• Journal of Periodontal and Implant Science
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• v.54 no.1
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• pp.53-62
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• 2024

Purpose: This study aimed to evaluate the long-term cumulative survival rate (CSR) of dental implants with micro-threads in the neck over a 10-year follow-up period and to examine the factors influencing the survival rate of dental implants. Methods: This retrospective study was based on radiographic and dental records. In total, 151 patients received 490 Oneplant^® dental implants with an implant neck micro-thread design during 2006-2010 in the Department of Periodontology of Seoul National University Dental Hospital. Implant survival was evaluated using Kaplan-Meier analysis. Cox proportional hazard regression analysis was used to identify the factors influencing implant failure. Results: Ten out of 490 implants (2.04%) failed due to fixture fracture. The CSR of the implants was 97.9%, and no significant difference was observed in the CSR between external-and internal-implant types (98.2% and 97.6%, respectively, P=0.670). In Cox regression analysis, 2-stage surgery significantly increased the risk of implant failure (hazard ratio: 4.769, P=0.039). There were no significant differences in influencing factors, including sex, age, implant diameter, length, fixture type, location, surgical procedure, bone grafting, and restoration type. Conclusions: Within the limitations of this retrospective study, the micro-thread design of the implant neck was found to be favorable for implant survival, with stable clinical outcomes.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.242-250
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• 2014

Purpose: This study aimed to evaluate the effects of fibronectin and oxysterol immobilized on machined-surface dental implants for the enhancement of cell attachment and osteogenic differentiation, on peri-implant bone healing in the early healing phase using an experimental model in dogs. Methods: Five types of dental implants were installed at a healed alveolar ridge in five dogs: a machined-surface implant (MI), apatite-coated MI (AMI), fibronectin-loaded AMI (FAMI), oxysterol-loaded AMI (OAMI), and sand-blasted, large-grit, acid-etched surface implant (SLAI). A randomly selected unilateral ridge was observed for 2 weeks, and the contralateral ridge for a 4-week period. Histologic and histometric analyses were performed for the bone-to-implant contact proportion (BIC) and bone density around the dental implant surface. Results: Different bone healing patterns were observed according to the type of implant surface 2 weeks after installation; newly formed bone continuously lined the entire surfaces in specimens of the FAMI and SLAI groups, whereas bony trabecula from adjacent bone tissue appeared with minimal new bone lining onto the surface in the MI, AMI, and OAMI groups. Histometric results revealed a significant reduction in the BIC in MI, AMI, and OAMI compared to SLAI, but FAMI demonstrated a comparable BIC with SLAI. Although both the BIC and bone density increased from a 2- to 4-week healing period, bone density showed no significant difference among any of the experimental and control groups. Conclusions: A fibronectin-coated implant surface designed for cell adhesion could increase contact osteogenesis in the early bone healing phase, but an oxysterol-coated implant surface designed for osteoinductivity could not modify early bone healing around implants in normal bone physiology.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.1
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• pp.31-69
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• 1996

The purpose of this investigation was to analyze stress distribution in implant supporting tissue according to different types of attachments such as combination bar attachment, Hader bar attachment, O-Ring attachment and Dal-Ro attachment that are used in mandibular overdenture by using two osseointegrated implants, to study the influence that POM IMC used in bar type attachment has in implant supporting tissue and compare the preceding analyses to find out an effective stress distribution method. Three dimensional photoelastic method was used to obtain the following results. (A) Analysis of stress distribution according to attachment type 1. Under vertical load condition, compressive stress was seen at implant supporting area of working side on all the photoelastic models but in Hader bar attachment tensional stress was seen at distal upper area of implant supporting area. Relatively Hader bar and O-Ring attachment showed even stress distribution pattern. 2. Under vertical load condition, compressive stress at implant apex area and tensional stress at implant lateral supporting area were seen at nonworking side of all models. 3. Under $25^{\circ}$ lateral load condition, general compressive stress was seen at working side implant supporting area in most of the models, especially at distal upper supporting area higher compressive stress concentration was seen in combination bar attachment and tensional stress concentration, in Hader bar attachment. 4. Under $25^{\circ}$ lateral load condition, compressive stress at implant apex area and tensional stress at implant lateral supporting area were seen at nonworking side of all models, except O-Ring model which showed compressive stress only. (B) Influence of POM IMC to stress distribution in bar type attachment 5. Under vertical load condition, better stress distribution pattern was seen at working side of combination bar and Hader bar attachment model using POM IMC. 6. Under vertical load condition, stress value was increased at nonworking side of combination bar attachment model using POM IMC and tendency of increasing compression was seen at nonworking side of Hader bar attachment model using POM IMC. 7. Under $25^{\circ}$ lateral load condition, better stress distribution pattern was seen at working side of combination bar attachment model using POM IMC but tendency of increasing stress was seen on working side of Hader bar attachment model using POM IMC. 8. Under $25^{\circ}$ lateral load condition, stress reduction was seen at nonworking side of combination bar attachment model using POM IMC but tendency of increasing stress was seen at nonworking side of Hader bar attachment model using POM IMC.

• Journal of Dental Rehabilitation and Applied Science
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• v.26 no.2
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• pp.121-143
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• 2010

To investigate the effect of implant types and bone resorption on the fracture characteristics. 4 types of Osstem$^{(R)}$Implant were chosen and classified into external parallel, internal parallel, external taper, internal taper groups. Finite elements analysis was conducted with ANSYS Multi Physics software. Fatigue fracture test was performed by connecting the mold to the dynamic load fatigue testing machine with maximum load of 600N and minimum load of 60N. The entire fatigue test was performed with frequency of 14Hz and fractured specimens were observed with Hitachi S-3000 H scanning electron microscope. The results were as follows: 1. In the fatigue test of 2 mm exposed implants group, Tapered type and external connected type had higher fatigue life. 2. In the fatigue test of 4 mm exposed implants group, Parallel type and external connected types had higher fatigue life. 3. The fracture patterns of all 4 mm exposed implant system appeared transversely near the dead space of the fixture. With a exposing level of 2 mm, all internally connected implant systems were fractured transversely at the platform of fixture facing the abutment. but externally connected ones were fractured at the fillet of abutment body and hexa of fixture or near the dead space of the fixture. 4. Many fatigue striations were observed near the crack initiation and propagation sites. The cleavage with facet or dimple fractures appeared at the final fracture sites. 5. Effective stress of buccal site with compressive stress is higher than that of lingual site with tensile stress, and effective stress acting on the fixture is higher than that of the abutment screw. Also, maximum effective stress acting on the parallel type fixtures is higher. It is careful to use the internal type implant system in posterior area.

• The Journal of Korean Academy of Prosthodontics
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• v.49 no.2
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• pp.168-176
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• 2011

Purpose: This study aims at investigating the influence of various insertion torques on thermal changes of bone. A proper insertion torque is derived based on the thermal analysis with two different implant designs. Materials and methods: For implant materials, bovine scapula bone of 15 - 20 mm thickness was cut into 35 mm by 40 - 50 mm pieces. Of these, the pieces having 2 - 3 mm thickness cortical bone were used as samples. Then, the half of the sample was immersed in a bath of $36.5^{\circ}C$ and the other half was exposed to ambient temperature of $25^{\circ}C$, so that the inner and surface temperatures reached $36.5^{\circ}C$ and $28^{\circ}C$, respectively. Two types of implants ($4.5{\times}10\;mm$ Br${\aa}$nemark type, $4.8{\times}10\;mm$ Microthread type) were inserted into bovine scapula bone and the temperature was measured by a thermocouple at 0.2 mm from the measuring point. Finite element method (FEM) was used to analyze the thermal changes at contacting surface assuming that the sample is a cube of $4\;cm{\times}4\;cm{\times}2\;cm$ and a layer up to 2 mm from the top is cortical bone and below is a cancellous bone. Boundary conditions were set on the basis of the shape of cavity after implants. SolidWorks was used as a CAD program with the help of Abaqus 6.9-1. Results: In the in-vitro experiment, the Microhead type implant gives a higher maximum temperature than that of the Br${\aa}$nemark type, which is attributed to high frictional heat that is associated with the implant shape. In both types, an Eriksson threshold was observed at torques of 50 Ncm (Br${\aa}$nemark) and 35 Ncm (Microthread type), respectively. Based on these findings, the Microthread type implant is more affected by insertion torques. Conclusion: This study demonstrate that a proper choice of insertion torque is important when using a specific type of implant. In particular, for the Microthread type implant, possible bone damage may be expected as a result of frictional heat, which compensates for initial high success rate of fixation. Therefore, the insertion torque should be adjusted for each implant design. Furthermore, the operation skills should be carefully chosen for each implant type and insertion torque.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.2
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• pp.385-402
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• 1996

The purpose of this study was to analyze how the stability of the implant prostheses and the loosening of the fastening screw was affected when the various types of Hex structure provided for the effect of anti-rotation of the single prostheses were given. Three dimensional finite element model was designed with which the implants with the external hex type of 0.75mm, 1.5mm and the implant with the internal hex type of 0.75mm, 1.5mm and the implant with the external hex type of $15^{\circ}$ tapered shape of 0.75mm were supposed to completely osseointegrate to the mandible. After fininshing the finite element model, the preload of 10N at the fastening screw was applied and then the vertical and $30^{\circ}$ lateral load of 200N was applied respectively at the cusp tips of the prostheses. The following results were obtained : 1. In case of displacement, the amount of displacement was increased at the internal hex type(model C, D) than at the external hex type(model A, B, E) when the vertical and lateral load was applied. 2. Less equivalent stress was represented at the model B with increased external hex height than at the model A when the vertical and lateral load was applied. 3. Much stress was represented at the model E with increased hex angle than at the model A in case of the stress happened to the implant body and the fastening screw when the vertical and lateral load was applied. 4. Much equivalent stress was represented at the model D with deepened internal hex height than at the model C when vertical and lateral load was applied. 5. The least stress was taken at the model B and the most stress was taken at the model D in case of the stress happened to the implant when the vertical and lateral load was applied. 6. The least stress was taken at the model C at the vertical load. And the least stress was taken at the model B at lateral load in case of the stress happened to the fastening screw. As a results of this study, the good lateral stability of prostheses and less stress of the component of implant was taken when the external hex height was increased, and the risk of neck fracture of implant and fastening screw was increased when the internal hex height was deepned because of long screw neck portion and thin implant neck portion.

• The Journal of Korean Academy of Prosthodontics
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• v.40 no.5
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• pp.507-524
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• 2002

Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study, 1. In all experimental models. the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows: type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems. more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread. selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.214-220
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• 2013

Implant prosthodontics is beneficial for edentulous patients in enhancing the support, retention, stability, phonation and so on. Various types of prosthesis supported by implant, including implant retained- or supported- overdenture for the removable type and ceramo-metal and fixed prostheses with processed acrylic teeth for the fixed type, are frequently used. Treatment planning for the prosthesis with implant must be made after considering individual characteristics such as form of residual ridge, soft tissue, interocclusal relationship, economic status. Fixed prosthesis with processed acrylic teeth (also known as 'implant hybrid prosthesis' or 'bone anchored bridge') has the advantages of both removable and fixed prosthesis such as proper soft tissue profile, esthetic outcome, increased masticatory efficiency and psychological stability. The 73-years-old female patient came to the department of prosthodontics, Dental hospital of Yonsei University. She was diagnosed with Kennedy class I partial edentulism in the maxilla and complete edentulism in the mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable partial denture in the maxilla and implant hybrid prosthesis in the mandible.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.2
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• pp.111-117
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• 2001

There are three designs of thread form in screw type implants: V-thread, Reverse buttress thread and Square thread. The purpose of this study was to find out how thread form designs have an influence on the equivalent stress, equivalent strain, maximum shear stress and maximum shear strain and which design of thread form generates more maximum equivalent stress and strain. 3-D finite element analysis was used to evaluate the stress and strain patterns of three tread types. The results of this study were as follow. 1. Under the 200N of axial load, the value of maximum equivalent stress is smallest in square thread and there is no significant difference between that of V thread and reverse buttress thread. 2. Under the 200N of axial load, the value of maximum equivalent strain is largest in V thread and smallest in square thread. 3. Under the 200N of axial load, the value of maximum shear stress is smallest in square thread and there is no significant difference between that of V thread and reverse buttress thread. 4. Under the 200N of axial load, the value of maximum equivalent strain is largest in V thread and there is no significant difference between that of square thread and reverse buttress thread. 5. Above results show that the square thread has special advantages in stress and strain compared with other thread types, especially in shear stess which is most determinant to implant-bone interface. Considering the superior biomechanical properties of square form implant, we presume that square form implant has better clinical results than the other types of implants in the same clinical conditions.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.4
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• pp.225-231
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• 2022

Objectives: This study aims to evaluate the efficacy and safety of two types of sandblasted with large-grit and acid-etched (SLA) surface implants with different surface roughness. Patients and Methods: This study was conducted based on a clinical record review of 55 patients (mean age, 53.00 years). A total of 80 SLA surface implants was placed. Among the 80 implants, 38 implants placed in 29 subjects had surface roughness (Ra) of 3.09 ㎛ (test group, TG), while the other 42 implants placed in 31 subjects had a surface roughness (Ra) of 2.50 ㎛ (control group, CG). A comparison was made of implant primary/secondary stability; success and survival rates; marginal bone loss; and soft tissue assessment including probing pocket depth (PPD), plaque index (PI), gingival index (GI), and bleeding on probing (BOP) between the groups at 1 year after implant placement. Results: Among the implants that were initially registered, 1 from the TG and 4 from the CG dropped out, leaving 37 implants in the TG and 38 implants in the CG to be traced and analyzed. Although 1 TG case showed unstable primary stability, all cases showed stable secondary stability. Success and survival rates at 1 year after implant placement were 100% in both groups. Marginal bone loss was 0.07 mm and 0.00 mm for the TG and CG, respectively, but the difference was not significant. Among the several parameters for evaluation of soft tissue, the TG showed lower PI at 1 year after implant placement (TG=0.00, CG=0.29; P=0.0004), while the remaining categories showed no significant difference between the groups. Conclusion: This study shows that the two types of SLA implants with different surface roughness have no difference in efficacy or safety. Therefore, both of the implants can be used safely and with promising outcomes.