• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.28 no.6
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• pp.472-479
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• 2002

Since $Br^{\circ}anemark$ introduced the osseointegrated implants, they have been granted for useful methods for the restoration of oral function. The original $Br^{\circ}anemark$ protocol recommended long stress-free healing periods to achieve the osseointegration of dental implants. However, many clinical and experimental studies have shown that the osseointegration is no wonder in almost cases and that early and immediate loading may lead to predictable osseointegration. So we are willing to introduce the Satellite Abutment newly invented for immediate loading. We think that it will make the occlusal forces dispersed to surrounding bone and that we can restore the oral function immediately after implant installation not disturbing osseointegration. In case of using Satellite abutment, stress concentrated to bone contact area of implant was distributed not only fixation plate and screws but also superior, middle portion of implant and cortical layer of jaw bone. It was clearly decreased on the bone contact surfaces around dental implants. 1. Stress was decreased more than 76.5% when satellite straight abutment was used. 2. Stress was decreased more than 50% when satellite angled abutment was used. 3. The stress around dental implant was well distributed along the cortical bone surface and the fixation plate and screw. This study concludes that satellite abutment can be used as all immediate loading implant prothesis because it was possible to distribute periimplant occlusal stress through implant contact bone surface and cortical layer of jaw bone.

• Journal of Periodontal and Implant Science
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• v.37 no.4
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• pp.681-690
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• 2007

Mini implants had been used provisionally for the healing period of implants in the beginning. But it becomes used for the on-going purpose, because it is simple to use, economic and especially suitable for the overdenture. But there is few studies about the stability of mini implants, that is most important factor for the on-going purpose, and particularly the implant parameters affecting the initial stability. The purpose of this study was to evaluate the stress and the strain distribution pattern of immediate-loaded screw type orthodontic mini-implant and the parameters affecting the initial stability of immediate-loaded mini-implant. Two dimensional finite element models were made and contact non-linear finite element analysis was performed. The magnitude and distribution of Von Mises stresses were evaluated. The obtained results were as follows: 1. The stress was concentrated on the thread tip of an implant in the cortical bone. 2. The direction of load is the most important factor for the stress distribution in cortical bone. 3. The diameter of an implant is the most important factor for the stress distribution in the trabecular bone. In conclusion, if the horizontal load vector is successfully controlled, mini-implants, which diameter is under 3mm, can be used for the on-going purpose.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.2
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• pp.317-334
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• 1995

The purpose of this study was to compare the bone formation, maturation around HA-and titaniumcoated dental implants in dog. 5 hydroxyapatite coated IMZ implants and 5 titanium coated IMZ implants were placed into the previously extracted site in the mandible of 5 adults dogs. All dogs were injected intravenously Tetracycline, Alizalin red S, and Calcein for bone fluorescent labelling, After the experimental period of 16weeks, the dogs were sacrificed and tissue samples around the implants were obtained. Microscopic observations(ligth, polariged and fluorescence microscope), morphometric analysis, line profile with EPMA, and quantitative analysis for Ca,P, and Ti were performed. The results were as follows ; 1. Bone maturations around the implants were relatively lower than those of natural teeth. No significant differences in bone maturation and remodeling patterns were observed between the two implants groups. 2. Calcification of bone surrounding the implants was initiated in 8-11 weeks for HA-coated implants, while it took 11 weeks or more for Ti-coated implants. 3. Bone-to-implants contact ratio of 82.63% was recorded for HA-coated group and 72.25% for titanium coated group, with no significant difference between the two groups. 4. Bone around the implants exhibited reduced quantity of Ca and P in the $100{\mu}m$ region relative to natural teeth, while the rest of the regions showed no statistical differences. No significant differences were found between the two implant groups. 5. There was a separation of HA layer from the implant core and subsequent infiltration of inflammatory cells into the resulting space in the HA-coated implants, and evidences of phagocytosis of HA particles by macrophages. Bone calcification was more rapid around HA-coated implants compared to titanium-coated implants, but HA coated implants did not show any significant differences either in the degree of calcification or the bone-to-implant contact ratio over Ti coated implants. HA coated implants may have complications associated with HA absorption and separation of HA layer from the implant core.

• 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.

• 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.35 no.3
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• pp.635-648
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• 2005

The procedure that enhances osteogenesis and shortens the healing period is required for successful implant therapy. It has been introduced that osteogenesis is enhanced by the generation of electric field. Many researchers have demonstrated that application of electric and electromagnetic field promote bone formation. It also has been shown that electrical stimulation enhances peri-implant bone formation. Recently, several investigators have reported that noninvasive electrical stimulation using negatively charged electret such as polytetrafluoroethylene(PTFE) promotes osteogenesis. Therefore, we were interested in the effect of noninvasive electrical stimulation using negatively charged electret on the periimplant bone healing. After titanium implant were installed in the proximal tibial metaphysis of New Zealand white rabbit, negatively charged PTFE membrane fabricated by corana dischage was inserted into the inner hole of the experimental implant and noncharged membrane was applied into control implant. After 4 weeks of healing, histomorphometric analysis was performed to evaluate peri-implant bone response. The histomorphometric evaluations demonstrated experimental implant tended to have higher values in the total bone-to-implant contact ratio(experimental ; $49.9{\pm}13.52%$ vs control ; $37.5{\pm}19.44%$) , the marrow bone contact ratio(experimental ; $34.94{\pm}13.32%$ vs control ; $24.15{\pm}13.69%$), amount of newly formed bone in the endosteal region(experimental ; $1.00{\pm}0.30mm$ vs control ; $0.61{\pm}0.24mm$) and bone area in the medullary canal(experimental ; $13.55{\pm}4.98%$ vs control ; $9.03{\pm}3.05%$). The mean values of the amount of newly formed bone(endosteal region) and bone area(medullary canal) of the experimental implant demonstrated a statistically significant difference as compared to the control implant(p<0.05). In conclusion, noninvasive electrical stimulation using negatively charged electret effectively promoted peri-implant new bone formation in this study. This method is expected to be used as one of the useful electrical stimulation for enhancing bone healing response in the implant therapy

• Maxillofacial Plastic and Reconstructive Surgery
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• v.22 no.3
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• pp.274-287
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• 2000

The use of dental implants has increased tremendously in recent years and is expected to increase even more in the future. The successful outcome of any implant procedure is surely dependent on interrelationship of the various components of an equation that includes biocompatibility of implant material, macroscopic and microscopic nature of the implant surface, the status of implant bed, surgical technique, undisturbed healing phase and subsequent prosthetic design and long-term loading phase. The purpose of this study was to clarify the effects of adrenalectomy on the osseointegration of pure titanium implants. Seventy rats, 11 weeks of age, were divided into two groups : an adrenalectomized group and a control group. Titanium screw implant(diameter, 2.0mm; length, 3.5mm) was placed into left tibia of 70 rats, 35 in control group and 35 in the experimental group. The rats were sacrificed at different time interval (1, 2, 3, 4, 6, 8, and 12 weeks after implantation) for histopathologic observation, histomorphometric analysis and immunohistochemistry with fibronectin and CD44 antibody. The results obtained from this study were as follows: 1. Histopathogically, findings, newly formed bone was seen at 3 weeks control group and became lamellar bone at 12 weeks. At 6 weeks, lipocytes were observed in bone marrow space. Thickness of regenerated trabecular bone increased till 6 weeks after then, that decreased gradually. 2. By histomorphometric analysis, marrow bone density and contact ratio of marrow bone to implant decreased significantly from 8 to 12 weeks in experimental group compared to control group and also total bone to implant contact ratio decreased significantly from 4 to 12 weeks in experimental group compared to control group. 3. Fibronectin immunoreactivity was very strong at 3 and 4 weeks control group. And after that reduced gradually. But it was continuously strong from 1 to 12 weeks experimental group. 4. CD44 immunoreactivity was very strong in the newly formed osteoblasts at 3 and 4 weeks control group. But it reacted minimally later. However, it reacted continuously strong from 3 to 12 weeks experimental group. From these results, bone to implant contact ratio decreased gradually from 4 weeks in adrenalectomized group compared to control group. CD44 and fibronectin immunoreactivities were strong at all times in adrenalectomized rats. Therefore, it could be stated that immature bone remained continuously for a long time and not readily proceeded into mature status.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.187-197
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• 2005

The aim of this study was to investigate the influence of peri-implant soft tissue and bone thickness on the early dimensional change of peri-implant soft tissue. Seventy-seven non-submerged implants of 39 patients which had been loaded more than 6 months were selected for the study. Following clinical parameters were measured; bucco-lingual bone width of the alveolar bone for implant placement before implant surgery; distance between implant shoulder and the first bone/implant contact at the surgery; presence of plaque, probing depth, bleeding on probing, width of keratinized mucosa, mucosa thickness, distance between implant shoulder and peri-implant mucosa, crown margin location at follow-up examination. The results showed that distance between implant shoulder and peri-implant mucosa (DIM) was correlated with probing depth and width of keratinized mucosa (p < 0.05). In addition, mucosa thickness was also correlated with probing depth (p<0.05). However, the bone width of alveolar bone and soft tissue thickness were not found to be correlated with DIM. It is important to understand the meaning of peri-implant tissue dimension in relation to dimensional changes of peri-implant soft tissue which designates appearance of implant-supported restorations. Future study is needed to elucidate the significance of the buccal bone thickness and soft tissue thickness with respect to the change of peri-implant soft tissue margin with the use of an instrument capable of measuring buccal bone thickness directly.

• The Journal of Korean Academy of Prosthodontics
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• v.28 no.2
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• pp.1-28
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• 1990

The severe atrophic edentulism with poor neuromuscular control militates against successful conventional denture therapy. To such situation, a prescribing of dental implant treatment has been considered with some probability. Implant materials used as a trial for dental implants includes metals, plastic polymers and ceramics. The purpose of this study was to observe histologic response in osseointegration process at titanium implant-tissue interface based on biocompatibility at specific period of sequential natures which were divided into a half month, one, month, two months, three months and immediate as a base line. In this study, unilateral lower left premolar and molar teeth were extraced in three dogs. After allowing to heal for 6 months, three kinds of osseointegrated implant, $Br{\aa}nemark$, Corevent and kimplant(a prototype of SNU implant study)were inserted in each dog respectively according to the above sequence from front to back. The specimens were taken from those dogs at the same time since implant were inserted quite reverse order of the specified periods, and decalcified and processed for histologic examination for the light microscopy and the electron microscopy. The microscopic histologic findings at the interface between titanium implants and tissue were interpretated as follows : A. Light microscopic findings : a. Immediate : Implant were surrounded by compact bone and spongy bone. Microcrak was observed in the superficial bone tissue. Osteocytes were disappeared and bone lacunae were observed as a vacant space in some parts. In the contacting with the spongy bone, bone trabeculae and bone marrow were in contact with the implant. b. A half Month : Osteoblasts exist as a monolayer in th inner bone trabeculae and do bone additiocn. Osteoblasts&inflammatory cells were observed in some parts. c. One Month : The presence of osteoclasts decreased. Osteoblasts did active bone fromation, and bone marrow was in contact with the implant in the many places. d. Two Months : Bone formation was advanced in comparison with the b and c. The presence of osteoclsts was not observed. e. Three Months : The superficial bone tissue contacted with the implants was entirely composed by the compact bone. B. Electron microscopic findings : a. A half month and one month group : In the parts of the active bone formation, osteoblasts with the well developed endoplasmic reticulum and Golgi apparatus were arranged in the monolayer. In the parts of the bone resorption, ruffled border was well developed and many osteoclasts with the well-developed golgi apparatus, mitochondria, vacuole, vesicle and lysosome were existed. b. Three months group : No osteoblasts were observed in the superficial bone tissue. Bone matrix with collaen fiber was observed. c. No significant dirrerence in the histologic findings was observed in $Br{\aa}nemark$, Core-vent and kimplant.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.16 no.4
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• pp.477-497
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• 1994

The purpose of this study was to investigate the effect of timing of implant insertion on osseointegration after tooth extraction. Fifteen mongrel dogs, weighing 15kg or more, were used. The lower right 1st, 2nd, 3rd, 4th premolars and 1st molar were extracted under general anesthesia. Implants were inserted at 2, 4, and 8 weeks after extraction of the teeth, being designated as 2-, 4-, and 8-week groups, respectively. Results obtained were as follows. 1. Macroscopically there was neither an infection at the implant site nor an exposure of the implant. 2. Histologically the surrounding bone of the implant was less mature in the 2-week group than in the 4- and 8-week groups. 3. The implant-bone contact ranged from 75 to 82%, with no significant differences among the groups. No increase in the implant-bone contact was found with increasing healing periods from 4 to 12 weeks after implant insertions. 4. The average depth (0.64mm) of the fibrous connective tissue ingrowth in the 2-week group was slightly deeper than those in the 4- (0.51mm) and 8-week (0.53mm) groups at 12 weeks after implant insertion. 5. the implant-bone interfacial bond strengths were 73.05 kgf in the 2-week group, 69.71 kgf in the 4-week group and 73.76 kgf in the 8-week group. No significant difference was noted in pullout force among the groups. The degree of confidence of interfacial bone strength was highest in the 8-week group, followed by the 4- and 2-week groups. These results indicate that at least 4 weeks of healing period will be required before implant is to be inserted following tooth extraction.