• Journal of Technologic Dentistry
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• v.46 no.2
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• pp.21-27
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• 2024

Purpose: This study aimed to analyze the stress distribution and deformation in implant abutments made from titanium (Ti-6Al-4V), zirconia, and polyetheretherketone (PEEK), including their screws and fixtures, under various loading conditions using finite element analysis (FEA). Methods: Three-dimensional models of the mandible with implant abutments were created using Siemens NX software (NX10.0.0.24, Siemens). FEA was conducted using Abaqus to simulate occlusal loads and assess stress distribution and deformation. Material properties such as Young's modulus and Poisson's ratio were assigned to each component based on literature and experimental data. Results: The FEA results revealed distinct stress distribution patterns among the materials. Titanium alloy abutments exhibited the highest stress resistance and the most uniform stress distribution, making them highly suitable for long-term stability. Zirconia abutments showed strong mechanical properties with higher stress concentration, indicating potential vulnerability to fracture despite their aesthetic advantages. PEEK abutments demonstrated the least stress resistance and higher deformation compared to other abutment materials, but offered superior shock absorption, though they posed a higher risk of mechanical failure under high load conditions. Conclusion: The study emphasizes the importance of selecting appropriate materials for dental implants. Titanium offers durability and uniform stress distribution, making it highly suitable for long-term stability. Zirconia provides aesthetic benefits but has a higher risk of fracture compared to titanium. PEEK excels in shock absorption but has a higher risk of mechanical failure compared to both titanium and zirconia. These insights can guide improved implant designs and material choices for various clinical needs.

• The korean journal of orthodontics
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• v.40 no.2
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• pp.106-114
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• 2010

Objective: The aim of this experimental study was to evaluate the effects of direct electrical current stimulation (DECS) on bone regeneration in response to an expansion of the inter-premaxillary suture in the rat. Methods: Sixteen 50 - 60 days old Wistar male rats were separated into two equal groups (control and experimental). Both groups were subjected to expansion, and 30-gram of force was applied to the maxillary incisors with helical-spring. In the experimental group, two metallic-screws were placed at lateral parts of the maxillary segments. Electrodes were connected to the screws. The device was activated with current adjustment to measure $10{\mu}A$ continuously and the current was monitored daily during the expansion and early-retention phase. Bone regeneration in the sutural area was histomorphometrically evaluated including new-bone area (${\mu}m^2$), bone perimeter (${\mu}m$), feret's diameter (${\mu}m$) and newly formed bone (%) parameters. Kruskal-Wallis rank and Mann-Whitney U tests were used for statistical evaluation at p < 0.05 level. Results: Statistical analysis showed significant differences between groups for all investigated histomorphometric parameters. New bone area (p = 0.002), bone perimeter (p = 0.004), feret's diameter (p = 0.002) and newly formed bone percentage (p = 0.002) measurements were significantly higher in the experimental group than the control group. Bone histomorphometric measurements revealed that bone architecture in the DECS group was improved. Conclusions: The application of DECS to an orthopedically expanded inter-premaxillary suture area during the early retention phase stimulated the formation of new bone.

• Journal of the Korean Arthroscopy Society
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• v.8 no.1
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• pp.19-25
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• 2004

Purpose: To compare the results of two different autografts used to reconstruct the anterior cruciate ligament(ACL): bone-patellar tendon-bone and quadruple hamstring tendon. Materials and Methods: Forty one cases (20 bone-patellar tendon-bone cases and 21 quadruple hamstring tendon cases) were followed up more than 2 years postoperatively. Patellar tendons were fixed with interference screws and hamstring tendons were fixed with cross pins and intrafix sheaths and screws. Follow-up results were evaluated with KT-2000 arthrometer, International knee Documentation Committee(IKDC) evaluation form and follow up X-ray Donor site morbidity was analysed. Results: Final IKDC) scores more than B grade and side to side differences of manual maximum test using KT-2000 arthrometer showed insignificant differences(p>) between the two groups. Plain radiographs of hamstring group showed marked widening of the femoral and tibial tunnels at postoperative 2 years. Patellar tendon group showed 30% rate of anterior knee complications. Conclusion: ACL reconstruction using autogenous hamstring graft with new fixation method showed comparable clinical results to using autogenous patellar tendon graft with fewer anterior knee symptoms.

• Journal of Dental Rehabilitation and Applied Science
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• v.30 no.3
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• pp.206-214
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• 2014

This study is to evaluate how different bearing surface angles of abutment screw affect the mechanical stability of the joint in the conical seal design implant system. Materials and Methods: Internal connection type regular implants, two-piece cemented type abutments and tungsten carbide/carbon-coated titanium alloy abutment screws were selected. Titanium alloy screws with conical ($45^{\circ}$) and flat ($90^{\circ}$) head designs which fit on to abutment were fabricated. The abutments were tightened to implants with 30 Ncm by digital torque gauge. The loading was applied once to the central axis of abutment. The mean axial displacement was measured using micrometer before and after the tightening and loading (n = 5). The abutment was tightened to implants with 30 Ncm and T-shape stainless steel crown was cemented. Then the change in the amount of reverse-torque was measured after the repeated loading to the central axis, and the place 5 mm away from the central axis. Compressive bending and fatigue strength were measured at the place 5 mm away from the central axis (n = 5). Results: Both groups showed the largest axial displacement when abutment screw tightening and total displacement was greater in the flat head group compared to conical head group (P < 0.05). However, there were no significant differences in reverse torque value, compressive bending and fatigue strength (P > 0.05). Conclusion: Within the limitations of this study, the abutment screw head design had no effect on two groups regarding the joint stability, however the conical head design affected the settlement of abutment resulting in the reduced total displacement.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.4
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• pp.243-248
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• 2012

Purpose: The purpose of this study is to compare the removal torque between prefabricated and customized implant abutment screw. Materials and methods: Three types of implant system (Osstem, Astra, Zimmer) were used. For each system, prefabricated abutment screw (control group) and customized abutment screw (test group) were used to connect the fixture and the abutment (n = 6). Digital torque gauze was used to control the tightening torque and the screws were tightened under each manufacturer's recommendation. 10 minutes after the connection the same tightening torque was applied, and 5 minutes after the second connection, the removal torque was measured. This procedure was repeated 10 times. In the cyclic loading test, 10 minutes after the first connection to the 6 groups (n = 3), the same tightening torque was applied, and a total of 1,000,000 time loading was applied at 30 degree angle to long axis with 50 N load. Repeated measures of ANOVA test (${\alpha}$=.05) was used as statistics to evaluate the effect of repeated loading number on the removal torque. Independent t-test was used to evaluate the difference in removal torque after cyclic loading. Results: The removal torque significantly decreased as the number of loading repetition increased (P<.05). In the 10 time repetition test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Also in the cyclic loading test, there was no significant difference between the prefabricated and customized implant abutment screw of the 3 implant system (P<.05). Conclusion: Within the limitation of this study, there was no significant difference in the removal torque between the prefabricated abutment screw and customized abutment screws.

• Journal of the Korean Orthopaedic Association
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• v.54 no.2
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• pp.141-149
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• 2019

Purpose: To compare the results of two different instruments made of stainless steel and titanium alloy for correction of single thoracic adolescent idiopathic scoliosis (AIS) using pedicle screw instrumentation. Materials and Methods: A total of 141 patients with single thoracic AIS treated with pedicle screw instrumentation and selective thoracic fusion were retrospectively reviewed after a follow-up of 2 years. The patients had a main thoracic curve of 40° to 75° and were divided into two groups based on instrument materials; S group (stainless steel, n=90) and T group (titanium alloy, n=51). The diameter of the stainless steel rod used was 7.0 mm while that of the titanium alloy rod was 6.35 mm or 6.0 mm. Standing long-cassette radiographic measurements including various coronal and sagittal parameters for the preoperative, early postoperative and 2-year postoperative followup were analyzed. There were no significant differences in the preoperative curve characteristics between the two groups. Results: In the S group, the preoperative main thoracic curve of 51.3°±8.4° was improved to 19.0°±7.6° (63.1% correction) and the lumbar curve of 32.3°±8.4° spontaneously decreased to 12.7°±8.2° (62.9% correction) at 2 years postoperatively. In the T group, the preoperative main thoracic curve of 49.5°±8.4° and the lumbar curve of 30.3°±8.9° was improved to 18.8°±7.4° (62.2% correction) and 11.3°±5.4° (63.3% correction), respectively. The corrections of coronal curves were not statistically different between the two groups (p>0.05). The thoracic kyphosis was changed from 16.8°±8.5° to 24.3°±6.1° in the S group and from 19.6°±11.2° to 26.6°±8.5° in the T group. There were no significant differences in the changes of sagittal curves, coronal and sagittal balances at the 2-year follow-up and the number of fused segments and used screws between the two groups (p>0.05). Conclusion: When conducting surgery for single thoracic AIS using pedicles screw instrumentation, two different instruments made of stainless steel and titanium alloy showed similar corrections for coronal and sagittal curves.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.83-91
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• 2017

Purpose: To investigate the clinical outcomes of distal hook augmentation using a pedicle screw in thoracolumbar fusion in elderly patients. Materials and Methods: This retrospective multicenter study recruited 20 patients aged 65 years or older, who underwent anterior support and long level posterior fusion in the thoracolumbar junction with a follow-up of one year. To assess the effect of distal hook augmentation, the patients were divided into two groups; the pedicle screw with hook group (PH group, n=10) and the pedicle screw alone group (PA group, n=10). Results: The average age was 72.4 years (65-83 years). The average fusion segment was 4.6 segments (3-6 segments). There were no significant differences in age, sex, causative diseases, bone mineral density of lumbar and proximal femur, number of patients with osteoporosis, and number of fused segments between the two groups (p≥0.05). At 1 year follow-up after surgery, parameters related with distal screw pullout were significantly worse in the PA group. No patients in the PH group had distal screw pullout. However, six patients (60%, 6/10) in the PA group had distal screw pullout. There were no significant differences in the progression of distal junctional kyphosis between the two groups. Conclusion: Distal hook augmentation is an effective procedure in protecting distal pedicle screws against the pullout when long level thoracolumbar fusion was performed in elderly patients aged 65 years or older.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.4
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• pp.343-358
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• 2011

As implant treatment has become popular, lots of different shapes and materials of the implant upper component have been supplied. And there are also diverse reports about failures including loosening of the abutment screw which is one of the most common reason. Purpose : The purpose of this study is to find out how different screw tightening orders and methods influence on screw loosening according to the different connection systems. The upper component was fabricated by casting method. After fabricating master models that are precisely attached to the upper component, 5 experimental models each for the external connection system and internal connection system were fabricated using splinting impression technique. First, to find out the influence of the screw tightening order, screws were tightened in 3 orders; 1-2-3-4, 2-3-1-4, 2-4-3-1. After tightening, removal torque values (RTV) of each group was measured. And also to find out the influence of screw tightening method, a model with 2-3-1-4 screw tightening order was tightened with 30 Ncm at one time(1-step method) and the RTV was compared with the same order group (2-3-1-4) in the 2 step method. In the external connection system, RTV appeared significantly lower in group 2-3-1-4 than group 2-4-3-1 (p<0.05). And also in the internal connection system, the RTV of group 2-3-1-4 appeared significantly lower than that of group 2-4-3-1 and 1-2-3-4 (p<0.05). When comparing the tightening number of the screw without considering the screw tightening order, the first tightened screw appeared significantly higher RTV than the second one in the external connection system (p<0.05), however there was no significant difference from the first tightened screw to the last tightened screw in the internal connection system. And there was no statistically significant difference between the two screw tightening methods in both internal and external connection system. In the comparison of external and internal connection system, each RTV appeared 16.27 Ncm and 14.25 Ncm and appeared as a statistically significant difference (p<0.05). There was a significant difference in RTV measured according to the screw tightening order. The lowest RTV appeared in the groups started tightening from the middle. There was also a significant difference in RTV between the two connection system groups. A further study is needed to find out the influence factors in RTV and also a study is required related to the load condition.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.499-502
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• 2013

An eight-year-old, castrated male, Poodle dog was presented with a bite wound in the neck region. Clinical examination revealed non-ambulatory signs of tetraparesis with deep pain, and upper motor neuron changes in all limbs. Fractures of the transverse process of C1 and the dorsal spinous process of C2 were observed on the radiographs and the computed tomography (CT). Conservative therapy was performed for 1 week. However the neurological problems were not alleviated until 7 days after injury. The owners agreed to perform surgical stabilization. The surgical stabilization was performed 7 days after presentation. Ventral stabilization was performed with screws, K-wires and bone cement. The dog stood up independently after 4 weeks and was able to walk 6 weeks postoperatively. In this report we suggest that using combined stabilization techniques are effective for this type of cervical fracture in which the dorsal and ventral structures of the vertebra are severely disrupted.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.28 no.3
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• pp.213-221
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• 2006

Purpose This study was aimed to evaluate the effect of the location and angle of drilling on the changes of the distance between the two block specimens. Materials and methods In experimental group 1, the screw holes were prepared by drilling in the distal portion of compression part of the plate at $90^{\circ}$. In experimental group 2, the drilling was performed at an angle of $30^{\circ}$ proximal to the miniplate, and in experimental group 3, at $30^{\circ}$ distal respectively. In control group, the drilling was performed to the center of hole at $90^{\circ}$. The fixation screw length was 5 mm, 7 mm, and 9 mm in all groups. The results were as follows. Results 1. In control group, the mean changes between two specimens were 0.01 mm, 0.02 mm, and 0.00 mm in 5 mm, 7 mm, and 9 mm screws respectively. 2. In experimental group 1, the compression part was moved toward the retention part. The range of mean changes were from -0.39 mm to -0.43 mm. 3. In experimental group 2, the compression part was moved toward the retention part. The range of mean changes were from -0.51 mm to -0.56 mm. 4. In experimental group 3, the compression part was moved apart from the retention part and the range of mean changes were from 0.55 mm to 0.56 mm. 5. The changes were significantly different between all groups(p<0.01). Conclusion These results suggest that 0.4$\sim$0.5 mm of compressive effect can be achieved by drilling on the distal area of the screw hole at an angle of $90^{\circ}$ and by the proximal angulation to the miniplate, and the gap between specimens can be increased by distal angulation to the miniplate during drilling.