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External vs internal connection implant system (External vs internal implant : 각각의 장점과 고려사항)

  • Seong, Dong-Jae;Hong, Seoung-Jin;Ha, Seung-Ryong
    • The journal of the Korean dental association
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    • v.54 no.3
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    • pp.184-190
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    • 2016
  • The osseointegration of titanium implants has been examined over the past 50 years. Many implant systems have been introduced and have become popular to the implant dentistry. The designs of the connection between implant fixture and abutment are divided into external vs internal connection. From beginning, the $Br{\aa}nemark$ system was characterized by an external hexagon. Internal connection has been developed to reduce stress transferred to the bone. These differences may have impact on the clinical procedures and protocols, laboratory and components costs, and incidence of complications. Therefore, the clinician has to know the different biomechanical features and understand their implications to produce successful implant-supported prosthesis with an external or an internal connection system.

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EFFECT OF CASTING PROCEDURE ON SCREW LOOSENING OF UCLA ABUTMENT IN TWO IMPLANT-ABUTMENT CONNECTION SYSTEMS

  • Ha, Chun-Yeo;Kim, Chang-Whe;Lim, Young-Jun;Kim, Myung-Joo
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.3
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    • pp.246-254
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    • 2008
  • STATEMENT OF PROBLEM: The cast abutment has advantages of overcoming angulation problem and esthetic problem. However, when a gold-machined UCLA abutment undergoes casting, the abutment surfaces in contact with the implant may change. PURPOSE: The purpose of this study was to compare the detorque values of prefabricated machined abutments with gold-premachined cast-on UCLA abutments before and after casting in two types of internal implant-abutment connection systems: (1) internal hexagonal joint, (2) internal octagonal joint. Furthermore, the detorque values of two implant-abutment connection systems were compared. MATERIALS AND METHODS: Twenty internal hexagonal implants with an 11-degree taper and twenty internal octagonal implants with an 8-degree taper were acquired. Ten prefabricated titanium abutments and ten gold-premachined UCLA abutments were used for each systems. Each abutment was torqued to 30 N㎝ according to the manufacturer's instructions and detorque value was recorded. The detorque values were measured once more, after casting with gold alloy for UCLA abutment, and preparation for titanium abutments. Group means were calculated and compared using independent t-test and paired t-test (${\alpha}$=0.05). RESULTS: The results were as follows: 1. The detorque values between titanium abutments and UCLA-type abutments showed significant differences in internal octagonal implants (P<0.05), not in internal hexagonal implants (P>0.05). 2. In comparison of internal hexagonal and octagonal implants, the detorque values of titanium abutments had significant differences between two connection systems on the initial analysis (P<0.05), not on the second analysis (P>0.05) and the detorque values of UCLA-type abutments were not significantly different between two connection systems (P>0.05). 3. The detorque values of titanium abutments and UCLA-type abutments decreased significantly on the second analysis than the initial analysis in internal hexagonal implants (P<0.05), not in internal octagonal implants (P>0.05). CONCLUSION: Casting procedures of UCLA-type abutments had no significant effect on screw loosening in internal implant-abutment connection systems, and UCLA-type abutments showed higher detorque values than titanium abutments in internal octagonal implants.

THE INFLUENCE OF IMPLANT FIXTURE-ABUTMENT CONNECTION DESIGN ON SCREW LOOSENING (임플랜트 지대주에 따른 나사 풀림의 연구)

  • Mun Yang-Suk;Park Sang-Won;Vang Mong-Sook;Yang Hong-So;Park Ha-Ok
    • The Journal of Korean Academy of Prosthodontics
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    • v.44 no.2
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    • pp.174-184
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    • 2006
  • Purpose: Current trend in implant dentistry is changing from external connection to internal connection. To evaluate the splinting of external and internal connection implant on screw loosening, 2-units prosthesis was fabricated with BioPlant $System^(R)$ of external connection type and Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. Material and Method: Experimental group is classified into three groups. 1) $G_1-EE$: 2-units prosthesis was fabricated with two Bioplant $System^(R)$ of external connection type. 2) $G_1-EI$: 2-units prosthesis was fabricated with one BioPlant $System^(R)$ of external connection type and one Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. 3) $G_1-II$: 2-units prosthesis was fabricated with two Lifecore STAGE-1 Single Stage Implant $System^(R)$ of internal connection type. In fabricating 2-units prosthesis, two hexed abutments are recommended when two implants are installed parallel, otherwise one hexed abutment is used on major occlusal force area and one nonhexed abutment is used on the other area. Since it is rare to find two implants being parallel, it is hard to fabricate prosthesis with passive adaptation using two hexed abutments. It is much more difficult to acquire passive adaptation when using hex abutment compared to nonhex abutment. To evaluate the influence of hexed and nonhexed abutment on screw loosening, 2-units prosthesis was fabricated with hexed and nonhexed abutment. Experimental group is classified into three groups. 1) $G_2-HH$: 2-units prosthesis was fabricated with two hexed abutments. 2) $G_2-HN$: 2-units prosthesis was fabricated with one hexed abutment and one nonhexed abutment. 3) $G_2-NN$: 2-units prosthesis was fabricated with two nonhexed abutments. Result: The results of comparing the detorque value after loading on a each prosthesis periodically are as follows. 1. In splinting group of external and internal connection implant, $G_1-II$ group demonstrated the biggest detorque value, followed by $G_1-EI$ group and $G_1-EE$ group. 2. There is no notable significance between external connection implant of $G_1-EI$ group and $G_1-EE$ group and also no significance between internal connection implant of $G_1-EI$ group and $G_1-II$ group. 3. $G_2-HH$ group showed higher detorque value than $G_2-HN\;and\;G_2-NN$ group. From the results, we can concluded that using both external connection and internal connection implant together is clinically acceptable and in order to acquire a good passive adaptation in fabricating 2-units implant prosthesis we can use two nonhexed abutments.

Comparison of fit accuracy and torque maintenance of zirconia and titanium abutments for internal tri-channel and external-hex implant connections

  • Siadat, Hakimeh;Beyabanaki, Elaheh;Mousavi, Niloufar;Alikhasi, Marzieh
    • The Journal of Advanced Prosthodontics
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    • v.9 no.4
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    • pp.271-277
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    • 2017
  • PURPOSE. This in vitro study aimed to evaluate the effect of implant connection design (external vs. internal) on the fit discrepancy and torque loss of zirconia and titanium abutments. MATERIALS AND METHODS. Two regular platform dental implants, one with external connection ($Br{\aa}nemark$, Nobel Biocare AB) and the other with internal connection (Noble Replace, Nobel Biocare AB), were selected. Seven titanium and seven customized zirconia abutments were used for each connection design. Measurements of geometry, marginal discrepancy, and rotational freedom were done using video measuring machine. To measure the torque loss, each abutment was torqued to 35 Ncm and then opened by means of a digital torque wrench. Data were analyzed with two-way ANOVA and t-test at ${\alpha}=0.05$ of significance. RESULTS. There were significant differences in the geometrical measurements and rotational freedom between abutments of two connection groups (P<.001). Also, the results showed significant differences between titanium abutments of internal and external connection implants in terms of rotational freedom (P<.001). Not only customized internal abutments but also customized external abutments did not have the exact geometry of prefabricated abutments (P<.001). However, neither connection type (P=.15) nor abutment material (P=.38) affected torque loss. CONCLUSION. Abutments with internal connection showed less rotational freedom. However, better marginal fit was observed in externally connected abutments. Also, customized abutments with either connection could not duplicate the exact geometry of their corresponding prefabricated abutment. However, neither abutment connection nor material affected torque loss values.

Tensile Strength and Concrete Cone failure in CFT Connection with Internal Diaphragms

  • Kim, Sun-Hee;Choi, Sung-Mo
    • International journal of steel structures
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    • v.17 no.2
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    • pp.643-652
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    • 2017
  • Concrete filled tube (CFT) system provides excellent structural performance thanks to the composite effect between the tube and the concrete. However, its closed sections impose complication on the fabrication of the column-to-beam connection and only a small number of connection methods have been developed. In square CFT column-to-beam connections, internal diaphragms reinforce the inside of the column for the loads and moments delivered from the beam. It is required to develop various connection types to secure structural capacity and concrete filling. In the process of making the square Hollow steel section (HSS), diaphragms are placed in channel members in advance and then the two channel members are welded longitudinally to produce a square HSS. It is superior to other connection types in terms of the degree of Complication in placing the internal diaphragms, economical efficiency and workability. In this study, strength formulas were suggested based on the yield line theory to evaluate the load capacity of the column-to-beam connections. For the connection of horizontal diaphragms, the strength of steel tube faces, internal diaphragms, and concrete cone failure were accumulated. For the connection of vertical perforated plates, the strength of steel tube faces, concrete cone failure, and perfobond were accumulated. Although there was a slight difference between the formula and test result, it can be used to estimate the strength of column-to-beam connections.

Splinted and non-splinted implant-supported restorations : prosthetic considerations for restoring multiple adjacent teeth (Splinted or Non-splinted: 다수의 인접한 치아 결손부 수복을 위한 임플란트 보철)

  • Yoon, Hyung-In
    • The journal of the Korean dental association
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    • v.54 no.3
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    • pp.198-205
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    • 2016
  • The purpose of this paper was to investigate the significance of splinted and non-splinted implant-supported restorations with an internal connection for multiple consecutively missing teeth. Upon examination of the effects of fixture-abutment connection, the distribution of occlusal load was favorable in splinted implant-prosthesis with an external connection, but effect of strain distribution was not significant in splinted implant-prosthesis with an internal connection. In splinted implant-prostheses for short implants, strain distribution was not affected by the method of retention. For cement-retained prostheses, the effect of strain distribution due to splinting was not significant. In clinical studies, non-splinted prostheses with an internal connection for multiple consecutively missing teeth showed high survival rate, mild marginal bone loss, and stable periodontal condition. However, failure to achieve optimal proximal contact between single-unit prostheses may lead to food impaction, and veneer fracture may be inevitable when the framework provides inadequate support in the proximal region. In conclusion, splinted implant-prosthesis is not an indication in all cases, and clinical consideration of its use should be based on the patient's oral condition, such as location and number of implants, formation of proximal contact, canine guidance, existence of parafunctional habit, and oral hygiene, when multiple consecutively missing teeth are replaced by internal connection type implant.

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Influence of the implant-abutment connection design and diameter on the screw joint stability

  • Shin, Hyon-Mo;Huh, Jung-Bo;Yun, Mi-Jeong;Jeon, Young-Chan;Chang, Brian Myung;Jeong, Chang-Mo
    • The Journal of Advanced Prosthodontics
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    • v.6 no.2
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    • pp.126-132
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    • 2014
  • PURPOSE. This study was conducted to evaluate the influence of the implant-abutment connection design and diameter on the screw joint stability. MATERIALS AND METHODS. Regular and wide-diameter implant systems with three different joint connection designs: an external butt joint, a one-stage internal cone, and a two-stage internal cone were divided into seven groups (n=5, in each group). The initial removal torque values of the abutment screw were measured with a digital torque gauge. The postload removal torque values were measured after 100,000 cycles of a 150 N and a 10 Hz cyclic load had been applied. Subsequently, the rates of the initial and postload removal torque losses were calculated to evaluate the effect of the joint connection design and diameter on the screw joint stability. Each group was compared using Kruskal-Wallis test and Mann-Whitney U test as post-hoc test (${\alpha}$=0.05). RESULTS. The postload removal torque value was high in the following order with regard to magnitude: two-stage internal cone, one-stage internal cone, and external butt joint systems. In the regular-diameter group, the external butt joint and one-stage internal cone systems showed lower postload removal torque loss rates than the two-stage internal cone system. In the wide-diameter group, the external butt joint system showed a lower loss rate than the one-stage internal cone and two-stage internal cone systems. In the two-stage internal cone system, the wide-diameter group showed a significantly lower loss rate than the regular-diameter group (P<.05). CONCLUSION. The results of this study showed that the external butt joint was more advantageous than the internal cone in terms of the postload removal torque loss. For the difference in the implant diameter, a wide diameter was more advantageous in terms of the torque loss rate.

Influence of internal connection length on screw loosening in internal connection implants (내측 연결 임플란트에서 지대주 내부길이가 나사 풀림에 미치는 영향)

  • Kim, Ji-Sun;Park, Young-Bum;Choi, Hynmin;Kim, Sungtae;Kim, Hyeon Cheol;Kim, Sun Jai;Moon, Hong-Seok;Lee, Jae-Hoon
    • The Journal of Korean Academy of Prosthodontics
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    • v.55 no.3
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    • pp.251-257
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    • 2017
  • Purpose: The purpose of this study was to evaluate whether the internal abutment length affected screw stability in an internal connection implant. Materials and methods: Twenty long internal connection implants (Replus system, $4.7{\times}11.5mm$) were selected for this investigation. Abutments were assigned to four groups depending on the length of the internal connection (abutments with internal lengths of 1, 2, 3, and 4 mm, respectively). Each implant fixture specimen was embedded in resin medium and connected to an abutment with an abutment screw. A load of 100 N, applied at an angle of $30^{\circ}$ to the long axis of the implant, was repeated for $1.0{\times}10^6$ cycles. Reverse torque values (RTV) were recorded before and after loading, and the change in RTV was calculated. Data were analyzed with the Kruskal-Wallis test. Results: The change in RTV was not significantly different among the groups (P>.05). Screw loosening and fractures were not observed in any groups, and joint stability was maintained. Conclusion: The internal length of the abutment may not significantly affect the degree of screw loosening.

THE ASSESSMENT OF ABUTMENT SCREW STABILITY BETWEEN THE EXTERNAL AND INTERNAL HEXAGONAL JOINT UNDER CYCLIC LOADING

  • Lee, Tae-Sik;Han, Jung-Suk;Yang, Jae-Ho;Lee, Jae-Bong;Kim, Sung-Hun
    • The Journal of Korean Academy of Prosthodontics
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    • v.46 no.6
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    • pp.561-568
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    • 2008
  • STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a $30^{\circ}$ inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group $1{\times}10^6$, $5{\times}10^6$ cyclic loading; second group $3{\times}10^6$, $3{\times}10^6$ for a total cyclic loading of $6{\times}10^6$) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with ${\alpha}$=0.05. RESULTS: In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after $1{\tims}10^6$ cyclic loading, and the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was not significant. The difference between the removal torque value after $3{\times}10^6$ cyclic loading and after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after $1{\times}10^6$ cyclic loading was not significant, but the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after $3{\times}10^6$ cyclic loading and the value after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. CONCLUSION: The external hexagonal connection was more stable than the internal hexagonal connection after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after $3{\times}10^6$, and additional $3{\times}10^6$ cycles.

A Study on the Joint Element Connection of Joint Element Structure Method (JES 공법의 JOINT ELEMENT 이음부에 관한 연구)

  • 엄기영;박명준
    • Journal of the Korean Society for Railway
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    • v.5 no.3
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    • pp.133-141
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    • 2002
  • Recently developed JES(Joint Element Structure) Method was researched as a more safe and economic method than other under pass construction method and was applied to many construction sites. The joint element connection of JES Method is the most important factor for the to behavior of structure. The connection of JES method is filled with the mortar, and the steel and mortar of connections produce the same behavior as one material. The results of experience and numerical analysis are following: The maximum internal stress of connection is decided by the end of connection. also, The connection of joint element structure method have sufficient internal stress against fatigue.