• 대한치과보철학회지
• /
• 제32권3호
• /
• pp.445-454
• /
• 1994

Osseointegrated implant prostheses are to provide normal function without compromising the unique interaction between the tissue and the implant. The essential requirement for the osseointegrated implant prostheses is passive fit of abutment. Therefore, the impression must be accurate and reproduciable since the resultant master cast precisely duplicates the clinical condition. The purpose of this study was to compare the accuracy of the master casts obtained from five impression techniques. Group 1 : To take impression with indirect technique and Impregum F. Group 2 : To take impression with unsplinted direct technique and Impregum F. Group 3 : To take impression with splinted direct technique and Impregum F. Group 4 : To take impression with unsplinted direct technique and Xanthano. Group 5 : To take impression with splinted dierct technique and Xanthano. The results were as follow : 1. In taking impression of Impregum F, there was no significant difference between to use of indirect technique and unsplinted direct technique.(p<0.05) 2. Unsplinted direct technique with Impregum F is less accurate than splinted direct technique with Impregum F or Xanthano and unsplinted direct technique with Xanthano.(p<0.05). 3. There was no significant difference between splinted direct technique with Impregum F and unsplinted direct technique with Xanthano.(p<0.05) 4. Splinted direct technique reproduce more accurate than unsplinted direct technique.(p<0.05) 5. Impression plaster produced less distortion than polyether.(p<0.05) As a result, splinted direct technique with Xanthano was the most accurate technique. As a result, splinted direct technique with Xanthano was the most accurate technique in this study. In addition to dimensinal changes in the materials used, positional errors were also attributed to the mechanical components used in the transfer porocess. Although the errors measured were relatively small, this study demonstrates the potential for distortions with the transfer technique used. Further study is indicated that ?the technique will be able to reproduce the intraoral relationship of implant fixtures reliably and predictably.

• Archives of Plastic Surgery
• /
• 제32권3호
• /
• pp.293-298
• /
• 2005

Osseointegrated prosthetic auricular reconstruction can be classified as either direct or indirect. In the $Br{\aa}nemark $ system of direct osseointegration, implants are placed into the mastoid process of the temporal bone. In the Epitec system of indirect osseointegration, implants are inserted into a three-dimensional carrier plate that is fixed to the mastoid by means of screws. We experienced forty-four cases using the indirect system and seventeen cases using the direct system. We compared with two systems by complications, such as skin reaction, implant loosening, implant loss. There were no specific differences in the skin reaction around the implants and abutments in relation to age or system used. The degree of skin reaction was different according to the conditions around the implant: in cases of virgin microtia, a skin flap was used to cover the implant, in contrast to grafted skin coverage for failed autogenous reconstruction. In both systems, the skin reaction was more severe and frequent in skin flap than in grafted skin. Loosening of the implant was more frequent in the direct system; however, accidental detachment of the implant from the abutment was more frequent in the indirect system. To reduce complications of skin reaction in osseointegrated prosthetic auricular reconstruction, it is important for soft tissue around implant to immobilize. Therefore, grafted skin is better than skin flap as soft tissue around implant. And immobilization of soft tissue around implant by wound dressing is major facter.

• Archives of Plastic Surgery
• /
• 제49권5호
• /
• pp.587-595
• /
• 2022

Background The incidence of breast animation deformity (BAD) is reported to be substantial after direct-to-implant breast reconstruction with subpectoral implant placement. It has, however, never been examined if BAD can occur following prepectoral implant placement. Our primary aim was to compare the incidence and degree of BAD after direct-to-implant breast reconstruction using either subpectoral or prepectoral implant placement. Secondary aim of this study was to assess and compare the level of pain between sub- and prepectoral reconstructed women. Methods In this randomized controlled trial, patients were allocated to reconstruction by either subpectoral or prepectoral implant placement in accordance with the CONSORT guidelines. The degree of BAD was assessed by the "Nipple, Surrounding skin, Entire breast (NSE)" grading scale 12 months after surgery. The level of postoperative pain was assessed on a numerical pain rating scale. Results We found a significant difference in the degree of BAD favoring patients in the prepectoral group (23.8 vs. 100%, p < 0.0001; mean NSE grading scale score: 0.4 vs. 3.6, p < 0.0001). The subpectoral reconstructed group reported higher levels of pain on the three subsequent days after surgery. No significant difference in pain levels could be found at 3 months postoperatively. Conclusion The incidence and degree of BAD was significantly lower in women reconstructed by prepectoral direct-to-implant breast reconstruction. Unexpectedly, we found mild degrees of BAD in the prepectoral group. When assessing BAD, distortion can be challenging to discern from rippling.

• 한국치위생학회지
• /
• 제15권6호
• /
• pp.983-990
• /
• 2015

Objectives: The purpose of the study is to investigate the influencing factors of satisfaction and revisiting intention of dental implant patients. Methods: An interview and a self-reported questionnaire were completed by 190 patients in 10 dental clinics in Daegu, Gyeongbuk, and Gyeongnam from September 17 to October 31, 2015. The questionnaire consisted of the general characteristics of the subjects and satisfaction of implant. The instrument for implant interview was adapted form Pjetursson et al. by Likert 5 points scale. Cronbach's ${\alpha}$ in the study was 0.768. Data were analyzed by SPSS/AMOS version 21.0 program. Results: Cost satisfaction had direct effect on satisfaction of expectation and indirect effect on revisiting intent. Mastication satisfaction had the direct effect on satisfaction of expectation and revisiting intent, and indirect effect on revisiting intent. Satisfaction of aesthetic function had the direct effect on satisfaction of expectation, and the indirect effect on revisiting intent. Conclusions: The determining factors of successful dental implant included expenses, mastication function, and aesthetic satisfaction. The competent dental implant teamwork and appropriate expenses can satisfy the implant patients.

• Archives of Plastic Surgery
• /
• 제49권6호
• /
• pp.710-715
• /
• 2022

Background The latissimus musculocutaneous flap (LD flap) is a useful option for breast reconstruction following mastectomy. It has the advantage of obtaining sufficient tissue padding and natural shape by using autologous tissue. However, with the emergence of the skin-sparing mastectomy technique and artificial dermis matrix, direct-to-implant (DTI) breast reconstruction has become the first choice of surgery. The purpose of this study was to compare the satisfaction levels of patients who underwent DTI and LD flap with implant using patient-reported Breast-Q results. Methods A retrospective study was performed reviewing the records of 49 women who underwent immediate breast reconstruction with DTI or LD flap with implant and responded to the BREAST-Q questionnaire after the operation. The patient-reported breast-Q results were analyzed and correlated to the demographic information and intraoperative information. Results A total of 26 patients who underwent reconstruction with LD flap with implant and 23 patients with DTI were identified and responded to the questionnaire after an average of 32.3 and 10.4 months postoperation, respectively. According to the patient response to the breast-q values, satisfaction with breast was 60.0 and 57.0 points, psychosocial well-being 61.0 and 60.0 points, and sexual well-being 41.0 and 43.0 points in the two groups. Overall, there was no significant difference in the breastQ score between the two groups. Conclusion Patients who underwent DTI breast reconstruction seemed equally satisfied with the appearance and outcome of their breast reconstruction compared with LD flap with implant. Therefore, it appears that DTI is adequately replacing LD with implant.

• 대한치과보철학회지
• /
• 제35권1호
• /
• pp.165-180
• /
• 1997

The purpose of this study was to observe bone apposition and marginal bone loss and to check the possibility of success on titanium implant, HA coated implant and the implant with natural coral that were place immediately after teeth extraction in dogs. Experimental subjects were divided into 4 groups ; the 1st group is the titanium implant, second the HA coated implant, third the implant with natural coral, and the last the control group that was prepared in the extraction sockets. After 12 weeks, the dogs were sacrificed for visual observation and microscopic examination approaching histologic and histomorphometric analysis. The results were as follows : 1. Neither the infection nor the exposure of implant was found at the sites of all implant. 2. In a histomorphometric analysis, mean percentage of direct bone contact with the titanium implant was 80.7% and the HA coated implant showed 81.5% apposition, but the implant with natural coral showed 64.9% apposition(P<0.05). 3. In a microscopic examination, mature lamellated bone was found around the immediate implants and control group, while unabsorbed natural coral around the immediate implants with natural coral was found. 4. All immediate implant groups showed the loss of marginal bone in order from implant with natural coral, titanium implant, and HA coated implant. 5. Implant with natural coral that was placed by the type I interface of the Barzilay's classification immediately after teeth extraction showed low percentage of direct bone contact area, low success rate and a lot of marginal bone loss. Above results suggested that the immediate implants are osseointegrated successfully, although slightly marginal bone was loss.

• Archives of Plastic Surgery
• /
• 제40권4호
• /
• pp.374-379
• /
• 2013

Background To date, various types of acellular dermal matrix (ADM) have been developed for clinical use. AlloDerm is the most familiar type of ADM to most surgeons in breast reconstruction. It is prepared by freeze-drying. CG CryoDerm is the first form of ADM that requires no drying process. Therefore, theoretically, it has a higher degree of preservation of the dermal structures than AlloDerm. We conducted this study to compare the clinical course and postoperative outcomes of patients who underwent direct-to-implant breast reconstructions using AlloDerm and those who did using CG CryoDerm. Methods We performed a retrospective analysis of the medical records in a consecutive series of 50 patients who underwent direct-to-implant breast reconstruction using AlloDerm (n=31) or CryoDerm (n=19). We then compared the clinical course and postoperative outcomes of the two groups based on the overall incidence of complications and the duration of drainage. Results The mean follow-up period was 16 months. There were no significant differences in the overall incidence of complications (seroma, infection, skin flap necrosis, capsular contracture, and implant loss) between the two groups. Nor was there any significant difference in the duration of drainage. Conclusions CG CryoDerm has the merits of short preparation time and easy handling during surgery. Our results indicate that CG CryoDerm might be an alternative allograft material to AlloDerm in direct-to-implant breast reconstruction.

• The Journal of Advanced Prosthodontics
• /
• 제8권3호
• /
• pp.207-213
• /
• 2016

PURPOSE. A recently introduced direct drill-guiding implant surgery system features minimal tolerance of surgical instruments in the metal sleeve by using shank-modified drills and a sleeve-incorporated stereolithographic guide template. The purpose of this study was to evaluate the accuracy of this new guided surgery system in partially edentulous patients using geometric analyses. MATERIALS AND METHODS. For the study, 21 implants were placed in 11 consecutive patients using the direct drill-guiding implant surgery system. The stereolithographic surgical guide was fabricated using cone-beam computed tomography, digital scanning, computer-aided design and computer-assisted manufacturing, and additive manufacturing processes. After surgery, the positional and angular deviations between planned and placed implants were measured at the abutment level using implant-planning software. The Kruskal-Wallis test and Mann-Whitney U test were used to compare the deviations (${\alpha}=.05$). RESULTS. The mean horizontal deviations were 0.593 mm (SD 0.238) mesiodistally and 0.691 mm (SD 0.344) buccolingually. The mean vertical deviation was 0.925 mm (SD 0.376) occlusogingivally. The vertical deviation was significantly larger than the horizontal deviation (P=.018). The mean angular deviation was 2.024 degrees (SD 0.942) mesiodistally and 2.390 degrees (SD 1.142) buccolingually. CONCLUSION. The direct drill-guiding implant surgery system demonstrates high accuracy in placing implants. Use of the drill shank as the guiding component is an effective way for reducing tolerance.

• 대한치과보철학회지
• /
• 제42권2호
• /
• pp.238-247
• /
• 2004

Statement of problem: Major objective in making on implant-supported prosthesis is the production of superstructure that exhibits a passive fit when connected to multiple abutments. One requirement to ensure passive fit is to make an accurate impression. Purpose : The purpose of this study was to compare the accuracy of master cast fabricated by using different impression methods at the different impression levels. Material and method: The master model used in this study was resin block having low implant analogs. Impression method studied were 1) direct method on fxiture level (Group FIX-D), 2) indirect method on fixture level(Group FIX-I), 3) modified indirect method on fixture level(Group FIX-M), 4) direct method on abutment level(Group AB-D) and 5) indirect method on abutment level(Group AB-I). Each of the five groups took 10 impressions. Fifty impressions were made for master cast by using Impregum $F^{(R)}$ impression material loaded on individual tray. Three dimensional measuring microscope was used to measure the inter-implant distance. Error rate of each inter-implant distance were calculated and evaluated. Results : The results were as follows. 1. Group FIX exhibited higher accuracy than group AB. 2. In group FIX, modified indirect method showed the highest accuracy, while indirect method showed the lowest accuracy. In group Ab, indirect method showed the higher accuracy than direct method. 3. Group FIX showed larger horizontal error than group AB. But, group AB showed the larger vertical error than group FIX. 4. Group Fix-M showed smallest vertical and horizontal error. Conclusion: An impression method have more effect on accuracy of master model than an impression level. A modified indirect method showed smallest vertical and horizontal error.

• 대한치과의사협회지
• /
• 제58권8호
• /
• pp.496-504
• /
• 2020

The osseointegrated implants react biomechanically in a different pattern to occlusal force, due to lack of the periodontal ligament unlike the natural teeth. The implants show markedly less movement and limited tactile sensitivity compared with the natural teeth. The implant occlusion concept aims to avoid overloading on the implants and to direct occlusal loads along the longitudinal axis of the implants, in order to compensate for the different biomechanics of the implants. Although many guidelines and theories on implant occlusion have been proposed, few have provided strong supportive evidence. Moreover, the outcome of treatment often quite successful in spite of different concepts of occlusion and there is an increasing tendency to doubt about the strict theoretical implant-specific occlusion concept. The purpose of this article is to review the previous reports about the concept of implant occlusion and discuss clinical occlusal considerations in implant rehabilitations.