즉시 부하 교정용 미니임플랜트의 안정성 평가를 위한 PeriotestⓇ의 유효성
The validation of Periotest values for the evaluation of orthodontic mini-implants’ stability
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Periotest(R)는 보철용 임플랜트 식립 3 - 4개월 후 골유착 정도를 평가하기 위해 사용되는 동요도 측정 기기로 교정용 미니임플랜트 안정성 평가에 적용가능성이 높다. 본 연구는 교정용 미니임플랜트의 안정성 평가를 위해 Periotest(R)의 유효성을 검증하고자 하였다. 성견 다섯 마리의 상악, 하악 협측골에 교정용 미니임플랜트를 식립하고, 식립 시 식립 토오크와 동요도를 측정하고 12주 동안 교정력을 부여한 후, 제거 시 제거 토오크와 동요도를 측정하였다. 동요도(Periotest(R) value, PTV) 측정은 재현성을 위해 동일 부위에 2회 측정하였다. PTV와 다른 변수와의 상관성 분석을 위해 모든 실험견은 CT 촬영 후 식립 부위의 골밀도와 피질골 두께를 계측하였다. 동요도 측정에 대한 재현성은 0.96의 상관계수를 나타내 매우 높았으며 (p ＜ 0.001) 골밀도와 피질골 두께에 있어 하악골 협측치조골이 상악골에 비해 유의하게 컸다 (p ＜ 0.05). 12주 동안 PTV 값은 −3.2에서 4.8의 범위를 나타내며 모든 임플랜트는 임상적으로 안정적이었다. 식립 시 PTV 값은 하악에서 식립 토오크(−0.51), 골밀도(−0.48), 피질골 두께(−0.42)와 상관성이 있었으나 (p ＜ 0.05), 상악에서는 상관성이 없었다. 제거 시 PTV 값은 하악에서 제거 토오크(−0.66)와 상관성이 있었으며 (p ＜ 0.05), 상악에서는 상관성이 없었다. 이상의 결과는 PeriotestⓇ를 이용하여 교정용 미니임플랜트의 안정성을 간접적으로 평가할 수 있으나 골밀도가 높고 피질골이 두꺼운 부위에서 제한적으로 응용할 수 있음을 시사한다. (대치교정지 2010;40(3):167-175)
Abstract
Objective: The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants’ stability. Methods: Sixty orthodontic mini-implants (7.0 mm x Ø1.45 mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning. Results: The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p ＜ 0.05). The PTV values ranged from −3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (−0.51), bone density (−0.48), cortical bone thickness (−0.42) (p ＜ 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (−0.66) (p ＜ 0.01) in the mandible. Conclusions: These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible. (Korean J Orthod 2010;40(3):167-175)
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