• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.48 no.3
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• pp.159-166
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• 2022

Objectives: The stability of crestal bone has been reported as a major factor in the success of dental implants. Implants can be placed in an equicrestal (crestal) or subcrestal position. The aim of this study was to evaluate the effect of implant depth placement on marginal bone loss. Materials and Methods: The study was created in a split-mouth design. Immediately after implant surgery, digital parallel radiographs were prepared and levels of bone were measured where marginal bone loss and bone level changes occurred. These measurements were repeated at 3-month and 6-month follow-up periods. Results: In this interventional study, 49 implants were evaluated in 18 patients. Primary bone height was not significant between the intervention and control groups in both mesial and distal aspects at 3 months and 6 months from the baseline. The mean marginal bone loss on the mesial side was 1.03 mm in the subcrestal group and 0.83 mm in the crestal group. In addition, mean marginal bone loss on the distal side was 0.88 mm and 0.81 mm in the subcrestal and crestal groups, respectively. Marginal bone loss was not significantly different between sexes, the maxilla or mandible, and in the anterior or posterior regions as well as between different lengths and diameters of implants. Conclusion: Based on the results of this study, there was no significant difference in terms of marginal bone loss between crestal and subcrestal implants.

• Journal of Korean Dental Science
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• v.1 no.1
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• pp.4-9
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• 2008

Purpose : This study sought to examine the aspects of crestal bone resorption and to evaluate the clinical outcomes of the TiUnite$^{(R)}$ (Nobel Biocare, Sweden) anodized implant system. Materials and Methods : Among the 67 patients (211 fixtures) who were treated using TiUnite(r) implants at Seoul National University Bundang Hospital between March 2004 and January 2007, 26 (91 fixtures) were considered in this study. Initial and secondary stabilities were measured using Periotest$^{(R)}$ and Ostell(tm) Mentor. The radiographic evaluation of crestal bone resorption was carried out by measuring the change in crestal bone level at the time of surgery compared to that 1 year after loading. Panoramic radiograph and periapical radiograph were used. Based on the radiographic findings, the shapes of crestal bone resorption were classified. Results : The average amount of crestal bone resorption after 1 year of functional implant loading was 0.30 mm. There was no saucerization in 40 implant fixtures (43.9%), although more than 1 thread were exposed in 51 implant fixtures (56.6%). The success rate of the implants was 94.5%, and the survival rate was 100%. Conclusions : Good clinical outcomes and minor crestal bone resorption were noted in this study. Saucerization for the establishment of biological width was not a general finding in the TiUnite$^{(R)}$ anodized implant system.

• Journal of Periodontal and Implant Science
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• v.28 no.3
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• pp.523-531
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• 1998

The purpose of this investigation was to examine the pattern of progression of periodontitis and the change in the extent and severity of the periodontal condition in young adults. Fourteen subjects with periodontitis, 11 males and 3 females in the age range 22-26, participated in the study. Following a baseline examination, the subjects were monitored for gingival index, probing pocket depth, gingival recession, probing attachment level and radiogrphic crestal bone height for 24 months without therapy. Re-examination were performed after 12 and 24 months. Gingival index, probing pocket depth, gingival recession and probing attachment level were assesed at 6 locations per tooth, and crestal bone height was assessed by subtraction radiography. The results from the follow-up examination revealed that the subjects underwent minor changes with respect to a series of different clinical parameters. The mean values of gingival index was improved, however, the mean values of probing pocket depth, gingival recession, probing attchment level and crestal bone height showed no significant change between baseline and the re-examination after 1 and 2 years.

• The Journal of Korean Academy of Prosthodontics
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• v.59 no.3
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• pp.281-290
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• 2021

Purpose. The aim of this study is to evaluate bone change around the implant in patients who underwent alveolar ridge preservation for implantation in the posterior teeth using radiographic data measuring changes of mesial, distal crestal bone level according to post-implantation, post-final prosthesis delivery and follow-up periods. Materials and methods. In total, 36 implants were placed in 32 patients. The mesial and distal crestal bone level of all the areas where alveolar ridge preservation was performed uses panoramic images taken post-implantation, post-final prosthesis delivery, and follow-up period each was measured and evaluated as a vertical value. The following factors were analyzed: associations between changes of crestal bone level and factors (e.g., age, sex, systemic diseases, dentist, implant location, tooth, bone type, membrane). The statistical analysis was performed using the mean, standard deviation and independent t-test, paired t-test (P < .05). Results. Analysis of crestal bone level differences between periods shows statistically significant differences (P < .05). There was no statistically significant difference when the changes of crestal bone level between post-implantation, post-final prosthesis delivery and follow-up periods were correlated with each factors. Conclusion. After alveolar ridge preservation, bone around the implant remained stable during the maintenance period without being affected by the patient and surgical factors, and alveolar ridge preservation is considered a clinically usable procedure.

• The Journal of Korean Academy of Prosthodontics
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• v.42 no.4
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• pp.458-470
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• 2004

Statement of problem: Br${\aa}$nemark or ITI are two currently most widely used implant systems but with contrasting design, surgical and restoration methods. Purpose: The purpose of this study was to compare changes and its statistical significance in bone height and shape which may rise due to the differences between two implant systems. Also to analyse the effect of inter-implant distance on annual bone height changes. Material & Method: Those patients who were treated with two or more of either Br${\aa}$nemark or ITI implants at posterior mandibular area at Yonsei University Dental Hospital, Implant Clinic were selected. At annual examination appointments, standardised radiographs using parallel technique were taken. Marginal bone and inter-implant crestal bone changes were measured and following results were obtained. Results: 1) When ITI and Br${\aa}$nemark system were compared, both annual marginal and inter-implant crestal bone height changes in ITI system in the first two years were smaller than Br${\aa}$nemark and they were statistically significant. On the third year, however, there was no statistical difference between two implant systems on their annual bone level changes (p>0.05). 2) The Marginal and inter-implant crestal bone changes were compared when inter-implant distance was less than 4mm. Statistically significant bone level changes were noted on the first year only for ITI implants but in the first and second year for Br${\aa}$nemark implants (p>0.05). 3) When comparing angulation changes between marginal bone and implant fixture, ITI system had smaller angulation changes but the annual changes were not statistically significant (p>0.05). Conclusion: Within the limitation of this study, it could be concluded that Br${\aa}$nemark implant systems had more changes in marginal and inter-implant crestal bone level in the first and second year after loading with statistical significance. Further studies are recommended to see the effects of these bone loss during the first and second year after loading on the long term prognosis of Br${\aa}$nemark Implants.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.385-393
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• 2009

Statement of problem: High stress concentration on the crestal cortical bone has been regraded as a major etiologic factor jeopardizing long term stability of endosseous implants. Purpose: To investigate if the design characteristics of crestal module, i.e. internal type, external type, and submerged type, affect stress distribution on the crestal cortical bone. Material and methods: A cylindrical shaped implant, 4.3 mm in diameter and 10 mm in length, with 3 different crestal modules, i.e. internal type, external type, and submerged type, were analysed. An axisymmetric scheme was used for finite elment formulation. A vertical load of 50 N and an oblique load of 50N acting at $45^{\circ}$ with the implant's long axis was applied. The peak crestal bone stress acting at the intersection of implant and crestal bone was compared. Results: Under vertical load, the crestal bone stress was high in the order of internal, external, and submerged types. Under the oblique loading condition, it was in the order of internal, submerged, and external types. Conclusion: Crestal module design was found to affect the level of the crestal bone stresses although the actual amount was not significant.

• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.394-405
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• 2009

Statement of problem: Crestal bone loss, a common problem associated with dental implant, has been attributed to excessive bone stresses. Design of implant's transgingival (TG) part may affect the crestal bone stresses. Purpose: To investigate if concavely designed geometry at a dental implant's TG part reduces peri-implant bone stresses. Material and methods: A total of five differently configured TG parts were compared. Base model was the ITI one piece implant (Straumann, Waldenburg, Switzerland) characterized by straight TG part. Other 4 experimental models, i.e. Model-1 to Model-4, were designed to have concave TG part. Finite element analyses were carried out using an axisymmetric assumption. A vertical load of 50 N or an oblique load of 50 N acting at $30^{\circ}$ with the implant's long axis was applied. For a systematic stress comparison, a total of 19 reference points were defined on nodal points around the implant. The peak crestal bone stress acting at the intersection of implant and crestal bone was estimated using regression analysis from the stress results obtained at 5 reference points defined along the mid plane of the crestal bone. Results: Base Model with straight configuration at the transgingival part created highest stresses on the crestal bone. Stress level was reduced when concavity was imposed. The greater the concavity and the closer the concavity to the crestal bone level, the less the crestal stresses. Conclusion: The transgingival part of dental implant affect the crestal bone stress. And that concavely designed one may be used to reduce bone stress.

• Journal of Periodontal and Implant Science
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• v.43 no.4
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• pp.153-159
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• 2013

Purpose: The level of the implant above the marginal bone and flap design have an effect on the bone resorption during the healing period. The aim of this study is to detect the relationship between the level of the implant at the implant placement and the bone level at the healing period in the mesial and distal side of implants placed with flapless (FL) and full-thickness flap (FT) methods. Methods: Twenty-two nonsubmerged implants were placed with the FL and FT technique. Periapical radiographs were taken of the patient at implant placement, and at 6 and 12 weeks. By using computer software, bone level measurements were taken from the shoulder of the healing cap to the first bone implant contact in the mesial and distal side of the implant surface. Results: At 6 weeks, the correlation between the crestal bone level at the implant placement and crestal bone level of the FT mesially was significant (Pearson correlation coefficient=0.675, P<0.023). At 12 weeks, in the FT mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.297, P<0.346). At 6 weeks in the FT distally, the correlation was nonsignificant (Pearson correlation coefficient=0.512, P<0.107). At 12 weeks in the FT distally, the correlation was significant (Spearman correlation coefficient=0.730, P<0.011). At 6 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient=0.083, P<0.809). At 12 weeks in the FL mesially, the correlation was nonsignificant (Spearman correlation coefficient= 0.062, P<0.856). At 6 weeks in the FL distally, the correlation was nonsignificant (Spearman correlation coefficient=0.197, P<0.562). At 12 weeks in the FL distally, the correlation was significant (Pearson correlation coefficient=0.692, P<0.018). Conclusions: A larger sample size is recommended to verify the conclusions in this preliminary study. The bone level during the healing period in the FT was more positively correlated with the implant level at implant placement than in the FL.

• The Journal of Korean Academy of Prosthodontics
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• v.45 no.2
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• pp.274-282
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• 2007

Statement of problem: Main consideration was given to the stresses at the site of implant entry into the cortical bone at the alveolar crest. As a suspectible factor affecting the occurrence of stress concentrations, the contact angle between the implant and the alveolar crest bone was addressed. Purpose: The purpose of this study is to evaluate angles between the alveolar crest bone and the implant effect on the implant crestal area induced stresses using a finite element method. Material and methods: Cylindrically shaped, standard size ITI implants entering into alveolar crest with four different contact angles of 0, 15, 30, and 45 deg. with the long axis of the implant were axisymmetrically modelled. Alterations of stresses around the implants were computed and compared at the cervical cortical bone. Results and conclusion: The results demonstrated that regardless of the difference of the implant/alveolar crest bone contact angles, stress concentration occurred at the cervical bone and the angle differences led to insignificant variations in stress level.

• Journal of Periodontal and Implant Science
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• v.33 no.3
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• pp.349-358
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• 2003

The success of dental implant therapy relies mainly upon the presence and maintenance of bone adjacent to implant. An 1-year prospective study was performed, upon the patients who were diagnosed as having chronic adult periodontitis, and had been treated with dental implant. The purpose of this study was to measure the radiographic bone level changes proximal to Astra Tech Single Tooth Implants (ATST, Astra Tech AB, $M{\"{o}}lndal$, Sweden) with microthread and Astra Tech TiOblast Implant (ATTB) without microthread supporting fixed partial prosthesis. Measurements were used to determine mean marginal bone loss during the first year of loading, 17 subjects with its partial prosthesis supported by 37 implants were followed up for an 1-year period. The marginal bone loss of implants was positively correlated with the retention factor, microthread($Microthread^{TM}$) in crestal area of ATST. The results were as follows. 1. The mean marginal bone loss of ATST was 0.226${\pm}$0.395mm, while ATTB was 0.440${\pm}$0.360mm. There was a statistically significant difference between ATST and ATTB (p<0.05). 2. The mean bone loss of the upper jaw fixtures was 0.269${\pm}$0.265mm for ATST and 0.529${\pm}$0.417mm for ATTB . There was a statistically significant difference between ATST and ATTB (p<0.05). In the lower jaw the corresponding figures were 0.167${\pm}$0.231mm and 0.313${\pm}$0.214mm, respectively. There was no significant difference between ATST and ATTB (p>0.05). 3. The mean bone loss of ATST was lower than that of ATTB at all sites according to bone quality. There was a statistically significant difference between ATST and ATTB at bone quality type III(p <0.05). In conclusion, the mean bone loss of ATST was smaller than that of ATTB . Therefore, the retention factor of crestal area, microthread ($Microthread^{TM}$) was effective to maintenance of marginal bone level around fixture.