• The Journal of Korean Academy of Prosthodontics
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• v.56 no.1
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• pp.88-94
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• 2018

Recently, digital implant systems are expanding its influence in dental area. Due to technical improvement, they jumped over their limits nowadays. We can use these newest systems to treat edentulous patient, from implant surgery to fabrication of prosthesis. In this case, The patient was a fifty years old female. She had a full edentulous ridge on mandible and wanted to reconstruct occlusion with using implants. We planned to use digital implant system with "all-on-4" concept on mandible and produced surgical guide for flapless implant surgery. After the surgery, we tried to fabricate full arch prosthesis just using a digital devices and confirmed satisfying result.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.1
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• pp.70-81
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• 2009

Statement of problem: The position and length of cantilever influence on the stress distribution of implants, superstructure and bone. In edentulous mandible, implant-supported cantilever prostheses that based 4 or 6 implants between mental foramens has been attempted. Excessive bite force loaded at cantilever prosthesis causes bone resorption and breakage of superstructure prosthesis around posterior implants. To complement the cantilever length of conventional prosthesis, In 1992, (McCartney) introduced "cantilever-rest-implant" and Malo reported "All-on-Four" in 2003. Purpose: Analyze and compare the stress distribution of conventional cantilever prostheses with rest implant and All-on-$Four^{TM}$ implant prostheses. Material and method: The external loads(300 N vertically, 75 N horizontally) are applied to first molar area. The stress value, stress distribution and aspect of stress dispersion are analyzed by three-dimensional finite element analysis program, ANSYS ver. 10.0. Results: 1. The rest implant and "All-on-Four" implant system are superior to conventional cantilever prostheses to reduce stress on the bone and the superstructure around implants. 2. The rest implant was of the greatest advantage to stress distribution on bone, implant and superstructure. 3. With same number of implants, distally tilted implants are preferred to conventional cantilever prostheses for reducing the length of cantilever.

• 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 Advanced Prosthodontics
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• v.8 no.2
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• pp.85-93
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• 2016

PURPOSE. The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-retained overdenture. MATERIALS AND METHODS. Maxillary implant-retained overdentures with 4 implants placed in the anterior region of edentulous maxilla were converted into a 3-D numerical model, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional finite element analysis. RESULTS. In all experimental models, the highest stress was concentrated on the most distal implant and implant supporting bone on loaded side. The stress at the most distal implant-supporting bone was concentrated on the cortical bone. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant and implant supporting bone on loaded side. CONCLUSION. It could be suggested that when making maxillary implant retained overdenture, using Hader bar instead of milled bar and full palatal coverage rather than partial palatal coverage are more beneficial in distributing the stress that is applied on implant supporting bone.

• The Journal of Advanced Prosthodontics
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• v.6 no.4
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• pp.245-252
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• 2014

PURPOSE. To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS. Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS. Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION. In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.4
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• pp.580-610
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• 1993

The purpose of this study was to analyse the deflection and stress distribution at the supporting bone and it's superstructure by the alteration of angulation between implant and it's implant abutment. For this study, the free-end saddle case of mandibular first and second molar missing would be planned to restore with fixed prosthesis. So the mandibular second premolar was prepared for abutment, and the cylinder type osseointegrated implant was placed at the site of mandibular second molar for abutment. The finite element stress analysis was applied for this study. 13 two-dimensional FEM models were created, a standard model at $0^{\circ}$ and 12 models created by changing the angulation between implant and implant abutment as increasing the angulation mesially and distally with $5^{\circ}$ unittill $30^{\circ}$. The preprocessing decording, solving and postprocessing procedures were done by using FEM analysis software PATRAN and SUN-SPARC2GX. The deflections and von Mises stresses were calculated under concentrated load (load 1) and distributed load(load 2) at the reference points. The results were as follows : 1. Observing at standard model, the amount of total deflection at the distobuccal cusp-tip of pontic under concentrated load was largest of all, and that at the apex of implant was least of all, and the amount of total deflection at the buccal cusp-tip of second premolar under distributed load was largest of all, and that at the apex of implant was least of all. 2. Increasing the angulation mesially or distally, the amounts of total deflection were increased or decreased according to the reference points. But the order according to the amount of total deflection was not changed except apex of second premolar and central fossa of implant abutment under concentrated load during distal inclination. 3. Observing at standard model, the von Mises stress at the distal joint of pontic under concentrated load was largest of all, and that at the apex of implant was least of all. The von Mises stress at the distal margin of second premolar under distributed load was largest of all, and that at the apex of Implant was least of ail. 4. Increasing the angulation of implant mesially, the von Mises stresses at the mesial crest of implant were increased under concentrated load and distributed load, but those were increased remarkably under distributed load and so that at $30^{\circ}$ mesial inclination was largest of all. 5. Increasing the angulation of implant distally, the von Mises stresses at the distal crest of implant were increased remarkably under concentrated load and distributed load, and so those at $30^{\circ}$ distal inclination were largest of all.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.5
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• pp.662-670
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• 2005

Statement of problem: Little is known about the effect of abutment preparation procedure on do-torque values in different implant platform and the relationship of final do-torque values with different implant platform size. Purpose: This study evaluated the effect of abutment preparation procedure on do-torque values in different implant platform and the relationship of final do-torque values with different implant platform size. Material and method: Six ITI implants (2 narrow-neck implants, 2 regular-neck implants, 2 wide-neck implants) and six Branemark implants (2 narrow platforms, 2 regular platforms, 2 wide platforms) were embedded in each acrylic resin block with epoxy resin. Eighteen $synOcta^(R)$ abutments (6 narrow-neck implant-abutments, 6 regular-neck implant-abutments, 6 wide-neck implant-abutments) and eighteen esthetic abutments (6 narrow platform-abutments, 6 regular platform-abutments, 6 wide platform-abutments) were tightened to each implant with digital torque gauge. Initial do-torque values were measured using digital torque gauge. After preparation of abutments, Final do-torque values were measured with digital torque gauge. Results and conclusion: 1. Screws loosening or abutments motion were not detected in all experimental group, but some scratches of implant-abutment joints were detected in all group 2. Reduction ratios of final do-torque values were greater than initial do-torque values in all measured group, except in narrow-neck implant-abutment group (p<0.05). 3. Reduction ratios of final do-torque values in wide-neck implant-abutment group were greater than regular-neck implant-abutment group (p<0.01). 4. The greatest standard deviation value was detected in wide platform group in both implant systems.

• Journal of Periodontal and Implant Science
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• v.53 no.2
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• pp.145-156
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• 2023

Purpose: The significance of keratinized tissue for peri-implant health has been emphasized. However, there is an absence of clinical evidence for the use of a xenogeneic collagen matrix (XCM) to manage peri-implant mucositis and peri-implantitis. Therefore, the purpose of this study was to investigate outcomes after keratinized tissue augmentation using an XCM for the management of peri-implant diseases. Methods: Twelve implants (5 with peri-implant mucositis and 7 with peri-implantitis) in 10 patients were included in this study. Non-surgical treatments were first performed, but inflammation persisted in all implant sites. The implant sites all showed a lack of keratinized mucosa (KM) and vestibular depth (VD). Apically positioned flaps with XCM application were performed. Bone augmentation was simultaneously performed on peri-implantitis sites with an intrabony defect (>3 mm). The following clinical parameters were measured: the probing pocket depth (PPD), modified sulcular bleeding index (mSBI), suppuration (SUP), keratinized mucosal height (KMH), and VD. Results: There were no adverse healing events during the follow-up visits (18±4.6 months). The final KMHs and VDs were 4.34±0.86 mm and 8.0±4.05 mm, respectively, for the sites with peri-implant mucositis and 3.29±0.86 mm and 6.5±1.91 mm, respectively, for the sites with peri-implantitis. Additionally, the PPD and mSBI significantly decreased, and none of the implants presented with SUP. Conclusions: Keratinized tissue augmentation using an XCM for sites with peri-implant mucositis and peri-implantitis was effective for increasing the KMH and VD and decreasing peri-implant inflammation.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.397-411
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• 2004

Purpose: The purpose of this study was to determine the effect of anchorage systems and palatal coverage of denture base on load transfer in maxillary implant-supported overdenture. Material and methods: Maxillary implant -supported overdentures in which 4 implants were placed in the anterior region of edentulous maxilla were fabricated, and stress distribution patterns in implant supporting bone in the case of unilateral vertical loading on maxillary right first molar were compared with each other depending on various types of anchorage system and palatal coverage extent of denture base using three-dimensional photoelastic stress analysis. Two photoelastic overdenture models were fabricated in each anchorage system to compare with the palatal coverage extent of denture base, as a result we got eight models : Hader bar using clips(type 1), cantilevered Hader bar using clips(type 2), Hader bar using clip and ERA attachments(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4). Result: 1. In all experimental models, the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. In every experimental models with or without palatal coverage of denture base, maximum fringe orders on the distal ipsilateral implant supporting bone in an ascending order is as follows; type 3, type 1, type 4, and type 2. 3. Each implants showed compressive stresses in all experimental models with palatal coverage of denture base, but in the case of those without palatal coverage of denture base, tensile stresses were observed in the distal contralateral implant supporting bone. 4. In all anchorage system without palatal coverage of denture base, higher stresses were concentrated on the most distal implant supporting bone on loaded side. 5. The type of anchorage system affected in load transfer more than palatal coverage extent of the denture base. Conclusion: To the results mentioned above, in the case of patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant, and poor bone quality, selecting a resilient type attachment or minimizing the distal cantilevered bar is considered to be an appropriate method to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• The Journal of Advanced Prosthodontics
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• v.13 no.4
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• pp.216-225
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• 2021

PURPOSE. The aim of this study is to evaluate the effects of canine guidance occlusion and group function occlusion on the degree of stress to the bone, implants, abutments, and crowns using finite element analysis (FEA). MATERIALS AND METHODS. This study included the implant-prosthesis system of a three-unit bridge made of monolithic zirconia and hybrid abutments. Three-dimensional (3D) models of a bone-level implant system and a titanium base abutment were created using the original implant components. Two titanium implants, measuring 4 × 11 mm each, were selected. The loads were applied in two oblique directions of 15° and 30° under two occlusal movement conditions. In the canine guidance condition, loads (100 N) were applied to the canine crown only. In the group function condition, loads were applied to all three teeth. In this loading, a force of 100 N was applied to the canine, and 200-N forces were applied to each premolar. The stress distribution among all the components of the implant-bridge system was assessed using ANSYS SpaceClaim 2020 R2 software and finite element analysis. RESULTS. Maximum stress was found in the group function occlusion. The maximum stress increased with an increase in the angle of occlusal force. CONCLUSION. The canine guidance occlusion with monolithic zirconia crown materials is promising for implant-supported prostheses in the canine and premolar areas.