• The Journal of Korean Academy of Prosthodontics
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• v.35 no.2
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• pp.255-264
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• 1997

The conventional osseointegration protocol calls for waiting up to 12 months for ossification of an extraction socket to heal before placing an endosseous implant. In this study, the possibility of placing a pure titanium implant directly into an extraction socket immediately after extraction was investigated. And the marginal bone loss of immediate nonsubmerged and submerged endosseous dental implants placed into extraction sockets was also compared. Pure titanium Nobelpharma Branemark implants and solid screw type ITI implants were placed into premolar extraction sockets of two adult dogs and allowed to heal for a period of 3 months, followed by functional loading of the implant. Radiographic examination was performed before implantation, immediately after implantation and 3, 6, 9, 12 months after implantation. The results obtained were as follows : 1. Immediately placed nonsubmerged ITI implants and submerged Branemark implants showed favorable radiographic osseointegration status and there were minimum marginal bone loss. 2. There were no significant differences in radiographic finding of osseointegration between conventional and immediate implantation. 3. Gingival tissue around implants showed more inflammatory signs than that of adjacent natural teeth. This study suggest that pure titanium Branemark implants and submerged ITI implants have the potential to integrate when placed immediatly after extraction of the teeth and warrants further investigation.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.4
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• pp.573-592
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• 1994

A two-stage procedure is ideal for getting a successful osseointegration. But if a one-stage procedure can achieve a similar osseointegration, the one-stage procedure has several advantages. The purpose of this study was to observe the initial bone formation and bone remodeling of open type (nonsubmerged) and closed type (submerged) titanium implants. Eight ITI hollow-screws and eight Branemark fixtures were divided into two groups (submerged and nonsubmerged) and were installed on the lower jaws of four mongrel dogs. The animals were sacrificed three months later and bone sections with implants were processed for light microscopic and fluorescent microscopic observation. The results were as follows : 1 There was no significant difference in bone-to-implant contact between submerged and nonsubmerged implants. 2. Smooth surface titanium implants showed more bone-to-implant contact than that of titanium plasma coated implants histologically. 3. Under fluorescent microscopy, the active bone remodeling and new bone formation were observed in the interface zone. 4. Under fluorescent microscopy, submerged and nonsubmerged implants had no difference in bone remodeling pattern, and intramembranous bone formation was more prominent. 5. The connective tissue fibers orienting perpendicularly toward implant surface were oberved in the neck of implants.

• Journal of Korean Dental Science
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• v.12 no.1
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• pp.29-37
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• 2019

Purpose: This study was aimed to compare the survival and success rates, and long-term crestal bone loss according to the use of 2 connection types of dental implants (submerged-USII and non-submerged-SSII; Osstem $Implant^{(R)}$) by analyzing the change in alveolar bone height after 1 year under load and during final follow-up period. Materials and Methods: Between December 2004 and August 2008, patients with two types of Osstem implants (USII and SSII) were retrieved retrospectively. A total of 92 patients with 284 implants (USII=60, SSII=224) was finally selected. Their mean follow-up period was 7.5 years. The mesial and distal alveolar crestal bone changes were measured using radiographic images and the average was calculated at 1 year after loading and during final follow-up period. Result: Among the 284 implants, 4 USII and 7 SSII implants were removed, indicating 93.3% and 96.9% survival rates. Of the survived implants, mean crestal bone loss 1 year after loading was 0.39 mm for USII and 0.19 mm for SSII (P=0.018). During the final follow-up, mean crestal bone loss was 0.63 mm and 0.35 mm for USII and SSII, respectively, without statistical significance (P=0.092). According to the criteria for the success and failure of the implant by Albreksson and colleagues, final success rate was estimated as 86.7% for USII and 91.5% for SSII, respectively. Conclusion At 1 year after loading, the average crestal bone loss was significantly different between USII and SSII; however, both types met the criteria for implant success. During the final follow-up, both groups showed insignificant bone resorption patterns and did not show any pathological clinical symptoms. Therefore, both implants exhibited high long-term stability.

• Journal of Periodontal and Implant Science
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• v.40 no.2
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• pp.69-75
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• 2010

Purpose: Implant survival rates using a bone-added osteotome sinus floor elevation (BAOSFE) procedure with simultaneous placement of a non-submerged sand blasted with large grit and acid etched (SLA) implant are well documented at sites where native bone height is less than 5 mm. This study evaluated the clinical results of non-submerged SLA Straumann implants placed at the time of the BAOSFE procedure at sites where native bone height was less than 4 mm. Changes in graft height after the BAOSFE procedure were also assessed using radiographs for 5 years after the implant procedure. Methods: The BAOSFE procedure was performed on 4 patients with atrophic posterior maxillas with simultaneous placement of 7 non-submerged SLA implants. At least 7 standardized radiographs were obtained from each patient as follows: before surgery, immediately after implant placement, 6 months after surgery, every year for the next 3 years, and after more than 5 years had passed. Clinical and radiographic examinations were performed at every visit. Radiographic changes in graft height were calculated with respect to the implant's known length and the original sinus height. Results : All implants were stable functionally, as well as clinically and radiographically, during the follow-up. Most of the radiographic reduction in the grafted bone height occurred in the first 2 years; reduction after 2 years was slight. Conclusions: The simultaneous placement of non-submerged SLA implants using the BAOSFE procedure is a feasible treatment option for patients with severe atrophic posterior maxillas. However, the grafted bone height is reduced during the healing period, and patients must be selected with care.

• 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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.6
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• pp.554-560
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• 2008

In posterior maxilla, it is difficult to achieve primary stability of implants due to sinus pneumatization, alveolar bone loss, and low bone quality. The accurate and objective primary stability assessment is important for good prognosis of implants. Purpose: The aim of this study was to assess the primary stability of the non-submerged, internal type implants with maxillary sinus augmentation using deproteinized bovine bone mineral by a resonance frequency analyzer, when residual alveolar bone height is under 8mm Materials and methods: A total of 20 implants was placed into 5 grafted maxillary sinuses in 5 patients. Deproteinized bovine bone mineral (Bio-$Oss^{(R)}$) was used as graft material. SS II implants (diameter 4.1mm, and length 11.5mm, SLA suface)) were placed. All of the patients received maxillary sinus graft procedure by 1-step technique. Residual bone height was $1.3{\sim}7.8mm$ (mean 4.4mm) measured by panorama radiography. After implant placement, RFA was measured at 4,8,12,20 weeks. The results were divided into 2 groups; RFA value under 4mm and over 5mm of bone height. It was statistically analyzed. Results: 1. The primary stability of implants was increased with time 2. The RFA value was above 65 ISQ at 12 weeks 3. There was no correlation between RFA and residual alveolar bone height in maxillary sinus augmentation by 1-step technique. Conclusion: 1-step surgical procedure is a feasible option for patients with as little as 4mm residual alveolar bone height, when utilizing non-submerged, internal type implants with xenografts.

• Journal of Periodontal and Implant Science
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• v.32 no.2
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• pp.361-370
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• 2002

The aim of this study was to analyze various data of 120 non-submerged ITI implants placed in 64 korean adults. The data were retrieved from patients' charts and registered in the computer and coded for a statistical analysis. The results revealed that the most common type of edentulism was a distal extension case, and the largest number of implants were placed in the mandibular first molar position. Implants were placed more frequently in mandibular, posterior position than maxillary, anterior position, respectively. With respect to the implant diameter and length, an implant with 4.1mm in diameter and more than 10mm in length was the most common. Since a molar position was the most prevalent position for implant placement in korean patients, clinicians should be careful about implant diameter which can resist a strong occlusal force expected in the molar position. In addition, the distance to the mandibular canal and the floor of maxillary sinus should be considered to avoid possible damages, such as nerve injury and sinus perforation in selecting a proper implant length.

• Journal of Periodontal and Implant Science
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• v.34 no.3
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• pp.535-541
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• 2004

The aims of the present study are firstly to investigate the amount of bone loss around non-submerged implants placed in the posterior region and secondly to investigate the relationship between inter-implant and implant-tooth distance and peri-implant bone loss. Thirty-one subjects with 60 implants were selected consecutively from the implant patient pool at the department of Chonbuk National University Hospital. To be included in the study subject, the implant should have been functioned more than 6 months after loading. Inter-implant and implant-tooth distance, distance between implant shoulder and the first bone contact with the implant(DIB) were measured from the scanning image of the radiograph of each implant. The result showed that; 1. inter-implant distance has a statistically significant relationship with DIB in Pearson correlation analysis. 2. the DIB at the implant facing surface of the implant was greater than that of tooth facing surface of the implant. Within limitation of this study, it is suggested to place an implant not too closely to adjacent implants, and the presence of a tooth adjacent to an implant may keep the level of tooth-facing surface of the implant. Further studies with a prospective design are needed to elucidate the relationship between bone changes and various dimensions around implants.

• Journal of Korean Dental Science
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• v.2 no.2
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• pp.12-17
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• 2009

Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.

• Journal of Korean Dental Science
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• v.2 no.2
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• pp.35-41
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• 2009

Objective : This study sought to investigate the clinical survival rate of two implants with different surfaces: resorbable blasting media (RBM)-treated and calcium metaphosphate (CMP)-coated implant. Study design : SSII non-submerged implants (Osstem, Seoul, Korea) were placed in a total of 48 patients with mean age of 38.8. At least 31 patients in the experimental group had a CMP-coated implant, and 1 patient in the control group received a, RBM surface implant. The evaluation period was between April 2006 and December 2007. Radiographs, periotest, clinical periodontal examination, and prosthetic adjustment and occlusion were used. Results : The survival rate of the experimental and control groups after 1 year was 97.2% and 100%, respectively. The Wald confidence interval reported for the experimental group was not inferior to the control group. Conclusion : No significant differences were found between the RBM and CMP groups. The observed data suggest that CMP-coated methods can provide favorable clinical results for the functioning and healing of dental implants.