임플란트 식립체 제거법에 대한 고찰
Different Techniques for Dental Implant Fixture Removal; a Review
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초록
임플란트는 지난 40여년 간 치의학에서 매우 중요한 상실치 수복을 위한 방법으로 사용되어져 왔다. 하지만 치과의사들은 기존의 보철에 의한 수복법이 그러했듯 다양한 이유로 인해 제거를 할 수 밖에 없는 상황이 초래되기도 함을 경험해왔다. 식립한 임플란트를 제거하는 이유는 다음과 같다. 첫 번째, osseointegration이 소실된 경우이다. 두 번째, 임플란트가 잘못된 위치에 식립된 경우이다. 세 번째, 치아 교정 과정에서 치아에 이동력을 가하기 위해 mini-screw를 식립하였다가 교정치료가 완료되고 이를 제거하는 경우이다. 네 번째, 생역학적 요인에 의해 임플란트에 유해한 힘이 가해지는 경우이다. 임플란트 제거가 필요할 경우 다양한 방법을 사용할 수 있다. 시중에 판매되고 있는 다양한 임플란트 제거 키트가 채택하고 있는 high torque wrench technique 외에도 fixture split technique, peizosurgery, bur-forceps technique, trephine drill technique, laser 등을 적용하여 임플란트 식립체 제거가 가능하다. 임플란트 식립체 제거 후 치아 상실부위의 재수복이 용이하도록 치조골을 최대한 보존하고 술 후 합병증을 최소화할 필요가 있기 때문에 임플란트 식립체 제거는 가장 비침습적이고 보존적인 방향으로 시행되어야 한다. 때문에 치과의사는 임플란트 제거를 요하는 상황과 그 제거법에 대해 숙지하고 있을 필요가 있다.
Abstract
The use of dental implants to restore edentulous spaces has grown popular since it was introduced in dentistry 40 years ago. Implants are generally a successful and well-established treatment for tooth replacement; however, like everything in dentistry, the results cannot be always satisfactory. The implant is removed for following reasons; 1. when the osseointegration is lost, 2. when the fixture is misplaced, 3. when it has served its purpose as an orthodontic anchorage, 4. when the biomechanical problem occurs. There are various implant removal techniques, such as high torque wrench technique which is adapted in implant removal kits, fixture split technique, piezosurgery, bur-forceps technique, trephine drill techniques, laser, and so on. Implant removal should be done in the least invasive and the most conservative manner. As a result, a clinician can minimize the occurrence of post-op complications and preserve as much alveolar bone as possible for the convenience of re-implantation. Consequently, a clinician should be well aware of when and how to remove the implant.
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