• The Journal of Advanced Prosthodontics
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• v.13 no.1
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• pp.55-64
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• 2021

PURPOSE. To investigate the biomechanical effect of marginal bone resorption (MBR) on the mandibular mini implant (MI)-retained overdenture (MI-OD) on the edentulous model. MATERIALS AND METHODS. The experimental mandibular edentulous model was modified from a commercial model with 2 mm thick artificial soft tissue under denture base. Two MIs (Φ2.6 mm × 10 mm) were bilaterally placed between the lateral incisor and the canine area and attached with magnetic attachments. Three groups were set up as follows: 1) alveolar bone around the MI without MBR (normal group), 2) with MBR to 1/2 the length of the implant (resorption group), and 3) complete denture (CD) without MI (CD group). Strain around the MI, pressure near the first molar area, and displacement of denture were simultaneously measured, loading up to 50 N under bilateral/unilateral loading. Statistical analysis was performed using independent-samples t test and one-way ANOVA (α=.05). RESULTS. The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure in CD was higher than in MI-ODs (P<.05), while there was no statistical difference between the normal and resorption group (P>.05). Similarly, the CD demonstrated a greater displacement of the denture base than did the MI-ODs during bilateral and unilateral loadings (P<.05). CONCLUSION. The strain around the MI with MBR was approximately 1.5 times higher than that without MBR. The pressure on posterior alveolar ridge and denture displacement of MI-ODs significantly decreased compared to CDs, even when MBR occurs. Bilateral balanced occlusion was recommended for MI-ODs, especially when MBR occurred.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.31 no.2
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• pp.47-55
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• 2022

Food impaction due to proximal space opening after implant restoration is a very common phenomenon in patients who have implant prosthesis. This occurs because the movement mechanism between the implant and the tooth is different, and it occurs about 30-60% over time. Contributing factors include the arch (mandible), region (posterior teeth), adjacent teeth (non-vital teeth), and antagonist teeth (natural teeth or implants), etc. While this phenomenon cannot be prevented, efforts should be made to minimize it. In order to have an ideal proximal contact as much as possible, the concave shape or the prominent lower proximal shape should be modified to create a symmetrical proximal shape. with the buccal dentate in the upper third height should be adjusted. Other conditions should be modified so that the heights of the marginal ridges are similar. Since an irregular occlusal plane is a cause of poor prognosis, food impaction should be minimized by restoring the ideal occlusal plane by correcting the extruded antagonist and reduction of the disto-buccal cusp.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.3
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• pp.171-177
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• 2022

Peri-implantitis is an inflammatory lesion of the periodontium surrounding an endosseous implant, with progressive loss of the supporting peri-implant bone. The main purposes of treatment for peri-implantitis due to biological factors include addressing the inflammation and restoring a healthy but reduced periodontium around the implant, similar to the treatment of periodontitis in natural teeth. The proposed treatment protocol includes surgical treatment, mainly resective surgery, after non-surgical treatment such as oral hygiene instructions, mechanical cleansing of the fixture, and general or topical antiseptic or antibiotic application according to the extent of inflammation. In this article, we present a 6-year follow-up case showing unusual marginal bone regeneration after resective surgery and decontamination of an implant surface for the treatment of peri-implantitis and discuss the possible reasons.

• The Journal of Korean Academy of Prosthodontics
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• v.62 no.2
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• pp.174-182
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• 2024

In patients with multiple missing molars, wear patterns or displacement of anterior teeth, collapsed occlusal plane, and reduction in vertical dimension may occur. Particularly, in case of a few remaining teeth on one side, a removable partial denture has biomechanical disadvantage. For this reason, an implant-assisted removable partial denture with a few implant surveyed crowns can be an alternative. In this case, due to the right mandibular posterior teeth loss, the anterior teeth were severely worn and the occlusal plane was collapsed. With minimal increasing vertical dimension, oral rehabilitation was performed using a maxillary fixed prosthesis and mandibular implant-assisted removable partial denture. As a result, functional and aesthetic clinical outcomes were obtained.

• Journal of Dental Rehabilitation and Applied Science
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• v.19 no.4
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• pp.257-268
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• 2003

The purpose of this study was to assess the loading distributing characteristics of implant prosthesis according to position and direction of load, under vertical and inclined loading using FEA analysis. The finite element model was designed according to standard fixture (4.1mm restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction (loading condition B), 200N at the centric usp in a $15^{\circ}$ inward oblique direction (loading condition C), 200N at the in a $30^{\circ}$ inward oblique direction (loading condition D) or 200N at the centric cusp in a $30^{\circ}$ outward oblique direction (loading condition E) individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant in both vertical and oblique loading but stresses in the cancellous bone were low in both vertical and oblique loading. 2. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading than with the vertical loading. 3. An offset of the vertical occlusal force in the buccolingual direction relative to the implant axis gave rise to increased bending of the implant. 4. The relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 5. The magnitude of the stress in the supporting bone, fixture and abutment screw was greater with the outward oblique loading than with the inward oblique loading and was the greatest under loading at the centric cusp in a $30^{\circ}$ outward oblique direction. Conclusively, this study provides evidence that bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. But it seems to be more important that how long is the distance from center of rotation of the implant itself to the resultant line of force from occlusal contact(leverage). The goal of improving implants should be to avoid bending of the implant.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.3
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• pp.186-194
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• 2015

Purpose: To evaluate the effects of implant location and length on stress distribution and displacement in osseointegrated-implants that were associated with mandibular distal extension removable partial dentures (DERPD). Materials and Methods: A sagittally cut model with the #33, #34 teeth and a removable partial denture of the left mandible was used. Seven models were designed with NX 9.0. Models A, B, C had implants with lengths of 11, 6, 4 mm, respectively, under the denture base of the #37 artificial tooth. Models D, E, F had implants with lengths of 11, 6, 4 mm, respectively, under the denture base of the #36 artificial tooth. Model G did not have any implants. Axial force (250 N) was loaded on #36 central fossa. The finite element analysis was performed with MSC Nastran. Von Mises stress maps were plotted to visualize the results. Results: The models of #37 implant placement showed much lower stress concentration on the surrounding bone of the implant compared with #36. The #36 implant position tended to reduce displacement more than #37. Conclusion: When an IARPD is designed, the distal positioning of implant placement has more advantages in the edentulous bone of DERPD on the prognosis of short implants and the stress distribution of edentulous alveolar bone. Using implants with longer lengths are important for stress distribution. However, Additional studies are necessary of the effects of length on implant survival.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.4
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• pp.235-243
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• 2019

Osseointegration has been reported to be a dynamic process in which the alveolar bone comes in direct contact with the implant. Various methods were tried to evaluate degree of osseointegration and the measurement of bone-implant contact (BIC) have been commonly used among them. To properly assess the BIC, only histologic analysis is available. However, few studies evaluated BIC of successfully osseointegrated implants in humans. Thus, this is a unique opportunity when implants should be explanted due to inappropriate positioning of implant, presence of pain or sensory disturbance, or broken screw or fixture. This report presents a case of the implant underwent 3-year functional load and a histologic analysis after the fixture fracture. The histomorphometric analysis revealed 53.1% of BIC measured along the whole implant and 70.9% measured only in subcrestal area, respectively. In the present study, although the implant was fractured, a high degree of BIC was observed.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.3
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• pp.176-182
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• 2020

Purpose: To evaluate the effects of load direction, number of implants, and alignment of implant position on stress distribution in implant, prosthesis, and bone tissue. Materials and Methods: Four 3D models were made to simulate posterior mandible bone block: two implants and 3-unit fixed dental prosthesis (FDP) with a pontic in the center (model M1), two implants and 3-unit FDP with a cantilever pontic at one end (model M2), FDP supported by three implants with straight line placement (model M3) and FDP supported by three implants with staggered implant configuration (model M4). The applied force was 120 N axially or 120 N obliquely. Results: Peak von Mises stresses caused by oblique occlusal force were 3.4 to 5.1 times higher in the implant and 3.5 to 8.3 times higher in the alveolar bone than those stresses caused by axial occlusal force. In model M2, the connector area of the distal cantilever in the prosthesis generated the highest von Mises stresses among all models. With the design of a large number of implants, low stresses were generated. When three implants were placed, there were no significant differences in the magnitude of stress between staggered arrangement and straight arrangement. Conclusion: The effect of staggering alignment on implant stress was negligible. However, the number of implants had a significant effect on stress magnitude.

• Journal of Dental Rehabilitation and Applied Science
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• v.36 no.4
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• pp.222-231
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• 2020

To use the external connection implant (EXT) appropriately, the inter-implant distance should be carefully considered during placement, and the bones raised above the implants should be trimmed during the second surgery. The hex abutment is more useful than the non-hex abutment. EXT is particularly useful when the inter-arch space is limited. The tissue level (TL, internal butt connection) implant has a biomechanical advantage of coronal wall thickness and a biological advantage of an inherent transmucosal smooth surface. During TL implant restoration, an abutment can be selected using the abutment and fixture margins with considerations for the inter-arch space. Since no single type of implant can satisfy all the cases, it is necessary to select the appropriate type, considering the occlusal force and the bone condition.

• Journal of Dental Rehabilitation and Applied Science
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• v.38 no.4
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• pp.196-203
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• 2022

Purpose: This study aimed to evaluate the accuracy and clinical usability of an identification model using deep learning for 79 dental implant types. Materials and Methods: A total of 45396 implant fixture images were collected through panoramic radiographs of patients who received implant treatment from 2001 to 2020 at 30 dental clinics. The collected implant images were 79 types from 18 manufacturers. EfficientNet and Meta Pseudo Labels algorithms were used. For EfficientNet, EfficientNet-B0 and EfficientNet-B4 were used as submodels. For Meta Pseudo Labels, two models were applied according to the widen factor. Top 1 accuracy was measured for EfficientNet and top 1 and top 5 accuracy for Meta Pseudo Labels were measured. Results: EfficientNet-B0 and EfficientNet-B4 showed top 1 accuracy of 89.4. Meta Pseudo Labels 1 showed top 1 accuracy of 87.96, and Meta pseudo labels 2 with increased widen factor showed 88.35. In Top5 Accuracy, the score of Meta Pseudo Labels 1 was 97.90, which was 0.11% higher than 97.79 of Meta Pseudo Labels 2. Conclusion: All four deep learning algorithms used for implant identification in this study showed close to 90% accuracy. In order to increase the clinical applicability of deep learning for implant identification, it will be necessary to collect a wider amount of data and develop a fine-tuned algorithm for implant identification.