• Imaging Science in Dentistry
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• v.40 no.3
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• pp.123-129
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• 2010

Purpose : To evaluate the effect of surgical treatment of ligature-induced peri-implantitis in dogs using fractal analysis. Also, the capabilities of fractal analysis as bone analysis techniques were compared with those of histomorphometric analysis. Materials and Methods : A total of 24 implants were inserted in 6 dogs. After a 3-months, experimental periimplantitis characterized by a bone loss of about 3 mm was established by inducing with wires. Surgical treatment involving flap procedure, debridement of implants surface with chlorhexidine and saline (group 1), guided bone regeneration (GBR) with absorbable collagen membrane and mineralized bone graft (group 2), and $CO_2$ laser application with GBR (group 3) were performed. After animals were sacrificed in 8 and 16 weeks respectively, bone sections including implants were made. Fractal dimensions were calculated by box-counting method on the skeletonized images, made from each region of interest, including five screws at medial and distal aspects of implant, were selected. Results : Statistically significant differences in the fractal dimensions between the group 1($0.9340{\pm}0.0126$) and group 3($0.9783{\pm}0.0118$) at 16 weeks were found (P<0.05). The fractal dimension was statistically significant different between 8($0.9395{\pm}0.0283$) and 16 weeks in group 3 (P<0.05). These results were similar with the result of the evaluation of new bone formation in histomorphometric analysis. Conclusions : Treatment of experimental peri-implantitis by using $CO_2$ laser with GBR is more useful than other treatments in the formation of new bone and also the tendency of fractal dimension to increase relative to healing time may be a useful means of evaluating.

• Journal of Periodontal and Implant Science
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• v.53 no.1
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• pp.69-84
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• 2023

Purpose: The objective of this study was to analyze the microbial profile of individuals with peri-implantitis (PI) compared to those of periodontally healthy (PH) subjects and periodontitis (PT) subjects using Illumina sequencing. Methods: Buccal, supragingival, and subgingival plaque samples were collected from 109 subjects (PH: 30, PT: 49, and PI: 30). The V3-V4 region of 16S rRNA was sequenced and analyzed to profile the plaque microbiota. Results: Microbial community diversity in the PI group was higher than in the other groups, and the 3 groups showed significantly separated clusters in the buccal samples. The PI group showed different patterns of relative abundance from those in the PH and PT groups depending on the sampling site at both genus and phylum levels. In all samples, some bacterial species presented considerably higher relative abundances in the PI group than in the PH and PT groups, including Anaerotignum lactatifermentans, Bacteroides vulgatus, Faecalibacterium prausnitzii, Olsenella uli, Parasutterella excrementihominis, Prevotella buccae, Pseudoramibacter alactolyticus, Treponema parvum, and Slackia exigua. Network analysis identified that several well-known periodontal pathogens and newly recognized bacteria were closely correlated with each other. Conclusions: The composition of the microbiota was considerably different in PI subjects compared to PH and PT subjects, and these results could shed light on the mechanisms involved in the development of PI.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.2
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• pp.142-149
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• 2008

The purpose of this study was to evaluate histomorphometrically a toothash - plaster of Paris mixture associated with collagen membrane ($Bio-Gide^{(R)}$), regarding new bone formation in the peri-implantitis defects in dogs. Three mandibular molars were removed from 1-year-old mongrel dogs. After 2 months of healing, 2 titanium implants with sandblasted with large grit and acid etched (SLA) surface were installed in each side of the mandible. Experimental peri-implantitis was induced with ligatures after successful osseointegration. Ligatures were removed after identification of bone defect beneath the level of 5th thread of fixture on radiographic image. The mucoperiosteal flaps were elevated and the contaminated fixtures were treated with chlorhexidine and saline. The bone defects were assigned to one of the following treatments: no guided bone regeneration (GBR) procedure (group 1), GBR with Bio-$Oss^{(R)}$ and Bio-$Gide^{(R)}$ (group 2), or GBR with toothash - plaster of Paris mixture (TPM) and Bio-$Gide^{(R)}$ (group 3). The dogs were sacrificed after 8 or 16 months. The mean percentages of new bone formation within the limits of the 5 most coronal threads were $17.83{\pm}10.69$ (8 weeks) and $20.13{\pm}13.65$ (16 weeks) in group 1, $34.25{\pm}13.32$ (8 weeks) and $36.33{\pm}14.21$ (16 weeks) in group 2, and $46.33{\pm}18.39$ (8 weeks) and $48.00{\pm}17.78$ (16 weeks) in group 3, respectively. The present study confirmed statistically considerable new bone formation within the threads in group 3 compared with group 1 at 8 and 16 weeks (P<0.05). Although, data analysis did not reveal significant differences between group 2 and 3, the latter showed better results during the period of 8 or 16 weeks. Our findings support the effectiveness of TPM as a GBR material in the treatment of peri-implantitis bone defect.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.33 no.4
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• pp.352-358
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• 2011

Purpose: This study evaluated the prognosis and survival rate of SLA (Sandblasted, Large-grit and Acid-etched) implants and it also evaluated the prosthodontic complications and the associated factors. Methods: Twenty seven patients (14 men and 13 women, mean age: 54.9) who visited Chosun University Hospital Implant Center with the chief desire for placement of an implant in an edentulous area from March, 2008 to December 2008 and who received placement of a SLA implant ($Implantium^{(R)}$, Dentium Co., Korea) were selected for this study. Results: The average follow-up period was 15 months and the study was based on the treatment records, radiographs and clinical examinations. A total of 69 implant cases were retrospectively assessed for the width and length of the implant, the primary and secondary stability, the combined surgery, the employed bone graft material and barrier membrane, the status of the opposing tooth, implant failure and the prosthetic complications. During the follow-up period (average: 15 months), the accumulative survival rate of the 69 implants in 27 patients was 100%. Complications such as infection, sinusitis and fixture exposure after surgery were seen for 5 implants in 4 patients. Complications such as screw loosening, contact loosening and peri-implant gingivitis after prosthodontic treatment occurred in 7 cases (10.14%). Conclusion: This study reports placement of SLA implants may cause various complications, yet the final accumulative survival rate was 100%. The SLA implant ($Implantium^{(R)}$) has an excellent clinical survival rate and outcome.

• Journal of Periodontal and Implant Science
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• v.52 no.4
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• pp.338-350
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• 2022

Purpose: Various studies have investigated 3-dimensional (3D)-printed implants using Ti6Al-4V powder; however, multi-root 3D-printed implants have not been fully investigated. The purpose of this study was to explore the stability of multirooted 3D-printed implants with lattice and solid structures. The secondary outcomes were comparisons between the 2 types of 3D-printed implants in micro-computed tomographic and histological analyses. Methods: Lattice- and solid-type 3D-printed implants for the left and right mandibular third premolars in beagle dogs were fabricated. Four implants in each group were placed immediately following tooth extraction. Implant stability measurement and periapical X-rays were performed every 2 weeks for 12 weeks. Peri-implant bone volume/tissue volume (BV/TV) and bone mineral density (BMD) were measured by micro-computed tomography. Bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) were measured in histomorphometric analyses. Results: All 4 lattice-type 3D-printed implants survived. Three solid-type 3D-printed implants were removed before the planned sacrifice date due to implant mobility. A slight, gradual increase in implant stability values from implant surgery to 4 weeks after surgery was observed in the lattice-type 3D-printed implants. The marginal bone change of the surviving solid-type 3D-printed implant was approximately 5 mm, whereas the value was approximately 2 mm in the lattice-type 3D-printed implants. BV/TV and BMD in the lattice type 3D-printed implants were similar to those in the surviving solid-type implant. However, BIC and BAFO were lower in the surviving solid-type 3D-printed implant than in the lattice-type 3D-printed implants. Conclusions: Within the limits of this preclinical study, 3D-printed implants of double-rooted teeth showed high primary stability. However, 3D-printed implants with interlocking structures such as lattices might provide high secondary stability and successful osseointegration.

• The Journal of the Korean dental association
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• v.56 no.3
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• pp.142-150
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• 2018

In the posterior maxillary area, due to resorption of the ridge after extraction and pneumatization of the maxillary sinus, the height of the alveolar ridge may not be sufficient for placement of implants. To solve this problem, sinus augmentation using both crestal and lateral approaches have been widely used. Jung et al. (2010) introduced the modified lateral approach technique, which is a simplified technique that combines the advantages of crestal and lateral approaches. The purpose of this case report is to report two cases in the posterior maxilla in which simultaneous implant placement with maxillary sinus augmentation has been performed using the modified lateral approach technique. In two female patients, 67 and 74 years old, respectively, simultaneous implant placement was performed using the modified lateral approach technique on the left maxillary second premolar and the first molar. In both patients, the residual bone height on the distal side of the maxillary second premolar was measured to be approximately 5 mm, and the residual bone height of the first molar was measured to be 2-3 mm. After flap elevation, osteotomy of the lateral window was performed in the form of a mesiodistally extended slot above the sinus floor and the Schneiderian membrane was elevated. Sequenced drilling was performed while protecting the membrane with a periosteal elevator. Bone graft and implant placement was performed after preparation of the implant site. Sufficient primary stability was achieved for each implant and sinus membrane was not perforated. After four and five months respectively, implant second surgery was performed. Clinically, the implants were observed to be stable. Implants and surrounding peri-implant mucosa were well maintained after prosthodontic treatment. In conclusion, the modified lateral approach could be a predictable and efficient technique for implant placement in the atrophied posterior maxilla.

• Journal of Periodontal and Implant Science
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• v.44 no.5
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• pp.242-250
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• 2014

Purpose: This study aimed to evaluate the effects of fibronectin and oxysterol immobilized on machined-surface dental implants for the enhancement of cell attachment and osteogenic differentiation, on peri-implant bone healing in the early healing phase using an experimental model in dogs. Methods: Five types of dental implants were installed at a healed alveolar ridge in five dogs: a machined-surface implant (MI), apatite-coated MI (AMI), fibronectin-loaded AMI (FAMI), oxysterol-loaded AMI (OAMI), and sand-blasted, large-grit, acid-etched surface implant (SLAI). A randomly selected unilateral ridge was observed for 2 weeks, and the contralateral ridge for a 4-week period. Histologic and histometric analyses were performed for the bone-to-implant contact proportion (BIC) and bone density around the dental implant surface. Results: Different bone healing patterns were observed according to the type of implant surface 2 weeks after installation; newly formed bone continuously lined the entire surfaces in specimens of the FAMI and SLAI groups, whereas bony trabecula from adjacent bone tissue appeared with minimal new bone lining onto the surface in the MI, AMI, and OAMI groups. Histometric results revealed a significant reduction in the BIC in MI, AMI, and OAMI compared to SLAI, but FAMI demonstrated a comparable BIC with SLAI. Although both the BIC and bone density increased from a 2- to 4-week healing period, bone density showed no significant difference among any of the experimental and control groups. Conclusions: A fibronectin-coated implant surface designed for cell adhesion could increase contact osteogenesis in the early bone healing phase, but an oxysterol-coated implant surface designed for osteoinductivity could not modify early bone healing around implants in normal bone physiology.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.116-124
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• 2008

Statement of the problem: Implant systems result in gaps and cavities between implant and abutment that can act as a trap for bacteria and thus possibly cause inflammatory reactions in the peri-implant soft tissues. Purpose: Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, Treponema denticola, and Aggregatibacter actinomycetemcomitans, related to implant-abutment interface microleakage. Material and methods: Samples were taken from 27 subjects with sterilized paper points and were transported in $1{\times}PBS$. The detection of periodontopathogens were performed by polymerase chain reaction with species-specific primers based on 16S rDNA. Results: Our data showed that the detection rate of P. gingivalis and P. intermedia in implant fixture was 59% and 82% in patients respectively. Detection rate of P. gingivalis and P. intermedia in implant crevice was 44% and 82% in patients. Detection rate of P. gingivalis and P. intermedias in tongue was 82% and 82% in patients. Conclusion: Current implant systems cannot safely prevent microbial leakage and bacterial colonization of the inner part of the implant.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.119-126
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• 2022

Mini-implant has been reported as an alternative method to conventional diameter implants in the treatment of mandibular anterior region with narrow ridge. However, one-piece type mini-implant showed biological and technical complications, such as peri-implantitis by residual cement and prosthetic detachment. Recently, one-piece type mini-implant with additional retentive structure has been introduced to increase the retention and stability of the mini-implant. The mini-implant is based on spreading the upper retentive structure with a spreader and connected it with the inner surface of the zirconia prosthesis. In two cases, we tried to reduce these complications through the mini-implant on the narrow mandibular anterior region, and it was possible to reduce the overall treatment period through a digital system. In this case report, restoration using the digital mini-implant system showed improvement of patient satisfaction on the aspect of function and esthetic in the narrow mandibular anterior region.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.1
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• pp.54-63
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• 2024

The long-term use of an implant overdenture shows problems, such as wear of attachment, concentrated occlusal forces on the anterior teeth, fracture of artificial teeth and rotation of denture. By transitioning to an Implant-assisted removable partial denture (IARPD) using additional implant placement, the problems can be solved. In this case report, a transition was made from implant overdenture to IARPD utilizing surveyed crowns to distribute occlusal forces concentrated on anterior teeth and to prevent denture rotation in a skeletal Class III patient. Design of definitive prosthesis with appropriate function and aesthetics was determined through several stages of provisional restorations. In this case, appropriate posterior occlusion and maintenance of peri-implant bone level of definitive prosthesis were observed.