• The Journal of the Korean dental association
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• v.58 no.6
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• pp.336-345
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• 2020

Peri-apical implant lesion, also known as 'retrograde peri-implantitis' can occur with multifactorial etiological factors. The purpose of this case report is to demonstrate resolution of periapical implant lesion by removal of causative factors and saving implant by regenerative therapy. A 54-year old male patient with mild dull pain around implant on the right mandibular second premolar area due to persistent peri-apical infection of the adjacent first premolar was treated. Extraction of tooth with symptomatic apical periodontitis and regenerative therapy on the buccal fenestration area of the implant and extraction site were performed. After 6-month reentry, notable regenerated bone tissue around implant was found, and implant placement on the previous extraction site was performed. After 14-month follow-up from the regenerative therapy, neither biological nor mechanical complication could be found around the implant, evidenced by high implant stability, normal clinical probing depth, and absence of discomfort spontaneously and during masticatory function. In conclusion, surgical intervention including regenerative therapy using bone graft and barrier membrane on periapical implant lesion can be suggested as one of the treatment options considering the extent of periapical lesion.

• The Journal of Korean Academy of Prosthodontics
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• v.48 no.4
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• pp.308-314
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• 2010

Purpose: The purpose of this study is to analyze the change in re-osseointegration over time and bone reaction at the interface between implant fixture and the surface of the bone, after destroying re-osseointegration by distorting the bone-implant interface artificially. Materials and methods: Experimental implant fixtures (cp titanium, ${\phi}3.75\;mm{\times}4\;mm$) which didn't have surface treatment were produced. Two or three fixtures were implanted on both tibias of twelve female rabbits (New Zealand white, more than 3.5 kg). Then after six weeks, removal torque (RT) was measured and the results were recorded as the first measurement values. The fixtures were submerged again to get reosseointegration between the bone and fixture. To identify the change in re-osseointegration of submerged fixtures over time, six groups had the healing time for four days (group I), one week (group II), two weeks (group III), three weeks (group IV), four weeks (group V) and five weeks (group VI), and then the secondary removal torque was measured for each group. To identify the bone formation under fluorescent light, tetracycline (15 mg/kg, IM) were treated on the rabbits of each group. After the second measurement, the rabbits were sacrificed, and 16 slides were made, two or three for each group. The slides were observed under the fluorescent light with light microscope. To find out the change in the secondary removal torque over the primary removal torque in progress of time, the averages of the increase rate of the primary and secondary torque removal force were calculated. Then, to find out if there were any critical differences between the primary removal torque and the secondary removal torque in each group and among the groups, the results were analyzed statistically by paired t- test, one-way ANOVA, and Duncan's Multiple Range Test. Results: In group I and II, secondary removal torque decreased, especially in group I. In group III, IV, V, and VI, secondary removal torque increased critically. Comparing the differences among the groups, the critical difference was shown between group I, II and group III, IV, V, VI. Mineralization at the interface between the bone and implant fixture was identified from the first week, and bone formation was shown more clearly from the second week. Conclusion: If the implant fixture remains unforced for a certain period of time after the fixture has had iatrogenic mobility, re-osseointegration occurs at the surface of the fixture, and for tibias of rabbits, higher re-osseointegration was obtained within two weeks.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.1
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• pp.71-83
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• 2001

The purpose of this study was to compare the effects of various surface treatments by measuring removal torque on bone healing around titanium implants. 40 Screw-shaped cp titanium implants with length of 4mm, outer diameter of 3.75mm, and pitch-height of 0.5mm were used Group 1 was left as machined(control), Group 2 was blasted with $50{\mu}m\;Al_2O_3$, group 3 was blasted and etched in etching solution($NH_4OH : H_2O_2:H_2O= 1 : 1 : 5$) at $90^{\circ}C$ for 1 minute group 4 was blasted and oxidated under pure oxygen at $800^{\circ}C$. The implant surface roughness was analyzed with SEM and CLSM(Confocal Laser Scanning Microscope) and implants were placed in proximal tibial metaphysis of 10 New Zealand White rabbits. After 3 months of healing period, removal torque of each implant was measured to compare bone healing around implant. The results obtained were as follows 1. In SEM view, blasting increased the roughness of the surface, but etching of that rough surface decreased the roughness due to the removal of the tip of the peak. Oxidation also decreased the roughness due to formation of needle-like oxide grains on the implant surface. 2. The Sa value from CLSM was least in the machined group($0.47{\mu}m$), greatest in blasted group($1.25{\mu}m$), and the value decreased after etching($0.91{\mu}m$) and oxidation($0.94{\mu}m$). 3. The removal torque of etched group(24.5Ncm) was greater than that of machined group(16.7Ncm) (P<0.05), and was greatest in the oxidated group(40.3Ncm) and the blasted group(34.7Ncm).

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.243-248
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• 2012

Purpose: The purpose of this study is to compare the removal torque between prefabricated and customized implant abutment screw. Materials and methods: Three types of implant system (Osstem, Astra, Zimmer) were used. For each system, prefabricated abutment screw (control group) and customized abutment screw (test group) were used to connect the fixture and the abutment (n = 6). Digital torque gauze was used to control the tightening torque and the screws were tightened under each manufacturer's recommendation. 10 minutes after the connection the same tightening torque was applied, and 5 minutes after the second connection, the removal torque was measured. This procedure was repeated 10 times. In the cyclic loading test, 10 minutes after the first connection to the 6 groups (n = 3), the same tightening torque was applied, and a total of 1,000,000 time loading was applied at 30 degree angle to long axis with 50 N load. Repeated measures of ANOVA test (${\alpha}$=.05) was used as statistics to evaluate the effect of repeated loading number on the removal torque. Independent t-test was used to evaluate the difference in removal torque after cyclic loading. Results: The removal torque significantly decreased as the number of loading repetition increased (P<.05). In the 10 time repetition test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Also in the cyclic loading test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Conclusion: Within the limitation of this study, there was no significant difference in the removal torque between the prefabricated abutment screw and customized abutment screws.

• 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.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.26-30
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• 2010

Purpose: Common complications of immediate breast reconstruction with implant are capsular contracture, malposition of implant, hematoma and seroma. Especially, the most severe complication is implant exposure caused by inflammation or necrosis of skin flap margin of mastectomy site. This article reports the experience of cases of salvage in such an exposure of implant. Methods: From July, 2002 to Feb., 2009, sixty-five patients who underwent immediate breast reconstruction with implant were retrospectively analyzed. Exposure of implant was happened in 5 of 65 patients and they were treated at out patient district. Two of five patients were reconstructed with saline implnt and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$ and Serratus muscle flap. Remaning three patients were reconstructed with silicone implant and all of them underwent the enveloping of the implant with AlloDerm$^{(R)}$. Results: In the group of patients who underwent reconstruction with saline implant, implant exposure was found in one patient due to partial necrosis of the margin of skin flap and debridement and primary repair were done. In the other one patient, dressing with antibiotic ointment were done. And debridement and primary repair were proceeded. In the group of patients who underwent reconstruction with silicone implant, implant exposure was found in one patient. After removal of the implant, tissue expansion was done and a new silicone implant was inserted. Implant exposure were found in the other two patients, antibiotics ointment application and primarily repaired. Conclusion: It was the common knowledge that the exposed implant should be removed. But salvage of the exposed implants may be possible with proper treatment. Four of five patients (80%) with exposed breast implant were salvaged with conservative management.

• Journal of Periodontal and Implant Science
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• v.31 no.1
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• pp.41-57
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• 2001

It is well known that the apposition of bone at implant surface would be influenced by the microstructure of titanium implants. The purpose of this study was to compare bone healing around the screw-shaped titanium implant with three different surface topographies in the canine mandibles by histological and biomechanical evaluation. All mandibular premolars of six mongrel dogs were extracted and implants were placed one month later. The pure titanium implants had different surface topographies: smooth and machined ($Steri-OSS^{(R)}$: Group II); sandblasted and acid-etched ($ITI^{(R)}$, SLA: Group III) surface. The fluorescent dyes were injected on the 2nd (calcein), 4th (oxytetracycline HCI) and 12th (alizarin red) weeks of healing. Dogs were sacrificed at 4 and 12 weeks after implantation. The decalcified and undecalcified specimens were prepared for histological and histo-metrical evaluation of implant-bone contact. Some specimens at 12 weeks after implantation were used for removal torque testing. Histologically, direct bone apposition to implant surface was found in all of the treated groups. More mature and dense bone was observed at the implant-bone interface at 12 weeks than that at 4 weeks after implantation. Under the fluorescent microscope, thick regular green fluorescent lines which mean early bone apposition were observed at the implant-bone interface in Group III, while yellow and red fluorescent areas were found at the implant-bone interface in Group I and II. The average implant-bone contact ratios at 4 weeks of healing were 54.3% in Group I, 57.7% in Group II and 66.2% in Group III. In Group I, implant-bone contact ratio was significantly lower than Group II and III(p<0.05). The average implant-to-bone contact ratios at 12 weeks after implantation were 64.3% in Group I, 66.7% in Group II and 71.2% in Group III. There was no significant difference among the three groups. In Group I and II, the implant-bone contact ratio at 12 weeks increased significantly in comparison to ratio at 4 weeks(p<0.05). The removal torque values at 12 weeks after implantation were 90.9 Ncm in Group I, 81.6 Ncm in Group II and 77.1 Ncm in Group III, which were significantly different(p<0.05). These results suggest that bone healing begin earlier and be better around the surface-treated implants compared to the smooth surface implants. The sandblasted and acid-etched implants showed the most favorable bone response among the three groups during the early healing stage and could reduce the waiting period prior to implant loading.

• 대한치과보철학회:학술대회논문집
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• 1993.12a
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• pp.20-21
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• 1993

• Journal of Periodontal and Implant Science
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• v.50 no.1
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• pp.56-66
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• 2020

Purpose: A stability-measuring device that utilizes damping capacity analysis (DCA) has recently been introduced in the field of dental implantology. This study aimed to evaluate the sensitivity and reliability of this device by measuring the implant stability of ex vivo samples in comparison with a resonance frequency analysis (RFA) device. Methods: Six implant beds were prepared in porcine ribs using 3 different drilling protocols to simulate various implant stability conditions. Thirty-six pork ribs and 216 bone-level implants measuring 10 mm in height were used. The implant beds were prepared using 1 of the following 3 drilling protocols: 10-mm drilling depth with a 3.5-mm-diameter twist drill, 5-mm drilling depth with a 4.0-mm-diameter twist drill, and 10-mm drilling depth with a 4.0-mm-diameter twist drill. The first 108 implants were external-connection implants 4.0 mm in diameter, while the other 108 implants were internal-connection implants 4.3 mm in diameter. The peak insertion torque (PIT) during implant placement, the stability values obtained with DCA and RFA devices after implant placement, and the peak removal torque (PRT) during implant removal were measured. Results: The intraclass correlation coefficients (ICCs) of the implant stability quotient (ISQ) results obtained using the RFA device at the medial, distal, ventral, and dorsal points were 0.997, 0.994, 0.994, and 0.998, respectively. The ICCs of the implant stability test (IST) results obtained using the DCA device at the corresponding locations were 0.972, 0.975, 0.974, and 0.976, respectively. Logarithmic relationships between PIT and IST, PIT and ISQ, PRT and IST, and PRT and ISQ were observed. The mean absolute difference between the ISQ and IST values on a Bland-Altman plot was -6.76 (-25.05 to 11.53, P<0.05). Conclusions: Within the limits of ex vivo studies, measurements made using the RFA and DCA devices were found to be correlated under a variety of stability conditions.

• The Journal of Advanced Prosthodontics
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• v.6 no.1
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• pp.35-38
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• 2014

PURPOSE. This study aimed to evaluate the correlation between microleakage and screw loosening at different types of implant-abutment connections and/or geometries measuring the torque values before and after the leakage tests. MATERIALS AND METHODS. Three different abutment types (Intenal hex titanium, internal hex zirconium, morse tapered titanium) with different geometries were connected to its own implant fixture. All the abutments were tightened with a standard torque value then the composition was connected to the modified fluid filtration system. After the measurements of leakage removal torque values were re-measured. Kruskal-wallis test was performed for non-parametric and one-way ANOVA was performed for parametric data. The correlation was evaluated using Spearman Correlation Test (${\alpha}=0.05$). RESULTS. Significantly higher microleakage was found at the connection of implant-internal hex zirconium abutment. Observed mean torque value loss was also significantly higher than other connection geometries. Spearman tests revealed a significant correlation between microleakage and screw loosening. CONCLUSION. Microleakage may provoke screw loosening. Removing torque values rationally decrease with the increase of microleakage.