하악 편측 유리단 가철성 국소의치의 설계에 따른 광탄성 응력 분석
Photoelastic stress analysis of the mandibular unilateral free-end removable partial dentures according to the design
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연구목적: 하악 우측 제1, 2 대구치가 결손된 Kennedy 분류 Ⅱ급 증례에서 임상적으로 적용할 수 있는 편측 유리단 가철성 국소의치의 종류에 따른 응력 분포양상을 비교하는 것이다. 연구 재료 및 방법: Kennedy 분류 Ⅱ급 증례의 광탄성 모형에서 클라스프를 이용한 국소의치, 코너스 치관을 이용한 국소의치, 완압형 어태치먼트를 이용한 국소의치, 탄성 레진을 이용한 국소의치를 편측성으로 제작하였다. 응력 동결로에서 응력 주기에 맞춰 각 국소의치의 제1 대구치 중심와에 6 kg의 수직하중을 가하면서 응력을 동결하였다. 광탄성 모형을 절단하여 만든 시편을 광탄성 실험 장치로 광탄성 등색선의 흑백 무늬를 관찰하고 디지털 카메라로 촬영하였다. 촬영된 사진에서 8개의 측정점을 정하여 육안으로 무늬차수를 계측하고 비교하였다. 결과: 각 절단 시편의 최대 무늬차수와 하중점 직하방의 잔존 치조제에 발생한 무늬차수는 탄성 레진을 이용한 국소의치, 클라스프를 이용한 국소의치, 완압형 어태치먼트를 이용한 국소의치, 코너스 치관을 이용한 국소의치 순으로 높게 관찰되었다. 제2 소구치 치근단에 발생한 무늬차수는 클라스프를 이용한 국소의치, 탄성 레진을 이용한 국소의치, 코너스 치관을 이용한 국소의치, 완압형 어태치먼트를 이용한 국소의치 순으로 높게 관찰되었다. 결론: 코너스 치관을 이용한 국소의치가 수직하중시 지대치 주위 치조골과 잔존 치조제에 대하여 응력을 가장 균형있게 분산시켰고, 탄성 레진을 이용한 국소의치는 지대치보다 잔존 치조제의 상태가 더 양호한 경우에 적용 가능할 것이다.
Abstract
Statement of problem: There are common clinical cases in which the mandibular first and second molars are missing unilaterally. Purpose: This study was designed to compare and evaluate the magnitude and distribution of stress produced by four kinds of mandibular unilateral free-end removable partial dentures that could be applied clinically in Kennedy classⅡcases. Material and methods: Four unilateral free-end removable partial dentures using clasp, Konus crown, resilient attachment, and flexible resin were fabricated on the photoelastic models of the Kennedy class Ⅱ cases. The vertical load of 6㎏ was applied on the central fossa of the first molar of every removable partial denture in the stress freezing furnace and the photoelastic models were frozen according to the stress freezing cycle. After these models were sliced mesio-distally to a thickness of 6mm, the photoelastic isochromatic white and black lines of the sliced specimens were examined with the transparent photoelastic experiment device and photographs were taken with a digital camera. The fringe order numbers at eight measuring points in the photograph were measured with the naked eye. Results: The maximum fringe order number of each sliced specimen and the fringe order number at the residual ridge just below the loading point were in the decreasing order of the unilateral removable partial dentures using flexible resin followed by clasp, resilient attachment, and Konus crown. The fringe order number at the root apex of the second premolar was in the decreasing order of the unilateral removable partial dentures using clasp followed by flexible resin, Konus crown, and resilient attachment. Conclusion: The removable partial denture using Konus crown showed the most equalized stress distribution to the supporting alveolar bone of abutment teeth and residual ridge under the vertical loads. The removable partial denture using flexible resin can be applied to the case that has a better state of residual ridge than abutment teeth.
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