국산 내부연결형 임플란트시스템(GS IIⓇ)에서 지대주 연결방식에 따른 응력분석에 관한 연구
Three-Dimensional Finite Element Analysis of Internal Connection Implant System (GsiiⓇ) According to Three Different Abutments and Prosthetic Design
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초록
임플란트 보철물에 저작력 등 외부 하중이 작용하면 내부 반응으로 응력이 발생되는데 지지골에 나타난 응력은 골재생 및 흡수 파괴, 임플란트에 나타난 응력은 임플란트 자체의 파절이나 나사의 풀림현상 및 파절, 상부 구조물에 나타난 응력은 보철물의 파절 등을 예견하는 지침이 될 수 있을 것이다. 지대주의 형상과 재질에 따라 연결방법과 보철방법이 달라지고 임플란트 내부의 하중전달 기전이 변하게 되고 이에 따라 악골에 발생하는 응력분포 역시 달라질 수 있다. 본 연구에서는 하악 제 1대구치 부위에 이중나사 구조를 갖고 원추형 내측연결 임플란트 시스템인 GSIIⓇ (Osstem, Korea)임플란트를 이용해 지대주의 종류를 티타늄 소재의 2-piece TransferTM abutment (GST), 금합금 소재의 2-piece GoldCastTM abutment(GSG), 외부 연결형태를 가진 3-piece ConvertibleTM abutment (GSC) 로 분류하여 이에 따른 응력분포 양상을 비교 분석하여 보았다. 결과 하중조건에 관계없이 응력은 주로 지대주와 고정체가 접촉하는 경부에 집중되었다. 또한 하중조건에 관계없이 임플란트의 고정체 상부와 접촉하는 치밀골에 높은 응력이 나타나고 해면골에는 아주 작은 응력이 나타났다. 축하중보다는 중심축을 벗어난 하중조건에서 더 높은 응력이 발생되었고 수직하중보다 경사하중에서 더 높은 응력이 발생되었다. 전체에 걸친 최대응력은 GSG에서는 지대주, 치관 및 고정체에 고르게 분포되었고 GST는 주로 고정체와 지대주 나사에, GSC는 고정체와 지대주에 집중되었다. 세 지대주 간 골내의 최대응력에는 유의한 차이가 없었고 GSG가 전체 구성부의 응력 분포에 있어 유리한 것으로 나타났다.
Abstract
In the internal connection system, the loading transfer mechanism within the inner surface of the implant and also the stress distribution occuring to the mandible can be changed according to the abutment form. Therefore it is thought to be imperative to study the difference of the stress distribution occuring at the mandible according to the abutment form. The purpose of this study was to assess the loading distributing characteristics of three different abutments for GS IIⓇ implant fixture(Osstem, Korea) under vertical and inclined loading using finite element analysis. Three finite element models were designed according to three abutments; 2-piece TransferTM abutment made of pure titanium(GST), 2-piece GoldCastTM abutment made of gold alloy(GSG), 3-piece ConvertibleTM abutment with external connection(GSC). This study simulated loads of 100N in a vertical direction on the central pit(load 1), on the buccal cusp tip(load 2) and 30° inward inclined direction on the central pit(load 3), and on the buccal cusp tip(load 4). The following results were obtained. 1. Without regard to the loading condition, greater stress was concentrated at the cortical bone contacting the upper part of the implant fixture and lower stress was taken at the cancellous bone. 2. When off-axis loading was applied, high stress concentration observed in cervical area. 3. GSG showed even stress distribution in crown, abutment and fixture. GST showed high stress concentration in fixture and abutment screw. GSC showed high stress concentration in fixture and abutment. 4. Maximum von Mises stress in the surrounding bone had no difference among three abutment type. In GS IIⓇ conical implant system, different stress distribution pattern was showed according to the abutment type and the stress-induced pattern at the supporting bone according to the abutment type had no difference among them.
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