• The Journal of Korean Academy of Prosthodontics
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• v.52 no.1
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• pp.9-17
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• 2014

Purpose: The purpose of this study was to compare zirconia implants with titanium implants from the view point of biomechanical stability and histologic response on osseointegration when those were placed with xenograft materials. Materials and methods: Specimens were divided into two groups; the control group was experimented with eighteen titanium implants which had anodized surface and the experimental group was experimented with eighteen sandblasted zirconia (Y-TZP) implants. At the tibias of six pigs, implants were installed into bone defect sites prepared surgically and treated with resorbable membranes and bovine bone. Two pigs were sacrificed after 1, 4 and 12 weeks respectively. Each implant site was sampled and processed for histologic and histomorphometric analysis. The stability of implants was evaluated with a $Periotest^{(R)}$. And the interfaces between bone and the implant were observed with a scanning electron microscope. Results: In stability analysis there was no significant difference between Periotest values of the control group and the experimental group. In histologic analysis with a light microscope after 4 weeks, there was new bone formation with the resorption of bovine bone and the active synthesis of osteoblasts in both groups. In bone-implant contact percentage there was significant difference between both groups (P<.05). In bone area percentage there was no significant difference between both groups. In analysis of both groups with a scanning electron microscope there was a gap between bone and a surface at 4 weeks and it was filled up with bone formed newly at 12 weeks. Conclusion: When accompanied by xenograft using membrane, bone to implant contact percentage of zirconia implants used in this experiment was significantly less than that of the titanium implants by surface treatment of anodic oxidation. So, it is considered that the improvement of zirconia implant is needed through ongoing research on surface treatment methods for its practical use.

• 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.

• Journal of Dental Rehabilitation and Applied Science
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• v.33 no.2
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• pp.114-118
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• 2017

Purpose: The aim of this study was to investigate the effects of a titanium component for the zirconia abutment in the internal connection implant system on screw loosening under thermocycling conditions. Materials and Methods: Internal connection titanium abutments and external connection zirconia abutments with titanium sockets were connected respectively to screw-shaped internal connection type titanium implants with 30 Ncm tightening. These implant-screw-abutment assemblies were divided into two groups of five specimens each; titanium abutments as control and zirconia abutments with titanium sockets as experimental group. The specimens were subjected to 2,000 thermocycles in water baths at $5^{\circ}C$ and $55^{\circ}C$, with 60 seconds of immersion at each temperature. The removal torque values (RTVs) of the abutment screws of the specimen were measured before and after thermocycling. RTVs pre- and post-thermocycling were investigated in statistics. Results: There was not screw loosening identified by tactile and visual inspection in any of the specimens during or after thermocycling. The mean RTV difference for the control group and the experimental group were $-1.34{\pm}2.53Ncm$ and $-1.26{\pm}2.06Ncm$, respectively. Statistical analysis using an independent t-test revealed that no significant differences were found in the mean RTV difference of the groups (P > 0.05). Conclusion: Within the limitations of this in vitro study, the titanium socket for the zirconia abutment did not show a significant effect on screw loosening under thermal stress compared to the titanium abutment in the internal connection implant.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.1
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• pp.9-17
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• 2017

Purpose: The purpose of this study was to evaluate the fracture strength of straight and angled zirconia abutments for internal hex and external hex implants. Materials and methods: Twenty internal hex implants and 20 external hex implants were prepared. The prefabricated straight zirconia abutments and 17-degree-angled zirconia abutments were connected to those 40 implants. The specimens were classified into 4 groups depending on the connection type and abutment angulation; internal hex implant/straight abutment, group INS; internal hex implant/angled abutment, group INA; external hex implant/straight abutment, group EXS; external hex implant/angled abutment, group EXA. All specimens were loaded at a 30-degree angle with a crosshead speed of 1 mm/min using universal testing machine. The fracture loads were analyzed using 2-way ANOVA and independent t-test (${\alpha}=.05$). Results: The mean fracture load for INS was 955.91 N, 933.65 N for INA, 1267.20 N for EXS, and 1405.93 N for EXA. External hex implant showed a significantly higher fracture load, as compared to internal hex implant (P < .001). No significant differences in fracture loads were observed between the straight and angled abutment in internal hex implants (P = .747) and external hex implants (P = .222). Internal hexes of abutments were fractured horizontally in internal connection implants, while lingual cervical neck portions were fractured in external connection implants. Conclusion: The zirconia abutments with external hex implants showed significantly higher fracture strength than those with internal hex implants. However there was no difference in fracture strength between the straight and 17-degree-angled zirconia abutment connected to both implant systems.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.185-195
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• 2011

In this study, titanium abutments and zirconia abutments were connected to each implant in external type implants. After that they were loaded 10000 times with 20Kg as occlusal force. The surface changes of external hexgon part and platform were observed in FESEM image. Viker's hardness of an implant, a titanium abutment and a zirconia abutment were measured respectively. 1. Viker's hardness of an implants, a titanium abutment and a zirconia abutment was $309.80{\pm}11.78$ HV, $318.40{\pm}11.82$ HV, and $1495.30{\pm}16.21$ HV respectively. There was no statistical significance between an implant and a titanium abutment (P>0.05, Anova). However, there was statistical significance between an implant and a zirconia abutment(P<0.05, Anova). 2. The wear was observed at the joint of implant and abutment in both a titanium abutment group and a zirconia abutment group after loading 10,000 times. The zirconia abutment showed more remarkable wear than the titanium one. In conclusion, the wear of external hexagon and platform was much more notable in a zirconia abutment group than a titanium one. It was suggested that it could result from the difference of surface hardness between titanium and zirconia. The wear of junction between an implant and a zirconia abutment becomes more severe, the connection of an implant and an abutment is much more unfit. This is likely to cause loosening and fracture of the abutment screw. so it is considered that the possibility of implant supra-structure failure can be increased.

• The Journal of Korean Academy of Prosthodontics
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• v.55 no.2
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• pp.151-155
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• 2017

Purpose: The aim of this study was to evaluate screw removal torque of the two-piece zirconia abutment with the novel titanium component compared to the conventional one-piece titanium abutment in the internal connection implant before and after dynamic cyclic loading. Materials and methods: Two types of the abutment assemblies with internal connection were prepared and divided into the groups; titanium abutment-titanium abutment screw assemblies as control, and zirconia abutment-titanium socket-titanium abutment screw assemblies as experimental group. A total of 12 abutments and implants were used of six assemblies each group. Each assembly was tightened to 30 Ncm. A cyclic load of 300 N at an angle of 30 degrees in reference to the loading axis was applied until one million cycles or failure. The removal torque values (RTVs) of the abutment screws were measured with a digital torque gauge before and after cyclic loading. The RTVs of the pre load and post load were analyzed with t-test, and P-values < .05 were considered statistically significant. Results: The assemblies of both groups survived all after the dynamic cyclic loading test without screw loosening. The statistically significant differences were found between the mean RTVs before and after the cyclic loading in both groups (P < .05). The RTV differences for the control and the experimental group were $-7.25{\pm}1.50Ncm$ and $-7.33{\pm}0.93Ncm$, respectively. Statistical analysis revealed that the RTV differences in both groups were not significantly different from each other (P > .05). Conclusion: Within the limitation of this study, the two-piece zirconia abutment with the titanium component did not show a significant RTV difference of the abutment screw compared to the titanium abutment after dynamic cyclic loading.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.4
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• pp.469-477
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• 2021

For successful restoration of maxillary anterior implants, both pink esthetics and white esthetics must be satisfied. For pink esthetic part, the role of appropriate provisional prosthesis restoration is important, and for white esthetic part, the color and shape of the definitive prosthesis is important. Multilayer zirconia can be used for natural tooth appearance due to the higher transparency of the incisal area compared to the conventional monolithic zirconia. Therefore, in this case, white esthetic part was achieved through multilayer zirconia after recovering function and esthetics through appropriate provisional prosthesis in a patient who lost the maxillary anterior teeth.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.3
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• pp.319-326
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• 2012

For many years, ceramics have been used in fixed prosthodontics for achieving optimal esthetics. but, they have another use as well. Many studies today show ceramics can be used for biomaterials. In the beginning researchers made a start in the study of aluminium oxide and sapphire for biomaterial. The appearance of Zirconia began a new phase of research. Zirconia was introduced into implantology as an alternative to titanium, because of its white color, good mechanical properties and superior biocompatibility. But it is not easy to surface treatment in comparison with titanium. To overcome the limitation, interconnected porous bodies of zirconia were fabricated by sintering technique. And the technique of coating was developed. Therefore, some zirconia implants are currently available. It is thought that Research of biomaterials as a variety of puposes for the use of zirconia is looking very promising. The purpose of this paper reviews are to evaluation of zirconia as biomaterials.

• Journal of Dental Rehabilitation and Applied Science
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• v.34 no.3
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• pp.196-207
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• 2018

An accurate implant placement with ideal location is significant for long-term success of the implant. An exact evaluation of nearby anatomic structures such as quality of residual bone, an inferior alveolar bone and a maxillary sinus is required. For a prosthetic-driven treatment, planned surgery, precise prosthesis and communication with the patient are significant requisites especially for full-mouth rehabilitation. In this case, the patient with severe alveolar bone resorption had a CT guided surgery supported by CT data and the data from scanning diagnostic wax-up. Afterward, edentulous area was restored by full mouth implant-supported prosthesis by using monolithic zirconia and CAD/CAM technique. This paper reports the outcome of the procedure which was remarkable both esthetically and functionally.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.1
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• pp.81-92
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• 2014

It is so hard to obtain optimal anterior esthetics in the implant prosthesis. This is not only because of hard and soft tissue problem such as alveolar bone resorption and interdental papilla loss but also because of prosthetic limitation related to marginal exposure of metal abutment and metal ceramics and low transillumination. In this case, guided soft tissue healing is obtained using a long term provisional restoration with soft and hard tissue augmentation or immediate implantation. Then, this healed tissue is transferred to final master model using a customized impression coping and the implant is restored with a customized zirconia abutment and a all ceramics. This case presents satisfying result esthetically and functionally.