• Archives of Craniofacial Surgery
• /
• v.9 no.2
• /
• pp.55-61
• /
• 2008

Purpose: The purpose of this study is to evaluate the effectiveness of internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw which is used for prevention of enophthalmos in posteriorly extended large orbital floor fracture. Methods: From Jun. 1997 to Dec. 2007, 21 patients who were diagnosed with posteriorly extended large orbital floor fractures were classified into two groups. One group(n=11) had undergone reduction surgery with regular $Medpor^{(R)}$ sheets without any fixation method, while the other group(n=10) had their $Medpor^{(R)}$ sheets fixed with the $BioSorb^{TM}FX$ screws. The two groups were evaluated by comparison of their enophthalmos degree and effectiveness. Results: In the non-fixation group, six patients had enophthalmos preoperatively and three of them showed persistent enophthalmos postoperatively. In postoperative CT examination, displacement of $Medpor^{(R)}$ implant with soft tissue impaction into maxillary sinus was observed in the patients. In the screw fixation group, three patients had enophthalmos preoperatively, but none of them suffer from complication such as residual enophthalmos, soft tissue impaction, muscle entrapment or optic nerve compression postoperatively. Conclusion: Internal fixation method of $Medpor^{(R)}$ implant with $BioSorb^{TM}FX$ screw on the medial surface of orbital floor provides firm stabilization of implants and surrounding soft tissues and can be an effective option especially when postoperative implant displacement or malposition was expected.

• The Journal of Korean Academy of Prosthodontics
• /
• v.43 no.3
• /
• pp.379-392
• /
• 2005

Statement of problem. One of the common problems of dental implant prosthesis is the loosening of the screw that connects each component, and this problem is more common in single implant-supported prostheses with external connection, and in molars. Purpose. The purposes of this study were: (1) to compare the initial abutment screw detorque values of the six different implant-abutment interface designs, (2) to compare the detorque values of the six different implant-abutment interface designs after cyclic loading, (3) to compare the detorque values of regular and wide diameter implants and (4) to compare the initial detorque values with the detorque values after cyclic loading. Material and methods. Six different implant-abutment connection systems were used. The cement retained abutment and titanium screw of each system were assembled and tightened to 32Ncm with digital torque gauge. After 10 minutes, initial detorque values were measured. The custom titanium crown were cemented temporarily and a cyclic sine curve load(20 to 320N, 14Hz) was applied. The detorque values were measured after cyclic loading of one million times by loading machine. One-way ANOVA test, scheffe’s test and Mann-Whitney U test were used. Results. The results were as follows : 1. The initial detorque values of six different implant-abutment connections were not significantly different(p>0.05). 2. The detorque values after one million dynamic cyclic loading were significantly different (p<0.05). 3. The SS-II regular and wide implant both recorded the higher detorque values than other groups after cyclic loading(p<0.05). 4. Of the wide implants, the initial detorque values of Avana Self Tapping Implant, MIS and Tapered Screw Vent, and the detorque values of MIS implant after cyclic loading were higher than their regular counterparts(p<0.05). 5. After cyclic loading, SS-II regular and wide implants showed higher detorque values than before(p<0.05).

• Structural Engineering and Mechanics
• /
• v.74 no.4
• /
• pp.567-576
• /
• 2020

Considerable controversy surrounds the choice of the best abutment type for implant prosthetics. The two most common structures are hex and non-hex abutments. The non-hex abutment typically furnishes a larger contact area between itself and the implant than that provided by a hex structure. However, when a hex abutment is loaded, the position of its contact area may be deeper than that of a non-hex abutment. Hence, the purpose of this study is to determine the different biomechanical behaviors of an internal bone-level implant based on the abutment type-hex or non-hex-and clinical crown length under static and cyclic loadings using finite element analysis (FEA). The hex structure was found to increase the implant and abutment stability more than the nonhex structure among several criteria. The use of the hex structure resulted in a smaller volume of bone tissues being at risk of hypertrophy and fatigue failure. It also reduced micromovement (separation) between the implant components, which is significantly related to the pumping effect and possible inflammation. Both static and fatigue analyses, used to examine short- and long-term stability, demonstrated the advantages of the hex abutment over the non-hex type for the stability of the implant components. Moreover, although its impact was not as significant as that of the abutment type, a large crown-implant ratio (CIR) increased bone strain and stress in the implant components, particularly under oblique loading.

• The Journal of Advanced Prosthodontics
• /
• v.8 no.5
• /
• pp.388-395
• /
• 2016

PURPOSE. The purpose of this study was to evaluate the resistance to deformation under static overloading by measuring yield and fracture strength, and to analyze the failure characteristics of implant assemblies made of different titanium grades and connections. MATERIALS AND METHODS. Six groups of implant assemblies were fabricated according to ISO 14801 (n=10). These consisted of the combinations of 3 platform connections (external, internal, and morse tapered) and 2 materials (titanium grade 2 and titanium grade 4). Yield strength and fracture strength were evaluated with a computer-controlled Universal Testing Machine, and failed implant assemblies were classified and analyzed by optical microscopy. The data were analyzed using the One-way analysis of variance (ANOVA) and Student's t-test with the level of significance at P=.05. RESULTS. The group $IT4_S$ had the significantly highest values and group IT2 the lowest, for both yield strength and fracture strength. Groups $IT4_N$ and ET4 had similar yield and fracture strengths despite having different connection designs. Group MT2 and group IT2 had significant differences in yield and fracture strength although they were made by the same material as titanium grade 2. The implant system of the similar fixture-abutment interfaces and the same materials showed the similar characteristics of deformation. CONCLUSION. A longer internal connection and titanium grade 4 of the implant system is advantageous for static overloading condition. However, it is not only the connection design that affects the stability. The strength of the titanium grade as material is also important since it affects the implant stability. When using the implant system made of titanium grade 2, a larger diameter fixture should be selected in order to provide enough strength to withstand overloading.

• The Journal of Korean Academy of Prosthodontics
• /
• v.45 no.3
• /
• pp.345-353
• /
• 2007

Statement of problem. Implant abutment screw joints tend to loosen under clinical conditions. Abutment screw loosening results in loss of preload in function. Purpose. Anti-rotational inner post screw (ARIPS) systems were compared with conventional abutment screws to reduce screw loosening. Reverse torque values were evaluated. Material and methods. 32 implant assemblies (Warentec, Co, Ltd, Seoul, Korea) were organized as the 30-Ncm-torque conventional groups and 30-Ncm-torque ARIPS groups in external and internal system. The specimens were tested to 106 cycles at a load of 200N. Preload reverse torque, postload reverse torque, and the ratio of postload reverse torque to preload reverse torque were evaluated. The data were analyzed with unpaired t-test in external and internal systems. Results. In the ratio of postload reverse torque to preload reverse torque, the ARIPS groups showed significant differences than the conventional screw group in both external and internal system. Conclusion. Within the limitations of this study, abutment screw loosening was effectively reduced using ARIPS system.

• The Journal of Korean Academy of Prosthodontics
• /
• v.44 no.4
• /
• pp.421-431
• /
• 2006

Statement of problem : Accurate impression is essential to success of implant prostheses. But there have been few studies about the accuracy of fixture-level impression technique in internal connection implant system. Purpose: This study evaluated the accuracy of splinted fixture-level impression technique using clinical methods and the effect of internal hex on fit of superstructure in internal connection implant system (Astra Tech). Material and method : Two metal master frameworks made from two abutments (Cast-to Abutment ST) each for parallel and divergent conditions and a corresponding. passively fitting, dental stone master cast with four future replicas (Fixture Replica ST) were fabricated. Ten dental stone casts were made with vinyl polysiloxane impressions from the master cast by acrylic resin splinted fixture-level impression technique. To evaluate the accuracy of impression technique, the fit of master frameworks for test models was evaluated using screw resistance test (SRT) and one-screw test. The results of SRT were recorded as SRT values from grade 1 to grade 5 by 1/4 turn. And to evaluate the effect of hex on fit of superstructure, the same tests were performed after removing hexes of master frameworks. Results: 1. There was only one case (2.5%) showing SRT value of test model below ade 2 in total before and after removing hexes of master frameworks. And, by removing hexes. SRT values decreased in only one test model (5%) and did not change in 17 test models (85%). 2. SRT values of the 1$^{st}$ screws were grade 2 in 80% of cases before, and grade 1 in 80% of cases after removing hexes. And, by removing hexes, SRT values decreased in 72.5% of cases. 3. SRT values of the 2$^{nd}$ screws were grade 3 in 85% of cases before, and grade 3 in 95% of cases after removing hexes. And, by removing hexes, SRT values did not change in 85% of cases. 4. There were only 2 cases regarded as acceptable fit by one-screw test, and SRT values of 2$^{nd}$ screws of both cases were grade 2. Conclusion. Within the limitations of this study, future-level impression of internal connection implant system is considered to obtain inaccurate working cast, even using acrylic resin splinted impression technique. And, it is considered to be unable improve the fit to remove the hexes of implant restoration.

• The Journal of Korean Academy of Prosthodontics
• /
• v.43 no.4
• /
• pp.544-561
• /
• 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 Advanced Prosthodontics
• /
• v.10 no.5
• /
• pp.388-394
• /
• 2018

PURPOSE. To measure axial displacement of different implant-abutment connection types and materials during screw tightening at the recommended torque by using a contact scanner for two-dimensional (2D) and three-dimensional (3D) analyses. MATERIALS AND METHODS. Twenty models of missing mandibular left second premolars were 3D-printed and implant fixtures were placed at the same position by using a surgical guide. External and internal fixtures were used. Three implant-abutment internal connection (INT) types and one implant-abutment external connection (EXT) type were prepared. Two of the INT types used titanium abutment and zirconia abutment; the other INT type was a customized abutment, fabricated by using a computer-controlled milling machine. The EXT type used titanium abutment. Screws were tightened at $10N{\cdot}cm$, simulating hand tightening, and then at the manufacturers' recommended torque ($30N{\cdot}cm$) 10 min later. Abutments and adjacent teeth were subsequently scanned with a contact scanner for 2D and 3D analyses using a 3D inspection software. RESULTS. Significant differences were observed in axial displacement according to the type of implant-abutment connection (P<.001). Vertical displacement of abutments was greater than overall displacement, and significant differences in vertical and overall displacement were observed among the four connection types (P<.05). CONCLUSION. Displacement according to connection type and material should be considered in choosing an implant abutment. When adjusting a prosthesis, tightening the screw at the manufacturers' recommended torque is advisable, rather than the level of hand tightening.

• Journal of Technologic Dentistry
• /
• v.35 no.3
• /
• pp.201-207
• /
• 2013

Purpose: In this study, the loosening torque test was conducted with three implant products that are produced, approved and sold in Korea, which are manufactured in different fixture and abutment tightening methods (internal submerged type, internal morse taper type, and external type) to examine the loosening torque of the screw according to the method of tightening the implant fixture and abutment. Methods: In the loosening torque test, the three types of fixtures and abutments with different tightening methods were tightened by rotating them clockwise with a $30N{\cdot}cm$ force using a driver equipped with an electric torque meter. The results of the test are as follows. Results: The loosening torque values of the internal submerged type, internal morse taper type and external type implants were $24.10{\pm}0.742N{\cdot}cm$, $29.10{\pm}1.710N{\cdot}cm$, and $26.60{\times}1.636N{\cdot}cm$, respectively. Conclusion: The screw loosening torque values of the three fixture and abutment tightening methods were analyzed via Kruskal Wallis test layout, and they were significantly different (p<0.05).

• The Journal of Korean Academy of Prosthodontics
• /
• v.55 no.3
• /
• pp.251-257
• /
• 2017

Purpose: The purpose of this study was to evaluate whether the internal abutment length affected screw stability in an internal connection implant. Materials and methods: Twenty long internal connection implants (Replus system, $4.7{\times}11.5mm$) were selected for this investigation. Abutments were assigned to four groups depending on the length of the internal connection (abutments with internal lengths of 1, 2, 3, and 4 mm, respectively). Each implant fixture specimen was embedded in resin medium and connected to an abutment with an abutment screw. A load of 100 N, applied at an angle of $30^{\circ}$ to the long axis of the implant, was repeated for $1.0{\times}10^6$ cycles. Reverse torque values (RTV) were recorded before and after loading, and the change in RTV was calculated. Data were analyzed with the Kruskal-Wallis test. Results: The change in RTV was not significantly different among the groups (P>.05). Screw loosening and fractures were not observed in any groups, and joint stability was maintained. Conclusion: The internal length of the abutment may not significantly affect the degree of screw loosening.