상악 임플란트 피개의치에서 유지장치 종류와 구개 피개 유무에 따른 응력분포에 대한 유한 요소분석
Effect of attachments and palatal coverage of maxillary implant overdenture on stress distribution: a finite element analysis
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목적: 상악 임플란트 피개의치에서 유지장치 종류와 구개 피개 유무에 따른 응력분포를 3차원 유한요소분석법을 통해 알아보고자 한다. 연구 재료 및 방법: CAD를 이용하여 전방부에 4개의 임플란트를 식립한 4종류의 상악 임플란트 피개의치에 대한 3차원 모델을 디자인하였다. 1) Ball-F: 볼 유지장치를 사용하고 구개를 피개한 군, 2) Ball-P: 볼 유지장치를 사용하고 구개를 피개하지 않은 군, 3) Bar-F: 바 유지장치를 사용하고 구개를 피개한 군, 4) Bar-P: 바 유지장치를 사용하고 구개를 피개하지 않은 군. 응력분석은 유한요소 분석 프로그램인 ANSYS Workbench Ver. 14를 사용하였으며, 편측 저작의 상황을 고려하여 우측 제1대구치에 100 N의 정적하중을 적용하여 임플란트, 임플란트 주위 골, 점막에 발생하는 최대 응력값을 기록하였다. 결과: 볼 유지장치를 사용한 군이 바 유지장치를 사용한 군보다 임플란트 및 임플란트 주위골에 발생하는 최대 응력값이 작았다. 하지만 점막에서의 최대 응력값은 그 반대로 나타났다. 구개를 피개하면 유지장치의 종류와 무관하게 임플란트, 임플란트 주위 골, 점막 모두에서 최대응력값이 작아졌다. 결론: 본 연구의 한계 내에서 상악동 전방부에 4개의 임플란트를 식립하여 수복된 피개의치에서 바 유지장치보다는 볼 유지장치를 사용하고 구개를 완전히 피개하는 경우가 임플란트와 임플란트 주위 골의 응력분산에 효과적이다. (구강회복응용과학지 2020;36(2):70-9)
Abstract
Purpose: The purpose of this study was to evaluate the effect of attachments and palatal coverage on stress distribution in maxillary implant overdenture using finite element analysis. Materials and Methods: Four maxillary overdenture 3-D models with four implants placed in the anterior region were fabricated with computer-aided design. 1) Ball-F: Non-splinted ball attachment and full palatal coverage, 2) Ball-P: Non-splinted ball attachment and U-shaped partial palatal coverage, 3) Bar-F: Splinted milled bar attachment and full palatal coverage, 4) Bar-P: Splinted milled bar attachment and U-shaped partial palatal coverage. Stress distribution analysis was performed with ANSYS workbench 14. 100 N vertical load was applied at the right first molar unilaterally and maximum stress was calculated at the implant, peri-implant bone and mucosa. Results: The use of the ball attachment showed lower maximum stress on implant and peri-implant bone than the use of the milled bar attachment. But it showed contrary tendency in the mucosa. Regardless of attachment, full palatal coverage showed lower maximum stress on implant, peri-implant bone and mucosa. Conclusion: Within the limitation of this study, ball attachment improved stress distribution on implant and periimplant bone rather than milled bar attachment in maxillary implant overdenture. Also, full palatal coverage is more favorable in stress distribution.
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