• 제목/요약/키워드: stable bone structure

검색결과 11건 처리시간 0.022초

임상가를 위한 특집 3 - 심하게 흡수된 치조제를 가진 환자에서 CAD/CAM을 이용한 임플란트 고정성 보철치료 (Implant fixed prosthetic treatment using CAD/CAM system in a patient with severe alveolar resorption)

  • 최유성
    • 대한치과의사협회지
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    • 제50권3호
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    • pp.126-139
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    • 2012
  • Loss of dentition can lead to not only compromised esthetics and functions of the patient, but also alveolar bone resorption. Bone grafting with prosthetic reconstruction of the gingiva can be selected for the treatment, and it provides many benefits as prosthetic gingival reconstruction does not require a complicated surgical process and is available within a short period of time, with stable clinical results. However, conventional porcelain fused to metal prosthesis has certain limits due to its size, and deformation after several firing procedures. In this clinical report, the author would like to introduce a patient with severe alveolar resorption who was treated with gingiva-shaped zirconia/titanium CAD/CAM implant fixed prosthesis for esthetic and functional rehabilitation. Clinical reports Clinical report 1, 2 : A case of loss of anterior dentition with atrophied alveolar bone. Implant retained zirconia bridge applied with Procera implant bridge system to simulate the gingiva. Upper structure was fabricated with zirconia all ceramic crown. Clinical report 3, 4 : A case of atrophied maxillary alveolus was reconstructed with fixed implant prosthesis, a CAD/CAM designed titanium structure covered wi th resin on its surface. Anterior dentition was reconstructed with zirconia crown. Conclusion and clinical uses. All patients were satisfied with the outcome, and maintained good oral hygiene. Zirconia/titanium implant fixed prosthesis fabricated by CAD/CAM system was highly accurate and showed adequate histological response. No critical failure was seen on the implant fixture and abutment overall. Sites of severe alveolar bone loss can be rehabilitated by implant fixed prosthesis with CAD/CAM system. This type of prosthesis can offer artificial gingival structure and can give more satisfying esthetics and functions, and as a result the patients were able to accept the outcome more fondly, which makes us less than hard to think that it can be a more convenient treatment for the practitioners.

골격근의 구조와 생역학에 관한 고찰 (A Review of Structure and Biomechanics of the Skeletal Muscle)

  • 공원태
    • 대한정형도수물리치료학회지
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    • 제13권1호
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    • pp.58-66
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    • 2007
  • The purpose of this study is to understand the structure and biomechanics of the skeletal muscle. The skeletal muscle takes 40 to 45% of the whole body. Stable posture requires a balance of muscle. However, when the muscle strength is unbalanced, movement initiates. The power generated by the muscle is a primary means to adjust the equilibrium of posture and movement. The structural unit of the skeletal muscle is a long cylindrical type muscle fiber which contains hundreds of nucleus. The thickness of muscle fiber is about $10-100{\mu}m$, and its length is about 1-50cm. Muscle fiber is composed of myofibril that is covered with plasma membrane which is called sarcolemma. In understanding the movement of human body, it is important to comprehend the movement of bone and joint and the tension of muscle. Understanding the structure and biomechanics of muscle also provides basic information on clinical treatment of patients.

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골유착 고정성 보철물 하에서 하중조건에 따른 삼차원 유한요소법적 분석 (THE THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF THE BONE ANCHORED FIXED PROSTHESIS ACCORDING TO THE LOAD CONDITION)

  • 양순익;정재헌
    • 대한치과보철학회지
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    • 제33권4호
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    • pp.780-806
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    • 1995
  • The purpose of this study was to describe the application of 3D finite element analysis to determine resultant stresses on the bone anchored fixed prosthesis, implants and supporting bone of the mandible according to fixture numbers and load conditions. 4 or 6 fixtures and the bone anchored fixed prosthesis were placed in 3D finite element mandibular arch model which represents an actual mandibular skull. A $45^{\circ}$ diagonal load of 10㎏ was labiolingually applied in the center of the prosthesis(P1). A $45^{\circ}$ diagonal load of 20㎏ was buccolingually applied at the location of the 10mm or 20mm cantilever posterior to the most distal implant(P2 or P3). The vertical distribution loads were applied to the superior surfaces of both the right and the left 20mm cantilevers(P4). In order that the boundary conditions of the structure were located to the mandibular ramus and angle, the distal bone plane was to totally fixed to prevent rigid body motion of the entire model. 3D finite element analysis was perfomed for stress distribution and deflection on implants and supporting bone using commercial software(ABAQUS program. for Sun-SPARC Workstation. The results were as follows : 1. In all conditions of load, the hightest tensile stresses were observed at the metal lates of prostheses. 2. The higher tensile stresses were observed at the diagonal loads rather than the vertical loads 3. 6-implants cases were more stable than 4-implants cases for decreasing bending and torque under diagonal load on the anterior of prosthesis. 4. From a biomechanical perspective, high stress developed at the metal plate of cantilever-to-the most distal implant junctions as a consequence of loads applied to the cantilever extension. 5. Under diagonal load on cantilever extension, the 6-implants cases had a tendency to reduce displacement and to increase the reaction force of supporting point due to increasing the bendign stiffness of the prosthesis than 4-implants cases. 6. Under diagonal load on cantilever extension, the case of 10mm long cantilever was more stable than that of 20mm long cnatilever in respect of stress distribution and displacement. 7. When the ends of 10mm or 20mm long cantilever were loaded, the higher tensile stress was observed at the second most distal implant rather than the first most distal implant. 8. The 6-implants cases were more favorable about prevention of screw loosening under repeated loadings because 6-implants cases had smaller deformation and 4-implants cases had larger deformation.

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Study of a "wing-type" implant on stress distribution and bone resorption at the alveolar crest

  • Park, Jong-Wook;Kim, Sin-Guen;Choi, Dong-Won;Choi, Mi-Ra;Yoon, Youn-Jin;Park, Jun-Woo;Choi, Dong-Ju
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권6호
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    • pp.337-342
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    • 2012
  • Objectives: Implants connect the internal body to its external structure, and is mainly supported by alveolar bone. Stable osseointegration is therefore required when implants are inserted into bone to retain structural integrity. In this paper, we present an implant with a "wing" design on its area. This type of implant improved stress distribution patterns and promoted changes in bone remodeling. Materials and Methods: Finite element analysis was performed on two types of implants. One implant was designed to have wings on its cervical area, and the other was a general root form type. On each implant, tensile and compressive forces ($30N/m^2$, $35N/m^2$, $40N/m^2$, and $45N/m^2$) were loaded in the vertical direction. Stress distribution and displacement were subsequently measured. Results: The maximum stresses measured for the compressive forces of the wing-type implant were $21.5979N/m^2$, $25.1974N/m^2$, $29.7971N/m^2$, and $32.3967N/m^2$ when $30N/m^2$, $35N/m^2$, $40N/m^2$, and $45N/m^2$ were loaded, respectively. The maximum stresses measured for the root form type were $23.0442N/m^2$, $26.9950N/m^2$, $30.7257N/m^2$, and $34.5584N/m^2$ when $30N/m^2$, $35N/m^2$, $40N/m^2$, and $45N/m^2$ were loaded, respectively. Thus, the maximum stresses measured for the tensile force of the root form implant were significantly higher (about three times greater) than the wing-type implant. The displacement of each implant showed no significant difference. Modifying the design of cervical implants improves the strength of bone structure surrounding these implants. In this study, we used the wing-type cervical design to reduce both compressive and tensile distribution forces loaded onto the surrounding structures. In future studies, we will optimize implant length and placement to improve results. Conclusion: 1. Changing the cervical design of implants improves stress distribution to the surrounding bone. 2. The wing-type implant yielded better results, in terms of stress distribution, than the former root-type implant.

Long-term outcomes after core extirpation of fibrous dysplasia of the zygomaticomaxillary region

  • Joseph Kyu-hyung Park;Se Yeon Lee;Jong-Ho Kim;Baek-kyu Kim
    • 대한두개안면성형외과학회지
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    • 제24권2호
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    • pp.59-65
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    • 2023
  • Background: Fibrous dysplasia (FD) is a localized bone disorder in which fibro-osseous tissue replaces the normal bone structure. Patients with craniofacial FD often present with gradual swelling, deformity, and compromised vision or hearing. We previously introduced "the core extirpation method," a novel surgical technique that is minimally invasive like traditional bone shaving but has longer-lasting effects. This study presents the long-term outcomes of our core extirpation method. Methods: We conducted a retrospective analysis of patients who underwent core extirpation for FD of the zygomaticomaxillary region from 2012 through 2021. Computed tomography (CT) scans were performed 6 to 12 months before the operation, immediately before and after the operation, and during follow-up visits. We performed all operations using the upper gingivobuccal approach, and we extirpated the core of the lesion while preserving the cortical structures of the zygoma and the maxilla to maintain symmetrical facial contour. Results: In 12 patients with lesions in the growth phase, anteroposterior/mediolateral (AP/ML) length discrepancies and the volume increased between preoperative and immediate postoperative CT scans. All patients' immediate postoperative AP/ML discrepancies were stable up to 12-17 months postoperatively. Postoperative volume showed continuous lesion growth; the median volume growth rate was 0.61 cc per month. Conclusion: In this article, we present our experiences managing FD using the minimally invasive core extirpation technique, which entails small expected blood loss and can be performed as day surgery. It provides similar cosmetic outcomes as traditional bone shaving but with longer-lasting results. Although there are some limitations with the study's retrospective nature and small sample size, our 4-year follow-up results show promising results of the core extirpation method in well-indicated patients.

비수계용 폴리이미드 합성 및 분리막 제조 (Synthesis and Membrane Preparation of Polyimides for Non-aqueous System)

  • 전종영;탁태문
    • 한국막학회:학술대회논문집
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    • 한국막학회 1997년도 추계 총회 및 학술발표회
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    • pp.39-45
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    • 1997
  • Introduction : Polyimides are one of the most important classes of the high performance polymers due to their excellent electrical, thermal, and high-temperature mechanical properties. But their uses are limited because of their poor solubility. Most polyimide derivatives are processed in the form of polyamic acids, which are subsequently converted into the imide structures.Recently, it has been found that the soluble polyimides with large molecular weight sufficient to application. For enhancing processability, the majority of approaches have involved the following factors. As much as, the separation of the imide ring along the back-bone, that is to say, reducing the density of imide ring in the repeat structure. The introduction of bulky substituents along the back-bone, in order to enhance the free volume of main-chain. The incorporation of flexible or thermally stable linkages in the main-chain, reducing the packing force. The disruption of symmetry or recurrence regularity through copolymerization in order to reduce crystallnity.The objectives of this investigation are the synthesis and characterization of soluble polyimides as membrane materials by the single-step polymerization and the preparation of the asymmetric polyimide membrane by using phase inversion technique. In the present study, three series of polyimide derivatives are synthesized; H series is homopolyimides, A series is prepared from single dianhydride and two diamines, B series is yielded from two dianhydrides and a diamine. The dope solution was directly prepared from the PI solution via one step polymerization from monomers.

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성견에 발치 후 즉시 임플란트 식립시 RBM 처리된 임플란트의 골융합에 관한 연구 (Comparative Study Of Osseointergration On Different Immediate Implants In Extraction Sockets Of Beagle Dogs)

  • 선기종;박재영;정은경;신미란;김윤상;피성희;신형식;유형근
    • Journal of Periodontal and Implant Science
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    • 제37권2호
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    • pp.209-221
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    • 2007
  • Recently, immediately after losing teeth. implant placement has been greatly attempted. Implant can help restoration of tooth functions within short time. This study was an attempt to examine the extent of osseointergation when the implants will be placed immediately after teeth extraction using domestic implant systems. Implants were inserted in beagle dogs and evaluated the clinical, radiological, histological and histomorphometric assay at 6 weeks and 12 weeks. For experimental materals, $STAGE-1^{(R)}$($4.1{\times}8mm$, Lifecore, USA), $SS-III^{(R)}$($4.0{\times}8mm$, OSSTEM, Korea) and $IFI^{(R)}$($4.0{\times}8mm$, Dio, Korea) implants treated with RBM were placed. All the placed site showed normal results without fail and inflammation clinically and radiologically. As a result of measurement by periotest, it showed $-2\;{\sim}\;-5$ and stable status comprehensively. There was no statistically significant difference among implants(p<0.05). Bone tissue adjacent to implant showed increased marrow tissue at 6 weeks. Nevertheless, osteogenic structure was not observed remarkably. In a 12 weeks opinion, bone tissue composed of osseointegration along implant interface showed significantly decreased marrow tissue containing central vessels unlike a 6 weeks opinion and matured compact bone whose osteogenic structure is well formed. BIC were 42.4%, 32.0% and 34.9%, respectively in 6 weeks and there was no statistically significant difference among group(p<0.05). In 12 weeks, BIC were 58.8%, 61.9% and 57.5%. respectively and there was no statistically significant difference among groups(p<0.05). It is considered that all 3 implant systems are suitable for immediate implant placement.

A STUDY ON THE RESPONSES OF OSTEOBLASTS TO VARIOUS SURFACE-TREATED TITANIUM

  • Lee Joung-Min;Kim Yung-Soo;Kim Chang-Whe;Jang Kyung-Soo;Lim Young-Jun
    • 대한치과보철학회지
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    • 제42권3호
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    • pp.307-326
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    • 2004
  • Statement of problem. The long-term success of implants is the development of a stable direct connection between bone and implant surface, which must be structural and functional. To improve a direct implant fixation to the bone, various strategies have been developed focusing on the surface of materials. Among them, altering the surface properties can modify cellular responses such as cell adhesion, cell motility and bone deposition. Purpose. This study was to evaluate the cellular behaviors on the surface-modified titanium by morphological observation, cellular proliferation and differentiation. Material and methods. Specimens were divided into five groups, depending on their surface treatment: electropolishing(EP) anoclizing(AN), machining(MA), blasting with hydroxyapatite particle(RBM) and electrical discharge machining(EDM). Physicochemical properties and microstructures of the specimens were examined and the responses of osteoblast-like cells were investigated. The microtopography of specimens was observed by scanning electron microscopy(SEM). Surface roughness was measured by a three-dimensional roughness measuring system. The microstructure was analyzed by X-ray diffractometer(XRD) and scanning auger electron microscopy(AES). To evaluate cellular responses to modified titanium surfaces, osteoblasts isolated from neonatal rat were cultured. The cellular morphology and total protein amounts of osteoblast-like cell were taken as the marker for cellular proliferation, while the expression of alkaline phosphatase was used as the early differentiation marker for osteoblast. In addition, the type I collagen production was determined to be a reliable indicator of bone matrix synthesis. Results. 1. Each prepared specimen showed specific microtopography at SEM examination. The RBM group had a rough and irregular pattern with reticulated appearance. The EDM-treated surface had evident cracks and was heterogeneous consisting of broad sheet or plate with smooth edges and clusters of small grains, deep pores or craters. 2. Surface roughness values were, from the lowest to the highest, electropolished group, anodized group, machined group, RBM group and EDM group. 3. All groups showed amorphous structures. Especially anodized group was found to have increased surface oxide thickness and EDM group had titaniumcarbide(TiC) structure. 4. Cells on electropolished, anodized and machined surfaces developed flattened cell shape and cells on RBM appeared spherical and EDM showed both. After 14 days, the cells cultured from all groups were formed to be confluent and exhibited multilayer proliferation, often overlapped or stratified. 5. Total protein amounts were formed to be quite similar among all the group at 48 hours. At 14 days, the electropolished group and the anodized group induced more total protein amount than the RBM group(P<.05). 6. There was no significant difference among five groups for alkaline phosphatase(ALP) activity at 48 hours. The AN group showed significantly higher ALP activity than any other groups at 14 days(P<.05). 7. All the groups showed similar collagen synthesis except the EDM group. The amount of collagen on the electropolished and anodized surfaces were higher than that on the EDM surface(P<.05).

IBAD를 이용하여 알루미나 위에 HAp를 Coating하는 연구와 이의 항균력 시험 (Ag Impregnated HAp Coatings on Alumina Substrate by IBAD and Its Biological Test)

  • 박의서;김택남;임혁준;김윤종;황득수;김정우;김선옥
    • 공학논문집
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    • 제3권1호
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    • pp.181-187
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    • 1998
  • Hydroxyapatite($Ca_10(PO_4)_6(OH)_2$)는 생체친화성이 뛰어나고 인체의 뼈와 성분이 비슷하여 생체이식재료로 많이 사용되고 있다. 한편 HAp는 소결후 낮은 강도 때문에 HAp자체만으로는 생체이식재료로서의 강도를 기대할 수가 없다. 그러나 알루미나는 생리화학적인 환경에서 높은 강도와 매우 안정한 성질을 가지고 있기 때문에 알루미나 위에 HAp를 coating시켜 사용하려는 시도가 있었다. 본 연구는 알루미나와 HAp의 장점만을 이용하고, HAp에 항균성 물질을 첨가하여 항균효과를 나타내도록 하였다. 항균test는 생체재료이식시 가장 많은 감염을 일으키는 bacteria를 사용하여 실시하였다. 먼저 HAp에서 $Ag^+$$Ca^{2+}$이 이온교환을 시키기 위하여 20ppm, 100ppm의 $AgNO_3$용액에 48시간동안 처리하고, 이 재료를 사용하여 항균test를 하였다. 항균test에 사용된 bacteria는 gram negative bacteria인 Escherichia coli와 Pseudomonas aeruginosa, gram positive bacteria인 Staphylococcus epidermidis를 사용하였고, 항균test결과는 매우 좋은 것으로 나타났다. $AgNO_3$용액에서 처리한 sample들은 SEM과 XRD를 사용하여 표면구조와 성분을 조사하고, 유사생체용액(Simulated Body Fluid)에서 Ag release curve를 조사하였다.

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Development and Evaluation of Natural Hydroxyapatite Ceramics Produced by the Heat Treatment of Pig Bones

  • Lim, Ki-Taek;Kim, Jin-Woo;Kim, Jangho;Chung, Jong Hoon
    • Journal of Biosystems Engineering
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    • 제39권3호
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    • pp.227-234
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    • 2014
  • Purpose: The aim of this research was to develop and evaluate natural hydroxyapatite (HA) ceramics produced from the heat treatment of pig bones. Methods: The properties of natural HA ceramics produced from pig bones were assessed in two parts. Firstly, the raw materials were characterized. A temperature of $1,200^{\circ}C$ was chosen as the calcination temperature. Fine bone powders (BPs) were produced via calcinations and a milling process. Sintered BPs were then characterized using field emission scanning electron microscopy (FE-SEM), X-ray diffraction (XRD), X-ray fluorescence spectroscopy (XRF), energy dispersive X-ray spectroscopy (EDX), Fourier transform infrared (FTIR) spectroscopy, and a 2-year in vitro degradability test. Secondly, an indirect cytotoxicity test was conducted on human osteoblast-like cells, MG63, treated with the BPs. Results: The average particle size of the BPs was $20{\pm}5{\mu}m$. FE-SEM showed a non-uniform distribution of the particle size. The phase obtained from XRD analysis confirmed the structure of HA. Elemental analysis using XRF detected phosphorus (P) and calcium (Ca) with the Ca/P ratio of 1.6. Functional groups examined by FTIR detected phosphate ($PO{_4}^{3-}$), hydroxyl ($OH^-$), and carbonate ($CO{_3}^{2-}$). The EDX, XRF, and FTIR analysis of BPs indicated the absence of organic compounds, which were completely removed after annealing at $1,200^{\circ}C$. The BPs were mostly stable in a simulated body fluid (SBF) solution for 2 years. An indirect cytotoxicity test on natural HA ceramics showed no threat to the cells. Conclusions: In conclusion, the sintering temperature of $1,200^{\circ}C$ affected the microstructure, phase, and biological characteristics of natural HA ceramics consisting of calcium phosphate. The Ca-P-based natural ceramics are bioactive materials with good biocompatibility; our results indicate that the prepared HA ceramics have great potential for agricultural and biological applications.