원추형 연결 임플란트에서 지대주 종류에 따른 나사풀림과 침하현상에 관한 연구 = Effect of various abutment systems on the removal torque and the abutment settling in the conical connection implant systems

다국어 초록 (Multilingual Abstract)

Purpose: The aim of this study was to evaluate the effects of different abutment materials on abutment screw loosening and settling-down effect in conical connection type implant system. Materials and methods: Three types of abutment, cementation, gold UCLA, and metal UCLA abutment were used. Two UCLA groups were fabricated in a similar pattern to cementation abutment. Type III gold alloy and Nickel-Chromium alloy was used for casting gold UCLA abutment and metal UCLA abutment, respectively. Fixture and abutment were tightened to 30 Ncm by using digital torque controller and re-tightening was conducted with same force after 10 minutes. Digital torque gauge was used to measure loosening torque and fixture/abutment length was measured by digital micrometer. Dynamic loads between 25 N and 250 N were applied with 0 degree angle to the abutment axis. After loading, fixture/abutment length was re-measured and amount of settlement was calculated. Loosening torque value was also measured for comparison. Results: All three groups showed significant differences of length when comparing before and after loading, but there was no significant difference of settling amount in all groups. Loosening torque values were significantly decreased when comparing before and after loading in all groups(P<.05). However, there was no significant difference in loss of loosening torque values when compared to groups. Conclusion: In internal conical connection type implants, dynamic load affected on settlement and loosening torque of implant, but there was no differences between abutments materials. Likewise gold UCLA abutment, metal UCLA abutment might be able to withstand functional load.

국문 초록 (Abstract)

연구 목적: 본 연구 목적은 서로 다른 재료로 제작된 지대주를 이용하여 동적하중을 가했을 때 풀림토크와 침하량에 대한 임플란트-지대주 연결부의 안정성에 대하여 알아보는 것이다. 연구 재료 및 방법: 원추형 내부연결 구조를 갖는 임플란트에 이용되는 세 가지 지대주, 티타늄 합금 지대주(Cement abutment, Osstem Co., Seoul, Korea), 귀금속 UCLA 지대주(UCLA Goldcast abutment, Osstem Co., Seoul, Korea), 비귀금속 UCLA 지대주(CCM Metalcast abutment, 3M ESPE, Seefeld, Germany)를 사용하였다. 귀금속 UCLA 지대주와 비귀금 속 UCLA 지대주를 티타늄 지대주와 유사한 형태로 납형을 형성 한 후 각각 제 3형 금합금(E-3, Heesung catalyst Co., Seoul, Korea)와 니켈-크롬 합금인(Rexillium III(R), Pentron(R), San Diego, USA)를 사용하여 주조 하였다. 임플란트와 지대주를 디지털 토크 컨트롤러를 이용하여 30 Ncm로 체결하였고 전하중 상실을 보상하기 위하여 10분 후 다시 같은 힘으로 체결 하였다. 디지털 토크 게이지를 사용하여 풀림토크를 측정하였고 디지털 마이크로미터를 이용하여 임플란트/지대주 길이를 측정하였다. 그 후 동적 하중 피로 시험기에 지대주를 장착한 후 최대 250 N, 최소 25 N, 주기 14 HZ의 sine형의 하중을 장축과 평행하게 가하였다. 하중 후 임플란트/지대주의 길이를 재측정 하고, 전후 길이 변화량을 이용하여 침하량을 계산하였으며 풀림토크를 측정하였다. 결과: 하중 전후의 길이를 비교하였을 때 세 군 모두에서 유의한 차이를 보였다(P<.05). 군 간의 침하량을 비교하였을 때 통계적으로 유의한 차이를 보이지는 않았다. 하중 전후의 풀림토크를 비교하였을 때 역시 세 군 모두에서 유의한 차이를 보이며 감소하였다 (P<.05). 하중 전 풀림토크와 하중 후 풀림토크를 군간 비교하였을 경우에는 통계적으로 유의한 차이를 보이지는 않았다. 결론: 원추형 내부 연결구조를 갖는 임플란트에서 동적하중은 임플란트의 침하량과 풀림토크에 영향을 미치는 것으로 보이나 지대주간 차이는 나타나지 않았다. 비귀금속 UCLA 지대주이 사용은 귀금속 UCLA 지대주와 마찬가지로 기능적 하중에서 안정적일 것으로 사료된다.

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