
The Journal of Advanced Prosthodontics
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v.10
no.4
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pp.265-270
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2018
PURPOSE. The purpose of this in vitro study was to evaluate the accuracy of a new implant impression technique using bite impression coping and a dual arch tray. MATERIALS AND METHODS. Two implant fixtures were placed on maxillary left second premolar and first molar area in dentoform model. The model with two fixtures was used as the reference. The impression was divided into 2 groups, n=10 each. In group 1, heavy/light body silicone impression was made with pick up impression copings and open tray. In group 2, putty/light body silicone impression was made with bite impression copings and dual arch tray. The reference model and the master casts with implant scan bodies were scanned by a laboratory scanner. Surface tessellation language (STL) datasets from test groups was superimposed with STL dataset of reference model using inspection software. The three-dimensional deviation between the reference model and impression models was calculated and illustrated as a color-map. Data was analyzed by independent samples T-test of variance at ${\alpha}=.05$. RESULTS. The mean 3D implant deviations of pick up impression group (group 1) and dual arch impression group (group 2) were 0.029 mm and 0.034 mm, respectively. The difference in 3D deviations between groups 1 and 2 was not statistically significant (P=.075). CONCLUSION. Within limitations of this study, the accuracy of implant impression using a bite impression coping and dual arch tray is comparable to that of conventional pick-up impression.
PURPOSE. The study aimed to determine the influence of implant angulation on the trueness of multi-unit implant impressions taken through different techniques and strategies. MATERIALS AND METHODS. As reference models, three partially edentulous mandibular models (Model 1: No angulation; Model 2: No angulation for #33, 15-degree distal angulation for #35 and #37; Model 3: No angulation for #33, 25-degree distal angulation for #35 and #37) were created by modifying the angulations of implant analogues. Using a lab scanner, these reference models were scanned. The obtained data were preserved and utilized as virtual references. Three intraoral scanning (IOS) strategies: IOS-Omnicam, ISO-Quadrant, and IOS-Consecutive, as well as two traaditional techniques: splinted open tray (OT) and closed tray (CT), were used to create impressions from each reference model. The best-fit alignment approach was used to sequentially superimpose the reference and test scan data. Computations and statistical analysis of angular (AD), linear (LD), and 3D deviations (RMS) were performed. RESULTS. Model type, impression technique, as well as interaction factor, all demonstrated a significant influence on AD and LD values for all implant locations (P < .05). The Model 1 and SOT techniques displayed the lowest mean AD and LD values across all implant locations. When considering interaction factors, CT-Model 3 and SOT-Model 1 exhibited the highest and lowest mean AD and LD values, respectively. Model type, impression technique, and interaction factor all revealed significant effects on RMS values (P ≤ .001). CT-Model 3 and SOT-Model 1 presented the highest and lowest mean RMS values, respectively. CONCLUSION. Splinted-OT and IOS-Omnicam are recommended for multi-unit implant impressions to enhance trueness, potentially benefiting subsequent manufacturing stages.
Journal of the Korean Academy of Esthetic Dentistry
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v.32
no.2
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pp.54-68
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2023
Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.
STATEMENT OF PROBLEM. Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE. In this study, Bicon$^{(R)}$ Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS. 10 Bicon$^{(R)}$ implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS. It was evident, that the amount of abutment sinking in Bicon$^{(R)}$ Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at $0.45{\pm}0.09\;mm$. CONCLUSION. Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location.
Purpose : This study was performed to determine the proper reference line for taking axial computed tomograms from which the good cross-sectional views can be reformatted by multiplanar reconstruction. Methods : Three dry mandibles with implanted gutta percha cones in the extracted socket were scanned axially according to 6 reference lines of 2 mandibular positions with computed tomogram Hitachi W550. The accuracy of measurements of the lengths of implanted gutta perch a cones in the each cross-sectional view reformatted from axial computed tomogram by multiplanar reconstruction was evaluated. Results: The difference between the measurements and the real length of implant was smallest in the bucco-lingual views reformatted from the axial views scanned according to the reference line of group V-a. The smaller the angle difference between reference line and occlusal line was, the smaller the difference between the measurements in the bucco-lingual views reformatted from axial views and the real length of implant. The majority of measured widths of implants in the bucco-lingually reformatted views were larger than the actual values. Conclusions : When the mandible is inclined within the limitation of gantry angle and scanned with the reference line coincident with occlusal plane, the bucco-lingual view can be reformatted without deformation of images from the axially scanned images.
Implant material, implant design, surface quality, status of the bone, surgical technique, and implant loading conditions were regarded as prerequisites for osseointegration which is a prime condition for implant success. The aim of this review paper was to investigate the survival rate of single implants in relation to the prerequisites for osseointegration. Fifty-eight papers reporting survival rates of single implants were selected by use of the 'PubMed' and hand searching. The survival rate of single implants were assessed with reference to factors influencing osseointegration. The results showed that single implants in general showed a high survival rate except a few failures in certain extreme conditions and early stages. Those failures and complications such as screw loosening and esthetic problem were almost solved with the development of implant components and surgical techniques and a better understanding of biology around a single implant. Single-tooth implant-replacement is now considered as a reliable and predictable treatment option for a single missing tooth and its application seems to expand to compromised situations which were previously thought to be impossible for single implant therapy.
The purpose of this study was to analyse the deflection and stress distribution at the supporting bone and it's superstructure by the alteration of angulation between implant and it's implant abutment. For this study, the free-end saddle case of mandibular first and second molar missing would be planned to restore with fixed prosthesis. So the mandibular second premolar was prepared for abutment, and the cylinder type osseointegrated implant was placed at the site of mandibular second molar for abutment. The finite element stress analysis was applied for this study. 13 two-dimensional FEM models were created, a standard model at $0^{\circ}$ and 12 models created by changing the angulation between implant and implant abutment as increasing the angulation mesially and distally with $5^{\circ}$ unittill $30^{\circ}$. The preprocessing decording, solving and postprocessing procedures were done by using FEM analysis software PATRAN and SUN-SPARC2GX. The deflections and von Mises stresses were calculated under concentrated load (load 1) and distributed load(load 2) at the reference points. The results were as follows : 1. Observing at standard model, the amount of total deflection at the distobuccal cusp-tip of pontic under concentrated load was largest of all, and that at the apex of implant was least of all, and the amount of total deflection at the buccal cusp-tip of second premolar under distributed load was largest of all, and that at the apex of implant was least of all. 2. Increasing the angulation mesially or distally, the amounts of total deflection were increased or decreased according to the reference points. But the order according to the amount of total deflection was not changed except apex of second premolar and central fossa of implant abutment under concentrated load during distal inclination. 3. Observing at standard model, the von Mises stress at the distal joint of pontic under concentrated load was largest of all, and that at the apex of implant was least of all. The von Mises stress at the distal margin of second premolar under distributed load was largest of all, and that at the apex of Implant was least of ail. 4. Increasing the angulation of implant mesially, the von Mises stresses at the mesial crest of implant were increased under concentrated load and distributed load, but those were increased remarkably under distributed load and so that at $30^{\circ}$ mesial inclination was largest of all. 5. Increasing the angulation of implant distally, the von Mises stresses at the distal crest of implant were increased remarkably under concentrated load and distributed load, and so those at $30^{\circ}$ distal inclination were largest of all.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
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v.35
no.4
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pp.240-247
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2009
Purpose: The purpose of this study was to evaluate marginal bone loss to the bone crest functionally loaded for up to eighteen months and also with regard to other variables of interest. Material and Methods: 135 endosseous implants(GS II, Osstem, South Korea) were placed in 35 patients. The design of GS II implant is straight with the microthread. Radiographic examinations were conducted at baseline (implant loading) and 3, 6, 9, 12 and 18 months after loading. Marginal bone level measurement was made from the reference point to the lowest observed point of contact of the marginal bone with the fixture. The reference point of the fixture was the border between the blasted surface and machined surface of the fixture. Results: Implants were on function for a mean 12.7 months(range, 3?18 months). For the 56 maxillary and 79 mandibular implants, mean marginal bone loss was 0.68 mm and 0.70 mm. Implants placed maxillary posterior area displayed more crestal bone loss than the other position. The difference between mesial and distal bone levels was statistically significant (p<0.05) with respective means of 0.51 mm and 0.62 mm. Also, The difference between bone graft group and no-bone graft group was statistically significant(p<0.05) with respective means of 0.38 mm and 0.66 mm. But no statistically significant influence of sex, type of surgery(one or two stage surgery), the implant length was observed(p>0.05). Conclusion: This study indicates the amount of marginal bone loss around implant has maintained a relative stable during follow-up periods.
PURPOSE. To investigate the influence of crown material (lithium-disilicate, 3Y-TZP zirconia) and abutment type (rigid implant, resin tooth with artificial periodontium) on wear performance of their antagonist teeth and adjacent teeth. MATERIALS AND METHODS. A mandibular left first molar (#36) with adjacent human teeth (mandibular left second premolar: #35, mandibular left second molar: #37) and antagonistic human teeth (maxillary left second premolar: #25, maxillary left first molar: #26, maxillary left second molar: #27) was prepared simulating a section of the jaw. Samples were made with extracted human molars (Reference), crowned implants (Implant), or crowned resin tooth analogues (Tooth). Crowns (tooth #36; n = 16/material) were milled from lithium-disilicate (Li, IPS e.max CAD) or 3Y-TZP zirconia (Zr, IPS e.max ZirCAD, both Ivoclar Vivadent). Thermal cycling and mechanical loading (TCML) in the chewing simulator were applied simulating 15 years of clinical service. Wear traces were analyzed (frequency [n], depth [㎛]) and evaluated using scanning electron pictures. Wear results were compared by one-way-ANOVA and post-hoc-Bonferroni (α = 0.05). RESULTS. After TCML, no visible wear traces were found on Zr. Li showed more wear traces (n = 30-31) than the reference (n = 21). Antagonistic teeth #26 showed more wear traces in contact to both ceramics (n = 27-29) than to the reference (n = 21). Strong wear traces (> 350 ㎛) on antagonists and their adjacent teeth were found only in crowned groups. Abutment type influenced number and depth of wear facets on the antagonistic and adjacent teeth. CONCLUSION. The clinically relevant model with human antagonistic and adjacent teeth allowed for a limited comparison of the wear situation. The total number of wear traces and strong wear on crowns, antagonistic and adjacent teeth were influenced by crown material.
Preis, Verena;Hahnel, Sebastian;Behr, Michael;Rosentritt, Martin
The Journal of Advanced Prosthodontics
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v.10
no.4
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pp.300-307
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2018
PURPOSE. To investigate the fatigue and fracture resistance of computer-aided design and computer-aided manufacturing (CAD/CAM) ceramic molar crowns on dental implants and human teeth. MATERIALS AND METHODS. Molar crowns (n=48; n=8/group) were fabricated of a lithium-disilicate-strengthened lithium aluminosilicate glass ceramic (N). Surfaces were polished (P) or glazed (G). Crowns were tested on human teeth (T) and implant-abutment analogues (I) simulating a chairside (C, crown bonded to abutment) or labside (L, screw channel) procedure for implant groups. Polished/glazed lithium disilicate (E) crowns (n=16) served as reference. Combined thermal cycling and mechanical loading (TC: $3000{\times}5^{\circ}C/3000{\times}55^{\circ}C$; ML: $1.2{\time}10^6$ cycles, 50 N) with antagonistic human molars (groups T) and steatite spheres (groups I) was performed under a chewing simulator. TCML crowns were then analyzed for failures (optical microscopy, SEM) and fracture force was determined. Data were statistically analyzed (Kolmogorow-Smirnov, one-way-ANOVA, post-hoc Bonferroni, ${\alpha}=.05$). RESULTS. All crowns survived TCML and showed small traces of wear. In human teeth groups, fracture forces of N crowns varied between $1214{\pm}293N$ (NPT) and $1324{\pm}498N$ (NGT), differing significantly ($P{\leq}.003$) from the polished reference EPT ($2044{\pm}302N$). Fracture forces in implant groups varied between $934{\pm}154N$ (NGI_L) and $1782{\pm}153N$ (NPI_C), providing higher values for the respective chairside crowns. Differences between polishing and glazing were not significant ($P{\geq}.066$) between crowns of identical materials and abutment support. CONCLUSION. Fracture resistance was influenced by the ceramic material, and partly by the tooth or implant situation and the clinical procedure (chairside/labside). Type of surface finish (polishing/glazing) had no significant influence. Clinical survival of the new glass ceramic may be comparable to lithium disilicate.
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