Bisphosphonate-associated osteonecrosis (BRONJ) is an adverse event associated with bisphosphonate drug treatment. An 81-year-old female has been taking bisphosphonates orally once a month for three years complained of pain in the left mandibular molar area after implant placement. Tenderness and fistula were formed. Extensive osteosclerosis in posterior area of the left mandible and bone resorption around distal side of #37i were shown on radiographs. She was given oral antibiotics for 6 weeks and bone resorption was improved. A 70-year-old male had a history of intravenous injection of bisphosphonates for blood cancer complained of #46i implant mobility. There was buccal fistula on #45 site. Radiographically, severe bone resorption and extensive osteosclerosis were shown. He was treated with removal of implant and inflammatory tissue. Patients who have taken bisphosphonates may develop BRONJ after tooth extraction or implant placement and are needed to meticulous plaque control for preventing BRONJ.

In case of gingival recession and alveolar bone defects due to tooth loss for a long period of time in a single tooth in the maxillary anterior region, it is not easy to obtain aesthetic results with a single implant prosthesis. For aesthetic restoration, it is important to preserve hard and soft tissues through alveolar bone augmentation as well as restore harmony with adjacent teeth and soft tissues by placing the implant in an ideal location. In this case, an implant was placed using guided bone regeneration and a connective tissue graft simultaneously with immediate implantation after extraction from the maxillary anterior region where only residual root was left for a long period of time.

본 연구는 MRI 검사 시 임플란트 자석 틀니의 자기 유지력 변화와 구조물 간의 금속 인공물을 분석하였다. 연구 방법으론 자기 유지력 변화의 평가를 위해 자석 구조체를 고속스핀에코 시퀀스로 검사하며 자력을 30분 간격으로 최대 90분까지 측정하였고, 금속 인공물 평가를 위해 자석 구조체와 임플란트 팬텀의 축상면 이미지에서 금속 인공물 크기를 측정하였다. 자석 구조체의 자력은 1.5T 검사에선 1.11 ∼ 5.29G의 차이를, 3.0T 검사에선 0.78 ∼ 2.97G의 차이를 보였으나 검사 시간과는 유의미한 상관관계를 보이지 않았다(p>0.05). 금속 인공물의 크기는 1.5T 장비에서 임플란트 팬텀은 15.02mm ∼ 21.97mm, 자석 구조체 팬텀은 87.86mm ∼ 102.54mm, 3.0T 장비에서 임플란트 팬텀은 19.15mm ∼ 25.81mm, 자석 구조체 팬텀은 94.18mm ∼ 125.56mm로 나타났다. 이로 인해 자석 구조체의 자력은 MRI 검사 시간에 따른 유의미 한 변화를 보이지 않으며, 자력을 가진 구조물이 일반적인 구조물보다 더 큰 금속 인공물을 보인다는 것을 알 수 있었다. 따라서 MRI 검사는 임플란트 자석 틀니의 자기 유지력에 영향을 미치지 않으며, 금속 인공물을 줄이기 위해 검사 전 자력을 가지는 삽입물은 제거되어야 한다.

Recently, a number of recent reports have reported cases of bone marrow defect (BMD) in the mandible. Among the diseases seen by BMD in radiographs, focal osteoporotic bone marrow defect(FOBMD) is asymptomatic, which is discovered incidentally and localized radiolucency. Because it varies in size, shape, trabeculae and border definition, it needs to biopsy to differential diagnose other intraosseous lesions that show radiological bone marrow defects. This cases report discusses the pre-operation considerations in patients planning to implant the mandible and suspected to have FOBMD in radiographs. The following 4 cases in Dental Hospital of Wonkwang University were taken in panoramic and Cone beam computed tomography(CBCT). In all cases, there were radiolucent lesion diagnosed with FOBMD under radiologic differential diagnosis. In three of cases the implant were placed without treatment plan change and one case changed the treatment plan with removable partial denture. BMD is anatomical state that can affect primary stability of implant fixture. During implant placement, it can lead to unexpected results that fixture is fallen into BMD and the nerve may be damaged after implant fixture removal to cause hyperesthesia. Preoperative diagnosis of these lesions by differential diagnosis with panoramic and CBCT can prevent the complications by changing the treatment plan or paying attention to the manipulation during surgery.

무릎 임플란트에서 접촉압력이 마모에 큰 영향을 미친다. 본 연구에서는 본 연구기관에서 개발한 무릎 임플란트 모델을 이용하여 유한요소해석을 하였다. 연구와 산업에서 실제로 사용하는 조합을 이용하여 총 10가지의 무릎 임플란트의 재료조 합에 대한 접촉압력을 분석하였다. 무릎이 30도, 45도 60도 기울어져있을 때의 하중을 가하여 접촉압력을 구하였다. 접촉압 력을 계산한 결과 티타늄합금-UHMWPE 조합에서 가장 작은 접촉압력이 나왔다. UHMWPE의 경우 대퇴골부에 어떠한 재 료를 사용하여도 접촉압력이 크게 변하지 않았다. 접촉압력이 가장 큰 조합과 작은 조합을 비교하였을 때 0.77% 차이를 보 였다. 반면에 Carbon/PEEK 복합재료의 경우 접촉압력이 가장 큰 경우와 작은 경우를 비교하였을 때 5.3% 차이를 보였다. 이를 통해 Carbon/PEEK 복합재료를 베어링부로 사용할 경우 대퇴골부의 재료가 마모에 영향을 미침을 알 수 있다. 본 연구 는 무릎 임플란트 마모예측과 마모를 최소화 연구에 도움이 될 것이라 생각한다.

With the multiple practices of bone graft using different artificial bone regenerative substitutes, the bone graft procedures have been widely performed to increase the bony stabilization of dental implant. Xenogenic bone graft materials have been well developed because of their good biocompatibility and abundant source of bone materials. The present study demonstrated the histological findings from excellent bony remodeling in xenogenic bone graft biopsies compared to those findings in autogenous bone graft. For the graft bone biopsies which were usually done in 5-9 months after graft bone insertion, five types of histological grades including excellent, favorable, partial, degenerative, and poor bony remodeling could be assessed to give prognostic information for dental implant. However, recently the xenograft bone materials have been much improved and produced strong osteogenic effect. Among 239 cases of trephine bur-supported core bone biopsy the excellent bony remodeling was found in 20 cases (13.1%) out of 153 xenogenic bone grafts and in 13 cases (43.3%) out of 30 autogenous bone grafts. They produced abundant new bones on the surface of the graft bones in 5–9 months, and the graft bones were partly resorbed and also surrounded by the repetitive deposition of new bone. The osteophytic new bones showed strong birefringence under polarizing microscope, and were gradually elongated and anastomosed with each other to form trabecular bony networks which became proper stress-baring structures for dental implant. Their marrow stromal tissues were composed of loose connective tissue which was well vascularized but rarely infiltrated with inflammatory cells. The present study compared the histological features of excellent bony remodeling between xenogenic and autogenous bone grafts. Although the ratio of excellent bony remodeling in xenogenic bone graft was still low, 13.1%, the recent advance of xenogeic bone products was remarkable in biological aspect and almost comparable to the autogenous bones. Therefore, it was suggested that the xenogenic bone graft will be applicable to the bone regeneration procedures for dental implant with beneficial output in the near future.

The trauma of incisive canal associated dental implant placement in the anterior maxilla can cause the nasopalatine duct cyst. It is difficult to identify the nasopalatine duct cyst or the location of the incisive canal, only using periapical radiograph or panorama radiograph. So it is necessary to take computed tomography scan for an analysis on the relation between the implant and the incisive canal. This case report present the patient had the nasopalatine duct cyst following the placement of dental implant in the anterior maxilla, and was undergone implant removal and cyst enucleation with bone graft.

A 57 years old female received xenogenic bone graft for the extraction socket augmentation of right maxillary molars and for the sinus floor elevation six months ago. The bone graft sites were healed uneventfully and showed marked radiopacity in the postoperative X-ray view. Before dental implant insertion the bone biopsy was made using trephine bur and examined pathologically. The graft bones showed minimum new bone deposition with dysplastic epithelium. The epithelium was proliferative on the surface of graft bones forming epithelial strands and nests, similar to the odontogenic epithelium. The immunohistochemical study was performed using different antisera of odontogenic markers, growth factors, oncogenes, etc. The epithelial cells were strongly positive for pan-keratins, EGF, pAKT, and HSP-70, consistently positive for PCNA, p53, EGFR, 14-3-3, and survivin, slightly positive for ameloblastin, but rarely positive for amelogenin. Particularly the matrix of graft bone was slightly positive for EGF. Taken together, it is presumed that the abnormal epithelium on the graft bones was derived from odontogenic epithelial elements, Malassez epithelial rests, distributed at the periodontal tissue of maxillary molars, and that they might undergo dysplastic proliferation affected by the release of growth factors and osteogenic proteins from the graft bones. It is also suggested that the graft bone substitutes inserted for the dental implant possibly have a potential to induce the proliferation of odontogenic epithelial rests leading to the pathogenesis of odontogenic cysts and tumors.

목 적 : 3.0T 자기 공명 영상에서 강자성 임플란트로 인해 발생한 자화감수성 인공음영에 대한 시퀀스별 WARP기법의 적정한 VAT(view angle tilting)값을 알아보았다. 대상 및 방법 : 자화감수성 인공음영(susceptibility artifact image)이 head용 워터 팬텀영상의 왜곡정도를 평가하기 위하여 head용 워터 팬텀에 강자성 임플란트(ferromagnetic implant)인 금속 와이어를 부착하여 영상을 획득하였다. 진행하였고(VAT(view angle tilting)) Warp를 사용하였다. 사용된 장비는 3.0T MRI system(MAGNETOM Skyra, Siemens, Munich, Germany)이었으며 20ch head/neck coil을 사용하여 TSE T2, TSE T1, FLAIR, Turbo IR T1 시퀀스에 WARP를 적용하여 VAT를 0~100% 범위내에서 10%씩 변화하여 각각 24개의 axial 영상을 얻었다. TSE T2 영상변수는 TR/TE 4410ms/79ms, Matrix 512×291이었으며, TSE T1 영상변수는 TR/TE 693ms/10ms, Matrix 512×291이었으며, Turbo IR T1 영상변수는 TR/TE 2000ms/9.5ms, Matrix 384×307이었으며, FLAIR 영상변수는 TR/TE 9000ms/96ms, Matrix 384×180이었다. 시퀀스별로 slice thickness 4mm, slice gap 0.4mm, NEX 1, bandwidth는 500Hz 였다. 정량평가는 팬텀영상의 대부분을 ROI로 설정 하여 표준편차를 구하였다. 정성 평가는 팬텀 영상 내에 dark area크기, image blurring 정도를 5점 척도로 하여 영상의 변화가 없는 경우 1점, 영상의 질이 약간 우수한 경우 2점, 보통 3점, 우수한 경우 4점, 매우 우수한 경우 5점으로 숙련된 방사선사 3명이 관찰 후 평가하였다. 결 과 : 정량분석으로 TSE T2와 TSE T1의 표준편차(SD)는 VAT 10%에서 VAT 적용전보다 많은 감소를 보였으며, VAT가 증가 할수록 감소하는 경향을 나타냈다. 그러나 IR 계열의 FLAIR와 Turbo IR T1은 WARP의 적용에 따른 영상차이가 없었다. 변동계수는 모든 시퀀스에서 30%이하였다. 또한 VAT 변화에 따라 영상의 위치변화도 나타났다. 정성분석으로 TSE T2는 VAT가 30~60%일 때 우수한 것으로 나타났고, TSE T1은 VAT가 10~70%일 때 우수한 것으로 나타났다. FLAIR와 Turbo IR T1은 WARP사용에 따른 영상의 변화가 없었다 결 론 : WARP는 TSE T2와 TSE T1의 자화감수성 인공음영을 줄이는데는 매우 효과적인 영상기법이었다. 그러나 WARP는 VAT를 증가시키면 image blurring도 증가함으로 VAT값을 최소화해서 사용 되어져야 할 것으로 사료된다.

The objective of this study was to compare peri-implant bone formation among uncoated (UC), hydroxyapatite (HA), collagen plus hydroxyapatite (CH), and silk plus hydroxyapatite (SH) implant groups. Surface coating was applied using the aerosol deposition method. The morphology of MG63 cells on the implant surfaces were examined by scanning electron microscopy (SEM) after 8 h cultures on the each of implant groups. After 48 h cultures, MTT assay was performed to compare cell viabilities of each group. Subsequently, a total of 20 implants from each group were installed in the tibia of the rabbits. The animals were sacrificed at 6 weeks after the implant installation. The peri-implant bone formation was evaluated from the histological sections. In the SEM images, SH coating implant showed better attachment of MG63 cells to the implant surface than the other groups. It also showed adequate cell viabilities and peri-implant bone formations compared with other implant groups. From these in vitro and vivo experiments, SH coating can be a possible candidate for the surface treatment of dental implant. This study was supported by a grant from the Next-Generation BioGreen21 Program (Center for Nutraceutical & Pharmaceutical Materials no. PJ009013)

Dental implants were used for reconstruction of oromaxillofacial defects and they were widely used in dental and medical fields. The implant materials are various , including titanium and ceramics such as zirconium. The property of implant materials have biocompatibility and mechanical strength. Titanium has direct bone anchorage without any other tissues between implant's interface. many researcher's had studied for raising the osseointegration success rate through various method. It was reported over 95% success ratio. many researcher's study the enhancing the speed of bone remodelling and osseointegration. Low Level Laser Therapy is one of the method to accelerlate the speed of bone remodelling and osseointegration. Thus it raise initial stability. The purpose of this study was to evaluate the effect of diode laser irradiation for ossoeintegration in implant interface and between the implants threads. 24 New Zealand white rabbits which were about 3Kg, used for experiment. 2 implant's were implanted every rabbit's tibia. 2 weeks, 4 weeks, 8 weeks after implantation, tissue sample were removed from sacrificed rabbit's tibia. 8 rabbit's were sacrificed every 2, 4, 8 weeks and undecalcified sample were got from tissue sample. The undecalcified samples were investigated by optical microscope. 2 weeks, 4 weeks, 8 weeks experimental groups which were irradiated low level laser therapy showed rapid bone remodelling than control groups. it showed many difference especially in initial stage. Low level laser irradiation increase the volume of new bone formation in implant interface . It was suggested that there were many influence in bone remodelling in early stage, because these were many differences between experimental and control groups. Low level laser irradiation were helpful for immediate loading implant

본 논문은 두 편으로 구성된 치과용 임플란트 구조설계에 대한 논문 중 두 번째 논문으로 첫 번째 논문에서 구조해석 비 교연구를 통하여 그 구조적 성능이 확인된 새로운 임플란트 구조모델에 대하여 시험 설계도면을 작성하여 완성하였으며, 이를 근거로 실제로 CNC 공작기계 등을 이용하여 임플란트를 가공․제작하고, 이를 평가함으로써 치과용 임플란트 구조 설계를 완성하였다. 설계도면 작업은 전용 Tool인 MDT를 이용하여 수행하였으며, 가공작업은 CNC 선반, 범용밀링머신, Wire EDM 등을 이용하여 수행하였다. 전자현미경을 이용하여 임플란트 표면의 가공 상태를 최종 평가 확인하였다. 평가 결과 매우 양호한 상태의 임플란트 시험제품을 설계 제작하였다.

본 논문은 두 편으로 구성된 치과용 임플란트 구조설계에 대한 논문 중 첫 번째 논문으로 먼저 치과용 임플란트의 종류 및 특징에 대하여 조사 분석을 수행하였다. 이를 통하여 현재 사용 중인 대표적인 치과용 임플란트들의 장단점들을 비교분 석하였다. 그 결과를 토대로 새로운 임플란트 구조모델을 제안하였다. 특히 제안된 새로운 구조형상의 임플란트에 대하여 기존의 대표적인 임플란트들과 유한요소해석 기법을 이용한 구조해석 비교연구를 수행하였다. 구조해석 비교연구를 수행한 결과 본 논문에서 제안한 치과용 임플란트의 구조적 성능의 우수성이 확인되었다. 본 연구에서 구조해석 비교연구를 수행한 치과용 임플란트 제품은 3i 임플란트 제품과 Sargon 임플란트 제품이다. 이들은 모두 수입 제품들인데 임플란트 종류 및 특 징 조사 결과 현재 임상으로 사용 중인 임플란트들은 대부분 골내식립형인데 이들도 그들 중 하나임을 알 수 있었다.

Optimal conditions for HA plasma spray-coating on Ti6Al4V alloy were investigated in order to obtain enhanced bone-bonding ability with Ti6Al4V alloy. The properties of plasma spray coated film were analyzed by SEM, XRD, surface roughness measurement, and adhesion strength test because the film's transformed phase and crystallinity were known to be influential to bone-bonding ability withTi6Al4V alloy. The films were formed by a plasma spray coating technique with various combinations of plasma power, spray distance, and auxiliary He gas pressure. The film properties were analyzed in order to determine the optimal spray coating parameters with which we will able to achieve enhanced bone-bonding ability with Ti6Al4V alloy. The most influential coating parameter was found to be the plasma spray distance to the specimen from the spray gun nozzle. Additionally, it was observed that a relatively higher film crystallinity can be obtained with lower auxiliary gas pressure. Moderate adhesion strength can be achievable at minimal plasma power. That is, adhesion strength is minimally dependent on the plasma power. The combination of shorter spray distance, lower auxiliary gas pressure, and moderate spray power can be recommended as the optimal spray conditions. In this study, optimal plasma spray coated films were formed with spray distance of 70 mm, plasma current of 800 A, and auxiliary gas pressure of 60 psi.

Recently, mini-implant is popular in the orthodontic treatment due to its simplicity and convenient surgical procedure. The objective of this study is to provide the anatomical guideline for mini-implant placement by analysing the cortical bone thickness in Korean. Hemi-sections of sixteen maxillae and twenty-two mandibles with normal teeth were used. Interdental areas between the 1st premolar and the 2nd premolar (Group 1), the 2nd premolar and the 1st molar (Gruop 2), and the 1st molar and the 2nd molar (Group 3) were sectioned and then scanned. After setting the axis of teeth, the cortical bone thickness was measured at the distance of 2 mm, 4mm, 6 mm, and 8 mm from alveolar crest. The mean thickness of cortical bone in the maxilla according to distance from alveolar crest was 1.30 ± 0.63 mm (2 mm), 1.49 ± 0.62 mm (4mm), 1.72 ± 0.64 mm (6mm), and 1.90 ± 0.90 mm (8 mm) at the buccal side and 1.33 ± 0.47 mm, 1.31 ± 0.45 mm, 1.37 ± 0.55 mm, and 1.39 ± 0.58 mm at the palatal side. In the mandible, that was 3.14 ± 1.71 mm, 4.31 ± 2.22 mm, 4.23 ± 1.94 mm, and 4.30 ± 1.57 mm at the buccal side and 1.98 ± 0.88 mm, 2.79 ± 1.01 mm, 3.35 ± 1.27 mm, and 3.93 ± 1.38 mm at the lingual side. The buccal cortical bone thickness in the maxilla was decreased from Group 1 to Group 3, while the thickness of palatal side was no change. In the mandible, it did not show a tendency at the buccal side and it was decreased from Group 1 to Group 3 without significant difference at the lingual side. Therefore, the buccal side of the Group 1 and Group 2 in both the maxilla and mandible seems to be the most appropriate site for a mini-implant placement with taking the stability and retention.

Currently, dental implants are generally used for reconstruction of oromaxillofacial defects. Implants are widely used in dental and medical fields. The materials of implants are variable such as metals and ceramics. The materials of implants must be have not toxicity and biocompatibility to host and mechanical(physical) strength. Bones must be attached to titanium surface without any other tissues. many researcher's had studied for raising the osseointegration through various method which are including implants designs and materials. It was reported over 95% success ratio. many researcher's study the methods which are enhancing the speed of bone remodelling and osseointegration. Thermo dynamic therapy is one of the method to accelerlate the speed of bone remodelling and osseointegration. Thus it raise stability of implants. The purpose of this study was to evaluate the effect of diode laser irradiation for ossoeintegration in implant interface and between the implants threads. 24 New Zealand white rabbits which were about 3kg weight, used for experiment. 2 implant's were implanted every rabbit's tibia. 2 weeks, 4 weeks, 8 weeks after implantation, tissue sample were removed from sacrificed rabbit's tibia. 8 rabbit's were sacrificed every 2, 4, 8 weeks and undecalcified sample were made from tissue sample. We have investigated the undecalcified samples by back scattered electron microscope. We have analysied the length rate and area rate in implant interface and inside the threads. The results were as follows. 2 weeks, 4 weeks, 8 weeks experimental groups which were irradiated low level laser therapy showed rapid bone remodelling than control groups. It was suggested that Initial bone remodelling may be effected by LLLT because of implant bone contact ratio between 4th weeks and 8th weeks had no siginifant difference. Initial bone remodelling may be more influenced than later bone remodelling by LLLT because of new bone formation area ratio between implant threads had no significant differences during 4th to 8th weeks. According to above results, low level laser irradiation accerlate the new bone formation in implant interface and inside the implants threads at initial stage. there were many factors which are increasing the bone remodelling, because there were many differences between experimental and control groups. Low level laser irradiation were helpful for increasing the initial stage of bone remodelling because of above results.

Currently, implants are widely used in dental and medical fields. Especially dental implants are widely used for reconstruction of oral and maxillofacial defects. Many researcher's had studied for raising the osseointegration through various method. It was reported high success rate. Also they study the enhancing the speed of bone remodelling and osseointegration. Low level laser therapy is introduced one of the methods to accelerate the speed of bone remodelling and osseointegration. The purpose of this study was to evaluate the effect of diode laser irradiation about to raise ossoeintegration. Twenty four New Zealand white rabbits which were about 3Kg were used for experiment. Two implants were implanted same side of rabbits tibia. Diode laser was irradiated 1cm diameter, 0.5 watt power, 1 minute duration at periphery of one of implants. Eight rab b its were sacrificed every 2, 4, 8 weeks, made undecalcified sample. We investigated in the undecalcified samples histological and histomorphometrc analysis by light microscope. The results were as follows. 2 weeks, 4 weeks, 8 weeks experimental groups which were showed rapid bone remodelling than control groups. They showed many difference especially in early healing time. Bone Implant contact rate were 47% in 2 weeks experimental group. 28% in 2 weeks control groups, 82% in 4 weeks experimental groups, 62% in 4 weeks control groups, 98% in 8 weeks experimental groups and 84% in 8 weeks control groups then experimental groups show statistically significant difference(p＜0.05). Bone remodelling area rate inside the implant threads were 49% in 2 weeks experimental groups. 31% in 2 weeks control groups, 90% in 4 weeks experimental groups, 82% in 4 weeks control groups, 99% in 8 weeks experimental groups and 97% in 8 weeks control groups then 2,4 weeks experimental groups show statistically significant difference(p＜0.05). Implant-bone contact length rate and bone remodelling area rate were no significant difference of linear regression equation of control and experimental groups then bone remodelling were different at early healing time but there were no differences of time changes. According to above results, one of the low level lasers diode laser irradiation was effected on the volume of new bone formation in implant interface and between the implants threads. Low level laser irradiation were helpful for initial stage of bone remodelling.