3본 나사 유지형 임플란트 보철물의 고정 방식에 따른 임플란트 고정체 치경부에 발생하는 변형율 비교분석
Analysis of implant strain value exerted using different screw itghtening protocols in screw-retained 3-unit prostheses
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목적: 본 연구의 목적은 3본 나사 유지형 임플란트 보철물의 나사 고정 방식에 따른 치경부에 발생하는 변형율을 측정하고 비교하기 위함이다. 재료 및 방법: 2가지 종류의 임플란트(외부연결방식, 내부연결방식)를 각각 2개씩 4개 임플란트 고정체 경부에 스트레인 게이지를 부착한 후, 각 종류의 아크릴릭 레진 모형 2개를 제작하였다. CAD-CAM을 이용하여 hex 및 nonhex 지대주를 제작하였고,(EH, ENH, IH& INH 군) 나사-시멘트 유지보철 개념으로 보철물을 비귀금속으로 제작하였다. 각 지대주를 10 Ncm 토크로 고정한 후, 보철물을 합착하였다. 나사를 3가지의 다른 방법으로 30 Ncm까지 고정한 다음, 5분 후 변형율을 측정한 후 평균비교 및 군간 상호작용을 평가하였다 (α = .05). 결과: 외부연결방식 군은 내부연결방식 군에 비하여 유의하게 낮은 변형율을 나타냈으며, EH군이 ENH군보다 유의하게 낮은 변형율을 나타내었으나 (P < .05), 나사 고정 방법에 따른 차이는 없었다 (P > .05). IH군이 INH군에 비하여 유의하게 높은 변형율을 나타내었으며 IH군에서만 나사 고정 방법에 따라서도 차이가 있었다 (P < .05). 결론: 나사 유지형 임플란트 보철물에서는 외부연결방식인 경우에는 큰 영향이 없으나, 내부연결방식에서는 보다 큰 변형율이 발생하고 나사 고정 방법도 영향을 주는 것으로 나타났다.
Abstract
Purpose: The purpose of this study was to measure and compare the strain value exerted on the cervical area using different screw tightening protocols in implant-supported, screw-retained 3-unit prostheses. Materials and methods: Strain gauges were attached to four implants: two external and two internal. Thereafter, two study model were designed each type using acrylic resin. CAD-CAM was used to design hex and nonhex abutments for each group (EH, ENH, IH, and INH group) and Screw-cement-retained prostheses were also designed using a nonprecious base metal. Abutment was fixed with 10 Ncm torque, and the prosthesis was cemented. Screws were fixed with 30 Ncm torque using different three protocols. After 5 min, the strain gauge level was measured, and group analysis was performed (α=.05). Results: External group showed significantly lower strain values than internal group and the EH group showed significantly lower strain values than the ENH group (P<.05). There was no difference in strain value based on the types of screw tightening protocols in same group (P>.05). The IH group exhibited significantly higher strain values than the INH group and the IH group showed a significant difference in strain values based on the types of screw tightening protocols used (P<.05). Conclusion: There was no significant effect on the external type in the implant-supported, screw-retained prostheses. However, strain values were high in the internal type, and the types of screw tightening protocol significantly affected these implants.
참고문헌 (24)
- Li J, "Mechanical aspects of dental implants and osseointegration: A narrative review", J Mech Behav Biomed Mater, 103, pp.103574~ (2020)
- Nishioka RS, "Machined and plastic copings in three-element prostheses with different types of implant-abutment joints: a strain gauge comparative analysis", J Appl Oral Sci, 18, pp.225~230 (2010)
- de Vasconcellos LG, "Axial loads on implant-supported partial fixed prostheses for external and internal hex connections and machined and plastic copings: strain gauge analysis", J Oral Implantol, 41, pp.149~154 (2015)
- Asvanund P, "A strain gauge analysis comparing external and internal implant-abutment connections", Implant Dent, 23, pp.206~211 (2014)
- Albrektsson T, "Is marginal bone loss around oral implants the result of a provoked foreign body reaction?", Clin Implant Dent Relat Res, 16, pp.155~165 (2014)
- Nishioka RS, "External hexagon and internal hexagon in straight and offset implant placement: strain gauge analysis", Implant Dent, 18, pp.512~520 (2009)
- Nissan J, "Stress levels for wellfitting implant superstructures as a function of tightening force levels, tightening sequence, and different operators", J Prosth Dent, 86, pp.20~23 (2001)
- Watanabe F, "Analysis of stress distribution in a screw-retained implant prosthesis", Int J Oral Maxillofac Implants, 15, pp.209~218 (2000)
- Al Quran FA, "Passive fit and accuracy of three dental implant impression techniques", Quintessence Int, 43, pp.119~125 (2012)
- Luk HW, "A double casting technique to minimize distortion when constructing fixed partial dentures on implants", J Prosth Dent, 91, pp.93~96 (2004)
- Karl M, "Strain development of screw-retained implant-supported fixed restorations: procera implant bridge versus conventionally cast restorations", Int J Prosthodont, 25, pp.166~169 (2012)
- Misch CE, "Dental implant prosthetics", pp.747~ (2014), CV Mosby
- Maeda Y, "In vitro differences of stress concentrations for internal and external hex implant-abutment connections: a short communication", J Oral Rehabil, 33, pp.75~78 (2006)
- Heckmann SM, "Cement fixation and screw retention: parameters of passive fit. An in vitro study of three-unit implant-supported fixed partial dentures", Clin Oral Implants Res, 15, pp.466~473 (2004)
- Karl M, "Bone adaptation induced by non-passively fitting implant superstructures: A randomized clinical trial", Int J Oral Maxillofac Implants, 31, pp.369~375 (2016)
- 임소민, "임플란트 나사에 적용되는 생역학적 원리: 문헌고찰", 대한치과보철학회지, 48(01), pp.61~68 (2010), 대한치과보철학회[DOI]
- Huang Y, "Mechanism of and factors associated with the loosening of the implant abutment screw: A review", J Esthet Restor Dent, 31, pp.338~345 (2019)
- Matsuzaki M, "A comparison of the peri-implant bone stress generated by the preload with screw tightening between ‘bonded’ and ‘contact’ model", Comput Methods Biomech Biomed Engin, 20, pp.393~402 (2017)
- Al-Otaibi HN, "The effects of two torque values on the screw preload of implant-supported prostheses with passive fit or misfit", Int J Oral Maxillofac Implants, 29, pp.1058~1063 (2014)
- Wentaschek S, "Preload, coefficient of friction, and thread friction in an implant-abutment-screw complex", Int J Prosthodont, 30, pp.542~544 (2017)
- Rutkunas V, "Clinical and laboratory passive fit assessment of implant‐supported zirconia restorations fabricated using conventional and digital workflow", Clin Implant Dent Relat Res, 22, pp.237~245 (2020)
- Siamos G, "Relationship between implant preload and screw loosening on implant-supported prostheses", J Oral Implantol, 28, pp.67~73 (2002)
- Zipprich H, "Effects of screw configuration on the preload force of implant-abutment screws", Int J Oral Maxillofac Implants, 33, pp.e25~e32 (2018)
- Lee JH, "Axial displacement of internal conical connection abutments under static load", MS, pp.2019