• Journal of radiological science and technology
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• v.43 no.2
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• pp.79-85
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• 2020

The influence of metal artifact in CT image depends on the type of metal materialsm, the reconstruction algorithm, and scan parameters. The presence of metal artifacts was quantitatively evaluated by applying the standard and MAR algorithms through the phantom study. In the change of tube voltage applied the standard algorithm, metal artifact decreased to 44.9% for 80 vs 120 kVp, 24% for 100 vs 120 kVp, while the image taken at 140 kVp increased the artifact by 19% compared to 120 kVp. When the tube current was increased from 100 to 300 mA, there was no significant difference in the CT value and noise. Black band and white strike artifacts occurred up to 65.9% in the adjacent ROI of the metal driver, whereas titanium screw produced lesser metal artifact than that of the metal driver. The combination of 120kVp or higher tube voltage-standard algorithm was effective in removing black band artifacts as well as white streak by high density materials. However, MAR reconstruction algorithm was useful in improving image quality under the environment of low kVp and high density materials, without increase of radiation exposure.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.51-56
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• 2015

Purpose As medical radiation exposures on patients are being social issues an interest in a relief of radiation exposures on patients is increasing. Further, there are many cases where some patients among who are getting PET/CT tests choose to get implanted with metal artifacts in their bodies. This study is to find out effects of presence or absence of metal artifacts when dose change or CT attenuation correction for the relief of radiation exposures are applied using phantoms through changes in standard uptake value (SUV). Materials and Methods GE company's Discovery 710 machine was used for PET/CT test equipments. We used NEMA IEC body phantoms. We also used screw and mesh cage made of titanium which are used in real clinical processes for the metal artifacts. Two experiments were conducted: One is to test and measure repeatedly about SUV about differences in CT attenuation corrections according to dose changes and another is to do the same procedure for SUV about the presence and absence of the metal artifacts. We injected $^{18}F-FDG$ into NEMA IEC body phantoms with a TBR ratio of 4:1 and then put the metal material into the transformation phantoms. Once a scanning for the metal artifacts was done we eliminated the metal artifacts and went on non-metal artifacts. For the each two experiments, we scanned repeatedly with CT kVp (140, 120, 100, 80) and mA (120, 80, 40, 20, 10) for an experimental condition. For PET, we reconstructed each with standard AC (STD) technique and quantitation achieved cnsistently QAC) technique among CT attenuation correction methods. We conducted a comparative analysis on measured average values and variations which were measured through repeated measure of SUV of region 1, 2, 3 spheres for each conditions of non-metal /metal scan. Results For each kVp, 120, 80, 40 (mA) of non/metal (screw, mesh cage) showed low frequency of fluctuation rates of above 2%. In 20, 10 mA above 2% of fluctuation rates appeared in high frequency. Also, when we compared the fluctuation rates of STD and QAC techniques in non/metal (screw, mesh cage) tests QAC technique showed about 1-10% of differences for each conditions compared to STD technique. In addition, metal types did not have significant effects on fluctuation rates. Conclusion We confirmed that SUV fluctuation rates for both STD and QAC techniques increase as dosage is lower. We also found that the SUV of PET data was maintained steadily in a low dosage for QAC technique when compared with STD technique. Hence, when the low dosage is used for the relief of radiation exposures on patients QAC technique may be exploited helpfully and this could be applied in the same way for patients with metal artifacts implanted in their bodies.

• The Journal of Korean Academy of Prosthodontics
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• v.56 no.3
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• pp.206-211
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• 2018

Purpose: Recently, a method of forming a slot in the prosthesis lingual has been introduced to solve the occlusal and aesthetic disadvantages of screw-retained prosthesis in the manufacture of implant-fixed prosthesis and to ensure retrievability in cement retained prostheses. The purpose of this study is to investigate the effect of the internal gap on the removal of the prosthesis in the preparation of cement-retained implant prostheses with lingual slots. Materials and methods: Titanium abutment and internal gap of the zirconia prosthesis to be attached to the upper part were set to 30, 35, and $50{\mu}m$, respectively. Three for each type total 15 were produced for each type. The zirconia prosthesis formed a retrievable cement-type slot with a space of 1 mm at the location where the titanium abutment meets the shelf area. Autocatalytic resin cement was used for bonding of abutment and zirconia prosthesis, and the maximum removal stress value was measured in units of Ncm by using the customized equipment of the cemented specimen. The Kruskal-Wallis test was used to compare the three groups by statistical analysis (${\alpha}=.05$), modified by post hoc test the Mann-Whitney U-test and the Bonferroni correction method were used to compare the two methods (${\alpha}=.017$). Results: There was no statistically significant difference in removal stress between the $30{\mu}m$ group and the $35{\mu}m$ group in the internal gap (P = .032), and there was a significant difference between the $30{\mu}m$ group and the $50{\mu}m$ group, between the $35{\mu}m$ group and the $50{\mu}m$ group (P < .017). Conclusion: Thus, the internal gap of computer-aided design affected the retention between the zirconia prosthesis and the titanium abutment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.4
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• pp.301-311
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• 2011

Introduction: This study examined the effect of the application of low intensity pulsed ultrasound on bone healing after an injection of adipose tissue-derived stem cells (ADSCs) during the implantation of a titanium implant in the tibia of diabetes-induced rats. Materials and Methods: Twelve Sprague-Dawely rats were used. After inducing diabetes, the ADSCs were injected into the hole for the implant. Customized screw type implants, 2.0 mm in diameter and 3.5 mm in length, were implanted in both the tibia of the diabetes-induced rats. After implantation, LIPUS was applied with parameters of 3 MHz, 40 mW/$cm^2$, and 10 minutes for 7 days to the left tibiae (experimental group) of the diabetesinduced rats. The right tibiae in each rat were used in the control group. At 1, 2 and 4 week rats were sacrificed, and the bone tissues of both tibia were harvested. The bone tissues of the three rats in each week were used for bone-to-implant contact (BIC) and bone area (BA) analyses and the bone tissues of one rat were used to make sagittal serial sections. Results: In histomorphometric analyses, the BIC in the experimental and control group were respectively, $39.00{\pm}18.17%$ and $42.87{\pm}9.27%$ at 1 week, $43.74{\pm}6.83%$ and $32.27{\pm}6.00%$ at 2 weeks, and $32.62{\pm}11.02%$ and $47.10{\pm}9.77%$ at 4 weeks. The BA in experimental and control group were respectively, $37.28{\pm}3.68%$ and $31.90{\pm}2.84%$ at 1 week, $20.62{\pm}2.47%$ and $15.64{\pm}2.69%$ at 2 weeks, and $11.37{\pm}4.54%$ and $17.69{\pm}8.77%$ at 4 weeks. In immunohistochemistry analyses, Osteoprotegerin expression was strong at 1 and 2 weeks in the experimental group than the control group. Receptor activator of nuclear factor kB ligand expression showed similar staining at each week in the experimental and control group. Conclusion: These results suggest that the application of low intensity pulsed ultrasound after an injection of adipose tissue-derived stem cells during the implantation of titanium implants in the tibia of diabetes-induced rats provided some positive effect on bone regeneration at the early stage after implantation. On the other hand, this method is unable to increase the level of osseointegration and bone regeneration of the implant in an uncontrolled diabetic patient.

• The Journal of Korean Academy of Prosthodontics
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• v.39 no.6
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• pp.659-681
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• 2001

Platelet-rich plasma(PRP) has been known to increase the rate and degree of bone formation by virtue of growth factors in concentrated platelets. Although its great healing effect on bone defect or pre-implantation site preparation in conjunction with bone substitute has been reported, the effect associated with implant is unknown. The purpose of this study was to investigate the effect of PRP on rapid osseointegration of endosseous dental implants in the rabbit tibiae. Twenty two adult female New Zealand white rabbits, weighing approximately 2.7-3.3kg, were used for this study. Twelve of the 22 animals were used for histomorphometric analysis and ten of the 22 were for removal torque test. Each animal received two implants in each tibia (two treated with PRP and two as control) and was given fluorochrome intramuscularly. For histomorphometric analysis, rabbits were divided into four groups according to the healing period. At 1 week, 2 weeks, 4 weeks and 8 weeks postoperatively, each three animals were sacrificed serially and the amount and rate of bone formation around dental implant were examined on the undecalcified sections under fluorescent microscope, polarized microscope and light microscope connected to a personal computer equipped with image analysis system. For removal torque test, rabbits were divided into two groups and removal torque tests were performed at 4 weeks, 10 weeks after implant placement. In total, 88 screw shaped, commercially pure titanium implants (Neoplant, Neobiotech, Seoul, Korea) were used in this study. Labeling pattern reflected differences of two groups in bone formation rate at each period. Histomorphometrically, PRP group showed significantly higher bone volume within threads compared to control group at 2 weeks ($70.30{\pm}4.96%$ vs. $50.68{\pm}6.33%$; P < .01) and 4 weeks ($82.59{\pm}5.94%$ vs. $72.94{\pm}4.57%$; P < .05 ). PRP group at 1, 2 and 4 weeks revealed similar degree of bone volume formation comparable to control group at 2, 4 and 8 weeks, respectively. On the other hand, while PRP group showed higher bone-implant contact ($47.37{\pm}8.09%$) than control group ($33.16{\pm}13.47%$) at 2 weeks, there were no significant differences between PRP group and control group for any experimental period. Removal torque values also showed no significant differences between PRP group and control group at any experimental period (P > .05). These findings imply that PRP could induce rapid, more bone formation around implant during early healing period and get faster secondary stability for reducing healing period, though it has not induced bone maturation enough to resist functional loading.

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.5
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• pp.594-605
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• 2006

Statement of problem: Modification of titanium implant surface has potential to ensure clinically favorable performance that several surface modification technologies have been introduced. Among the methods. anodizing method and sol-gel hydroxyapatite coating method have gained much interest due to its roughness and chemical composition of the coating layer, but more of its biocompatibility result is required. Purpose : The purpose of this study was to compare bone-implant interface shear strength of four different surface treated implants as time elapsed. Resonance frequency analysis(RFA) and removal torque measurement methods were employed to measure implant stability at one week and six week after implantation. Material and method: A total of 80 screw-shaped implant [20 machined, 20 resorbable media blasted(RBM), 20 anodized, and 20 anodized+hydroxyapatite sol-gel coated] were prepared, and one of each group was implanted in the tibia of a New Zealand white rabbit that total 20 of them were used. In order to test the implant stability and implant-tissue interface contact changing in the bone bed, each 10 rabbit were sacrificed 1 week and 6 week later while resonance frequency and removal torque were measured. One-way analysis of variance and the Tukey test were used for statistical analysis. Results : The results were as follows. 1. There was no statistically significant difference of implant stability quotients(ISQ) value in RFA between individual groups after 1 week of implantation and 6 weeks(p>0.05). But, there was statistically significant increase of ISQ value in 6 weeks group compared to 1 week group(p<0.05). 2. There was no statistically significant difference in removal torque analysis between individual groups after 1 week of implantation and 6 weeks(p>0.05). but there was statistically significant increase in all 4 groups after 6 weeks compared to 1 week later(p<0.05). 3. There was no statistically significant difference in removal torque analysis between anodized group and HA coating after anodic oxidation 6 weeks later(p>0.05), but significant difference was appeared in both groups compared to RBM group and smooth-machined group(p<0.05). Conclusions : It can be suggested that changes in surface characteristics affect bone reactions. Anodized and anodized+hydroxyapatite sol-gel coating showed significantly improved bone tissue response to implants, but further study on the effect of hydroxyapatite dissolution is needed.

• Journal of Periodontal and Implant Science
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• v.50 no.2
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• pp.106-120
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• 2020

Purpose: A new form of porous polyethylene, characterized by higher porosity and pore interconnectivity, was developed for use as a tissue-integrated implant. This study evaluated the effectiveness of porous polyethylene blocks used as an onlay bone graft in rabbit mandible in terms of tissue reaction, bone ingrowth, fibrovascularization, and graft-bone interfacial integrity. Methods: Twelve New Zealand white rabbits were randomized into 3 treatment groups according to the study period (4, 12, or 24 weeks). Cylindrical specimens measuring 5 mm in diameter and 4.5 mm in thickness were placed directly on the body of the mandible without bone bed decortication, fixed in place with a titanium screw, and covered with a collagen membrane. Histologic and histomorphometric analyses were done using hematoxylin and eosin-stained bone slices. Interfacial shear strength was tested to quantify graft-bone interfacial integrity. Results: The porous polyethylene graft was observed to integrate with the mandibular bone and exhibited tissue-bridge connections. At all postoperative time points, it was noted that the host tissues had grown deep into the pores of the porous polyethylene in the direction from the interface to the center of the graft. Both fibrovascular tissue and bone were found within the pores, but most bone ingrowth was observed at the graft-mandibular bone interface. Bone ingrowth depth and interfacial shear strength were in the range of 2.76-3.89 mm and 1.11-1.43 MPa, respectively. No significant differences among post-implantation time points were found for tissue ingrowth percentage and interfacial shear strength (P>0.05). Conclusions: Within the limits of the study, the present study revealed that the new porous polyethylene did not provoke any adverse systemic reactions. The material promoted fibrovascularization and displayed osteoconductive and osteogenic properties within and outside the contact interface. Stable interfacial integration between the graft and bone also took place.

• Journal of Periodontal and Implant Science
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• v.35 no.1
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• pp.153-161
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• 2005

파이브로넥틴은 세포외기질에 존재하는 당단백질로 세포의 부착, 이동, 성장 및 분화에 관여하며, 섬유아세포 성장인자는 세포의 증식 이동 및 분화에 영향을 주는 중요한 성장인자로 알려져 있다. 최근 연구에 의하면, 파이브로넥틴은 조골세포의 타이태늄 임플란트 표면으로 이주와 증식 및 골생성을 촉진하며, 섬유아세포 성장 인자는 파이브로넥틴에 상승작용을 한다고 보고된 바 있다. 이 실험의 목적은 파이브로넥틴 및 섬유아세포 성장인자의 복합 단백질을 이용하여 타이태늄 임플란트의 골 반응을 알아보는 것이다. 체중 2.5 kg 내외의 건강한 18 마리의 웅성가토를 준비하여 무균 사육하였고, 순수 타이태늄을 절삭가공하여 직경 3.5mm, 길이 6mm 의 machined surface를 지니는 screw type 의 임플란트를 준비하였다. 사람의 유전자를 기초로, 유전자 재조합법을 통해, 적절한 primer를 이용하여 얻은 섬유아세포 성장인자를 파이브로넥틴 III 형 분절의 9-10 번 도메인에 결합시켜 얻은 복합 단백질을 준비된 임플란트에 표면처리하여 실험군으로 하였고, 표면처리하지 않은 임플란트를 대조군으로 하여, 가토의 좌우 경골에 각각 2 개씩의 임플란트를 식립하였다. 4주 후, 가토를 희생시켜 각 경골 당 한 개의 임플란트에서 뒤틀림 제거력을 측정하였고 나머지 임플란트 식립 부위 에서는 경골을 포함하는 조직표본을 제작하였다. 조직표본상에서 골접촉이 가장 좋은 3 개의 나사산의 길이를 측정하고, 나사와 접촉하는 골의 길이를 측정하여 골-임플란트 접촉도를 구하고, 같은 부위에서 나사산 사이의 면적과 골이 차지하는 면적을 비교하여 골생성률을 얻었다. 실험군과 대조군의 결과는 Student t-test 를 이용하여 신뢰도 95% 수준에서 통계학적 유의성을 검정하였다. 파이브로넥틴과 섬유아세포 성장인자의 복합 단백질로 표면처리된 임플란트와 표면처리를 하지 않은 임플란트는 뒤틀림 제거력에서는 통계적 유의성이 나타나지 않았으나, 골-임플란트 접촉도와 골생성률에서 복합 단백질로 처리된 임플란트가 통계적으로 유의하게 높은 결과를 보였다. 이상의 연구결과로, 섬유아세포 성장인자와 파이브로넥틴 복합 단백질로 처리한 타이태늄 임플란트가 주변 골 형성을 촉진시켜, 골유합을 증진시킴을 알 수 있었다. 따라서, 복합 단백질이 타이태늄 임플란트의 성공률을 높이기 위한 표면개질 물질로 이용될 가능성을 확인할 수 있었다.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.1
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• pp.78-94
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• 2005

Purpose. The purpose of this study was to compare the effects of various surface treatments by measuring resonance frequency and histomorphometric analyses. Material and methods. In 5 adult dogs, the mandibular premolar were extracted. Six months later, 30 screw titanium implants (Dentium Co., Seoul, Korea) 6mm in length and 3.4mm in diameter, were placed in the mandibles of 5 dogs. Implants were divided into five groups following to surface treatment methods ; Group 1 is machined controls, Group 2 is sandblasted with large grit and acid-etched (SLA), Group 3 is anodized (Autoelectric Co., Korea, 660Hz, Duty10), Group 4 is hydroxyapatite(HA) coated by ion beam assisted deposition(E-beam), Group 5 is hydroxyapatite(HA) coated with Sol-gel coating process. Resonance frequency was measured implant placement immediately, and 3, 6 weeks and 10 weeks of healing perods. With the animal subject's sacrifice 10 weeks after implantation, implants were removed on bloc and histologic and computer-based histomorphometric analyses were performed. Histomorphometric analysis involved quantification of the entire bone to metal contact around the implants. Statistical analyses were performed using the SPSS for Windows (ver. 9.0 SPSS Inc.) Statistical differences were considered significant at P<0.05. Results. The results were as follows : 1) In five groups, mean value of resonance frequency analysis(RFA) were highest in group 5 (Sol-gel implant) at implantation and those of group 4 (E-beam)was highest at 10 weeks . but there was no correlation between surface treatments and RFA. 2) In all surface treatment groups, the RFA values of implants decreased until 3 weeks and increased to 10 weeks. 3) The percentage of direct bone-to-implant contact (BIC) had statistical significance between five groups in cancellous bone, (P<0.05) the percentage of bone density inside the thread had no statistical significance between five groups. (P>0.05) 4) There was a significant difference between cortical bone and cancellous bone in BIC. (P<0.05) and bone density. (P<0.05) 5) There was a correlation between the RFA value of implants at 10 weeks and BIC in cancellous bone, and between the RFA value of implants at 10 weeks and bone density in cortical bone. (P<0.05). Conclusions. These results indicate that surface treatment does not affect the implant stability in case of good bone quality.

• Journal of Dental Rehabilitation and Applied Science
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• v.29 no.3
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• pp.209-223
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• 2013

This study was to evaluate the stress distributions of prefabricated, customized abutments and fixtures according to their material and shape by three-dimensional finite element analysis. And to investigate the fatigue life and fracture characteristics. Mandibular models were fabricated by reconstruction of the CT scan of patients with normal occlusion. A total of six finite element models were designed, a load of 100 N was applied on the buccal cusps vertically, and 30 degree obliquely. 10 specimens each were fabricated for the more clinically widely used 4 type abutments and were loaded according to ISO 14801. Differences in stress distribution patterns were not found according to the materials of the abutments and fixtures. But a slight difference in the stress level was detected. Customized abutment groups showed lower crown stress levels. One-piece zirconia implant showed the lowest bone stress levels. In the fatigue test, highest values were measured in group 7. Prefabricated abutments showed less variation of fatigue life (P<0.05). Use of customized abutments can improve the fracture resistance of restorations. Especially, use of customized zirconia abutments reinforced by titanium screw connecting parts is recommended.