• Journal of Dental Rehabilitation and Applied Science
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• v.21 no.2
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• pp.169-182
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• 2005

The purpose of this study was to compare the stress distribution around the surrounding bone according to the splinted and non-splinted conditions on the finite element models of the two implant crowns with the different vertical bone level. The finite element model was designed with the parallel placement of the two fixtures ($4.0mm{\times}11.5mm$) with reverse buttress thread on the mandibular 1st and 2nd molars. As the bone quality, the inner cancellous bone and the outer 2 mm cortical bone were designed, and the cortical and cancellous bone were assumed to be perfectly bonded to the implant fixture. The splinted model(Model 1) had 2 mm contact surface and the non-splinted model(Model 2) had $8{\mu}m$ gap between two implant crowns. Two group (Splinted and non-splinted) was loaded with 200 N magnitude in the vertical and oblique directions on the loading point position on the central position of the crown, the 2 mm and 4 mm buccal offset point from the central position. Von Mises stress value was recorded and compared in the fixture-bone interface in the bucco-lingual and mesio-distal sections. The results were as follows; 1. In the vertical loading condition of central position, the stress was distributed on the cortical bone and the cancellous bone around the thread of the fixture in the splinted and non-splinted models. In the oblique loading condition, the stress was concentrated toward the cortical bone of the fixture neck, and the neck portion of 2nd molar in the non-splinted model was concentrated higher than that of 1st molar compared to the splinted model. 2. In the 2 mm buccal offset position of the vertical loading compared to the central vertical loading, stress pattern was shifted from apical third portion of the fixture to upper third portion of that. In the oblique loading condition, the stress was distributed over the fixture-bone interface. 3. In the 4 mm buccal offset position of the vertical loading, stress pattern was concentrated on the cortical bone around the buccal side of the fixture thread and shifted from apical third portion of the fixture to upper third portion of that in the splinted and non-splinted models. In the oblique loading, stresses pattern was distributed to the outer position of the neck portion of the fixture thread on the mesio-distal section in the splinted and non-splinted models. Above the results, it was concluded that the direction of loading condition was a key factor to effect the pattern and magnitude of stress over the surrounding bone of the fixture under the vertical and oblique loading conditions, although the type with or without proximal contact did not effect to the stress distribution.

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.153-159
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• 2013

Purpose: The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods. Methods: Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface. Results: At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient= 0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018). Conclusions: A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.

• The korean journal of orthodontics
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• v.36 no.4
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• pp.295-307
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• 2006

Objective: The purpose of this study was to compare the histological and biomechanical characteristics of self-tapping and self-drilling microscrew implants. Methods: 112 microscrew implants (56 self-drilling and 56 self-tapping) were placed into the tibia of 28 rabbits. The implants were loaded immediately with no force, light (100 gm), or heavy force (200 gm) with nickel-titanium coil springs. The animals were sacrificed at 3- and 5-weeks after placement and histologic and histomorphometric analysis were performed under a microscope. Results: All microscrew implants stayed firm throughout the experiment. There was no significant difference between self-drilling and self-tapping microscrew implants both in peak insertion and removal torques. Histologic examinations showed there were more defects in the self-tapping than the self-drilling microscrew implants, and newly formed immature bone was increased at the interface in the self-tapping 5-week group. There was proliferation of bone towards the outer surface of the implant and/or toward the marrow space in the self-drilling group. Histologically, self-drilling microscrew implants provided more bone contact initially but the two methods became similar at 5 weeks. Conclusion: These results indicate the two methods can be used for microscrew implant placement, but when using self-tapping microscrew implants, it seems better to use light force in the early stages.

• Journal of Periodontal and Implant Science
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• v.49 no.6
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• pp.382-396
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• 2019

Purpose: The purpose of this study was to elucidate the efficacy and safety of carbonate apatite (CO₃Ap) granules in 2-stage sinus floor augmentation through the radiographic and histomorphometric assessment of bone biopsy specimens. Methods: Two-stage sinus floor augmentation was performed on 13 patients with a total of 17 implants. Radiographic assessment using panoramic radiographs was performed immediately after augmentation and was also performed 2 additional times, at 7±2 months and 18±2 months post-augmentation, respectively. Bone biopsy specimens taken from planned implant placement sites underwent micro-computed tomography, after which histological sections were prepared. Results: Postoperative healing of the sinus floor augmentation was uneventful in all cases. The mean preoperative residual bone height was 3.5±1.3 mm, and this was increased to 13.3±1.7 mm by augmentation with the CO₃Ap granules. The mean height of the augmented site had decreased to 10.7±1.9 mm by 7±2 months after augmentation; however, implants with lengths in the range of 6.5 to 11.5 mm could still be placed. The mean height of the augmented site had decreased to 9.6±1.4 mm by 18±2 months post-augmentation. No implant failure or complications were observed. Few inflammatory cells or foreign body giant cells were observed in the bone biopsy specimens. Although there were individual differences in the amount of new bone detected, new bone was observed to be in direct contact with the CO₃Ap granules in all cases, without an intermediate layer of fibrous tissue. The amounts of bone and residual CO₃Ap were 33.8%±15.1% and 15.3%±11.9%, respectively. Conclusions: In this first demonstration, low-crystalline CO₃Ap granules showed excellent biocompatibility, and bone biopsy showed them to be replaced with bone in humans. CO₃Ap granules are a useful and safe bone substitute for two-stage sinus floor augmentation.

• The korean journal of orthodontics
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• v.36 no.3 s.116
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• pp.178-187
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• 2006

The present study was performed to evaluate the stress distribution on the diameter of the mini-implant and insertion angle to the bone surface. To perform three dimensional finite element analysis, a hexadron of $15{\times}15{\times}20mm^3$ was used, with a 1.0 mm width of cortical bone. Mini-implants of 8 mm length and 1.2 mm, 1.6 mm, and 2.0 mm in diameter were inserted at $90^{\circ},\;75^{\circ},\;60^{\circ},\;45^{\circ},\;and\;30^{\circ}$ to the bone surface. Two hundred grams of horizontal force was applied to the center of the mini-implant head and stress distribution and its magnitude were analyzed by ANSYS, a three dimensional finite element analysis program. The findings of this study showed that maximum von Mises stresses in the mini-implant and cortical and cancellous bone were decreased as the diameter increased from 1.2 mm to 2.0 mm with no relation to the insertion angle. Analysis of the stress distribution in the cortical and cancellous bone showed that the stress was absorbed mostly in the cortical bone, and little was transmitted to the cancellous bone. The contact area increased according to the increased diameter and decreased insertion angle to the bone surface, but maximum von Mises stress in cortical bone was more significantly related with the contact point of the mini-implant into the cortical bone surface than the insertion angle to the bone surface. The above results suggest that the maintenance of the mini-implant is more closely related with the diameter and contact point of the mini-implant into the cortical bone surface rather than the insertion angle.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.5
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• pp.294-301
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• 2013

Purpose: The purpose of this study is to assess the effectiveness of beta-tricalciumphosphate (${\beta}$-TCP) as a bone graft material on new bone formation and regeneration of mandible bone defect around dental implants. Methods: Both mandibular sites of ten rabbits were exposed. The experimental subjects were divided into two groups. Rabbits in the control group (right site of the mandible) had dental implants around cortical bone defects, without treatment, while, in the experimental group (left site of the mandible), ${\beta}$-TCP was grafted into the bone defect around the implant. Rabbits were sacrificed after one, two, three, four, and eight weeks, and histomorphometric evaluation and analysis of the bone implant contact rate were performed using an optical microscope. Results: Bone formation rates in the experimental group were greater than those in the control group from one to eight weeks, and percentages of implant surface contacted to bone were greater in the experimental group than in the control group from three weeks after implantation. Conclusion: These results suggest that the bone formation activity around dental implants was increased by osteoconduction activity of ${\beta}$-TCP.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.55-61
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• 2010

Tooth restoration with implant placement have been interested in modern veterinary dentistry. It is important to reduce the interval between the tooth extraction and the insertion of the implants, to determine the restoration time after implant placement in dogs The aim of the this study was to compare the bone mineral apposition rate of immediately loaded implants with an unloaded control during the early healing state in the artificial extraction mandible. In four Beagles, two premolar sockets (PM2 and PM3) of the both sides of the mandible were installed with a one stage titanium mini-implant with a length of 11 mm and a diameter of 3.37 mm immediately after tooth extraction. Provisional restroration was given to implants, 3 weeks after implant placement in the left side (immediate loading) and 12 weeks in the right side (delayed loading), respectively. Radiographic and histologic examinations were performed. Radiographic evaluation revealed no significant difference between two groups. Bone-implant contact was $47.1{\pm}8.9$ in immediate loading and $50.2{\pm}8.2$ in delayed loading, interthread bone density was $78.7{\pm}10.9$ in immediate loading and $73.1{\pm}15.5$ in delayed loading, and peri-implant bone density was $95.4{\pm}7.1$ in immediate loading and $95.0{\pm}5.2$ in delayed loading, respectively. Three histologic analyses showed no significant difference between delayed and immediate loading. Followed by this study, the immediate loading of implants insterted into fresh extraction sockets after tooth extraction could be considered in veterinary dentistry.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.267-284
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• 1991

Since the concept of a direct contact between bone and implants, without interposed soft- tissue layers, was reported by Dr. $Br{\aa}nemark$, there has been increasing necessity for correct under-standing of bone-implant interface and surrounding tissue response. Beside quality of bone, surgical technique, load applied to implants, one must consider implant materials, design and surface characteristics to obtain osseointegration. In this study HA plasma-sprayed implants, TPS implants and $Al_2O_3$ implants were inserted into the alveolar bone of dog and tissue response was observed with radiograph, stereoscope, light microscope, and scanning electron microscope. Results were as follows : 1. There was rapid and active bone formation in the region adjacent to HA plasma-sprayed implants but in the deep supporting bone only slight bone formation was seen. 2. There was considerable lamella bone formation in the region adjacent to TPS implants and the deep supporting bone became more compact. 3. There was some gap and sclerosing bone formation in the adjacent region of $Al_2O_3$ implants, but there was irregular new bone formation in the deep supporting bone. Therefore, it seems that $Al_2O_3$ is not adequate for osseointegrated implants.

• Journal of Periodontal and Implant Science
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• v.54 no.2
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• pp.96-107
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• 2024

Purpose: Deproteinized bovine bone or synthetic hydroxyapatite are 2 prevalent bone grafting materials used in the clinical treatment of peri-implant bone defects. However, the differences in bone formation among these materials remain unclear. This study evaluated osteogenesis kinetics in peri-implant defects using 2 types of deproteinized bovine bone (Bio-Oss^® and Bio-Oss/Collagen^®) and 2 types of synthetic hydroxyapatite (Apaceram-AX^® and Refit^®). We considered factors including newly generated bone volume; bone, osteoid, and material occupancy; and bone-to-implant contact. Methods: A beagle model with a mandibular defect was created by extracting the bilateral mandibular third and fourth premolars. Simultaneously, an implant was inserted into the defect, and the space between the implant and the surrounding bone walls was filled with Bio-Oss, Bio-Oss/Collagen, Apaceram-AX, Refit, or autologous bone. Micro-computed tomography and histological analyses were conducted at 3 and 6 months postoperatively (Refit and autologous bone were not included at the 6-month time point due to their rapid absorption). Results: All materials demonstrated excellent biocompatibility and osteoconductivity. At 3 months, Bio-Oss and Apaceram-AX exhibited significantly greater volumes of formation than the other materials, with Bio-Oss having a marginally higher amount. However, this outcome was reversed at 6 months, with no significant difference between the 2 materials at either time point. Apaceram-AX displayed notably slower bioresorption and the largest quantity of residual material at both time points. In contrast, Refit had significantly greater bioresorption, with complete resorption and rapid maturation involving cortical bone formation at the crest at 3 months, Refit demonstrated the highest mineralized tissue and osteoid occupancy after 3 months, albeit without statistical significance. Conclusions: Overall, the materials demonstrated varying post-implantation behaviors in vivo. Thus, in a clinical setting, both the properties of these materials and the specific conditions of the defects needing reinforcement should be considered to identify the most suitable material.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.3
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• pp.557-565
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• 1997

Screw-shaped implants of commercially pure (c.p.) titanium, c.p. niobium, c.p. zirconium, and stainless steel(Sus 304) were inserted in the rabbit tibial bone over 12 weeks of follow-up. New developed torque gauge instrument was used to evaluate the implant holding power and a image analysis program coupled to a microscope was used for histomorphometry. The three best consecutive threads of each implant were measured. Quantitative analyses at 12 weeks revealed a partial bone contact to the four kinds investigated metals. There were no obvious adverse tissue reactions to any of the biomaterials. At 12 weeks the average removal torques for titanium, niobium and zirconium were better than that needed for Sus 304 screws, on the other hand high score of bony contact ratio of titanium and niobium were showed in comparison to those of zirconium and Sus 304. There was no significant differences in the amount of interfacial bone of zirconium and Sus 304 whereas there was significant difference in the torque forces of niobium and Sus 304. Three months after implant insertion, the average removal torque was 6.64 Ncm for the titanium, 6.57 Ncm for the niobium, 6.38 Ncm for the zirconium, and 4.25 Ncm for the Sus 304. On average bone contacts there were 51.24% in the titanium, 48.19% in the niobium, 31.79% in the zirconium, 23.54% in the Sus 304. Biocompatibility of the titanium, niobium and zirconium was acceptable level in comparison to the Sus 304.