• The Journal of Korean Academy of Prosthodontics
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• v.49 no.4
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• pp.346-353
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• 2011

Purpose: The peri-implant soft tissue is remodeled by the initial marginal bone resorption affecting the prognosis and esthetic result of treatment. Thus various designs on implant neck design are studied to preserve peri-implant bone. The purpose of this study is to review on the causes of initial marginal bone resorption, the configuration of peri-implant soft tissue, and the implant crestal module favorable in preserving peri-implant tissue. Materials and methods: The studies on the causes of initial marginal bone resorption and the implant crestal modules are researched and reviewed using Pubmed database. The implant crestal modules including one piece and two-piece implant, internal and external hex abutment, taper and butt joint connection, scalloped design abutment, and platform switching concept are reviewed. Results: A number of clinical and experimental studies preferred one piece implant to two-piece in preserving initial peri-implant tissue. For two piece implants, internal hex abutment and taper joint connection appear more favorable than external hex abutment and butt joint connection relatively. Controversial issues still exist on scalloped design requiring more studies on it. Although the rationale is not certain, the concept of platform switching seems favorable in preserving initial peri-implant tissue based on clinical and experimental studies. Conclusion: Each implant crestal module contains its own advantages and disadvantages with various controversial issues. In the aspect of preservation of initial peri-implant tissue, however, one-piece implant seems beneficial. In cases when two-piece implant is more appropriate due to prosthodontic concerns or any other problems, the application of platform switching concept, internal connection abutment, and taper joint connection may be favorable for the preservation of peri-implant tissues.

• Journal of Periodontal and Implant Science
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• v.46 no.3
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• pp.152-165
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• 2016

Purpose: This study investigated the effects of bone density and crestal cortical bone thickness at the implant-placement site on micromotion (relative displacement between the implant and bone) and the peri-implant bone strain distribution under immediate-loading conditions. Methods: A three-dimensional finite element model of the posterior mandible with an implant was constructed. Various bone parameters were simulated, including low or high cancellous bone density, low or high crestal cortical bone density, and crestal cortical bone thicknesses ranging from 0.5 to 2.5 mm. Delayed- and immediate-loading conditions were simulated. A buccolingual oblique load of 200 N was applied to the top of the abutment. Results: The maximum extent of micromotion was approximately $100{\mu}m$ in the low-density cancellous bone models, whereas it was under $30{\mu}m$ in the high-density cancellous bone models. Crestal cortical bone thickness significantly affected the maximum micromotion in the low-density cancellous bone models. The minimum principal strain in the peri-implant cortical bone was affected by the density of the crestal cortical bone and cancellous bone to the same degree for both delayed and immediate loading. In the low-density cancellous bone models under immediate loading, the minimum principal strain in the peri-implant cortical bone decreased with an increase in crestal cortical bone thickness. Conclusions: Cancellous bone density may be a critical factor for avoiding excessive micromotion in immediately loaded implants. Crestal cortical bone thickness significantly affected the maximum extent of micromotion and peri-implant bone strain in simulations of low-density cancellous bone under immediate loading.

• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.46-54
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• 2021

Purpose. The design of the implant-abutment complex is thought to be responsible for marginal bone loss (MBL) and might affect the condition of the peri-implant tissues. This the present study aimed to evaluate the influence of the implant-abutment complex on MBL and the peri-implant tissues in partially edentulous patients treated with dental implants and determine the most advantageous design. Materials and Methods. A total of ninety-one endosseous implants with different designs of implant-abutment complex [tissue level-TL (n = 30), platform switch-PS (n = 18), and platform match-PM (n = 43)] were reviewed for MBL, Probing Pocket Depth (PPD) and Bleeding on Probing (BoP). MBL was calculated for first year of the insertion and the following years. Results. The median MBL for the PM implants (2.66 ± 1.67 mm; n = 43) in the first year was significantly higher than those for the other types (P=.033). The lowest rate of MBL (0.61 ± 0.44 mm; n = 18) was observed with PS implants (P=.000). The position of the crown-abutment border showed a statistically significant influence (P=.019) and a negative correlation (r=-0.395) on MBL. BoP was found significantly higher in PM implants (P=.006). The lowest BoP scores were detected in PS implants, but the difference was not significant (P=.523). The relation between PPD and connection type revealed no statistically significant influence (P>.05). Conclusion. Within the limitations of the present study, it may be concluded that PS implants seem to show better peri-implant soft tissue conditions and cause less MBL.

• Advances in biomechanics and applications
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• v.1 no.2
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• pp.95-109
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• 2014

Peri-acetabular bone ingrowth plays a crucial role in long-term stability of press-fit acetabular cups. A poor bone ingrowth often results in increased cup migration, leading to aseptic loosening of the implant. The rate of peri-prosthetic bone formation is also affected by the polar gap that may be introduced during implantation. Applying a mechano-regulatory tissue differentiation algorithm on a two-dimensional plane strain microscale model, representing implant-bone interface, the objectives of the study are to gain an insight into the process of peri-prosthetic tissue differentiation and to investigate its relationship with implant-bone relative displacement and size of the polar gap. Implant-bone relative displacement was found to have a considerable influence on bone healing and peri-acetabular bone ingrowth. An increase in implant-bone relative displacement from $20{\mu}m$ to $100{\mu}m$ resulted in an increase in fibrous tissue formation from 22% to 60% and reduction in bone formation from 70% to 38% within the polar gap. The increase in fibrous tissue formation and subsequent decrease in bone formation leads to weakening of the implant-bone interface strength. In comparison, the effect of polar gap on bone healing and peri-acetabular bone ingrowth was less pronounced. Polar gap up to 5 mm was found to be progressively filled with bone under favourable implant-bone relative displacements of $20{\mu}m$ along tangential and $20{\mu}m$ along normal directions. However, the average Young's modulus of the newly formed tissue layer reduced from 2200 MPa to 1200 MPa with an increase in polar gap from 0.5 mm to 5 mm, suggesting the formation of a low strength tissue for increased polar gap. Based on this study, it may be concluded that a polar gap less than 0.5 mm seems favourable for an increase in strength of the implant-bone interface.

• The Journal of Advanced Prosthodontics
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• v.6 no.2
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• pp.146-149
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• 2014

The major drawback of cement-retained restorations is the extrusion of the excess cement into the peri-implant sulcus, with subsequent complications. Insufficient removal of the excess cement may initiate a local inflammatory process, which may lead to implant failure. This article presents a method of controlling cement flow on implant abutments, minimizing the excess cement around implant-retained restorations.

• The Journal of the Korean dental association
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• v.51 no.12
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• pp.637-642
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• 2013

Because the implant is regarded as a common treatment. It is clinically important that systemic and local risk factor of threatening peri implant mucosa should be considered during the process. The most risk factors are detected in clinical diagnosis, but it might be difficult and not clear to recognize systemic or combined factors. This article reviews risk factors of peri-implantitis. Local factors are biomechanics, periodontal soft tissue characteristics, infected site and oral hygiene. Systemic factors are alcohol, smoking and genetic traits.

• 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.39 no.3
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• pp.273-281
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• 2001

Digital subtraction radiography may be one of the most precise and noninvasive methods for assessing subtle density changes in peri-implant bone, providing additional diagnostic information on implant tissue integration in overall maintenance. The aims of this study were to evaluate density changes after first, second surgery of dental implant and to measure the amount of marginal bone loss 9 months after second surgery using digital subtraction radiography. Bone change around 30 screw-shaped implants in 16 patients were assessed on radiographs. 17 Branemark implants of 3.75mm in diameter(Nobel Biocare, Goteborg, Sweden), 2 Branemark implants of 5.0mm in diameter, 11 $Replace^{TM}$ implants of 4.3mm in diameter(Nobel Biocare, Goteborg, Sweden) were used. To standardize the projection geometry of serial radiographs of implants, customized bite block was fabricated using XCP film holder(Rinn Corporation, Elgin, IL.) with polyether impression material of Impregum(ESPE, Germany) and direct digital image was obtained. Qualitative and quantitative changes on radiographs were measured with Emago software(The Oral Diagnostic System, Amsterdam, Netherlands). The results were as follows: 1. The peri-implant bone density of 69.2% implants did not change and the peri-implant bone density of 30.8% implants decreased after 3 months following first surgery. 2. The crestal bone density of 53.9% implants decreased first 3 months after second surgery. The crestal bone density of 58.8% implants increased 9 months after second surgery. No density change was observed around the midportion of the implants after second surgery, 3. The amount of marginal bone loss between different kinds of implants showed no statistically significant differences (p>0.05). 4. More than 90% of total marginal bone loss recorded in a 9-month period occurred during the first 3 months.

• The Journal of Advanced Prosthodontics
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• v.14 no.4
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• pp.223-235
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• 2022

PURPOSE. To compare the clinical outcomes of two types of implant restoration for posterior edentulous area, 3-unit bridge supported by 2 implants and 3 implant-supported splinted crowns. MATERIALS AND METHODS. The data included 127 implant-supported fixed restorations in 85 patients: 37 restorations of 3-unit bridge supported by 2 implants (2-IB), 37 restorations of 3 implant-supported splinted crowns (3-IC), and 53 single restorations (S) as controls. Peri-implantitis and mechanical complications that occurred for 14 years were analyzed by multivariable Cox regression model. Kaplan-Meier curves and the multivariable Cox regression model were used to analyze the success and survival of implants. RESULTS. Peri-implantitis occurred in 28.4% of 2-IB group, 37.8% of 3-IC group, and 28.3% of S control group with no significant difference. According to the implant position, middle implants (P2) of the 3-IC group had the highest risk of peri-implantitis. The 3-IC group showed a lower mechanical complication rate (7.2%) than the 2-IB (16.2%) and S control group (20.8%). The cumulative success rate was 52.8% in S (control) group, 62.2% in 2-IB group, and 60.4% in 3-IC group. The cumulative survival rate was 98.1% in S (control) group, 98.6% in 2-IB group, and 95.5% in 3-IC group. There was no significant difference in the success and survival rate according to the restoration type. CONCLUSION. The restoration type was not associated with the success and survival of implants. The risk of mechanical complications was reduced in 3 implant-supported splinted crowns. However, the middle implants of the 3 implant-supported splinted crowns had a higher risk of peri-implantitis.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.5
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• pp.454-469
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• 2006

Today, there is considerable evidence to support a cause-effect relationship between microbial colonization and the pathogenesis of implant failures. The presence of bacteria on implant surfaces may result in an inflammation of the peri-implant mucosa, and, if left untreated, it may lead to a progressive destruction of alveolar bone supporting the implant, which has been named as peri-impantitis. Several maintenance regimens and treatment strategies for failing implants have been suggested. Recently, in addition to these conventional tools, the use of different laser systems has also been proposed for treatment of peri-implant infections. As lasers can perform excellent tissue ablation with high bactericidal and detoxification effects, they are expected to be one of the most promising new technical modalities for treatment of failing implants. It is introduced that Er,Cr:YSGG laser, operating at 2780nm, ablates tissue by a hydrokinetic process that prevents temperature rise. We studied the change of the titanium implant surface under scanning electron microscopy after using Er,Cr:YSGG laser at various energies, irradiation time. In this study, Er,Cr:YSGG laser irradiation of implant fixture showed different effects according to implant surface. Er,Cr:YSGG laser in TPS surface with RBM not alter the implant surface under power setting of 4 Watt(W) and irradiation time of 30sec. But in TPS surface with $Ca_3P$ coating alter above power setting of 2W and irradiation time of 10sec. TPS surface with RBM showed microfracture in 4W, 30sec and TPS surface with $Ca_3P$ coating showed destruction of fine crystalline structure, melting in excess of 2W, 10sec. We concluded that proper power setting, air, water of each implant surface must be investigated and implant surface must be irradiated under the damaged extent.