• 구강회복응용과학지
• /
• 제18권2호
• /
• pp.81-91
• /
• 2002

Dental implant systems have shown many post-surgical problems and One of the most frequent problem is screw loosening. To reduce screw loosening, a number of methods have been tried and recently fundamental modification of fixture-abutment connection structure was developed and used the most frequently. Former implant system structure, such as Br${\aa}$nemark, had external hex with the height of 0.7 mm and later, fixture with external hex of 1.0 mm height and internal hex structure were developed. In addition, the method of morse taper application was introduced to reduce screw loosening. In this study, the level of screw loosening of each implant systems was compared based on the vibration loosening measurement of abutment screw of each implant systems. Analysis of measured value was performed using 3 kinds of methods, (i) Percentage of average of initial 3 times loosening-torque value(initial loosening value) to tightening-torque of 30 Ncm, (ii) Percentage of loosening-torque value after 200 N strength loaded(experimental value) to initial loosening value and (iii) Percentage of experimental value to 30 Ncm of tightening-torque. Each result of analyses shows the value of initial loosening, loosening by repetitive load and final loosening level. The results of this study were as follows. (1) Percentage of initial loosening value to tightening-torque was increased in order of 0.7 mm external hex, 1.0 mm external hex, internal hex and internal taper and all values between each groups showed statistical significance (p<0.05). (2) Percentage of experimental value to initial loosening value was increased in order of internal hex, 0.7 mm external hex, 1.0 mm external hex and internal taper. Value of internal taper showed significant difference with that of 0.7 mm external hex and internal hex (p<0.05). (3) Percentage of experimental value to tightening torque was increased in order of 0.7 mm external hex, 1.0 mm external hex, internal hex and internal taper. Values of all groups showed statistical significance (p<0.05) except between the groups of 1.0 mm external hex and internal hex. Based on those results, there was no significant difference of loosening-torque by repetitive loading except internal taper. It is supposed that implant system with high resistant capability against initial loosening could be recommended for clinical use. In addition, in case of single implant restoration, 1.0 mm external hex or internal hex could be recommended rather than 0.7 mm external hex, and the use of internal taper would be the most useful way to reduce screw loosening.

• 대한치과보철학회지
• /
• 제55권1호
• /
• pp.9-17
• /
• 2017

목적: 내부 연결형과 외부 연결형의 임플란트에서 직선형과 경사형 지르코니아 지대주의 파절강도를 비교하였다. 재료 및 방법: 내부육각 연결형 임플란트 20개와 외부육각 연결형 임플란트 20개에, 기성 직선형 지르코니아 지대주와, $17^{\circ}$ 경사형 지르코니아 지대주를 10개씩 체결하였다. 시편은 연결 방식과 지대주 각도에 따라 4개의 군으로 나누었다: 내부 연결형/ 직선형 지대주, INS군; 내부 연결형/ 경사형 지대주, INA 군; 외부 연결형/ 직선형 지대주, EXS 군; 외부 연결형/ 경사형 지대주, EXA 군. 모든 시편은 만능시험기에서 1 mm/min의 crosshead speed로 $30^{\circ}$ 하중을 가했다. 지대주의 파절강도를 측정하고, 2-way ANOVA와 independent t-test로 통계처리 하였다(${\alpha}=.05$). 결과: 각 군의 평균파절강도는 다음과 같다: INS군, 955.91 N; INA군, 933.65 N; EXS군, 1267.20 N; EXA군, 1405.93 N. 외부 연결형이 내부 연결형에 비해 파절강도가 높았다(P < .001). 내부연결형(P = .747)과 외부 연결형(P = .222)에서 지대주 각도에 따른 파절강도는 차이가 없었다. 또한 내부 연결형 지대주는 육각 부위에서 수평 파절이 일어난 반면, 외부 연결형 지대주는 설측 치경부에서 파절되었다. 결론: 외부 연결형 지르코니아 지대주가 내부 연결형 지대주에 비해 파절 강도가 높았고, 직선형과 경사형 지르코니아 지대주의 파절강도는 차이가 없었다.

• 대한치과보철학회지
• /
• 제34권2호
• /
• pp.385-402
• /
• 1996

The purpose of this study was to analyze how the stability of the implant prostheses and the loosening of the fastening screw was affected when the various types of Hex structure provided for the effect of anti-rotation of the single prostheses were given. Three dimensional finite element model was designed with which the implants with the external hex type of 0.75mm, 1.5mm and the implant with the internal hex type of 0.75mm, 1.5mm and the implant with the external hex type of $15^{\circ}$ tapered shape of 0.75mm were supposed to completely osseointegrate to the mandible. After fininshing the finite element model, the preload of 10N at the fastening screw was applied and then the vertical and $30^{\circ}$ lateral load of 200N was applied respectively at the cusp tips of the prostheses. The following results were obtained : 1. In case of displacement, the amount of displacement was increased at the internal hex type(model C, D) than at the external hex type(model A, B, E) when the vertical and lateral load was applied. 2. Less equivalent stress was represented at the model B with increased external hex height than at the model A when the vertical and lateral load was applied. 3. Much stress was represented at the model E with increased hex angle than at the model A in case of the stress happened to the implant body and the fastening screw when the vertical and lateral load was applied. 4. Much equivalent stress was represented at the model D with deepened internal hex height than at the model C when vertical and lateral load was applied. 5. The least stress was taken at the model B and the most stress was taken at the model D in case of the stress happened to the implant when the vertical and lateral load was applied. 6. The least stress was taken at the model C at the vertical load. And the least stress was taken at the model B at lateral load in case of the stress happened to the fastening screw. As a results of this study, the good lateral stability of prostheses and less stress of the component of implant was taken when the external hex height was increased, and the risk of neck fracture of implant and fastening screw was increased when the internal hex height was deepned because of long screw neck portion and thin implant neck portion.

• 대한치과보철학회지
• /
• 제41권4호
• /
• pp.393-404
• /
• 2003

Statement of problem. Higher incidence of prosthetic complications such as screw loosening, screw fracture has been reported for posterior single tooth implant. So, there is ongoing research regarding stability of implant-abutment interface. One of those research is increasing the implant diameter and prosthetic table width to improve joint stability. In another part of this research, internal conical type implant-abutment interface was developed and reported joint strength is higher than traditional external hex interface. Purpose. The purpose of this study is to compare stress distribution in single molar implant between external hex butt joint implant and internal conical joint implant when increasing the implant diameter and prosthetic table width : 4mm diameter, 5mm diameter, 5mm diameter/6mm prosthetic table width. Material and method. Non-linear finite element models were created and the 3-dimensional finite element analysis was performed to see the distribution of stress when 300N static loading was applied to model at $0^{\circ},\;15^{\circ},\;30^{\circ}$ off-axis angle. Results. The following results were obtained : 1. Internal conical joint showed lower tensile stress value than that of external hex butt joint. 2. When off-axis loading was applied, internal conical joint showed more effective stress distribution than external hex butt joint. 3. External hex butt joint showed lower tensile stress value when the implant diameter was increased. 4. Internal conical joint showed lower tensile stress value than external hex butt joint when the implant diameter was increased. 5. Both of these joint mechanism showed lower tensile stress value when the prosthetic table width was increased. Conclusion. Internal conical joint showed more effective stress distribution than external hex joint. Increasing implant diameter showed more effective stress distribution than increasing prosthetic table width.

• The Journal of Advanced Prosthodontics
• /
• 제8권6호
• /
• pp.465-471
• /
• 2016

PURPOSE. The purpose of this study is to evaluate the stability of interface between Co-Cr-Mo (CCM) UCLA abutment and external hex implant. MATERIALS AND METHODS. Sixteen external hex implant fixtures were assigned to two groups (CCM and Gold group) and were embedded in molds using clear acrylic resin. Screw-retained prostheses were constructed using CCM UCLA abutment and Gold UCLA abutment. The external implant fixture and screw-retained prostheses were connected using abutment screws. After the abutments were tightened to 30 Ncm torque, 5 kg thermocyclic functional loading was applied by chewing simulator. A target of $1.0{\times}10^6$cycles was applied. After cyclic loading, removal torque values were recorded using a driving torque tester, and the interface between implant fixture and abutment was evaluated by scanning electronic microscope (SEM). The means and standard deviations (SD) between the CCM and Gold groups were analyzed with independent t-test at the significance level of 0.05. RESULTS. Fractures of crowns, abutments, abutment screws, and fixtures and loosening of abutment screws were not observed after thermocyclic loading. There were no statistically significant differences at the recorded removal torque values between CCM and Gold groups (P>.05). SEM analysis revealed that remarkable wear patterns were observed at the abutment interface only for Gold UCLA abutments. Those patterns were not observed for other specimens. CONCLUSION. Within the limit of this study, CCM UCLA abutment has no statistically significant difference in the stability of interface with external hex implant, compared with Gold UCLA abutment.

• 대한치과보철학회지
• /
• 제42권1호
• /
• pp.83-93
• /
• 2004

Statement of problem : Since the concept of osseointegrated dental implant by $Br{\aa}nemark$ et al was first applied to mandibular full edentulous patients. Recently it is considerated the first treatment option on missing teeth. A common problem associated with dental implant restorations is loosening of screws that retain the prosthesis to the abutment and the abutment to the implant fixture. Purpose : This study is to examine the influence on screw loosening of implant-abutment designs. Material and methods : External hex, cone screw, beveled hex, cam cylinder, cylinder hex by means of evaluating the loosening torques, with respect to a range of tightening torques after repeated loading. Result : 1. Cone screw, beveled hex groups are the highest initial tightening rate and cylinder hex, external hex groups are the lowest initial tightening rate (p < 0.05). 2. Cone screw groups are the highest after repeated loading tightening rate and cylinder hex groups are lowest after repeated loading tightening rate(p < 0.05). 3. Cone screw groups have the highest initial stability and anal stability. 4. All groups are decreased tightening rate after repeated loading.

• 대한치과보철학회지
• /
• 제43권5호
• /
• pp.671-683
• /
• 2005

Statement of problem: The most commonly reported problem associated with dental implant restoration is the loosening of the screws. Purpose: This study compared the efficacy of an implant system incorporating an anti-rotational locking sleeve(Anti-Rotating Inner Post Screw System(ARIPS-system)) with other, traditional implant systems as a means of minimizing vibration loosening. Materials and methods: Three implant systems were examined; the conventional external hex type, the ARIPS-system, and the internal taper type implant system 30 specimens(10 samples per group)were fabricated and each abutment screw was secured to the implant future with 32Ncm of torque force and loosening torque was measured using a Torque Gauge. The procedure was repeated 3 times, recording initial loosening torque each time. The re-tightened abutment screw was subjected to a cyclic load having a maximum forte of 200N and minimum of 20N at 2Hz over a period of 12,600 cycles. after which the loosening torque was measured. Measured values were calaulated for statistical analysis. Analysis of measured value was performed by 3 methods: (i) as a percentage average of the initial 3 loosening-torque values(initial loosening value) to the tightening torque of 32Ncm, (ii) as a percentage of the loosening torque value after a load of 200N(experimental value) to the initial loosening value, and (iii) as a percentage of the experimental value to the 32Ncm of tightening torque. The analyses shows the amount of initial loosening at the screw, loosening by repetitive load and the the final loosening value. Results: The results of this study were as follows (1) Percentage of initial loosening value to tightening-torque was increased in order of external hex, ARIPS-system and internal taper and all values between each groups showed statistical significance (p<0.05). (2) Percentage of experimental value to initial loosening value was increased in order of external hex, ARIPS-system and internal taper. Value of internal taper showed significant difference with those of external hex and ARIPS-system (p<0.05). (3) Percentage of experimental value to tightening torque was increased in order of external hex, ARIPS-system and internal taper and all values between each groups showed statistical significance (p<0.05). Conclusion: The results of the analysis of the final loosening level value, which are closely correlated to clinical use, show that the ARIPS-system can be a useful means of minimizing abutment screw loosening when compared to the external hex type system. Although further clinical studies need to be made, the ARIPS-system should be considered to maximize the long-term success of the implant prosthesis.

• 대한치과보철학회지
• /
• 제49권4호
• /
• pp.346-353
• /
• 2011

연구 목적: 임플란트 식립 후 변연골 흡수에 따라 임플란트 주위 연조직이 재구성되며, 이에 따라 치료의 예후 및 심미성 등에 영향을 주게 된다. 그러므로 임플란트 경부 주위 골조직 보존을 위한 임플란트 경부에 다양한 디자인이 연구되고 있다. 본 고찰의 목적은 초기 변연골 흡수의 원인과 이에 따른 임플란트 주위의 연조직 변화에 대해 고찰하고, 어떠한 임플란트 경부 디자인이 임플란트 주위 조직의 보존에 유리한 지 알아보고자 한다. 연구 재료 및 방법: Pubmed database에서 임플란트 초기 변연골 흡수의 원인과 관련된 논문과 임플란트 경부의 여러 디자인에 관한 논문을 검색하여 분석하였다. 임플란트 경부 디자인은 one piece implant, two piece implant, internal hex abutment, external hex abutment, taper joint connection, butt joint connection, scalloped design abutment, platform switching concept에 관해 검토하였다. 결과: 초기의 임플란트 주위 조직 보존에 대하여 one piece implant가 two piece implant보다 유리한 것으로 여러 임상적, 실험적 연구가 있다. Two piece implant에서는 internal hex abutment가 external hex abutment보다, taper joint connection가 butt joint connection보다 유리할 것으로 보여진다. Scalloped design abutment에 대해서는 논쟁의 여지가 있어 더 많은 연구가 필요할 것으로 판단된다. Platform switching concept은 그 원인이 명확히 밝혀지지는 않았으나 임상적, 실험적으로 초기 임플란트 주위 조직 보존에 대해 유리한 것으로 판단된다. 결론: 임플란트 경부의 디자인마다 각각의 장단점이 있고 추가적인 연구가 더 필요한 제한이 있지만 현재까지의 선행 연구들을 분석 종합해 보면 초기 임플란트 주위 조직 보존을 고려한다면 가능한 경우 one piece implant가 유리할 것으로 판단되며, 보철적인 문제나 다른 이유로 인하여 two piece implant를 고려할 경우 platform switching concept, internal connection abutment, taper joint connection을 이용하는 것이 임플란트 주위 조직 보존에 좀더 유리할 것으로 사료된다.

• The Journal of Advanced Prosthodontics
• /
• 제8권1호
• /
• pp.62-69
• /
• 2016

PURPOSE. The purpose of this study was to evaluate the effects of abutment screw length and cyclic loading on the removal torque (RTV) in external hex (EH) and internal hex (IH) implants. MATERIALS AND METHODS. Forty screw-retained single crowns were connected to external and internal hex implants. The prepared titanium abutment screws were classified into 8 groups based on the number of threads (n = 5 per group): EH 12.5, 6.5, 3.5, 2.5 and IH 6.5, 5, 3.5, 2.5 threads. The abutment screws were tightened with 20 Ncm torque twice with 10-minute intervals. After 5 minutes, the initial RTVs of the abutment screws were measured with a digital torque gauge (MGT12). A customized jig was constructed to apply a load along the implant long axis at the central fossa of the maxillary first molar. The post-loading RTVs were measured after 16,000 cycles of mechanical loading with 50 N at a 1-Hz frequency. Statistical analysis included one-way analysis of variance and paired t-tests. RESULTS. The post-loading RTVs were significantly lower than the initial RTVs in the EH 2.5 thread and IH 2.5 thread groups (P<.05). The initial RTVs exhibited no significant differences among the 8 groups, whereas the post-loading RTVs of the EH 6.5 and EH 3.5 thread groups were higher than those of the IH 3.5 thread group (P<.05). CONCLUSION. Within the limitations of this study, the external hex implants with short screw lengths were more advantageous than internal hex implants with short screw lengths in torque maintenance after cyclic loading.

• The Journal of Advanced Prosthodontics
• /
• 제9권4호
• /
• pp.271-277
• /
• 2017

PURPOSE. This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS. Two regular platform dental implants, one with external connection ($Br{\aa}nemark$, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at ${\alpha}=0.05$ of significance. RESULTS. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.