Effect of cyclic loading on axial displacement of abutment into implant with internal tapered connection: a pilot study / 대한치과보철학회지

PURPOSE: To evaluate the axial displacement of implant-abutment assembly after cyclic loading in internal tapered connection system. MATERIALS AND METHODS: External butt-joint connection implant and internal tapered connection implant were connected with three types of abutment for cement-retained prostheses, i.e. external type abutment (Ext group), internal tapered 1-piece abutment (Int-1 group), and internal tapered 2-piece abutment (Int-2 group). For each group, 7 implants and abutments were used. The implantabutments assemblies were clamped into the implant holder for vertical loads. A dynamic cyclic loading was applied for 150 +/- 10 N at a frequency of 4 Hz. The amount of axial displacement of the abutment into the implant was calculated at each cycle of 0, 5, 10, 50, 100, 1,000, 5,000, and 10,000. A repeated measures analysis of variance (ANOVA) for the overall effect of cyclic loading and the pattern analysis by linear mixed model were used for statistical analysis. Differences at P<.05 were considered statistically significant. RESULTS: The mean axial displacement after 10,000 cycles were 0.714 +/- 0.488 microm in Ext group, 5.286 +/- 1.604 microm in Int-1 group, and 11.429 +/- 1.902 microm in Int-2 group. In the pattern analysis, Int-1 and Int-2 group showed continuous axial displacement at 10,000 cycles. There was no declining pattern of axial displacement in the Ext group. CONCLUSION: The pattern of linear mixed model in Ext group showed no axial displacement. There were continuous axial displacements in abutment-implant assemblies in the Int-1 and Int-2 group at 10,000 cycles. More axial displacement was found in Int-2 group than in Int-1 group.

Influence of cement thickness on resin-zirconia microtensile bond strength

PURPOSE: The aim of this study was to evaluate the influence of resin cement thickness on the microtensile bond strength between zirconium-oxide ceramic and resin cement. MATERIALS AND METHODS: Thirty-two freshly extracted molars were transversely sectioned at the deep dentin level and bonded to air-abraded zirconium oxide ceramic disks. The specimens were divided into 8 groups based on the experimental conditions (cement type: Rely X UniCem or Panavia F 2.0, cement thickness: 40 or 160 microm, storage: thermocycled or not). They were cut into microbeams and stored in 37degrees C distilled water for 24 h. Microbeams of non-thermocycled specimens were submitted to a microtensile test, whereas those of thermocycled groups were thermally cycled for 18,000 times immediately before the microtensile test. Three-way ANOVA and Sheffe's post hoc tests were used for statistical analysis (alpha=95%). RESULTS: All failures occurred at the resin-zirconia interface. Thermocycled groups showed lower microtensile bond strength than non-thermocycled groups (P.05). The number of adhesive failures increased after thermocycling in all experimental conditions. No cohesive failure was observed in any experimental group. CONCLUSION: When resin cements of adhesive monomers are applied over air-abraded zirconia restorations, the degree of fit does not influence the resin-zirconia microtensile bond strength.

Influence of air abrasion and different dentin sealing techniques on microtensile bond strength to dentin / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the effect of various methods of dentin bonding agent application and air abrasion pretreatment on microtensile bond strength between dentin and resin, using a self-etching adhesive system. MATERIAL AND METHODS: Thirty freshly extracted human molars were obtained and divided into 6 groups of 5 teeth. A 2-step self etching adhesive system (Clearfil SE Bond) was used for all groups. The control specimens were prepared using a direct immediate bonding technique. The delayed dentin sealing specimens were prepared using an indirect approach without dentin prebonding. The immediate dentin sealing specimens were prepared using dentin prebonding immediately following preparation. Immediate dentin sealing teeth and delayed dentin sealing teeth had provisional restorations using Fermit for two weeks. Then all specimens of each group were divided into two groups of three, depending on air abrasion pretreatment. Composite "crowns" were incrementally built on and specimens were stored in water for 24 hours. All teeth were prepared for a microtensile bond strength test. Bond strength data were analyzed with a one-way ANOVA test, and post hoc comparison was done using the Scheffe's test. RESULTS: The mean microtensile bond strengths of all groups were not statistically different from each other. CONCLUSION: When preparing teeth for indirect restorations, IDS and DDS with Clearfil SE bond, have no difference on the microtensile bond strength between dentin and resin. Air abrasion pretreatment did not affect the microtensile bond strength when using IDS and DDS with Clearfil SE bond.

Accuracy of 5-axis precision milling for guided surgical template / 대한치과보철학회지

PURPOSE: The template-guided implant surgery offers several advantages over the traditional approach. The purpose of this study was to evaluate the accuracy of coordinate synchronization procedure with 5-axis milling machine for surgical template fabrication by means of reverse engineering through universal CAD software. MATERIALS AND METHODS: The study was performed on ten edentulous models with imbedded gutta percha stoppings which were hidden under silicon gingival form. The platform for synchordination was formed on the bottom side of models and these casts were imaged in Cone beam CT. Vectors of stoppings were extracted and transferred to those of planned implant on virtual planning software. Depth of milling process was set to the level of one half of stoppings and the coordinate of the data was synchronized to the model image. Synchronization of milling coordinate was done by the conversion process for the platform for the synchordination located on the bottom of the model. The models were fixed on the synchordination plate of 5-axis milling machine and drilling was done as the planned vector and depth based on the synchronized data with twist drill of the same diameter as GP stopping. For the 3D rendering and image merging, the impression tray was set on the conbeam CT and pre- and post-CT acquiring was done with the model fixed on the impression body. The accuracy analysis was done with Solidworks (Dassault systems, Concord, USA) by measuring vector of stopping's top and bottom centers of experimental model through merging and reverse engineering the planned and post-drilling CT image. Correlations among the parameters were tested by means of Pearson correlation coefficient and calculated with SPSS (release 14.0, SPSS Inc. Chicago, USA) (alpha = 0.05). RESULTS: Due to the declination, GP remnant on upper half of stoppings was observed for every drilled bores. The deviation between planned image and drilled bore that was reverse engineered was 0.31 (0.15 - 0.42) mm at the entrance, 0.36 (0.24 - 0.51) mm at the apex, and angular deviation was 1.62 (0.54 - 2.27)degrees. There was positive correlation between the deviation at the entrance and that at the apex (Pearson Correlation Coefficient = 0.904, P = .013). CONCLUSION: The coordinate synchronization 5-axis milling procedure has adequate accuracy for the production of the guided surgical template.

The level of buccal gingival margin around single and two adjacent implant restorations: a preliminary result

STATEMENT OF PROBLEM: Little information is available about the buccal gingival level of multiple implant restorations. PURPOSE: This study was aimed to evaluate the relationship between width and height of buccal soft tissue around single and 2 adjacent implant restorations. MATERIAL AND METHODS: Four implant restoration groups (first and second molars, single second molars, posterior single restorations between teeth, and anterior single restorations between teeth) were randomly chosen from one dental institute. Each group comprised of 6 patients. After 6 months of function, silicone impressions were taken and stone models were fabricated for each restoration group. The stone models were cut in bucco-lingual direction at the most apical point of buccal gingival margin. The height and width of buccal supra-implant soft tissue were measured. One way ANOVA and Tukey HSD post hoc tests were performed to analyze the data obtained (P < .05). RESULTS: The most unfavorable width-height ratio was noted for the group, which was comprised of the second molar in the multiple adjacent (first and second molar) implant-supported restorations. The group also resulted in the shorter height of buccal supra-implant mucosa rather than that of anterior single implant restorations between natural teeth. CONCLUSION: To achieve a favorable level of buccal gingival margin, greater thickness of buccal supra-implant mucosa is required for the implant restorations without a neighboring natural tooth compared to the implant restorations next to a natural tooth.

The change of rotational freedom following different insertion torques in three implant systems with implant driver

STATEMENT OF PROBLEM: Implant drivers are getting popular in clinical dentistry. Unlike to implant systems with external hex connection, implant drivers directly engage the implant/abutment interface. The deformation of the implant/abutment interface can be introduced while placing an implant with its implant driver in clinical situations. PURPOSE: This study evaluated the change of rotational freedom between an implant and its abutment after application of different insertion torques. MATERIAL AND METHODS: Three kinds of internal connection implants were utilized for the current study (4.5 x 12 mm Xive, 4.3 x 11.5 mm Inplant Magicgrip, 4.3 x 12 mm Implantium MF). An EstheticBase, a 2-piece top, a Dual abutment was used for its corresponding implant system. The rotational freedom between an implant and its abutment were measured before and after applying 45, 100 Ncm insertion torque. Repeated measures ANOVA was used for statistical analysis. RESULTS: Under 45 Ncm insertion torque, the rotational freedom between an implant and its abutment was significantly increased in Xive (P = .003). However, no significant change was noted in Inplant Magicgrip and Implantium MF. Under 100 Ncm torque, both in Xive (P = .0005) and Implatium MF (P = .03) resulted in significantly increased rotational freedom between the implant and its abutment. DISCUSSION: The design of the implant/implant driver interface effectively prevented the deformation of implant/abutment interface. Little change was noted in the rotational freedom between an implant and its abutment, even though the insertion torque was far beyond clinical application. CONCLUSIONS: The implant/abutment joint of internally connecting implants were quite stable under insertion torque in clinical situation.

Impact of immediate and non-immediate provisionalization on the soft tissue esthetics of final restorations on immediately placed implants / 대한치과보철학회지

STATEMENT OF PROBLEM: Interpoximal papilla could be re-established without immeidate support with a provisional resotration following an immdiate implant placement. PURPOSE: Successful esthetic outcomes were reported utilizing immediate provisionalization following immediate implant placements. The aim of this study was to evaluate the soft tissue esthetics around immediately placed single tooth implant restorations with or without immediate provisional restorations. METHODS: A total of ten patients, who had a hopeless maxillary anterior tooth, were enrolled in this study. Screw retained provisional restorations were delivered to the randomly chosen 5 patients (immediate provisionalization group) on the day of immediate implant placement and maintained for about 5 months. For the remaining five patients (non-immediate provisionalization group), healing abutments were delivered on the day of surgery, replaced with screw retained provisional restorations approximately 3 months afterwards, and the provisional restorations were maintained for about 3 months. Digital photographs were taken at the delivery of final restorations in order to assess following variables; mesial papilla, distal papilla, soft tissue level, soft tissue contour and facial soft tissue prominence. The variables were compared to those of the contralateral natural tooth and scored by prosthodontists, periodontists, orthodontists and dental students. RESULTS: The immediate provisionalization group marked significantly higher scores on the following variables; soft tissue level and facial soft tissue prominence. In evaluating each variable, there were no notable differences in opinion between four dentist groups. CONCLUSION: Immediate provisionalization can be a treatment option to achieve superior soft tissue esthetics around immediately placed single implant restorations rather than non-immediate provisionalization approaches.

Radiographic evaluation of marginal bone resorption around two types of external hex implants: preliminary study / 대한치과보철학회지

STATEMENT OF PROBLEM: Changes of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. It was proposed that bone-retention elements such as microthreads at the coronal part of implant might help maintain the marginal bone level. PURPOSE: This study was designed to evaluate the effect of microthread configuration within the marginal coronal portion of the implant fixture at the marginal bone changes after loading around two different external hex implants. MATERIAL AND METHODS: Twenty-four patients were included and randomly assigned to treatment with Branemark system implants (Group 1, rough-surfaced implants, n=20) and Oneplant system implants (Group 2, rough-surfaced neck with microthreads, n=20). Clinical and radiographic examinations were conducted at baseline (implant loading) and 1 year postloading. Data analysis was performed by the SAS statistical package version 9.1.3 (SAS Institute, Cary, NC, USA) and the final model was calculated by the MIXED procedure (three-level ANCOVA) for marginal bone change of each test group at baseline and 1 year follow-up. RESULTS: Comparing to baseline, significant differences were noted in marginal bone level changes for the 2 groups at 1 year follow-up (P<0.05). Group 1 had a mean crestal bone level changes of 0.83+/-0.31mm; Group 2 had a mean crestal bone level changes of 0.44+/-0.36mm. Rough-surfaced with microthreads implants showed significantly less marginal bone loss than rough surfaced neck without microthread implants. CONCLUSION: A rough surface with microthreads at the implant was beneficial design to maintain the marginal bone level against functional loading.

The comparison of microtensile bond strength with immediate and delayed dentin sealing / 대한치과보철학회지

PURPOSE: The purpose of this study was to evaluate the effect of various methods of dentin bonding agent application on microtensile bond strength between dentin and resin, using a 2-step etch-and-rinse dentin bonding agent. MATERIAL AND METHODS: Twenty freshly extracted human molars were obtained and divided into 4 groups of 5 teeth. 2-step etch-and-rinse dentin bonding agent was used for all groups. The control specimens were prepared using a direct immediate bonding technique. The delayed dentin sealing (A, C) specimens were prepared using an indirect approach with delayed dentin sealing. For group A, resin was built-up on uncured dentin bonding agent, and for group C, resin was built-up on pre-cured dentin bonding agent. Preparation of the immediate dentin sealing (B) specimens also used an indirect approach with immediate dentin sealing immediately following preparation. All teeth were prepared for a microtensile bond strength test. Specimens were stored in water for 24 hours. Ten beams (1.0 x 1.0 x 11 mm) from each tooth were selected for testing. Bond strength data (MPa) were analyzed with a one-way ANOVA test, and post hoc comparison was done using the Scheffe's test. RESULTS: The mean microtensile bond strengths of control group, B and C (DDS with pre-cure) were not statisticaaly different from each other at 32.7, 33.3, 34.2 MPa. the bond strength for group A (DDS without pre-cure), 19.5 MPa, was statistically different (P < .01) from the other 3 groups. CONCLUSION: When preparing teeth for indirect bonded restorations, DDS with pre-curing dentin bonding agent and IDS results in the same bond strength between dentin and resin. On the contrast, the bond strength was decreased when DDS without pre-curing dentin bonding agent was used.

Bonding between resin and ceramics / 대한치과보철학회지

STATEMENT OF PROBLEM: Literature showed different results on the durability of bonded ceramic restoration. PURPOSE: The purpose of this article is to review the effect of surface treatment of ceramics in resin-ceramic bond to get predictable results. MATERIAL AND METHOD: PubMed data base was utilized to search the articles which were written in English and published in 1986 and 2006. Some electronic published articles which are forthcoming to publish in paper were also included for this review. This review article focused on the effect of acid etching and silane application on the silica based ceramics. The durability of resin-ceramic bonding, the methodology for bond strength test and resin bonding to alumina or zirconia based ceramics were compared in brief at the end of the review. RESULTS AND CONCLUSION: the effect of silane application can be influenced by the contaminations of saliva or solutions. Micromechanical retention by acid etching as well as silane application plays an important role in initial and durable bond strength between resin and ceramic. The use of phosphate modified resin cement following tribochemical silica coating and silane application produced best bond strength for alumina or zirconia based ceramics.

An optimization of onebody type implant system considering various design parameters / 대한치과보철학회지

STATEMENT OF PROBLEM: The researches on the influence of design variables on the stress distribution in cortical and trabecular bones and on optimal design for implant system were limited. PURPOSE: The purpose of this study is to identify the sensitivities of design parameters and to suggest the optimal parameters for designing the onebody type implant system. MATERIAL AND METHODS: Stresses arising in the implant system were obtained by finite element analysis using a three dimensional model. An onebody type implant system [Oneplant (Warrantec. Co. Ltd., Korea)]was considered in this study. Vertical load(150 N) was applied on the top of the abutment along the axial direction. The initial design variables set for sensitivity analysis were radius of fixture, numbers of micro thread, numbers of power thread, height of micro thread, fixture length, tapered angle of fixture, inclined angle of thread, width of micro thread and width of power thread. The statistical technique of Design of Experiments(DOE) was applied to the simulation model to deduce effective design parameters on stress distributions in bones. The deduced design parameters were incorporated into a fully automated design tool which is coupled with the finite element analysis and numerical optimization to determine the optimal design parameters. RESULTS: 1. The result of sensitivity analysis showed six design variables - radius of fixture, tapered angle of fixture, inclined angle of thread, numbers of power thread, numbers of micro thread and height of micro thread - were more influential than the others. 2. The optimal values of design variables can be deduced by coupling finite element analysis (FEA) and design optimization tool(DOT).

Three-dimensional finite element analysis of stress distribution and preload of different connection types implant with initial clamping / 대한치과보철학회지

STATEMENT OF PROBLEM: One of common problems associated with single teeth dental implant prosthetic is the loosening of screws that retain the implants. PURPOSE: The maintenance of screw joint stability is considered a function of the preload achieved in the screw when the suggested initial tightening torque is applied. The purpose of this study was to investigate acquired preload after initial clamping torque for estimating screw joint stability. MATERIAL AND METHODS: A comparative study on the effect of initial clamping of two types of implant systems with different connections was conducted. Three dimensional non-linear finite element analysis is adopted to compare the characteristics of screw preloads and stress distributions between two different types of implant systems composed with abutment, screw, and fixture under the same loading and boundary conditions. RESULTS: 1. When the initial clamping torque of 32Ncm was applied to the implant systems, all types of implants generated the maximum effective stress at the first helix region of screw. 2. Morse taper connection types of implants generate lower stress distributions compared to those by butt joint connection types of implants due to large contact surface between abutment and fixture. 3. The internal types of implant systems with friction grip type implant systems have higher resistance to screw loosening than that of the external types of implant systems since the internal types of implant systems generated larger preload than that generated by the external types for the same tightening moments.

Cell-matrix adhesions of soft tissue cells around dental implants / 대한치과보철학회지

The importance of soft tissue response to implant abutments has become one of the major issues in current implant dentistry. To date, numerous studies have emphasized on maintaining connective tissue barriers in quantity, as well as in quality for the long term success of dental implants. The cells mainly consisting the soft tissue around dental implants are fibroblasts and epithelial cells. The mechanism of the fibroblasts'adhesions to certain substrata can be explained by the 'focal adhesion'theory. On the other hand, epithelial cells adhere to the substratum via hemidesmosomes. The typical integrin-mediated adhesions of cells to certain matrix are called 'cell-matrix adhsions'. The focal adhesion complex of fibroblasts, in relation to the cell-matrix adhsions, consists of the extracellular matrix(ECM) such as fibronectin, the transmembrane proteins such as integrins, the intracellular cytoplasmic proteins such as vinculin, talin, and more, and the cytoskeletal structures such as filamentous actin and microtubules. The mechanosensory function of integrins and focal adhesion complexes are considered to play a major role in the cells'adhesion, migration, proliferation, differentiation, division, and even apoptosis. The '3-D matrix adhesions'defined by Cukierman et al. makes a promising future for the verification of the actual process of the cell-matrix adhesions in vivo and can be applied to the field of implant dentistry in relation to obtaining strong soft tissue attachment to the implant abutments.

Cell-matrix adhesions of soft tissue cells around dental implants / 대한치과보철학회지

The importance of soft tissue response to implant abutments has become one of the major issues in current implant dentistry. To date, numerous studies have emphasized on maintaining connective tissue barriers in quantity, as well as in quality for the long term success of dental implants. The cells mainly consisting the soft tissue around dental implants are fibroblasts and epithelial cells. The mechanism of the fibroblasts'adhesions to certain substrata can be explained by the 'focal adhesion'theory. On the other hand, epithelial cells adhere to the substratum via hemidesmosomes. The typical integrin-mediated adhesions of cells to certain matrix are called 'cell-matrix adhsions'. The focal adhesion complex of fibroblasts, in relation to the cell-matrix adhsions, consists of the extracellular matrix(ECM) such as fibronectin, the transmembrane proteins such as integrins, the intracellular cytoplasmic proteins such as vinculin, talin, and more, and the cytoskeletal structures such as filamentous actin and microtubules. The mechanosensory function of integrins and focal adhesion complexes are considered to play a major role in the cells'adhesion, migration, proliferation, differentiation, division, and even apoptosis. The '3-D matrix adhesions'defined by Cukierman et al. makes a promising future for the verification of the actual process of the cell-matrix adhesions in vivo and can be applied to the field of implant dentistry in relation to obtaining strong soft tissue attachment to the implant abutments.

Soft tissue responses to differential shapes of the implant abutment / 대한치주과학회지

No abstract available.

Effect of implant designs on insertion torque and implant stability quotient (ISQ) value / 대한치과보철학회지

Statement of problem. Primary implant stability has long been identified as a prerequisite to achieve osseointegration. So the application of a simple, clinically applicable noninvasive test to assess implant stability and osseiointegratation are considered highly desirable. Purpose. The purpose of this study was to evaluate the ISQ value and the insertion torque of the 3 different implant system, then to evaluate whether there was a correlation between ISQ value and insertion torque; and to determine whether implant design has an influence on either insertion torque or ISQ value. Material and method. The experiment was composed of 3 groups: depending on the implant fixture design. Group1 was Bra.nemark type parallel implant in 3.75*7mm. Group2 was Oneplant type straight implant in 4.3*8.5mm. Group3 was Oneplant type tapered implant in 4.3*8.5mm. Depending on the density of the bone, 2 types of bone were used in this experiment. Type I bone represented for cortical bone, type II bone represented for cancellous bone. With the insertion of the implant in type I and type II bone, the insertion torque was measured, then the ISQ value was evaluated, and then the correlation between insertion torque and ISQ value was analyzed Result and conclusion. Within the limitations of this study, the following conclusions were drawn. 1. Within the 3 different implants, the insertion torque value and ISQ value were higher in type I bone, when compared with type II bone.(p0.05) 4. Significant linear correlation was found in Bra.nemark type parallel implant: 3.75*7mm in type II bone.

Histological response of anodized titanium implant / 대한치주과학회지

No abstract available.

Histological response of anodized titanium implant / 대한치주과학회지

No abstract available.

Three-dimensional stress analysis of implant systems in the mandibular bone with various abutment types and loading conditions / 대한치과보철학회지

STATEMENT OF PROBLEM: There are many studies focused on the effect of shape of fixtures on stress distribution in the mandibular bone. However, there are no studies focused on the effect of the abutment types on stress distribution in mandibular bone. PURPOSE: The purpose of this study is to investigate the effect of three different abutment types on the stress distributions in the mandibular bone due to various loads by performing finite element analysis. Material and method : Three different implant systems produced by Warantec (Seoul, Korea) were modeled to study the effect of abutment types on the stress distribution in the mandibular bone. The three implant systems are classified into oneplant (Oneplant, OP-TH-S11.5), internal implant (Inplant, IO-S11.5) and external implant (Hexplant, EH-S11.5). All abutments were made of titanium grade ELI, and all fixtures were made of titanium grade IV. The mandibular bone used in this study is constituted of compact and spongeous bone assumed to be homogeneous, isotropic and linearly elastic. A comparative study of stress distributions in the mandibular bone with three different types of abutment was conducted. RESULTS: It was found that the types of abutments have significant influence on the stress distribution in the mandibular bone. It was due to difference in the load transfer mechanism and the size of contact area between abutment and fixture. Also the maximum effective stress in the mandibular bone was increased with the increase of inclination angle of load. CONCLUSION: It was concluded that the maximum effective stress in the bone by the internal implant was the lowest among the maximum effective stresses by other two types.

CLINICAL STUDY OF ENDOSSEOUS HYDROXYAPATITE COATED IMPLANTS / 대한치과보철학회지

Root-form endosseous implants which are in use today have a variety of materials, designs and surface characteristics. Among them, pure titanium surface implants and titanium matrix coated with HA are popular as well as are available in many studies. Rate of clinical success is obviously lower in jaw with cancellous bone than dense bone., In order to increase the rate of success in poor bone quality. More advanced techniques of implant surgery and surface treatment of implant fixture body have been developed. As a successful result, the installation of HA coated implant in bone quality type III or IV became highly successful. Since most clinical studies were performed without knowing the characteristics of HA coated implants, it has been impossible to come up with proper clinical data. Therefore the characterization of HA coated implants is essential to understand long term clinical performance and the predictability of HA coated implant system. Our results showed that HA coated implants had the success rate at 93.7% in bone quality type III, IV for 3.8 years, and the fixture of Steri-Oss showed more stability with time.