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A retrospective randomized study of success rates according to abutment selection in DENTIS submerged implant with an internal hex connection (DENTIS 내부연결형 서브머지드 임플란트에서 지대주 선택에 따른 성공률의 후향적 연구)

  • Kim, Eun-Hee;Lee, Joeng-Eun;Hwang, Hee-Seong;Kim, Chul-Hoon;Kim, Jung-Han;Kim, Bok-Joo
    • The Journal of the Korean dental association
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    • v.56 no.11
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    • pp.605-614
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    • 2018
  • PURPOSE. The purpose of this study is to determine the efficacy of the DENTIS submerged-type implant with an internal hex connection and to build corresponding abutment-selection criteria. MATERIAL AND METHODS. A total of 204 patients received submerged implant fixtures with an internal hex connection at the Dong-A University Hospital Dental clinic in Busan from January 2013 and May 2016. Three specific abutments, UCLA abutments, customized abutments, ready-made abutments, were randomly selected. Implant success was defined as the basis of the International Congress of Oral Implantologists(ICOI, 2007) criteria. The relationship between the implant success rate and the abutment factor was analyzed using the Kruskal-Wallis test(P<.05). RESULTS. A total of 508 implants were placed in 204 patients. After a mean observation period of 38.6 months, 493 out of 508 implants were in normal function, yielding an overall success rate of 97.05%. A total of 15 implants failed: 10 in the maxillary molar area, 4 in the mandibular molar area, and 1 in the mandibular incisal area. All of the implant failures occurred in a single-implant prosthesis, especially high in the maxillary molar area. The Kruskal-Wallis analysis showed that abutment selection has no significant correlation with implant failure(P>.05). CONCLUSION. DENTIS submerged implants with an internal hex connection showed predictable results with a success rate of 97.05%. It is no influence on the success rate in the selection of submerged implant abutment with an internal hex connection.

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A retrospective comparison of clinical outcomes of implant restorations for posterior edentulous area: 3-unit bridge supported by 2 implants vs 3 splinted implant-supported crowns

  • Yi, Yuseung;Heo, Seong-Joo;Koak, Jai-Young;Kim, Seong-Kyun
    • The Journal of Advanced Prosthodontics
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    • v.14 no.4
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    • pp.223-235
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    • 2022
  • PURPOSE. To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS. The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS. Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION. The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.

Influence of crown-to-implant ratio of short vs long implants on implant stability and marginal bone loss in the mandibular single molar implant (하악 구치 단일임플란트 수복에서 임플란트 길이에 따른 치관-임플란트 비율이 임플란트안정성 및 변연골소실에 주는 영향)

  • Baek, Yeon-Wha;Kim, Bongju;Kim, Myung-Joo;Kwon, Ho-Beom;Lim, Young-Jun
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.4
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    • pp.280-289
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    • 2018
  • Purpose: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). Materials and Methods: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III $active^{(R)}$ long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III $active^{(R)}$ short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. Results: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). Conclusion: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.

Bone-level implants placed in the anterior maxilla: an open-label, single-arm observational study

  • Gao, EnFeng;Hei, Wei-Hong;Park, Jong-Chul;Pang, KangMi;Kim, Sun Kyung;Kim, Bongju;Kim, Soung-Min;Lee, Jong-Ho
    • Journal of Periodontal and Implant Science
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    • v.47 no.5
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    • pp.312-327
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    • 2017
  • Purpose: This study assessed marginal bone remodeling and soft tissue esthetics after the loading of single bone-level implants in the anterior maxilla. Methods: An open, single-arm observational clinical trial with 3 years of follow-up was performed, including 22 implants. The patients presented with a single tooth gap in the anterior maxilla (tooth positions 14-24), with natural or restored adjacent teeth. An implant was placed at least 8 weeks post-extraction and healed submerged for 6 weeks. After the second-stage operation, a fixed provisional prosthesis was provided. The final restoration was placed 6 months after the provisional restoration. The time of the provisional crown connection was considered to be the baseline in this study. Esthetic parameters and the marginal bone level were assessed at 6, 12, 24, and 36 months. Results: All implants were well integrated in the bone. A statistically significant increase was found in the mean implant stability quotient between the time of the provisional prosthesis and the time of the final prosthesis. Most implants (95.5%) revealed marginal bone resorption (<0.5 mm), and just 1 implant (4.5%) showed a change of 2.12 mm from baseline to 36 months (mean $0.07{\pm}0.48mm$), while the crestal bone level decreased significantly, from $2.34{\pm}0.93mm$ at baseline to $1.70{\pm}1.10mm$ at 36 months. The facial gingival margin and papilla were stable and the esthetic scores indicated high patient and dentist satisfaction. Conclusions: Platform-switching bone-level implants placed in maxillary single-tooth gaps resulted in successful osseointegration with minimal marginal bone resorption. The peri-implant soft tissue was also esthetically satisfying and stable.

Clinical study on screw loosening in dental implant prostheses: a 6-year retrospective study

  • Lee, Ki-Young;Shin, Kyung Su;Jung, Ji-Hye;Cho, Hye-Won;Kwon, Kyung-Hwan;Kim, Yu-Lee
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.2
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    • pp.133-142
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    • 2020
  • Objectives: In this study, we determined the incidence and pattern of screw loosening in patients who received dental implants. Materials and Methods: Patients who received implants between January 2008 and October 2013 and completed their prosthetic rehabilitation were evaluated for the incidence, frequency, and onset of screw loosening using dental charts and radiographs. The association between each factor and screw loosening was analyzed using the chi-square test and a multivariate analysis with binary logistic regression models (P<0.05). Results: Total 1,928 implants were placed in 837 patients (448 males, 389 females), whose follow-up period after loading varied from 0.25 to 70 months (mean period, 31.5 months). Screw loosening occurred in 7.2% of implants. Most cases occurred less than six months after loading. Among those, 22.3% experienced recurrent screw loosening. Screw loosening was most common in the molar region (8.5%) and frequently associated with an implant diameter of ≥5 mm (14.2%). External implant-abutment connections (8.9%) and screw-retained implant prostheses (10.1%) showed higher incidence of problems than internal implant-abutment connections and cement-retained implants, respectively. Screw loosening was most common in implant prostheses with single crowns (14.0%). Conclusion: Within the limits of the current study, we conclude that the incidence of screw loosening differs significantly according to the position of implant placement, the type of implant and manufacturer, implant diameter, the type of implant-abutment connection, the type of retention in the implant prosthesis, and the type of implant prosthesis.

Photoelastic Stress Analysis of Single Implant Restoration According to Implant Fixture Size and Abutment Diameter (단일치 임플란트에서 고정체와 지대주 직경의 차이에 따른 광탄성 응력 분석)

  • Lee, Jin-Han;Cho, Hye-Won
    • Journal of Dental Rehabilitation and Applied Science
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    • v.24 no.3
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    • pp.253-267
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    • 2008
  • The purpose of this study was to evaluate the pattern and the magnitude of stress distribution in the supporting tissues surrounding implant fixture with different diameter of implant fixtures(3i implant, Ø4.0, Ø5.0, Ø6.0mm and UCLA abutments(Ø4.1, Ø5.0, Ø6.0mm using photoelastic stress analysis. Photoelastic model was made with PL-2 resin(Measurements Group, Raleigh, USA) and three implants of each diameter were placed in the mandibular posterior edentulous area distal to the canine. Individual crowns were fabricated using UCLA abutments. Photoelastic stress analysis was carried out to measure the fringe order around the implant supporting structure under simulated loading conditions(15 lb, 30 lb). The results were as follows; 1. The more the diameter of implant fixture was increased, the less the stress concentration on cervical area of fixture was observed under loading. 2. Increasing mesiodistal diameter of implant superstructure had no much influence on stress distribution around implant fixture. 3. The use of smaller abutment had no influence on stress distribution around implant fixture. The use of smaller abutment diameter than that of implant fixture had no favorable effect on implant supporting tissue at biomechanical consideration.

Ridge Augmentation Using Block Type of Autogenous Tooth Bone Graft Material in Severe Alveolar Bone Resorption of Single Tooth: Case Report (단일치아의 심한 치조골 소실 환자에서 블록형 자가치아골이식재를 이용한 치조능증대술: 증례보고)

  • Park, In-Sook
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.6
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    • pp.462-465
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    • 2012
  • Horizontal and vertical ridge augmentation with implant placement was performed, using a block type of autogenous tooth bone graft in a 37-year old male patient. This material was very useful for the case of severe alveolar bone resorption of a single tooth. After 13 months, excellent bony healing was obtained and final restoration was performed successfully.

Three-dimensional finite element analysis of stress distribution for different implant thread slope and implant angulation (임플란트 나사선 경사각과 식립 각도에 따른 3차원 유한요소 응력분석)

  • Seo, Young-Hun;Lim, Hyun-Pil;Yun, Kwi-Dug;Yoon, Suk-Ja;Vang, Mong-Sook
    • The Journal of Korean Academy of Prosthodontics
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    • v.51 no.1
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    • pp.1-10
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    • 2013
  • Purpose: The purpose of this study was to find an inclination slope of the screw thread that is favorable in distributing the stresses to alveolar bone by using three dimensional finite element analysis. Materials and methods: Three types modelling changed implant thread with fixed pitch of 0.8 mm is the single thread implant with $3.8^{\circ}$ inclination, double thread implant with $7.7^{\circ}$ inclination and the triple thread implant with $11.5^{\circ}$ inclination. And three types implant angulation is the $0^{\circ}$, $10^{\circ}$ and $15^{\circ}$ on alveolar bone. The 9 modelling fabricated for three dimensional finite element analysis that restored prosthesis crown. The crown center applied on 200 N vertical load and $15^{\circ}$ tilting load. Results: 1. The more tilting of implant angulation, the more Von-Mises stress and Max principal stress is increasing. 2. Von-Mises stress and Max principal stress is increasing when applied $15^{\circ}$ tilting load than vertical load on the bone. 3. When the number of thread increased, the amount of Von-Mises stress, Max principal stress was reduced since the generated stress was effectively distributed. 4. Since the maximum principal stress affects on the alveolar bone can influence deeply on the longevity of the implants. When comparing the magnitude of the maximum principal stress, the triple thread implant had a least amount of stress. This shows that the triple thread implant gave a best result. Conclusion: A triple thread implant to increase in the thread slope inclination and number of thread is more effective on the distribution of stress than the single and double thread implants especially, implant angulation is more tilting than $10^{\circ}$ on alveolar bone. Thus, effective combination of thread number and thread slope inclination can help prolonging the longevity of implant.

THREE-DIMENSIONAL FINITE ELEMENT STRESS ANALYSIS OF SINGLE IMPLANT RESTORATION USING DIFFERENT FIXTURE AND ABUTMENT SCREW DIAMETERS (단일치 임플랜트 지지 보철물에서 고정체와 지대주 나사 직경의 차이에 따른 삼차원 유한요소법적 응력 분석)

  • Kwon Joo-Hong;Choi Min-Ho;Kim Yu-Lee;Cho Hye-Won
    • The Journal of Korean Academy of Prosthodontics
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    • v.43 no.1
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    • pp.105-119
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    • 2005
  • Statement of problem. As the effects of the various diameters of fixture and abutment screw on stress distribution was not yet examined, this study focused on the different design of single implant restoration using three dimensional finite element analysis. Purpose. This study was to compare five different fixture-abutment combinations for single implant supported restorations with different fixture and abutment screw diameters. Material of methods. The five kinds of finite element models were designed by 3 diameter fixtures ($\oslash$3.3, 3.75, 5.0 mm) with 3 different abutment screws $\oslash$1.5, 1.7, 2.0 mm). The crown for mandibular first molar was made using UCLA abutment according to Wheeler's anatomy. 244 N was applied at the central fossa with two different loading directions, vertically and obliquely (30$^{\circ}$) and at the buccal cusp vertically. Maximum von Mises stresses were recorded and compared in the supporting bone, crowns, fixtures, and abutment screws. Results. 1. The stresses in supporting bone and implant-abutment structure under oblique loading were greater than those under vertical or offset loading. The stresses under vertical loading were the least among 3 loading conditions regardless of the implant and abutment screw diameters. 2. The stresses in the narrow implants were greater than the wider implants. The narrow implant with narrow abutment screw showed highest stresses in the lingual crest, but the narrow implant with standard abutment screw showed highest stress in abutment screw. 3. The stresses of abutment screws were influenced by the diameter of fixtures and loading conditions. The wide implants showed least difference between two different abutment screw diameters. Conclusions. The wide implants showed lesser stresses than the narrow implants and affected least by the different abutment screw diameters. The narrow implants with standard abutment screw showed highest stresses in the lingual bony crest under oblique loading.

Subjective Symptoms of Peri-Implantitis and Satisfaction according to Prosthesis Methods (임플란트 보철방식에 따른 임플란트 주위염 자각증상 및 만족도)

  • Cha, Ji-Ae;Han, Gyeong-Soon
    • Journal of dental hygiene science
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    • v.17 no.2
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    • pp.175-182
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    • 2017
  • From March 1, 2016 to August 31, 2016, 375 dental implant patients between the ages of 30 and 70 years to evaluate their subjective symptoms and satisfaction according to prosthesis methods. The collected data were analyzed using the chi-square distribution test, t-test, one-way analysis of variance, and multiple logistic regression. Of the patients with subjective symptoms of peri-implantitis, 40.5% reported food impaction, 49.1% reported bleeding, 61.1% reported pain, 61.9% reported halitosis, and the overall satisfaction level with the implants was 3.95 points. In the prosthesis methods, implant-teeth connective group showed the lowest level of the food impaction (21.3%), the pain (35.5%), and the halitosis (36.6%) (p<0.001), and the lowest bleeding was the implant single (33.8%) (p<0.05). Patient satisfaction was higher in the implant-teeth connective group (4.06 points) and the group without bone grafting (4.03 points) (p<0.01). Factor analysis showed that implant satisfaction was 0.43 times lower in the single implant group and 0.44 times lower in the implant-implant connective group than in the implant-teeth connective group. As a result of the study, it is expected that the method of extending the life of adjacent teeth and restoring the function of the tooth defect region is an implant-teeth connection method, so that it can be utilized positively through various clinical studies.