• The Journal of Korean Academy of Prosthodontics
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• v.47 no.4
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• pp.445-456
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• 2009

Statement of problem: Many studies have been conducted to improve the primary stability of implants by providing bioactive surfaces via surface treatments. Increase of surface roughness may increase osteoblast activity and promote stronger bonding between bone and implant surface and it has been reported that bioactive surface or titanium can be obtained through alkali and heat treatment. Purpose: The purpose of this study was to evaluate the stability of alkali and heat treated implants via histomorphometric analysis. Material and methods: Specimens were divided into three groups; group 1 was the control group with machined surface, the other groups were treated for 24 hours in 5 M NaOH solution and heat treated for 1 hour at $600^{\circ}C$ in the atmosphere (group 2) and vacuum (group 3) conditions respectively. Surface characteristics were analyzed and fixtures were implanted into rabbits. The specimens were histologically and histomorphometrically compared according to healing periods and change in bone composition were analyzed with EPMA (Electron Probe Micro Analyzer). Results: 1. Groups treated with alkali and heat showed increase of oxidization layer and Na ions. Groups 2 which was heat treated in atmosphere showed significant increase of surface roughness (P<.05). 2. Histomorphometric analysis showed significant increase in BIC (bone to implant contact) according to increase in healing period and there was significant increases in groups 2 and 3 (P<.05). 3. BA(bone area) ratio showed similar results as contact ratio, but according to statistical analysis there was significant increase according to increase in healing period in group 2 only (P<.05). 4. EPMA analysis revealed no difference in gradation of bone composition of K, P, Ca, Ti in surrounding bone of implants according to healing periods but groups 2 and 3 showed increase of Ca and P in the initial stages. Conclusion: From the results above, it can be considered that alkali and heat treated implants in the atmosphere have advantages in osseointegration in early stages and may decrease the time interval between implantation and functional adaptation.

• Journal of Periodontal and Implant Science
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• v.30 no.1
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• pp.187-203
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• 2000

The precipitation of calcium phosphate on implant surface has been known to accelerate osseointegration and to enhance osseous adaptation. The present study was performed to examine whether the precipitation of calcium phosphate on Ti-6Al-4V alloy could be affected by the immersion in NaOH solution and heat treatment. Ti-6Al-4V alloy plates of $15{\times}3.5{\times}1mm$ in dimension were polished sequentially from #240 to #2,000 emery paper and one surface of each specimen was additionally polished with $0.1{\mu}m$ alumina paste. Polished specimens were soaked in various concentrations of NaOH solution(0.1, 1.0, 3.0, 5.0, 7.0, 10.0 M) at $60^{\circ}C$ for 24 hours for alkali treatment, and 5.0 M NaOH treated specimens were heated for 1 hour at each temperature of 400, 500, 600, 700, $800^{\circ}C$. After the alkali and heat treatments, specimens were soaked in the Hank's solution with pH 7.4 at $36.5^{\circ}C$ for 30days.The surface ingredient change of Ti-6Al-4V alloy was evaluated by thin-film X-ray diffractometer(TF-XRD) and the surface microstructure was observed by scanning electron microscope(SEM), and the elements of surface were analyzed by X-ray photoelectron spectroscopy(XPS). The results were obtained as follows ; 1. The precipitation of calcium phosphate on Ti-6Al-4V alloy was accelerated by the immersion in NaOH solution and heat treatment. 2. In Alkali treatment for the precipitation of calcium phosphate on Ti-6Al-4V alloy, the optimal concentration of NaOH solution was 5.0 M. 3. In heat treatment after alkali treatment in 5.0 M NaOH solution, the crystal formation on alloy surface was enhanced by increasing temperature. In heat treated alloys at $600^{\circ}C$, latticed structure and prominences of calcium phosphate layer were most dense. On heat treated alloy surface at the higher temperature(${\geq}700^{\circ}C$), main crystal form was titanium oxide rather than apatite. The above results suggested that the precipitation of calcium phosphate on the surface of Ti-6Al-4V alloy could be induced by alkali treatment in 5.0 M-NaOH solution and by heat treatment at $600^{\circ}C$.

• The Journal of Advanced Prosthodontics
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• v.5 no.3
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• pp.234-240
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• 2013

PURPOSE. This study evaluated the effectiveness of various methods for removing provisional cement from implant abutments, and what effect these methods have on the retention of prosthesis during the definitive cementation. MATERIALS AND METHODS. Forty implant fixture analogues and abutments were embedded in resin blocks. Forty cast crowns were fabricated and divided into 4 groups each containing 10 implants. Group A was cemented directly with the definitive cement (Cem-Implant). The remainder were cemented with provisional cement (Temp-Bond NE), and classified according to the method for cleaning the abutments. Group B used a plastic curette and wet gauze, Group C used a rubber cup and pumice, and Group D used an airborne particle abrasion technique. The abutments were observed using a stereomicroscope after removing the provisional cement. The tensile bond strength was measured after the definitive cementation. Statistical analysis was performed using one-way analysis of variance test (${\alpha}$=.05). RESULTS. Group B clearly showed provisional cement remaining, whereas the other groups showed almost no cement. Groups A and B showed a relatively smooth surface. More roughness was observed in Group C, and apparent roughness was noted in Group D. The tensile bond strength tests revealed Group D to have significantly the highest tensile bond strength followed in order by Groups C, A and B. CONCLUSION. A plastic curette and wet gauze alone cannot effectively remove the residual provisional cement on the abutment. The definitive retention increased when the abutments were treated with rubber cup/pumice or airborne particle abraded to remove the provisional cement.

• Journal of Periodontal and Implant Science
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• v.29 no.4
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• pp.861-872
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• 1999

Since pathologic changes of exposed root surface inhibit cell attachment and new attachment of connective tissue have been made, many efforts were apply to change the exposed root surface condition. Scaling and root planing can not remove the endotoxin completely and forms the smear layer which prohibits the new attachment of connective tissue. Therefore, many kinds of chemicals were used for controlling the pathologic change of the root surface. The purposes of this study was to compare and observe the changes of the exposed root surface treated by scaling and root planning, Tetracycline HCl and Argon Laser. After the scaling and root planning of ten extracted premolars, the differences & the root surface among groups were observed under SEM. Control group showed smear layer and irregular amorphous surface. The dentinal tubule was not exposed. The debris and scale like texture were also observed. Tetracycline HCl treated group showed relatively smooth surface and the collagen fiber was observed in the dentinal tubule. Argon Laser treated group showed the most effective results under the conditions of 0.8 to 1.0w irradiation for 0.5 to 1.0 sec with pulse wave. The results of this study showed that the root surface change was associated with the intensity and the duration of Argon Laser irradiation. Further investigation for the surface change with the Argon Laser irradiation is recommended for understanding of clinical effect.

• Journal of Periodontal and Implant Science
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• v.38 no.3
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• pp.453-466
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• 2008

Purpose: The purpose of this research is to study about initial adhesion, proliferation and activation of osteoblast to titanium surface treated with machined, hydroxyapatite coating, resorbable blast material blasting and anodizing method. Material and Methods: After treating the titanium surface of each block with machined, impurities were removed and sterilized. The number of cells attached from cultured osteoblast of respective experimental groups were measured at 1, 4, 7, and 14day and alkaline phosphatase, calcium, and inorganic phosphate concentration of cultured solution was measured. Result: Anodizing group showed the highest rate of cell attachment and proliferation activity. RBM treated group showed the highest increasing on their alkaline phosphatase activity, on the calcium apposition, on inorganic phosphate apposition of 1 and 4 days in cultured osteoblast to compare with other groups. Conclusion: On the basis of these findings, we conclude that surface modification of titanium was profoundly effected on the attachment, proliferation and activation of osteoblast in initial stage osseointegration.

• Journal of Periodontal and Implant Science
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• v.23 no.2
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• pp.283-299
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• 1993

The purpose of this study was to observe early connective tissue attachment on dentin surface treated with citric acid, tetracycline, and fibrin sealants and compare their conditioning effects on dentin surface. Experimental dentin blocks conditioned with citric acid, tetracycline or fibrin sealant, and only root planned control block were surgically implanted in the pouch under buccal mucoperiosteal flaps of left mandible, right maxilla, left maxilla, right mandible of 18 male rabbits. Rabbits were sacrificed after 1 and 6 hours, 1, 3, 7 and 14 days after implantation and then specimens including dentin block and surrounding soft tissue were obtained, and prepared for light and transmission electron microscopic examination. 1 and 6 hours after dentin block implantation, there was plasma proteins adsorption followed by fibrin clot formation and no differences among specimens. At the 1-day observation interval, delicate fibrin network was observed in the all groups, and there were proliferative fibroblasts, angiogenesis and macrophage in the all 3-day specimens. Cellular aggregates and abundant connective tissue adhered dentin surface and tetracycline or citric acid treated group showed much proliferative fibroblast and abundant collagen fibers at 1 week. But at 2 week, citric acid treated group showed much proliferative fibroblast and abundant collagen fibers. These observations suggested that new connective tissue attachment to dentin was initiated by the adsorption of plasma proteins to the dentin surface and followed by fibrin clot formation. Tetracycline and citric acid seemed to make dentin surface more biologically favorable for the connective tissue attachment.

• The Journal of Korean Academy of Prosthodontics
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• v.46 no.3
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• pp.307-319
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• 2008

STATEMENT OF PROBLEM: It is known that an anodic oxidation technique, one of the methods for the implant surface treatment, remarkably increased surface area, enhanced wettability and accelerated the initial bone healing. Purpose: This study was performed to evaluate the wettability of anodized titanium surface which has a nanotubular structure, to assess osseointegration after the placement of implant with nano-size tubes on tibia of rats and to analyze quantitatively transferable rhBMP-2 on each surface. MATERIAL AND METHOD: Four different kinds of surface-treated titanium discs (polished (machined surface) group, micro (blasting surface) group, nano (anodizedmachined surface) group, and nano-micro (anodized-blasting surface) group) were fabricated (n=10). Three different media were chosen to measure the surface contact angles; distilled water, plasma and rhBMP-2 solution. After a single drop (0.025 $m{\ell}$) of solution, the picture was taken with the image camera, and contact angle was measured by using image analysis system. For the test of osseointegration, 2 kinds of anodized surface (anodized-machined surface, anodized-blasting surface) implants having 2.0 mm in diameter and 5.0 mm in length inserted into the tibia of Wistar rats. After 3 weeks, tibia were harvested and the specimens were stained with hematoxylin and eosin for histological analysis. To test the possibility of drug delivery, after soaking sample groups in the concentration of 250 ng/$m{\ell}$l of rhBMP-2 for 48 hours, the excess solution of rhBMP-2 were removed. After that, they were lyophilized for 24 hours, and then the rhBMP-2 on the surface of titanium was resolved for 72 hours in PBS. All the extracted solution was analyzed by ELISA. One-way analysis of variance (ANOVA) was performed on the data. RESULTS: The wettability is improved by anodic oxidation. The best wettability was shown on the nano-micro group, and it was followed by nano group, micro group, and polished group. In the histological findings, all implants showed good healing and the new bone formation were observed along the implant surface. After 3 days, nano-micro group delivered the most amount of rhBMP-2, followed by nano group, micro group, and polished group. CONCLUSION: It indicated that anodic oxidation on blasting surface produce functionally graded nano-micro porous structure and enhance hydrophilicity of the surface and osseointegration. The findings suggest that the nano-micro porous structure could be a useful carrier of osteogenic molecules like rhBMP-2.

• Journal of Periodontal and Implant Science
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• v.29 no.1
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• pp.65-80
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• 1999

The purpose of this study was to evaluate the effects of periodontal curet and various rotating instruments on the root surfaces. Thirty-five extracted teeth with advanced periodontal disease were used. They was root planed with periodontal curet, periodontal Perio-Clean bur, periodontal Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur. To find dentinal tubule orifices on the root surface, tetracycline HCI solution was applied to the one tooth of treated each group. Then, root surfaces were investigated using scanning electron microscope. Amount of loss of cementum was evaluated by loss of tooth substance index. The results were as follows. 1. Groups treated with periodontal curet and Perio-Clean bur showed irregular surface and concavities. Concavities seemed to be lacunae of cementocyte. Other groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur showed partially opened dentinal tubule orifice. 2. Groups treated with periodontal curet and Perio-Clean bur and tetracycline HCl showed irregular surface. No dentinal tubule orifice was seen. Other groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur and tetracycline HCl showed dentinal tubule orifice with various shape and size. 3. Loss of tooth substance indices were compared between groups. There was no statistically difference between periodontal curet and Perio-Clean bur groups. There were statistically differences between periodontal curet and Roto-Perio bur, ET bur, and diamond fissure bur groups. As a result of this study, groups treated with Roto-Perio bur, resin polishing ET bur, and resin polishing diamond fissure bur showed more cementum removed than groups treated with periodontal curet and Perio-Clean bur. Therefore, in a conventional treatment for periodontal disease, it was recommended that periodontal curet or Perio-Clean bur should be used. In a treatment for regeneration of periodontal tissue, it was recommended that Roto-Perio bur, resin polishing ET bur, or resin polishing diamond fissure bur should be used

• The Journal of Korean Academy of Prosthodontics
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• v.44 no.4
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• pp.443-454
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• 2006

Purpose: This study aims to get the fundamental data which is necessary to the development direction of implant surface treatment hereafter, based on the understanding the surface structure and properties of titanium which is suitable for the absorption of initial tissue fluid by researching effects of additional surface treatments fir sandblasted with large git and acid-etched(SLA) titanium on surface micro-roughness, static wettability, fibronectin adsorption Materials and Method: In the Control groups, the commercial pure titanium disks which is 10mm in diameter and 2mm in thickness were treated with HCI after sandblasting with 50$\mu$m $Al_2O_3$. The experiment groups were made an experiment each by being treated with 1) 22.5% nitric acid according to SLA+ASTM F86 protocol, 2) SLA+30% peroxide, 3) SLA+NaOH, 4) SLA+ Oxalic acid, and 5) SLA+600$^{\circ}C$ heating. In each group, the value of Ra and RMS which are the gauges of surface roughness was measured, surface wettability was measured by analyzing with Sessile drop method, and fibronectin adsorption was measured with immunological assay. The significance of each group was verified by (SPSS, ver.10.0 SPSS Inc.) Kruskal-Wallis Test. (α=0.05) And the correlation significance between Surface micro-roughness and surface wettability. surface roughness and fibronectin adsorption, and surface wettability and fibronectin adsorption was tested by Spearman's correlation analysis. Result: All measure groups showed the significant differences in surface micro-roughness, surface wettability, and fibronectin adsorption. (p<0.05) There was no significance in correlation among the surface micro-roughness, surface wettability, and fibronectin adsorption. (p>0.05) Conclusion: Surface micro-roughness and surface wettability rarely affected the absorption of initial tissue fluid on the surface of titanium.

• Journal of Periodontal and Implant Science
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• v.34 no.1
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• pp.71-81
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• 2004

Peri-implantitis could be the result of biomechanical and occlusal overload as well as microbiologic invasion. The dental implant may be more susceptible to dental plaque than the natural tooth, as the predictability of a stable soft tissue attachment complex has not yet been confirmed. With the development of peri-implantitis, the implant surface would be exposed to the oral environment and becomes coated with bacteria. The objective of therapy for this condition is to regain integration of the implant with bone. Since fibroblast adherence to surfaces is impeded by endotoxin, it would seem that decontamination would be desirable to obtain maximum osseointegration. The purpose of this study was to determine whether various chemotherapeutic and mechanical treatments(distilled water, air-powder abrasive, hypersaturated citric acid, tetracycline) can detoxify contaminated titanium implant surface by means of kinetic LAL test. Experimental rough surface titanium disks were fabricated. All of them were divided into two groups(A.a group and P.g group) and each contaminated by A. actinomycetemcomitans and P. gingivalis suspension. Contaminated disks were treated with distilled water, air-powder abrasive, citric acid and tetracycline, and then all disks were placed into LPS-free water for elution. The results were as follows : 1. In A.a group, LPS elute level of all test groups were significantly lower than control group(p<0.05). 2. In A.a group, LPS elute level of test 2, test 3 and test4 groups were significantly lower than that of control group(p<0.05). But, among the test 2, test 3, test4 groups, the significant differences were not detected. 3. In P.g group, LPS elute level of test 2, test 3 and test 4 groups were lower than that of control group(p<0.05). But, among the test groups, the significant differences were not detected. From the result of this study, it would be concluded that air-powder abrasive, hypersaturated citric acid and tetracycline treatments may be effective at reducing endotoxin level on rough titanium implant surfaces, and can be clinically used. But the treatments in peri-implantitis differentially impact osseointegration making one method clinically superior. To gain this knowledges, further molecular biologic and histopathologic studies should be developed.