• The Journal of Korean Academy of Prosthodontics
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• v.29 no.3
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• pp.1-32
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• 1991

Tho osseointegrated dental prosthetic treatment has develped for the edentulous patient with severely resorbed alveolar ridge, and has given us a successful clinical results to date. Nowadays the partially edentulism is included among the indications of the osseointegrated prosthetic treatment. 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 superstructure. Two dimensional finite element stress analysis was applied for this study. FEM models were created using software Super SAP for MBM 16bit personal computer. Three modalities of connection were modeled and analyzed under load condition. The results were as follws: 1. The stress develped at tooth and implant in the cancellous bone was lower in the case of rigid connection than in the case of norigid connection, but higher between the two implants in the case of rigid connection than in the case of nonrigid connection. 2. The stress developed at the cortical bone and at the supporting bone interface was lower in the case of rigid connection than in the case of nonrigid connection 3. The stress developed at the supporting tissue interface of the implant nearby the tooth, was lower in the case of rigid connection than in the case of nonrigid connection. 4. The stress developed at the supporting tissue interface of posteriormost implant, was same between the cases of rigid and nonrigid connection. 5. The stress distribution related to the freestanding case was generally similar to the stress distribution pattern of nonrigid connection case. 6. The magnitude of applied load which produces deformation within elastic limit, had influence on the absolute value of stress, but had no influence on the pattern of stress distribution of the same case.

• Archives of Plastic Surgery
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• v.44 no.2
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• pp.150-156
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• 2017

Background Digital amputation is a common upper extremity injury and can cause significant impairment in hand function, as well as psychosocial stigma. Currently, the gold standard for the reconstruction of such injuries involves autologous reconstruction. However, when this or other autologous options are not available, prosthetic reconstruction can provide a functionally and aesthetically viable alternative. This study describes a novel technique, known as a tripod titanium mini-plate, for osseointegrated digit prostheses, and reviews the outcomes in a set of consecutive patients. Methods A retrospective review of patients who underwent 2-stage prosthetic reconstruction of digit amputations was performed. Demographic information, occupation, mechanism of injury, number of amputated fingers, and level of amputation were reviewed. Functional and aesthetic outcomes were assessed using the quick disabilities of the arm, shoulder, and hand (Q-DASH) scale and a visual analog scale (VAS) score, respectively. In addition, complications during the postoperative period were recorded. Results Seven patients were included in this study. Their average age was 29 years. Five patients had single-digit amputations and 2 patients had multiple-digit amputations. Functional and aesthetic outcomes were assessed using the Q-DASH score (average, 10.4) and VAS score (average, 9.1), respectively. One episode of mild cellulitis was seen at 24 months of follow-up. However, it was treated successfully with oral antibiotics. No other complications were reported. Conclusions When autologous reconstruction is not suitable for digit reconstruction, prosthetic osseointegrated reconstruction can provide good aesthetic and functional results. However, larger series with longer-term follow-up are required in order to rule out the possibility of other complications.

• The Journal of Korean Academy of Prosthodontics
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• v.34 no.3
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• pp.501-532
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• 1996

This study investigated the effects of cantilever length, location and load condition on stress distribution developed in the implants, prostheses and supporting tissues. The osseointegrated prostheses with two 10mm Branemark implants at 2nd premolar and 1st molar sites with cantilever extensions at 1st premolar, 2nd and 3rd molar sites were constructed. Under 100N, 200N of vertical and $45^{\circ}$ oblique loads at the cantilever pontics, stress distribution patterns and displacement were analyzed with three dimensional finite element method. The results were as follows : 1. The stress was concentrated at the joint of the cantilever pontic and implant superstructure, the neck of implant and the ridge crest near the cantilever But there was little load transfer to the lower supporting tissues of implants. 2. The implant near the cantilever was displaced inferiorly while the implant far from the cantilever was displaced superiorly. In horizontal direction the implants were displaced to the direction where the loads were applied, except the apexes of the implants. 3. In case of anterior cantilever, the stress and displacement were higher than the prosthesis connected with natural tooth. 4. The stress developed in the posterior cantilevered type was higher than in the anterior cantilevered type. The greastest stress was concentrated at the ridge crest near the posterior cantilever. 5. The longer the cantilever, the more the stress was developed and was concentrated at the joint of the cantilever pontic and implant superstructure. 6. Under oblique load, the stress was concentrated at the necks of implants and the ridge crests, but decreased at the joint of the cantilever pontic and implant superstructure than under vertical load.

• The Journal of Korean Academy of Prosthodontics
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• v.30 no.4
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• pp.582-610
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• 1992

The long-term success of any dental implant is dependent upon the optimization of stresses which occur during oral function and parafunction. Especially, it has been suggested that there is an unique set of problems associated with joining an osseointegrated implant and a natural tooth with a fixed partial denture. For this particular case, although many literatures suggest different ways to avoid high stress concentrations on the bone surrounding the implant under static and dynamic loading conditions, but few studies on the biomechanical efficacy of each assertion have been reported. The purpose of this investigation was to evaluate the efficacies of clinically suggested methods on stress distribution under static load and shock absorption under dynamic load, using two dimensional finite element method. In FEM models of osseointegrated implant-natural tooth supported fixed partial dentures, calculations were made on the stresses in surrounding bone and on the deflections of abutments and superstructure, first, to compare the difference in stress distribution effects under static load by the flexure of fastening screw or prosthesis, or intramobile connector, and second, to compare the difference in the shock absorption effects under dynamic load by intramobile connector or occlusal veneering with composite resin. The results of this analysis suggest that : 1. Under static load condition, using an implant design with fastenign screw connecting implant abutment and prosthesis or increasing the flexibility of fastening screw, or increasing the flexibility of prosthesis led to the .increase in height of peak stresses in cortical bone surrounding the implant, and has little effect on stress change in bone around the natural tooth. 2. Under static load condition, intramobile connector caused the substantial decrease in stress concentration in cortical bone surrounding the implant and the slight increase in stress in bone around the natural tooth. 3. Under dynamic load condition, both intramobile connector and composite resin veneering showed shock absorption effect on bone surrounding the implant and composite resin veneering had a greater shock absorption effect than intramobile connector.

• Journal of Periodontal and Implant Science
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• v.54 no.4
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• pp.280-291
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• 2024

Purpose: This study aimed to investigate whether new-onset periodontitis or apical periodontitis in the adjacent teeth affects osseointegrated dental implants in a beagle dog model. Methods: One control group and 2 experimental groups (periodontitis and apical periodontitis groups) were defined based on the presence of experimental periodontitis or apical periodontitis, with 1 beagle dog randomly assigned to each group. The mandibular second and fourth premolars on both sides of the 3 beagles were extracted. Eight weeks after extraction, 4 bone-level implant fixtures, 2 on both sides of each mandible, were placed in each beagle. Six weeks after implant surgery, healing abutments were connected. After sufficient osseointegration, plaque control was performed in the control group, while periodontitis and apical periodontitis were induced in the experimental groups. The beagles were euthanized for histological analyses 20 weeks after induction of experimental periodontitis. Statistical analyses were performed using the Kruskal-Wallis test with the Bonferroni correction to compare the 3 groups. Results: The implants in the control and apical periodontitis groups were well-maintained, while those in the periodontitis group showed clinical signs of inflammation with bone resorption. The bone-to-implant contact (BIC) and bone area values in the periodontitis group were lower than those in the other groups. The distance between the implant shoulder and the first BIC was significantly greater in the periodontitis group than in the control group (P<0.05). Conclusions: The presence of periodontitis in adjacent teeth can pose a risk to dental implants, potentially resulting in peri-implantitis. However, this was not observed for apical periodontitis. Within the limitations of this study, periodontal care is necessary to reduce the impact of periodontitis in adjacent teeth on osseointegrated implants.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.1
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• pp.87-99
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• 1993

Many studies have been reported on the successful replacement of missing teeth with osseointegrated dental Implants. However, little research has been carried out on the bio-mechanical aspect of the stress on the surrounding bone of the free-standing type of dental implant prostheses. This experimental study was aimed to analyze the stress distribution pattern on the supporting tissues depending upon the position of osseointegrated implants supporting fixed bridges. In the cases of unilateral partially edentulous mandible (the 2nd premolar and the 1st and 2nd molars missing), two osseointegrated implants were placed at the 2nd premolar and 2nd molar sites (Model A) , the 1st and 2nd molar sites (Model B, Anterior cantilevered type), the 2nd premolar and 1st molar sites (Model C, Posterior cantilevered type). Chewing forces of dentate patients and denture wearer were applied vertically on the 2nd premolar, the 1st molar, and the 2nd molar of each model. A 3-Unit fixed partial denture was constructed at each model and cantilevered extension parts were involved in Model B and Model C. Two dimensional finite element analysis was undertaken. The commercial software (Super SAP) for IBM 16 bit personal computer was utilized. The results were as follows : 1. The magnitude of applied load influenced on the total value of stresses, but did not in-fluence on the pattern of stress distribution. 2. The magnitude of stress developed from the supporting tissues were in order of Model C,Model A,Model B. 3. High stresses were concentrated on the cervical and apical portion of the implant/bone interface. 4. A difference of the stress magnitude on the implant/bone interface between mesial and distal implant was most prominant in Model C and in order of Model A and Model B. 5. The stresses developed in Model A were evenly distributed throughout both implants. 6. The stresses concentrated on the cervical portion of cantilevered side were higher in the posterior cantilevered type than in the anterior cantilevered type.

• The Journal of Korean Academy of Prosthodontics
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• v.38 no.5
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• pp.724-743
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• 2000

One of the biggest clinical problems of osseointegrated implant prosthesis is the excessive stress caused by bite forces which are transfered directly into the bone through the osseointegrated implant fixtures. So several biodynamic problems occur when there is an excessive fatigue stress. The factors of stress distribution are the number, kind, position, arrangement of the implants, and the distance between the implants, and the kind, quality of superstructure prosthesis and connection type between the rest implant and the superstructure. Recently, a distal short additional implant, socalled rest implant, is employed to reduced the stresses in conventional cantilevered prostheses. This study was undertaken to analyze the stresses transfered by osseointegrated implant cantilevered prostheses depending upon the number and the position of implants, the presence of rest implant, and the type of their connection. Three dimensional finite element analysis was attempted using ANSIS ver. 5.3 program under IBM INDIGO computer. The results were as follows : 1. The rest implant influenced on the pattern of stress distribution on the anterior area of the mandible and the superstructure. 2. In the group employing the rest implants, the fixed type of connection between the rest implant and the superstructure was more stable than the ball attachment type on the stress distribution. 3. In the group employing the ball attachment between the rest implant and the superstructure, the case with 4-implants(on canine, premolar) was little more stable than the case with 6-implants and the case with 4-implants(on incisor, premolar) on the stress distribution. 4. In the cantilevered group, the case with 4-implants(on incisor, premolar) and the case with 6-implants were more stable than the case with 4-implants(on canine, premolar) on the stress distribution. 5. In all of the group, the case with 6-implants and the fixed type of connection was the most stable and the case with 4-implants (on canine, premolar) was the most unstable on the stress distribution.

• The Journal of Korean Academy of Prosthodontics
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• v.31 no.4
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• pp.679-686
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• 1993

The osseointegrated implant conducts the stress directly to the bone due to lack of cushoning effect of periodontal ligament. So, the design and material quality of superstructure plays an important role in resolution and diffusion of stress. Recently, the various superstructures have been developed to improve esthetics and resolve various complicated conditions. The purpose of this study was to evaluate the stress induced by various system on the osseointegrated implant using UCLA abutment, EsthetiCone abutment, Anatomic abutment as well as Branemark conventional abutment. The stress distribution was evaluated by the photoelastic method which can simultaneously observe all around stress distribution. The superstructures embedded in epoxy resin specimen were loaded at various angle with a force of 15Kg to analyse the stress distribution of the fixture. The results of this study were obtained as follows : 1. Under vertical loading, the large and broad stress was distributed below the fixture in all systems. 2. The fringe order of the stress was increased in proportion to tillting the specimen. The largest stress was shown in 25 angled degree tilting case. 3. The Branemark conventional abutment showed the lowest value, and EsthetiCone abutment, Anatomic abutment and UCLA abutment showed the stress value in accending order.

• The Journal of Korean Academy of Prosthodontics
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• v.36 no.6
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• pp.806-815
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• 1998

Regular radiographic examination has been considered as an essential diagnostic method for the osseointegrated dental implantation. This study investigated the marginal bone loss through the measurement on the periapical radiograph around 46 endosseous dental implants. Marginal bone loss have been observed for 5 years after delivery of prostheses. The results were as follows : 1. According to the experimental periods, average marginal bone loss in total implant was 1.821mm in the first year, 1.833mm in the second, 1.892mm at third, 1.910mm at forth and 1.957mm at fifth after delivery of prostheses(P<0.05). 2. The average bone loss was 1.832mm in the maxillae and 1.819mm in the mandible in three years but there was no significant difference between the upper and lower jaw(P>0.05). 3. The average bone loss was 1.824mm in males and 1.818mm in females in five years but there was no significant difference according to the sex(P>0.05). These results indicate that the most of the alveolar bone loss occur within the first year after delivery of dental prostheses resulting in the exposure of polished neck positions, and the bone level stabilizes at first thread portion of the implant fixtures.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.698-708
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• 2001

This study was to evaluate the clinical evidence for the success and the predictability of the osseointegrated dental implants in the partially edentulous Korean patients. 201 patients have received total of 502 Branemark implants, which were restored with either single or multiunit fixed superstructures at the Implants Clinic, Yonsei University Dental Hospital. The clinical and radiographic evaluations carried out on the patients for maximum 8 years were assessed annually for peri-implant inflammation, implant mobility (PTV), Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), Keratinized Mucosa width and any changes in the surrounding bone level. The radiographs were taken at completion of the restoration, and annually thereafter. On the last recall appointments the patients filled a questionnaire consist of 29 questions in four categories. The cumulative non-failure rate of success was 93.9%. The first year mean bone loss was 0.3mm and less than 0.2mm annually thereafter. The periodontal parameters, keratinized tissue width and periotest values stabilized after initial changes in the first few years. The questionnaire has shown general satisfactory responses in all four aspect of dental implants treatment, including chewing efficacy, comfort, aesthetics and speech. The results support the predictability and success of the long-term rehabilitation of implant supported prostheses in partially edentulous Korean patients.