• The Journal of Advanced Prosthodontics
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• v.11 no.3
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• pp.147-154
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• 2019

PURPOSE. This study aimed to evaluate the effect of two different implant-abutment connection structures with identical implant design on peri-implant bone level. MATERIALS AND METHODS. This clinical study was a patient-blind randomized controlled trial following the CONSORT 2010 checklists. This trial was conducted in 24 patients recruited between March 2013 and July 2015. Implants with internal friction connection were compared to those with external hex connection. One implant for each patient was installed, replacing the second molar. Implant-supported crowns were delivered at four months after implant insertion. Standardized periapical radiographs were taken at prosthesis delivery (baseline), and one year after delivery. On the radiographs, distance from implant shoulder to first bone-to-implant contact (DIB) and peri-implant area were measured, which were the primary and secondary outcome, respectively. RESULTS. Eleven external and eleven internal implants were analyzed. Mean changes of DIB from baseline to 1-year postloading were 0.59 (0.95) mm for the external and 0.01 (0.68) mm for the internal connection. Although no significant differences were found between the two groups, medium effect size was found in DIB between the connections (Cohen's d = 0.67). CONCLUSION. Considering the effect size in DIB, this study suggested the possibility of the internal friction connection structure for more effective preservation of marginal bone.

• Journal of Dental Rehabilitation and Applied Science
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• v.20 no.1
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• pp.57-70
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• 2004

The significance of occlusion has regained its popularity in dentistry with the introduction of implant therapy. Literature has reported that the clinical success and longevity of dental implants can be achieved by biomechanically controlled occlusion. Occlusal overload is known to be one of the main causes for implant failure. Evidences have suggested that occlusal overload contribute to early implant bone loss as well as deosseointegration of successfully integrated implants. Unlike natural teeth, osseointegrated implants are ankylosed to surrounding bone without the periodontal ligament (PDL) which provides mechanoreceptors as well as shock-absorbing function. Moreover, the crestal bone around dental implants may act as a fulcrum point for lever action when a force (bending moment) is applied, indicating that implants/implant prosthesis could be more susceptible to crestal bone loss by applying force. Hence, it is essential for clinicians to understand inherent differences between teeth and implants and how force, either normal or excessive force, may influence on implants under occlusal loading. The purposes of this paper are to review the importance of implant occlusion, to establish the optimum implant occlusion with biomechanical rationale, to provide clinical guidelines of implant occlusion and to discuss how to manage complications related to implant occlusion.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.27 no.4
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• pp.307-314
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• 2005

After dental implant are planted into their bony site among the various growth factors associated with bone formation. BMP is expressed in the bone surrounding the implant fixture. By taking a close look at BMP2, BMP4 which are growth factors that take put in bone formation, its histologic features and radiographic bone healing patterns we would like to examine the mechanism of osseointegration. We randomly used 8 male and female house rabbit amd used diameter 5 mm height spiral shaped implants(Ostem, Korea) for animal use handled as a resorbable blast machined(RBM) surface and machined surface. 2group were formed and each group had RBM surface and machined surface implant or a simple bone cavity. After 3, 7, 14 and 28 days post surgery 2 objects were sacrificed from each group and histologic specimens were acquired. RT-PCR analysis was conducted and after H&E staining the extent of osseointegration was measured applying a histologic feature and histomorphometric analysis program. Quanitity one -4.41(Bio-Rad, USA) was used after scanning the PCR product image of the growth factors manifested in each group. According to the histomorphometric features the RBM, Machined surface group showed increased contact between bone and implant surface at 3, 7, 14 and 28 days after surgery. The BMP2 level increased in both experiment groups but remained unchanged in the contrast group. BMP4 levels stayed steady after the early post implantation period for RBM but showed decreased in the machined surface group and contrast group. The amount of contact between bone and implant surface increased with the passage of time. BMP2, BMP4 were expressed in both experimental group and contrast group. These growth factors play a role in osseointegration of implant.

• Journal of Periodontal and Implant Science
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• v.48 no.4
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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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.34 no.3
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• pp.186-199
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• 2012

Purpose: Single implants, of which screw loosening has been observed frequently, presents problems such as fixtures fractures, marginal bone loss, and inflammation of the soft tissue around the implant. However, the single implant is more conservative, cost effective, and predictable compared to the 3 unit bridge with respect to the long-term outcome. This study evaluated the survival rate as well as future methods aimed at increasing the survival rate in single implants in posterior teeth. Methods: Among the implants placed in the Dankook University Dental Hospital department of Oral & Maxillofacial surgery from January 2001 to June 2008, 599 implants placed in the maxillar and mandibular posterior were evaluated retrospectively. Survival rates were investigated according to implant location, cause of tooth loss, gender, age, general disease, fixture diameter and length, surface texture, implant type and shape, presence of bone graft, surgery stage, surgeons, bone quality and opposite teeth. Results: Out of 599 single implants in posterior teeth, 580 implants survived and the survival rate was 96.8%. The difference in survival rate was statistically significant according to the implant location. The survival rate was low (84.2%) in implants exhibiting a wide diameter (${\geq}5.1mm$) and the surface treated by the acid etching group demonstrated a significantly lower survival rate (91.1%). One stage surgical procedure, which implemented a relatively better bone quality survival rate (100%), was higher than the two stage surgical procedure (96.1%). The survival rate of type IV bone quality (75%) was significantly lower than the other bone quality. Conclusion: Single posterior teeth implant treatments should use an improved surface finishing fixture as well as careful and safe procedures when performing implant surgery in the maxilla premolar and molar regions since bone quality is poor.

• Journal of Periodontal and Implant Science
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• v.33 no.4
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• pp.717-728
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• 2003

This study was performed to evaluate the difference of the bone-to-implant contact according to the surface roughness of the implants. Two beagles were used in the experiment. Extraction of the all premolars was performed in the mandible. In 3 months of healing, screw-shaped pure titanium machined surface implants (Implantium(R), Dentium Co. Korea), implants blasted with 45${\mu}m$ $TiO_2$ particles, (Implantium(R), Dentium Co. Korea) and implants blasted with 100${\mu}m$ $TiO_2$ particles (Implantium(R), Dentium Co. Korea) in diameter 3.4mm and length 6mm were installed in the edentulous mandible. Each dog was sacrificed at 4, 12 weeks after placement and then nondecalcified specimens were prepared for histologic analysis. The results of this study were as follows. 1. At 4 , 12 weeks after the surgery, bone-to-implant contact in the surface blasted with $TiO_2$ particles was higher than that in the pure titanium machined surface respectively. 2. Osseointegration in the surface blasted with 45${\mu}m$ $TiO_2$ particles was more increased than that in the surface blasted with 100${\mu}m$ $TiO_2$ particles. 3. Bone-to-implant contact was increased with time independent of surface roughness. 4. Bone formation was in the outfolded area more than inside the threads independent of surface roughness. From the above results, we were able t o find the most bone-to-implant contact in 45${\mu}m$ $TiO_2$ blasted implant.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.1-16
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• 1991

In order to see the possible effect of the functional load-bearing after osseointegration of the titanium root form implant in dog a histologic study was conducted. One side of lower jaw was surgically prepared edentulousness and titanium implants were inserted. Some implants were functionally loaded through fixed detachable prosthesis and some are isolated and unloaded. The dog was sacrificed four months later and bone sections with implants were processed for histologic evaluation and the results were as follows ; (1) The bone to implant interface after four months of load bearing presented no mobility and no marginal bone loss radiographically and histologically. (2) The interface zone between compact bone and implant revealed a direct bone to implant contact and in some areas marrow tissue contacts were examined at the light microscopic level. (3) At the ultrastructural level the interface of surrounding compact bone matrix and implant, three types of superficial layers were found ; one with moderate electron dense amorphous granular substance layer, other with high electron dense fine granular substance layer, and another type of amorphous granular substance covered with high electron dense line of minute granules. (4) The osteoblasts in the marrow tissue neighboring implants and osteocytes in compact bone showed typical normal characteristics and in the marrow tissues some of lymphocytes and mast cells were observed. (5) The abscence of abnormal tissue reactions at a cellular level indicates a high degree of biocompatibility for the experimental titanium implant and basically no difference was found between functionally loaded and unloaded implants.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.6
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• pp.671-678
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• 2004

Statement of problem. Reducing treatment time in implant dentistry is a matter of main concern. There are so many factors affecting the success rate of immediate or early loaded implant for the initial bone response. The especially microscopic properties of implant surfaces playa major role in the osseous healing of dental implant. Purpose. The aims of this study were to perform a histologic and histomorphometric comparison of the healing characteristics anodically roughened surface, HA coated surface and RBM surface implant, and to compare of ISQ values measured by $Osstell^{TM}$ for resonance frequency analysis in dogs mandible during 2 weeks. Material and method. Bone blocks from 2 dogs were caught after covered healing for 0 day(2 h); Group I, 1 week; Group II and 2 weeks; Group III. One longitudinal section was obtained for each implant and stained with hematoxylin and eosin. Histomorphometric analysis was done with Kappa Imagebase system to calculate bone-to-implant contact and bone volumes inside the threads. ISQ values were measured in every time of surgery schedule. Conclusion. The experiment revealed that: 1. The percentages of bone-to-implant contact on the fixture in each group were not significantly different(P > 0.05). 2. The percentages of bone area inside the threads on the fixture in each group were not significantly different(P > 0.05). 3. The ISQ level showed clinical stability of each fixture during 2 weeks(all ISQ level ${\geq}71$ ).

• Journal of Periodontal and Implant Science
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• v.45 no.3
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• pp.94-100
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• 2015

Purpose: The aim of this study was to investigate the combined effects of physical and chemical surface factors on in vivo bone responses by comparing chemically modified hydrophilic sandblasted, large-grit, acid-etched (modSLA) and anodically oxidized hydrophobic implant surfaces. Methods: Five modSLA implants and five anodized implants were inserted into the tibiae of five New Zealand white rabbits (one implant for each tibia). The characteristics of each surface were determined using field emission scanning electron microscopy, energy dispersive spectroscopy, and confocal laser scanning microscopy before the installation. The experimental animals were sacrificed after 1 week of healing and histologic slides were prepared from the implant-tibial bone blocks removed from the animals. Histomorphometric analyses were performed on the light microscopic images, and bone-to-implant contact (BIC) and bone area (BA) ratios were measured. Nonparametric comparison tests were applied to find any significant differences (P<0.05) between the modSLA and anodized surfaces. Results: The roughness of the anodized surface was $1.22{\pm}0.17{\mu}m$ in Sa, which was within the optimal range of $1.0-2.0{\mu}m$ for a bone response. The modSLA surface was significantly rougher at $2.53{\pm}0.07{\mu}m$ in Sa. However, the modSLA implant had significantly higher BIC than the anodized implant (P=0.02). Furthermore, BA ratios did not significantly differ between the two implants, although the anodized implant had a higher mean value of BA (P>0.05). Conclusions: Within the limitations of this study, the hydrophilicity of the modSLA surface may have a stronger effect on in vivo bone healing than optimal surface roughness and surface chemistry of the anodized surface.

• Journal of Periodontal and Implant Science
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• v.40 no.5
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• pp.239-243
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• 2010

Purpose: The purpose of this study was to evaluate the effects of implant shape and bone preparation on the primary stability of the implants using resonance frequency analysis. Methods: Sixty bovine rib blocks were used for soft and hard bone models. Each rib block received two types of dental implant fixtures; a straight-screw type and tapered-screw type. Final drilling was done at three different depths for each implant type; 1 mm under-preparation, standard preparation, and 1 mm over-preparation. Immediately after fixture insertion, the implant stability quotient (ISQ) was measured for each implant. Results: Regardless of the bone type, the ISQ values of the straight-screw type and tapered-screw type implants were not significantly different (P>0.05). Depth of bone preparation had no significant effect on the ISQ value of straight-screw type implants (P>0.05). For the tapered-screw type implants, under-preparation significantly increased the ISQ value (P<0.05), whereas overpreparation significantly decreased the ISQ value (P<0.05). Conclusions: Within the limitations of this study, it is concluded that bone density seemed to have a prevailing effect over implant shape on primary stability. The primary stability of the tapered-screw type implants might be enhanced by delicate surgical techniques.