• The Journal of Korean Academy of Prosthodontics
• /
• v.47 no.4
• /
• pp.394-405
• /
• 2009

Statement of problem: Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses. Purpose: To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses. Material and methods: A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at $30^{\circ}$ with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone. Results: Base Model with straight configuration at the transgingival part created highest stresses on the crestal bone. Stress level was reduced when concavity was imposed. The greater the concavity and the closer the concavity to the crestal bone level, the less the crestal stresses. Conclusion: The transgingival part of dental implant affect the crestal bone stress. And that concavely designed one may be used to reduce bone stress.

• Journal of Periodontal and Implant Science
• /
• v.52 no.5
• /
• pp.411-421
• /
• 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.

• The Journal of Korean Academy of Prosthodontics
• /
• v.40 no.5
• /
• pp.507-524
• /
• 2002

Load transfer of implant overdenture varies depending on anchorage systems that are the design of the superstructure and substructure and the choice of attachment. Overload by using improper anchorage system not only will cause fracture of the framework or screw but also may cause failure of osseointegration. Choosing anchorage system in making prosthesis, therefore, can be considered to be one of the most important factors that affect long-term success of implant treatment. In this study, in order to determine the effect of anchorage systems on load transfer in mandibular implant overdenture in which 4 implants were placed in the interforaminal region, patterns of stress distribution in implant supporting bone in case of unilateral vertical loading on mandibular left first molar were compared each other according to various types of anchorage system using three-dimensional photoelastic stress analysis. The five photoelastic overdenture models utilizing Hader bar without cantilever using clips(type 1), cantilevered Hader bar using clips(type 2), cantilevered Hader bar with milled surface using clips(type 3), cantilevered milled-bar using swivel-latchs and frictional pins(type 4), and Hader bar using clip and ERA attachments(type 5), and one cantilevered fixed-detachable prosthesis(type 6) model as control were fabricated. The following conclusions were drawn within the limitations of this study, 1. In all experimental models. the highest stress was concentrated on the most distal implant supporting bone on loaded side. 2. Maximum fringe orders on ipsilateral distal implant supporting bone in a ascending order is as follows: type 5, type 1, type 4, type 2 and type 3, and type 6. 3. Regardless of anchorage systems. more or less stresses were generated on the residual ridge under distal extension base of all overdenture models. To summarize the above mentioned results, in case of the patients with unfavorable biomechanical conditions such as not sufficient number of supporting implants, short length of the implant and unfavorable antero-posterior spread. selecting resilient type attachment or minimizing distal cantilever bar is considered to be appropriate methods to prevent overloading on implants by reducing cantilever effect and gaining more support from the distal residual ridge.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.4
• /
• pp.331-338
• /
• 2004

Stress transfer to the surrounding tissues is one of the factors involved in the design of dental implants. Unfortunately, insufficient data are available for stress transfer within the regenerated bone surrounding dental implants. The purpose of this study was to investigate the concentration of stresses within the regenerated bone surrounding the implant using three-dimensional finite element stress analysis method. Stress magnitude and contours within the regenerated bone were calculated. The $3.75{\times}10-mm$ implant (3i, USA) was used for this study and was assumed to be 100% osseointegrated, and was placed in mandibular bone and restored with a cast gold crown. Using ANSYS software revision 6.0, a program was written to generate a model simulating a cylindrical block section of the mandible 20 mm in height and 10 mm in diameter. The present study used a fine grid model incorporating elements between 165,148 and 253,604 and nodal points between 31,616 and 48,877. This study was simulated loads of 200N at the central fossa (A), at the outside point of the central fossa with resin filling into screw hole (B), and at the buccal cusp (C), in a vertical and $30^{\circ}$ lateral loading, respectively. The results were as follows; 1. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were increased from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, concentrated on the top of the cylindrical collar loading point B and C in vertical loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were increase from loading point A to C in vertical loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in vertical loading. 2. In case the regenerated bone (bone quality type IV) was surrounded by bone quality type I and II, stresses were decreased from loading point A to C in lateral loading. Stresses according to the depth of regenerated bone were concentrated on the top of the cylindrical collar in loading point A and B, distributed along the implant evenly in loading point C in lateral loading. And, In case the regenerated bone (bone quality type IV) was surrounded by bone quality type III, stresses were decreased from loading point A to C in lateral loading. And stresses according to the depth of regenerated bone were distributed along the implant evenly in loading point A, B and C in lateral loading. In summary, these data indicate that both bone quality surrounding the regenerated bone adjacent to implant fixture and load direction applied on the prosthesis could influence concentration of stress within the regenerated bone surrounding the cylindrical type implant fixture.

• Journal of Technologic Dentistry
• /
• v.38 no.1
• /
• pp.9-22
• /
• 2016

Purpose: The Purpose of this study are to describe the Dental field of present health insurance for custom-made prosthetic implant by dental technicians' work. Results: A total of 300 dental technicians working at dental laboratories in Korea were randomly selected and surveyed, 206(68.7%) of them were used for the statistical analysis. Conclusion: Average daily working time was 10 hours 66%. The average cumulative credit of the clinic for dental prosthesis fabrication rates was Less than 10 million won(21.8%), 10~80 million won(11.7%), more than one hundred million won(1.5%). Remake dental prosthesis was one more than the monthly average of 98.5%. Causes of remake dental prosthesis was dentist impression 83% but did not pay 62.5%. Dental technicians Implant production period was 7 days(48.5%), 10 days(35%) was commissioned by dentists production time is 5 days(46.1%), 7 days(36.5%). President of dental laboratories 3.86 points and dental technicians 3.06 points knew differently about starting of implant health insurance coverage(p<.001). They alike were in favor of insurance coverage for the implant. Dental technicians were lower by 2.36 points for work do you know whether your health insurance application of dental prostheses. Dental technicians are 2.16 points on whether confidence in the pores payment of insurance coverage dental prosthesis, dental laboratory president was lower by 1.85 points. They are very low with 1.97 points on whether confidence in the rate payment of health insurance coverage dental prosthesis(p<.01). The implant prosthesis abutment selected, the abutments designed, design of the implant upper prosthetic, the upper prosthetic fitting dental technicians participate of dental laboratory president showed higher score (p <.05). Conclusion: Hours of dental technicians were making this short period of remake dental prosthesis-related dental prosthesis. Dental clinic and a detailed representation of the dental prosthodontic fabrication request is required for communication between the laboratory in order to reduce the remake of a dental prosthesis, dental insurance coverage written dental prosthodontic fabrication request should be legislated. Implant classification standard medical practice 1-3 Step conduct a thorough costing a total of no. 73 of the correct classification standard medical practice in addition to eight times defined by the act of dental technicians should be defined.

• Imaging Science in Dentistry
• /
• v.33 no.2
• /
• pp.79-83
• /
• 2003

Purpose : To assess the relationship between the direction of the indicating rod of the radiographic stent for ideal prosthetic design and the actual possible path of implant fixture placement when residual ridge resorption is considered. Materials and Methods: The study materials consisted of 326 implant sites (male 214 cases and female 112 cases) from a total of 106 patients (male 65 patients and female 41 patients) who desired implant prostheses. Computed tomography of patients were taken and reformatted using ToothPix/sup (R)/ software. Bony defects, bony sclerosis, the change of the direction of indicating rod, and root proximity of the adjacent teeth were examined on the CT-derived images. Results: The rate of the irregular crestal cortex was relatively high on premolar and molar area of maxilla. Mandibular molar area showed relatively high rate of focal sclerosis on the area of implant fixture insertion. The position of the indicating rods were relatively acceptable on the molar areas of both jaws. However, the position of the indicating rods should be shifted to buccal side with lingual rotation of the apical end on maxillary anterior teeth and premolar area. Conclusion: Clinically determined rod direction and position of the indicating rod for implant placement was not always acceptable for insertion according to the reformatted CT images. The pre-operative treatment plan for implant should be determined carefully, considering the state of the alveolar bone using the reformatted CT images.

• Journal of Periodontal and Implant Science
• /
• v.23 no.3
• /
• pp.400-410
• /
• 1993

Dental implants have been widely used in the treatment of esthetic and functional problems of the mouth due to alveolar bone loss, after tooth extraction. The success of implantation strongly depends on osseointegration. For osseointegration, implant material, methodology, and design have been investigated. For materials, two popular materials at present are titanium and hydroxyapatite. For methods, immediate implantation is being used recently. The purpose of this study is to evaluate osseointegration between the unthreaded cylindrical TPS implant and the HA-coated implant by a histomorphometric analysis. For this analysis, experimental periodontits was induced on the 3, 4 premolars of adult dogs by the ligation of orthodontic threads. Thereafter, each tooth was extracted. TPS. Implants and HA-coated implants were immediately inserted in the extraction socket. In control group, TPS implants were immediately inserted, and In experimental group, HA implants were immediately inserted. The dogs were sacrificed after 12 weeks, then the specimens were prepared for LM and histomorphometric analysis. The conclusion of this study is as follows l. In both control and experimental group, no inflammatory cells were observed. 2. The results of the histomorphometric analysis showed that the total osseointegration was 48.5% in control group, and 68.8% in expermental group. The experimental group was higher than the control group, and the difference was not statistically significant (p<0.05). 3. The results of the histomorphometric analysis showed that the osseointegration in the hole was 40.6% in control group, and 70.2% in experimental group. The experimental group was higher than the control group, and the difference was statistically significant (p<0.05). In both control and experinental group, no inflammatory cells were observed. 4. The results of the histomorphometric analysis showed that the osseointegration in the lower part was 52.1% in control group, and 73.3% in experimental group. The experimental group was higher than the control group, and the difference was statistically significant (p<0.05). 5. In experimental group, the bone to HA interface seemed to be mixed of bone and HA. We could not distinguish HA from the bone. The HA coating was detached from the titanium surface.

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

• Clinics in Shoulder and Elbow
• /
• v.16 no.2
• /
• pp.170-177
• /
• 2013

Total elbow arthroplasty is still in its infancy compared with other arthroplasties, such as knee or hip arthroplasties. Implant design has been evolving with clinical experiences; however, there are only limited data on the long-term clinical outcome of elbow arthroplasty in the literature. The design of total elbow prostheses can be divided into three categories: linked (constrained or semi-constrained), unlinked (unconstrained), and convertible types. The choice between an unlinked (unconstrained) implant and a linked (semi-constrained) implant depends on joint stability and adequacy of the bone stock. Linked elbow arthroplasty has provided high patient satisfaction, and pain relief thanks to proper patient selection, advancement of implant design, improvement in cement techniques, meticulous surgical technique, and appropriate postoperative rehabilitation. Concerns remain about the use of this implant in young or high-demand patients. This article focuses on the linked (semi-constrained) prostheses, which provides an overview of the current state of linked total elbow arthroplasty.

• The Journal of Korean Academy of Prosthodontics
• /
• v.53 no.4
• /
• pp.301-309
• /
• 2015

Purpose: The aim of this study was to evaluate the clinical performance of screw- and cement-retained implant prosthesis (SCP) design in terms of retained preload of abutment screws and cement washout. Materials and methods: Patients with the partial posterior edentulous areas comprised the study group. Implants were placed, and SCPs were delivered after 3 to 6 months healing. Follow-up examinations were performed. The implant survival rate and the prosthetic success rate were evaluated. The retained preload ratio of abutment screws and the prosthetic decementation ratio were measured. Results: Twenty one SCPs (forty three implants)in twenty patients were followed up to 64 months. All of the implants survived during the follow-up period (mean follow-up: 34 months). The prosthetic success rate was 100 % considering no abutment, screw, porcelain or metal frame fractures, as well as no screw loosening. The retained preload ratio of SCPs at the end of follow-up period was 97.61% (${\pm}16.29$) and the decementation ratio was 9.5 %. Conclusion: Within the limitations of this clinical study, SCP design showed favorable short-term clinical performances in respect of screw loosening and cement washout.