• Journal of Periodontal and Implant Science
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• v.42 no.1
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• pp.20-24
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• 2012

Purpose: The purpose of this study was to evaluate the soft tissue and bone change around two adjacent implants in onestage implant surgery. Methods: Eleven subjects (7 males, 4 females) who were needed placement of 2 adjacent implants in the molar area were included. The two implants were placed with the platform at the level of the alveolar crest. The interproximal bone between the 2 implants was not covered with gingiva. After surgery, an alginate impression was taken to record the gingival shape and radiographs were taken to evaluate implant placement. Using a master cast, the gingival height was measured at baseline, 4 weeks, and 12 weeks. In the radiograph, the alveolar bone level was measured at the mesial and distal side of both implants at baseline and 12 weeks. Results: The exposed bone was covered with gingiva at both 4 and 12 weeks. Loss of alveolar bone around implants was found in all areas. The alveolar bone level in the exposed bone area did not differ from that in the non-exposed area. Conclusions: This study showed that the alveolar bone level and gingival height around 2 adjacent implants in the exposed bone area did not differ from that in unexposed bone area.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.418-437
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• 1995

The effect of the hydroxyapatite coatings on Titanium implants has been the subject of recent investigations. So far, the use of HA coating remains substantially controversial.This study was aimed to evaluate histologically the bone healing patterns around titanium plasm sprayed(TPS) amd HA-coated implant after implantation into the femur neck of ten adult dogs. After implantation, animals were sacrificed at the intervals of 2,4,6,8 and 12 weeks.The fluorescent dyes were injected on the postoperative 4th and 12th week into the animals supposed to be killed at the 12th week. The morphology and direction of new bone formation was similar in both TPS and HA-coated implants.There was a tendency toward more bone formation in the cortical bone area than in the cancellous bone area. Histologically,in the interface of the HA-coated implants, bone response and bone maturation was faster, compared to the TPS implants in the 2nd and 4th week. By fluorescent microscopy, new bone formation was active in the 4th week around both implants and was directed from the periosteum overlying cortical bone to the cancellous bone. These results suggest that the bone formation and maturation is faster during the early healing stage in the interface of the HA-coated implant and where the cortical bone quality is poor, HA coated implant is superior to the TPS implant in the early phase of new bone formation.

• Journal of Korean Dental Science
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• v.4 no.2
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• pp.67-72
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• 2011

Purpose: This study sought to evaluate the effects of bone graft wedging on the initial stability of implants in bone sites of unfavorable quality. Materials and Methods: Three male beagle dogs were used in this study. Osteotomies were performed with parallel drills (${\O}4.1{\times}10mm$), and fixtures (${\O}3.3{\times}8mm$) were placed. The control group was given implants without bone graft. Experiment group A was given implants with minimal initial stability using autobone grafts, whereas experiment group B was given xenografts. Groups were also divided by healing times at 4, 8, and 12 weeks. Results: All implants in the control group failed to osseointegrate. On the other hand, all implants in the experiment groups were clinically well-maintained during the entire experiment period. After 4, 8, and 12 weeks, bone-to-implant contact (BIC) ratio and implant stability quotient (ISQ) increased in the experiment groups. The differences between experiment groups A and B were not statistically significant, however. Conclusion: In unfavorable bone regions for dental implants, bone graft packing into the osteotomy prior to implant placement secured minimal initial stability and showed reasonable BIC ratios and ISQ values throughout the study period.

• The Journal of Korean Academy of Prosthodontics
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• v.32 no.4
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• pp.573-592
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• 1994

A two-stage procedure is ideal for getting a successful osseointegration. But if a one-stage procedure can achieve a similar osseointegration, the one-stage procedure has several advantages. The purpose of this study was to observe the initial bone formation and bone remodeling of open type (nonsubmerged) and closed type (submerged) titanium implants. Eight ITI hollow-screws and eight Branemark fixtures were divided into two groups (submerged and nonsubmerged) and were installed on the lower jaws of four mongrel dogs. The animals were sacrificed three months later and bone sections with implants were processed for light microscopic and fluorescent microscopic observation. The results were as follows : 1 There was no significant difference in bone-to-implant contact between submerged and nonsubmerged implants. 2. Smooth surface titanium implants showed more bone-to-implant contact than that of titanium plasma coated implants histologically. 3. Under fluorescent microscopy, the active bone remodeling and new bone formation were observed in the interface zone. 4. Under fluorescent microscopy, submerged and nonsubmerged implants had no difference in bone remodeling pattern, and intramembranous bone formation was more prominent. 5. The connective tissue fibers orienting perpendicularly toward implant surface were oberved in the neck of implants.

• The Journal of Advanced Prosthodontics
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• v.3 no.4
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• pp.190-195
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• 2011

PURPOSE. This study evaluated the initial stability of different implants placed above the bone level in different types of bone. MATERIALS AND METHODS. As described by Lekholm and Zarb, cortical layers of bovine bone specimens were trimmed to a thickness of 2 mm, 1 mm or totally removed to reproduce bone types II, III, and IV respectively. Three Implant system (Br${\aa}$nemark System$^{(R)}$ Mk III TiUnite$^{TM}$, Straumann Standard Implant SLA$^{(R)}$, and Astra Tech Microthread$^{TM}$-OsseoSpeed$^{TM}$) were tested. Control group implants were placed in level with the bone, while test group implants were placed 1, 2, 3, and 4 mm above the bone level. Initial stability was evaluated by resonance frequency analysis. Data was statistically analyzed by one-way analysis of variance in confidence level of 95%. The effective implant length and the Implant Stability Quotient (ISQ) were compared using simple linear regression analysis. RESULTS. In the control group, there was a significant difference in the ISQ values of the 3 implants in bone types III and IV (P<.05). The ISQ values of each implant decreased with increased effective implant length in all types of bone. In type II bone, the decrease in ISQ value per 1-mm increase in effective implant length of the Br${\aa}$nemark and Astra implants was less than that of the Straumann implant. In bone types III and IV, this value in the Astra implant was less than that in the other 2 implants. CONCLUSION. The initial stability was much affected by the implant design in bone types III, IV and the implant design such as the short pitch interval was beneficial to the initial stability of implants placed above the bone level.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.40 no.1
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• pp.17-20
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• 2014

Objectives: The aim of this study was to retrospectively evaluate the clinical survival rate of Astra Tech implants in the maxillary molar region performed with sinus lift and bone graft. Materials and Methods: Ninety-nine Astra Tech implants (Osseospeed) placed in the maxillary molar region using sinus lift from September 2009 to February 2012 were selected with a minimum follow-up period of 1 year. The height of alveolar bone, sinus approach technique, bone material and implant survival rate were evaluated. Results: Of the 99 implants, the survival rate was 90.9%; 8 implants failed within 1 year after implant placement, and 1 implant failed 1 year after implant loading. All failed implants were placed with sinus lift simultaneously. The average height of alveolar bone before implant placement was 6.9 mm, while the height of alveolar bone of failed implants was 2.1 mm, on average. Conclusion: Astra Tech implants placed in the maxillary molar region had generally good survival rates, but the relationship between reduced pre-implant alveolar bone height and implant failure requires further attention.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.164-174
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• 1996

In order to develop the allogeneic bone implants instead of autogenous bone grafts for maxillofacial reconstruction, undemineralized freeze-dried human bone was processed. The freeze-dried human bone was implanted into the cranial and mandibular defects of the rabbits. The implants were evaluated clinically, roentgenographically and histomophometrically. And immunohistochemical evaluation of the implants was performed on the rat. The results were as follows : 1. When compared with control defects of $0.8{\times}0.8\;cm$, the implants on the rabbit defects displayed complete osseous bridging clinically and roentgenographically. Histomophometrically a minimal inflammatory cell infiltrate was present but the defects healed well clinically. 2. When compared with control grafts, the freeze-dried implants on the rat muscle displayed decreased antigenicity by immunohistochemical evaluation, due to freeze-drying process. 3. Undemineralized freeze-dried human bone in this study can be preserved as a bank bone in this study and seems to be applicable for clinical allogeneic bone grafts.

• Journal of Periodontal and Implant Science
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• v.34 no.2
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• pp.303-315
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• 2004

The success and failure of dental implants depends on various factors such as patient's systemic status, quantity and quality of surrounding bone, presence or absence of marginal infection and mechanical loading condition. The measurement of crestal bone changes around the implants is implemental to evaluate the success and long-term prognosis of the implant. This study was to evaluate the cumulative survival rate of the implants which had been placed in the Department of Periodontics, Chonnam National University Hospital between 1992 and 2003, and to observe the crestal bone loss around the implants which had at least 2 consecutive periapical radiographs after connecting the transmucosal abutment. The radiographs were scanned and digitalized, and the crestal bone levels on the mesial and distal surface of implants were measured using Image analyzer (Image Pro Plus, Media Cybernetics, USA), immediately after implant placement, at 2nd surgery, and 3 months, 6 months, 1 year, and every year thereafter. Any bone loss was not observed during the period between the 1stand 2nd surgery, and the bone loss was 0.86 ${\pm}$ 0.92 mm for the first year of loading after connecting the transmucosal abutment. After 1 year of loading, annual bone loss was 0.1 ${\pm}$ 0.27 mm, and total bone loss was 0.90 ${\pm}$ 0.80 mm (during the average follow-up periods of 22.5 ${\pm}$ 25.6 Mos), The implant, with smooth surface, in the mandible, and with the fixed bridge prosthesis showed greater bone loss, compared to those, with the rough surface, in the maxilla and with single crown. In systemically diseased patients (including DM or osteoporosis), the greater bone loss was observed. The cumulative survival rate among 432 implants was 94.10% for 7 years. Among 15 failed implants, 9 implants were removed due to mobility from disintegration of bone-implant interface. From this results, crestal bone loss around the implants were greatest during 1 year after transmucosal abutment connection, and various factors could affect peri-implant bone loss. To prevent and predict the bone loss around the implants and improve the prognosis, further comprehensive maintenance and follow-up schedules are required.

• Journal of Periodontal and Implant Science
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• v.50 no.6
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• pp.379-391
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• 2020

Purpose: The aims of this study were to evaluate the 5-year cumulative survival rate (CSR) of implants placed with guided bone regeneration (GBR) compared to implants placed in native bone, and to identify factors contributing to implant failure in regenerated bone. Methods: This retrospective cohort study included 240 patients who had implant placement either with a GBR procedure (regenerated bone group) or with pristine bone (native bone group). Data on demographic features (age, sex, smoking, and medical history), location of the implant, implant-specific features, and grafting procedures and materials were collected. The 5-year CSRs in both groups were estimated using Kaplan-Meier analysis. Risk factors for implant failure were analyzed with a Cox proportional hazards model. Results: In total, 264 implants in the native bone group and 133 implants in the regenerated bone group were analyzed. The 5-year CSRs were 96.4% in the regenerated bone group and 97.5% in the native bone group, which was not a significant difference. The multivariable analysis confirmed that bone status was not an independent risk factor for implant failure. However, smoking significantly increased the failure rate (hazard ratio, 10.7; P=0.002). Conclusions: The 5-year CSR of implants placed in regenerated bone using GBR was comparable to that of implants placed in native bone. Smoking significantly increased the risk of implant failure in both groups.

• Journal of Periodontal and Implant Science
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• v.43 no.2
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• pp.58-63
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• 2013

Purpose: The aim of this study was to measure the peri-implant bone length surrounding implants that penetrate the sinus membrane at the posterior maxilla and to evaluate the survival rate of these implants. Methods: Treatment records and orthopantomographs of 39 patients were reviewed and analyzed. The patients had partial edentulism at the posterior maxilla and limited vertical bone height below the maxillary sinus. Implants were inserted into the posterior maxilla, penetrating the sinus membrane. Four months after implant insertion, provisional resin restorations were temporarily cemented to the abutments and used for one month. Then, a final impression was taken at the abutment level, and final cement-retained restorations were delivered with mutually protected occlusion. The complications from the implant surgery were examined, the number of failed implants was counted, and the survival rate was calculated. The periimplant bone lengths were measured using radiographs. The changes in initial and final peri-implant bone lengths were statistically analyzed. Results: Nasal bleeding occurred after implant surgery in three patients. No other complications were found. There were no failures of the investigated implants, resulting in a survival rate of 100%. Significantly more bone gain around the implants (estimated difference=-0.6 mm, P=0.025) occurred when the initial residual bone height was less than 5 mm compared to the >5 mm groups. No significant change in peri-implant bone length was detected when the initial residual bone height was 5 mm or larger. Conclusions: This study suggests that implants penetrating the sinus membrane at the posterior maxilla in patients with limited vertical bone height may be safe and functional.