• Journal of Periodontal and Implant Science
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• v.50 no.5
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• pp.340-354
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• 2020

Purpose: This pilot study was conducted to evaluate the cleaning efficacy of an angled implant brush for home oral hygiene of full-arch fixed-implant prostheses. Methods: Forty-one patients treated with a full-arch implant rehabilitation in the maxilla or mandible (164 implants) for at least 4 months were enrolled. The screw-retained fixed prostheses were removed and baseline (T0) parameters were recorded, including plaque index (PI), probing depth (PD), and bleeding on probing (BOP). All patients completed a 5-item questionnaire on hygiene maintenance and received an implant brush for home hygiene. After 1 month (T1) PI, PD, and BOP were recorded again and patients completed a 7-item questionnaire to evaluate their satisfaction with the implant brush. One-way repeated-measures analysis of variance was conducted to evaluate the significance of changes in PI, PD, and BOP. A P value <0.05 was considered to indicate statistical significance. Results: A statistically significant reduction of BOP (0.62±0.6 at T0 vs. 0.5±0.5 at T1; P=0.032) was found, while no statistically significant changes in PD (1.74±0.5 mm at T0 vs. 1.77±0.5 mm at T1; P=0.050) or PI (1.9±0.7 at T0 vs. 1.7±0.7 at T1; P=0.280) occurred. According to the 7-item questionnaire, patients reported no difficulty in using the angled brush (63.4%) and deemed it highly (46.3%) or very highly (4.8%) effective in improving their home oral hygiene. Conclusions: Within the limits of the present pilot study, the patients experienced a reduction of BOP 1 month after being instructed to use the angled implant brush. The angled implant brush appeared to be a well-accepted device for home-care hygiene of full-arch fixed-implant rehabilitations.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.209-231
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• 1999

Even though titanium(Ti) and its alloys are the most used dental implant materials, there are some problems that Ti wears easily and interferes normal osteogenesis due to the metal ions. Ti coated with bioactive ceramics such as hydroxyapatite has also such problems as the exfoliation or resorption of the coated layer, Recent studies on implant materials have been proceeding to improve physical properties of the implant substrate and biocompatibility of the implant surfaces. The purpose of the present study was to examine the physical property and bone tissue compatibility of bioinert nitrides ion plated Ti, Button type specimens(14mm in diameter, 2.32rrun in height) for the abrasion test and cytotoxicity test and thread type implants(3.75mm in diameter, 6mm in length) for the animal experiments were made from Ti(grade 2) and 316LVM stainless steel. Ti specimens were ion plated with TiN, ZrN by the low temperature arc vapor deposition, and the depth profile of the TiN/Ti, ZrN/Ti ion plated surface was examined by Auger Electron Spectroscopy. Three kind of button type specimens .of TiN/Ti, ZrN/Ti and Ti were used for abrasion test, and HEPAlClC7 cells and CCD cells were cultivated for 4 days with the specimens for cytotoxicity test. Thread type implants of TiN/Ti, ZrN/Ti, Ti, 316LVM were implanted on the femur of 6 adult dogs weighing 10kg-13kg. Two dogs were sacrified for histological examination after 45 days and 90 days, and four dogs were sacrified for the removal torque test of the implant') after 90 days. The removal torque force was measured by Autograph (Shimadzu Co., AGS-1000D series, Japan). Abrasion resistance of TiN/Ti was the highest, and that of ZrN/Ti and Ti were followed. The bioinert nitride ion plated Ti had much better abrasion resistance, compared with Ti, In the cytotoxicity test, the number of both cells were increased in all specimens, and there were no significant difference in cytotoxic reaction among all groups (p>0.1), In histological examination, 316LVM showed the soft tissue engagement in interface between the implant and bone, but the other materials after 45 days noted immature new bone formation in the medullary portion along the implant surface, and those after 90 days showed implant support by new bone formation in both the cortical and the medullary portion, The removal torque force of Tilv/Ti showed significantly higher than that of Ti(p(O,05). The difference in removal torque force between TiN/Ti and ZrN/Ti was not significant(p>0.05), and that of 316LVM was lowest among all groups(p<0.05). These results suggest that bioinert nitrides ion plated Ti can resolve the existing problems of Ti and bioactive ceramics, and it may be clinically applicable to human.

• 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.

• Journal of Periodontal and Implant Science
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• v.47 no.2
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• pp.106-115
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• 2017

Purpose: The possibility of immediate or early loading has become popular in implant dentistry. A prerequisite for the immediate or early loading of an implant prosthesis is the achievement of initial stability in the implant. Moreover, in response to clinicians' interest in verifying clinical stability to determine the optimal time point for functional loading, a non-invasive method to assess implant stability has been developed on the basis of resonance frequency analysis (RFA). The primary objective of this study was to monitor the stability of sandblasted, large-grit, and acid-etched (SLA) implants with different diameters during the early phases of healing by RFA. The secondary objective was to evaluate how the initial stability of implants varied depending on different surface modifications and other contributing factors. Methods: Thirty-five implants (25 SLA implants and 10 resorbable blasting media [RBM] implants) placed in 20 subjects were included. To measure implant stability, RFA was performed at baseline and at 1, 2, 3, 4, 6, and 10 weeks after surgery. Results: The longitudinal changes in the implant stability quotient (ISQ) values were similar for the SLA implants with different diameters and for the RBM implants. During the initial healing period, the ISQ decreased after installation and reached its lowest values at 1 week and 2 weeks, respectively. The mean ISQ values in the SLA implants were significantly higher in ${\varnothing}5.0mm$ implants than in ${\varnothing}4.0mm$ implants. Men showed a higher ISQ than women. Mandibular sites showed a higher ISQ than maxillary sites. Conclusions: All implants used in this study are suitable for immediate or early loading under appropriate indications. A wider diameter and SLA surface treatment of implants could improve the stability, if the implant is fixed with at least 30 Ncm of insertion torque.

• Journal of Periodontal and Implant Science
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• v.43 no.1
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• pp.41-46
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• 2013

Purpose: The objective of this study was to evaluate the effect of microthreads on removal torque and bone-to-implant contact (BIC). Methods: Twelve miniature pigs for each experiment, a total of 24 animals, were used. In the removal torque analysis, each animal received 2 types of implants in each tibia, which were treated with sandblasting and acid etching but with or without microthreads at the marginal portion. The animals were sacrificed after 4, 8, or 12 weeks of healing. Each subgroup consisted of 4 animals, and the tibias were extracted and removal torque was measured. In the BIC analysis, each animal received 3 types of implants. Two types of implants were used for the removal torque test and another type of implant served as the control. The BIC experiment was conducted in the mandible of the animals. The $P_1-M_1$ teeth were extracted, and after a 4-month healing period, 3 each of the 2 types of implants were placed, with one type on each side of the mandible, for a total of 6 implants per animal. The animals were sacrificed after a 2-, 4-, or 8-week healing period. Each subgroup consisted of 4 animals. The mandibles were extracted, specimens were processed, and BIC was analyzed. Results: No significant difference in removal torque value or BIC was found between implants with and without microthreads. The removal torque value increased between 4 and 8 weeks of healing for both types of implants, but there was no significant difference between 8 and 12 weeks. The percentage of BIC increased between 2 and 4 weeks for all types of implants, but there was no significant difference between 4 and 8 weeks. Conclusions: The existence of microthreads was not a significant factor in mechanical and histological stability.

• The Journal of Advanced Prosthodontics
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• v.12 no.2
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• pp.75-82
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• 2020

PURPOSE. The aim of this study was to investigate the shear bond strength of luting cements used with implant retained restorations on to titanium specimens after different surface treatments. MATERIALS AND METHODS. One hundred twenty disc shaped specimens were used. They were divided into three groups considering the surface treatments (no treatment, sandblasting, and oxygen plasma treatment). Water contact angle of specimens were determined. The specimens were further divided into four subgroups (n=10) according to applied cement types: polycarboxylate cement (Adhesor Carbofine-AC), temporary zinc oxide free cement (Temporary CementZOC), non eugenol provisional cement for implant retained prosthesis (Premier Implant Cement-PI), and non eugenol acrylic-urethane polymer based provisional cement for implant luting (Cem Implant Cement-CI). Shear bond strength values were evaluated. Two-way ANOVA test and Regression analysis were used to statistical analyze the results. RESULTS. Overall shear bond strength values of luting cements defined in sandblasting groups were considerably higher than other surfaces (P<.05). The cements can be ranked as AC > CI > PI > ZOC according to shear bond strength values for all surface treatment groups (P<.05). Water contact angles of surface treatments (control, sandblasting, and plasma treatment group) were 76.17° ± 3.99, 110.45° ± 1.41, and 73.80° ± 4.79, respectively. Regression analysis revealed that correlation between the contact angle of different surfaces and shear bond strength was not strong (P>.05). CONCLUSION. The retentive strength findings of all luting cements were higher in sandblasting and oxygen plasma groups than in control groups. Oxygen plasma treatment can improve the adhesion ability of titanium surfaces without any mechanical damage to titanium structure.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.4
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• pp.291-296
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• 2003

The use of resonance frequency analysis (RFA) provides a possibility to clinically measure implant stability and osseointegration. The implant stability quotient (ISQ) value of RFA is well known that influenced by effective abutment length and stiffness of the implant in the surrounding tissues. Among these factors stiffness is not accurately defined histologically yet. And the purpose of this study was to find the histolgical relationship of RFA. 17 implants in 3 beagle dogs were used for this study. Among these implants 10 were survived for 7 months, 4 were survived for 3 months and 3 were immediate status after placement. Resonance frequency analyses were conducted and the dogs were sacrificed. Percentage of the bone to implant contact (BIC) in the interface, percentage of the mineralized bone (bone area) within the threads of the implant, and marginal bone level were measured under light microscopy. The correlation between resonance frequency and histomorphometric measurements were analysed and following results were obtained. 1. There was statistically significant correlation between ISQ value and BIC on healed implants. But ISQ value and BIC of all implants were not significantly correlated. (P<0.01) 2. Significant correlation between ISQ value and bone area was not found in this study. 3. There was statistically significant correlation between ISQ value and marginal bone level on all implants as well as on healed implants. (P<0.01).

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.535-542
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• 2007

Background : Repeated dis/re-connection of implant abutment caused bone loss around implant fixtures due to the new formation of biologic width of the mucosal-implant barrier. The aim of this clinical study was to evaluate whether the repeated dis/re-connection of implant abutment cause bone loss clinically and the effect of cleansing methods on a bone loss during the early healing period. Methods : A total 50 implants were installed in 20 patients and repeated dis/re-connection of abutment was performed at the time of surgery and once per week for 12 weeks. 0.9% normal saline solution as group1 and 0.1% chlorhexidine solution as group 2 was used to clean abutments. All patients had radiographs taken at the placement of implant and 4, 8, and 12 weeks postoperatively. The data for bone loss around implant were analyzed. Results: The marginal bone loss at 12 weeks were $1.28{\pm}0.51mm$, $1,32{\pm}0,57mm$ in the mesial and distal sides in group1, $1.94{\pm}0.75mm$, $1.81{\pm}0.84mm$ in group 2, respectively. In view of marginal bone loss, there was not a significant statistical difference between groups. Conclusions : Repeated dis/re-connection of implant abutment may not cause marginal bone loss around implant fixture although limited samples and short-term observation period. In spite of more bone loss in group 2, there was no statistical significant difference between groups. In context of those results, the clinical significance of the repeated dis/re-connection of implant abutment and the cleansing method of abutments is debatable when it comes to marginal bone loss during early healing period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.42 no.6
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• pp.345-351
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• 2016

Objectives: This study compared the impact of implant surface treatment on the stability and osseointegration of implants in dog mandibles. Materials and Methods: Six adult dogs received a total of 48 implants that were prepared using four different surface treatments; resorbable blast media (RBM), hydroxyapatite (HA), hydrothermal-treated HA, and sand blasting and acid etching (SLA). Implants were installed, and dogs were separated into 2- and 4-week groups. Implant stability was evaluated via Periotest M, Osstell Mentor, and removal torque analyzers. A histomorphometric analysis was also performed. Results: The stability evaluation showed that all groups generally had satisfactory values. The histomorphometric evaluation via a light microscope revealed that the HA surface implant group had the highest ratio of new bone formation on the entire fixture. The hydrothermal-treated HA surface implant group showed a high ratio of bone-to-implant contact in the upper half of the implant area. Conclusion: The hydrothermal-treated HA implant improved the bone-to-implant contact ratio on the upper fixture, which increased the implant stability.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.1
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• pp.31-69
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• 1996

The purpose of this investigation was to analyze stress distribution in implant supporting tissue according to different types of attachments such as combination bar attachment, Hader bar attachment, O-Ring attachment and Dal-Ro attachment that are used in mandibular overdenture by using two osseointegrated implants, to study the influence that POM IMC used in bar type attachment has in implant supporting tissue and compare the preceding analyses to find out an effective stress distribution method. Three dimensional photoelastic method was used to obtain the following results. (A) Analysis of stress distribution according to attachment type 1. Under vertical load condition, compressive stress was seen at implant supporting area of working side on all the photoelastic models but in Hader bar attachment tensional stress was seen at distal upper area of implant supporting area. Relatively Hader bar and O-Ring attachment showed even stress distribution pattern. 2. Under vertical load condition, compressive stress at implant apex area and tensional stress at implant lateral supporting area were seen at nonworking side of all models. 3. Under $25^{\circ}$ lateral load condition, general compressive stress was seen at working side implant supporting area in most of the models, especially at distal upper supporting area higher compressive stress concentration was seen in combination bar attachment and tensional stress concentration, in Hader bar attachment. 4. Under $25^{\circ}$ lateral load condition, compressive stress at implant apex area and tensional stress at implant lateral supporting area were seen at nonworking side of all models, except O-Ring model which showed compressive stress only. (B) Influence of POM IMC to stress distribution in bar type attachment 5. Under vertical load condition, better stress distribution pattern was seen at working side of combination bar and Hader bar attachment model using POM IMC. 6. Under vertical load condition, stress value was increased at nonworking side of combination bar attachment model using POM IMC and tendency of increasing compression was seen at nonworking side of Hader bar attachment model using POM IMC. 7. Under $25^{\circ}$ lateral load condition, better stress distribution pattern was seen at working side of combination bar attachment model using POM IMC but tendency of increasing stress was seen on working side of Hader bar attachment model using POM IMC. 8. Under $25^{\circ}$ lateral load condition, stress reduction was seen at nonworking side of combination bar attachment model using POM IMC but tendency of increasing stress was seen at nonworking side of Hader bar attachment model using POM IMC.