내부연결 임플란트 상부구조물에서 나사조임술식이 풀림토크값에 미치는 영향
The effect of screw tightening techniques on the detorque value in internal connection implant superstructure
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
연구 목적: 본 연구는 잘 맞는 임플란트 상부구조물에서 서로 다른 나사조임순서와 조임방법이 나사의 풀림토크값에 미치는 영향을 평가하였다. 연구 재료 및 방법: 서로 수동적 적합 관계를 갖는 완전 무치악 하악 주모형과 네 개의 평행한 임플란트 (Astra Tech)에 직접 연결되는 금속구조물을 제작하였다. 금속구조물과 잘 맞는 실험모형을 위해 주모형에서 연결인상법을 이용하여 여섯 개의 경석고 모형을 얻었다. 20 Ncm로 조인 후 나사의 풀림토크값을 두 번 측정하였다. 세 가지 나사 조임순서 (1-2-3-4, 2-4-3-1, 그리고 2-3-1-4)와 두 가지 나사조임방법 (two-step과 one-step)에 대한 나사의 풀림토크값과 최소풀림토크값을 유의수준 .05에서 각각 다원분산분석법 (multi-way ANOVA)과 이원분산분석법 (two-way ANOVA)을 이용하여 통계분석 하였다. 결과: 나사조임순서에 대한 나사의 평균 풀림토크값은 12.8 Ncm (2-4-3-1)에서 13.1 Ncm (2-3-1-4)의 값을 보였고, 나사조임방법에 대한 값은 13.1 Ncm (two-step)와 11.8 Ncm (one-step)였다. 나사조임순서에 대한 나사의 평균 최소풀림토크값은 11.1 Ncm (1-2-3-4)와 11.2 Ncm (2-4-3-1과 2-3-1-4)였고, 나사조임방법에 대한 값은 11.2 Ncm (two-step)와 9.9 Ncm (one-step)였다. 나사의 풀림토크값과 최소풀림토크값은 세 가지 나사조임순서 간에 통계학적으로 유의성 있는 차이가 없었다. 그러나 두 가지 나사조임방법 간에는 두 값 모두 통계학적으로 유의성 있는 차이가 있었다. 나사를 두 단계로 나누어 조이는 방법이 한 번에 조이는 방법보다 더 큰 풀림토크값 (P = .0003)과 더 큰 최소풀림토크 값 (P= .0035)을 보였다. 결론: 본 연구와 같은 조건하에서, 연결인상법으로 얻은 잘 맞는 임플란트 상부구조물에 있어서 나사조임순서는 나사의 풀림토크값에 영향을 미치는 중요한 요소는 아니었다. 그러나 나사를 두 단계로 나누어 조이는 방법은 한 번에 조이는 방법보다 더 큰 풀림토크값을 보였다.
Abstract
Purpose: This study evaluated the effect of different screw tightening sequences and methods on detorque values in a well-fitting implant superstructure. Materials and methods: A fully edentulous mandibular master model and a metal framework directly connected to four parallel implants (Astra Tech) with a passive fit to each other were fabricated. Six stone casts were made with a splinted impression technique to represent a‘ well-fitting’situation with the metal framework. Detorque values were measured twice after screw tightening using 20 Ncm. Detorque values and minimum detorque values for three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and for two tightening methods (two-step and one-step) were analyzed using multi-way analysis of variance and two-way analysis of variance, respectively, at a .05 level of significance. Results: The mean detorque values for screw tightening sequences ranged from 12.8 Ncm (2-4-3-1) to 13.1 Ncm (2-3-1-4), and for screw tightening methods were 13.1 Ncm (two-step) and 11.8 Ncm (one-step). The mean of mimimum detorque values for screw tightening sequences were 11.1 Ncm (1-2-3-4) and 11.2 Ncm (2-4-3-1 and 2-3-1-4), and for screw tightening methods were 11.2 Ncm (two-step) and 9.9 Ncm (one-step). No statistically significant differences among three screw tightening sequences were found for detorque values and for mimimum detorque values. But, statistically significant differences between two screw tightening methods were found for two values. Two-step screw tightening method showed higher detorque value (P = .0003) and higher minimum detorque value (P = .0035) than one-step method. Conclusion: Within the limitations of this study, the screw tightening sequence was not a critical factor for the detorque values in a well-fitting implant superstructure by the splinted impression technique. But, two-step screw tightening method showed greater detorque values than one-step method.
참고문헌 (40)
- Kallus T, "Loose gold screws frequently occur in fullarch fixed prostheses supported by osseointegrated implants after 5 years", Int J Oral Maxillofac Implants, 9, pp.169~178 (1994)
- Zarb GA, "The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto study. Part III: Problems and complications encountered", J Prosthet Dent, 64, pp.185~194 (1990)
- Lekholm U, "Osseointegrated implants in the treatment of partially edentulous jaws: A prospective 5-year multicenter study", Int J Oral Maxillofac Implants, 9, pp.627~635 (1994)
- Wyatt CC, "Treatment outcomes of patients with implantsupported fixed partial prostheses", Int J Oral Maxillofac Implants, 13, pp.204~211 (1998)
- Wennerberg A, "Complications in partially edentulous implant patients: a 5-year retrospective follow-up study of 133 patients supplied with unilateral maxillary prostheses", Clin Implant Dent Relat Res, 1, pp.49~56 (1999)
- Ortorp A, "Clinical experiences of implant-supported prostheses with laser-welded titanium frameworks in the partially edentulous jaw: a 5-year follow-up study", Clin Implant Dent Relat Res, 1, pp.84~91 (1999)
- Hosny M, "Within-subject comparison between connected and nonconnected tooth-to-implant fixed partial prostheses: up to 14-year follow-up study", Int J Prosthodont, 13, pp.340~346 (2000)
- Behneke A, "The longitudinal clinical effectiveness of ITI solid-screw implants in partially edentulous patients: a 5-year follow-up report", Int J Oral Maxillofac Implants, 15, pp.633~645 (2000)
- Brägger U, "Biological and technical complications and failures with fixed partial dentures (FPD) on implants and teeth after four to five years of function", Clin Oral Implants Res, 12, pp.26~34 (2001)
- Gotfredsen K, "A prospective 5-year study of fixed partial prostheses supported by implants with machined and TiO2-blasted surface", J Prosthodont, 10, pp.2~7 (2001)
- Jemt T, "Implant-supported laser-welded titanium and conventional cast frameworks in the partially edentulous law: a 5-year prospective multicenter study", Int J Prosthodont, 16, pp.415~421 (2003)
- Andersson B, "Ceramic implant abutments for short-span FPDs: a prospective 5-year multicenter study", Int J Prosthodont, 16, pp.640~646 (2003)
- Preiskel HW, "Cement- and screw-retained implantsupported prostheses: up to 10 years of follow-up of a new design", Int J Oral Maxillofac Implants, 19, pp.87~91 (2004)
- Pjetursson BE, "A systematic review of the survival and complication rates of fixed partial dentures (FPDs) after an observation period of at least 5 years", Clin Oral Implants Res, 15, pp.625~642 (2004)
- 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)
- Carr AB, "Effects of fabrication, finishing, and polishing procedures on preload in prostheses using conventional ‘gold’and plastic cylinders", Int J Oral Maxillofac Implants, 11, pp.589~598 (1996)
- Sakaguchi RL, "Nonlinear finite element contact analysis of dental implant components", Int J Oral Maxillofac Implants, 8, pp.655~661 (1993)
- Sakaguchi RL, "Nonlinear contact analysis of preload in dental implant screws", Int J Oral Maxillofac Implants, 10, pp.295~302 (1995)
- 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)
- Watanabe F, "Analysis of stress distribution in a screw-retained implant prosthesis", Int J Oral Maxillofac Implants, 15, pp.209~218 (2000)
- Duyck J, "Pre-load on oral implants after screw tightening fixed full prostheses: an in vivo study", J Oral Rehabil, 28, pp.226~233 (2001)
- Nissan J, "Stress levels for well-fitting implant superstructures as a function of tightening force levels, tightening sequence, and different operators", J Prosthet Dent, 86, pp.20~23 (2001)
- 최정한, "임플랜트 지지 상부구조물에서 나사조임순서와 조임방법이 풀림토크값에 미치는 영향", 대한치과보철학회지, 45(5), pp.653~664 (2007), 대한치과보철학회
- Mojon P, "Polymerization shrinkage of index and pattern acrylic resins", J Prosthet Dent, 64, pp.684~688 (1990)
- Assif D, "A modified impression technique for implant-supported restoration", J Prosthet Dent, 71, pp.589~591 (1994)
- Pagniano RP, "Linear dimensional change of acrylic resins used in the fabrication of custom trays", J Prosthet Dent, 47, pp.279~283 (1982)
- Goldfogel M, "Dimensional change of acrylic resin tray materials", J Prosthet Dent, 54, pp.284~286 (1985)
- Davis GB, "The bonding properties of elastomer tray adhesives", J Prosthet Dent, 36, pp.278~285 (1976)
- "Revised American Dental Association Specification no. 19 for Nonaqueous, Elastomeric Dental Impression Materials", J Am Dent Assoc, 94, pp.733~741 (1977)
- Hobo S IE, "Chapter 9 Fully bone anchored prostheses. Osseointegration and occlusal rehabilitation", pp.163~186 (1989), Quintessence
- Jemt T, "Failures and complications in 391 consecutively inserted fixed prostheses supported by Braånemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup", Int J Oral Maxillofac Implants, 6, pp.270~276 (1991)
- Burguete RL, "Tightening characteristics for screwed joints in osseointegrated dental implants", J Prosthet Dent, 71, pp.592~599 (1994)
- Dixon DL, "Comparison of screw loosening, rotation, and deflection among three implant designs", J Prosthet Dent, 74, pp.270~278 (1995)
- Schulte JK, "Comparison of screw retention of nine abutment systems: a pilot study", Implant Dent, 6, pp.28~31 (1997)
- Jaarda MJ, "Providing optimum torque to implant prostheses: a pilot study", Implant Dent, 2, pp.50~52 (1993)
- 김남건, "The effect of abutment height on screw loosening in single implant-supported prostheses after dynamic cyclic loading", 대한치과보철학회지, 42(6), pp.664~670 (2004), 대한치과보철학회
- Norton MR, "An in vitro evaluation of the strength of an internal conical interface compared to a butt joint interface in implant design", Clin Oral Implants Res, 8, pp.290~298 (1997)
- Merz BR, "Mechanics of the implant-abutment connection: an 8-degree taper compared to a butt joint connection", Int J Oral Maxillofac Implants, 15, pp.519~526 (2000)