금 합금 보철물의 교합면 삭제로 인한 임플란트-골 계면으로의 열전달에 관한 연구
Study of heat transfer to the implant-bone interface induced by grinding of occlusal surface of implant gold prosthesis
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연구 목적: 임플란트-골 계면에서 발생하는 과도한 열은 골유착을 저해하여 임플란트의 실패를 유발한다. 이에 이번 연구에서는 임플란트 금 합금 보철물의 교합면 삭제시 임플란트-골 계면으로의 열전달 양상과 냉각 방식의 효율성을 알아 보고자 하였다. 연구 재료 및 방법: 온도 감지 장치 제작을 위하여 Internal cone 연결형태의 임플란트에 16개의K형 열전대를 부착하여 아크릴릭 레진에 포매하였다. 치과용 금 합금과 주조용 abutment를 사용하여 교합면에 3개의 요철을 가지는 시편을 10개 제작하였고, 연결 나사를 이용하여 임플란트와 연결한 뒤 온도 감지 장치를 37℃로 유지되는 수조에 위치시켰다. 저속 핸드피스와 green stone bur를 이용하여 30초 동안 보철물의 요철을 삭제하였는데, 무냉각군, 공기 냉각 군, 물 분사 냉각 군으로 나누어 요철을 삭제하였다. 보철물이 삭제 되는 동안 임플란트의 부위별로 온도가 0.05초 간격으로 기록되었고, 삭제를 멈춘 뒤에도 무 냉각 군의 경우 임계 온도인 47℃ 이하로 온도가 하강할 때까지, 공기 냉각군과 물 분사 냉각군의 경우 삭제 중단 후 30초 동안 추가로 온도를 기록하였다. 냉각 방식에 따른 임플란트-골 계면의 온도를 알아보고, 임플란트의 부위별 온도변화의 유의차를 알아보기 위하여 one-way ANOVA를 실시하였고, Turkey HSD 이용하여 95% 유의수준에서 사후 검증하였다. 결과: 무 냉각 군은 임플란트-골 계면의 온도가 47℃ 이상으로 상승하였으며, 임플란트의 경부에서 유의하게 높은 열이 측정되었다(P>.05). 공기냉각군과 물분사 냉각군은 임플란트-골 계면의 온도가 47℃ 이하로 유지되었다. 무 냉각 군에서 임플란트 경부의 온도가 47℃에 도달되는 데는 약 10.8 ± 1.5초가 소요되었다. 공기 냉각 군과 물 분사 냉각 군 사이에서는 임플란트-골 계면 온도의 유의차가 없었다(P>.05)결론: 이상의 결과로부터 임플란트 금 합금 보철물의 교합면 삭제 시, 임플란트 주위 조직에 위해를 가할 수 있는 임계 온도 이상의 열이 발생했음을 알 수 있었으며, 냉각방식은 공기 냉각과 물 분사 냉각 모두 효과적이라고 생각된다.
Abstract
Purpose: The purpose of this study was to analyze temperature change along the implant-bone interface induced by grinding the occlusal surface of implant gold prosthesis and to compare the temperature generated by grinding of prosthesis with different cooling methods. Materials and methods: The experimental gold prostheses were fabricated with dental gold alloy and castable abutment. The prostheses had 3 cylindrical protrusions on the occlusal surface with 1mm in height. Temperature was measured using 16 thermocouple wires attached to the implant fixture surface and the fixture was embedded in an acrylic resin block inside the 37℃ water bath. Cylinders were grinded for a period of 30 second with a low-speed handpiece with green stone point. One cylindrical protrusion was grinded without cooling, the second one was grinded with air blow, and the third one was grinded with water-spray. Results: The mean maximum temperature was measured more than 47℃ of the implant and the maximum temperature was measured at the cervical portion of the implant in the group without cooling. There was statistically significant difference between the group without cooling and the groups with cooling (P<.05). However, there was no significant difference at all portion of implant in the groups with cooling (P>.05). Conclusion: The results of this study support that the grinding of implant gold prosthesis without cooling may damage the peri-implant tissue. The continuous use of air blow and water-spray adjacent to prosthesis during the grinding of implant gold prosthesis may prove to be beneficial for cooling of the implant.
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