• The Journal of Korean Academy of Prosthodontics
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• v.62 no.3
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• pp.193-200
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• 2024

In patients with severe alveolar bone resorption on mandibular anterior edentulous areas, it can be difficult to place implants in the location for crowns, and to create the fixed prosthesis having an adequate emergence profile or embrasure, which makes maintenance difficult. Fabricating a removable zirconia prosthesis with a milled bar on poorly positioned implants can be a good option because of easy maintenance. In this case, the patient had severe bone resorption on mandibular anterior region, and large vertical space. We report on the aesthetical and easy-to-maintain results by placing two implants and fabricating a zirconia prosthesis using milled bar.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.1
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• pp.11-21
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• 2013

The purpose of this study was to get a proper time when implant was loaded and superstructure was fabricated by tracing a change of the implant stability in bone type for 1 year. We carried out RFA(resonance frequency analysis) of 67 implants in 36 patients at the time of surgery, 2, 6, 10, 14weeks, and 1year postoperatively for each implant, and analyzed data for different bone density. The ISQ value at the time of 10 & 14weeks postoperatively were significant(P<0.01) in subjective grouping, while that were not significant in objective grouping(P>0.05). The change pattern of ISQ value could be expressed $y=y_0+a{\times}\{1-\exp(-b{\times}x)\}$ for 1 year in this study, ISQ value at surgery might be used to estimate the time of superstructure fabrication consequentially.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.209-223
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• 2013

This study was to evaluate the stress distributions of prefabricated, customized abutments and fixtures according to their material and shape by three-dimensional finite element analysis. And to investigate the fatigue life and fracture characteristics. Mandibular models were fabricated by reconstruction of the CT scan of patients with normal occlusion. A total of six finite element models were designed, a load of 100 N was applied on the buccal cusps vertically, and 30 degree obliquely. 10 specimens each were fabricated for the more clinically widely used 4 type abutments and were loaded according to ISO 14801. Differences in stress distribution patterns were not found according to the materials of the abutments and fixtures. But a slight difference in the stress level was detected. Customized abutment groups showed lower crown stress levels. One-piece zirconia implant showed the lowest bone stress levels. In the fatigue test, highest values were measured in group 7. Prefabricated abutments showed less variation of fatigue life (P<0.05). Use of customized abutments can improve the fracture resistance of restorations. Especially, use of customized zirconia abutments reinforced by titanium screw connecting parts is recommended.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.3
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• pp.333-340
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• 2021

Although gag reflex is an essential function and a useful physiological defense mechanism, it can become an obstacle in a dental treatment. In this case, a questionnaire was designed and used in consultations to objectify the factors associated with gag reflex. Based on the questionnaire, various treatment protocols were planned, such as behavioral control, which is a systematic desensitization that adapts by placing dental instruments in the oral cavity, and habit control to eliminate vomiting habits after drinking. Except for the placement of the implant fixture under general anesthesia, all restoration procedures were performed in the outpatient clinic in the same manner as the conventional implant fixed prosthetic restoration. The systematic desensitization and behavior technique were repeated until the patient was able to endure discomfort and relieve gag reflex in dental treatment. The patient was successfully received the implant-fixed prosthetic restoration in the partial edentulous region.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.101-112
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• 2023

Purpose. This retrospective study was to investigate the survival and complication rates of posterior single implant according to the implant diameters, lengths and position. Materials and methods. Patients who had been restored single implant prosthesis in the posterior area by the three prosthodontists in the department of prosthodontics, Daejeon dental hospital of Wonkwang university, in the period from February 2014 to May 2018 were selected for the study. A total of 505 patients with 697 implants were observed. The survival and complications of implants were investigated using electronic medical records and radiographs. Fixture diameters, lengths, position, patient's sex and age were assessed as possible factor affecting the survival and complications of implants. Results. 3-year cumulative survival rates of posterior single implants were 98.5% and 5-year cumulative survival rates were 94.4%. 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm (97.0%) than implants with diameter ≤ 4.0 mm (89.5%), and in females (98.8%) than males (92.4%). There were statistically significant differences (P < .05). The mechanical complication rate was 20.1% and the biological complication rate was 4.7%. Complications occurred in order of abutment screw loosening (7.5%), decementation (6.3%), proximal contact loss (3.7%) and so on. Abutment screw loosening occurred more frequently in the lower molar region (10.5%), in males (9.5%) than females (5.1%), and in patients aged < 65 years (9.4%) than patients aged ≥ 65 years (5.1%). There were statistically significant differences (P < .05). Conclusion. The 5-year cumulative survival rates were higher in implants with diameter > 4.0 mm than implants with diameter ≤ 4.0 mm and in females than males. Abutment screw loosening which was the most commonly occurring complication occurred more frequently in the lower molar region, in males than females, and in patients aged < 65 years than patients aged ≥ 65 years. There were statistically significant differences.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.4
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• pp.391-401
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• 2009

The successful outcome of dental implants is mainly the result of intial implant stability following placement. The aim of this study was to investigate the effect of a self-tapping blades and implant design on initial stability of two tapered implant systems in poor bone quality. The two different implant systems included one with self-tapping blades and one without self-tapping blades. D4 bone model using Solid Rigid Polyurethane Form was used to simulate poor bone densities. The insertion torque during implant placement was recorded. Resonance frequency Analysis (RFA), measured as the implant stability quotient (ISQ), was assessed immediately after insertion. Finally, the implant-bone specimen was transferred to an Universal Testing Machine to measure the axial pull-out force. Insertion torque values and maximum pull-out torque value of the non self-tapping implants were significantly higher than those in the self-tapping group (P = 0.008). No statistically differences were noted between the two implant designs in RFA. Within the each implant system, no correlation among insertion torque, maximum pull-out torque and RFA value could be determined. Higher insertion torque of the non-self-tapping implants appeared to confirm higher clinical initial stability. In conclusion, implants without self-tapping blades have higher initial stability than implants with self-tapping blades in poor bone quality.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.4
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• pp.266-272
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• 2010

Purpose: The purpose of this study was to investigate the effects of the surface morphology of the implant neck on marginal bone stress measured by using finite element analysis in six implant models. Materials and methods: The submerged type rescue implant system (Dentis co., Daegu, Korea) was selected as an experimental model. The implants were divided into six groups whose implant necks were differently designed in terms of height (h, 0.4 and 1.0 mm) and width (platform width, w = 3.34 + 2b [b, 0.2, 0.3 and 0.4 mm]). Finite element models of implant/bone complex were created using an axisymmetric scheme. A load of 100 N was applied to the central node on the top of crown in parallel with the implant axis. The maximum compression stress was calculated and compared. Results: Stress concentration commonly observed around dental implants did not occur in the marginal bone around all six test implant models. Marginal bone stress varied according to the implant neck bevel which had different width and height. The stress was affected more markedly by the difference in height than in width. Conclusion: This result indicates that the implant neck bevel may play an important role in improving stress distribution in the marginal bone area.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.3
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• pp.156-161
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• 2012

Purpose: This study was conducted to obtain difference in fracture strength according to the diameter of one-body O-ring-type of mini implant fixture, to determine the resistance of mini implant to masticatory pressure, and to examine whether overdenture using O-ring type mini implant is clinically usable to maxillary and mandibular edentulous patients. Materials and methods: For this study, 13 mm long one body O-ring-type mini implants of different diameters (2.0 mm, 2.5 mm and 3.0 mm) (Dentis, Daegu, Korea) were prepared, 5 for each diameter. The sample was placed at $30^{\circ}$ from the horizontal surface on the universal testing machine, and off-axis loading was applied until permanent deformation occurred and the load was taken as maximum compressive strength. The mean value of the 5 samples was calculated, and the compressive strength of implant fixture was compared according to diameter. In addition, we prepared 3 samples for each diameter, and applied loading equal to 80%, 60% and 40% of the compressive strength until fracture occurred. Then, we measured the cycle number on fracture and analyzed fatigue fracture for each diameter. Additionally, we measured the cycle number on fracture that occurred when a load of 43 N, which is the average masticatory force of complete denture, was applied. The difference on compressive strength between each group was tested statistically using one-way ANOVA test. Results: Compressive strength according to the diameter of mini implant was $101.5{\pm}14.6N$, $149{\pm}6.1N$ and $276.0{\pm}13.4N$, respectively, for diameters 2.0 mm, 2.5 mm and 3.0 mm. In the results of fatigue fracture test at 43 N, fracture did not occur until $2{\times}10^6$ cycles at diameter 2.0 mm, and until $5{\times}10^6$ cycles at 2.5 mm and 3.0 mm. Conclusion: Compressive strength increased significantly with increasing diameter of mini implant. In the results of fatigue fracture test conducted under the average masticatory force of complete denture, fracture did not occur at any of the three diameters. All of the three diameters are usable for supporting overdenture in maxillary and mandibular edentulous patients, but considering that the highest masticatory force of complete denture is 157 N, caution should be used in case diameter 2.0 mm or 2.5 mm is used.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.3
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• pp.189-198
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• 2017

Purpose: This study aims to analyze the stress distribution of mandibular molar restoration supported by the implants with external hex and internal taper abutment connection design. Materials and Methods: Models of external connection (EXHEX) and internal connection (INCON) implants, corresponding abutment/crowns, and screws were developed. Supporting edentulous mandibular bony structures were designed. All the components were assembled and a finite element analysis was performed to predict the magnitude and pattern of stresses generated by occlusal loading. A total of 120 N static force was applied both by axial (L1) and oblique (L2) direction. Results: Peak von Mises stresses produced in the implants by L2 load produced 6 - 15 times greater than those by L1 load. The INCON model showed 2.2 times greater total amount of crown cusp deflection than the EXHEX model. Fastening screw in EXHEX model and upside margin of implant fixture in INCON model generated the peak von Mises stresses by oblique occlusal force. EXHEX model and INCON model showed the similar opening gap between abutment and fixture, but intimate sealing inside the contact interface was maintained in INCON model. Conclusion: Oblique force produced grater magnitudes of deflection and stress than those by axial force. The maximum stress area at the implant was different between the INCON and EXHEX models.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.196-203
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• 2022

Purpose: This study aimed to evaluate the accuracy and clinical usability of an identification model using deep learning for 79 dental implant types. Materials and Methods: A total of 45396 implant fixture images were collected through panoramic radiographs of patients who received implant treatment from 2001 to 2020 at 30 dental clinics. The collected implant images were 79 types from 18 manufacturers. EfficientNet and Meta Pseudo Labels algorithms were used. For EfficientNet, EfficientNet-B0 and EfficientNet-B4 were used as submodels. For Meta Pseudo Labels, two models were applied according to the widen factor. Top 1 accuracy was measured for EfficientNet and top 1 and top 5 accuracy for Meta Pseudo Labels were measured. Results: EfficientNet-B0 and EfficientNet-B4 showed top 1 accuracy of 89.4. Meta Pseudo Labels 1 showed top 1 accuracy of 87.96, and Meta pseudo labels 2 with increased widen factor showed 88.35. In Top5 Accuracy, the score of Meta Pseudo Labels 1 was 97.90, which was 0.11% higher than 97.79 of Meta Pseudo Labels 2. Conclusion: All four deep learning algorithms used for implant identification in this study showed close to 90% accuracy. In order to increase the clinical applicability of deep learning for implant identification, it will be necessary to collect a wider amount of data and develop a fine-tuned algorithm for implant identification.