치조골 폭경과 임플랜트 고정체의 직경에 따른 지지조직의 응력분포

STRESS ANALYSIS OF SUPPORTING TISSUES ACCORDING TO IMPLANT FIXTURE DIAMETER AND RESIDUAL ALVEOLAR BONE WIDTH

  • 한상운 (전남대학교 치의학전문대학원 치과보철학교실) ;
  • 방몽숙 (전남대학교 치의학전문대학원 치과보철학교실) ;
  • 양홍서 (전남대학교 치의학전문대학원 치과보철학교실) ;
  • 박상원 (전남대학교 치의학전문대학원 치과보철학교실) ;
  • 박하옥 (전남대학교 치의학전문대학원 치과보철학교실) ;
  • 임현필 (전남대학교 치의학전문대학원 치과보철학교실)
  • Han, Sang-Un (Department of Dental Science, Graduate School, Chonnam National University) ;
  • Vang, Mong-Sook (Department of Dental Science, Graduate School, Chonnam National University) ;
  • Yang, Hong-So (Department of Dental Science, Graduate School, Chonnam National University) ;
  • Park, Sang-Won (Department of Dental Science, Graduate School, Chonnam National University) ;
  • Park, Ha-Ok (Department of Dental Science, Graduate School, Chonnam National University) ;
  • Lim, Hyun-Pil (Department of Dental Science, Graduate School, Chonnam National University)
  • 발행 : 2007.08.31

초록

Statement of problem: The cumulative success rate of wide implant is still controversial. Some previous reports have shown high success rate, and some other reports shown high failure rate. Purpose: The aim of this study was to analyze, and compare the biomechanics in wide implant system embeded in different width of crestal bone under different occlusal forces by finite element approach. Material and methods: Three-dimensional finite element models were created based on tracing of CT image of second premolar section of mandible with one implant embedded. One standard model (6mm-crestal bone width, 4.0mm implant diameter central position) was created. Varied crestal dimension(4, 6, 8 mm), different diameter of implants(3.3, 4.0, 5.5, 6.0mm), and buccal position implant models were generated. A 100-N vertical(L1) and 30 degree oblique load from lingual(L2) and buccal(L3) direction were applied to the occlusal surface of the crown. The analysis was performed for each load by means of the ANSYS V.9.0 program. Conclusion: 1. In all cases, maximum equivalent stress that applied $30^{\circ}$ oblique load around the alveolar bone crest was larger than that of the vertical load. Especially the equivalent stress that loaded obliquely in buccal side was larger. 2. In study of implant fixture diameter, stress around alveolar bone was decreased with the increase of implant diameter. In the vertical load, as the diameter of implant increased the equivalent stress decreased, but equivalent stress increased in case of the wide implant that have a little cortical bone in the buccal side. In the lateral oblique loading condition, the diameter of implant increased the equivalent stress decreased, but in the buccal oblique load, there was not significant difference between the 5.5mm and 6.0mm as the wide diameter implant. 3. In study of alveolar bone width, equivalent stress was decreased with the increase of alveolar bone width. In the vertical and oblique loading condition, the width of alveolar bone increased 6.0mm the equivalent stress decreased. But in the oblique loading condition, there was not a difference equivalent stress at more than 6.0mm of alveolar bone width. 4. In study of insertion position of implant fixture, even though the insertion position of implant fixture move there was not a difference equivalent stress, but in the case of little cortical bone in the buccal side, value of the equivalent stress was most unfavorable. 5. In all cases, it showed high stress around the top of fixture that contact cortical bone, but there was not a portion on the bottom of fixture that concentrate highly stress and play the role of stress dispersion. These results demonstrated that obtaining the more contact from the bucco-lingual cortical bone by installing wide diameter implant plays an important role in biomechanics.

키워드

참고문헌

  1. Branemark PI. Osseointegration and its experimental background. J Prosthet Dent 1983:50:399-410 https://doi.org/10.1016/S0022-3913(83)80101-2
  2. Adell R, Lekholm U, Branemark PI. A 15 year study of osseointegrated edentulous jaw. J Oral Surg 1981:10:387-416 https://doi.org/10.1016/S0300-9785(81)80077-4
  3. Borchers L, Reichart P. Three dimensional stress distribution around a dental implant at different stages of iterface development. J Dent Res 1983:62:155-9 https://doi.org/10.1177/00220345830620021401
  4. Hobo S, Ichida E, Garcia LT. Osseointegration and occlusal rehabilitation. Chicago, Quintessence Publ. Co., 1989:265
  5. Williams KR, Watson CJ, Murphy WM, Scott J, Gregory M, Sinobad D. Finite element analysis of fixed prosthesis attached to osseointegrated implant. Quintessence 1990:21:563-70
  6. Haraldson T, Branemark PI. The silient period and jaw jerk reflex in patients with osseointegrated oral implant bridge. Scand J Dent Res 1979:87:365-72
  7. Isidor F. Loss of osseointegration caused by occlusal load of oral implants. A clinical and radiographic study in monkeys. Clin Oral Impl Res 1996:7:143-52 https://doi.org/10.1034/j.1600-0501.1996.070208.x
  8. Spray JR, Black CG, Morris HF, Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontal 2000:5:119-28 https://doi.org/10.1902/annals.2000.5.1.119
  9. Covani U, Bortolaia C, Barone A, Sbordone L. Bucco-lingual crestal bone changes after immediate and delayed implant placement. J Periodontol 2004:75:1605-12 https://doi.org/10.1902/jop.2004.75.12.1605
  10. Renouard F, Arnoux JP, Sarment DP. Fivs-mm-diameter implants without a smooth surface collar: Report on 98 consecutive placements. Int J Oral Maxillofac Implants 1999:14:101-7
  11. Wilson TG Jr. Buser D. Advances in the use of guided tissue regeneration for localized ridge augmentation in combination with dental implants. Tex Dent J 1994:111:5, 7-10
  12. Misch CE. Contemporary implant dentistry, Mosby-Year Book Inc., St. Louis. 1993
  13. Sahin S, Akagawa Y, Wadamoto M, Sato Y. The Three-dimensional bone interface of an osseointegrated implant. II : A morphometric evaluation after three months of loading. J Prosthet Dent 1996:76:176-80 https://doi.org/10.1016/S0022-3913(96)90303-0
  14. Palacci P, Ericsson I, Engstrand P, Rangert B. Optimal implant positioning & soft tissue management for the Branemark system. Chicago, Quintessence Publ. Co., 1995
  15. Davarpanah M, Martinez H, Kebir M, Etienne D. Tecucianu JF. Wide-diameter implants: New concepts. Int J Perio Rest Dent 2001:21:149-59
  16. Graves SL, Jansen CE, Siddiqui AA, Beaty KD. Wide diameter implants : indications. considerations and preliminary results over a two-year period. Aust Prosthodont J 1994:8:31-7
  17. Aparicio C, Orozco P. Use of 5-mm-diameter implants : Periotest values related to a clinical and radiographic evaluation. Clin Oral Implants Res 1998:9:398-406 https://doi.org/10.1034/j.1600-0501.1996.090605.x
  18. Matsushita M, Kitoh M, Mizuta K, Ikeda H, Suetsugu T. Two-dimensional FEM analysis of hydroxyapatite implants : Diameter effects on stress distribution. J Oral Implantol 1990:16:6-11
  19. Langer B, Langer L, Herrman I, Jorneus L. The wide fixture : a solution for special bone situations and a rescue for the compromised implant. part I. Int J Oral Maxillofac Implants 1993:8:400-8
  20. Eckert SE, Meraw SJ, Weaver AL, Lohse CM. Early experience with Wide-Platform Mk II implants. part I : implants survival. Part II : Evaluation of risk factors involving implant survival. Int J Oral Maxillofac Implants 2001:16:208-16
  21. Major M Ash Jr. Wheeler s Dental anatomy. physiology and occlusion.: 7th ed W.B. Saunders Co. 1993:218-231
  22. Gibbs CH, Mahan PE, Lundeen HC, Brehnan K, Walsh EK. Holbrook WB, Occlusal forces during chewing and swallowing as measured by sound transmission. J Prosthet Dent 1981:46:443-9 https://doi.org/10.1016/0022-3913(81)90455-8
  23. Craig RG. Restorative Dental Materials. 6th ed : C.V. Mosby Co. 1980:602
  24. Anderson DJ. Measurement of stress in mastication I. J Dent Res 1956:35:664-70 https://doi.org/10.1016/j.jdent.2007.05.002
  25. Anderson DJ. Measurement of stress in mastication II. J Dent Res 1956:35: 671-3 https://doi.org/10.1177/00220345560350050301
  26. Cellant NL, Ismail YH, Zail HS, Pipko D. Three-dimensional finite element stress analysis in and around the Screw-Vent implant. Int J Oral Maxillofac implants 1991:6:391-8
  27. Ryu SY, Yang HS, Cho KZ. Two dimensional stress analysis of root and supporting tissues by various post design. J Korean Dental Association 1988:26:737
  28. Craig GG, Peyton FA. Measurement of stresses in field bridge restortations using brittle coating technique. J Dent Res 1965:44:756 https://doi.org/10.1177/00220345650440042201
  29. Dirtoft BI, Jansson JF, Abramson NH. Using holography for measurement of in vivo deformation in complete maxillary denture. J Prosthet Dent 1985:54:843-6 https://doi.org/10.1016/0022-3913(85)90484-6
  30. Kim YH, Kim YS. A study on the connection modality between implant and tooth in osseointegrated prosthetic treament using finite element analysis. J Kor Acad Prosthodont 1991:29:1
  31. Yang HS, Van P Thompson. A two dimensional stress analysis of fixed prosthesis with rigid or nonrigid connectors. J Kor Acad Prosthodont 1992:30:445
  32. Hirayama M, Wang M. Bone morphology associated with biologic width among various dental implant designs. The Advanced J Clinical Implant Dentistry : Sensible. 2002:2:17
  33. Jung JW, Lee CH. The effect of the difference of the implant fixture and abutment diameter for stress distribution. J Kor Acad Prosthodont 2004:42: 583-596
  34. Ahn JK, Kay KS, Chung CH. Finite element stress analysis of implant prosthesis with internal connection between the implant and the abutment. J Kor Acad Prosthodont 2004:42:356-372
  35. Jarvis WC. Biomechanical advantages of wide-diameter implants. Compend Contin Educ Dent 1997:18:687-92, 694
  36. Weinberg LA. The biomechanics of force distribution in implant-supported prostheses. Int J Oral Maxillofac Implants 1993:8:19-31
  37. Clelland NL, Lee JK, Bimbenet OC, Gilat A. Use of an axisymmetric finite element method to compare maxillary bone variables for a loaded implant. J Prosthodont 1993:2:183-9 https://doi.org/10.1111/j.1532-849X.1993.tb00405.x
  38. Holmes DC, Loftus JT. Influence of bone quality on stress distribution for endosseous implants. J Oral Implantol 1997:23:104-11
  39. Stegaroiu R, Sato T, Kusakari H, Miyakawa O. Influence of restoration type on stress distribution in bone around implants : A three-dimensional finite element analysis. Int J Oral Maxillofac Implants 1998:13:82-90
  40. Ichikawa T, Kanitani H, Wigianto R, Kawamoto N, Matsumoto N. Influence of bone quality on the stress distribution: An in vitro experiment. Clin Oral Implants Res 1997:8:18-22 https://doi.org/10.1111/j.1600-0501.1997.tb00003.x
  41. Choi JH, Seo KY, Choi JH, Han JS. Effects of bone engagement type&implant length on stress distribution: a three dimensional finite element analysis. J Kor Acad Prosthodont 1999:37:687-700
  42. Burr DB, Martin RB. Errors in bone remodeling : toward a unified theory of metabolic bone disease. Am J Anat 1989:186:186-216 https://doi.org/10.1002/aja.1001860208