임플란트 피개의치에서 지대주와 골의 변형률에 관한 연구
Strains of abutment and bones on implant overdentures
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연구목적: 임플란트 피개의치에서 연결고정형과 비연결고정형 보철물 지대주와 골의 변형률을 비교하고 임플란트 식립 경사에 따른 변형률을 비교 분석하고자 하였다. 연구 재료 및 방법: 2개의 아크릴릭 레진 모형의 좌측과 우측 견치 부위에 2개의 외부연결형 임플란트를 각각의 모형에 식립하였다. 한 모형에는 두 개의 임플란트를 평행하게 식립하였고, 다른 모형에는 순측과 설측으로 10도의 이개도 (divergence)를 가지게 임플란트를 식립하였다. 모형에서 바를 이용한 연결고정형 지대주와 볼을 이용한 비연결고정형 지대주를 고정체에 번갈아 연결하고, 각각의 경우 대응하는 유지장치가 부착된 피개의치를 제작하여 지대주 상에 안착시켰다. 전기저항 스트레인 게이지 (strain gauge)를 이용하여 피개의치에 100 N에서 200 N의 부하를 가하였을 때 지대주와 가상골 표면의 변형률 (strain)을 측정하였다. 결과 및 결론: 측정된 값들을 통계분석하여 얻은 결과는 다음과 같다. 바를 이용한 연결고정형 보철물은 비연결형 보철물 보다 높은 변형률 값을 보였다. 그러나 방향은 주로 압축력이었으며 부하는 분산되었다 (P < .05). 볼을 이용한 비연결고정형 보철물은 연결고정형보다 낮은 변형률 값을 보였다 (P < .05). 순측경사된 임플란트에서는 비연결고정형 보철물이 연결고정형 보철물보다 더 높은 변형률 값을 보였다. 설측경사된 임플란트는 순측경사된 임플란트보다 낮은 변형률을 보였다 (P < .05). 임플란트가 평행하게 식립된 경우보다 평행하지 않게 식립된 경우 지대주와 가상골의 변형률 값이 더 높았다 (P< .05).
Abstract
Statements of the problem: Over the past decades, conventional complete dentures were used for various patients although they have incomplete function. Overdentures using dental implants could help the improvement of denture function. Purpose: The purpose of this study was to compare the strains of abutment and bone on implant overdenture between splinted and unsplinted type of prosthesis. Additionally, the strain values of parallel placed implant model and unparallel placed implant model were compared. Material and methods: Two acrylic resin model were prepared and two implants were placed at the canine positions in each model. In the first model, two implant were placed parallel. In the second model, two implants were placed with 10 degree labiolingual divergence. Two types of abutment were connected to the fixtures alternatively. One was splint type of Hader bar, the other was unsplint type of ball abutment. Overdentures were fabricated with corresponding attachment systems and seated on abutments. Strains of abutments and labial bone simulants were measured with electric resistance strain gauges when static load from 100 N to 200 N were applied to overdentures. Results: 1. Splinted type of overdentures using bar and clip showed higher absolute strain values. But the strain was compressive and the load was shared by two implants (P < .05). 2. Unsplinted type overdentures using ball and O-ring showed low absolute strain values (P < .05). 3. Labially inclined implant showed higher tensile strain values in unsplinted type of prosthesis than in splinted type of prosthesis. Lingually inclined implant showed rather low strain values under load (P < .05). 4. Non parallel implant model showed higher absolute strain values than parallel placed implant model comprehensively (P< .05).
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