• 대한치과보철학회지
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• 제41권2호
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• pp.223-231
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• 2003

Statement of problem : Little is known about the effect of a counter-torque device and the internal hexagon of abutment on the tightening torque transmitted to the implant. Purpose : The purpose of this study was to examine the effect of a counter-torque device and the internal hexagon of abutment on the tightening torque transmitted to the implant. Material and Methods : In this study, three types of abutment were used, (1) two-piece conical abutment with hexagon, (2) two-piece conical abutment without hexagon, and (3) one-piece conical abutment without hexagon. The experimental groups were divided into five groups according to the type of abutment and the usage of a counter-torque device. Group I : two-piece conical abutment with internal hexagon was tightened without the use of a counter-torque device. Group II : two-piece conical abutment without internal hexagon was tightened without the use of a counter-torque device. Group III : one-piece conical abutment without internal hexagon was tightened without the use of a counter-torque device. Group IV : two-piece conical abutment with internal hexagon was tightened with the use of a counter-torque device Group V : two-piece conical abutment without internal hexagon was tightened with the use of a counter-torque device. Abutments were tightened 20Ncm torque with the use of manual torque wrench and then torque values were measured by torque-gauge. After the measurement of torque values, all groups were loosened with the use of manual torque wrench and then detorque values were measured by torque-gauge. Results : The results were as follows. 1. There were no differences in torque values among three types of abutment. 2. Regardless of the existence of the internal hexagon of abutment, a counter-torque device decreased the tightening torque transmitted to the implant about 92% 3. In group III showed the highest detorque value, however there were no differences among group I, II, IV and V. Conclusion : Within the limitations of this study, it was concluded that the internal hexagon of abutment has no effect on the tightening torque transmitted to the implant and the detorque value of abutment screw. The use of a counter-torque device is essential to prevent microfracture on the implant-bone interface but has no effect on preload.

• Journal of Korean Neurosurgical Society
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• 제62권5호
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• pp.577-585
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• 2019

Objective : Comparing the effects of magnetically controlled growing rod (MCGR) and traditional growing rod (TGR) techniques on the sagittal plane in the treatment of early-onset scoliosis (EOS). Methods : Twelve patients were operated using dual MCGR technique in one center, while 15 patients were operated using dual TGR technique for EOS in another center. Patients' demographic characteristics, complications and radiological measurements such as cobb angle, thoracic kyphosis, lumbar lordosis, T1-S1 range (mm), proximal junctional angle, distal junctional angle, sagittal balance, coronal balance, pelvic incidence, sacral slope and pelvic tilt were assessed and compared in preoperative, postoperative and last follow-up period. Results : Age and sex distributions were similar in both groups. The mean number of lengthening in the MCGR group was 12 (8-15) and 4.8 (3-7) in the TGR group. Two techniques were shown to be effective in controlling the curvature and in the increase of T1-S1 distance. In TGR group, four patients had rod fractures, six patients had screw pull-out and four patients had an infection, whereas three patients had screw pull-out and one patient had infection complications in the MCGR group. Conclusion : There was no significant difference between the two groups in terms of cobb angle, coronal and sagittal balance and sagittal pelvic parameters. MCGR can cause hypokyphosis and proximal junctional kyphosis in a minimum 2-year follow-up period. The implant-related complications were less in the MCGR group. However, larger case groups and longer follow-up periods are required for the better understanding of the superiority of one method on other in terms of complications.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권1호
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• pp.49-53
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• 2011

Introduction: This study compared the strength of osseointegration as determined by the resistance to reverse torque rotation of three different hydroxyapatite coated implants in the rabbit femur model. Materials and Methods: Three hydroxyapatite coated implants (HAPTITE), Tapered Screw-Vent (TSV) and BioTite-H - were used. A total of 40 implants were placed in the femur of 20 adult male rabbits. The animals were divided into two groups. In group A (n=10); one HAPTITE was placed into each right femur and one TSV was placed into each left femur. In group B (n=10); one HAPTITE was placed into each right femur and one BioTite-H was placed into each left femur. Five rabbits of each group were sacrificed at 4 and 8 weeks. The implants were removed by reverse torque rotation using a digital torque-measuring device. A total of 40 implants in 20 rabbits were used for the removal torque measurements. Results: In the Group A, 4 weeks after implant placement, the mean removal torque for the HAPTITE and TSV was $70.7{\pm}31.6$ N cm and $28.9{\pm}15.1$ N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and TSV was $87.9{\pm}26.2$ N cm and $54.9{\pm}22.4$ N cm, respectively. In the Group B, 4 weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was $58.0{\pm}29.6$ N cm and $37.7{\pm}14.1$ N cm, respectively. Eight weeks after implant placement, the mean removal torque for the HAPTITE and BioTite-H was $91.4{\pm}47.1$ N cm and $30.8{\pm}9.8$ N cm. HAPTITE showed a higher removal torque than the other implants. Conclusion: These results suggest that HAPTITE increases the strength of osseointegration significantly as determined by the resistance to reverse torque rotation.

• Journal of Periodontal and Implant Science
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• 제50권2호
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• pp.97-105
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• 2020

Purpose: The present retrospective clinical study aimed to evaluate and compare the clinical and radiographic parameters, complications, and satisfaction in patients who received fixed prostheses supported by narrow-diameter implants (NDIs) in the anterior and posterior jaw. Methods: Patients aged ≥30 years who had NDI-supported fixed prostheses in the anterior or posterior region of either jaw for at least 2 years were included. Complications such as chipping of the crown; loosening or fracture of the screw, crown abutment, or implant; and loss of retention were recorded. Clinical peri-implant outcomes and crestal bone loss (CBL) were measured. A questionnaire was used to record responses regarding the aesthetics and function of the fixed restorations. Analysis of variance was used to assess the significance of between-group mean comparisons. The log-rank test was performed to analyze the influence of location and prosthesis type on technical complications. Results: Seventy-one patients (mean age: 39.6 years) provided informed consent with a mean follow-up duration of 53 months. Only bleeding on probing showed a statistically significant difference between NDIs in the anterior and posterior regions. The complication rate for NDIs in the posterior region was significantly higher than that for NDIs in the anterior region (P=0.041). For NDIs, CBL was significantly higher around splinted crowns than single crowns (P=0.022). Overall mean patient satisfaction was 10.34±3.65 on a visual analogue scale. Conclusions: NDIs in the anterior and posterior jaws functioned equally well in terms of periimplant soft and hard tissue health and offered acceptable patient satisfaction and reasonable complication rates.

• 대한심미치과학회지
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• 제28권2호
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• pp.64-73
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• 2019

심한 치조골의 위축과 흡수로 인한 형태학적 변화는 임플란트의 성공적인 식립과 임플란트의 골유착에 영향을 미친다. 이를 극복하기 위한 다양한 골증대술 중 치조제분할술은 좁은 치조골 폭을 성공적으로 증대시키는 수술방법으로 보고되었다. 또한 다양하게 개발되는 임플란트 디자인과 치조제 팽창 기구 등은 심하게 흡수된 위축된 하악부위에서도 협측골 파절을 최소화할 수 있다. 가철성 부분의치의 사용으로 심하게 흡수된 하악 구치부에 치조제 분할술과 최소 크기의 블록형 골이식술을 이용해 한개의 스크류로 수용부의 고정을 획득한 후 동시적 접근법을 이용한 골이식 증례를 보고 하고자 한다. 보철과와 치주과의 협업으로 환자의 기능과 심미를 회복해준 증례로 사료된다.

• 대한치과보철학회지
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• 제54권2호
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• pp.93-102
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• 2016

목적: 본 연구의 목적은 내부육각 연결형 임플란트에서 두 가지 지르코니아 지대주와 티타늄 지대주의 변연 및 내면 적합도를 비교하고자 하였다. 재료 및 방법: 티타늄 지대주와 두 종류의 지르코니아 지대주를 내부육각연결 구조형 임플란트(TSV, Zimmer)에 체결하였다. 기성 티타늄 지대주(Hex-Lock, Zimmer)를 대조군으로 하여, 기성 지르코니아 지대주(ZirAce, Acucera)와 copy milling 시스템(Zirkonzahn Max, Zirkonzahn)으로 제작한 맞춤형 지르코니아 지대주를 비교하였다. 임플란트 고정체에 30 Ncm의 토크로 지대주를 연결하였으며, 각 실험군 당 8개의 시편을 제작하였다. 아크릴 레진에 포매하여 절단시편을 제작한 후 주사전자현미경으로 고정체-임플란트 계면에서 변연간극과 내부육각 내면간극을 측정하고, 지대주 나사와 지대주 나사받침 사이 계면에서 수직 및 수평간극을 측정했다. 측정치는 일원배치분산분석과 Scheffe test로 통계 처리하였다(${\alpha}=0.05$). 결과: 맞춤형 지르코니아 지대주의 변연 간극은 두 가지 기성 지대주에 비해 컸다. 내부육각 내면간극은 맞춤형 지르코니아 지대주와 기성 지르코니아 지대주 사이에 유의차를 보이지 않았고 기성 티타늄 지대주보다 컸다. 기성 지르코니아 지대주의 지대주 나사 수직간극과 수평간극은 기성 티타늄 지대주보다 컸다. 맞춤형 지르코니아 지대주의 경우. 지대주 나사 수평간극은 두 가지 기성 지대주보다 컸으며, 지대주 나사 수직간극을 측정할 수 없었다. 기성 지르코니아 지대주는 나사받침이 명확하게 형성되어 있었으나, 나사받침의 형태가 지대주 나사와 조화되지 않았다. 맞춤형 지르코니아 지대주의 경우에는 나사받침이 명확하게 형성되어 있지 않았다. 결론: 내부육각 연결형 임플란트에서 기성 티타늄 지대주가 두 종류의 지르코니아 지대주보다 적합도가 좋았다. 맞춤형 지르코니아 지대주는 두가지 기성 지대주에 비해 변연간극이 크고 나사와 나사받침 사이의 적합도가 낮았다.

• 대한치과보철학회지
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• 제50권2호
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• pp.85-91
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• 2012

연구 목적: 합금의 종류와 지대주의 재질의 차이가 변연적합도에 미치는 영향을 비교 분석하고자 한다. 연구 재료 및 방법: 2개의 임플란트 유사체를 평행하게 위치시킨 후 아크릴릭 레진으로 포매하여 연구모형을 제작하였다. 바 구조물은 gold UCLA 지대주에 고귀금속 합금(high noble metal alloy)과 귀금속 합금(noble metal alloy)을, 그리고 metal UCLA 지대주에 고귀금속 합금과 비귀금속 합금(base metal alloy)을 이용하여 총 4 종류의 바 구조물을 7개씩 시편을 제작하였다. 주조된 바 구조물을 레진 모형에 장착하고 한쪽 지대나사를 조인 후, 반대쪽 임플란트-지대주 간극의 수직 거리를 앞, 뒤, 측면 3부위에서 입체 광학 현미경으로 관찰하여 기록하였다. 결과: 각 군들의 변연오차 평균값은 gold UCLA 지대주에 고귀금속 합금과 귀금속 합금을 사용했을 때 각각 $13.69{\pm}6.74{\mu}m$와 $267.26{\pm}65.85{\mu}m$이었으며, metal UCLA 지대주에 고귀금속 합금과 비귀금속 합금을 사용했을 때 $26.19{\pm}8.14{\mu}m$와 $61.90{\pm}33.65{\mu}m$이었다. One-way ANOVA를 이용하여 변연 적합도의 차이를 분석했을 때 고귀금속 함금을 사용한 군들을 제외하고, 모든 군간에 유의한 차이가 존재하였다($P$<.05). Gold UCLA 지대주-귀금속 합금 조합을 제외하고 모두 $70{\mu}m$ 이하의 수직오차를 보였다. 결론: 임플란트 바 유지 장치의 제작에 있어서 고귀금속 합금 대신 비귀금속 합금과 metal UCLA 지대주를 사용하는 것은 임상적 타당성이 있다고 판단된다.

• 구강회복응용과학지
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• 제26권4호
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• pp.433-445
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• 2010

본 연구에서는 주모형으로부터 인상체를 제거한 후 인상용 코핑이 인상체 내에 남아있는 개방형 트레이 인상법의 이용 시, 인상용 코핑의 연결고정에 따른 효과와 인상 채득 시 사용될 수 있는 수종의 트레이가 주모형의 정확성에 미치는 영향에 대해 비교 연구해 보고자 하였다. 자가중합형 트레이 레진으로 제작한 개인 트레이, 플라스틱 금속 복합 트레이 그리고 폴리카보네이트 기성 트레이 등의 3종류의 트레이가 사용되었고, 각 트레이 마다 인상용 코핑의 연결고정 여부에 따라 두 개의 군으로 나누었다. 이렇게 나누어진 총 6개의 군에서 각 실험군당 10개의 시편을 제작하였다. 임플랜트 유사체와 지대주 사이에 발생한 수직오차의 측정에는 1-screw test법을 이용하였다. 1시편 당 총 6부위를 측정하였고, 3회씩 측정하여 동일한 수치를 나타낼 경우에 기록하여 통계 처리하였다. 인상용 코핑의 연결고정 여부와 상관없이 개인 트레이군, 플라스틱 금속 복합 트레이군 그리고 폴리카보네이트 기성 트레이군 사이에 유의한 차이는 나타나지 않았다. 하지만 개인 트레이, 플라스틱 금속 복합 트레이 그리고 폴리카보네이트 기성 트레이를 이용하여 인상 채득한 경우 패턴 레진으로 연결고정한 군이 비연결고정 군보다 더 정확한 결과를 보여주었다 (p<0.05).

• The Journal of Advanced Prosthodontics
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• 제10권1호
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• pp.65-72
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• 2018

PURPOSE. The aim of this in vitro study was to investigate the fracture resistance under chewing simulation of implant-supported posterior restorations (crowns cemented to hybrid-abutments) made of different all-ceramic materials. MATERIALS AND METHODS. Monolithic zirconia (MZr) and monolithic lithium disilicate (MLD) crowns for mandibular first molar were fabricated using computer-aided design/computer-aided manufacturing technology and then cemented to zirconia hybrid-abutments (Ti-based). Each group was divided into two subgroups (n=10): (A) control group, crowns were subjected to single load to fracture; (B) test group, crowns underwent chewing simulation using multiple loads for 1.2 million cycles at 1.2 Hz with simultaneous thermocycling between $5^{\circ}C$ and $55^{\circ}C$. Data was statistically analyzed with one-way ANOVA and a Post-Hoc test. RESULTS. All tested crowns survived chewing simulation resulting in 100% survival rate. However, wear facets were observed on all the crowns at the occlusal contact point. Fracture load of monolithic lithium disilicate crowns was statistically significantly lower than that of monolithic zirconia crowns. Also, fracture load was significantly reduced in both of the all-ceramic materials after exposure to chewing simulation and thermocycling. Crowns of all test groups exhibited cohesive fracture within the monolithic crown structure only, and no abutment fractures or screw loosening were observed. CONCLUSION. When supported by implants, monolithic zirconia restorations cemented to hybrid abutments withstand masticatory forces. Also, fatigue loading accompanied by simultaneous thermocycling significantly reduces the strength of both of the all-ceramic materials. Moreover, further research is needed to define potentials, limits, and long-term serviceability of the materials and hybrid abutments.

• Journal of Periodontal and Implant Science
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• 제34권1호
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• pp.177-193
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• 2004

Several experimental studies showed that the application of small amounts of electric current to bone stimulated osteogenesis at the site of the cathode and suggested that electrical currents promote osseointegration around dental implants. The purpose of this study was to determine the effect of direct microcurrent to endosseous titanium implants placed in bone defects. The right and left 2nd, 3rd and 4th mandibular premolars in ten mongrel dogs (15Kg of weight) were extracted. One monthe later, Ti-machined screw type implants(3.8 mm diameter x 8.5 mm length, $AVANA^{(R)}$, Ostem) were placed in surgically created circumferential defect area(width 5mm, depth 4mm). The implants were divided into three groups according to the treatment modalities: Control group- implants without electrical stimulation; Experimental group I- implants with allogenic demineralized freeze dried bone grafting; and Experimental group II-implants allogenic demineralized freeze dried bone grafting and electric stimulation. The animals were sacrificed in the 4th and 8th week after implant placement and un-decalcified specimens were prepared for histological and histometrical evaluation of bone-implant contact ratio (BIC) and bone formation area ratio (BFA) in defect area. Some specimens at 8 weeks after implantation were used for removal torque testing. Histologically, there was connective tissue infiltration in the coronal part of defect area in control and the experimental group I, whereas direct bone contact was found in the experimental group II without connective tissue invasion. Average BIC ratios at 4 weeks of healing were 60.1% in the experimental group II, 47.4% in the experimental group I and 42.7% in the control. Average BIC ratios at 8 weeks after implantation were 67.6% in the experimental group II, 55.9% in the experimental group I and 54.6% in the control. The average BFA ratio was 84.0% in the experimental group II, 71.8% in the experimental group I and 58.8% in the control at 4 weeks, and the BFA ratios were 89.6% in the experimental group II, 81.4% in the experimental group I and 70.5% in the control at 8 weeks after implantation. The experimental group II showed also significantly greater BIC and BFA ratios compared to the control and the experimental group I (p<0.05). The removal torque values at 8 weeks after implantation were 56 Ncm in the experimental group II, 49 Ncm in the experimental group I and 43 Ncm in the control. There was a statistically significant difference among 3 groups (p<0.05). These results suggest that electrical stimulation improve and accelerate bone healing around endosseous titanium implants in bone defect.