• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권4호
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• pp.295-300
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• 2011

Introduction: Hydroxyapatite(HA) coating implant can accelerate osseointegration, however, there are many controversies. Materials and Methods: This study examined the early osseointegration of two types of hydroxyapatite coated implants. Twelve adult male miniature pigs (Medi Kinetics Micropigs, Medi Kinetics Co., Ltd., Busan, Korea) were used in this study. In the implants placed in the mandible, a histomorphometric evaluation was performed to evaluate the bone-implant contact (BIC) ratio. Results: The BIC ratio increased with time. TS III HA and Zimmer HA were not significantly different (P>0.05). At 8 weeks, the BIC of Zimmer HA was higher than TS III HA, but there was no significant difference (P>0.05). Conclusion: HA coated implants will accelerate early osseointegration.

• 대한치과보철학회지
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• 제49권4호
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• pp.300-307
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• 2011

연구 목적: 본 연구에서는 난소절제술을 시행한 백서의 골결손부에 골이식을 시행하고 소형 임플란트를 제작하여 식립한 후 PostGraft$^{TM}$를 투여하여 임플란트의 골유착 및 안정성에 미치는 영향에 대해 알아보고자 하였다. 연구 재료 및 방법: 난소절제술을 시행한 백서 48 마리의 골결손부에 Biocera$^{TM}$를 사용하여 골이식을 시행하고 소형 임플란트를 제작하여 식립한 후 PostGraft$^{TM}$를 투여한 군 24마리와 투여하지 않은 대조군 24마리를 식립 2, 4, 6주 후 Periotest$^{(R)}$를 이용한 임플란트 안정성, 골밀도, 골-임플란트 접촉률 측정 및 조직학적 검사 등을 통하여 비교 분석하였다. 결과: Periotest$^{(R)}$ 측정 결과 시간이 지남에 따라 실험군과 대조군에서 모두 측정값이 감소하였고 실험군에서 더 낮은 값을 나타내었으나 각 군 간에 유의한 차이는 관찰되지 않았다. 골밀도 값은 골다공증으로 인해, 시간이 경과함에 따라 실험군과 대조군에서 모두 감소하였고 실험군에서 더 적은 감소량을 보였으나 각 군 간에 유의한 차이는 관찰되지 않았다. 골-임플란트 접촉률 측정 결과 시간이 경과함에 따라 실험군과 대조군 모두 증가하였고 실험군에서 더 높은 값을 보였으나 2주와 4주에서는 각 군 간에 유의한 차이가 없었고 6주에서는 각 군 간에 유의한 차이가 관찰되었다(P<.05). 조직학적 검사 결과 시간이 경과함에 따라 실험군과 대조군 모두 골반응이 증가하였으며 실험군에서 더 활발한 골형성이 이루어졌다. 결론: PostGraft$^{TM}$의 경구 투여가 난소절제술을 시행한 백서의 경골에 식립한 임플란트의 골유착과 골형성을 향상시키는 효과가 있을 수 있다.

• 구강회복응용과학지
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• 제19권4호
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• pp.257-268
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• 2003

The purpose of this study was to assess the loading distributing characteristics of implant prosthesis according to position and direction of load, under vertical and inclined loading using FEA analysis. The finite element model was designed according to standard fixture (4.1mm restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction (loading condition B), 200N at the centric usp in a $15^{\circ}$ inward oblique direction (loading condition C), 200N at the in a $30^{\circ}$ inward oblique direction (loading condition D) or 200N at the centric cusp in a $30^{\circ}$ outward oblique direction (loading condition E) individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant in both vertical and oblique loading but stresses in the cancellous bone were low in both vertical and oblique loading. 2. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading than with the vertical loading. 3. An offset of the vertical occlusal force in the buccolingual direction relative to the implant axis gave rise to increased bending of the implant. 4. The relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 5. The magnitude of the stress in the supporting bone, fixture and abutment screw was greater with the outward oblique loading than with the inward oblique loading and was the greatest under loading at the centric cusp in a $30^{\circ}$ outward oblique direction. Conclusively, this study provides evidence that bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. But it seems to be more important that how long is the distance from center of rotation of the implant itself to the resultant line of force from occlusal contact(leverage). The goal of improving implants should be to avoid bending of the implant.

• Archives of Reconstructive Microsurgery
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• 제15권2호
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• pp.111-116
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• 2006

An infection after total knee arthroplasty has many complications such as severe bone defect, skin and soft tissue problems, devastated general condition, so arthrodesis is preferred as treatment option. However, poor bony contact due to severe bone defect and inadequate conditions of the soft tissue often cause nonunion or severe limb shortening after arthrodesis. More over these conditions, it is not easy to choose appropriate fixative devices. In these situations, the arthrodesis using vascularized fibular graft can be the solution. Vascularized fibular graft (VFG) can playa role as a suitable material for the treatment of bone defects. And VFG can overcome poor blood circulation caused by scar tissues, and can be relatively more durable and adequate length. In the long term, VFG can be hypertrophied by weight bearing, and will give mechanical stablility. The purpose of the paper is to report the successful results of arthrodesis using VFG in a patient who got extensive bone defect after failed revision total knee arthroplasty with infection.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권4호
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• pp.712-717
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• 1996

The term osteomyelitis literally means inflammation of bone marrow. It is described as an inflammatory condition of bone primarily engaging the medullary cavity extending to the periosteum. Following circulatory collapse and ischemia, the involved portions of the bone become necrotic. Cellulitis and osteomyelitis are the most frequent complications of fractures of the mandible and maxilla, because there is an abscessed tooth in the line of fracture. Since most fractures are compound fractures, infection may develop because of contact with oral secretions or outside air. The treatment of chronic osteomyelitis is still under debate. Some authors rely on antibiotics alone, while others advocate combination with surgery. But when infection occurs, establish proper drainage and administer antibiotics. Author treated a case of infected mandibular fracture with mandibular osteotomy, sequestrectomy, iliac bone graft and hyperbaric oxygen therapy, who had suffered suppurative osteomyelitis and mandibular nonunion following the open reduction of the mandibular fracture.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제19권1호
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• pp.35-44
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• 1997

The most critical factor in determining which type of implant to be used would be the available bone of the patient. Usually a minimum of 5mm in the bone width and 8mm in the bone height is necessary to ensure primary implant stability and maintain the integrity of bone contact surface. Placement of implant is limited by the several anatomic strutures such as maxillary sinus, floor of the nose, inferior alveolar neurovascular bundle and nasopalatine foramen, etc. When severe resorption of alveolar ridge is encountered, implant placement would be a problematic procedure. A number of techniques to improve the poor anatomic situations have been proposed. This article reports 4 cases of patients using surgical procedures such as blade implant technique, cortical split technique in the anterior maxillary area, sinus lifting and lateral repositioning of inferior alveolar nerve, We treated dental implant candidates with unfavorable alveolar ridge utilizing various surgical techniques, resulted in successful rehabilitation of edentulous ridge.

• Biomaterials and Biomechanics in Bioengineering
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• 제3권2호
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• pp.85-104
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• 2016

Stability and loosening of implanted femoral stems in Total Hip Replacement have been well established as barriers to the primary concerns of osseointegration and long term implant survival. In-vitro experiments and finite element modeling have for years been used as a primary tool to assess the bone stem interface with variable methodologies leading to a wide range of micromotion, interference fit and stress shielding values in the literature. The current study aims to provide a comprehensive review of currently utilized methodologies for in-vitro mechanical testing as well as finite element modeling of both micromotion and interference of implanted femoral stems. A total of 12 studies detailed in 33 articles were selected for inclusion. Experimental values of micromotion ranged from 12 to $182{\mu}m$ while finite element analysis reported a wider range from 2.74 to $1,277{\mu}m$. Only two studies were found that modeled bone/implant contact with consideration for interference fit. In studies evaluating stem micromotion in THA, the reference surface at the bone/stem interface should be well defined. Additionally, the amount of penetration considered should be disclosed and associated with bone density and roughness.

• Journal of Periodontal and Implant Science
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• 제48권4호
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• pp.202-212
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• 2018

Purpose: Bone-to-implant contact (BIC) is difficult to measure on micro-computed tomography (CT) because of artifacts that hinder accurate differentiation of the bone and implant. This study presents an advanced algorithm for measuring BIC in micro-CT acquisitions using a spiral scanning technique, with improved differentiation of bone and implant materials. Methods: Five sandblasted, large-grit, acid-etched implants were used. Three implants were subjected to surface analysis, and 2 were inserted into a New Zealand white rabbit, with each tibia receiving 1 implant. The rabbit was sacrificed after 28 days. The en bloc specimens were subjected to spiral (SkyScan 1275, Bruker) and round (SkyScan 1172, SkyScan 1275) micro-CT scanning to evaluate differences in the images resulting from the different scanning techniques. The partial volume effect (PVE) was optimized as much as possible. BIC was measured with both round and spiral scanning on the SkyScan 1275, and the results were compared. Results: Compared with the round micro-CT scanning, the spiral scanning showed much clearer images. In addition, the PVE was optimized, which allowed accurate BIC measurements to be made. Round scanning on the SkyScan 1275 resulted in higher BIC measurements than spiral scanning on the same machine; however, the higher measurements on round scanning were confirmed to be false, and were found to be the result of artifacts in the void, rather than bone. Conclusions: The results of this study indicate that spiral scanning can reduce metal artifacts, thereby allowing clear differentiation of bone and implant. Moreover, the PVE, which is a factor that inevitably hinders accurate BIC measurements, was optimized through an advanced algorithm.

• 대한치과보철학회지
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• 제36권1호
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• pp.183-198
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• 1998

This study was designed to investigate the peri-implant tissue reaction in ovariectomized osteoporotic female rats, and to evaluate effects of estrogen, calcitonin, parathyroid hormone on the bone - implant interface in osteoporotic rats. 120 Sprague - Dawley rats were used in this experiments. Osteoporosis was induced by bilateral ovariectomy. They were divided 5 groups : sham-operated control group(Sham), ovariectomized group (OVX), OVX and estrogen treated group (OVX+E), OVX and PTH treated group (OVX+PTH), and OVX and calcitonin treated group (OVX+CT). Eight weeks after ovariectomy, two titanium screw implants were inserted into the left tibia of each rat. Eight weeks after the insertion of the implants, the periotest values (PTV) of implant were examined, and the rats were sacrificed, and examined the reaction of bone tissue surrounding the implant both histologically and histomorphometrically. The bone density and ash weight of opposite right tibia were examined. Over 40 rats were fractured on left tibia that was implant inserted. On histologically finding, all groups were osseointegrated well, especially in OVX+PTH group. In OVX group, tibial cortical bone showed many large harversian canal and microfracture lines. The OVX+PTH group showed the lowest mean PTV (-2.33) (p<0.05), and the hightest mean bone - implant contact percentage (89%) (p>0.05). But the OVX+CT group showed the highest mean bone density ($5.45mg/cm^3$) and ash weight (56.12%) (p<0.05). The results indicate that PTH treatment enhances osseointegration of implant in OVX rats, and CT treatment depresses bone turnover and prevent the development of osteopenia in OVX rats.

• 구강회복응용과학지
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• 제23권1호
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• pp.31-42
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• 2007

The purpose of this study was to compare the stress distribution according to the splinting condition and non-splinting conditions on the finite element models of the two units implant prostheses. The finite element model was designed with the parallel placement of two fixtures ($4.0mm{\times}11.5mm$) on the mandibular 1st and 2nd molars. A cemented abutment and gold screw were used for superstructures. A FEA models assumed a state of optimal osseointegration, as the bone quality, inner cancellous bone and outer 2 mm compact bone was designed. This concluded that the cortical and trabecular bone were assumed to be perfectly bonded to the implant. Splinting condition had 2 mm contact surface and non-splinting condition had $8{\mu}m$ gap between two implant prosthesis. Two group (Splinting and non-splinting) were loaded with 200 N magnitude in vertical axis direction and were divided with subdivision group. Subdivision group was composed of three loading point; Center of central fossa, the 2 mm and 4 mm buccal offset point from the central fossa. Von Mises stress value were recorded and compared in the fixture-bone interface and bucco-lingual sections. The results were as follows; 1. In the vertical loading condition of central fossa, splinting condition had shown a different von Mises stress pattern compared to the non-splinting condition, while the maximum von Mises stress was similar. 2. Stresses around abutment screw were more concentrated in the splinting condition than the non-splinting condition. As the distance from central fossa increased, the stress concentration increased around abutment screw. 3. The magnitude of the stress in the cortical bone, fixture, abutment and gold screw were greater with the 4 mm buccal offset loading of the vertical axis than with the central loading.