• 대한치과보철학회지
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• 제48권2호
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• pp.111-121
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• 2010

연구목적: 본 연구에서는 임플란트 주변 골흡수 양상의 차이가 임플란트와 주변골의 응력 분산에 미치는 영향을 알아보기 위해 수평 골흡수와 임플란트 주변 수직 골흡수에 있어서 주변골의 응력분산, 생물학적 폭경의 형성과 응력분산의 변화 관계 및 병적인 골흡수시의 주변골 응력분포를 유한요소 분석법을 사용하여 비교하고자 하였다. 연구 재료 및 방법:우측 제1 소구치 전방에서 제2 대구치 후방까지의 하악골 모형에서 자연치를 제거하고 직경 4.0 mm, 길이 10.0 mm의 나사형 임플란트를 제1 대구치 부위에 식립하였다. 수평 수직 골흡수의 차이를 보기 위하여 골흡수가 나타나지 않은 형태를 대조군 (I)으로 하여, 1.5 mm 수평 골흡수 (H1.5), 3.0 mm 수평 골흡수 (H3.0) 모형과 이에 상응하는 수직 골흡수 모형 (VW1.5; 1.5 mm, VW3.0; 3.0 mm)을 설계하였고, 생물학적 폭경의 형성과 응력 변화를 관찰하기 위해 생물학적 폭경이 형성되는 과정을 가정한 모형(B0; 피질골에서 임플란트와의 골유착이 없이 밀접하게 접촉된 상태, B1; 피질골에 0.5 mm 폭의 수직 골흡수가 발생한 상태)과 생물학적 폭경이 형성된 상태 (B2)의 모형을 설계하였으며, 생물학적 폭경이 형성된 상태는 0.5 mm 폭을 가지며 임플란트 장축에 경사진 형태를 가지고 있는 1.5 mm 깊이의 수직 골흡수 상태로 형성하였다. 병적 골흡수 상태는 수직 골흡수를 가정한 기존 모형 (VW1.5, VW3.0)과 골흡수가 더 진행된 VW4.5, 기저부에 피질골화가 이루어지지 못한 VO3.0, VO4.5, VO6.0모형을 추가하였다. 하중조건은 수직, 수평하중 그리고 협측 $45^{\circ}$경사하중을 각각 100 N씩 임플란트 보철물 부위에 가하였다. 결과: 분석결과 수평 골흡수와 수직 골흡수에 있어서 전반적인 응력의 크기와 임플란트에 가해지는 응력의 크기는 서로 대응하는 모형에서 유사하였으며, 수직 골흡수에 서 수직력을 받을 때 C2에서 C4로 1.5 mm의 골흡수가 증가하였으나 골에서 발생한 최대응력은 오히려 감소하였다. 수직 골흡수에서 응력이 결손부의 수직 벽을 통해 상부로 분산되는 것을 볼 수 있었다. 생물학적 폭경 형성 단계에서 응력이 가해지는 경우 피질골에서의 결합이 없는 A2에서 피질골 전반에 높은 응력이 발생하였으며 생물학적 폭경의 완성을 가정한 B1에서는 임플란트와 피질골의 경계에서 발생한 응력이 경사진 피질골을 따라서 퍼져나가고 있음을 보였다. 병적 골흡수에서 골결손부 하방에 피질골이 없는 경우는 골흡수에 비례하여 응력이 증가 하였으나 피질골이 있는 경우에는 응력의 증가가 골흡수량의 증가와 비례하지 않음을 보였다. 결론: 임플란트 주변 골흡수의 양이 같아도 흡수된 형태에 따라 발생하는 응력의 크기와 응력분산이 다르게 나타났으며 초기 골흡수 현상은 피질골과의 결합이 약할 때 이 부위에 응력이 증가되어 나타나며, 이후 응력이 감소되어 평형을 이루는 것으로 보인다. 수직 골흡수가 증가할 경우 피질골의 존재 유무가 응력 분산에 큰 영향을 미치며 피질골이 있는 경우 일정 범위에서 응력의 감소가 나타나 응력분산에 유리한 형태에서 골흡수의 진행을 감소시킬 수 있을 것으로 보인다.

• The Journal of Advanced Prosthodontics
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• 제6권6호
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• pp.498-504
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• 2014

PURPOSE. Dental implant has gained clinical success over last decade with the major drawback related to osseointegration as properties of metal (Titanium) are different from human bone. Currently implant procedures include endosseous type of dental implants with nanoscale surface characteristics. The objective of this review article is to summarize the role of nanotopography on titanium dental implant surfaces in order to improve osseointegration and various techniques that can generate nanoscale topographic features to titanium implants. MATERIALS AND METHODS. A systematic electronic search of English language peer reviewed dental literature was performed for articles published between December 1987 to January 2012. Search was conducted in Medline, PubMed and Google scholar supplemented by hand searching of selected journals. 101 articles were assigned to full text analysis. Articles were selected according to inclusion and exclusion criterion. All articles were screened according to inclusion standard. 39 articles were included in the analysis. RESULTS. Out of 39 studies, seven studies demonstrated that bone implant contact increases with increase in surface roughness. Five studies showed comparative evaluation of techniques producing microtopography and nanotopography. Eight studies concluded that osteoblasts preferably adhere to nano structure as compared to smooth surface. Six studies illustrated that nanotopography modify implant surface and their properties. Thirteen studies described techniques to produce nano roughness. CONCLUSION. Modification of dental osseous implants at nanoscale level produced by various techniques can alter biological responses that may improve osseointegration and dental implant procedures.

• 대한치과보철학회지
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• 제44권5호
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• pp.594-605
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• 2006

Statement of problem: Modification of titanium implant surface has potential to ensure clinically favorable performance that several surface modification technologies have been introduced. Among the methods. anodizing method and sol-gel hydroxyapatite coating method have gained much interest due to its roughness and chemical composition of the coating layer, but more of its biocompatibility result is required. Purpose : The purpose of this study was to compare bone-implant interface shear strength of four different surface treated implants as time elapsed. Resonance frequency analysis(RFA) and removal torque measurement methods were employed to measure implant stability at one week and six week after implantation. Material and method: A total of 80 screw-shaped implant [20 machined, 20 resorbable media blasted(RBM), 20 anodized, and 20 anodized+hydroxyapatite sol-gel coated] were prepared, and one of each group was implanted in the tibia of a New Zealand white rabbit that total 20 of them were used. In order to test the implant stability and implant-tissue interface contact changing in the bone bed, each 10 rabbit were sacrificed 1 week and 6 week later while resonance frequency and removal torque were measured. One-way analysis of variance and the Tukey test were used for statistical analysis. Results : The results were as follows. 1. There was no statistically significant difference of implant stability quotients(ISQ) value in RFA between individual groups after 1 week of implantation and 6 weeks(p>0.05). But, there was statistically significant increase of ISQ value in 6 weeks group compared to 1 week group(p<0.05). 2. There was no statistically significant difference in removal torque analysis between individual groups after 1 week of implantation and 6 weeks(p>0.05). but there was statistically significant increase in all 4 groups after 6 weeks compared to 1 week later(p<0.05). 3. There was no statistically significant difference in removal torque analysis between anodized group and HA coating after anodic oxidation 6 weeks later(p>0.05), but significant difference was appeared in both groups compared to RBM group and smooth-machined group(p<0.05). Conclusions : It can be suggested that changes in surface characteristics affect bone reactions. Anodized and anodized+hydroxyapatite sol-gel coating showed significantly improved bone tissue response to implants, but further study on the effect of hydroxyapatite dissolution is needed.

• Journal of Korean Neurosurgical Society
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• 제61권5호
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• pp.559-567
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• 2018

Objective : The aim of this study was to evaluate the effect for biodegradable screws containing bone morphogenetic protein-2 (BMP-2) in an osteoporotic rat model. Methods : Twenty-four female Wistar rat (250-300 g, 12 weeks of age) were randomized into four groups. Three groups underwent bilateral ovariectomy (OVX). Biodegradable screws with or without BMP-2 were inserted in the proximal tibia in two implantation groups. The extracted proximal metaphysis of the tibiae were scanned by exo-vivo micro-computed tomography. Evaluated parameters included bone mineral density (BMD), trabecular bone volume (BV/TV), trabecular number, trabecular thickness, and trabecular separation (Tb.Sp). The tibia samples were pathologically evaluated by staining with by Hematoxylin and Eosin, and trichrome. Results : Trabecular formation near screw insertion site was evident only in rats receiving BMP-2 screws. BMD and BV/TV significantly differed between controls and the OVX and OVX with screw groups. However, there were no significant differences between control and OVX with screw BMP groups. Tb.Sp significantly differed between control and OVX and OVX with screw groups (p<0.05), and between the OVX and OVX with screw BMP group (p<0.05), with no statistically significant difference between control and OVX with screw BMP groups. Over the 12 weeks after surgery, bone lamellae in direct contact with the screw developed more extensive and thicker trabecular bone around the implant in the OVX with screw BMP group compared to the OVX with screw group. Conclusion : Biodegradable screws containing BMP-2 improve nearby bone conditions and enhance ostoeintegration between the implant and the osteoporotic bone.

• 대한치과보철학회지
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• 제48권3호
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• pp.209-214
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• 2010

연구 목적: 본 연구의 목적은 골 유착된 임플란트에 인위적 비틀림을 가한 후 골 유착이 다시 일어나는지, 혹은 일어나지 않는지, 일어난다면 이전의 골유착보다 강화되는지, 약화되는지에 대해 알아보기 위함이다. 연구 재료 및 방법:상업적으로 순수한 티타늄 (commercial pure titanium 99%)으로 직경 3.75 mm, 길이 4 mm의 표면처리 없는 실험용 임플란트를 제작하였다. 3.0 kg이상의 뉴질랜드산 흰색 암컷 토끼 7마리의 좌우 경골에 제작한 임플란트를 2개씩 식립 후, 6주의 골유착 유도 기간 부여 후 비틀림 제거력을 측정한 경우를 I군으로, 다시 임플란트 고정체를 재위치시키고 봉합하여 4주간의 치유기간을 더 두고 측정한 경우를 II군으로 분류하였다. 광학현미경을 이용한 조직 형태학적 분석을 위하여, 1차 비틀림 제거력 측정 직후 1마리의 토끼를 희생시키고, 2차 비틀림 제거력 측정 직후 2마리의 토끼를 희생시켜 각각 4개, 7개의 시편을 제작하여, 광학현미경 (${\times}20$) 분석에서 골-임플란트 접촉 (Bone-Implant contact, BIC, %)비율과 치밀골 부위에 위치하는 임플란트의 나사산 수를 측정하여 CBa (Bone area in the cortical passage)비율을 측정하였다. 비틀림 제거력과 BIC및 CBa비율에서의 I군과 II군의 통계적 유의성 ($\alpha$=.05)을 평가하였다. 결과: 비틀림 제거력 측정에서 I군은 $10.8{\pm}3.6$ NCm로 측정되었으며, II군은 $20.2{\pm}9.7$ NCm로 측정되었으며, I군보다II군의 비틀림 제거력이 평균 98.1% 증가되었다 (P<.05). 조직 형태학적 분석에서 BIC와 CBa 비율은 I군과 II군 사이에 통계적 유의성을 나타내지 않았고 (P>.05), RT/BIC와 RT/CBa 값은 I군과 II군 사이에 통계적 유의성을 나타냈다 (P<.05). 결론: 임플란트 고정체에 의원성 비틀림 동요가 발생한 경우에 초기 골유착을 얻기 위해 필요로 했던 치유기간보다 짧은 기간 내에 이전보다 견고한 골유착을 얻을 수 있을 것으로 생각된다.

• Journal of Periodontal and Implant Science
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• 제50권2호
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• pp.106-120
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• 2020

Purpose: A new form of porous polyethylene, characterized by higher porosity and pore interconnectivity, was developed for use as a tissue-integrated implant. This study evaluated the effectiveness of porous polyethylene blocks used as an onlay bone graft in rabbit mandible in terms of tissue reaction, bone ingrowth, fibrovascularization, and graft-bone interfacial integrity. Methods: Twelve New Zealand white rabbits were randomized into 3 treatment groups according to the study period (4, 12, or 24 weeks). Cylindrical specimens measuring 5 mm in diameter and 4.5 mm in thickness were placed directly on the body of the mandible without bone bed decortication, fixed in place with a titanium screw, and covered with a collagen membrane. Histologic and histomorphometric analyses were done using hematoxylin and eosin-stained bone slices. Interfacial shear strength was tested to quantify graft-bone interfacial integrity. Results: The porous polyethylene graft was observed to integrate with the mandibular bone and exhibited tissue-bridge connections. At all postoperative time points, it was noted that the host tissues had grown deep into the pores of the porous polyethylene in the direction from the interface to the center of the graft. Both fibrovascular tissue and bone were found within the pores, but most bone ingrowth was observed at the graft-mandibular bone interface. Bone ingrowth depth and interfacial shear strength were in the range of 2.76-3.89 mm and 1.11-1.43 MPa, respectively. No significant differences among post-implantation time points were found for tissue ingrowth percentage and interfacial shear strength (P>0.05). Conclusions: Within the limits of the study, the present study revealed that the new porous polyethylene did not provoke any adverse systemic reactions. The material promoted fibrovascularization and displayed osteoconductive and osteogenic properties within and outside the contact interface. Stable interfacial integration between the graft and bone also took place.

• 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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• 제38권4호
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• pp.603-610
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• 2008

Purpose: The guided bone regeneration (GBR) technique is widely used in periradicular surgery. However, there is still some controversy regarding the effectiveness of GBR in promoting bone healing after periradicular surgery. The purpose of this study was to evaluate the resorbable membrane on the osteointegration of immediate implants in sites with periradicular lesion that had been removed by periradicular surgery. Materials and methods: Six roots of lower second premolars and 15 roots of lower third and fourth premolars of dogs were used as control and experimental teeth, respectively. Periradicular lesions were induced only in the experimental teeth. Twelve weeks later, the control and experimental teeth were extracted and implants were placed immediately. Periradicular lesions were removed with osteotomy, curettage and saline irrigation. Resorbable membranes were used in experimental group 1 but not in experimental group 2. After 12 week of healing period, the implants were clinically not mobile and showed no signs of infection. Data obtained by histomorphometric analysis were analyzed by Kruskal-Wallis test. Results: The control group showed a significantly higher bone to implant contact (BIC) ($74.14{\pm}16.18$) than experimental group 1 ($40.28{\pm}15.96$) and 2 ($48.70{\pm}17.75$)(p<0.05). However, there was no significant difference between experimental group 1 and 2. Conclusion: Although BIC in experimental groups were lower than in control group, immediate implant can be successfully placed at extraction socket with periradicular lesion and osseous defect. However, the use of resorbable membrane in bony defect created during periradicular surgery was questioned.

• Journal of Yeungnam Medical Science
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• 제36권1호
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• pp.43-49
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• 2019

Background: In the osseointegration of dental implants, the implant surface properties have been reported to be some of the most important critical factors. The effect of implant's surfaces created by resorbable blast media (RBM) followed by laser ablation on bone tissue reactions was examined using the removal torque test and histomorphometric analysis. Methods: Two types of dental implants, RBM-laser implants (experimental group) and RBM implants (control group) (CSM implant system, Daegu, Korea; L=6 mm, diameter=3.75 mm) were placed into the right and left distal femoral metaphysis of 17 adult rabbits. Six weeks after placement, removal torque was measured and histomorphometric analysis was performed. Results: The mean removal torque was $24.0{\pm}10.2Ncm$ and $46.6{\pm}16.4Ncm$ for the control and test specimens, respectively. The experimental RBM-laser implants had significantly higher removal torque values than the control RBM implants (p=0.013). The mean values of total and cortical bone to implant contact (BIC) were respectively $46.3{\pm}10.8%$ and $65.3{\pm}12.5%$ for the experimental group, and $41.9{\pm}18.5%$ and $57.6{\pm}10.6%$ for the control group. The experimental RBM-laser implants showed a higher degree of total and cortical BIC compared with RBM implants, but there was no statistical significance (p=0.482, 0.225). Conclusion: The removal torque and BIC of the test group were higher than those of the control group. In this study, the surface treatment created by RBM treatment followed by laser ablation appears to have a potential in improving bone tissue reactions of dental implants.

• 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.