경사지게 식립된 임플랜트 모형에서 지대주를 인상용 코핑으로 이용한 새로운 인상법의 정확성 비교 연구

Comparative accuracy of new implant impression technique using abutments as impression copings with an angulated implant model

  • 이혁재 (서울대학교 치과대학 보철학교실) ;
  • 김창회 (서울대학교 치과대학 보철학교실) ;
  • 임영준 (서울대학교 치과대학 보철학교실) ;
  • 김명주 (서울대학교 치과대학 보철학교실)
  • Lee, Hyeok-Jae (Department of Prosthodontics, College of Dentistry, Seoul National University) ;
  • Kim, Chang-Whe (Department of Prosthodontics, College of Dentistry, Seoul National University) ;
  • Lim, Young-Jun (Department of Prosthodontics, College of Dentistry, Seoul National University) ;
  • Kim, Myung-Joo (Department of Prosthodontics, College of Dentistry, Seoul National University)
  • 발행 : 2008.04.30

초록

연구목적: 시멘트 유지형 지대주를 인상용 코핑으로 이용하고 레진이나 금속 구조물에 접착하여 스플린팅하는 새로운 인상법을 시도하였다. 연구의 목적은 첫 번째, 3개의 임플랜트가 $15^{\circ}$ 경사지게 식립된 모형에서 closed tray 인상법과 레진 스플린팅한 open tray 인상법의 정확성을 비교하는 것이고 두 번째, 새로운 인상법의 정확성을 앞의 두 가지 인상법과 비교하는 것이다. 연구 재료 및 방법: 3개의 임플랜트 아날로그가 선상으로 배열되고 가운데 아날로그는 모형에 수직이고 양쪽 끝 아날로그는 이것에 앞뒤로 $15^{\circ}$ 경사지게 배열된 주모형과 주모형에 잘 적합되는 기준구조물을 제작하였다. closed tray 인상법, 레진 스플린팅한 open tray 인상법, 지대주-레진구조물 접착 인상법, 지대주-금속구조물 접착 인상법, 각 10개씩 40번의 인상을 채득하여 복제모형을 제작하였다. 이미지 처리할 수 있는 광학 현미경을 이용하여 기준구조물과 복제모형내의 아날로그와의 수직간격을 측정하여 인상의 정확성을 평가하였다. 통계처리는 one-way ANOVA와 사후 검정으로 Tukey test를 5% 유의수준으로 시행하였다. 결과: closed tray 인상법;74.3 (${\pm}33.4$)${\mu}m$의 간격은 레진 스플린팅한 open tray 인상법과 다른 두 가지 새로운 인상법보다 간격의 크기가 통계적 유의성 있게 컸다(P<.05). 지대주-금속구조물 접착 인상법;42.5 (${\pm}11.9$)${\mu}m$은 다른 인상법들 보다 간격의 크기가 통계적 유의성 있게 작았다(P<.05). 지대주-레진구조물 접착 인상법;51.0 (${\pm}14.1$)${\mu}m$은 레진 스플린팅한 open tray 인상법50.3 (${\pm}16.9$)${\mu}m$과 통계적 유의성 있는 차이를 보이지 않았다(P>.05). 결론: 이 연구의 한계 내에서, 레진 스플린팅한 open tray 인상법은 closed tray 인상법보다 우수한 정확성을 나타내었고, 지대주를 금속구조물에 접착하는 새로운 인상법의 정확성은 레진 스플린팅한 open tray 인상법보다 우수하였다.

Statement of problem: A new implant impression technique which use abutments as impression coping, and use resin cement as a splinting material was described. Accuracy of this technique was compared with conventional closed tray and resin splinted open tray technique for a $15^{\circ}$ angled 3-implant model Material and methods: A dental stone master model with 3 linearly positioned implant analogue and a reference framework which was passively fitted to it were fabricated. The center analogue was perpendicular to the plane of model and the outer analogues had a $15^{\circ}$angulation forward or backward. 10 closed tray impressions, 10 resin splinted open tray impressions, 10 abutment-resin framework cementation impressions and 10 abutment-metal framework cementation impressions were made with additional silicone material and poured with dental stone. A light microscope with image processing was used to record the vertical gap dimension between reference framework and analogue of duplicated cast made with each 4 impression techniques. Statistical analysis used one-way ANOVA with post-hoc tests Tukey test of .05 level of significance Results: Significant difference in the vertical gap dimension was found between closed tray technique; 74.3 (${\pm}33.4$)${\mu}m$ and resin splinted open tray technique, and two other new technique. (P<.05) Abutment-metal framework cementation technique;42.5 (${\pm}11.9$)${\mu}m$ was significantly different from resin splinted open tray technique. (P<.05) Abutmentresin framework cementation technique;51.0 (${\pm}14.1$)${\mu}m$ did not differ significantly from resin splinted open tray technique;50.3 (${\pm}16.9$)${\mu}m$. (P>.05) Conclusion: Within limitations of this study, the accuracy of implant level impressions of resin splinted open tray technique was superior to that of closed tray technique. A new technique using abutment and metal framework cementation was more accurate than resin splinted open tray technique.

키워드

참고문헌

  1. Adell R, Lekholm U, Rockler B, Branemark PL. A 15- year study of osseointegrated implants in the treatment of the edentulous jaw. Int J Oral Surg 1981;10:387-416 https://doi.org/10.1016/S0300-9785(81)80077-4
  2. Skalak R. Biomechanical considerations in osseointegrated prostheses. J Prosthet Dent 1983;49:843-8 https://doi.org/10.1016/0022-3913(83)90361-X
  3. Conrad HJ, Pesun IJ, DeLong R, Hodges JS. Accuracy of two impression techniques with angulated implants. J Prosthet Dent 2007;97:349-56 https://doi.org/10.1016/S0022-3913(07)60023-7
  4. Carr AB. Comparison of impression techniques for a twoimplant 15-degree divergent model. Int J Oral Maxillofac Implants 1992;7:468-75
  5. Carr AB. A Comparison of Impression techniques for a five-implant mandibular model Int J Oral Maxillofac Implants 1991;6:448-55
  6. Phillips KM, Nicholls JI, Ma T, Rubenstein J. The Accuracy of three implant impression techniques: A threedimensional analysis. Int J Oral Maxillofac Implants 1994;9:533-40
  7. Choi JH, Lim YJ, Lim SH, Kim CW. Evaluation of the accuracy of implant-level impression techniques for internalconnection implant prostheses in parallel and divergent models. Int J Oral Maxillofac Implants 2007;22;761-8
  8. Assuncao WG, Filho HG, Zaniquelli O. Evaluation of transfer impressions for osseointegrated implants at various angulations. Implant Dentistry 2004;13:358-64 https://doi.org/10.1097/01.id.0000144509.58901.f7
  9. Assif D, Nissan J, Varsano I, Singer A. Accuracy of implant impression splinted techniques: effect of splinting material. Int J Oral Maxillofac Implants 1999;14:885-8
  10. Assif D, Marshak B, Schmidt A. Accuracy of implant impression techniques. Int J Oral Maxillofac Implants 1996;11:216-22
  11. Vigolo P, Majzoub Z, Cordioli G. Evaluation of the accuracy of three techniques used for multiple implant abutment impressions. J Prosthet Dent 2003;89:186-92 https://doi.org/10.1067/mpr.2003.15
  12. Vigolo P, Fonzi F, Majzoub Z, Cordioli G. Master cast accuracy in single-tooth implant replacement cases: an in vitro comparison. A technical note. Int J Oral Maxillofac Implants 2005;20:455-60
  13. Assif D, Fenton A, Zarb G, Schmitt A. Comparative accuracy of implant impression procedures. Int J Periodont Rest Dent 1992;12:113-21
  14. Naconecy MM, Teixeira ER, Shinkai RS, Frasca LC, Cervieri A. Evaluation of accuracy of 3 transfer techniques for implant-supported prostheses with multiple abutments. Int J Oral Maxillofac Implants 2004;19:192-8
  15. Wee AG, Aquilino SA, Schneider RL. Strategies to achieve fit in implant prosthodontics: A review of the literature. Int J Prosthodont 1999;12:167-78
  16. De La Cruz JE, Funkenbusch PD, Ercoli C, Moss ME, Graser GN, Tallents RH. verification jig for implant-supported prostheses: A comparison of standard impressions with verification jigs made of different materials. J Prosthet Dent 2002;88:329-36 https://doi.org/10.1067/mpr.2002.128070
  17. Osman SA, McCabe JF, Walls AW. Film thickness and rheological properties of luting agents for crown cementation. Eur J Prosthodont Restor Dent 2006;14:23-7
  18. Mojon P, Oberholzer JP, Meyer JM, Melser UC. Polymerization shrinkage of index and pattern acrylic resins. J Prosthet Dent 1990;64:684-8 https://doi.org/10.1016/0022-3913(90)90296-O
  19. Feilzer AJ, De Gee AJ, Davidson CL. Setting stress in composite resin in relation to configuration of the restoration. J Dent Res 1987;66:1636-9 https://doi.org/10.1177/00220345870660110601
  20. Balkenhol M, Mautner MC, Ferger P, Wostmann B. Mechanical properties of provisional crown and bridge materials; chemical-curing versus dual-curing systems. J Dent 2008;36:15-20
  21. Plotino G, Grandle NM, Bedini R, Pameijer CH, Somma F. Flexural properties of endodontic posts and human root dentin. Dent Mater 2007;23:1129-35 https://doi.org/10.1016/j.dental.2006.06.047
  22. Ma T, Nichholls JI, Rubenstein JE. Tolerance measurements of various implant components. Int J Oral Maxillofac Implants 1997;12:371-5
  23. Assif D, Fenton A, Zarb G, Schmitt A. Comparative accuracy of implant impression procedures. Int J Periodontics Restorative Dent 1992;12:112-21
  24. Vigolo P, Majzoub Z, Cordioli G. Evaluation of the accuracy of three techniques used for multiple implant abutment impressions. J Prosthet Dent 2003;89:186-92 https://doi.org/10.1067/mpr.2003.15
  25. Vigolo P, Fonzi F, Majzoub Z, Cordioli G. An evaluation of impression techniques for multiple internal connection implant prostheses. J Prosthet Dent 2004;92:470-6 https://doi.org/10.1016/j.prosdent.2004.08.015
  26. Herbst D, Nel JC, Driessen CH, Becker PJ. Evaluation of impression accuracy for osseointegrated implant supported superstructures. J Prosthet Dent 2000;83:555-61 https://doi.org/10.1016/S0022-3913(00)70014-X
  27. Humphries RM, Yaman P, Bloem TJ. The accuracy of implant master casts constructed from transfer impressions. Int J Oral Maxillofac Implants 1990;5:331-6
  28. Burns J, Palmer R, Howe L, Wilson R. Accuracy of open tray implant impressions: an in vitro comparisson of stock versus custom trays. J Prosthet Dent 2003;89:250-5 https://doi.org/10.1067/mpr.2003.38
  29. Wee AG. Comparison of impression materials for direct multi-implant impressions. J Prosthet Dent 2000;83:323-31 https://doi.org/10.1016/S0022-3913(00)70136-3
  30. Kim SJ, Nicholls JI, Han CH, Lee KW. Displacement of implant components from impressions to definitive casts. Int J Oral Maxillofac Implants 2006;21:747-55