Journal of Dental Rehabilitation and Applied Science (구강회복응용과학지)

Korean Academy of Stomatognathic Function and Occlusion (대한턱관절교합학회)
권호 표지

Effect of Implant Length on the Immediate Loading at the Anterior Maxilla

즉시하중시 상악 전치부에 식립된 임플란트 길이 변화에 따른 응력 분포의 삼차원 유한요소 연구

  • Lee, Joon-Seok (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kim, Myung-Joo (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kwon, Ho-Beom (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Lim, Young-Jun (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University)
  • 이준석 (서울대학교 치의학대학원 치과보철학 교실) ;
  • 김명주 (서울대학교 치의학대학원 치과보철학 교실) ;
  • 권호범 (서울대학교 치의학대학원 치과보철학 교실) ;
  • 임영준 (서울대학교 치의학대학원 치과보철학 교실)
  • Received : 2009.07.25
  • Accepted : 2009.09.25
  • Published : 2009.09.30
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Abstract

Recently many studies have been published on application of immediate loaded implants. However, the immediate loading protocol has not been well documented. The purpose of the present study was to evaluate the stress distribution between bone-implant interfaces and the effect of implant length in the anterior maxilla using 3 dimensional finite element analyses. The diameter 4.0 mm threaded type implants with different length(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm) were used in this study. The bone quality of anterior maxillary bone block was assumed to D3 bone. Bone-implant interfaces of immediately loaded implant were constructed using a contact element for simulating the non osseointegration status. For simplification of all the processing procedures, all of the material assumed to be homogenous, isotropic, and linearly elastic. The 178 N of static force was applied on the middle of the palatoincisal line angle of the abutment with $120^{\circ}$ angle to the long axis of abutment. Maximum von Mises stress were concentrated on the labial cortical bone of the implant neck area, especially at the cortical-cancellous bone interfaces. Compared the different length, highest peak stress value was observed at the 8.5 mm implants and the results indicated a tendency towards favorable stress distribution on the bone, when the length was increased. Presence of cortical bone was very important to immediate loading, and it appears that implants of a length more than 13 mm are preferable for immediate loading at the anterior maxilla.

즉시 하중에 대한 관심과 시도가 증가되고 있지만, 명확한 술식이 정립되어 있지는 않다. 본 연구에서는 상악 전치부 임플란트에서 즉시 하중시에 골과 임플란트에 나타나는 응력분포 양상을 3차원 유한요소법을 이용하여 알아보고자 하였다. 골질이 D3인 상악 전치부의 골모형을 구성하고, 서로 다른 길이(8.5 mm, 10.0 mm, 11.5 mm, 13.0 mm, 15.0 mm)의 직경 4.0 mm 나사형 임플란트를 식립한 모형을 제작하였다. 해석 절차의 간소화를 위하여 모든 물성은 등방성, 선형탄성, 균질성으로 가정하였다. 골-임플란트 계면은 접촉 요소법으로 처리하여 골유착이 일어나기 전 상태로 구성하였다. 지대주 장축에 120도의 각도로 지대주의 구개 절단각 중앙부에 176 N의 정하중을 가하고 응력분포를 관찰하였다. von Mises stress를 이용하여 응력을 분석한 결과 모든 모형에서 순측 피질골에 응력이 집중되었으며 피질골과 망상골의 경계부에서 최대 응력값을 나타내었다. 길이에 따른 비교시 8.5 mm 모형에서 가장 큰 최대 응력값을 나타냈으며, 임플란트 길이가 증가될수록 좀 더 양호한 응력 분포를 나타내었다. 상악 전치부 즉시 하중시에 피질골의 존재 유무는 매우 중요하며, 길이가 긴 임플란트를 식립하는 것이 유리하며, 가능하면 13.0 mm 이상의 임플란트를 식립하는 것이 즉시하중을 시행할 때 응력 분산에 유리한 것으로 판단된다.

Keywords

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