All-on-6 implant fixed prosthesis restoration with fulldigital system on edentulous patient: A case report / 대한치과보철학회지

All-on-six concept can be used as one of the treatment options to maximize the use of available residual alveolar bone for implant-supported fixed prosthesis on edentulous patients. But this process is complex and cumbersome. Digital system can be used at multiple steps, from implantation to prosthetic restoration, to overcome this shortcoming. In this case of a maxillary edentulous patient aged 76, digital system was used for restoration of 1-piece design, screw retained fixed prosthesis from diagnosis, implant surgery to fabrication of provisional and final prosthesis. For preoperative diagnosis and treatment planning stage, intra-oral information of a patient was digitalized by direct intra-oral scan. Surgical guide and immediate provisional prosthesis was designed based on this digitalized data. Patient’s inconvenience was minimized by applying immediate provisional prosthesis, which was delicately fabricated according to the location data of six implants on most suitable residual alveolar bone. Then, final prosthesis was designed and fabricated going through new interim prosthesis which was newly designed and fabricated, considering patient’s requests, stable vertical dimension and occlusion, and esthetic factors using digital system. We hereby report a case successfully applying digital system to multiple steps including implant surgery to fabricating prosthesis, to simplify existing complicated implant treatment procedure to an edentulous patient.

Radiographic evaluation of computer aided design/computer aided manufacturing (CAD/CAM) customized abutment of implant / 대한치과보철학회지

PURPOSE: In this study, the retrospective radiographic study is executed to evaluate amount of bone loss of various conditions in patients using customized abutment for 4 years of follow-up. MATERIALS AND METHODS: The subjects of this study were implant fixed dental prosthesis using CAD/CAM customized abutments. CAD/CAM customized abutment and fixed dental prosthesis were manufactured by the Prosthodontics Department of Chosun University Dental Hospital from August 1, 2011 to July 31, 2012. Radiological assessments were performed on the patients who were treated by the fixed prosthodontics. After each treatment, a retrospective study was performed for a total of 4 years at 3 months, 6 months, 1 year, 2 years, 3 years, and 4 years. RESULTS: As a result of the study, the customized abutment using CAD/CAM showed less bone loss than the results of existing research. There was no statistically significant differences at alveolar bone loss between splinting group and non-splinting group (respectively 0.27 mm, 0.5 mm). Also, there were statistically significant differences at alveolar bone loss in mx. anterior, mx. posterior, mn. anterior and mn. posterior part (respectively 1.37 mm, 0.39 mm, 0.00 mm, 0.30 mm). CONCLUSION: The customized abutment using CAD/CAM showed less bone loss than the results of existing research, there were statistically significant differences at alveolar bone loss in implant positions.

Accuracy of the CT guided implant template by using an intraoral scanner according to the edentulous distance / 대한치과보철학회지

PURPOSE: The purpose of this study is to compare the accuracy of the CT guided implant template that was produced by using an intraoral scanner according to the edentulous distance. MATERIALS AND METHODS: Five maxillary casts were fabricated using radiopaque acrylic resin with the second premolars, first molars, and second molars missing. Then a virtual cast was acquired by scanning each resin cast. Implant treatment was planned on the missing sites by superimposing the presurgical CT DICOM file and the virtual cast. Then the implants were placed using a surgical template followed by postsurgical CT scan. The distance and angle of the platform and apex between the presurgical implant and postsurgical implant were measured using the X, Y, and Z axis of the superimposed presurgical CT and postsurgical CT via software followed by statistical analysis using Kruskall-Wallis test and Mann-Whitney test. RESULTS: The implant placement angle error increased towards the second molars but there was no statistically significant difference. The implant placement distance error at the platform and apex also increased towards the second molars and there was a statistically significant error at the second molars. CONCLUSION: Although the placement angle had no statistically significant difference between the presurgical implant and postsurgical implant, the placement distance at the platform and apex showed a larger error and a statistically significant difference at the second molar implant.

Contour of lingual surface in lower complete denture formed by polished surface impression

PURPOSE: The aim of this study was to analyze the shapes of lingual polished surfaces in lower complete dentures formed by polished surface impressions and to provide reference data for use when manufacturing edentulous trays and lower complete dentures. MATERIALS AND METHODS: Twenty-six patients with mandibular edentulism were studied. After lower wax dentures were fabricated, wax was removed from the lingual side of the wax denture and a lingual polished surface impression was obtained with tissue conditioner. The definitive denture was scanned with a three-dimensional scanner, and scanned images were obtained. At the cross-sections of the lingual frenum, lateral incisors, first premolars, first molars, and anterior border of the retromolar pads, three points were marked and eight measurements were taken. The Kruskal-Wallis test and a post hoc analysis with the Mann-Whitney test were performed. RESULTS: Each patient showed similar values for the same areas on the left and right sides without a statistically significant difference. The height of the contour of the lingual polished surface at the lingual frenum was halfway between the occlusal plane and lingual border, it moved gradually in a downward direction. The angle from the occlusal plane to the height of the contour of the lingual polished surface was increased as it progressed from the lingual frenum towards the retromolar pads. CONCLUSION: The shape of the mandibular lingual polished surface was convex at the lingual frenum, lateral incisors and gradually flattened towards the first molars and retromolar pads.

Fit analysis of CAD-CAM custom abutment using micro-CT / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate screw joint stability and sagittal fit between internal connection implant fixtures of two different manufacturers and customized abutments. MATERIALS AND METHODS: Internal connection implant systems from two different manufacturers (Biomet 3i system, Astra Tech system) were selected for this study (n=24 for each implant system, total n=48). For 3i implant system, half of the implants were connected with Ti ready-made abutments and the other half implants were connected with Ti CAD-CAM custom ones of domestic-make (Myplant, Raphabio Co., Seoul, Korea) and were classified into Group 1 and Group 2 respectively. Astra implants were divided into Group 3 and Group 4 in the same way. Micro-CT sagittal imaging was performed for fit analysis of interfaces and preloading reverse torque values (RTV) were measured. RESULTS: In the contact length of fixture-abutment interface, there were no significant differences not only between Group 1 and Group 2 but also between Group 3 and Group 4 (Mann-Whitney test, P>.05). However, Group 2 and Group 4 showed higher contact length significantly than Group 1 and Group 3 in abutmentscrew interface as well as fixture-screw one (Mann-Whitney test, P<.05). In addition, RTV was lower in CAD-CAM custom abutments compared to ready-made ones (Student t-test, P<.05). CONCLUSION: It is considered that domestically manufactured CAD-CAM custom abutments have similar fit at the fixture abutment interface and it could be used clinically. However, RTV of CAD-CAM custom abutments should be improved for the increase of clinical application.

Clinical evaluation of retained preload and cement washout in screw- and cement-retained implant prosthesis / 대한치과보철학회지

PURPOSE: The aim of this study was to evaluate the clinical performance of screw- and cement-retained implant prosthesis (SCP) design in terms of retained preload of abutment screws and cement washout. MATERIALS AND METHODS: Patients with the partial posterior edentulous areas comprised the study group. Implants were placed, and SCPs were delivered after 3 to 6 months healing. Follow-up examinations were performed. The implant survival rate and the prosthetic success rate were evaluated. The retained preload ratio of abutment screws and the prosthetic decementation ratio were measured. RESULTS: Twenty one SCPs (forty three implants)in twenty patients were followed up to 64 months. All of the implants survived during the follow-up period (mean follow-up: 34 months). The prosthetic success rate was 100 % considering no abutment, screw, porcelain or metal frame fractures, as well as no screw loosening. The retained preload ratio of SCPs at the end of follow-up period was 97.61% (+/-16.29) and the decementation ratio was 9.5 %. CONCLUSION: Within the limitations of this clinical study, SCP design showed favorable short-term clinical performances in respect of screw loosening and cement washout.

Effect of cement washout on loosening of abutment screws and vice versa in screw- and cement- retained implant-supported dental prosthesis

PURPOSE: The purpose of this study was to examine the abutment screw stability of screw- and cement-retained implant-supported dental prosthesis (SCP) after simulated cement washout as well as the stability of SCP cements after complete loosening of abutment screws. MATERIALS AND METHODS: Thirty-six titanium CAD/CAM-made implant prostheses were fabricated on two implants placed in the resin models. Each prosthesis is a two-unit SCP: one screw-retained and the other cemented. After evaluating the passive fit of each prosthesis, all implant prostheses were randomly divided into 3 groups: screwed and cemented SCP (Control), screwed and noncemented SCP (Group 1), unscrewed and cemented SCP (Group 2). Each prosthesis in Control and Group 1 was screwed and/or cemented, and the preloading reverse torque value (RTV) was evaluated. SCP in Group 2 was screwed and cemented, and then unscrewed (RTV=0) after the cement was set. After cyclic loading was applied, the postloading RTV was measured. RTV loss and decementation ratios were calculated for statistical analysis. RESULTS: There was no significant difference in RTV loss ratio between Control and Group 1 (P=.16). No decemented prosthesis was found among Control and Group 2. CONCLUSION: Within the limits of this in vitro study, the stabilities of SCP abutment screws and cement were not significantly changed after simulated cement washout or screw loosening.

Implant prosthesis using intraoral scanner: Case Report / 대한치과보철학회지

Accuracy is the most important thing in implant prosthesis, for this reason it is essential procedure to check the accuracy of impression taking. However, impression material has its own error and the error occurs in model-making procedure. As an alternative way to this, using intraoral scanner can be suggested and many studies were issued reporting that there's no statistically significant difference in accuracy between intraoral scanner and conventional impression. Therefore, the purpose of this study is to report the process of making of implant prosthesis using intraoral scanner, which is more convenient, fast, accurate compared with conventional method.

Comparison of condylar guidance using ARCUSdigma 2 and Checkbite / 대한치과보철학회지

PURPOSE: Nowadays, checkbite methods and a digital sensor are used to analyze the movement of mandible. However, there are no study comparing two methods. Therefore, this study has compared measuring the condylar inclination methods by using the new ARCUSdigma 2 system and the checkbite method. MATERIALS AND METHODS: Young 20 adults without any orthodontic treatment experiences, missing teeth, and restorations with the change of occlusal plane were tested. Angles of condylar path were measured 3 times each, based on Camper's line, by using two methods. KaVo PROTAR Evo 7 semi-adjustable articulator was used and the data were statistically analyzed. RESULTS: The anterior sagittal condylar inclination by ARCUSdigma 2 system were measured as 26.97degrees(+/-7.38degrees) on the left side and 29.80degrees(+/-8.19degrees) on the right side. The lateral condylar inclination were measured as 5.75degrees(+/-3.47degrees) on the left side and 8.10degrees(+/-4.98degrees) on the right side. 2. The anterior sagittal condylar inclination by checkbite method were measured as 25.20degrees(+/-6.53degrees) on the left side and 28.18degrees(+/-7.38degrees) on the right side. The lateral condylar inclination were measured as 10.97degrees(+/-5.63degrees) on the left side and 12.03degrees(+/-5.22degrees) on the right side. There was no statistically significant difference between male and female (P>.05). 3. The lateral condylar inclinations of ARCUSdigma 2 were statistically significantly smaller than that of checkbite method (P.05). However, the lateral condylar inclinations of ARCUSdigma 2 were statistically significantly smaller than that of checkbite method (P<.05).

Palatal obturator restoration of a cleft palate patient with velopharyngeal insufficiency: a clinical report / 대한치과보철학회지

Cleft lip and palate is congenital deformity in oral and maxillofacial area. Normal soft palate has velopharyngeal closure action by connecting oral cavity and nasal cavity at rest and moving upward at swallowing and specific pronunciation. Cleft palate patients with velopharyngeal insufficiency have difficulty in mastication, swallowing and pronunciation because velopharyngeal closure is incomplete. At this time, a prosthetic device used to cover palate defects is called a palatal obturator. A palatal obturator separates oral cavity and nasal cavity and recovers pronunciation, mastication, swallowing and esthetic function. The purpose of this case study is to report the results because it reaches a satisfactory result in functional and esthetic aspects through functional impression procedures using modeling compound and tissue conditioner for restoration of a cleft palate patient with velopharyngeal insufficiency.

A comparative study on the fit and screw joint stability of ready-made abutment and CAD-CAM custom-made abutment / 대한치과보철학회지

PURPOSE: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. MATERIALS AND METHODS: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (alpha=.05). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. RESULTS: The pre-loading reverse torque values were 26.0 +/- 0.30 Ncm (ready-made abutment; Transfer abutment) and 26.3 +/- 0.32 Ncm (CAD-CAM custom-made abutment; CustomFit abutment) and 24.7 +/- 0.67 Ncm (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. CONCLUSION: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

Effect of various intraoral repair systems on the shear bond strength of composite resin to zirconia

PURPOSE: This study compared the effect of three intraoral repair systems on the bond strength between composite resin and zirconia core. MATERIALS AND METHODS: Thirty zirconia specimens were divided into three groups according to the repair method: Group I- CoJet(TM) Repair System (3M ESPE) [chairside silica coating with 30 microm SiO2 + silanization + adhesive]; Group II- Ceramic Repair System (Ivoclar Vivadent) [etching with 37% phosphoric acid + Zirconia primer + adhesive]; Group III- Signum Zirconia Bond (Heraus) [Signum Zirconia Bond I + Signum Zirconia Bond II]. Composite resin was polymerized on each conditioned specimen. The shear bond strength was tested using a universal testing machine, and fracture sites were examined with FE-SEM. Surface morphology and wettability after surface treatments were examined additionally. The data of bond strengths were statistically analyzed with one-way ANOVA and Tamhane post hoc test (alpha=.05). RESULTS: Increased surface roughness and the highest wettability value were observed in the CoJet sand treated specimens. The specimens treated with 37% phosphoric acid and Signum Zirconia Bond I did not show any improvement of surface irregularity, and the lowest wettability value were found in 37% phosphoric acid treated specimens. There was no significant difference in the bond strengths between Group I (7.80 +/- 0.76 MPa) and III (8.98 +/- 1.39 MPa). Group II (3.21 +/- 0.78 MPa) showed a significant difference from other groups (P<.05). CONCLUSION: The use of Intraoral silica coating system and the application of Signum Zirconia Bond are effective for increasing the bond strength of composite resin to zirconia.

Cortical and cancellous bone thickness on the anterior region of alveolar bone in Korean: a study of dentate human cadavers

PURPOSE: The cortical bone thickness on the anterior region is important for achieving implant stability. The purpose of this study was to examine the thickness of the cortical and cancellous bones on the anterior region of the maxilla and mandible. MATERIALS AND METHODS: Twenty-five cadaver heads were used (16 male and 9 female; mean death age, 56.7 years). After the long axis of alveolar process was set up, it was measured in 5 levels starting from 2 mm below the cementoenamel junction (L1) at intervals of 3 mm. All data was analysed statistically by one-way ANOVA at the .05 significance level. RESULTS: The cortical bone thickness according to measurement levels in both the labial and lingual sides increased from L1 to L5, and the lingual side below L3 was significantly thicker than the labial side on the maxilla and mandible. In particular, the labial cortical bone thickness in the maxilla was the thinnest compared to the other regions. The cancellous bone thickness according to measurement levels increased from L1 to L5 on the maxilla, and on the mandible it was the thinnest at the middle level of the root. CONCLUSION: For implant placement on the anterior region, a careful evaluation and full knowledge on the thickness of the cortical and cancellous bone are necessary, therefore, these results may provide an anatomic guideline to clinicians.

Comparison of fatigue fracture strength by fixture diameter of mini implants / 대한치과보철학회지

PURPOSE: This study was conducted to obtain difference in fracture strength according to the diameter of one-body O-ring-type of mini implant fixture, to determine the resistance of mini implant to masticatory pressure, and to examine whether overdenture using O-ring type mini implant is clinically usable to maxillary and mandibular edentulous patients. MATERIALS AND METHODS: For this study, 13 mm long one body O-ring-type mini implants of different diameters (2.0 mm, 2.5 mm and 3.0 mm) (Dentis, Daegu, Korea) were prepared, 5 for each diameter. The sample was placed at 30degrees from the horizontal surface on the universal testing machine, and off-axis loading was applied until permanent deformation occurred and the load was taken as maximum compressive strength. The mean value of the 5 samples was calculated, and the compressive strength of implant fixture was compared according to diameter. In addition, we prepared 3 samples for each diameter, and applied loading equal to 80%, 60% and 40% of the compressive strength until fracture occurred. Then, we measured the cycle number on fracture and analyzed fatigue fracture for each diameter. Additionally, we measured the cycle number on fracture that occurred when a load of 43 N, which is the average masticatory force of complete denture, was applied. The difference on compressive strength between each group was tested statistically using one-way ANOVA test. RESULTS: Compressive strength according to the diameter of mini implant was 101.5 +/- 14.6 N, 149 +/- 6.1 N and 276.0 +/- 13.4 N, respectively, for diameters 2.0 mm, 2.5 mm and 3.0 mm. In the results of fatigue fracture test at 43 N, fracture did not occur until 2x106 cycles at diameter 2.0 mm, and until 5x106 cycles at 2.5 mm and 3.0 mm. CONCLUSION: Compressive strength increased significantly with increasing diameter of mini implant. In the results of fatigue fracture test conducted under the average masticatory force of complete denture, fracture did not occur at any of the three diameters. All of the three diameters are usable for supporting overdenture in maxillary and mandibular edentulous patients, but considering that the highest masticatory force of complete denture is 157 N, caution should be used in case diameter 2.0 mm or 2.5 mm is used.

Resorption of labial bone in maxillary anterior implant

PURPOSE: The purpose of this study was to evaluate the amount of resorption and thickness of labial bone in anterior maxillary implant using cone beam computed tomography with Hitachi CB Mercuray (Hitachi, Medico, Tokyo, Japan). MATERIALS AND METHODS: Twenty-one patients with 26 implants were followed-up and checked with CBCT. 21 OSSEOTITE NT(R) (3i/implant Innovations, Florida, USA) and 5 OSSEOTITE(R) implants (3i/implant Innovations, Florida, USA) were placed at anterior region and they were positioned vertically at the same level of bony scallop of adjacent teeth. Whenever there was no lesion or labial bone was intact, immediate placement was tried as possible as it could be. Generated bone regeneration was done in the patients with the deficiency of hard tissue using Bio-Oss(R) (Geistlich, Wolhusen, Switzerland) and Bio-Gide(R) (Geistlich, Wolhusen, Switzerland). Second surgery was done in 6 months after implant placement and provisionalization was done for 3 months. Definite abutment was made of titanium abutment with porcelain, gold and zirconia, and was attached after provisionalization. Two-dimensional slices were created to produce sagittal, coronal, axial and 3D by using OnDemand3D (Cybermed, Seoul, Korea). RESULTS: The mean value of bone resorption (distance from top of implant to labial bone) was 1.32 +/- 0.86 mm and the mean thickness of labial bone was 1.91 +/- 0.45 mm. CONCLUSION: It is suggested that the thickness more than 1.91 mm could reduce the amount and incidence of resorption of labial bone in maxillary anterior implant.

Bond-strength of several metal-meramic alloys and meneered-porcelain / 대한치과보철학회지

PURPOSE: In this study, we evaluated the bond-strength between a few metal ceramic-alloys and veneered-porcelain and found if the bond strength of metal-ceramic alloy with lower gold content than the presently used gold alloy was high enough. MATERIALS AND METHODS: For this study, after plasticizing porcelain only for gold alloy, metal specimen was fabricated using Ni-Cr alloy and gold alloy with different gold content. Three point flexural test were performed to measure their bond-strength. RESULTS: The bonding strength of Group 1 to porcelain was 40.62 +/- 3.32 MPa, which was the highest (P.05), while there was a significant difference between that of Group 2, Group 3 and Group 4 and that of Group 6 (Duncan's test, P<.05). The bonding strength between gold alloy and porcelain increased according to the content of gold. In all experimental groups showed higher value than 25 MPa, which is the least value recommended by ISO 9693. CONCLUSION: In all groups, bonding strength was higher than 25 MPa, which is the least value of ISO9693. Therefore, it is considered that metal gold alloy with low gold content is clinically usable.

Anthropometric analysis of maxillary anterior buccal bone of Korean adults using cone-beam CT

PURPOSE: The aim of this study was to evaluate the thickness of buccal and palatal alveolar bone and buccal bony curvature below root apex in maxillary anterior teeth of Korean adults using Cone-beam CT images. MATERIAL AND METHODS: The 3D image was reconstructed with dicom file obtained through CBCT from 20 - 39 year old Korean subjects (n = 20). The thickness of buccal and palatal plate, root diameter, the buccal bony curvature angle below root apex and the distance from root apex to the deepest point of buccal bony curvature were measured on maxillary anterior teeth area using OnDemand3D program. RESULTS: Mean thickness of buccal plate 3 mm below CEJ was 0.68 +/- 0.29 mm at central incisor, 0.76 +/- 0.59 mm at lateral incisor, and 1.07 +/- 0.80 mm at canine. Mean thickness of palatal plate 3 mm below CEJ was 1.53 +/- 0.55 mm of central incisor, 1.18 +/- 0.66 mm of lateral incisor, 1.42 +/- 0.77 mm of canine. Bucco-lingual diameter 3 mm below CEJ was 5.13 +/- 0.37 mm of central incisor, 4.58 +/- 0.46 mm of lateral incisor, and 5.93 +/- 0.47 mm of canine. Buccal bony curvature angle below root apex was 134.7 +/- 17.5degrees at central incisor, 151.0 +/- 13.9degrees at lateral incisor, 153.0 +/- 9.5degrees at canine. Distance between root apex and the deepest point of buccal bony curvature of central incisor was 3.67 +/- 1.28 mm at central incisor, 3.90 +/- 1.51 mm at lateral incisor, and 5.13 +/- 1.70 mm at canine. CONCLUSION: Within the limitation of this study in Korean adults, the thickness of maxillary anterior buccal plate was very thin within 1mm and the thickness of palatal plate was thick, relatively. The buccal bony curvature below root apex of maxillary central incisor was higher than that of lateral incisor and canine and it seems that the buccal bony plate below root apex of central incisor is most curved.

Abrasion of abutment screw coated with TiN

STATEMENT OF PROBLEM: Screw loosening has been a common complication and still reported frequently. PURPOSE: The purpose of this study was to evaluate abrasion of the implant fixture and TiN coated abutment screw after repeated delivery and removal with universal measuring microscope. MATERIAL AND METHODS: Implant systems used for this study were Osstem and 3i. Seven pairs of implant fixtures, abutments and abutment screws for each system were selected and all the fixtures were perpendicularly mounted in liquid unsaturated polyesther with dental surveyor. After 20 times of repeated closing and opening test, the evaluation for the change of inner surface of implant and TiN-coated abutment screw, and weight loss were measured. Mann-Whitney test with SPSS statistical software for Window was applied to analyze the measurement of weight loss. RESULTS: TiN-coated abutment screws of Osstem and 3i showed lesser loss of weight than non-coated those of Osstem and 3i (P < .05, Mann-Whitney test). CONCLUSION: Conclusively, TiN coating of abutment screw showed better resistance to abrasion than titanium abutment screw. It was concluded that TiN coating of abutment screw would reduce the loss of preload with good abrasion resistance and low coefficient of friction, and help to maintain screw joint stability.

Sinking and fit of abutment of locking taper implant system

STATEMENT OF PROBLEM: Unlike screw-retention type, fixture-abutment retention in Locking taper connection depends on frictional force so it has possibility of abutment to sink. PURPOSE: In this study, Bicon(R) Implant System, one of the conical internal connection implant system, was used with applying loading force to the abutments connected to the fixture. Then the amount of sinking was measured. MATERIAL AND METHODS: 10 Bicon(R) implant fixtures were used. First, the abutment was connected to the fixture with finger force. Then it was tapped with a mallet for 3 times and loads of 20 kg corresponding to masticatory force using loading application instrument were applied successively. The abutment state, slightly connected to the fixture without pressure was considered as a reference length, and every new abutment length was measured after each load's step was added. The amount of abutment sinking (mm) was gained by subtracting the length of abutment-fixture under each loading condition from reference length. RESULTS: It was evident, that the amount of abutment sinking in Bicon(R) Implant System increased as loads were added. When loads of 20 kg were applied more than 5 - 7 times, sinking stopped at 0.45 +/- 0.09 mm. CONCLUSION: Even though locking taper connection type implant shows good adaption to occlusal force, it has potential for abutment sinking as loads are given. When locking taper connection type implant is used, satisfactory loads are recommended for precise abutment location.

Detorque force and surface change of coated abutment screw after repeated closing and opening / 대한치과보철학회지

STATEMENT OF PROBLEM: Recently researches about WC/C (Tungsten Carbide/Carbon) or TiN (Titanium Nitride) coating on abutment screws are going on. It decreases friction coefficient, resistance against corrosion and withdrawal of physical fragility when the coating is applied to the metal surfaces. It is reported that coated abutment screws improved abrasion, adaptability and detorque force. PURPOSE: This study is about the effects of coated abutment screws on loosening of screw and for the purpose of solving the loosening phenomenon of abutment screws which is clinical problem. MATERIAL AND METHODS: Detorque force and surface changes are compared when 10 times of repeated closing and opening are applied to both uncoated titanium abutment screws (Group A) and coated abutment screws with WC/C (Group B) and TiN (Group C). Each group was made up of 10 abutment screws. RESULTS: 1. Before repeated closing and opening, Somewhat rough surface with regular direction was observed in Group A. Coated granules were observed in group B and group C and overall coated layer appeared in regular and smooth form. 2. Before repeated closing and opening, The coated surface showed bigger and thicker size of coated granules in Group C than Group B. 3. After repeated closing and opening, abrasion and deformation of abutment screw surface was observed in Group A and Group B. Exfoliation phenomenon was observed in Group B. 4. Group A showed biggest range of decrease when the weight changes of abutment screws were measured before and after repeated closing and opening. Group C showed less weight changes than Group B but there was no statistical difference between two groups. 5. Group B and Group C showed higher average detorque force than Group A and there was statistical difference. 6. Group A showed more prominent decrease tendency of average detorque force than Group B and Group C. CONCLUSION: Coated abutment screws with WC/C or TiN did not show prominent surface changes than uncoated titanium abutment screws even though they were repeatedly used. And they showed excellent resistance against friction and high detorque force. Thus it is considered that adaptation of WC/C or TiN coating on abutment screws will improve the screw loosening problem.