• The Journal of Advanced Prosthodontics
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• v.13 no.6
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• pp.396-407
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• 2021

PURPOSE. Zirconia has exceptional biocompatibility and good mechanical properties in clinical situations. However, finite element analysis (FEA) studies on the biomechanical stability of two-piece zirconia implant systems are limited. Therefore, the aim of this study was to compare the biomechanical properties of the two-piece zirconia and titanium implants using FEA. MATERIALS AND METHODS. Two groups of finite element (FE) models, the zirconia (Zircon) and titanium (Titan) models, were generated for the exam. Oblique (175 N) and vertical (175 N) loads were applied to the FE model generated for FEA simulation, and the stress levels and distributions were investigated. RESULTS. In oblique loading, von Mises stress values were the highest in the abutment of the Zircon model. The von Mises stress values of the Titan model for the abutment screw and implant fixture were slightly higher than those of the Zircon model. Minimum principal stress in the cortical bone was higher in the Titan model than Zircon model under oblique and vertical loading. Under both vertical and oblique loads, stress concentrations in the implant components and bone occurred in the same area. Because the material itself has high stiffness and elastic modulus, the Zircon model exhibited a higher von Mises stress value in the abutments than the Titan model, but at a level lower than the fracture strength of the material. CONCLUSION. Owing to the good esthetics and stress controllability of the Zircon model, it can be considered for clinical use.

• The Journal of the Korean dental association
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• v.52 no.9
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• pp.541-549
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• 2014

The restorative treatment using titanium implants has become a standard procedures in everyday clinical practice. However, there are several concerns about the use of titanium as a materials. Above all, the grayish metal color provokes esthetic problems when the soft tissue around the implants is not optimal. Recently, zirconia has been emerging as an alternative to titanium due to its white color and superior physicochemical properties. In this paper, the current findings about zirconia implants was reviewed based on the results from animal and clinical experiments. In addition, the immediate implantation protocols using the natural tooth form zirconia implants was introduced as a novel procedures and future perspectives were discussed.

• The korean journal of orthodontics
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• v.47 no.4
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• pp.229-237
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• 2017

Objective: The aim of this study was to compare the initial stability as insertion and removal torque and the clinical applicability of novel orthodontic zirconia micro-implants made using a powder injection molding (PIM) technique with those parameters in conventional titanium micro-implants. Methods: Sixty zirconia and 60 titanium micro-implants of similar design (diameter, 1.6 mm; length, 8.0 mm) were inserted perpendicularly in solid polyurethane foam with varying densities of 20 pounds per cubic foot (pcf), 30 pcf, and 40 pcf. Primary stability was measured as maximum insertion torque (MIT) and maximum removal torque (MRT). To investigate clinical applicability, compressive and tensile forces were recorded at 0.01, 0.02, and 0.03 mm displacement of the implants at angles of $0^{\circ}$, $10^{\circ}$, $20^{\circ}$, $30^{\circ}$, and $40^{\circ}$. The biocompatibility of zirconia micro-implants was assessed via an experimental animal study. Results: There were no statistically significant differences between zirconia micro-implants and titanium alloy implants with regard to MIT, MRT, or the amount of movement in the angulated lateral displacement test. As angulation increased, the mean compressive and tensile forces required to displace both types of micro-implants increased substantially at all distances. The average bone-to-implant contact ratio of prototype zirconia micro-implants was $56.88{\pm}6.72%$. Conclusions: Zirconia micro-implants showed initial stability and clinical applicability for diverse orthodontic treatments comparable to that of titanium micro-implants under compressive and tensile forces.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.4
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• pp.307-313
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• 2017

The object of this case report is to introduce milled zirconia bar and PEKK female part made by CAD/CAM technology for bar attachment implant supported overdenture in maxillary edentulous patients. For over 2 years, in terms of function and esthetics, satisfactory result was obtained. Esthetically and functionally satisfactory results were obtained in periodic follow up check.

• Journal of Technologic Dentistry
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• v.32 no.4
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• pp.317-325
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• 2010

Purpose: The aim of this study is to make some basic materials to find retention force difference based on the total height of CAD/CAM zirconia abutment used for implant, retention force difference based on how to regulate the height of the abutment, retention force difference based on the size and retention force difference based on the design group. Methods: The retention force was measured by being pulled at the speed of 1mm/min after being combined with zirconia block and abutment using Temp-BOND of Kerr. The experiment was done at the research lab of OSTEM in Busan by useing UNIVERSAL TESTING MACHINE on March 3rd, 2010. Results: After analysing the total height and the retention force, p-value had minor difference by 0.01 statistically. Namely, 3mm, 4mm, 5mm had the retention force difference and we could see retention force difference on 3mm and 5mm at the post test. After analyzing how to regulate the height and retention force, p-value had minor difference by 0.000 statistically. Namely, 1mm and 2mm had the retention difference and we could see that 1mm and 2mm with the total height had retention difference. After analyzing the retention force based on the size, p-value had minor retention force difference by 0.000 statistically. Namely, 7 different size had retention force difference and we could see the size 21.9mm, 32.9mm, 32.9mm, 38.4mm, 48.9mm and 54.9mm had retention force difference. Conclusion: Namely 9 different design group had retention difference and we could see that 9 design group with 5.6.7.8 design group and 9 design group with 1.2.3.4. design group had retention force.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.218-224
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• 2017

The implant-supported fixed dental prosthesis in irradiated maxilla needs meticulous treatment planning due to low bone healing capacity. All-on-4 concept implantation can reduce the number of implants to be placed avoiding bone grafting procedure. Conventionally, prefabricated angled abutments for tilted implants have been used. However, in this case, it was replaced with computer-aided design and computer-aided manufacturing (CAD/CAM) abutment. This case report described all-on-4 concept implantation and fabrication of CAD/CAM zirconia fixed dental prostheses using CAD/CAM titanium abutments.

• The Journal of Korean Academy of Prosthodontics
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• v.51 no.3
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• pp.190-198
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• 2013

Purpose: The purposes of this study were to investigate osseointegration around zirconia implants which had machined or alumina sandblasted surface, and to compare the results with titanium implants. Materials and methods: The study was performed on the tibia of 6 pigs. Three types of implants were investigated: group T-titanium implant, group Z-machined zirconia implant, group ZS-alumina sandblasting treated zirconia implant. Zirconia implants were manufactured from yttria-stabilized tetragonal zirconia polycrystalline (Acucera Inc., Pocheon, Korea). A total of 36 implants were installed in pigs' tibias. After 1, 4 and 12 weeks of healing period, the periotest and the histomorphometric analysis were performed. The data were analyzed using one-way ANOVA and significance was assessed by the Scheffe test (${\alpha}=.05$). Results: In the measurement of surface roughness, highest Ra value was measured in group T with significant difference. No significant differences were found among groups regarding Periotest values. After 1 week, in comparison of bone to implant contact (BIC), group Z showed higher value with significant difference. In comparison of bone area (BA), group T and group Z showed higher value with significant difference than group ZS. After 4 weeks, in comparison of BIC, group T showed higher value with significant difference. Comparison of BA showed no significant difference among each implant. After 12 weeks, the highest mean BIC values were found in group T with significant difference. Group ZS showed higher BIC value with significant difference than group Z. In comparison of BA, group T and group ZS showed higher value with significant difference than group Z. Conclusion: Zirconia implant showed low levels of osseointegration in this experiment. Modification of surface structure should be taken into consideration in designing zirconia implants to improve the success rate.

• The Journal of Advanced Prosthodontics
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• v.6 no.5
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• pp.346-350
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• 2014

PURPOSE. Impact forces in implant supported FDP (fixed dental prosthesis) are higher than that of tooth supported FDPs and the compositions used in frameworks also has a paramount role for biomechanical reasons. The aim of this study was to evaluate the flexural strength of two different zirconia frameworks. MATERIALS AND METHODS. Two implant abutments with 3.8 mm and 4.5 mm platform were used as premolar and molar. They were mounted vertically in an acrylic resin block. A model with steel retainers and removable abutments was fabricated by milling machine; and 10 FDP frameworks were fabricated for each Biodenta and Cercon systems. All samples were thermo-cycled for 2000 times in $5-55^{\circ}C$ temperature and embedded in $37^{\circ}C$ artificial saliva for one week. The flexural test was done by a rod with 2 mm ending diameter which was applied to the multi-electromechanical machine. The force was inserted until observing fracture. The collected data were analyzed with SPSS software ver.15, using Weibull modulus and independent t-test with the level of significance at ${\alpha}=.05$. RESULTS. The mean load bearing capacity values were higher in Biodenta but with no significant differences (P>.05). The Biodenta frameworks showed higher load bearing capacity ($F_0=1700$) than Cercon frameworks ($F_0=1520$) but the reliability (m) was higher in Cercon (m=7.5). CONCLUSION. There was no significant difference between flexural strengths of both zirconia based framework systems; and both Biodenta and Cercon systems are capable to withstand biting force (even parafunctions) in posterior implant-supported bridges with no significant differences.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.164-173
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• 2009

Purpose: The purpose of this study was to evaluate the effect of abutment material on screw-loosening before and after cyclic loading. Among the different materials of abutments, zirconia and metal abutment were used. Material and methods: Two types of implant systems: external butt joint(US II, Osstem Implant, Korea) and internal conical joint(GS II, Osstem Implant, Korea) were used. In each type, specimens were divided into two different kinds of abutments: zirconia and metal(n=5). The implant was rigidly held in a special holding to device ensure fixation. Abutment was connected to 30 Ncm with digital torque gauge, and was retightened in 30 Ncm after 10 minutes. The initial removal torque values were measured. The same specimens were tightened in 30 Ncm again and held in the cycling loading simulator(Instron, USA) according to ISO/FPIS 1480. Cycling loading tests were performed at loads 10 to 250 N, for 1 million cycles, at 14 Hz,(by subjecting sinusoidal wave from 10 to 250 N at a frequency of 14 Hz for 1 million cycles,) and then postload removal torque values were evaluated. Results: 1. In all samples, the removal values of abutment screw were lower than tightening torque values(30 Ncm), but the phenomenon of the screw loosening was not observed. 2. In both of the implant systems, initial and postload removal torque of zirconia abutment were significantly higher than those of metal abutment(P<.05). 3. In both of the implant systems, the difference in removal torque ratio between zirconia abutment and metal abutment was not significant(P>.05). 4. In metal abutments, the removal torque ratio of GS II system(internal conical joint system) was lower than that of US II system(external butt joint system)(P<.05). 5. In zirconia abutments, the difference in removal torque ratio between the two implant systems was not significant(P>.05). Conclusion: Zirconia abutment had a good screw joint stability in the condition of one million cycling loading.

• Journal of Periodontal and Implant Science
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• v.48 no.3
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• pp.182-192
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• 2018

Purpose: The purpose of the present study was to validate an experimental model for assessing tissue integration of titanium and zirconia implants with and without buccal dehiscence defects. Methods: In 3 dogs, 5 implants were randomly placed on both sides of the mandibles: 1) Z1: a zirconia implant (modified surface) within the bony housing, 2) Z2: a zirconia implant (standard surface) within the bony housing, 3) T: a titanium implant within the bony housing, 4) Z1_D: a Z1 implant placed with a buccal bone dehiscence defect (3 mm), and 5) T_D: a titanium implant placed with a buccal bone dehiscence defect (3 mm). The healing times were 2 weeks (one side of the mandible) and 6 weeks (the opposite side). Results: The dimensions of the peri-implant soft tissue varied depending on the implant and the healing time. The level of the mucosal margin was located more apically at 6 weeks than at 2 weeks in all groups, except group T. The presence of a buccal dehiscence defect did not result in a decrease in the overall soft tissue dimensions between 2 and 6 weeks ($4.80{\pm}1.31$ and 4.3 mm in group Z1_D, and $4.47{\pm}1.06$ and $4.5{\pm}1.37mm$ in group T_D, respectively). The bone-to-implant contact (BIC) values were highest in group Z1 at both time points ($34.15%{\pm}21.23%$ at 2 weeks, $84.08%{\pm}1.33%$ at 6 weeks). The buccal dehiscence defects in groups Z1_D and T_D showed no further bone loss at 6 weeks compared to 2 weeks. Conclusions: The modified surface of Z1 demonstrated higher BIC values than the surface of Z2. There were minimal differences in the mucosal margin between 2 and 6 weeks in the presence of a dehiscence defect. The present model can serve as a useful tool for studying peri-implant dehiscence defects at the hard and soft tissue levels.