• The Journal of Korean Academy of Prosthodontics
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• v.40 no.3
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• pp.275-286
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• 2002

Statement of problem. Surface alteration of the implant screws after function may be associated with mechanical failure. Theses metal fatigue appears to be the most common cause of structural failure. Purpose. The purpose of this study was to evaluate surface alteration of the implant screws after function through the examination of used and unused implant screws in SEM(scanning electron microscope). Materials and methods. In this study, abutment screws(Steri-oss, 3i), gold retaining screw(3i) and titanium retaining screw(3i) were retrieved from patients. New, unused abutment and retaining screws were prepared for control group. Each of the old, used screws was retrieved with a screwdriver. And retrieved implant complex of Steri-oss system was prepared for this study. Then, SEM investigation and EDS analysis of abutment and retaining screws were performed. And SEM investigation of cross-sectioned sample of retrieved implant complex was performed. Results. In the case of new, unused implant screws, as maunfactured circumferential grooves are regularly examined and screw thread are sharply remained. Before ultrasonic cleansing of old, used implant screw, a lot of accumulation and corrosion products were existed. After ultrasonic cleansing of old, used implant screws, circumferential grooves as examined before function were randomly deepened and scratches increased. Also, dull screw thread was examined. More surface alterations after function were examined in titanium screw than gold screw. And more surface alteration was examined when retrieved with driver than retrieved without driver. Conclusions. These surface alteration after function may result in the screw instability. Regularly cleansing and exchange of screws was recommended. We recommend the use of gold screw rather than titanium screw, and careful manipulation of the driver.

• The Journal of Korean Academy of Prosthodontics
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• v.43 no.6
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• pp.727-735
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• 2005

Statement of problem. Platform switching in implant prosthesis has been used for esthetic and biological purpose. But there are few reports for this concept. Purpose. The purpose of this study is evaluation of platform switching in wide implant by three dimensional finite element analysis. Materials and Methods. The single implant and prosthesis was modeled in accordance with the geometric designs for Osstem implant system. Three-dimensional finite element models were developed for (1) a wide diameter 3i type titanium implant 5 mm in diameter, 13 mm in length with wide cemented abutment, titanium alloy abutment screw, and prosthesis (2) a wide diameter 3i type titanium implant 5 mm in diameter, 13 mm in length with regular cemented abutment, titanium alloy abutment screw and prosthesis(platform switching) was made for finite element analysis. The abutment screws were subjected to a tightening torque of 30 Ncm. The amount of preload was hypothesized to 650N, and round and flat type prostheses were loaded to 200 N. Four loading offset point (0, 2, 4, 6 mm from the center of the implants) were evaluated. Models were processed by the software programs HyperMesh and ANSA. The PAM-CRASH 2G simulation software was used for analysis of stress. The PAM-VIEW and HyperView were used for post processing. Results. The results from experiment were as follows; 1. von Mises stress value is increased in order of bone, abutment, implant and abutment screw. 2. von Mises stress of abutment screw is lower when platform switching. 3. von Mises stress of implant is lower when platform switching until loading offset 4 mm. 4. von Mises stress of abutment is similar between each other. 5. von Mises stress of bone is slightly higher when platform switching. Conclusion. The von Mises stress pattern of implant components is favor when platform switch ing but slightly higher in bone stress distribution than use of wide abutment. The research about stress distribution is essential for investigation of the cortical bone loss.

• Journal of Periodontal and Implant Science
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• v.31 no.2
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• pp.333-344
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• 2001

The present study was performed to evaluate the effect of tetracycline - HCl on the change of implant surface microstructure according to application time. Implants with pure titanium machined surface and titanium plasma-sprayed surface were utilized. Implant surface was rubbed with 50mg/ml tetracycline - HCl solution for 1 min., $1\frac{1}{2}\;min$., 2 min., $2\frac{1}{2}\;min$. and 3min. respectively in the test group and with saline for 1 min. in the control group. Then, the specimens were processed for scanning electron microscopic observation. The following results were obtained. 1. Pure titanium machined surfaces conditioned with saline for 1 min., showed a few shallow grooves and ridges and were less irregular. 2. Pure titanium machined surfaces conditioned with 50mg/ml tetracycline - HCl solution showed more irregular and corrosive surfaces compared to the control group irrespective of the application time of tetracycline - HCl solution. 3. Titanium plasma-sprayed surfaces conditioned with saline for 1 min., were deposited with round amorphous particles and showed round or irregular pores that can be connected to each other. 4. The irregularity of titanium plasma-sprayed surfaces conditioned with 50mg/ml tetracycline - HCl solution was lessened and the flattened areas were wider relative to the application time of tetracycline - HCl solution. 5. Titanium plasma-sprayed surfaces conditioned with tetracycline - HCl solution for 1 min. and $1\frac{1}{2}\;min$. were very similar to that of the control group, but the surfaces conditioned for 2 min., $2\frac{1}{2}\; min$. and 3 min. were changed. In conclusion, pure titanium machined surfaces were changed irrespective of the application time of tetracycline - HCl solution. And titanium plasma-sprayed surfaces conditioned with tetracycline - HCl solution began to be changed from $1\frac{1}{2}\;min$. This results will be applicable to the regenerative procedures for peri-implantitis treatment.

• Journal of Applied Reliability
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• v.16 no.2
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• pp.104-109
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• 2016

Purpose: The purpose of this study is to analyze fracture behavior and failure mechanism of porous titanium for dental implant fabricated by space holder process. Method: Three porous titanium specimens with a specific volume fraction of open pore were test by 3 point bending and compression stress condition, respectively. Fracture appearance was observed by scanning electron microscope and discussed in relation with oxygen content. Results: For compression-tested specimens, two specimen showed brittle failure, while the other one showed normal failure after deformation. High oxygen content was detected in the brittle-fractured specimen. Several micro-cracks initiated at the struts propagated down to the bottom of the specimen resulting in normal failure. Conclusion: Oxygen contamination during the fabrication process can leads brittle premature failure, and hence quality problem of the porous titanium for dental implant.

• Archives of Plastic Surgery
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• v.43 no.1
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• pp.84-87
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• 2016

Titanium micro-mesh implants are widely used in orbital wall reconstructions because they have several advantageous characteristics. However, the rough and irregular marginal spurs of the cut edges of the titanium mesh sheet impede the efficacious and minimally traumatic insertion of the implant, because these spurs may catch or hook the orbital soft tissue, skin, or conjunctiva during the insertion procedure. In order to prevent this problem, we developed an easy method of inserting a titanium micro-mesh, in which it is wrapped with the aseptic transparent plastic film that is used to pack surgical instruments or is attached to one side of the inner suture package. Fifty-four patients underwent orbital wall reconstruction using a transconjunctival or transcutaneous approach. The wrapped implant was easily inserted without catching or injuring the orbital soft tissue, skin, or conjunctiva. In most cases, the implant was inserted in one attempt. Postoperative computed tomographic scans showed excellent placement of the titanium micro-mesh and adequate anatomic reconstruction of the orbital walls. This wrapping insertion method may be useful for making the insertion of titanium micro-mesh implants in the reconstruction of orbital wall fractures easier and less traumatic.

• Journal of Periodontal and Implant Science
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• v.25 no.2
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• pp.418-437
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• 1995

The effect of the hydroxyapatite coatings on Titanium implants has been the subject of recent investigations. So far, the use of HA coating remains substantially controversial.This study was aimed to evaluate histologically the bone healing patterns around titanium plasm sprayed(TPS) amd HA-coated implant after implantation into the femur neck of ten adult dogs. After implantation, animals were sacrificed at the intervals of 2,4,6,8 and 12 weeks.The fluorescent dyes were injected on the postoperative 4th and 12th week into the animals supposed to be killed at the 12th week. The morphology and direction of new bone formation was similar in both TPS and HA-coated implants.There was a tendency toward more bone formation in the cortical bone area than in the cancellous bone area. Histologically,in the interface of the HA-coated implants, bone response and bone maturation was faster, compared to the TPS implants in the 2nd and 4th week. By fluorescent microscopy, new bone formation was active in the 4th week around both implants and was directed from the periosteum overlying cortical bone to the cancellous bone. These results suggest that the bone formation and maturation is faster during the early healing stage in the interface of the HA-coated implant and where the cortical bone quality is poor, HA coated implant is superior to the TPS implant in the early phase of new bone formation.

• The Journal of the Korean dental association
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• v.50 no.3
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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.

• Journal of Dental Rehabilitation and Applied Science
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• v.27 no.2
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• pp.223-231
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• 2011

The purpose of this case report is to introduce new attachment system(milled titanium bar with $Locator^{(R)}$ attachment) for implant supported overdenture in maxillary edentulous patients. A 56-years-old male patient visited the hospital due to the mobility of his maxillary fixed partial dentures(10-unit bridge). Including temporomandibular joint(TMJ), there was no specific PMHs to influence dental treatment. In radiographic and clinical evaluation, there was a severe bone resorption and mobility in maxillary teeth. Accordingly all the remaining maxillary teeth was extracted and fabrication of implant supported overdenture was planned. The milled titanium bar with $Locator^{(R)}$ was designed as an attachment system, considering the stability and retention of denture, masticatory efficiency, oral hygiene care, esthetics, pronunciation, and patient's financial state. The milled titanium bar was manufactured using CAD/CAM technology, and $Locator^{(R)}$ attachment connected to the bar by tap & drill method. For over 1-year, in terms of function and esthetics, satisfactory result was obtained.

• Journal of Periodontal and Implant Science
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• v.25 no.3
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• pp.741-755
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• 1995

Currently titanium is the material of choice for implants because of its biological acceptance. This high degree of biocompatibility is thought to result, in part, from the protective and stable oxide layer that presumably aids in the bonding of the extracellular matrix at the implant-tissue interface. Endosseous dental implants are interfaced with bone, connective tissue, and epithelium when implanted into the jaw bone. The soft tissue interface including connective tissue and epithelium is one of the most critical factors in the determination of implant maintenance and prognosis. For maintenance of failing or failed implants, it is essential to treat the implant fixture surface to remove bacterial endotoxins and make a surface tolerated by surrounding soft and hard tissues. In this study, the effect of mechanical treatment on titanium plasma sprayed implant on adhesiveness and proliferation of human gingival fibroblasts and changed surface characteristics were studied. titanium plasma sprayed discs manufactured by Friedrichsfeld company were treated with loaw speed stone bur, a rubber point and a jetpolisher. Its surface components were analyzed with Energy dispersive X-ray spectroscopy to evaluate whether the surface characteristics were altered or not. To observe the spreading pattern of the human gingival fibroblasts which attached to the all specimens author used the scanning electron microscope. The results were as follows : Pure titanium and plasma sprayed titanium, stone polished titanium showed titanium peak and small amout of aluminum, so there was no alteration on surface characteristics. Under the scanning electron microscopic examination in the initial attachment of human gingival fibroblast, there was a slight enhancement in pure titanium, stone polished titanium than plasma sprayed titanium. After 6 hours, the pure titanium and stone polished titanium showed human gingival fibroblasts were elongated and connected with numerous processes. Human gingival fibroblasts were more intimately attached on the pure titanium discs than on the other discs. The human gingival fibroblasts attached on the plasma sprayed titanium by thin and elongated processes. After 24 hours, the human gingival fibroblasts connected with each other via numerous processes and compeletly covered the pure titanium and stone polshed titanium discs. Human gingival fibroblasts had multiple point contacts with more long and thin lamellopodia and showed a little bare surface on plasma sprayed titanium discs.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.19 no.4
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• pp.383-394
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• 1997

This study was done to examine adherence of oral bacteria to titanium dental implant and to know the effective prophylactic antibiotics using an in vivo model. Three samples each of the implant material were set in an acrylic resin flange and placed in the maxillary buccal sulcus of twenty volunteers. At 6- and 54-hour intervals, each sample was placed on blood agar plate (BAP) and chocolate agar, and then they were incubated and identified. Also antibiotic susceptibility test was performed. The results obtained mere as follows ; 1. The microorganisms were chain-like Gram positive cocci and staphyline Gram positive cocci, Gram positive bacilli in order of frequency were found at 6-hour and 54-hour samples by Gram staining. 2. Streptococci was found predominantly at both 6-hour and 54-hour samples, but number of streptococci was decreased as compared to 6-hour samples. 3. There was no difference in the bacterial species adherent to implant between 6-hour and 54-hour samples. 4. All the microbes were sensitive to AMC (amoxacillin clavulanic acid), chloramphenicol, quinolone and vancomycin in the antibiotic susceptibility test. Above results suggest that streptococcus are mainly adhered to titanium implant after implant was placed in the oral cavity and AMC is the most recommendable antibiotics to prevent the peri-implant inflammation.