• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.222-231
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• 2020

To use the external connection implant (EXT) appropriately, the inter-implant distance should be carefully considered during placement, and the bones raised above the implants should be trimmed during the second surgery. The hex abutment is more useful than the non-hex abutment. EXT is particularly useful when the inter-arch space is limited. The tissue level (TL, internal butt connection) implant has a biomechanical advantage of coronal wall thickness and a biological advantage of an inherent transmucosal smooth surface. During TL implant restoration, an abutment can be selected using the abutment and fixture margins with considerations for the inter-arch space. Since no single type of implant can satisfy all the cases, it is necessary to select the appropriate type, considering the occlusal force and the bone condition.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.2
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• pp.92-98
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• 2012

Purpose: The aim of this study was to evaluate the effects of different abutment materials on abutment screw loosening and settling-down effect in conical connection type implant system. Materials and methods: Three types of abutment, cementation, gold UCLA, and metal UCLA abutment were used. Two UCLA groups were fabricated in a similar pattern to cementation abutment. Type III gold alloy and Nickel-Chromium alloy was used for casting gold UCLA abutment and metal UCLA abutment, respectively. Fixture and abutment were tightened to 30 Ncm by using digital torque controller and re-tightening was conducted with same force after 10 minutes. Digital torque gauge was used to measure loosening torque and fixture/abutment length was measured by digital micrometer. Dynamic loads between 25 N and 250 N were applied with $0^{\circ}$ angle to the abutment axis. After loading, fixture/abutment length was re-measured and amount of settlement was calculated. Loosening torque value was also measured for comparison Results: All three groups showed significant differences of length when comparing before and after loading, but there was no significant difference of settling amount in all groups. Loosening torque values were significantly decreased when comparing before and after loading in all groups($P$<.05). However, there was no significant difference in loss of loosening torque values when compared to groups. Conclusion: In internal conical connection type implants, dynamic load affected on settlement and loosening torque of implant, but there was no differences between abutments materials. Likewise gold UCLA abutment, metal UCLA abutment might be able to withstand functional load.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.3
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• pp.251-257
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• 2017

Purpose: The purpose of this study was to evaluate whether the internal abutment length affected screw stability in an internal connection implant. Materials and methods: Twenty long internal connection implants (Replus system, $4.7{\times}11.5mm$) were selected for this investigation. Abutments were assigned to four groups depending on the length of the internal connection (abutments with internal lengths of 1, 2, 3, and 4 mm, respectively). Each implant fixture specimen was embedded in resin medium and connected to an abutment with an abutment screw. A load of 100 N, applied at an angle of $30^{\circ}$ to the long axis of the implant, was repeated for $1.0{\times}10^6$ cycles. Reverse torque values (RTV) were recorded before and after loading, and the change in RTV was calculated. Data were analyzed with the Kruskal-Wallis test. Results: The change in RTV was not significantly different among the groups (P>.05). Screw loosening and fractures were not observed in any groups, and joint stability was maintained. Conclusion: The internal length of the abutment may not significantly affect the degree of screw loosening.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.4
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• pp.370-378
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• 2016

Purpose: The purpose of this study was to investigate screw joint stability and sagittal fit between internal connection implant fixtures of two different manufacturers and customized abutments. Materials and methods: Internal connection implant systems from two different manufacturers (Biomet 3i system, Astra Tech system) were selected for this study (n=24 for each implant system, total n=48). For 3i implant system, half of the implants were connected with Ti ready-made abutments and the other half implants were connected with Ti CAD-CAM custom ones of domestic-make (Myplant, Raphabio Co., Seoul, Korea) and were classified into Group 1 and Group 2 respectively. Astra implants were divided into Group 3 and Group 4 in the same way. Micro-CT sagittal imaging was performed for fit analysis of interfaces and preloading reverse torque values (RTV) were measured. Results: In the contact length of fixture-abutment interface, there were no significant differences not only between Group 1 and Group 2 but also between Group 3 and Group 4 (Mann-Whitney test, P>.05). However, Group 2 and Group 4 showed higher contact length significantly than Group 1 and Group 3 in abutment-screw interface as well as fixture-screw one (Mann-Whitney test, P<.05). In addition, RTV was lower in CAD-CAM custom abutments compared to ready-made ones (Student t-test, P<.05). Conclusion: It is considered that domestically manufactured CAD-CAM custom abutments have similar fit at the fixture abutment interface and it could be used clinically. However, RTV of CAD-CAM custom abutments should be improved for the increase of clinical application.

• 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.

• 대한치과보철학회:학술대회논문집
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• 2004.11a
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• pp.64-64
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• 2004

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.2
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• pp.125-135
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• 2009

Statement of problem: Loosening or fracture of the abutment screw is one of the common problems related to the dental implant. Generally, in order to make the screw joint stable, the preload generated by tightening torque needs to be increased within the elastic limit of the screw. However, additional tensile forces can produce the plastic deformation of abutment screw when functional loads are superimposed on preload stresses, and they can elicit loosening or fracture of the abutment screw. Therefore, it is necessary to find the optimum tightening torque that maximizes a fatigue life and simultaneously offer a reasonable degree of protection against loosening. Purpose: The purpose of this study was to present the influence of tightening torque on the implant-abutment screw joint stability with the 3 dimensional finite element analysis. Material and methods: In this study, the finite element model of the implant system with external butt joint connection was designed and verified by comparison with additional theoretical and experimental results. Four different amount of tightening torques(10, 20, 30 and 40 Ncm) and the external loading(250 N, $30^{\circ}$) were applied to the model, and the equivalent stress distributions and the gap distances were calculated according to each tightening torque and the result was analyzed. Results: Within the limitation of this study, the following results were drawn; 1) There was the proportional relation between the tightening torque and the preload. 2) In case of applying only the tightening torque, the maximum stress was found at the screw neck. 3) The maximum stress was also shown at the screw neck under the external loading condition. However in case of applying 10 Ncm tightening torque, it was found at the undersurface of the screw head. 4) The joint opening was observed under the external loading in case of applying 10 Ncm and 20 Ncm of tightening torque. 5) When the tightening torque was applied at 40 Ncm, under the external loading the maximum stress exceeded the allowable stress value of the titanium alloy. Conclusion: Implant abutment screw must have a proper tightening torque that will be able to maintain joint stability of fixture and abutment.

• Journal of Dental Rehabilitation and Applied Science
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• v.39 no.1
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• pp.32-44
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• 2023

Purpose: The purpose of this study was to investigate the effect of implant connection type on marginal bone loss (MBL) and to analyze the factors that affect MBL. This study focuses on single implants planted in the upper and lower first molar area. Materials and Methods: A total of 87 implants from 68 patients were tracked for a period over 5 years. There were 57 external connection type (EC) implants and 30 internal connection type (IC) implants in 38 males and 30 females. The MBL and EA were measured from intraoral radiograph images taken after 5 years at most. Results: Significant difference in MBL between EC and IC type was observed in patients without GBR or diabetes. Patients without GBR exhibited an MBL of -0.065 ± 0.859 mm in EC type and -0.627 ± 0.639 mm in IC type (P = 0.025). Using multiple regression analysis, a statistically significant negative correlation was observed between MBL and conditions including implant-abutment connection type (β = -0.303), diabetes (β = -0.113), emergence angle > 30° (β = -0.234), and age (β = -0.776). Conclusion: Within this results, IC type implants had less MBL than EC type, and implant prosthesis with emergence angle over 30° showed greater MBL. To minimize the MBL of the implant and ensure implant stability, careful consideration should be given to the EA of implant prosthesis and its connection type.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.2
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• pp.119-127
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• 2012

Purpose: This study was performed to compare the stress distribution pattern of abutment-fixture connection area using 3-dimensional finite element model analysis when 5 different implant systems which have internal connection. Materials and methods: For the analysis, a finite element model of implant was designed to locate at first molar area. Stress distribution was observed when vertical load of 200 N was applied at several points on the occlusal surfaces of the implants, including center, points 1.5 mm, 3.0 mm away from center and oblique load of 200 N was applied $30^{\circ}$ inclined to the implant axis. The finite element model was analyzed by using of 3G. Author (PlassoTech, California, USA). Results: The DAS tech implant (internal step with no taper) showed more favorable stress distribution than other internally connected implants. AS compare to the situations when the loading was applied within the boundary of implants and an oblique loading was applied, it showed higher equivalent stress and equivalent elastic strain when the loading was applied beyond the boundary of implants. Regardless of loading condition, the abutments showed higher equivalent stress and equivalent elastic strain than the fixtures. Conclusion: When the occlusal contact is afforded, the distribution of stress varies depending on the design of connection area and the location of loading. More favorable stress distribution is expected when the contact load was applied within the diameter of fixtures and the DAS tech implant (internal step with no tapering) has more benefits than the other design of internally connected implants.