• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.119-126
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• 2012

State of problem: Cement-retained implant-supported prostheses are routinely used in dentistry. The use of high strength cements has become more popular with the increasing confidence in the stability of the implant-abutment screw connection and the high survival rates of osseointegrated implants. No clinical data on retention of metal copings using CAD/CAM. To evaluate retention of metal copings using CAD/CAM system bonded to short titanium abutment with four different cements and compare retentive strength of metal copings with sandblasting or without sandblasting before cementation. Forty titanium abutment blocks were fabricated and divided into 4 groups of 10 samples each. Forty metal copings with occlusal hole to allow for retention testing were fabricated using CAD/CAM technology. The four cements were Fujicem(Fuji, Japan), Maxcem Elite(Kerr, USA), Panavia F2.0(Kurarary, Japan) and Superbond C&B(Sunmedical, Japan). The copings were cemented on the titanium abutment according to manufacture's recommendation. All samples were stored for 24h at 37oC in 100% humidity and tested for retention using universal testing machine(Instron) at a crosshead speed of 1.0mm/min. Force at retentive failure was recorded in Newton. The mode of failure was also recorded. Means and standard deviations of loads at failure were analyzed using ANOVA and Paired t-test. Statistical significance was set at P<0.05. Panavia F2.0 provided significantly higher retentive strength than Fujicem, Maxcem Elite(P<0.05). Sandblasting significantly increased bond strength(P<0.05). The mode of failure was cement remaining principally on metal copings. Within the limitation of this study, Panavia F2.0 showed significantly stronger retentive strength than Fujicem, Maxcem Elite(p<0.05). The Ranking order of the cements to retain the copings was Panavia F2.0, Fujicem = Maxcem Elite. Sandblasting significantly increased bond strength(P<0.05). The retentive strength of metal copings on implant abutment were influenced by surface roughness and type of cements.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.1
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• pp.120-147
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• 1994

This study was performed for the purpose of evaluating the stress distribution around threaded type implants, cylindrical type implants and teeth connected with rigid or non-rigid connector. The stress distribution around the surrounding bone was analyzed by three-dimensional photoelastic method. Twelve mandibular photoelastic epoxy resin models and a circular polariscope were used to record the isochromatic fringes. After the stress distribution around the implant and tooth was observed, the results were as follows ; 1. In threaded type implants, stress concentrated patterns were observed at the neck either vertical or 25 degree lateral force. 2. The stress concentrated patterns were observed at the tooth apical portion and neck portions of the implant and tooth when a threaded implant was connected with the tooth by either a rigid or non-rigid connector. More force was generated at the tooth neck portion by a rigid connector and more force at the implant neck portion by a non-rigid connector. 3. The stress concentrated patterns were observed at the apical portion of the implant and tooth when a cylindrical type ,implant was connected with the tooth either by a rigid or non-rigid connector. More force was generated at the tooth apical portion by a rigid connector and more force at the neck portion of the tooth and implant by a non-rigid connector. 4. The stress around the tooth was more equally distributed in a threaded type implant than in a cylindrical implant when the tooth was connected with either a rigid or non-rigid connector. 5. The stress around a threaded type implant was progressively more equally distributed in the following order : 1) when used a single implant, 2) a non-rigid connection with the implant and tooth, 3) a rigid connection with the implant and tooth, 4) a rigid connection with two implant fixtures.

• Journal of Dental Rehabilitation and Applied Science
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• v.28 no.2
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• pp.179-190
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• 2012

The installation of an implant in the distal extension area to assist a partial dentrue (IARPD) was used carefully in clinical situations. The purpose of this review on the IARPD is describing the concept, clinical results and guidelines of IARPD. For the review, a literature search was performed using the PubMed. The data from the literature suggest that the placement of the implants could improve function and patient satisfaction. In addition, IARPD reduced the residual ridge resorption. Longer and wider implant should be placed. Less than $15^{\circ}$ angulation may be not harmful. To prevent the loosening of the abutment, modified abutment or resilient attachment should be used. However, the connection method between the clasp retention and IARPD should be considered for long time success. Moreover, longitudinal clinical studies are required for evaluation of IARPD.

• The Journal of Korean Academy of Prosthodontics
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• v.53 no.4
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• pp.345-351
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• 2015

Purpose: The purpose of this study was to evaluate the proper axial thickness of zirconia abutment applied to implant in the anterior region. Materials and methods: Zirconia abutments were prepared at different axial wall thickness by processing pre-sintered zirconia blocks via CAD/CAM to obtain equal specimens. The abutments were each produced with a thickness of 0.5 mm (Group 1), 0.8 mm (Group 2), 1.2 mm (Group 3), or 1.5 mm (Group 4). The implant used in this study was a external connection type one (US, Osstem, Pussan, Korea) product and the zirconia abutment was prepared via replication of a cemented abutment. The crowns were prepared via CAM/CAM with a thickness of 1.5 mm and were cemented to the abutments using $RelyX^{TM}$ UniCem cement. A universal testing machine was used to apply load at 30 degrees and measure fracture strength of the zirconia abutment. Results: Fracture strength of the abutments for Group 1, Group 2, Group 3, and Group 4 were $236.00{\pm}67.55N$, $599.00{\pm}15.80N$, $588.20{\pm}33.18N$, and $97.83{\pm}98.13N$, respectively. Group 1 showed a significantly lower value, as compared to the other groups (independent Mann-Whitney U-test. P<.05). No significant differences were detected among Group 2, Group 3, and Group 4 (independent Mann-Whitney U-test. P>.05). Conclusion: Zirconia abutment requires optimal thickness for fracture resistance. Within the limitation of this study, > 0.8 mm thickness is recommended for zirconia abutment in anterior implants.

• Journal of Periodontal and Implant Science
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• v.40 no.5
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• pp.244-248
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• 2010

Purpose: The purpose of this study was to radiographically evaluate marginal bony changes in relation to different vertical positions of dental implants. Methods: Two hundred implants placed in 107 patients were examined. The implants were classified by the vertical positions of the fixture-abutment connection (microgap): 'bone level,' 'above bone level,' or 'below bone level.' Marginal bone levels were examined in the radiographs taken immediately after fixture insertion, immediately after second-stage surgery, 6 months after prosthesis insertion, and 1 year after prosthesis insertion. Radiographic evaluation was carried out by measuring the distance between the microgap and the most coronal bone-to-implant contact (BIC). Results: Immediately after fixture insertion, the distance between the microgap and most coronal BIC was $0.06{\pm}0.68\;mm$; at second surgery, $0.43{\pm}0.83\;mm$; 6 months after loading, $1.36{\pm}0.56\;mm$; and 1 year after loading, $1.53{\pm}0.51\;mm$ ($mean{\pm}SD$). All bony changes were statistically significant but the difference between the second surgery and the 6-month loading was greater than between other periods. In the 'below bone level' group, the marginal bony change between fixture insertion and 1 year after loading was about 2.25 mm, and in the 'bone level' group, 1.47 mm, and in 'above bone level' group, 0.89 mm. Therefore, the marginal bony change was smaller than other groups in the 'above bone level' group and larger than other groups in the 'below bone level' group. Conclusions: Our results demonstrated that marginal bony changes occur during the early phase of healing after implant placement. These changes are dependent on the vertical positions of implants.

• The Journal of Korean Academy of Prosthodontics
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• v.50 no.1
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• pp.36-43
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• 2012

Purpose: To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. Materials and methods: Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type ${\phi}4.0mm{\times}11.5mm$ Osstem$^{(R)}$ USII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture's external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group's implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. Results: The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2mm, there was no significant influence on the stress distribution. Conclusion: For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed.

• The Journal of Korean Academy of Prosthodontics
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• v.61 no.2
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• pp.113-124
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• 2023

Purpose. The purpose of this study is to help increase the success rate by analyzing the types and characteristics of implant prosthesis and the survival rate. Materials and methods. Among implants placed between 2011 and 2020 at Sanbon Dental Hospital, College of Dentistry, Wonkwang University, a case restored by a prosthetic surgeon was investigated for the characteristics and correlation of failure. The causes of failure were classified as failure of osseointegration, peri-implantitis, fixture fracture, abutment fracture, screw fracture, screw loosening, prosthesis fracture, and loss of prosthesis retention. Prosthetic method, cantilever presence, placement location, etc. were analyzed for their correlation with implant failure. Results analysis was derived through Chi-square test and Kaplan-Meier survival analysis using SPSS ver 25.0 (IBM, Chicago, IL, USA). Results. A total of 2587 implants were placed, of which 1141 implants were restored with Single Crown and 1446 implants with Fixed Partial Denture, and the cumulative survival rate was 88.1%. The success rate of SC was 86.2% (984) and the success rate of FPD was 89.6% (1295), showing statistically significant differences, among which factors that had significant differences were abutment fracture, screw fracture, and screw loosening (P < .05). Conclusion. As a result of the 10-year follow-up, more failures occurred due to biomechanical factors than biological factors. Further studies on the success of implants will be needed in the future.

• The Journal of Korean Academy of Prosthodontics
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• v.54 no.2
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• pp.103-109
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• 2016

Purpose: This study is to evaluate the clinical significance of implantation with simultaneous bone graft by comparing the marginal bone loss around maxillary anterior implants with or without bone graft. Materials and methods: Patients treated with implant-retained restorations on maxillary anterior region at Implant Center, Dental Hospital, Wonkwang University between June 2011 and May 2014 were included in this study. Date of implant placement, implant diameter, implant length, implant-abutment connection type and whether the bone graft was done were investigated. The patient's periapical radiographs taken immediately after implantation and at the most recent visit were compared. Marginal bone loss was measured using Emago advanced v5.6 program (Oral diagnostic systems, Amsterdam, Netherlands). Statistical analysis was done in independent t-test by using SPSS 22.0 program. Results: As a result of observing on 83 implants (without bone graft: 44, with bone graft: 39) of 52 patients for 6 - 45 months (average: 18.4 months), implants without bone graft showed $1.42{\pm}0.42mm$, implants with bone graft showed $1.28{\pm}0.45mm$ of marginal bone loss. Conclusion: In limitations of this study, implants with simultaneous bone graft had significantly less marginal bone loss than implants without bone graft.

• 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.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.2
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• pp.157-168
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• 2008

Statement of problem: Over the past two decades, implant supported fixed prosthesis have been widely used. However, there are few studies conducted systematically and intensively on the splinting effect of implant systems in mandible. Purpose: The purpose of this study was to investigate the changes in stress distributions in the mandibular implants with splinting or non-splinting crowns by performing finite element analysis. Materials and methods: Cortical and cancellous bone were modeled as homogeneous, transversely isotropic, linearly elastic. Perfect bonding was assumed at all interfaces. Implant models were classified as follows. Group 1: $Br{{\aa}}nemark$ length 8.5mm 13mm splinting type Group 2: $Br{{\aa}}nemark$ length 8.5mm 13mm Non-splinting type Group 3: ITI length 8.5mm 13mm splinting type Group 4: ITI length 8.5mm 13mm Non-splinting type An load of 100N was applied vertically and horizontally. Stress levels were calculated using von Mises stresses values. Results: 1. The stress distribution and maximum von Mises stress of two-length implants (8.5mm, 13mm) was similar. 2. The stress of vertical load concentrated on mesial side of implant while the stress of horizontal load was distributed on both side of implant. 3. Stress of internal connection type was spreading through abutment screw but the stress of external connection type was concentrated on cortical bone level. 4. Degree of stress reduction was higher in the external connection type than in the internal connection type.