• The Journal of Korean Academy of Prosthodontics
• /
• v.41 no.2
• /
• pp.169-181
• /
• 2003

Statement of problem : The survival rate of wide diameter implants was lower than of 3.75-mm implants in some clinical researches. Purpose : The purpose of this study was to investigate the influence of implant diameter on the osseointegration of implants in the rabbit femoral condyle and tibial metaphyses by means of removal torque measurements and histomorphometric analysis. Material and Method : Ten adult New Zealand White rabbits were used in this study Two 3.75-mm diameter implants were inserted through one cortical layer in the tibial metaphyses and one 3.75-mm diameter implant was inserted in the femoral condyle. 5.0-mm diameter implants were inserted in the other leg in the same manner. A total of 60 implants (3.75-mm diameter implants:30 : 5.0-mm diameter implants:30) were installed. After a healing time of 4 and 12 weeks, the peak removal torque values required to shear off the implants were recorded. From the removal torque values (Ncm) obtained, the mean shear stress ($N/mm^2$) was calculated. And the percentage of direct bone-to-implant contact and the percentage of bone area inside the thread were measured by Kappa Image Base-metreo. The Student's t-test was undertaken for statistical analysis (p<0.05). Results : The removal torque value of 5.0-mm diameter implants was higher than of 3.75-mm diameter implants (p<0.05). The difference of shear stress value between 3.75-mm and 5.0-mm diameter implants was not statistically significant (p>0.05). The percentage direct bone-to-implant contact had no statistical difference between two groups (p>0.05). The percentage of bone area inside the thread had no statistical difference between two groups (p>0.05). Conclusion It is concluded that the quality f osseointegration is not influenced by increasing implant diameter.

• The Journal of Korean Academy of Prosthodontics
• /
• v.54 no.2
• /
• pp.103-109
• /
• 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 the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.1
• /
• pp.30-35
• /
• 2011

Introduction: Dental implants are used routinely with high success rates in generally healthy individuals. By contrast, their use in patients with diabetes mellitus is controversial because altered bone healing around implants has been reported. This study examined the bone healing response around titanium implants placed immediately in rats with controlled and uncontrolled diabetes. Materials and Methods: Twenty rats were divided into the control, insulin-treated and diabetic groups. The rats received streptozotocin (60 mg/kg) to induce diabetes; animals in the insulin-treated group also received three units of subcutaneous slow-release insulin. A titanium implant ($1.2{\times}3\;mm$) was placed in the extraction socket of the maxillary first molar and bone block was harvested at 1, 2 and 4 weeks. Results: Bone formation around the implants was consistently (from 1 to 4 week post-implantation) slower for the diabetic group than the control and insulin-treated group. Bone morphogenesis in the diabetic rats was characterized by fragmented bone tissues and extensive soft tissue intervention. Conclusion: The immediate placement of titanium implants in the maxilla of diabetic rats led to an unwanted bone healing response. These results suggest that immediate implant insertion in patients with poorly controlled diabetes might be contraindicated.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.31 no.2
• /
• pp.116-126
• /
• 2009

The use of short implants has been accepted risky from biomechanical point of view. However, short implants appear to be a long term viable solution according to recent clinical reports. The purpose of this study was to investigate the effect of different diameter and length of implant size to the different type of bone on the load distribution pattern. Stress analysis was performed using 3-dimensional finite element analysis(3D-FEA). A three-dimensional linear elastic model was generated. All implants modeled were of the various diameter(${\phi}4.0$, 4.5, 5.0 and 6.0 mm) and varied in length, at 7.0, 8.5 and 10.0 mm. Each implant was modeled with a titanium abutment screw and abutment. The implants were seated in a supporting D2 and D4 bone structure consisting of cortical and cancellous bone. An amount of 100 N occlusal load of vertical and $30^{\circ}$ angle to axis of implant and to buccolingual plane were applied. As a result, the maximum equivalent stress of D2 and D4 bones has been concentrated upper region of cortical bone. As the width of implant is increased, the equivalent stress is decreased in cancellous bone and stress was more homogeneously distributed along the implants in all types of bone. The short implant of diameter 5.0mm, 6.0mm showed effective stress distribution in D2 and D4 bone. The oblique force of 100N generated more concentrated stress on the D2 cortical bone. Within the limitations of this study, the use of short implant may offer a predictable treatment method in the vertically restricted sites.

• The Journal of Advanced Prosthodontics
• /
• v.14 no.3
• /
• pp.143-149
• /
• 2022

PURPOSE. Masticatory loading triggers active bone remodeling, altering alveolar bone mineral density (BMD). While dental implants are placed to bear masticatory loading, their influence on changing bone properties has not been fully investigated. Objective of this pilot study was to examine whether the dental implantation has an effect on BMD distribution of bone by comparing dentate, edentulous, and edentulous patients with implants. MATERIALS AND METHODS. Cone beam computed tomography (CBCT) images of 19 partially edentulous patients (Dent), 19 edentulous patients (Edent), and 16 edentulous patients who received implants in the mandible (Edent+Im), were obtained. CBCT images were also obtained from 5 patients within Edent+Im group, before implant placement and after implant loading. Basal cortical bone region of the mandible was digitally isolated. A histogram of gray levels proportional to BMD was obtained to assess mean, histogram standard deviation (HSD), fifth percentile of low and high values (Low₅ and High₅) of the BMD distribution. Multivariate analysis of variance and paired t-test were used to compare the BMD parameters among the 3 dental status groups and between pre- and post-implantation, respectively. RESULTS. Edentulous patients with implants had significantly greater HSD and High₅ values compared to edentulous patients (P < .013). All other comparisons were not significant (P > .097). Mean, HSD, and High₅ values significantly increased after receiving implants (P < .022). CONCLUSION. The current findings suggested that receiving dental implants promoted oral bone mineralization for edentulous patients. The longitudinal investigation could provide valuable information on understanding the effects of implantation on the behavior of oral bone quality.

• Journal of Periodontal and Implant Science
• /
• v.43 no.6
• /
• pp.291-300
• /
• 2013

Purpose: Calcium phosphate (CaP)-coated implants promote osseointegration and survival rate. The aim of this study was to (1) analyze the dissolution behavior of the residual CaP particles of removed implants and (2) evaluate bone apposition of CaP-coated machined surface implants at the early healing phase. Methods: Mandibular premolars were extracted from five dogs. After eight weeks, the implants were placed according to drilling protocols: a nonmobile implant (NI) group and rotational implant (RI) group. For CaP dissolution behavior analysis, 8 implants were removed after 0, 1, 2, and 4 weeks. The surface morphology and deposition of the coatings were observed. For bone apposition analysis, block sections were obtained after 1-, 2-, and 4-week healing periods and the specimens were analyzed. Results: Calcium and phosphorus were detected in the implants that were removed immediately after insertion, and the other implants were composed mainly of titanium. There were no notable differences between the NI and RI groups in terms of the healing process. The bone-to-implant contact and bone density in the RI group showed a remarkable increase after 2 weeks of healing. Conclusions: It can be speculated that the CaP coating dissolves early in the healing phase and chemically induces early bone formation regardless of the primary stability.

• The Journal of the Korean dental association
• /
• v.53 no.9
• /
• pp.628-643
• /
• 2015

Purpose: The aim of this retrospective study was to compare marginal bone loss and survival rates of double short implants(multiple implant) which had been installed and restored in severely atrophic maxillary molar site without a grafting procedure. Material and Method: The subjects were patients (90 patients, 180 implants) who had been installed double short implants in severely atrophic maxillary single molar site without bone augmentation procedure from 2006 to 2014 in dental clinic in Chuncheon city. Following data were collected from dental records and radiographic panoramic views: patient's age, gender, smoking status, implant site, timing of implant installation, residual ridge height. The correlation between those factors and survival rate and marginal bone loss were analyzed. Statistical analysis was performed using Chi-square test, Student's t- test and ANOVA. Result: Eleven implants in 6 patients failed and the cumulative survival rate was 93.9%. No significant differences were found in relation to the following factors: patient's age, gender, implant site, timing of implant installation (P> .05). There were significant differences in smoking status and residual ridge height(P< .05). The average follow-up time was $45{\pm}14.7months$. The mean marginal bone loss of survived 169 implants was $0.08{\pm}0.59mm$. Conclusion: Despite the short term outcomes, the survival rate of double short implants was comparable to normal length implants. This study demonstrated that placement of double short implants without the use of bone grafting procedure for severely atrophic posterior maxilla is a simple and predictable treatment procedure.

• The Journal of Korean Academy of Prosthodontics
• /
• v.46 no.6
• /
• pp.602-609
• /
• 2008

STATEMENT OF PROBLEM: Loss of the marginal bone to the first thread have been accepted but continuous effort have been made to reduce this bone loss by varying implant design and surface texture. PURPOSE: This animal study has examined the histomorphometric variations between implants with micro-thread, micro-grooved and turned surfaced neck designs. MATERIAL AND METHODS: Four mongrel dogs have been used the premolars removed and left to heal for three months. One of each implant systems with turned neck, micro-thread and micro-grooved were placed according to the manufacturers’protocol and left submerged for 8 and 12 weeks. These were then harvested for histological examination. RESULTS: The histologically all samples were successfully ossointegrated and active bone remodelling adjacent to implants. With the micro-grooved implants 0.40 mm and 0.26 mm of the marginal bone level changes were observed at 8 and 12 weeks respectively. The micro-threaded implants had changes of 0.79 mm and 0.56 mm at 8 and 12 weeks respectably. The turned neck designed implants had marginal bone level changes of 1.61 mm and 1.63 mm in 8 and 12 weeks specimens. A complex soft tissue arrangement could be observed against micro-threaded and micro-grooved implant surfaces. CONCLUSION: Within the limitations of this study, it could be concluded that implants with micro-grooved had the least and the turned neck designed implants had the most changes in the marginal bone level. The textured implant surfaces affect soft tissue responses.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.42
• /
• pp.10.1-10.9
• /
• 2020

Background: The aim of this study was to evaluate the long-term clinical stability of implants with acid-etched surfaces sandblasted with alumina using retrospective analyses of the survival rate, success rate, primary and secondary stability, complications, and marginal bone loss of the implants. Methods: Patients who had implants placed (TS III SA, SS II SA, SS III SA, and U III SA) with SA surfaces from Osstem (Osstem Implant Co., Busan, Korea) at the Seoul National University Bundang Hospital, from January 2008 to December 2010 were selected for the study. Patients' medical records and radiographs (panorama, periapical view) were retrospectively analyzed to investigate sex, age, location of implantation, diameter, and length of the implants, initial and secondary stability, presence of bone grafting, types of bone grafting and membranes, early and delayed complications, marginal bone loss, and implant survival rate. Results: Ninety-six implants were placed in 45 patients. Five implants were removed during the follow-up period for a total survival rate of 94.8%. There were 14 cases of complications, including 6 cases of early complications and 8 cases of delayed complications. All five implants that failed to survive were included in the early complications. The survival of implants was significantly associated with the occurrence of complications and the absorption of bone greater than 1 mm within 1 year after prosthetic completion. In addition, the absorption of bone greater than 1 mm within 1 year after prosthetic completion was significantly associated with the occurrence of complications, primary stability, and implant placement method. Five cases that failed to survive were all included in the early complications criteria such as infection, failure of initial osseointegration, and early exposure of the fixture. Conclusions: Of the 96 cases, 5 implants failed resulting in a 94.8% survival rate. The failed implants were all cases of early complications such as infection, failure of initial osseointegration, and early exposure of the fixtures. Periimplantitis was mostly addressed through conservative and/or surgical treatment and resulted in very low prosthetic complications. Therefore, if preventive measures are taken to minimize initial complications, the results can be very stable.

• Journal of Periodontal and Implant Science
• /
• v.31 no.1
• /
• pp.41-57
• /
• 2001

It is well known that the apposition of bone at implant surface would be influenced by the microstructure of titanium implants. The purpose of this study was to compare bone healing around the screw-shaped titanium implant with three different surface topographies in the canine mandibles by histological and biomechanical evaluation. All mandibular premolars of six mongrel dogs were extracted and implants were placed one month later. The pure titanium implants had different surface topographies: smooth and machined ($Steri-OSS^{(R)}$: Group II); sandblasted and acid-etched ($ITI^{(R)}$, SLA: Group III) surface. The fluorescent dyes were injected on the 2nd (calcein), 4th (oxytetracycline HCI) and 12th (alizarin red) weeks of healing. Dogs were sacrificed at 4 and 12 weeks after implantation. The decalcified and undecalcified specimens were prepared for histological and histo-metrical evaluation of implant-bone contact. Some specimens at 12 weeks after implantation were used for removal torque testing. Histologically, direct bone apposition to implant surface was found in all of the treated groups. More mature and dense bone was observed at the implant-bone interface at 12 weeks than that at 4 weeks after implantation. Under the fluorescent microscope, thick regular green fluorescent lines which mean early bone apposition were observed at the implant-bone interface in Group III, while yellow and red fluorescent areas were found at the implant-bone interface in Group I and II. The average implant-bone contact ratios at 4 weeks of healing were 54.3% in Group I, 57.7% in Group II and 66.2% in Group III. In Group I, implant-bone contact ratio was significantly lower than Group II and III(p<0.05). The average implant-to-bone contact ratios at 12 weeks after implantation were 64.3% in Group I, 66.7% in Group II and 71.2% in Group III. There was no significant difference among the three groups. In Group I and II, the implant-bone contact ratio at 12 weeks increased significantly in comparison to ratio at 4 weeks(p<0.05). The removal torque values at 12 weeks after implantation were 90.9 Ncm in Group I, 81.6 Ncm in Group II and 77.1 Ncm in Group III, which were significantly different(p<0.05). These results suggest that bone healing begin earlier and be better around the surface-treated implants compared to the smooth surface implants. The sandblasted and acid-etched implants showed the most favorable bone response among the three groups during the early healing stage and could reduce the waiting period prior to implant loading.