• 대한치과의사협회지
• /
• 제53권6호
• /
• pp.418-426
• /
• 2015

The appropriate occlusion is one of the most important factors for the long-term success of implant and its restorations. The purpose of this review is to investigate and define occlusal considerations to reduce failure of implant prostheses. The physiological movement of implants is markedly lower than that of natural teeth and they also lack in occlusal sensitivity. Proper occlusal pattern may be assigned to compensate for the biological disadvantages and occlusal contacts must be formed where the cantilever effect is minimized. Moreover, the long-term success of implants after osseointegration can be assured by reducing early occlusal loading to avoid implant overloading and selecting appropriate occlusion material. Occlusal overload was brought by the number and location of occlusal contacts, which are under the clinician's control. The concept of implant occlusion is based on the concepts derived from traditional prosthetics. Moreover, there are few evidence on the concept or design of implant occlusion. Several occlusal design was recommended for implant prosthesis. Mutually protected occlusion, group function occlusion and bilateral balance occlusion was recommended for the specific types of implant restorations. This article reviews proper design of occlusion for implant restoration and offers occlusion strategy clinically.

• Structural Engineering and Mechanics
• /
• 제91권3호
• /
• pp.251-262
• /
• 2024

Numerical modeling using the finite element method (FEM) offers crucial insights into the mechanical behavior of prostheses, including stress and strain distribution, load transfer, and stress intensity factors. Analyzing cracking in PMMA surgical cement (polymethylmethacrylate) for total hip prostheses (THP) is essential for understanding the loosening phenomenon, as the rupture of orthopedic cement is a primary cause. By understanding various failure mechanisms, significant advancements in cemented total prostheses can be achieved. This study performed a numerical analysis using a 3D FEM model to evaluate stress levels in different THP models, aiming to model damage in the orthopedic cement used in total hip arthroplasty. Utilizing ABAQUS software, FEM, and XFEM, the damage in three types of THPs-Charnley (CMK3), Osteal (BM3), and THOMPSON was modeled under stumbling loading conditions. XFEM allowed for the consideration of crack propagation between the cement and bone, while the GEARING criterion employed a user-defined field subroutine to model damage parameters. The study's findings can contribute to improving implant fixation techniques and preventing postoperative complications in orthopedic surgery.

• 대한치과보철학회지
• /
• 제31권2호
• /
• pp.271-300
• /
• 1993

The purpose of this study was to analyze the stress distribution at supporting bone according to the types of connection modality between implant and tooth in the superstrcture. This investigation evaluated the stress patterns in a photoelastic model produced by three different types of dental implants such as Branemark, Steri-Oss, IMZ and resin tooth using the techniques of quasi three dimensional photoelasticity. The teeth-supported bridge had a first molar pontic supported by second premolar and second molar as a control group. The implant and toothsupported bridge had a first molar pontic supported by second premolar and implant posterior retainer as an experimental group. Prostheses were mechanically connected to an adjacent second premolar by the rigid of nonrigid connection, Nonrigid connection used an attachment placed between the tooth-supported and fixture-supported component. The female(keyway) of attachment was placed on the distal end of the retainer supported by the tooth ; the male(Key) of attachment connected to the osseointegrated bridge was engaged into the keyway. All prostheses were casted in the same nonprecious alloy and were cemented and screwed on their respective abutments and implants. 16㎏ of vertical loads on central fossae of second premolar, first molar pontic, implant of second molar were applied respectively and 6.5㎏ of inclined load on middle buccal surface of first molar pontic was applied. The results were as follows : 1. Under the vertical load on the central fossa of first mloar pontic, the stress developed at the apex of tooth of implat was more uniformly distributed in the case of nonrigid connection than in the case of rigid connection. 2. Under the vertical load on the central fossa of first molar pontic, the stress developed around the cervical area of tooth of implant was larger in the case of rigid connection than in the case of nonrigid connection because the bending moment was more occured in the case of rigid connection than in the case of nonrigid connection. 3. Stress was more restricted to the loaded side of nonrigid connection than to that of rigid connection 4. Under the inclined load. The set screw loosening of implant was more easily occured in the case of nonrigid connection than in the case of rigid connection due to torque moment. 5. In the case of Branemark implant, the stress concentration in second premolar was larger and the stress developed around the cervical area of implant was lower than any other cases under the vertical load, because Branemark implant with the flexible gold screw was showed in incline toward second premolar by a bending moment. 6. The stress developed around the apex of tooth or implant was more uniformly distributed in the case of Steri-Oss implant with stiff screw than in the case of Branemark implant under the vertical load. But, the stress developed around the cervical area of the Steri-Oss implant was larger than that of any other implants because bending moment was occured by vertical migration of second premolar. 7. The stress distribution in the case of IMZ implant was similar to the case of natural teeth under small vertical load. But, the residual stress around the implant was showed to occurdue to deformation of IMC and sinking of screw under larger vertical load.

• The Journal of Advanced Prosthodontics
• /
• 제3권1호
• /
• pp.1-9
• /
• 2011

PURPOSE. This study investigated the strain of implants using a chewing simulator with strain gauges in mandibular implant-supported fixed prostheses under various dynamic loads. MATERIALS AND METHODS. Three implant-supported 5-unit fixed prostheses were fabricated with three different occlusion types (Group I: Canine protected occlusion, Group II: Unilaterally balanced occlusion, Group III: Bilaterally balanced occlusion). Two strain gauges were attached to each implant abutment. The programmed dynamic loads (0 - 300 N) were applied using a chewing simulator (MTS 858 Mini Bionix II systems, MTS systems corp., Minn, USA) and the strains were monitored. The statistical analyses were performed using the paired t-test and the ANOVA. RESULTS. The mean strain values (MSV) for the working sides were 151.83 ${\mu}{\varepsilon}$, 176.23 ${\mu}{\varepsilon}$, and 131.07 ${\mu}{\varepsilon}$ for Group I, Group II, and Group III, respectively. There was a significant difference between Group II and Group III (P < .05). Also, the MSV for non-working side were 58.29 ${\mu}{\varepsilon}$, 72.64 ${\mu}{\varepsilon}$, and 98.93 ${\mu}{\varepsilon}$ for Group I, Group II, and Group III, respectively. One was significantly different from the others with a 95% confidence interval (P < .05). CONCLUSION. The MSV for the working side of Groups I and II were significantly different from that for the non-working side (Group I: t = 7.58, Group II: t = 6.25). The MSV for the working side of Group II showed significantly larger than that of Group III (P < .01). Lastly, the MSV for the non-working side of Group III showed significantly larger than those of Group I or Group II (P < .01).

• 대한치과보철학회지
• /
• 제60권1호
• /
• pp.44-54
• /
• 2022

다수 치아의 상실 상태로 장시간 지속시 구치부 지지의 부족 및 치아들의 과정출이 발생되어 교합 부조화, 수직고경 상실 및 기능 장애 등의 심각한 문제가 초래된다. 본 증례는 장기간 다수치아 결손으로 인하여 대합치가 정출하면서 교합평면의 붕괴가 일어난 환자의 완전 구강 회복에 관한 증례이다. 상기 환자는 서울대학교 치과병원 치과보철과로 내원한 68세 남환으로 오래된 상악 의치를 빼다가 치아가 함께 발거되었으며, 하악 전치부가 상악 전치부와 강하게 닿아서 불편함을 호소하며 내원하였다. 여러가지 평가를 통해 수직고경을 4 mm 거상하였으며, 무치악부는 진단 및 치료계획시 설계한 최종 보철 수복물 제작을 고려하여 정확한 임플란트 식립을 위해 CAD-CAM (Computer-aided design-computer-aided manufacturing) 기술을 이용한 Computer guided implant surgery를 시행하고, 임플란트 고정성 보철 수복으로 진행하였고, 환자는 저작, 기능 및 심미 모두 큰 개선에 만족하였다.

• 핵의학기술
• /
• 제14권2호
• /
• pp.110-116
• /
• 2010

PET/CT 검사는 기술의 발전에 따라 감쇄보정 방법이 $^{68}Ge$이나 $^{137}Cs$등의 동위원소를 사용하지 않고, CT 기반의 감쇄보정 영상을 구현하여 검사 시간의 단축과 해부학적인 영상을 제공한다. 그러나 CT 기반의 금속에 의한 CT 영상의 인공물이 발생하여 감쇄보정된 PET 영상에 영향을 준다. 그러므로 본 연구는 임상 실험과 phantom 실험을 통해 금속 치과 임상 실험은 구강 내질환이 없는 40명의 환자(평균나이: $56{\pm}17$세)를 대상으로 하였으며, 치아에 치과보철을 매식한 환자 20명과 치과 임플란트를 매식한 환자 20명을 대상으로 PET/CT 검사를 시행했다. phantom 실험은 원형 phantom내에 치과보철과 치과 임플란트를 매식한 치아모형을 이용하여 PET/CT 검사를 시행했다. 분석방법은 같은 단층상의 PET/CT 영상에서 CT 영상의 CT 값과 PET 영상의 표준섭취계수 변화를 인공물의 영향이 없는 부분, 어둡게 인공물이 나타난 부분, 밝게 인공물이 나타난 부분, 세 부분의 관심영역을 설정하여 측정했고, 통계분석은 대응표본 t-test를 이용했다. 치아 보철을 매식한 실험에서 환자의 경우 표준섭취계수가 인공물의 영향이 없는 부분에 비해 어둡게 인공물이 나타난 부분은 약 19.6% (p<0.05) 감소됐고, 밝게 인공물이 나타난 부분은 90.1% (p>0.05) 증가했다. phantom의 경우 표준섭취계수가 인공물의 영향이 없는 부분에 비해 어둡게 인공물이 나타난 부분은약 18.1% 감소됐고, 밝게 인공물이 나타난 부분은 18.0% 증가했다. 치아 임플란트를 매식한 실험에서 환자의 경우 표준섭취계수가 인공물의 영향이 없는 부분에 비해 어둡게 인공물이 나타난 부분은 약 19.1% (p<0.05) 증가됐고, 밝게 인공물이 나타난 부분은 96.6% (p>0.05) 증가했다. phantom의 경우 표준섭취계수가 인공물의 영향이 없는 부분에 비해 어둡게 인공물이 나타난 부분은 약 14.4% 감소됐고, 밝게 인공물이 나타난 부분은 7.0% 증가했다. PET/CT 검사의 CT 기반 보정 영상 구현 시 금속 치과 재료로 인해 CT 값에 영향을 주어 PET 영상에서도 표준섭취계수에 영향이 미치는 것을 볼 수 있다. 그리고 치아 임플란트보다 치아 보철에서 과 보정이 된 것을 볼 수 있다. 특히, 임상 실험에서 치아 보철의 표준섭취계수가 어둡게 인공물이 나타난 부분이 19.6% 감소되어 나타난 것을 확인 할 수 있어 위 음성으로 오인할 가능성이 있다. 그러므로 금속 치아 보철이나 임플란트를 시행한 환자들의 PET/CT 검사 시 구강내 병변이 의심 된다면, CT 영상으로 보정이 되지 않은 무보정(non-attenuation correction) PET 영상을 확인하는 것이 정확한 진단에 도움을 줄 것으로 사료된다.

• Journal of Periodontal and Implant Science
• /
• 제49권6호
• /
• pp.397-405
• /
• 2019

Purpose: This study examined the prevalence and risk factors of peri-implant disease after at least 7 years of dental implant loading. Methods: A total of 111 patients with 218 dental implants were treated. The follow-up period for all implants was at least 7 years. The patients' dental records were collected and risk factors of peri-implant disease were investigated through logistic regression analysis. Results: The overall implant survival rate was 95.87%, because 9 of the 218 implants failed. The prevalence of peri-implant mucositis and peri-implantitis was 39.7% and 16.7%, respectively. As risk factors, smoking and prosthetic splinting showed significant associations with peri-implantitis (P<0.05). Conclusions: Within the limits of this study, no significant correlations were found between any risk factors and peri-implant mucositis, but a significantly elevated risk of peri-implantitis was observed in patients who smoked or had splinted prostheses in 2 or more implants.

• 대한기계학회:학술대회논문집
• /
• 대한기계학회 2003년도 추계학술대회
• /
• pp.1373-1377
• /
• 2003

Current prostheses for amputees are generally extrinsic wearing socket type that the coupling between body stump and appliance wraps the soft tissue and this structure causes several problems :applying direct weight to soft tissue such as skin and muscle, skin trouble of contacting area and pain. In this study, osseointegration implant is a method to directly connect prosthesis to the residual stump skeletal tissue of arm, finger and leg through surgical operation. Technology presented in this paper essentially solves the problems of pain and abnormal weight transfer system indicated above and recovers the functions of the amputated arm and leg. In this paper, implant shape was designed for the first step for the development of osseointegration implant and then we studied the possibility to apply this osseointegration implant to human body by performing implant insertion operation to beagle tibia for the clinical animal test and normal beagle's gait analysis was executed in order to quantitatively verify the beagle's skeletal functions after the implant insertion.

• 대한치과기공학회지
• /
• 제42권3호
• /
• pp.262-271
• /
• 2020

Purpose: This study aimed to provide the basic data for improving patient satisfaction and dental services by examining the satisfaction of implant patients who have become important customers of dental treatment due to the increased demand for implants and identifying the factors affecting satisfaction. Methods: Out of 145 questionnaires, excluding 15 questionnaires that were unfaithfully responded to or difficult to analyze, 130 questionnaires were used for the analysis of the satisfaction of the dental patients with implant treatment in 19 dental hospitals and clinics in Gyeonggi-do, South Korea. Results: Implant satisfaction was as high as 3.20 (±0.56) for masticatory function satisfaction, 3.19 for psychological function satisfaction (±0.59), and 3.01 (±0.58) for social function satisfaction. Conclusion: Consistent patient care is important because an implant is not a one-shot cure but ends over a period of several months to several years. It is meaningful in that this study measured the satisfaction of implant prostheses evaluated from a patient's point of view and examined various factors and needs affecting patient satisfaction to provide the basic data for research that can contribute to improving the satisfaction of implant patients.

• 대한치과보철학회지
• /
• 제31권3호
• /
• pp.447-459
• /
• 1993

A two dimensional finite element model was constructed to analyze the mechanical behavior of four unit fixed partial dentures (FPD) with a 2nd premolar abutment either employing a rigid or nonrigid connector and a 2nd molar abutment(Branemark implant, IMZ implants and natural tooth). Gap elements were used to model the clearance space of the nonrigid connectors and each components of implants. All FPDs with a implant abutment alter the patterns of stress distribution and displacement, but the magnitude of stress in the periodontium was not greater than that of the control. A FPD with rigid connectors induced the smaller stresses in the periodontium than a FPD with a nonrigid connector. A FPD with a Branemark implant exhibited the more desirable mechanical stress states as compared to the IMZ implants with IME or IMC.