• Journal of Periodontal and Implant Science
• /
• 제37권4호
• /
• pp.825-838
• /
• 2007

Endosseous implants are used in the treatment of various types of tooth loss, and numerous long-term studies have demonstrated the excellent reliability of this method of treatment. However, the increase of implant failure are associated with inadequate quality and/or height of bone. At the end of the 1980s, Wide(>3.75mm) implants were initially used for managing these difficult bone situations. The recommended indications for its use included poor bone quality, inadequate bone height. immediate placement in fresh extraction sockets, and immediate replacement of failed implants. At the 2000s, wider implants(6.0mm and 6.5mm) were used in a few studies. Although good clinical outcomes have been reported in recent years, there is still a controversy on this topic. Therefore, the purpose of this study was to estimate the survival rate of wide implants($6.0{\sim}8.0mm$) in molar regions, evaluating the clinical outcome. In this study, 1135 RBM surfaced wide implants($Rescue^{TM}$, MEGAZEN Co., Korea/595 maxillary, 540 mandibular) were placed in 650 patients(403 male, 247 female/age mean: $51.2{\pm}11.1$ years, range 20 to 83 years). Of the total, 68.3% were used to treat fully or partially edentulous situations, including single-tooth losses and 31.7% were placed immediately after teeth extraction or removal of failed implants, of which all were in the molar regions. Implant diameter and length ranged from 6.0 to 8.0mm and from 5.0 to 10.0mm respectively. The implants were followed for up to 42 months (mean: $14.6{\pm}9.5$ months). Of 1135 placed implants, 58 implants were lost. Among them, 53 implants were lost within 12 months after implant placement. The survival rate was 93.6% in the maxilla and 96.3% in the mandible, yielding an overall survival rate of 94.9%, for up to 42 months. As the result of Cox regression model, prosthetic type, sinus graft, and patient gender have an statistical significance on the implant survival rate in this study. This study suggests that the use of wide implants($6.0{\sim}8.0mm$) would provide a predictable treatment alternative in posterior areas.

• Journal of Periodontal and Implant Science
• /
• 제37권4호
• /
• pp.805-824
• /
• 2007

Purpose: Developments in micro/macrostructures of implants and surgical techniques brought out stable outcomes of implant dentistry. The aim of this study was to evaluate the distributions of implant patients, the types of implanted sites, and the success or survival rates of various implant systems and to analyze the implant placement done at each specificintraoral site and situation. Materials and Methods: The data of dental implantations collected between 1992 and 2006 at the Department of Periodontology in 00000 University Hospital were analyzed. Results: 1. Largest part of the patients were at the age of 40s and 50s in bothgender who lost their teeth mostly by periodontaldiseases and caries at the posterior intraoral sites as major ones. Bone densities of type II(mandible) and III(maxilla) were likely to be seen with quantity of type B. Lengths of the implants between 10 and 15 mm and wide platform took the largest part. 2. Survival rates of $Implantium^{(R)}(98.8%)$, $Xive^{(R)}(100%)$ and ITI $TE^{(R)}(100%)$ were high when $Frialit-2^{(R)}$ showed 82%(poor bone density area) or 87.2%(combined with additional therapy). $IMZ^{(R)}$ had lowest cumulative survival(67.5%) and success rate(49.4%) amongst all. 3. Replacement with 2 wide or 3 regular platforms showed no significant differences in survival rate and marginal bone loss atmandibular posterior area. In single restoration of mandibular second molar, 5-year success rate of machined surface $Br{\aa}nemark^{(R)}(70.37%)$ was lower than that of rough surface $ITI^{(R)}$ SLA(100%). 4. Replacement of single tooth in anterior area showed high survival rate of 94.5%. 5. The success rates of $Br{\aa}nemark$ Ti-Unite and ITI SLA at posterior maxilla with poor bone density both showed stable outcomes. 6. 10-year cumulative survival rate of implants with maxillary sinus augmentation by lateral window approach appeared to be 96.60%. Low survival rate(75%) was shown when there were more than two complications combined. Height of grafted bone remained stable above the implant apex. Conclusions : Rough surfaced implants showed stable outcomes in most of the situation including poor bone density and additional therapy combined.

• 대한치과교정학회지
• /
• 제52권3호
• /
• pp.236-245
• /
• 2022

New digital technologies, many involving three-dimensional printing, bring benefits for clinical applications. This article reports on the clinical procedure and fabrication of a skeletally anchored mesialization appliance (Mesialslider) using computer-aided design/computer-aided manufacturing (CAD/CAM) for space closure of a congenitally missing lateral incisor in a 12-year-old female patient. The insertion of the mini-implants and appliance was performed in a single appointment. Bodily movement of the molars was achieved using the Mesialslider. Anchorage loss, such as deviation of the anterior midline or palatal tilting of the anterior teeth, was completely avoided. CAD/CAM facilitates safe and precise insertion of mini-implants. Further, mini-implants can improve patient comfort by reducing the number of office visits and eliminating the need for orthodontic bands and physical impressions.

• Journal of Periodontal and Implant Science
• /
• 제37권3호
• /
• pp.523-534
• /
• 2007

This study is an analysis of types of patients and distribution of implant site and survival rate of $Xive^{(R)}$ implant. The following results on patient type, implant distribution and survival rate were compiled from 324 implant cases of 140 patients treated at the periodontal dept. of Yonsei University Hospital and G dental clinic between February 2003 and April 2006. 1. There are no dissimilarities between men and women, with patients in their 30, 40, 50s accounting for 80% of patients and accounted for 82% of implant treatments; the largest share of patients and implant treatments. 2. Mn, posterior area. accounted for 57% of implant treatments followed by Mx. posterior area(29%), Mx, anterior area(8%) and Mn, anterior area(6%). 3. Partial edentulous patients treated by single crown and bridge-type prosthesis accounted for 96% and fully edentulous patient accounted for the remaining 4%. 4. The major cause of tooth loss is periodontal disease, followed by dental canes, trauma and congenital missing. 5, The distribution of bone quality for maxillae was 54,2% for type III, followed by 30.8% for type II, 15% for type IV and 0% for type I. As for mandible, the distribution was 63% for type II, followed by 34% for type III, 2,5% for type I and 0,5% for type IV. 6. The distribution of bone quantity for maxillae was 55% for type C, followed by 35% for type B, 8% for type D and 2% for type A. As for mandible, the distribution was 60% for type B, followed by 32% for type C, 7% for type A and 0% for type D. 7. The majority of implants were those of 9.5-13 mm in length(95%) and regular diameter in width(82%). 8. The total survival rate was 98%. The survival rate was 97% in the maxillae region and 99% in the mandible region. 9. The survival rate in type I was 83%, in type II was 99%, in type III was 97% and in type IV was 100%. As for the bone quantity, the survival rate in type A and D(100%) was most, followed by type B(99%) and type C(96%). The results showed that $Xive^{(R)}$ implant could be used satisfactorily compare for the other implant system. But we most to approach carefully in certain extreme condition especially with poor bone quality and quantity.

• 구강회복응용과학지
• /
• 제34권4호
• /
• pp.280-289
• /
• 2018

목적: 이 연구의 목적은 임플란트의 길이 및 치관-임플란트 비율(crown-to-implant (C/I) ratio)이 임플란트의 안정성과 임플란트 변연골 소실량(MBL)에 영향을 주는지 알아보기 위함이다. 연구 재료 및 방법: 연구대상자로 하악 구치부에 단일치를 상실한 46명의 환자를 선별하였다. 대조군에는 총 19개의 직경 5.0 mm, 길이 10 mm의 임플란트(CMI IS-III $active^{(R)}$ long implant)를 식립하였고, 실험군에는 직경 5.5 mm, 길이 6.6, 7.3, 8.5 mm의 임플란트 총 27개(CMI IS-III $active^{(R)}$ short implant)를 식립하였다. 각각의 임플란트는 디지털 방식으로 술 전 제작한 수술가이드를 사용하여 식립하였고 임시보철물을 장착하여 즉시부하를 시행하였다. 술 후 3개월에 CAD-CAM 방식으로 제작한 지르코니아 크라운으로 최종 수복하였다. 술 후 48주에 ISQ 값과 변연골 소실량을 측정하여 치관-임플란트 비율과 ISQ 및 변연골 소실량 간의 상관관계를 비교하였다. 결과: 두 그룹 모두 안정도 및 변연골 소실량 면에서 성공적인 결과를 나타내었다. 술 후 48주에 측정한 두 그룹간 ISQ와 변연골 소실량 값은 통계적으로 유의미한 차이가 없었다(P > 0.05). 치관-임플란트 비율과 안정성 및 치관-임플란트 비율과 변연골 소실량 간에 어떤 상관관계도 관찰되지 않았다(P > 0.05). 결론: 두 그룹의 하악 단일 임플란트에서 치관-임플란트 비율은 안정성 및 변연골 소실량에 영향을 주지 않는 것으로 나타났다. 골높이가 부족한 하악에서 단일 임플란트 수복 시, 짧은 임플란트는 상대적으로 높은 치관-임플란트 비율에도 불구하고 제한된 조건 하에서 적절한 대안이 될 수 있다.

• Journal of Periodontal and Implant Science
• /
• 제47권6호
• /
• pp.372-380
• /
• 2017

Purpose: The aim of this prospective pilot study was to compare alveolar ridge preservation (ARP) procedures with open-healing approach using a single-layer and a double-layer coverage with collagen membranes using radiographic and clinical analyses. Methods: Eleven molars from 9 healthy patients requiring extraction of the maxillary or mandibular posterior teeth were included and allocated into 2 groups. After tooth extraction, deproteinized bovine bone mineral mixed with 10% collagen was grafted into the socket and covered either with a double-layer of resorbable non-cross-linked collagen membranes (DL group, n=6) or with a single-layer (SL group, n=5). Primary closure was not obtained. Cone-beam computed tomography images were taken immediately after the ARP procedure and after a healing period of 4 months before implant placement. Radiographic measurements were made of the width and height changes of the alveolar ridge. Results: All sites healed without any complications, and dental implants were placed at all operated sites with acceptable initial stability. The measurements showed that the reductions in width at the level 1 mm apical from the alveolar crest (including the bone graft) were $-1.7{\pm}0.5mm$ in the SL group and $-1.8{\pm}0.4mm$ in the DL group, and the horizontal changes in the other areas were also similar in the DL and SL groups. The reductions in height were also comparable between groups. Conclusions: Within the limitations of this study, single-layer and double-layer coverage with collagen membranes after ARP failed to show substantial differences in the preservation of horizontal or vertical dimensions or in clinical healing. Thus, both approaches seem to be suitable for open-healing ridge preservation procedures.

• 대한치과의사협회지
• /
• 제51권4호
• /
• pp.190-197
• /
• 2013

A titanium based screw shaped dental implant was first introduced by Branemark and a treatment protocol where the restoration of edentulous area by connecting abutment after the osseointegration of the titanium surface of the implant and surrounding bone structure has been proposed. Although this protocol is widely accepted as a standard up to date, the healing duration of 3-6 months as well as the need for provisional prostheses during this period present as a major drawback. Immediate loading has been accomplished through the advent of various implant designs, enforced surface treatments, diverse forms of abutment, and delicate surgical techniques together with the increase in demand from the patients. The success rate of the immediate loading technique has been first reported as 85.7% by Dr. Schnitman in 1990 which recently has been reported up to 100% in the case of immediate loading in single tooth by Dr. Kan. To ameliorate the success rate of immediate loading technique, selection of patients presenting a sound bone quality and quantity, acquiring primary stability through delicate surgical techniques and fabrication of prostheses which accounts for biological stabilities should all be taken into consideration. This presentation introduces the understanding of biological stability of immediate loading, various methods for measurement of stability and clinical cases regarding immediate loading technique.

• Journal of Periodontal and Implant Science
• /
• 제36권3호
• /
• pp.673-682
• /
• 2006

Recent study shows that implant design has a great impact on initial stability in bone. The ITI $TE^{(R)}$ implant, designed originally for immediate placement has a tapered/ cylindrical form which fits the anatomical shape of the natural alvelous or tooth root. The increased diameter at the collar region coupled with more threads lead to more bone contact and enhanced stability. The aim of this retrospective study is to evaluate the clinical use and the efficacy of recently introduced ITI TE implant with a new macro-design. The following results are compiled from 139 patients who received ITl TE implant surgery at the periodontal department. of Yonsei University Hospital between July 2002 and September 2005. 1. 139 patients received 173 ITl $TE^{(R)}$ implants in their maxilla and mandible (Mx 82, Mn 91). Posterior area accounted for 84% of the whole implant surgery, 2. In the distribution of bone quality, type III(41,0%) was the most, followed by type IV(41,0%) and type II (27.7%). As for the bone quantity, type B(43.9%) was the most, followed by type C(42.2%), type D(12.2%) and type A(1.7%). 3. 125 implants(83.9%) were treated by single crown, which accounted for the majority. 4, The total implant survival rate was 100% after a mean follow-up period of 21.2 months. This preliminary data with ITl $TE^{(R)}$ implant showed excellent survival rate although the majority of implants evaluated in this study were placed in the posterior region of the jaw and compromised sites.

• Journal of Periodontal and Implant Science
• /
• 제41권5호
• /
• pp.248-252
• /
• 2011

Purpose: The anterior region is a challenge for most clinicians to achieve optimal esthetics with dental implants. The provisional crown is a key factor in the success of obtaining pink esthetics around restorations with single implants, by soft tissue and inter-proximal papilla shaping. Provisional abutments bring additional costs and make the treatment more expensive. Since one of the aims of the clinician is to reduce costs and find more economic ways to raise patient satisfaction, this paper describes a practical method for chair-side fabrication of non-occlusal loaded provisional crowns used by the authors for several years successfully. Methods: Twenty two patients (9 males, 13 females; mean age, 36,72 years) with one missing anterior tooth were treated by using the presented method. Metal definitive abutments instead of provisional abutments were used and provisional crowns were fabricated on the definitive abutments for all of the patients. The marginal fit was finished on a laboratory analogue and temporarily cemented to the abutments. The marginal adaptation of the crowns was evaluated radiographically. Results: The patients were all satisfied with the final appearance and no complications occurred until the implants were loaded with permanent restorations. Conclusions: The use of the definitive abutments for provisional crowns instead of provisional abutments reduces the costs and the same results can be obtained.

• 대한치과보철학회지
• /
• 제45권2호
• /
• pp.240-249
• /
• 2007

Statement of problem: A phenomenon of screw-loosening in implant abutment is frequently occurred in a single and multiple implant restoration. Purpose: This study was performed to evaluate an effect of abutment material on screw-loosening before and after a cyclic loading. In a single-tooth implant, different materials of abutment, Type III Gold alloy and Zirconium composite$(ZrO_2/Al_2O_3)$ were used. Material and method: The Gold alloy(Type III) and Zirconium composite$(ZrO_2/Al_2O_3)$ were used to make a superstructure of implant, the one of types of UCLA, Each group was constituted of 5 sample with a 30-degree offset angulated loading platform. The external hexagonal fixture was rigidly hel d in a special holding zig to ensure solid fixation without rotation during the tightening and a cyclic loading. A Titanium-alloy screw was used to connect and controlled to be tighten in 20Ncm torque by a digital torque gauge. A 20 times of consecutive closing/opening cycle were performed to evaluate the immediate torque loss. In 5 sample of each material group, an initial opening torque was recorded during 3 closing/opening cycle, then 2Hz, 200N, 1,000,000 cyclic loadings were performed, then a opening torque was evaluated. Result & Conclusion: 1. In this limited study, titanium alloy screw tightened in 20Ncm, a cold-welding phenomen on was not observed during the 20 times of closing/opening cycle(p=0.11, p=0.18). 2. In titanium alloy abutment screw, repeated opening and closing of the screw caused to progressive decrease of opening torque(p=0.014). 3. The difference in preload of screw between gold alloy abutment and ceramic$(ZrO_2/Al_2O_3)$ abutment was not significant(p=0.78). 4. The difference in torque loss of screw between gold alloy abutment and ceramic$(ZrO_2/Al_2O_3)$ abutment was not significant after 2Hz,200N, 1,000,000 cyclic loading(p=0.92). 5. In titanium alloy abutment screw tightened by 20Ncm, the screw loosening was not significant on each group after 2Hz, 200Ncm, 1,000,000 cyclic loading(p=0.59).