호환 가능한 수종의 치과용 임플란트 나사의 풀림토크값에 대한 연구

Detorque Values of Various Compatible Dental Implant Screws

  • 이주리 (가톨릭대학교 서울성모치과병원 보철과) ;
  • 이동환 (성균관대학교 의과대학 삼성서울병원 치과진료부 보철과) ;
  • 황재웅 (성균관대학교 의과대학 삼성서울병원 치과진료부 보철과) ;
  • 최정한 (성균관대학교 의과대학 삼성서울병원 치과진료부 보철과)
  • Lee, Ju-Ri (Department of Prosthodontics, Seoul ST. Mary's Dental Hospital, The Catholic University of Korea) ;
  • Lee, Dong-Hwan (Department of Prosthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Hwang, Jae-Woong (Department of Prosthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Choi, Jung-Han (Department of Prosthodontics, The Institute of Oral Health Science, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • 투고 : 2010.06.21
  • 심사 : 2010.09.25
  • 발행 : 2010.09.30

초록

이 연구는 다수의 임플란트에 의해 지지되는 보철물과 단일 임플란트 보철물에서 호환 가능한 세 가지 종류의 나사의 풀림토크값을 측정하여 나사 결합부 안정성에 차이가 있는지를 알아보고자 하였다. 이를 위해, 네 개의 외부 육각 임플란트에 직접 연결되는 임플란트 상부구조물을, 아크릴릭 레진을 이용한 연결인상법으로 얻은 총 6개의 실험모형에 20 Ncm의 힘으로 조인 후, 각 나사의 풀림토크값을 총 2회 측정하였다. 사용한 지대주 나사는 토크타이트(TorqTite), 골드타이트(Gold-Tite), 그리고, 티타늄(Titanium) 나사였다. 또한, 단일 임플란트 수복의 경우 를 가정하여 총 5개의 실험모형 상의 2개의 임플란트에, 한 개의 지대주(GoldAdapt Engaging)를 다시 세 종류의 나사로 연결한 후, 각 나사의 풀림토크값을 총 2회 측정하였다. 나사의 풀림토크값의 비교를 위한 통계적 분석을 혼합모형(mixed model)을 이용하여 유의수준 .05에서 실시한 결과, 다수 임플란트 지지 상부구조물의 경우, 나사의 종류에 따른 풀림토크값은 통계적으로 유의성 있는 차이를 보이지 않았다(p>0.05). 그러나 단일 임플란트 지대주의 경우에는 통계적으로 유의성 있는 차이를 보였으며(p=0.0175), 토크타이트 나사(p=0.0462)와 티타늄 나사(p=0.0348)는 각각, 골드타이트 나사보다 유의성 있게 큰 풀림토크값을 보였으나, 두 나사 간에는 유의성 있는 차이가 없었다(p>0.05). 이상의 연구 결과로 보아, 서로 다른 종류의 나사가 나사 결합부의 초기 안정성에 미치는 영향은, 단일 임플란트 보철물의 경우에서와는 달리, 다수의 임플란트에 의해 지지되는 보철물의 경우에는 미미하다고 할 수 있다.

This study evaluated the effect of 3 different compatible screws on the detorque values in a multiple implant-supported superstructure and single implant abutments. An implant superstructure directly connected to 4 implants was screwed to 6 experimental dental stone casts made by acrylic resin splinted impressions, using 20 Ncm. The detorque values of screws were measured twice. Three compatible abutment screws used in this study were TorqTite screw, Gold-Tite screw, and, Titanium screw. And, using single implant abutments (GoldAdapt Engaging abutments), the detorque values of 3 different screws were measured twice on 2 implants of 5 experimental casts. According to statistical analysis of detorque values using mixed model at a .05 level of significance, no statistically significant differences among 3 different compatible screws were found in a multiple implant-supported superstructure (p>0.05). But, in single implant abutments, statistically significant differences among 3 different compatible screws were found (p=0.0175). The detorque values of TorqTite(p=0.0462) and Titanium(p=0.0348) screws were significantly higher than those of Gold-Tite screw, but no statisticantly significantlydifferences were found between TorqTite and Titanium screws(p>0.05). Therefore, various compatible screws showed significant effects on the detorque values for single implant abutment, but, showed no significant effects for a multiple implant-supported superstructure.

키워드

참고문헌

  1. Cox J, Zarb G. The longitudinal clinical efficacy of osseointegrated implants. Int J Oral Maxillofac Implants 1987;2:91-100.
  2. Adell R, Eriksson B, Lekholm U et al. A long-term follow-up of osseointegrated implants in the treatment of totally edentulous jaws Int J Oral Maxillofac Implants 1990;5:347-359.
  3. Zarb G, Schmitt A. The longitudinal clinical effectiveness of osseointegrated dental implants: the Toronto Study. Part III. Problems and complications encountered. J Prosthet Dent 1990;64:185-194. https://doi.org/10.1016/0022-3913(90)90177-E
  4. Jemt T, Laney W, Harris Dea. Osseointegrated implants for single tooth replacement: A 1-year report from a multi-center prospective study. Int J Oral Maxillofac Implants 1991;6:29-36.
  5. Becker W, Becker B. Replacement of maxillary and mandibular molars with single endosseous implant restorations: A retrospective study. J Prosthet Dent 1995;74:51-55. https://doi.org/10.1016/S0022-3913(05)80229-X
  6. Kreissl M, Gerds T, Muche R et al. Technical complications of implant-supported fixed partial dentures in partially edentulous cases after an average observation period of 5 years Clin Oral Impl Res 2007;18:720-726. https://doi.org/10.1111/j.1600-0501.2007.01414.x
  7. Bragger U, Aeschlimann S, Burgin W et al. Biological and technical complications and failures with fixed partial dentures( FPD) on implants and teeth after four to five years of function. Clin Oral Impl Res 2001;12:26-34. https://doi.org/10.1034/j.1600-0501.2001.012001026.x
  8. Patterson EA, Johns RB. Theoretical analysis of the fatigue life of fixture screws in osseointegrated dental implants. Int J Oral Maxillofac Implants 1992;7: 26-33.
  9. Lang L, Wang R, May K. The influence of abutment screw tightening on screw joint configuration. J Prosthet Dent 2002;87:74-79. https://doi.org/10.1067/mpr.2002.121488
  10. Sakaguchi RL, Borgersen SE. Nonlinear contact analysis of preload in dental implant screws. Int J Oral Maxillofac Implants 1995;10:295-302.
  11. Binon P, Sutter F, Beaty K et al. The role of screws in implant systems. Int J Oral Maxillofac Implants 1994;9( suppl):48-63.
  12. McGlumphy E, Mendel D, Holloway J. Implant screw mechanics. Dent Clin North Am 1988;42:71-89.
  13. Haack J, Sakaguchi R, Sun T et al. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofac Implants 1995;10:529-536.
  14. Burguete RL, Johns RB, King T et al. Tightening characteristics for screwed joints in osseointegrated dental implants. J Prosthet Dent 1994;71:592-599. https://doi.org/10.1016/0022-3913(94)90443-X
  15. Jorneus L, Jemt T, L C. Loads and designs of screw joints for single crowns supported by osseointegrated implants. Int J Oral Maxillofac Implants 2001;7: 353-359.
  16. Martin W, Woody R, Miller B et al. Implant abutment screw rotations and preloads for four different screw materials and surfaces. J Prosthet Dent 2001;86:24-32. https://doi.org/10.1067/mpr.2001.116230
  17. Porter S, Robb T. Increasing implant-abutment preload by thin gold coating abutment screws (Abstract) J Dent Res 1998;77:837.
  18. Binon P. Implants and Components: Entering the new millennium. Int J Oral Maxillofac Implants 2000;15: 76-95.
  19. Cibirka R, Nelson S, Lang B et al. Examination of the implant-abutment interface after fatigue testing. J Prosthet Dent 2001;85:268-275. https://doi.org/10.1067/mpr.2001.114266
  20. Assif D, Fenton A, Zarb G et al. Comparative accuracy of implant impression procedures. Int J Periodontics Restorative Dent 1992;12:112-121.
  21. Assif D, Marshak B, Schmidt A. Accuracy of implant impression techniques. Int J Oral Maxillofac Implants 1996;11:216-222.
  22. Inturregui JA, Aquilino SA, Ryther JS et al. Evaluation of three impression techniques for osseointegrated oral implants. J Prosthet Dent 1993;69:503-509. https://doi.org/10.1016/0022-3913(93)90160-P
  23. Pagniano RP, Scheid RC, Clowson RL et al. Linear dimensional change of acrylic resins used in the fabrication of custom trays. J Prosthet Dent 1982;47:279-283. https://doi.org/10.1016/0022-3913(82)90157-3
  24. Goldfogel M, Harvey WL, Winter D. Dimensional change of acrylic resin tray materials. J Prosthet Dent 1985;54:284-286. https://doi.org/10.1016/0022-3913(85)90306-3
  25. Davis GB, Moser JB, Brinsden GI. The bonding properties of elastomer tray adhesives. J Prosthet Dent 1976;36:278-285. https://doi.org/10.1016/0022-3913(76)90183-9
  26. Revised American Dental Association Specification no. 19 for Non-aqueous, Elastomeric Dental Impression Materials. J Am Dent Assoc 1977;94: 733-741.
  27. Jemt T. Failures and complications in 391 consecutively inserted fixed prostheses supported by Branemark implants in edentulous jaws: a study of treatment from the time of prosthesis placement to the first annual checkup. Int J Oral Maxillofac Implants 1991;6:270-276.
  28. Sones A. Complication with osseointegrated implant. J Prosthet Dent 1989;62:581-585. https://doi.org/10.1016/0022-3913(89)90084-X
  29. Misch C. Density of bone: effect on treatment plans, surgical approach, healing, and progressive loading. Int J Oral Maxillofac Implants 1995;10:303-311.
  30. Carr AB. Comparison of impression techniques for a five-implant mandibular model. Int J Oral Maxillofac Implants 1991;6:448-455.
  31. Barrett MG, de Rijk WG, Burgess JO. The accuracy of six impression techniques for osseointegrated implants. J Prosthodont 1993;2:75-82. https://doi.org/10.1111/j.1532-849X.1993.tb00387.x
  32. Byrne D, Houston F, Cleary R et al. The fit of cast and premachined implant abutments. J Prosthet Dent 1998;80:184-192. https://doi.org/10.1016/S0022-3913(98)70108-8
  33. Carr AB. Comparison of impression techniques for a two-implant 15-degree divergent model. Int J Oral Maxillofac Implants 1992;7:468-475.
  34. Bartlett DW, Greenwood R, Howe L. The suitability of head-of-implant and conventional abutment impression techniques for implant-retained three unit bridges: an in vitro study. Eur J Prosthodont Restor Dent 2002;10:163-166.
  35. Nissan J, Gross M, Shifman A et al. Stress levels for well-fitting implant superstructures as a function of tightening force levels, tightening sequence, and different operators. J Prosthet Dent 2001;86:20-23. https://doi.org/10.1067/mpr.2001.115182
  36. Kim JM, Han JS, Lee SH et al. A study of screw loosening after dynamic continous fatigue test of several abutment screw. J Korean Acad Prosthodont 2003;41:519-531.
  37. Byrne D, Jacobs S, O'Connell B et al. Preloads generated with repeated tightening in three types of screws uned in dental implant assemblies. J Prosthodont 2006;15:164-171. https://doi.org/10.1111/j.1532-849X.2006.00096.x
  38. Merz B, Hunenbart S, Belser U. Mechanics of the implant-abutment connection : an 8-degree taper compared to an butt joint design. Int J Oral Maxillofac Implants 2000;15:519-526.
  39. Norton M. An in vitro evaluation of the strength of an internal conical interface compared to a butt joint interface in implant dsign. Clin Oral Impl Res 1997;8:290-298. https://doi.org/10.1034/j.1600-0501.1997.080407.x