구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제28권2호
  • /
  • Pages.147-161
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  • 2012
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
권호 표지

3차원 유한요소법에 의한 임플란트 지지 3본 고정성 가공 의치의 부적합도가 인접골 응력에 미치는 영향 분석

Finite Element Analysis of Bone Stress Caused by Horizontal Misfit of Implant Supported Three-Unit Fixed Prosthodontics

  • 이승환 (경북대학교 치의학전문대학원 치과보철학교실) ;
  • 조광헌 (경북대학교 치의학전문대학원 치과보철학교실)
  • Lee, Seung-Hwan (Department of Dentistry Graduate School, Kyungpook National University) ;
  • Jo, Kwang-Hun (Department of Prosthodontics, College of Dentistry, Kyungpook National University)
  • 투고 : 2012.04.20
  • 심사 : 2012.06.25
  • 발행 : 2012.06.30
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초록

본 연구에서는 유한요소해석 방법을 사용하여 임플란트 지지 3본 고정성 가공 의치에 수평적인 부적합이 존재할 때 그 정도가 임플란트 인접골 응력 발생에 미치는 영향에 대해 조사하였다. 3본 고정성 가공의치, 임플란트/악골 복합체로 구성된 해석 모델은 3차원으로 연구되었다. 3본 고정성 가공의치의 체결 간격은 하악 제2 소구치와 제2 대구치에 17.9mm 거리로 식립된 임플란트 간격에 비해 0.1mm 짧거나(17.8mm), 0.1mm 길게(18.0mm) 모델링하였다. 3본 고정성 가공의치와 임플란트 지대주 간의 체결은 총 6단계로 모사되었고 각 단계별로 가공의치가 하방으로 0.1mm 씩 변위되었다. 유한요소해석에는 PC용으로 출시된 DEFORM$^{TM}$ 3D 프로그램(ver 6.1, SFTC, Columbus, OH, USA)을 사용하였다. 3본 고정성 가공의치와 임플란트 사이의 응력은 von-Mises 응력, 최대 압축 응력, 필요한 경우 방사상 응력을 평가하였다. d=18.0mm인 모델에서는 가공의치와 지대주간의 체결이 이루어지지 않은 반면, d=17.8mm 인 모델에서는 성공적으로 체결이 가능했다. 체결 여부를 떠나 과도하게 높은 응력이 체결과정과 그 이후에 발생되었는데, 17.8mm 모델의 경우 체결완료 후에도 임플란트 주위 변연골에서 잔류하는 인장 및 압축 응력이 각각 최대 186.9MPa과 114.1MPa이었다. 이 경우 임플란트로부터 2mm 떨어진 부분까지 압축 응력이 골개조 장애 임계 응력인 55MPa($4,000{\mu}{\varepsilon}$과 같은 크기)보다 크게 측정되었다. 3본 고정성 가공의치의 0.1mm 크기의 수평적 부적합은 체결 과정뿐만 아니라 완료 후에도 인접 변연골에 높은 응력을 발생시킬 수 있다.

This study is to assess the effect of horizontal misfit of an implant supported 3-unit fixed prosthodontics on the stress development at the marginal cortical bone surrounding implant neck. Two finite element models consisting of a three unit fixed prosthodontics and an implant/bone complex were constructed on a three dimensional basis. The three unit fixed prosthodontics were designed either shorter (d=17.8mm model) or longer (d=18.0mm model) by 0.1mm than the span of two implants placed at the mandibular second premolar and second molar areas 17.9mm apart. Fitting of the fixed prosthodontics onto the implant abutments was simulated by a total of 6 steps, that is to say, 0.1mm displacement per each step, using DEFORM 3D (ver 6.1, SFTC, Columbus, OH, USA) program. Stresses in the fixed prosthodontics and implants were evaluated using von-Mises stress, maximum compressive stress, and radial stress as necessary. The d=17.8mm model assembled successfully on to the implant abutments while d=18.0mm model did not. Regardless if the fixed prosthodontics fitted onto the abutments or not, excessively higher stresses developed during the course of assembly trial and thereafter. On the marginal cortical bone around implants during the assembly, the peak tensile and compressive stresses were as high as 186.9MPa and 114.1MPa, respectively, even after the final sitting of the fixed prosthodontics (for d=17.8mm model). For this case, the area of marginal bone subject to compressive stresses above 55MPa, equivalent of the $4,000{\mu}{\varepsilon}$, i.e. the reported threshold strain to inhibit physiological remodeling of human cortical bone, extended up to 2mm away from implant during the assembly. Horizontal misfit of 0.1mm can produce excessively high stresses on the marginal cortical bone not only during the fixed prosthodontics assembly but also thereafter.

키워드

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