• The Journal of the Korean dental association
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• v.50 no.3
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• pp.126-139
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• 2012

Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

• Journal of Periodontal and Implant Science
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• v.44 no.1
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• pp.39-47
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• 2014

Purpose: Peri-implantitis, a clinical term describing the inflammatory process that affects the soft and hard tissues around an osseointegrated implant, may lead to peri-implant pocket formation and loss of supporting bone. However, this imprecise definition has resulted in a wide variation of the reported prevalence; ${\geq}10%$ of implants and 20% of patients over a 5- to 10-year period after implantation has been reported. The individual reporting of bone loss, bleeding on probing, pocket probing depth and inconsistent recording of results has led to this variation in the prevalence. Thus, a specific definition of peri-implantitis is needed. This paper describes the vast variation existing in the definition of peri-implantitis and suggests a logical way to record the degree and prevalence of the condition. The evaluation of bone loss must be made within the concept of natural physiological bony remodelling according to the initial peri-implant hard and soft tissue damage and actual definitive load of the implant. Therefore, the reason for bone loss must be determined as either a result of the individual osseous remodelling process or a response to infection. Methods: The most current Papers and Consensus of Opinion describing peri-implantitis are presented to illustrate the dilemma that periodontologists and implant surgeons are faced with when diagnosing the degree of the disease process and the necessary treatment regime that will be required. Results: The treatment of peri-implantitis should be determined by its severity. A case of advanced peri-implantitis is at risk of extreme implant exposure that results in a loss of soft tissue morphology and keratinized gingival tissue. Conclusions: Loss of bone at the implant surface may lead to loss of bone at any adjacent natural teeth or implants. Thus, if early detection of peri-implantitis has not occurred and the disease process progresses to advanced peri-implantitis, the compromised hard and soft tissues will require extensive, skill-sensitive regenerative procedures, including implantotomy, established periodontal regenerative techniques and alternative osteotomy sites.

• Journal of Periodontal and Implant Science
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• v.32 no.3
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• pp.523-537
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• 2002

The present study was performed to evaluate the effect of tetracycline - HCl on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, SLA surface and $TiO_2blasted$ surface were used. Implant surface was rubbed with 5Omg/ml tetracycline - HCl solution for ${\frac}{1}{2}$ min., 1 min., $1{\frac}{1}{2}$ min., 2 min., and 3min. respectively in the test group and with no conditioning in the control group. Then, the specimens were processed for scanning electron microscopic observation. The following results were obtained. 1. In the pure titanium machined surfaces, the control specimen showed a more or less rough machined surface composed of alternating positive and negative lines corresponding to grooves and ridges. After treatment, machining line was more pronounced for the control specimens. but in general, test specimens were similar to control. 2. In the SLA surfaces, the control specimen showed that the macro roughness was achieved by large-grit sandblasting. subsequently, the acid-etching process crated the micro roughness, which thus was superimposed on the macro roughness. 3. In the SLA surfaces, irrespective of the application time of 50mg/ml tetracycline-HCl solution, in general, test specimens were similar to control. 4. In the $TiO_2blasted$ surfaces the control specimen showed the rough surface with small pits. The irregularity of the $TiO_2blasted$ surfaces with 50mg/ml tetracycline-HCl solution was lessened and the flattened areas were wider relative to the application time of tetracycline - HCl solution. In conclusion, pure titanium machined surfaces and SLA surfaces weren't changed irrespective of the application time of tetracycline-HCl solution. And the $TiO_2blasted$ surfaces conditioned with tetracycline - HCl solution began to be changed from $1{\frac}{1}{2}$ min. This results are expected to be applied to the regenerative procedures for peri-implantitis treatment.

• Journal of Korean Dental Science
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• v.9 no.1
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• pp.19-27
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• 2016

Purpose: Laser treatment has become a popular method in implant dentistry, and lasers have been used for the decontamination of implant surfaces when treating peri-implantitis. This study was performed to evaluate the effects of an Erbium-doped:Yttrium-Aluminum-Garnet (Er:YAG) laser with different settings on machined (MA), sand-blasted and acid-etched (SA), and resorbable blast media (RBM) titanium surfaces using scanning electron microscopy and confocal microscopy. Materials and Methods: Four MA, four SA, and four RBM discs were either irradiated at 40 mJ/20 Hz, 90 mJ/20 Hz, or 40 mJ/25 Hz for 2 minutes. The specimens were evaluated with scanning electron microscopy and confocal microscopy. Result: The untreated MA surface demonstrated uniform roughness with circumferential machining marks, and depressions were observed after laser treatment. The untreated SA surface demonstrated a rough surface with sharp spikes and deep pits, and the laser produced noticeable changes on the SA titanium surfaces with melting and fusion. The untreated RBM surface demonstrated a rough surface with irregular indentation, and treatment with the laser produced changes on the RBM titanium surfaces. The Er:YAG laser produced significant changes on the roughness parameters, including arithmetic mean height of the surface (Sa) and maximum height of the surface (Sz), of the MA and SA surfaces. However, the Er:YAG laser did not produce notable changes on the roughness parameters, such as Sa and Sz, of the RBM surfaces. Conclusion: This study evaluated the effects of an Er:YAG laser on MA, SA, and RBM titanium discs using confocal microscopy and scanning electron microscopy. Treatment with the laser produced significant changes in the roughness of MA and SA surfaces, but the roughness parameters of the RBM discs were not significantly changed. Further research is needed to evaluate the efficiency of the Er:YAG laser in removing the contaminants, adhering bacteria, and the effects of treatment on cellular attachment, proliferation, and differentiation.

• Journal of Periodontal and Implant Science
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• v.37 no.3
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• pp.575-584
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• 2007

The present study was performed to evaluate the effect of citric acid on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface, and HA coated surface were utilized. Pure titanium machined surface and HA coated surface were rubbed with pH 1 citric acid for 30s., 45s., 60s., 90s., and 120s. respectively. Then, the specimens were processed for scanning electron microscopic observation. The following results were obtained. 1. The specimens showed a few shallow grooves and ridges in pure titanium machined surface implants. The roughness of surfaces conditioned with pH 1 citric acid was slightly increased. 2. In HA-coated surfaces, round particles were deposited irregularly. The specimens were not significant differences within 45s. But, began to be changed from 60s. The roughness of surfaces was lessened and the surface dissolution was increased relative to the application time. In conclusion, pure titanium machined surface implants and HA coated surface implants can be treated with pH 1 citric acid for peri-implantitis treatment if the detoxification of these surfaces could be evaluated.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.5
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• pp.606-616
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• 2006

Purpose: This experiment examined the effect of different surface treatment on the osseointegration and stability of implants. Material and methods: In this study, 40 each of machined, SLA and RBM implants, which are the most commonly used implants, were implanted into the tibia of 20 normal rabbits using $OsseoCare^{TM}$. The rabbits were sacrificed after 1 week, 4 weeks, 8 weeks and 12 weeks for implant stability analysis, removal torque analysis, histologic and histomorphometric analysis. Result : ISQ showed significant difference between Machined and RBM at first week and at 4 weeks. There was significant difference between Machined and both SLA and RBM(p<0.05) but after 8 weeks there were no significant difference between each group. In the removal torque, RBM showd significantly higher values than SLA and Machined surface at 1st week. At 4th and 12th week, there was significant difference between Machined and SLA, RBM(p<0.05). In the bone to implant contact variable, there was no significant difference between each surface treatment method. In the Machined surface group, there was no significant difference between each time interval. but in SLA group, there were significant differences between the 1st week and 12th week and in RBM group, there were significant differences between the 1st week and 8th, 12th week and between 4th and 12th week(p<0.05). The bone area showed significantly higher values in SLA and RBM compared to Machined surface 1st and 8th week and significantly higher values in SLA than Machined surface at the 4th week(p<0.05). Conclusion: The roughened surface of implants showed positive effect in the early stages of implantation and assisted in bone formation After the bone formation stage, there was no statistical difference between Machined and roughened surface groups. In dental implantation, where initial stability is critical to the success of implants, the use of roughened surface implants should assist in reducing the healing period after implantation.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.4
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• pp.340-348
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• 2015

Peri-implantitis is the most common reason for a late failure and can occur even after years of successful osseointegration. The role of microbial plaque accumulation in the development of peri-implantitis has been well documented. On the other hand, the ideal method of implant surface decontamination to re-establish the health of peri-implant tissue remains to be determined. Removal of bacterial deposits is essential in the treatment of peri-implant infections, and various therapeutic approaches have been described in the literature, including mechanical debridement, disinfection with chemotherapeutic agents, and laser therapy. Recently, there has been a plenitude of scientific data regarding the use of laser irradiation to achieve titanium surface decontamination. Thus, research is focusing on lasers' potential use in the treatment of peri-implantitis. The aim of this literature review is to analyze and evaluate the efficacy of laser therapy for the treatment of peri-implantitis.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.631-639
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• 2000

Root-form endosseous implants which are in use today have a variety of materials, designs and surface characteristics. Among them, pure titanium surface implants and titanium matrix coated with HA are popular as well as are available in many studies. Rate of clinical success is obviously lower in jaw with cancellous bone than dense bone. In order to increase the rate of success in poor bone quality. More advanced techniques of implant surgery and surface treatment of implant fixture body have been developed. As a successful result, the installation of HA coated implant in bone quality type III or IV became highly successful. Since most clinical studies were performed without knowing the characteristics of HA coated implants, it has been impossible to come up with proper clinical data. Therefore the characterization of HA coated implants is essential to understand long term clinical performance and the predictability of HA coated implant system Our results showed that HA coated implants had the success rate at 93.7% in bone quality type III, IV for 3.8 years, and the fixture of Steri-Oss showed more stability with time.

• Journal of Periodontal and Implant Science
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• v.32 no.1
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• pp.69-87
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• 2002

Implant material, implant design, surface quality, status of the bone, surgical technique, and implant loading conditions were regarded as prerequisites for osseointegration which is a prime condition for implant success. The aim of this review paper was to investigate the survival rate of single implants in relation to the prerequisites for osseointegration. Fifty-eight papers reporting survival rates of single implants were selected by use of the 'PubMed' and hand searching. The survival rate of single implants were assessed with reference to factors influencing osseointegration. The results showed that single implants in general showed a high survival rate except a few failures in certain extreme conditions and early stages. Those failures and complications such as screw loosening and esthetic problem were almost solved with the development of implant components and surgical techniques and a better understanding of biology around a single implant. Single-tooth implant-replacement is now considered as a reliable and predictable treatment option for a single missing tooth and its application seems to expand to compromised situations which were previously thought to be impossible for single implant therapy.

• Proceedings of the Korean Institute of Surface Engineering Conference
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• 2018.06a
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• pp.75-75
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• 2018

Commercially pure titanium (CP-Ti) and Ti-6Al-4V alloys have been widely used in implant materials such as dental and orthopedic implants due to their corrosion resistance, biocompatibility, and good mechanical properties. However, surface modification of titanium and titanium alloys is necessary to improve osseointegration between implant surface and bone. Especially, when titanium oxide nanotubes are formed on the surface of titanium alloy, cell adhesion is greatly improved. In addition, plasma electrolytic oxide (PEO) coatings have a good safety for osseointegration and can easily and quickly form coatings of uniform thickness with various pore sizes. Recently, the effects of bone element such as magnesium, zinc, strontium, silicon, and manganese for bone regeneration are researching in dental implant field. The purpose of this study was researched on the surface morphology of PEO-treated Ti-6Al-4V alloy after anodic titanium oxide treatmentusing various instruments. Ti-6Al-4V ELI disks were used as specimens for nanotube formation and PEO-treatment. The solution for the nanotube formation experiment was 1 M $H_3PO_4$ + 0.8 wt. % NaF electrolyte was used. The applied potential was 30V for 1 hours. The PEO treatment was performed after removing the nanotubes by ultrasonics for 10 minutes. The PEO treatment after removal of the nanotubes was carried out in the $Ca(CH_3)_2{\cdot}H_2O+(CH_3COO)_2Mg{\cdot}4H_2O+Mn(CH_3COO)_2{\cdot}4H_2O+Zn(CH_3CO_2)_2Zn{\cdot}2H_2O+Sr(CH_2COO)_2{\cdot}0.5H_2O+C_3H_7CaO_6P$ and $Na_2SiO_3{\cdot}9H_2O$ electrolytes. And the PEO-treatment time and potential were 3 minutes at 280V. The morphology changes of the coatings on Ti-6Al-4V alloy surface were observed using FE-SEM, EDS, XRD, AFM, and scratch tester. The morphology of PEO-treated surface in 5 ion coating solution after nanotube removal showed formation or nano-sized mesh and micro-sized pores.