• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.48 no.3
• /
• pp.159-166
• /
• 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 the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.5
• /
• pp.571-577
• /
• 2008

Introduction: Possible etiologic factors associated with bone loss around implants after implantation are surgical trauma, occlusal overload, periimplantitis, presence of micro gap and the formation of biologic distances. Tarnow et al. observed that the crestal bone loss was greater when the distance between the implants was <3mm than when the implants were ${\geq}\;3mm$ apart. The aim of this study was to evaluate the influence of different interimplant distance on marginal bone and crestal bone resorption in the beagle dogs. Materials and methods: The mandibular premolars of 5 dogs were extracted bilaterally. After 12 weeks of healing, each dog received 7 implants. On each side, implants were separated by 2mm (Group 1) and by 5mm (Group 2). After 16 weeks of healing, the dogs were sacrificed. Marginal bone loss was determined through linear measurements made between the implant-abutment junctions and the most coronal portions of the bone in contact with the implant surface. A line was drawn uniting the implant-abutment junctions of the adjacent implants, and a linear measurement was made at the midpoint in the direction of the most coronal peak of the interimplant bone crest to determine the crestal bone loss. Both of them was measured radiologically and histologically. Result and conclusion: In radiological analysis, the mean of marginal bone loss was $1.26{\pm}0.14mm$ for group 1 and $1.23{\pm}0.34mm$ for group 2, the mean of crestal bone loss was $1.10{\pm}0.14mm$ for group 1 and $1.02{\pm}0.30mm$ for group 2. The results were not statistically significant between 2 groups. In histological analysis, the mean of marginal bone loss was $1.63{\pm}0.48mm$ for group 1 and $1.62{\pm}0.50mm$ for group 2, the mean of crestal bone loss was $1.23{\pm}0.35mm$ for group 1 and $1.15{\pm}0.39mm$ for group 2. The differences were also not statistically significant. The clinical significance of this result is that the increase in the crestal bone loss results in the increase in the distance between the base of the interproximal contact of the crowns and the bone crest, and this determines if papilla will be present or absent between implants. Considering this fact, keeping up sufficient interimplant distance is important to minimize crestal bone loss.

• Journal of Periodontal and Implant Science
• /
• v.38 no.2
• /
• pp.135-142
• /
• 2008

Purpose: Numerous studies have shown that crestal bone resorption around the implant was related to the location of the implant abutment junction(IAJ). Recently it was hypothesized that platform switching termed the inward horizontal repositioning of the IAJ might limit bone resorption around the implants. The purpose of this clinical study was to evaluate the effect of platform switching on crestal bone resorption. Materials and Methods: The crestal bone loss of 65 external hex implants in 26 patients were radiographically measured at crown placement and follow-up examinations. 23 standard implants(non-platform switching group, NP) were connected with the matching abutments and 42 wide implants(platform switching group, PS) were connected with the 1 mm smaller diameter abutments. Results: There was significant difference of crestal bone loss between NP group and PS group. For implants in the NP group, mean crestal bone loss was $1.18{\pm}0.68\;mm$ at crown placement and $1.42{\pm}0.41\;mm$ at follow-up. The meal bone loss in PS group was $0.47{\pm}0.52\;mm$ at crown placement and $0.60{\pm}0.65\;mm$ at follow-up. When the crestal bone changes according to placement depths of implants were compared, subcrestal position of IAJ had a significantly less bone loss in PS group, but it was not in NP group. Conclusion: Within the limits of the present study, it was concluded that platform switching technique might decrease crestal bone loss around the implants. Additionally, when the IAJ of implant was placed 1 mm deeper in the alveolar bone, the effect of platform switching on bone loss was enhanced.

• Journal of Periodontal and Implant Science
• /
• v.34 no.2
• /
• pp.303-315
• /
• 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 Korean Dental Science
• /
• v.12 no.1
• /
• pp.29-37
• /
• 2019

Purpose: This study was aimed to compare the survival and success rates, and long-term crestal bone loss according to the use of 2 connection types of dental implants (submerged-USII and non-submerged-SSII; Osstem $Implant^{(R)}$) by analyzing the change in alveolar bone height after 1 year under load and during final follow-up period. Materials and Methods: Between December 2004 and August 2008, patients with two types of Osstem implants (USII and SSII) were retrieved retrospectively. A total of 92 patients with 284 implants (USII=60, SSII=224) was finally selected. Their mean follow-up period was 7.5 years. The mesial and distal alveolar crestal bone changes were measured using radiographic images and the average was calculated at 1 year after loading and during final follow-up period. Result: Among the 284 implants, 4 USII and 7 SSII implants were removed, indicating 93.3% and 96.9% survival rates. Of the survived implants, mean crestal bone loss 1 year after loading was 0.39 mm for USII and 0.19 mm for SSII (P=0.018). During the final follow-up, mean crestal bone loss was 0.63 mm and 0.35 mm for USII and SSII, respectively, without statistical significance (P=0.092). According to the criteria for the success and failure of the implant by Albreksson and colleagues, final success rate was estimated as 86.7% for USII and 91.5% for SSII, respectively. Conclusion At 1 year after loading, the average crestal bone loss was significantly different between USII and SSII; however, both types met the criteria for implant success. During the final follow-up, both groups showed insignificant bone resorption patterns and did not show any pathological clinical symptoms. Therefore, both implants exhibited high long-term stability.

• Journal of Korean Dental Science
• /
• v.2 no.2
• /
• pp.12-17
• /
• 2009

Purpose : To determine whether peri-implant crestal bone loss could be affected by systemic disease, primary ISQ value, implantation method (submerged vs. non-submerged), surface treatment, and bone density Materials and methods : Patients who underwent fixture installation from June 24, 2005 to October 23, 2008 at Seoul National University Bundang Hospital were evaluated. A total of 157 patients (male: 52, female: 85) had 346 fixtures installed. Among them, 49 patients had periapical radiographs taken 1 year after prostheses were first set. A total of 97 fixtures were implanted. In particular, 30 fixtures were installed in patients with systemic diseases such as diabetes mellitus, cardiovascular disease, hypertension, and liver disease. The immediate stability of implants was measured with $Osstell^{tm}$. Implant surface treatment was classified into two groups (RBM, Cellnest (Anodized)), and bone density, into four groups (D1~D4). The bone resorption on the mesial and distal areas of fixtures was measured with periapical radiographs using the paralleling technique, and the mean value was calculated. The length determination program in IMPAX (AGFA, Belgium) was used. Results : At least 332 out of 346 (96%) installed GS II implants were successfully osseointegrated 1 year after prostheses were first set. The mean value of the bone resorption of the installed GS II implants was 0.44mm. The minimum value was 0mm, and the maximum value, 2.85mm. There was a statistically significant difference between the implantation methods (submerged, non-submerged) with regard to the amount of alveolar bone loss 1 year after prostheses were first set (p<0.05). Non-submerged implants showed less crestal bone loss. Note, however, that other variables had no correlation with crestal bone loss (p>0.05). Conclusion : There was a statistically significant difference between the 1-stage method and 2-stage method with regard to the amount of alveolar bone loss 1 year after prostheses were first set. Systemic disease, primary ISQ value, surface treatment, and bone density were not associated with alveolar bone loss. Other variables were assumed to have a correlation with alveolar bone loss.

• The Journal of the Korean dental association
• /
• v.45 no.9 s.460
• /
• pp.562-570
• /
• 2007

Many dentists and patients expect that implant function and esthetics will not change over time. However, even the most successful implant restorations with ideal position, vertical height, and occlusion can be aesthetically pleasing, but may hide a common problem. Many dentists noticed that there can be some circumferential bone loss around the neck of the implants. To circumvent this bone loss, a "platform switching" concept was introduced recently. The basic concept of platform switching is by moving the fixture-abutment interface further away from the crestal bone to minimize crestal bone loss. Since crestal bone loss is a multifactor problem, it is important to consider microgap formation and micromotion between the implant and abutment because platform switching does not solve the problem on its own. In this article, we reviewed studies concerning platform switching and discussed the clinical application and the problems that may occur with its use.

• The Journal of the Korean dental association
• /
• v.46 no.4
• /
• pp.243-247
• /
• 2008

Purpose : Ridge expansion osteotomy (REO) has been introduced when it is necessary to expand narrow crestal ridge with simultaneous implant placement. This study has designed to evaluate the clinical availability of REO. Materials and methods : Subject were patients who had visited Seoul National University Bundang Hospital from July. 2003 to December, 2005 for implant placement using REO by one surgeon. Intraoperative and postoperative complication, failure of initial osseointegration and marginal bone resorption were estimated using electronic medical record and periapical radiography. Twenty?three patients, 8 males and 15 females, mean age 51, ranged 18 to 72, were treated for mean 26 months, ranged from 16 months to 46 months. Results : Mean diameter and length of implants placed at upper anterior, were 3.72mm and 13.32mm each other. Guided bone regeneration and ridge splitting were accompanied in this study. Five cases of cortical bone fracture, three cases of crestal bone loss more than 2mm, 2cases of gingival recession, and 2 cases of infection were noted, but there were no implants removed because of disintegration. Success rate of implant was 91.7%, even if survival rate of implant was 100%. In addition, there were no statistical significance between the success rate of REO and bone graft(p>0.05). Conclusion : Based on the results of the present study, it can be concluded that REO technique is reliable for implant placement at atrophic ridge with adequate height compared to bone graft and other osteotomies for ridge expansion, but care should be taken of esthetic problem such as gingival recession because of crestal bone resorption from trauma by osteotome.

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

• Journal of Periodontal and Implant Science
• /
• v.46 no.5
• /
• pp.337-349
• /
• 2016

Purpose: The aim of this study was to compare and analyze the peri-implant tissue conditions and prospective clinical outcomes associated with 2 types of hydroxyapatite (HA)-coated implants: (1) fully HA-coated implants and (2) partially HA-coated implants with resorbable blast medium on the coronal portion of the threads. Methods: Forty-four partially edentulous patients were randomly assigned to undergo the placement of 62 HA-coated implants, and were classified as the control group (partially HA-coated, n=30) and the test group (fully HA-coated, n=32). All patients had chronic periodontitis with moderate crestal bone loss around the edentulous area. The stability and clinical outcomes of the implants were evaluated using the primary and secondary implant stability quotient (ISQ), as well as radiographic, mobility, and peri-implant soft tissue assessments around the implants. The Wilcoxon signed-rank test and the Mann-Whitney test were used to evaluate differences between and within the 2 groups, with P values <0.05 considered to indicate statistical significance. Results: The fully HA-coated implants displayed good retention of crestal bone, and insignificant differences were found in annual marginal bone loss between the 2 types of HA-coated implants (P>0.05). No significant differences were found in the survival rate (group I, 100%; group II, 100%) or the success rate (group I, 93.3%; group II, 93.8%). The fully HA-coated implants also did not significantly increase the risk of peri-implantitis (P>0.05). Conclusions: The fully HA-coated implants did not lead to an increased risk of peri-implantitis and showed good retention of the crestal bone, as well as good survival and success rates. Our study suggests that fully HA-coated implants could become a reliable treatment alternative for edentulous posterior sites and are capable of providing good retention of the crestal bone.