Abstract
The dental implants for edentulous Patients have been used for more than 20 years. After the introduction of osseointegration by $Br{\aa}nemark$, the commercially pure titanium implants were accepted by most practitioners. Recently dental implants are used for orthodontic anchorages as well as prosthetic abutment. Many researchers have reported implants as a good orthodontic anchorage through basic research and clinical evaluation. But previous researches were done after the healing time for osseointegration of inserted implants. If dental implants are to be used for prosthetic abutment the healing time for osseointegration is necessary, but orthodontic forces to implants are different from bite force regarding its amount of force, duration and direction. The authors evaluated the effect of orthopedic force to implants on bone tissue before osseointegration. 48 implants were placed at 12 rabbits. 2 implants into left side and 2 implants into right side were inserted along the long axis of femur respectively 2 weeks (2 weeks group), 4 weeks (4 weeks group) and 6 weeks (6 weeks group) after implants placement, 300g force had been applied to the implants at left side femur by Ni-Ti close coil spring for 4 weeks (experimental group) and no force applied to implants at right side femur (control group). After the force application for 4weeks, rabbits were sacrificed and microscopic evaluation was done by hematoxylin-eosin stain and Masson trichrome stain. The result3 were followed. 1. All implants in experimental group remained rigid after the force application for 4 weeks. 2. More fibrous tissue between bone and implants were noticed at 2 weeks experimental group than 2 weeks control group 3. More bone remodeling was noticed at 4weeks group than 2 weeks group and it was difficult to find out fibrous tissue between bone and implants at both experimental and control group of 4 weeks group. 4. It was hard to distinguish experimental group from control group at 6 weeks group. Therefore if initial stability can be obtained on implant insertion, it can be possible to use implants as a orthodontic anchorage before the healing time for osseointegration.
저자들은 임프란트 매식 후 골유착을 위한 초기 치유기간 이전에 악정형력이 임프란트 주위 조직에 미치는 영향을 관찰하기 위하여 가토 12마리의 양측 대퇴골에 임프란트를 식립하고 2주, 4주 그리고 6주후에 각각 300g의 악정형력을 Ni-Ti close coil spring을 이용하여 매식된 임프란트에 4주동안 가하고 관찰한 후 다음과 같은 결론을 얻었다. 1. 모든 실험군의 임프란트는 4주간의 악정형력 적용후에도 안정된 견고성을 유지하였다. 2. 2주 실험군에서 대조군에 비해 임프란트와 골조직 사이의 섬유조직 증식이 많이 관찰 되었으나 특이할만한 염증소견은 관찰되지 않았다. 3. 4주 실험군, 대조군에서는 2주 실험군, 대조군과 각각 비교하였을 때 보다 많은 양의 골재생이 관찰 되었으며 실험군과 대조군 모두에서 임프란트와 골조직 사이의 섬유조직은 관찰하기 힘들었다. 4. 6주에서는 실험군과 대조군 사이에 뚜렷한 차이가 발견되지 않았다. 이상의 결과로 보아 임프란트 주위의 골조직 재생이 충분하지 않아도 골의 양과 질이 우수해 임프란트 식립시 견고한 초기고정을 얻을 수 있다면 골유착이 완성되는 초기 치유기간 이전에도 치과교정적 고정원으로 사용가능할 것으로 사료된다.