CAD/CAM을 이용한 맞춤형 임플란트 지대주의 나사 풀림 토크 평가
Evaluation of reverse torque value of abutment screws on CAD/CAM custom-made implant abutments
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연구 목적: 본 연구는 국내 개발된 맞춤형 임플란트 지대주와 기성 임플란트 지대주의 반복 하중 전과 후의 나사 풀림 토크 값을 측정, 비교하여 나사 결합부 안전성에 차이가 있는지를 알아보고자 하였다. 연구 재료 및 방법: 총 12개의 임플란트 고정체(Implantium, Dentium Co., Seoul, Korea)를 알루미늄 원통에 레진으로 고정하고, 그것을 각각 4개씩, 3개의 군으로 나눠서 각 군별로 기성 티타늄 지대주(Implantium, Dentium Co., Seoul, Korea), 캐드캠 맞춤형 티타늄 지대주(Myplant, Raphabio Co., Seoul, Korea), 그리고 금속 연결부가 있는 캐드캠 맞춤형 지르코니아 지대주(Zirconia Myplant, Raphabio Co., Seoul, Korea)를 제작하여 임플란트에 연결하였다. 금속관은 지대주에 맞춰서 티타늄을 밀링해서 제작한뒤 지대주에 합착하였다. 반복 하중을 가하기 전에 지대주 나사를 30 Ncm 토크로 조이고 약 30분 후 나사의 초기 풀림 토크값을 측정하였다. 그 후 반복 하중을 30 N에서 120 N의 싸인 곡선을 이루는 압축력으로 2 Hz의 빈도로 50만 싸이클을 가하고 하중 후 풀림 토크값을 측정하였으며, 풀림 토크 상실률을 구하여서 군끼리 비교하였다. 나사의 풀림 토크값의 상실률의 비교를 위해 Kruskal-Wallis test를 이용해서 유의수준 .05에서 분석하였다. 결과: 반복하중 후 나사 풀림 상실률에서 기성 티타늄 지대주 군에 비해 맞춤형 티타늄 지대주는 높은 값을 보였으나 유의성 있는 차이를 보이지 않았다(P>.05). 반면, 맞춤형 지르코니아 지대주는 기성 티타늄 지대주에 비해 유의하게 높은 값을 보였다(P=.014). 결론: 본 실험의 한계 내에서 캐드캠 맞춤형 티타늄 임플란트 지대주는 기성 임플란트 지대주에 비해 나사 안정성이 떨어진다고 볼 수 없다. 반면, 캐드캠 맞춤형 지르코니아 지대주 는 기성 임플란트 지대주에 비해 나사 안정성이 다소 떨어진다고 볼 수 있다.
Abstract
Purpose: The purpose of this study was to compare the screw joint stability between the CADCAM custom-made implant abutment and the prefabricated implant abutment by measuring the reverse torque value after cyclic loading. Materials and methods: Twelve screw type implants (Implantium, Dentium Co., Seoul, Korea) were embedded in aluminum cylinder with acrylic resin. The implant specimens were equally divided into 3 groups, and connected to the prefabricated titanium abutments (Implantium, Dentium Co., Seoul, Korea), CADCAM custom-made titanium abutments (Myplant, Raphabio Co., Seoul, Korea) and CADCAM custom-made zirconia abutments (Zirconia Myplant, Raphabio Co., Seoul, Korea). The CAD-CAM milled titanium crown (Raphabio Co., Seoul, Korea) was cemented on each implant abutment by resin cement. Before cyclic loading, each abutment screw was tightened to 30 Ncm and the reverse torque value was measured about 30 minutes later. After the crown specimen was subjected to the sinusoidal cyclic loading (30 to 120 N, 500,000 cycles, 2 Hz), postloading reverse torque value was measured and the reverse torque loss ratio was calculated. Kruskal-Wallis test was used for statistical analysis of the reverse torque loss ratio. Results: The CADCAM custom-made titanium abutments presented higher values in reverse torque loss ratio without statistically significant differences than the prefabricated titanium abutments (P>.05). Reverse torque loss ratio of the custom-made zirconia abutments was significantly higher compared to that of the prefabricated titanium abutments (P=.014). Conclusion: Within the limitation of the present in-vitro study, it was concluded that there was no significant difference in screw joint stability between the CADCAM custom-made titanium abutments and the prefabricated titanium abutments. On the other hand, the CADCAM custom-made zirconia abutments showed lower screw joint stability than prefabricated titanium abutments.
참고문헌 (31)
- Branemark PI, "Osseointegration and its experimental background", J Prosthet Dent, 50, pp.399~410 (1983)
- Johns RB, "A multicenter study of overdentures supported by Branemark implants", Int J Oral Maxillofac Implants, 7, pp.513~522 (1992)
- Jemt T, "Osseointegrated implants for single tooth replacement: a 1-year report from a multicenter prospective study", Int J Oral Maxillofac Implants, 6, pp.29~36 (1991)
- Andersson B, "Single-tooth restorations supported by osseointegrated implants: results and experiences from a prospective study after 2 to 3 years", Int J Oral Maxillofac Implants, 10, pp.702~711 (1995)
- Jorne′us L, "Loads and designs of screw joints for single crowns supported by osseointegrated implants", Int J Oral Maxillofac Implants, 7, pp.353~359 (1992)
- Misch CE, "Principles for screw-retained prostheses, In Contemporary implant dentistry" (1999), CV Mosby
- Bickford JH, "An introduction to the design and behavior of bolted joints" (1995), Marcel Dekker
- Jemt T, "Customized titanium single-implant abutments: 2-year follow-up pilot study", Int J Prosthodont, 11, pp.312~316 (1998)
- Sundh A, "A study of the bending resistance of implantsupported reinforced alumina and machined zirconia abutments and copies", Dent Mater, 24, pp.611~617 (2008)
- Wu T, "Design of a custom angled abutment for dental implants using computer-aided design and nonlinear finite element analysis", J Biomech, 43, pp.1941~1946 (2010)
- 김성태, "COMPARISON OF FRACTURE RESISTANCE OF PRESSABLE METAL CERAMIC CUSTOM IMPLANT ABUTMENTS WITH CAD", CAM COMMERCIALLY FABRICATED ZIRCONIA IMPLANT ABUTMENTS, 200904, pp.101, 226~230[DOI]
- Henriksson K, "Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-year follow-up study", Int J Prosthodont, 16, pp.626~630 (2003)
- Lang LA, "Evaluation of the precision of fit between the Procera custom abutment and various implant systems", Int J Oral Maxillofac Implants, 18, pp.652~658 (2003)
- Magne P, "Fatigue resistance and failure mode of CAD", CAM composite resin implant abutments restored with type III composite resin and porcelain veneers, 2011, pp.2, 1275~1281
- Magne P, "Fatigue resistance and failure mode of novel-design anterior single- tooth implant restorations: influence of material selection for type III veneers bonded to zirconia abutments", Clin Oral Implants Res, 22, pp.195~200 (2011)
- Kreissl ME, "Technical complications of implant-supported fixed partial dentures in partially edentulous cases after an average observation period of 5 years", Clin Oral Implants Res, 18, pp.720~726 (2007)
- Haack JE, "Elongation and preload stress in dental implant abutment screws", Int J Oral Maxillofac Implants, 10, pp.529~536 (1995)
- Martin WC, "Implant abutment screw rotations and preloads for four different screw materials and surfaces", J Prosthet Dent, 86, pp.24~32 (2001)
- Cibirka RM, "Examination of the implant-abutment interface after fatigue testing", J Prosthet Dent, 85, pp.268~275 (2001)
- Breeding LC, "Torque required to loosen single-tooth implant abutment screws before and after simulated function", Int J Prosthodont, 6, pp.435~439 (1993)
- Dixon DL, "Comparison of screw loosening, rotation, and deflection among three implant designs", J Prosthet Dent, 74, pp.270~278 (1995)
- Carlsson GE, "Functional response, In Tissue integrated prostheses. Osseointegration in clinical dentistry", pp.74~78 (1986), Quintessence
- Bates JF, "Masticatory function - a review of the literature. III. Masticatory performance and efficiency", J Oral Rehabil, 3, pp.57~67 (1976)
- Richter EJ, "In vivo vertical forces on implants", Int J Oral Maxillofac Implants, 10, pp.99~108 (1995)
- Mericske-Stern R, "In vivo measurements of some functional aspects with mandibular fixed prostheses supported by implants", Clin Oral Implants Res, 7, pp.153~161 (1996)
- Patterson EA, "Theoretical analysis of the fatigue life of fixture screws in osseointegrated dental implants", Int J Oral Maxillofac Implants, 7, pp.26~33 (1992)
- Jaarda MJ, "Effect of preload torque on the ultimate tensile strength of implant prosthetic retaining screws", Implant Dent, 3, pp.17~21 (1994)
- Mitrani R, "Accuracy of electronic implant torque controllers following time in clinical service", Int J Oral Maxillofac Implants, 16, pp.394~399 (2001)
- Cantwell A, "Preload loss in gold prosthesis-retaining screws as a function of time", Int J Oral Maxillofac Implants, 19, pp.124~132 (2004)
- Gutierrez J, "Accuracy of the implant torque wrench following time in clinical service", Int J Prosthodont, 10, pp.562~567 (1997)
- Kim DG, "Comparison of accuracy of implant torque controllers", J Korean Acad Stomatognathic Func Occl, 24(2), pp.157~168 (2008), 대한턱관절교합학회