• The Journal of Advanced Prosthodontics
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• 제13권1호
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• pp.12-23
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• 2021

Purpose. The aim of the study was to compare the lingualized implant placement creating a buccal cantilever with prosthetic-driven implant placement exhibiting excessive crown-to-implant ratio. Materials and Methods. Based on patient's CT scan data, two finite element models were created. Both models were composed of the severely resorbed posterior mandible with first premolar and second molar and missing second premolar and first molar, a two-unit prosthesis supported by two implants. The differences were in implants position and crown-to-implant ratio; lingualized implants creating lingually overcontoured prosthesis (Model CP2) and prosthetic-driven implants creating an excessive crown-to-implant ratio (Model PD2). A screw preload of 466.4 N and a buccal occlusal load of 262 N were applied. The contacts between the implant components were set to a frictional contact with a friction coefficient of 0.3. The maximum von Mises stress and strain and maximum equivalent plastic strain were analyzed and compared, as well as volumes of the materials under specified stress and strain ranges. Results. The results revealed that the highest maximum von Mises stress in each model was 1091 MPa for CP2 and 1085 MPa for PD2. In the cortical bone, CP2 showed a lower peak stress and a similar peak strain. Besides, volume calculation confirmed that CP2 presented lower volumes undergoing stress and strain. The stresses in implant components were slightly lower in value in PD2. However, CP2 exhibited a noticeably higher plastic strain. CONCLUSION. Prosthetic-driven implant placement might biomechanically be more advantageous than bone quantity-based implant placement that creates a buccal cantilever.

• Journal of Periodontal and Implant Science
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• 제52권5호
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• pp.411-421
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• 2022

Purpose: In this study, we aimed to evaluate the degree of heat generation when a novel drill design with an irrigation slot was used with metal sleeve-free (MF) and metal sleeve-incorporated (MI) surgical guides in an environment similar to that of the actual oral cavity. Methods: A typodont with a missing mandibular right first molar and 21 bovine rib blocks were used. Three-dimensional-printed MF and MI surgical guides, designed for the placement of internal tapered implant fixtures, were used with slot and non-slot drills. The following groups were compared: group 1, MI surgical guide with slot drill; group 2, MI surgical guide with a non-slot drill; and group 3, MF surgical guide with a slot drill. A constant-temperature water bath at 36℃ was used. The drilling was performed in 6 stages, and the initial, highest, and lowest temperatures of the cortical bone were measured at each stage using a non-contact infrared thermometer. Results: There were no temperature increases above the initial temperature in any drilling procedure. The only significant difference between the non-slot and slot groups was observed with the use of the first drill in the MI group, with a higher temperature in the non-slot group (P=0.012). When the heat generation during the first and the second drilling was compared in the non-slot group, the heat generation during the first drilling was significantly higher (P<0.001), and there was no significant difference in heat generation between the drills in the slot group. Conclusions: Within the limitations of this study, implant-site preparation with the surgical guide showed no critical increase in the temperature of the cortical bone, regardless of whether there was a slot in the drill. In particular, the slotted drill had a cooling effect during the initial drilling.

• 대한치과보철학회지
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• 제47권4호
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• pp.445-456
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• 2009

연구목적: 임플란트를 이용한 수복의 임상적인 성공에 중요한 역할을 하는 초기 골유착의 향상을 위해 티타늄의 표면 거칠기 조절과 함께 생체활성도를 가진 표면으로 변화시키는 방법에 관한 연구가 이루어지고 있다. 표면 거칠기의 적절한 증가는 조골세포의 활동을 증가시키고 골과 임플란트의 접촉과 유지를 촉진시킨다고 보고되고 있고 또한 알칼리와 열처리를 통하여 생체 활성 표면을 얻을 수 있는 것으로 보고되고 있다. 이에 본 연구에서는 알칼리 및 열을 이용한 티타늄 표면 처리가 골유착에 어떤 영향을 미치는지 알아보고자 하였다. 연구재료 및 방법: 기계절삭된 임플란트를 대조군으로 하여 (1군), 5 M NaOH 용액에 처리한 임플란트를 대기 중에서 열처리한 군 (2군)과 진공에서 열처리한 군 (3군)으로 분류하였다. 알칼리와 열처리를 시행한 임플란트들의 표면 특성을 관찰하고 가토에 식립하여 치유 기간에 따라서 조직학적 및 조직형태계측학적으로 비교하고 EPMA (Electron Probe Micro Analyzer)를 이용하여 치유 기간 별 골성분의 변화를 분석하였다. 결과 및 결론: 대기 중에서 열처리한 2군이 통계적으로 유의하게 (P<.05) 증가된 표면 거칠기를 보였다. 이렇게 만들어진 임플란트를 가토에 식립하여 조직 형태계측학적 분석을 시행한 결과 골-임플란트 접촉율은 전반적으로 치유기간이 경과하면서 증가하는 것으로 나타났으며 2군과 3군에서 통계적 분석결과 치유기간 간에 유의한 차이가 관찰되었고 (P<.05), 골-임플란트 면적율 (BA) 또한 골 임플란트 접촉율과 비슷한 양상을 보였으며 통계적 분석결과 2군에서만 치유기간별로 통계적으로 유의한 차이가 관찰되었다 (P<.05). 치유 기간별로 임플란트 주변 골에서 칼륨 (K), 인 (P), 칼슘 (Ca), 티타늄 (Ti)의 분포를 EPMA로 보았을 때 빈도의 편향은 관찰되지 않았으며 2군과 3군에서 초기에 칼슘과 인이 증가되는 것이 관찰되었다. 이상의 결과로 볼 때 알칼리 및 대기 중에서 열처리로 표면 처리된 임플란트의 사용은 초기에 안정된 골유착에 도움을 주며 임플란트 식립 후 기능까지의 시간을 감소시킬 것으로 사료된다.

• 한국가금학회지
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• 제18권3호
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• pp.141-150
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• 1991

국내에서 분리된 CAA의 병아리에 대한 병원성시험과 야외계군에서의 CAA에 대한 항체 보유상황을 조사한 결과 다음과 같은 결론을 얻었다. 1. CAA국내 분리주 89-69를 감수성이 있는 1일령의 SPF병아리에 접종하였을 때 접종 14일 후 심한 빈혈과 흉선 및 Fabricius낭의 위축이 유발되었고 접종계 및 그 동거계에서 CAA가 재분리되었다. 2. CAA분리주 89-69를 유래가 다른 1일령의 SPF 두 계군의 병아리에 각각 근육접종하였을 때 두 계군간 CAA분리주에 대한 감수성의 차이를 보여 주었으며 이는 이 두 계군에서의 CAA에 대한 항체보유율과 관련이 있었다. 3. 간접형광항체반응 시험으로 야외계군에서의 CAA에 대한 항체보유상항을 조사한 결과 39계군중 29계군(74％)이 CAA에 대한 항체를 보유한 것으로 나타났으며 두 SPF계군중 한 SPF계군에서도 항체가 검출되었다.

• 대한심미치과학회지
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• 제10권1호
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• pp.30-45
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• 2001

In recent years, clinicians' and dentists' esthetic demands in dentistry have increased rapidly. The ultimate goal in modern restorative dentistry is to achieve "white" and "pink" esthetics in the esthetically important zones. Therefore, modern esthetic dentistry involves not only the restoration of lost teeth and their associated hard tissues, but increasingly the management and reconstruction of the encasing gingiva with adequate surgical techniques. Interdental space are filled by interdental papilla in the healthy gingiva, preventing plaque deposition and protecting periodontal tissue from infection. This also inhibits impaction of food remnants and whistling through the teeth during speech. These functional aspects are obviously important, but esthetic aspects are important as well. Complete and predictable restoration of lost interdental papillae remains one of the biggest challenges in periodontal reconstructive surgery. One of the most challenging and least predictable problems is the reconstruction of the lost interdental papilla. The interdental papilla, as a structure with minor blood supply, was left more or less untouched by clinicians. Most of the reconstructive techniques to rebuild lost interdental papillae focus on the maxillary anterior region, where esthetic defects appear interproximally as "black triangle". Causes for interdental tissue loss are, for example, commom periodontal diseases, tooth extraction, excessive surgical periodontal treatment, and localized progressive gingiva and periodontal diseases. If an interdental papilla is absent because of a diastema, orthodontic closure is the treatment of choice. "Creeping" papilla formation has been described by closing the interdental space and creating a contact area. In certain cases this formation can also be achieved with appropriate restorative techniques and alteration of the mesial contours of the adjacent teeth. The presence of an interdental papilla depends on the distance between the crest of bone and the interproximal contact point, allowing it to fill interdental spaces with soft tissue by altering the mesial contours of the adjacent teeth and positioning the contact point more apically. The interdental tissue can also be conditioned with the use of provisional crowns prior to the definitive restoration. If all other procedures are contraindicated or fail, prosthetic solutions have to be considered as the last possibility to rebuild lost interdental papillae. Interdental spaces can be filled using pink-colored resin or porcelain, and the use of a removable gingival mask might be the last opportunity to hide severe tissue defects.

• 대한통합의학회지
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• 제9권4호
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• pp.85-89
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• 2021

Background : Klippel-Trenaunay-Weber syndrome (KTS) is a rare congenital medical condition characterized by complex vascular malformation. KTS consists of a classic triad of capillary malformation (hemangioma), venous malformations and bone or soft tissue hypertrophy causing limb asymmetry. The aim of this report is to describe management for gait disturbance and foot pain in a Patient with KTS using custom-made total contact insole. Case presentation : A 32-year-old man with KTS presented with a 3-year history of gait disturbance on hard surface due to right first toe pain and Achilles tendon tightness. The patient had soft tissue hypertrophy, varicose veins and port-wine stains over the right lower limb associated with KTS. True leg length discrepancy was 2 cm. We prescribed custom-made total contact insole to protect his deformed foot and correct leg length discrepancy. The insole of right side included wedge shaped heel lift and the insole of left side included full length lift to add extra support on unaffected side. Also, we provided compression stocking and physiotherapy including manual lymphatic drainage for lymphedema and stretching exercise for tightness in right lower extremity. At 3 years follow-up, postural alignment including pelvic obliquity was improved using a custom-made total contact insole. The degree of scoliosis and foot pain were also reduced. Conclusion : An individualized and multidisciplinary approach is essential regarding the complexity of comorbidities in patients with KTS. For patients with KTS, orthotic management should be considered to prevent and correct deformities related to KTS. Active orthotic management, compression stocking and physiotherapy can enhance the quality of life and function in patients.

• Journal of Periodontal and Implant Science
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• 제33권2호
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• pp.301-310
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• 2003

The purpose of this study is to evaluate the biocompatibility and the biorsorbability of several types of calcium polyphosphate made through change of manufacturing process for 12 month. To solve limitation of calcium phosphate, we developed a new ceramic, Calcium Polyphosphate(CPP), and report the biologic response to CPP in extraction sites of beagle dog. Porous CPP blocks were prepared by condensation of anhydrous $Ca(H_2PO_4)_2$ to form non-crystalline $Ca(PO_3)_2$ and then milled to produce CPP powder. CPP powder, CPP block, and CPP granules added with $Na_2O$ were implanted in extraction sockets and histologic observation were performed at 12 months later. Like 3 months results, histologic observation at 12 months revealed that CPP matrix were mingled with and directly apposed to new bone without any adverse tissue reaction, CPP powder show direct bony contact, but new bone formation and fibrous tissue encapsulation showed in CPP block. 10% $Na_2O$ CPP granules show more inflammatory cells infiltration around graft materials compared at 3 month, but 15% $Na_2O$ CPP granules show less. This result revealed that regardless of addition of $Na_2O$, CPP had a high affinity for bone and had been resorbed slowly. From this results, it was suggested that CPP is promising ceramic as a bone substitute and addition of $Na_2O$ help biodegradation but optimal concentration of $Na_2O$ and other additive component to increase degradation rate should be determined in further study.

• Journal of Periodontal and Implant Science
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• 제42권1호
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• pp.13-19
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• 2012

Purpose: The aim of this study was to examine whether a previous peri-implantitis site can affect osseointegration, by comparing implant placement at a site where peri-implantitis was present and at a normal bone site. A second aim of this study was to identify the tissue and bone reaction after treating the contaminated implant surface to determine the optimal treatment for peri-implant diseases. Methods: A peri-implant mucositis model for dogs was prepared to determine the optimal treatment option for peri-implant mucositis or peri-implantitis. The implants were inserted partially to a length of 6 mm. The upper 4 mm part of the dental implants was exposed to the oral environment. Simple exposure for 2 weeks contaminated the implant surface. After 2 weeks, the implants were divided into three groups: untreated, swabbed with saline, and swabbed with $H_2O_2$. Three implants from each group were placed to the full length in the same spot. The other three implants were placed fully into newly prepared bone. After eight weeks of healing, the animals were sacrificed. Ground sections, representing the mid-buccal-lingual plane, were prepared for histological analysis. The analysis was evaluated clinically and histometrically. Results: The untreated implants and $H_2O_2$-swabbed implants showed gingival inflammation. Only the saline-swabbed implant group showed re-osseointegration and no gingival inflammation. There was no difference in regeneration height or bone-to-implant contact between in situ implant placement and implant placement in the new bone site. Conclusions: It can be concluded that cleaning with saline may be effective in implant decontamination. After implant surface decontamination, implant installation in a previous peri-implant diseased site may not interfere with osseointegration.

• 구강회복응용과학지
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• 제31권3호
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• pp.203-211
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• 2015

목적: 완전한 골-임플란트 결합을 가졌던 임플란트가 갑자기 골유착을 잃은 경우의 시간에따른 재골유착을 연구하기 위함이다. 연구 재료 및 방법: 23마리 토끼의 좌우 경골에 각각 2개씩 실험목적으로 제작한 RBM임플란트를 식립 후, 6주 후에 1차로 비틀림 제거력을 측정한 다음, 임플란트를 다시 재위치 침하시키고, 4일, 7일, 11일, 2주, 4주, 6주, 그리고 8주의 재침하시간 경과 후 2차로 비틀림 제거력을 측정하고 시편을 제작하여 조직 형태학적 검사를 하였다. 통계학적 검사를 위해 paired t-test를 시행했고, One-way ANOVA와 Tukey's post-hoc test 통해 그룹간 차이를 비교하여 다음과 같은 결과를 얻었다. 결과: 1차 비틀림 제거력과 비교해봤을 때 2차에서 11일 후에는 증가했으며, 2주 후부터 유의성 있게 증가하였다. 형광조사검사에서, 7일 후부터 골-임플란트 계면 사이에 형광밴드가 나타나는 광물화 현상이 관찰되고, 11일 후부터는 분명한 골 형성이 나타났다. 결론: 토끼에서는 11일 이후가 되면 충분한 재골유착을 얻을 수 있었다.

• Journal of Periodontal and Implant Science
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• 제52권4호
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• pp.338-350
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• 2022

Purpose: Various studies have investigated 3-dimensional (3D)-printed implants using Ti6Al-4V powder; however, multi-root 3D-printed implants have not been fully investigated. The purpose of this study was to explore the stability of multirooted 3D-printed implants with lattice and solid structures. The secondary outcomes were comparisons between the 2 types of 3D-printed implants in micro-computed tomographic and histological analyses. Methods: Lattice- and solid-type 3D-printed implants for the left and right mandibular third premolars in beagle dogs were fabricated. Four implants in each group were placed immediately following tooth extraction. Implant stability measurement and periapical X-rays were performed every 2 weeks for 12 weeks. Peri-implant bone volume/tissue volume (BV/TV) and bone mineral density (BMD) were measured by micro-computed tomography. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were measured in histomorphometric analyses. Results: All 4 lattice-type 3D-printed implants survived. Three solid-type 3D-printed implants were removed before the planned sacrifice date due to implant mobility. A slight, gradual increase in implant stability values from implant surgery to 4 weeks after surgery was observed in the lattice-type 3D-printed implants. The marginal bone change of the surviving solid-type 3D-printed implant was approximately 5 mm, whereas the value was approximately 2 mm in the lattice-type 3D-printed implants. BV/TV and BMD in the lattice type 3D-printed implants were similar to those in the surviving solid-type implant. However, BIC and BAFO were lower in the surviving solid-type 3D-printed implant than in the lattice-type 3D-printed implants. Conclusions: Within the limits of this preclinical study, 3D-printed implants of double-rooted teeth showed high primary stability. However, 3D-printed implants with interlocking structures such as lattices might provide high secondary stability and successful osseointegration.