• 구강회복응용과학지
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• 제31권3호
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• pp.203-211
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• 2015

목적: 완전한 골-임플란트 결합을 가졌던 임플란트가 갑자기 골유착을 잃은 경우의 시간에따른 재골유착을 연구하기 위함이다. 연구 재료 및 방법: 23마리 토끼의 좌우 경골에 각각 2개씩 실험목적으로 제작한 RBM임플란트를 식립 후, 6주 후에 1차로 비틀림 제거력을 측정한 다음, 임플란트를 다시 재위치 침하시키고, 4일, 7일, 11일, 2주, 4주, 6주, 그리고 8주의 재침하시간 경과 후 2차로 비틀림 제거력을 측정하고 시편을 제작하여 조직 형태학적 검사를 하였다. 통계학적 검사를 위해 paired t-test를 시행했고, One-way ANOVA와 Tukey's post-hoc test 통해 그룹간 차이를 비교하여 다음과 같은 결과를 얻었다. 결과: 1차 비틀림 제거력과 비교해봤을 때 2차에서 11일 후에는 증가했으며, 2주 후부터 유의성 있게 증가하였다. 형광조사검사에서, 7일 후부터 골-임플란트 계면 사이에 형광밴드가 나타나는 광물화 현상이 관찰되고, 11일 후부터는 분명한 골 형성이 나타났다. 결론: 토끼에서는 11일 이후가 되면 충분한 재골유착을 얻을 수 있었다.

• 대한치과보철학회지
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• 제46권2호
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• pp.125-136
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• 2008

골유착 개념에 기반한 치과용 임플랜트가 $Br{\aa}nemark$ 등에 의해 도입된 이후로 치과 치료에서 임플랜트를 이용한 방법은 장기적으로 높은 성공률을 보여 왔다. 임플랜트를 이용한 치료법이 상실된 치아의 수복을 위해 우선적으로 고려되어야 할 중요한 방법으로 인식되면서 임플랜트를 이용한 방법을 선호하게 되었고 적용 범위 및 사용 빈도도 급증하였다. 예전에 비해서 국산 임플랜트의 사용도 증가하였으나 장기간의 임상적, 객관적인 자료를 가진 국산 임플랜트의 수는 많지 않은 상태이다. 본 연구는 SLA 표면 처리 및 외측 연결형의 국산 임플랜트에 관하여 18개월에서부터 57개월까지의 임상적, 방사선학적 결과에 대한 후향적 분석을 실시하였다. 연세대학교 치과대학병원에서 네오플란트$^{(R)}$ 임플랜트 (네오바이오텍, 서울, 한국)를 이용하여 치료받은 25명의 환자에게 식립된 96개의 임플랜트를 대상으로 하였고, 대상자 중 남성의 평균 연령은 63.5세, 여성의 평균 연령은 44.3세였다. 진료기록부를 통해 성별, 연령, 무치악 유형, 식립 위치, 식립된 임플랜트의 직경 및 길이, 2차 수술 여부, 보철물의 유형, 대합치의 유형, 임상적 합병증의 종류 및 빈도 등을 조사하여 그에 따른 분포 및 생존율의 차이와 함께 이들 항목이 변연골 흡수량에 미치는 영향을 조사하여 다음과 같은 결과를 얻었다. 1. 총 25명에게 식립된 96개의 임플랜트 중 2개가 실패하여 누적 생존율은 97.9%로 나타났다. 2. 정기검진이 가능했던 88개의 임플랜트에 대해서는 상악에서의 생존율이 96.2%, 하악에서의 생존율은 98.4%였고, 구치부에서의 생존율은 97.5%였으며 전치부에서의 생존율은 100%였다. 3. 보철물 장착 후 1년과 1년 이후의 연간 흡수량에서 남성이 여성보다 변연골 흡수량이 많았다 (P<0.05). 4. 임플랜트 지지 보철물 후방에 자연치가 존재하는 경우가 존재하지 않는 경우보다 보철물 장착 후 첫 1년과 1년 이후 모두에서 연간 흡수량이 적었다 (P<0.05). 5. 보철물 장착 1년 이후의 연간 흡수량은 전치보다 구치에서 더 많은 변연골 흡수를 보였다 (P<0.05). 6. 악궁 간, 보철물의 유형, 대합치의 유형, 2차 수술 여부에 따른 변연골 흡수량의 차이는 보이지 않았다 (P>0.05). 이상의 결과를 토대로 변연골 흡수량에 영향을 주는 요소로 성별, 무치악의 유형, 악궁 내 위치였으며, 악궁 간, 보철물의 유형, 대합치의 유형, 2차 수술 여부에 따른 변연골 흡수량 차이는 없었다. 본 연구에서 최대 57개월까지의 기간 동안 SLA 표면 처리 및 외측 연결형의 국산 임플랜트의 임상적인 성공률은 만족스러운 결과를 보였으며 변연골 흡수량도 임플랜트 성공기준에 부합하였으나, 이보다 더 장기적인 평가가 필요하며 다양한 국산 임플랜트 시스템에 대한 중장기적인 연구가 지속되어야 할 것이다.

• Journal of Periodontal and Implant Science
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• 제39권3호
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• pp.339-348
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• 2009

Purpose: The purpose of the present study was to analyze the implant stability quotient(ISQ) values for Korean non-submerged type implant and determine the factors that affect implant stability. Methods: A total of 49 Korean non-submerged type implants were installed in 24 patients, and their stability was measured by resonance frequency analysis(RFA) at the time of surgery, and 1, 2, 3, 4, 8, 12 weeks postoperatively. The data for implant site, age, sex, implant length and diameter, graft performing, bone type, and insertion torque were analyzed. Results: The lowest mean stability measurement was at 3 weeks. There was significant difference between implant placement and 12 weeks. There was significant difference between implant placement and 12 weeks in diameters of 4.1 mm and 4.8 mm. Also, there were significant differences between diameters of 4.1 mm and 4.8 mm at implant placement and 12 weeks after surgery. This result suggests that the factor related to implant diameter may affect the level of implant stability. No statistically significant relationship was found between the resonance frequency analysis and the variables of maxilla/mandible, sex, anterior/posterior, implant length, age of patient, graft performing, bone type, insertion torque during initial healing period. Conclusions: These findings suggest that the factor related to implant diameter may affect the variance of implant stability, and ISQ value of implant was stable enough for proved stability level during initial healing period.

• Journal of Periodontal and Implant Science
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• 제44권2호
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• pp.94-99
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• 2014

Purpose: Various surgical techniques target achieving adequate keratinized tissue around dental implants; however, these techniques are usually performed before implant placement or upon the exposure of submerged implants. The aim of this case report is to describe a simultaneous placement of an interpositional free gingival graft (iFGG) with that of nonsubmerged implants in a patient lacking keratinized tissue and to assess the longterm outcome of this grafted gingiva. Methods: A wedge-shaped free gingnival graft (FGG), including an epithelium-connective tissue (E-C) portion and a connective-tissue-only (CT) portion, was harvested from the palate. The CT portion was inserted under the buccal flap, and the E-C portion was secured tightly around the implants and to the lingual flap. Results: At the 8-year follow-up, the gingival graft remained firmly attached and was well maintained, with no conspicuous shrinkage or reported discomfort during oral hygiene procedures. The use of an iFGG at a nonsubmerged implant placement minimizes the required number of surgical steps and patient discomfort while providing adequate buccal keratinized tissue. Conclusions: Therefore, the technique could be considered an alternative method in increasing the keratinized tissue for cases that have a minimal amount of keratinized tissue.

• Journal of Periodontal and Implant Science
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• 제47권5호
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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.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.373-384
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• 2008

Purpose: The aim of this study is to compare the healing response of various Hydroxyapatite(HA) coated dental implants by Ion-Beam Assisted Deposition(IBAD) placed in the surgically created circumferential gap in dogs. Materials and methods: In four mongrel dogs, all mandibular premolars and the first molar were extracted. After an 8 weeks healing period, six submerged type implants were placed and the circumferential cylindrical 2mm coronal defects around the implants were made surgically with customized step drills. Groups were divided into six groups : anodized surface, anodized surface with 150nm HA and heat treatment, anodized surface with 300nm HA and heat treatment, anodized surface with 150nm HA and no heat treatment, and anodized surface with 150nm HA, heat treatment and bone graft, anodized surface with bone graft. The dogs were sacrificed following 12 weeks healing period. Specimens were analyzed histologically and histomorphometrically. Results: During the healing period, healing was uneventful and implants were well maintained. Anodized surface with HA coating and $430^{\circ}C$ heat treatment showed an improved regenerative characteristics. Most of the gaps were filled with newly regenerated bone. The implant surface was covered with bone layer as base for intensive bone formation and remodeling. In case that graft the alloplastic material to the gaps, most of the coronal gaps were filled with newly formed bone and remaining graft particles. The bone-implant contact and bone density parameters showed similar results with the histological findings. The bone graft group presented the best bone-implant contact value which had statistical significance. Conclusion: Within the scope of this study, nano-scale HA coated dental implants appeared to have significant effect on the development of new bone formation. And additional bone graft is an effective method in overcoming the gaps around the implants.

• Journal of Periodontal and Implant Science
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• 제38권sup2호
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• pp.385-394
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• 2008

Purpose: The aim of this study was to evaluate the factors affecting healing patterns of surgically created circumferential gap defects around implants in dogs. Materials and Methods: In four mongrel dogs, all mandibular premolars were extracted. After 8 weeks of healing periods, implants were submerged. According to the surface treatment, turned surface was designated as a group A and rough surface as a group B. In each dog, surgical defects on the left side were made with a customized tapered step drill and on the right with a customized paralleled drill. Groups were also divided according to the width of the coronal gaps: 1.0mm, 1.5mm, or 2.0mm. The dogs were sacrificed following 8 weeks and the specimens were analyzed histologically and histomorphometrically. Results: During the postoperative period, healing was uneventful and implants were well-maintained. As the size of the coronal gap was increased, the amount of bone-to-implant contact was decreased. The bone healing was greater in rough surface implants compared to the turned ones. About the defect morphology, tapered shape showed much bone healing and direct bone to implant contact even in the smooth surface implants. Conclusion: Healing of the circumferential defect around dental implant is influenced by the implant surface, defect width and the morphology of the defect. When using rough surface implants, circumferential gap defects within 2 mm do not need any kinds of regenerative procedures and the healing appeared to be faster in the tapered defect morphology than the paralleled one.

• 대한치과보철학회지
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• 제47권2호
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• pp.136-147
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• 2009

연구목적: 골유착이라는 개념이 도입된 후, 임플란트의 등장은 치과계에 많은 변화를 일으키게 되었다. 임플란트를 이용한 상실치아의 수복은 안정된 시술방법으로 시행되어져 왔으며 그 적용 범위가 확대되었고 사용 빈도도 급격히 증가해왔다. 이에 따라 국산 임플란트의 사용 빈도도 높아지고 그 종류 또한 증가하였으나 장기간의 임상적, 객관적인 자료를 가진 국산 임플란트의 수는 많지 않은 상태이다. 본 연구는 연세대학교 치과대학 병원에 내원한 환자 중 SLA 표면 처리 및 미세나사선을 가진 내측 연결형의 $Implantium^{(R)}$ 임플란트를 이용하여 치료받은 38명의 환자에게 식립된 106개의 임플란트를 대상으로 6개월에서 30개월까지의 임상적, 방사선학적 결과를 후향적으로 분석하였다. 연구재료 및 방법: 진료기록부를 통해 성별, 연령, 식립 위치, 식립 부위의 골 상태, 식립된 임플란트의 직경 및 길이, 2차수술및골이식여부, 대합치의 유형, 임상적 합병증의 유형 및 빈도 등을 조사하여 그에 따른 분포 및 생존율의 차이와 함께 이들 항목이 변연골 흡수량에 미치는 영향을 조사하였다. 방사선 사진분석으로 임플란트 식립시, 보철물 장착 후 첫 6개월 내지 1년간, 그 이후 연간 변연골 흡수량을 측정하여 분석하였다. 결과: 1. 총 38명에게 식립된 106개의 임플란트 중 1개가 실패하여 누적 생존율은 99.1%로 나타났다. 2. 보철물 장착 후 최소 6개월 이상 정기검진이 가능했던 96개의 임플란트에서 상악에서의 생존율이 97.0%, 하악에서의 생존율은 100%였고, 구치부에서의 생존율은 98.9%였으며 전치부에서의 생존율은 100%였다. 3. 보철물 장착 후 첫 1년간의 변연골 흡수량은 평균 0.17 mm 이었으며, 1년 이후의 연간 변연골 흡수량은 평균 0.04 mm로 통계학적으로 유의차 있게 적은 골소실량을 나타내었다(P<.05). 4. 보철물 장착 후 첫 1년간 연령에 따른 변연골 흡수량의 차이는 보이지 않았으나(P>.05), 1년 이후의 정기 검진 기간에서 50세 이상의 환자에서 50세 미만의 환자보다 큰 연간 변연골 흡수량을 보였다(P<.05). 5. 성별 간, 악궁 간, 전치부와 구치부위 간, 2차 수술 및 골 이식 여부, 보철물의 유형, 대합치의 유형에 따른 변연골 흡수량의 차이는 보이지 않았다(P>.05). 결론: 이상의 결과를 토대로 변연골 흡수량에 영향을 주는 요소로 연령을 들 수 있었으며 성별, 악궁 간, 악궁 내 위치, 2차 수술 및 골 이식 여부, 보철물의 유형, 대합치의 유형에 따른 변연골 흡수량의 차이는 없었다. 본 연구에서 최대 30개월까지의 기간 동안 SLA 표면 처리 및 미세나사선을 가진 내측 연결형의 국산 임플란트의 임상적인 성공률은 만족스러운 결과를 보였으며 변연골 흡수량도 임플란트 성공 기준에 부합하였다.

• 대한치과기공학회지
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• 제35권3호
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• pp.201-207
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• 2013

Purpose: In this study, the loosening torque test was conducted with three implant products that are produced, approved and sold in Korea, which are manufactured in different fixture and abutment tightening methods (internal submerged type, internal morse taper type, and external type) to examine the loosening torque of the screw according to the method of tightening the implant fixture and abutment. Methods: In the loosening torque test, the three types of fixtures and abutments with different tightening methods were tightened by rotating them clockwise with a $30N{\cdot}cm$ force using a driver equipped with an electric torque meter. The results of the test are as follows. Results: The loosening torque values of the internal submerged type, internal morse taper type and external type implants were $24.10{\pm}0.742N{\cdot}cm$, $29.10{\pm}1.710N{\cdot}cm$, and $26.60{\times}1.636N{\cdot}cm$, respectively. Conclusion: The screw loosening torque values of the three fixture and abutment tightening methods were analyzed via Kruskal Wallis test layout, and they were significantly different (p<0.05).

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권2호
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• pp.112-123
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• 2013

This study aims to investigate the clinical outcome following treatment of peri-implantitis lesions. Five subjects with 7 implants were treated with surgical approach. Four subjects with 6 implants were initially treated with non-surgical approach or hygiene control. However, inflammation was not resolved and more bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant$^{(R)}$, B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.