기능적 부하 후“Short Implant”주변의 골 흡수에 대한 방사선학적 연구
Study on the radiographic evaluation of marginal bone loss around short-length implant after functional loading
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임플란트 식립시 하악의 구치부에서는 하치조 신경까지의 거리가 가까울수록 신경 손상의 위험이 커지며, 상악의 구치부에서는 상악동의 함기화에 따라 가용골의 수직적 골 높이가 부족하게 된다. 이러한 경우수직적 골 이식술이 시행될 수 있지만, 그 술식의 한계와 부가적인 술식에 따른 시간적, 비용적 문제가 있기때문에 임상 적용에 한계가 있다. “Short implant”는 이러한 잔존치조골의 수직적골량 부족을 추가적인 술식 없이 해결할 수 있는 하나의 대안으로 제시되어 왔다1~4).“ Short implant”라는 용어의 정의는 문헌 별로 다양한 의견이 제시되었기때문에 다소 주관적인 의미를 지니고 있다. Friberg,Johns 등은 치조골이 심하게 위축된 하악에서 7㎜ 이하의 Branemark 임플란트의 평균 8년 동안의 예후에 대해서 연구하였고2), Fugazzotto 등은 9㎜ 이하의 임플란트를“Short implant”로 정의하여 2073개의 임플란트에서 7년간의 성공적인 임상결과를 보고하였다5). Testori 등은 이 기준을 10mm 미만이라고정의하여 임플란트의 길이가 임플란트의 성공률에 영향을 미치지 않는다는 결과를 발표하였다6). 이에 본 연구에서는 6㎜ 길이 이하의 임플란트(Bicon Dental implants, USA)를 Short implant 로 정의하고 기능적 부하 후“Short implant”주변의 골 흡수에 대한 방사선학적 측정과8㎜, 11㎜ 길이 임플란트 군과의 비교, 그리고 증가된치관-임플란트 비율이 변연골 흡수량에 미치는 영향을 알아보고“Short implant”의 임상적 가능성을평가하는데 목적을 두었다.
Abstract
Purpose: The short dental implant is considered as possible solution in the alveolar bone height deficient cases. The aim of this study was to evaluate clinical availability of short implants by measuring the marginal bone loss of short length implants and comparing with that of conventional length implants. Materials and Methods: The groups were composed of patients who had received at least one implant. The samples of this study were selected from patients who with functional loading after prosthetic treatment for 1 year follow up period. The implants with a length of 5.7 and 6 were considered short. (Bicon Dental implants, USA). The experiment group was composed of 4.5x6 , 5x6 , 6x5.7 implants (total 18 implants were placed in 14 patients, 8 on maxilla, 10 on mandible). The control group was composed of 4.5x8 , 5x8 , 4.5x11 , 5x11 . All implants were selected only by implants placed on molar area. We evaluated marginal bone loss in radiographic images at baseline (implant loading) and 3, 6, 12 months after loading. Additionally, crown-to-implant ratio was evaluated, and marginal bone loss according to crown-to-implant ratio after functional loading was analyzed. Results: The short implant group had a mean marginal bone level of -0.52±0.69 ; the 8 group, -0.22±0.82 ; and the 11group, -0.10±1.09 after 1 year of functional loading. But significant differences were not detected between three groups at every follow-up period. Crown-to-implant ratio in short implant group was 1.55±0.23; 8 group was 1.15±0.18; and 11 group was 0.92±0.15. Additionally, significant differences between three groups were founded. (P<.0001) The greatest marginal bone loss after 1 year follow-up was founded at crown-to-implant ratio 1~1.49 range in short implant. Conclusion:The marginal bone loss of short implants was comparable to that of long implants. So, the short implants can be a clinically acceptable option.
참고문헌 (9)
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