대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제43권2호
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  • Pages.248-257
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  • 2005
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
권호 표지

치밀골 두께 변화에 따른 임플랜트 1차안정성과 즉시하중부담능 평가

AN EVALUATION OF THE PRIMARY IMPLANT STABILITY AND THE IMMEDIATE LOAD-BEARING CAPACITY ACCORDING TO THE CHANGE OF CORTICAL BONE THICKNESS

  • 이양진 (강릉대학교 치과대학 치과보철학교실) ;
  • 박찬진 (강릉대학교 치과대학 치과보철학교실) ;
  • 조리라 (강릉대학교 치과대학 치과보철학교실)
  • Yi Yang-Jin (Dept. of Prosthodontics, College of Dentistry, Kangnung National University, and Research Institute of Oral Science) ;
  • Park Chan-Jin (Dept. of Prosthodontics, College of Dentistry, Kangnung National University, and Research Institute of Oral Science) ;
  • Cho Lee-Ra (Dept. of Prosthodontics, College of Dentistry, Kangnung National University, and Research Institute of Oral Science)
  • 발행 : 2005.04.01
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초록

Statement of problem. Cortical bone plays an important role in the primary implant stability, which is essential to immediate/early loading. However, immediate load-bearing capacity and primary implant stability according to the change of the cortical bone thickness have not been reported. Purpose. The objectives of this study were (1) to measure the immediate load-bearing capacity of implant and primary implant stability according to the change of cortical bone thickness, and (2) to evaluate the correlation between them. Material and methods.48, screw-shaped implants (3.75 mm$\times$7 mm) were placed into bovine rib bone blocks with different upper cortical bone thickness (0-2.5 mm) and resonance frequency (RF) values were measured subsequently. After fastening of healing abutment. implants were subjected to a compressive load until tolerated micromotion threshold known for the osseointegration and load values at threshold were recorded. Thereafter, RF measurement after loading, CT taking and image analysis were performed serially to evaluate the cortical bone quality and quantity. Immediate load-bearing capacity and RF values were analyzed statistically with ANOVA and post-hoc method at 95% confidence level (P<0.05). Regression analysis and correlation test were also performed. Results. Existence and increase of cortical bone thickness increased the immediate load-bearing capacity and RF value (P<0.05) With the result of regression analysis, all parameter's of cortical bone thickness to immediate load-bearing capacity and resonance frequency showed significant positive values (P<0.0001). A significant high correlation was observed between the cortical bone thickness and immediate load-beating capacity (r=0.706, P<0.0001), between the cortical bone thickness and resonance frequency (r=0.753, P<0.0001) and between the immediate load-bearing capacity and resonance frequency (r=0.755, P<0.0001). Conclusion. In summary, cortical bone thickness change affected the immediate load-baring capacity and the RF value. Although RF analysis (RFA) is based on the measurement of implant/bone interfacial stiffness, when the implant is inserted stably, RFA is also considered to reflect implant/bone interfacial strength of immediately after placement from high correlation with the immediate load-baring capacity. RFA and measuring the cortical bone thickness with X-ray before and during surgery could be an effective diagnosis tool for the success of immediate loading of implant.

키워드

참고문헌

  1. Gapski R, Wang H, Mascarenhas P, Lang NP. Critical review of immediate implant loading. Clin Oral Impl Res 2003;14:515-27 https://doi.org/10.1034/j.1600-0501.2003.00950.x
  2. Meredith N. Assessment of implant stability as a prognostic determinant. Int J Prosthodont 1998;11(5):491-501
  3. Friberg B, Sennerby L, Linden B, Grondahl K. Lekholm U. Stability measurements of onestage Branemark implants during healing in mandibles. A clinical resonance frequency analysis study. Int J Oral Maxillofac Surg 1999;28(4):266-72 https://doi.org/10.1016/S0901-5027(99)80156-8
  4. Friberg B, Sennerby L, Meredith N, Lekholm U. A comparison between cutting torque and resonance frequency measurements of maxillary implants. A 20-month clinical study. Int J Oral Maxillofac Surg 1999:28(4):297-303 https://doi.org/10.1016/S0901-5027(99)80163-5
  5. Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res 2004;15(5):529-39 https://doi.org/10.1111/j.1600-0501.2004.01042.x
  6. Niimi A, Ozeki K, Ueda M, Nakayama B. A comparative study of removal torque of endosseous implants in the fibula, iliac crest and scapula of cadavers: preliminary report. Clin Oral Implants Res 1997;8(4):286-9 https://doi.org/10.1034/j.1600-0501.1997.080406.x
  7. Sennerby L, Thomsen P, Ericson LE. A morphometric and biomechanic comparison of titanium implants inserted in rabbit cortical and cancellous bone. Int J Oral Maxillofac Implants 1992;7(1):62-71
  8. Holmes DC, Loftus JT. Influence of bone quality on stress distribution for endosseous implants. J Oral Implantol 1997;23(3):104-11
  9. Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the implanttissue interface using resonance frequency analysis. Clin Oral Implants Res 1996;7(3):261-7 https://doi.org/10.1034/j.1600-0501.1996.070308.x
  10. Meredith N, Book K, Friberg B, Jemt T, Sennerby L. Resonance frequency measurements of implant stability in vivo. A cross-sectional and longitudinal study of resonance frequency measurements on implants in the edentulous and partially dentate maxilla. Clin Oral Implants Res 1997;8(3):226-33 https://doi.org/10.1034/j.1600-0501.1997.080309.x
  11. Meredith N, Shagaldi F, Alleyne D, Sennerby L, Cawley P. The application of resonance frequency measurements to study the stability of titanium implants during healing in the rabbit tibia. Clin Oral Implants Res 1997;8(3):234-43 https://doi.org/10.1034/j.1600-0501.1997.080310.x
  12. Lekholm U, Zarb GA. Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T., eds. Tissue-integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence;1985:199-209
  13. Friberg B, Sennerby L, Roos J, Johansson P. Strid CG, Lekholm U. Evaluation of bone density using cutting resistance measurements and microradiography: an in vitro study in pig ribs. Clin Oral Implants Res 1995;6(3):164-71 https://doi.org/10.1034/j.1600-0501.1995.060305.x
  14. Shahlaie M, Gantes B, Schulz E,Riggs M, Crigger M. Bone density assessmentof dental implant sites: 1. Quantitative computed tomography. Int J Oral Maxillofac Implants 2003;18:224-231
  15. Szmukler-Moncler S, Salama H, Reingewirtz Y, Dubruille JH. Timing of loading and effect of micromotion on bone-dental implant interface: review of experimental literature. J Biomed Mater Res 1998;43(2):192-203 https://doi.org/10.1002/(SICI)1097-4636(199822)43:2<192::AID-JBM14>3.0.CO;2-K
  16. Nikellis I, Levi A, Nicolopoulos C. Immediate loading of 190 endosseous dental implants: a prospective observational study of 40 patient treatments with up to 2-year data. lnt J Oral Maxillofac Implants 2004;19(1):116-23
  17. Buchs AU, Levine L, Moy P. Preliminary report of immediately loaded Altiva Natural Tooth Replacement dental implants. Clin Implant Dent Relat Res 2001;3(2):97-106 https://doi.org/10.1111/j.1708-8208.2001.tb00237.x
  18. De Boever JA, McCall WD Jr, Holden S, Ash MM Jr. Functional occlusal forces: an inves-tigation by telemetry J Prosthet Dent. 1978:40(3):326-33 https://doi.org/10.1016/0022-3913(78)90042-2
  19. Nedir R, Bischof M, Szmukler-Moncler S, Bernard JP. Samson J. Predicting osseoin-tegration by means of implant primary stability. Clio Oral Implants Res 2004;15(5):520-8 https://doi.org/10.1111/j.1600-0501.2004.01059.x
  20. Watanabe Y, Takai S, Arai Y, Yoshino N, Hirasawa Y. Prediction of mechanical properties of healing fractures using acoustic emission. J Orthop Res 2001;19(4):548-53 https://doi.org/10.1016/S0736-0266(00)00042-5
  21. Glauser R, Sennerby L, Meredith N, Ree A, Lundgren A, Gottlow J, Hammerle CH. Resonance frequency analysis of implants subjected to immediate or early functional occlusal loading. Successful vs. failing implants. Clin Oral Implants Res 2004;15(4):428-34 https://doi.org/10.1111/j.1600-0501.2004.01036.x
  22. Rho JY, Hobatho MC, Ashman RB. Relations of mechanical properties to density and CT numbers in human bone. Med Eng Phys 1995;17(5):347-55 https://doi.org/10.1016/1350-4533(95)97314-F
  23. Wolfinger GJ, Balshi TJ, Rangert B. Immediate functional loading of Branemark system implants in edentulous mandibles: Clinical report of the results of developmental and simplified protocols. Int J Oral Maxillofac Implants 2003;18:250-57
  24. Nkenke E, Lehner B, Weinzierl K, Thams U, Neugebauer J, Steveling H et al. Bone contact, growth, and density around immediately loaded implants in the mandible of mini pigs. Clin Oral Inpl Res 2003;14:312-21 https://doi.org/10.1034/j.1600-0501.2003.120906.x
  25. Levine R, Rose L, Salama H. Immediate loading of root-form implants: Two case reports 3 years after loading. Int J Periodontics Restorative Dent 1998;18(4):333-43
  26. Olsson M, Urde G, Anderson JB, Sennerby L. Early loading of maxillary fixed cross-arch dental prostheses supported by six or eight oxidized titanium implants: Results after lyear of loading, case series, Clin Implant Dent Relat Res 2003;5 Sup pl 1:81-5 https://doi.org/10.1111/j.1708-8208.2003.tb00019.x