• The Journal of the Korean dental association
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• v.58 no.9
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• pp.583-589
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• 2020

If the implant is planted in the wrong position or direction, it is disadvantageous for stress distribution, and it is easy to cause complications such as screw loosening, abutment fracture, and implant fracture. If the position or orientation of the implant is not good, efforts should be made to minimize the problem through proper implant prosthetic treatment. In this article, the prosthetic method for facilitating future maintenance in cases with poor implant placement or orientation will be presented.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.4
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• pp.544-561
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• 2005

Purpose : This study was to assess the loading distributing characteristics of implant systems with internal connection or external connection under vertical and inclined loading using finite element analysis. Materials and methods : Two finite element models were designed according to type of internal connection or external connection The crown for mandibular first molar was made using cemented abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the centric cusp tip in a 15$^{\circ}$ inward inclined direction (loading condition B), or 200N at the centric cusp tip in a 30$^{\circ}$ outward inclined direction (loading condition C) respectively. Von Mises stresses were recorded and compared in the supporting bone, fixture, abutment and abutment screw. Results : 1. In comparison with the whole stress or the model 1 and model 2, the stress pattern was shown through th contact of the abutment and the implant fixture in the model 1, while the stress pattern was shown through the abutment screw mainly in the model 2. 2. Without regard to the loading condition, greater stress was taken at the cortical bone, and lower stress was taken at the cancellous bone. The stress taken at the cortical bone was greater at the model 1 than at the model 2, but the stress taken at the cortical bone was much less than the stress taken at the abutment, the implant fixture, and the abutment screw in case of both model 1 and model 2. 3. Without regard to the loading condition, the stress pattern of the abutment was greater at the model 1 than at the model 2. 4. In comparison with the stress distribution of model 1 and model 2, the maximum stress was taken at the abutment in the model 1. while the maximum stress was taken at the abutment screw in the model 2. 5. The magnitude of the maximum stress taken at the supporting bone, the implant fixture, the abutment, and the abutment screw was greater in the order of loading condition A, B and C. Conclusion : The stress distribution pattern of the internal connection system was mostly distributed widely to the lower part along the inner surface of the implant fixture contacting the abutment core through its contact portion because of the intimate contact of the abutment and the implant fixture and so the less stress was taken at the abutment screw, while the abutment screw can be the weakest portion clinically because the greater stress was taken at the abutment screw in case of the external connection system, and therefore the further clinical study about this problem is needed.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.318-323
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• 2012

Implant prostheses were classified into screw-retained prosthesis and cement-retained prosthesis by their method of retaining, and there is screw and cement retained implant prosthesis (SCRP) which has been made reflecting the strengths of these two. The advantages of the SCRP technique are easy retrievability and passive fit of implant prostheses. However, the occlusal screw holes of implant prostheses can be thought as a disadvantage with respect to esthetics and occlusion. Inappropriately positioned implants also limited the use of the SCRP technique. The present study is reporting about the case where nine implants (US II, OSSTEM, Seoul, Korea) were placed in maxilla and eight in mandible respectively in fully edentulous patients. Then, the cement-retained prosthesis was applied for the part in which the screw hole positioned improperly, and screw-retained prosthesis for properly positioned implants so that the combined screw-cement prosthesis has been produced where the satisfying result has shown in both function and esthetics. Three-year follow-up has been done for the patient.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.2
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• pp.192-209
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• 2004

Purpose : The purpose of this study was to evaluate the machining accuracy and consistency of implant/abutment/screw combination or internal connection type. Material and methods: In this study, each two randomly selected internal implant fixtures from ITI, 3i, Avana, Bicon, Friadent, Astra, and Paragon system were used. Each abutment was connected to the implant with 32Ncm torque value using a digital torque controller or tapping. All samples were cross-sectioned with grinder-polisher unit (Omnilap 2000 SBT Inc) after embeded in liquid unsaturated polyester (Epovia, Cray Valley Inc). Then optical microscopic and scanning electron microscopic(SEM) evaluations of the implant-abutment interfaces were conducted to assess quality of fit between the mating components. Results : 1) Generally, the geometry of the internal connection system provided for a precision fit of the implant/abutment into interface. 2) The most precision fit of the implant/abutment interface was provided in the case of Bicon System which has not screw. 3) The fit of the implant/abutment interface was usually good in the case of ITI, 3I and Avana system and the amount of fit of the implant/abutment interface was similar to each other. 4) The fit of the implant/abutment interface was usually good in the case of Friadent, Astra and Paragon system. The case of Astra system with the inclined contacting surface had the most Intimate contact among them. 5) Amount of intimate contact in the abutment screw thread to the mating fixture was larger in assembly with two-piece type which is separated screw from abutment such as Friadent, Astra and Paragon system than in that with one-piece type which is not seperated screw from abutment such as ITI, 3I and Avana system. 6) Amount of contact in the screw and the screw seat of abutment was larger in assembly of Friadent system than in asembly of Astra system of Paragon system. Conclusion: Although a little variation in machining accuracy and consistency was noted in the samples, important features of all internal connection systems were the deep, internal implant-abutment connections which provides intimate contact with the implant walls to resist micro-movement, resulting in a strong stable interface. From the results of this study, further research of the stress distribution according to the design of internal connection system will be required.

• Journal of the Korean Society of Industry Convergence
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• v.20 no.2
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• pp.169-176
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• 2017

Dental implants are required to have biomechanical functions and biostability in order to perform authoring, pronunciation, and aesthetic functions in the oral cavity. In terms of biostability, pure titanium for medical have good biostability and no rejection in the alveolar bone. with appropriate strength in terms of strength as well as biocompatibility. In recent years, various surgical methods and devices have been developed to improve the convenience and safety of the procedure. However, as the number of procedures increases, the screw loosening of the abutment screw connecting the artificial root and the abutment There are many reports of artificial root and abutment fracture. Fig. 1 is an example of a case where the upper part of the abutment screw is arbitrarily modified to remove the abutment by the abutment fracture due to the loosening of the abutment screw. The fundamental cause of abduction of the abutment screw is caused by the slight movement due to the lowering of the retention force of the abutment screw. It is necessary to minimize loosening of the abutment screw to avoid problems such as fracture during the period of using the implant. The purpose of this study is to investigate the structure of the abutment screw to prevent the loosening of the abutment screw by forming 0.5mm slot.

• The Journal of Advanced Prosthodontics
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• v.10 no.6
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• pp.415-421
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• 2018

PURPOSE. This study investigated the effects of abutment screw lengths on screw loosening and removal torque in external connection implants after oblique cyclic loading. MATERIALS AND METHODS. External connection implants were secured with abutment screws to straight abutments. The abutment-implant assemblies were classified into seven groups based on the abutment screw length, with each group consisting of five assemblies. A cyclic load of 300 N was applied at a $30^{\circ}$ angle to the loading axis until one million cycles were achieved. Removal torque values (RTVs) before and after loading, and RTV differences were evaluated. The measured values were analyzed using repeated measures of analysis of variance with the Student-Newman-Keuls multiple comparisons. RESULTS. All assemblies survived the oblique cyclic loading test without screw loosening. There was a significant decrease in the RTVs throughout the observed abutment screw lengths when the abutment-implant assemblies were loaded repeatedly (P<.001). However, the abutment screw length did not show significant difference on the RTVs before and after the experiment when the abutment screw length ranged from 1.4 to 3.8 mm (P=.647). CONCLUSION. Within the limit of this experiment, our results indicate that the abutment screw length did not significantly affect RTV differences after oblique cyclic loading when a minimum length of 1.4 mm (3.5 threads) was engaged. These findings suggest that short abutment screws may yield stable clinical outcomes comparable to long screws in terms of load resistance.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.5
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• pp.653-664
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• 2007

Statement of problem: The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure. Material and method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance. Results: 1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values. Conclusion: Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.1
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• pp.105-119
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• 2005

Statement of problem. As the effects of the various diameters of fixture and abutment screw on stress distribution was not yet examined, this study focused on the different design of single implant restoration using three dimensional finite element analysis. Purpose. This study was to compare five different fixture-abutment combinations for single implant supported restorations with different fixture and abutment screw diameters. Material of methods. The five kinds of finite element models were designed by 3 diameter fixtures ($\oslash$3.3, 3.75, 5.0 mm) with 3 different abutment screws $\oslash$1.5, 1.7, 2.0 mm). The crown for mandibular first molar was made using UCLA abutment according to Wheeler's anatomy. 244 N was applied at the central fossa with two different loading directions, vertically and obliquely (30$^{\circ}$) and at the buccal cusp vertically. Maximum von Mises stresses were recorded and compared in the supporting bone, crowns, fixtures, and abutment screws. Results. 1. The stresses in supporting bone and implant-abutment structure under oblique loading were greater than those under vertical or offset loading. The stresses under vertical loading were the least among 3 loading conditions regardless of the implant and abutment screw diameters. 2. The stresses in the narrow implants were greater than the wider implants. The narrow implant with narrow abutment screw showed highest stresses in the lingual crest, but the narrow implant with standard abutment screw showed highest stress in abutment screw. 3. The stresses of abutment screws were influenced by the diameter of fixtures and loading conditions. The wide implants showed least difference between two different abutment screw diameters. Conclusions. The wide implants showed lesser stresses than the narrow implants and affected least by the different abutment screw diameters. The narrow implants with standard abutment screw showed highest stresses in the lingual bony crest under oblique loading.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.1
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• pp.60-66
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• 2015

Screw loosening and screw fracture of abutment is one of most frequent mechanical complications in implant restoration. Fractured fragments in implant restoration like abutment and screw should be completely removed and the procedure needs minimal damage to the fixture of implant. In some cases, it could fail to remove fractured fragments and cause a lot of damage to the fixture of implant. These situations could render implant unusable at the worst. This article describes three different situations and simple techniques for successful removal of fractured fragments without damage of implants. The procedures used are described in this clinical report.