• The Journal of Advanced Prosthodontics
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• v.9 no.5
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• pp.371-380
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• 2017

PURPOSE. The aim of this study is to evaluate and compare the stress distribution in Locator attachments in mandibular two-implant overdentures according to implant locations and different loading conditions. MATERIALS AND METHODS. Four three-dimensional finite element models were created, simulating two osseointegrated implants in the mandible to support two Locator attachments and an overdenture. The models simulated an overdenture with implants located in the position of the level of lateral incisors, canines, second premolars, and crossed implant. A 150 N vertical unilateral and bilateral load was applied at different locations and 40 N was also applied when combined with anterior load at the midline. Data for von Mises stresses in the abutment (matrix) of the attachment and the plastic insert (patrix) of the attachment were produced numerically, color-coded, and compared between the models for attachments and loading conditions. RESULTS. Regardless of the load, the greatest stress values were recorded in the overdenture attachments with implants at lateral incisor locations. In all models and load conditions, the attachment abutment (matrix) withstood a much greater stress than the insert plastic (patrix). Regardless of the model, when a unilateral load was applied, the load side Locator attachments recorded a much higher stress compared to the contralateral side. However, with load bilateral posterior alone or combined at midline load, the stress distribution was more symmetrical. The stress is distributed primarily in the occlusal and lateral surface of the insert plastic patrix and threadless area of the abutment (matrix). CONCLUSION. The overdenture model with lateral incisor level implants is the worst design in terms of biomechanical environment for the attachment components. The bilateral load in general favors a more uniform stress distribution in both attachments compared to a much greater stress registered with unilateral load in the load side attachments. Regardless of the implant positions and the occlusal load application site, the stress transferred to the insert plastic is much lower than that registered in the abutment.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.4
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• pp.391-409
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• 2001

Since the early study about the osseointegration, lots of researches have been performed to increase the success rate and the stress around the implant in the jaw bone has been considered as one of the causes of failure. The purpose of this study was to examine the relationship between the implant failure and the stress by analysing the influence of different bone quality and bite force of some foods on the stress distribution around the implant, and to estimate the treatment result according to the bone quality and dietary pattern of patients. Bone quality was divided in 4 groups and models were drawn with the assumption that thread type implant(Nobel Biocare AB, Goteborg, Sweden) of 3.75mm diameter, 13mm length was installed to the bones. Various bite forces were applied to the occlusal surface of superstructure and the stress distributed around the implant were analysed with finite element analysis program. The results were as follows ; 1. The stress was changed proportionally to the bite forces of foods at all measuring points in all load cases. 2. The stress at the marginal bone was higher than that of the other measuring points in all load cases, and it was decreased at the first thread area. 3. The stress at the marginal bone was highest in type IV bone in all load cases. Especially it was twice those of other bone types at the bucco-lingual marginal bone and 50% higher at the mesio-distal marginal bone. 4. The stress at the bucco-lingual sides of the bone around the apical portions of implant showed little differences among the bone types, while type IV bone showed lower stress concentration than the other bone types in the mesio-distal sides. 5. Under the buccal oblique load ($15^{\circ}$ ), the stress at the lingual marginal bone was higher than that of buccal marginal bone, and the difference between the two points was almost same regardless of bone types.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.4
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• pp.580-610
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• 1993

The purpose of this study was to analyse the deflection and stress distribution at the supporting bone and it's superstructure by the alteration of angulation between implant and it's implant abutment. For this study, the free-end saddle case of mandibular first and second molar missing would be planned to restore with fixed prosthesis. So the mandibular second premolar was prepared for abutment, and the cylinder type osseointegrated implant was placed at the site of mandibular second molar for abutment. The finite element stress analysis was applied for this study. 13 two-dimensional FEM models were created, a standard model at $0^{\circ}$ and 12 models created by changing the angulation between implant and implant abutment as increasing the angulation mesially and distally with $5^{\circ}$ unittill $30^{\circ}$. The preprocessing decording, solving and postprocessing procedures were done by using FEM analysis software PATRAN and SUN-SPARC2GX. The deflections and von Mises stresses were calculated under concentrated load (load 1) and distributed load(load 2) at the reference points. The results were as follows : 1. Observing at standard model, the amount of total deflection at the distobuccal cusp-tip of pontic under concentrated load was largest of all, and that at the apex of implant was least of all, and the amount of total deflection at the buccal cusp-tip of second premolar under distributed load was largest of all, and that at the apex of implant was least of all. 2. Increasing the angulation mesially or distally, the amounts of total deflection were increased or decreased according to the reference points. But the order according to the amount of total deflection was not changed except apex of second premolar and central fossa of implant abutment under concentrated load during distal inclination. 3. Observing at standard model, the von Mises stress at the distal joint of pontic under concentrated load was largest of all, and that at the apex of implant was least of all. The von Mises stress at the distal margin of second premolar under distributed load was largest of all, and that at the apex of Implant was least of ail. 4. Increasing the angulation of implant mesially, the von Mises stresses at the mesial crest of implant were increased under concentrated load and distributed load, but those were increased remarkably under distributed load and so that at $30^{\circ}$ mesial inclination was largest of all. 5. Increasing the angulation of implant distally, the von Mises stresses at the distal crest of implant were increased remarkably under concentrated load and distributed load, and so those at $30^{\circ}$ distal inclination were largest of all.

• The Journal of Korean Academy of Prosthodontics
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• v.35 no.4
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• pp.627-646
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• 1997

In order to find the degree of osseointegration at bone-implant interface of clinically successful implants, models including the 3.75mm wide, 10mm long screw type $Br{\aa}nemark$ implant as a standard and cylinder, 15mm long, 5.0mm wide, two splinted implants, and implants installed in various cancellous bone density were designed. Also, the amount of load and material of prostheses were changed. The stress and minimum contact fraction were analyzed on each model using three-dimensional finite element method(I-DEAS and ABAQUS version 5.5). The results of this study were as follows. 1. 10mm long, 3.75mm diameter-screw type implant had $36.5{\sim}43.7%$ of minimum contact fraction. 2. Cylinder type implant showed inferior stress distribution and higher minimum contact fraction than screw type. 3. As implant length was increased, minimum contact fraction was increased a little, however, maximum principal stress was decreased. 4. Implants with a large diameter had lower stress value with slightly higher minimum contact fraction than standard screw type. 5. Two splinted implants showed no change of minimum contact fraction. 6. The higher bone density, the lower stress value. 7. The material of occlusal surface had no effect on the stress of the bone-implant interface.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.189-197
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• 1999

The use of osseointegrated implant has been reported that is an acceptable procedure for the restoration of totally or partially edentulous patient and that offers good predictability of long term success. It is difficult to get high success rate in edentulous maxillae with inadequate bony quality and quantity, and anatomic limitations such as pneumatic maxillary sinus and nasal floor. The various trials such as sinus lifting, bone grafting, guided bone regeneration, trabecular condensation with osteotome, and the use of wide-diameter implant have been introduced to solve these problems. This study was undertaken to assess the evaluation of clinical prognosis of the implant restorations with these various implantation techniques in the maxillary edentulous area. One hundred eight patients were treated with a total of 386 endosseous implants from March 1994 to January 1998 at Dept. of Dentistry, Korea Veterans Hospital in Seoul Korea. The various techniques for implantation in the edentulous maxillae were supplied to overcome the limitations of implant fixation. These techniques consist of sinus lifting, guided bone regeneration, onlay bone grafting, and osteotome trabecular condensation technique. The total success rate of implant restoration of this study was 93% in the maxillae. The success rate of implant restorations with conventional technique was 94.6%, with osteotome trabecular condensation technique was 94.1%, with guided bone regeneration technique was 93.3%, with bone grafting technique was 92.9%, with sinus lifting technique was 83.8%. The success rate on the maxillary anterior area was 95.2% and that on the posterior area was 91.9%. The failures were associated not only with surgical installation techniques but also bony quality and quantity, characteristics of implant, and stress distribution when in function.

• Journal of Periodontal and Implant Science
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• v.46 no.1
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• pp.35-45
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• 2016

Purpose: Porphyromonas gingivalis fimA is a virulence factor associated with periodontal diseases, but its role in the pathogenesis of peri-implantitis remains unclear. We aimed to evaluate the relationship between the condition of peri-implant tissue and the distribution of P. gingivalis fimA genotypes in Koreans using a new primer. Methods: A total of 248 plaque samples were taken from the peri-implant sulci of 184 subjects. The control group consisted of sound implants with a peri-implant probing depth (PD) of 5 mm or less with no bleeding on probing (BOP). Test group I consisted of implants with a peri-implant PD of 5 mm or less and BOP, and test group II consisted of implants with a peri-implant PD of more than 5 mm and BOP. DNA was extracted from each sample and analyzed a using a polymerase chain reaction (PCR) with P. gingivalis -specific primers, followed by an additional PCR assay to differentiate the fimA genotypes in P. gingivalis-positive subjects. Results: The Prevalence of P. gingivalis in each group did not significantly differ (P>0.05). The most predominant fimA genotype in all groups was type II. The prevalence of type Ib fimA was significantly greater in test group II than in the control group (P<0.05). Conclusions: The fimA type Ib genotype of P. gingivalis was found to play a critical role in the destruction of peri-implant tissue, suggesting that it may be a distinct risk factor for periimplantitis.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.2
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• pp.110-119
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• 2022

When restoration for partially edentulous patients, abutments are not always in favorable positions for making removable partial dentures. Because of these situations, patients are sometimes unsatisfied with the stability and support of their removable partial prostheses. In this regard, removable partial denture using a few implant surveyed crown prostheses can be a good alternative. It can be expected to increase stability and support of removable partial dentures by strategically placing a small number of implants and restoring with implant-supported surveyed crowns. In these cases, the patients who had unilateral residual teeth on mandible were treated with two implant surveyed crowns in the tactical place to have bilateral distribution. After definitive removable partial prosthesis, the patients showed satisfaction with the masticatory function and comfort of using removable dentures.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.6
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• pp.765-781
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• 2000

The purpose of this study was to compare the screw loosening characteristics of three avail-able cementation type abutments: one-piece cementation type abutment; two-piece cementation type abutment using titanium abutment screw; two-piece cementation type abutment using gold abutment screw. Two implant supported three-unit superstructures were fabricated using a pair of 3 kinds of abutments for each experimental model. Cyclic loading was applied on the specimen, and made to stop when the superstructure showed movement over threshold range. The loaded cycle was counted until the machine stopped. Frequency analysis was done to measure the change of natural frequency before and after the application of cyclic load and to find the effect of screw loosening on the change of natural frequency. The specimen assembly was modeled to perform the finite element analysis to see the distribution of the stress induced by the application of preload over the screw joint and to compare the pattern of the distribution of stress induced by the external force with the change of the preload condition. The following results were obtained: 1. The failure loading cycle of two-piece cementation type abutment using gold screw was significantly greater than those of the other groups. 2. One-piece cementation type abutment applied to multi-unit restoration case did not show greater resistance to screw loosening compared to two-piece cementation type abutments. 3. Frequency analysis showed decrease in natural frequency when screw loosening occured.

• Journal of Technologic Dentistry
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• v.29 no.1
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• pp.93-101
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• 2007

The purpose of this study is to evaluate the effect of three different oblique mechanical loading to occlusal surfaces of posterior implant partial dentures on the stress distributions in surrounding bone, using 3-dimensional finite element method. A 3-dimensional finite element model of a posterior implant partial dentures composed of three unit implants, simplified 3 gold alloy crown and supporting bone was developed according to the design of AVANA self tapping implant for this study. Three kinds of surface distributed oblique loads(300 N) are applied to following occlusal surfaces in the three crowns; 1) All occlusal surfaces in the three crown(load of 300 N was shared to three crown), 2) Occlusal surface of centered crown (load of 300 N was applied to a centered crown), 3) Occlusal surface of proximal crown(load of 300 N was applied to a distal proximal crown). In the results, 141 MPa of maximum von Mises stress was calculated at third loading condition and 98 MPa of minimum von Mises stress was calculated at first loading condition. From the results, location and type of occlusive loading conditions are important for the safety of supporting bone.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.2
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• pp.125-137
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• 2003

The use of screw-retaind prosthesis on an osseointegrated implant is a popular treatment modality offering relative ease in the removal of the restoration. One of the complications associated with this modality is the loosening of the abutment and coping screws. Loosening of the screws results in patient dissatisfaction, frustration to the dentist and, if left untreated, component fracture. There are several factors which contribute to the loosening of implant components which can be controlled by the restorative dentist and lab technician. This article offers pratical solutions to minimize this clinical problem and describes the factors involved in maintaining a stable screw joint assembly. To avoid joint failure, adherence to specific clinical, as well as mechanical, parameters is critical. With respect to hardware, optimal tolerance and fit, minimal rotational play, best physical properties, a predictable interface, and optimal torque application are mandatory. In the clinical arena, optimal implant distribution; load in line with implant axis; optimal number, diameter, and length of implants; elimination of cantilevers; optimal prosthesis fit; and occlusal load control are equally important.