The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Biomechanical considerations for the screw of implant prosthesis: A literature review

임플란트 나사에 적용되는 생역학적 원리: 문헌고찰

  • Im, So-Min (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Dae-Gon (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Cha, Min-Sang (Gangneung Asan Hospital, College of Medicine, University of Ulsan) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University)
  • 임소민 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 김대곤 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 차민상 (강릉아산병원 보철과) ;
  • 조리라 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소)
  • Published : 2010.01.29
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Abstract

Purpose: This article attempted to determine the factors affecting the preload and screw loosening. Methods: Available clinical studies from 1981 to 2008 from the PUBMED that presented screw loosening data and review articles regarding screw joint stability were evaluated. Eleven studies dealing the biomechanical principles of the screw mechanics were reviewed. Moreover, the results of our data were included. Results: The frequency of screw loosening was consequently reduced due to the advancement in torque tightening with torque wrench, screw material, coating technique for reducing the frictional force, and thread design, etc. If preload in the screw falls below a critical level, joint stability may be compromised, and the screw joint may fail clinically. The types of fatigue failure of screw were divided to adhesive wear, plastic deformation, and screw fracture. Conclusion: An optimum preload is essential to the success of the implant-abutment complex. To maintain optimum preload, using a torque wrench and re-tightening at recall time were needed.

연구 목적: 임플란트 보철물의 유지 나사에 적용되는 전하중은 나사를 조임으로써 임플란트와 지대주 사이에 인장력이 발생하면서 나사가 신장되는 힘을 말한다. 이 연구는 전하중에 영향을 미치는 생역학적 요인들과 나사 풀림에 기여하는 다양한 요인에 대하여 문헌을 고찰하고자 하였다. 연구 재료 및 방법: 1981년부터 2009년까지 발표된 나사 풀림을 다룬 임상연구 중 설정한 기준에 합당한 문헌을 요약하여 나사 풀림의 빈도를 밝혔고 나사의 안정성과 전하중에 관한 생역학을 다룬 문헌을 조사하고 요약하였다. 또한, 본 교실에서 연구한 실험실적 결과도 포함시켰다. 결과 및 결론: 나사 풀림의 정도는 나사에 토크를 가하는 기술이 발달함에 따라 현저히 감소하고 있다. 그 외에도 나사의 재질, 마찰계수를 감소시키기 위한 피복 기술의 발달 및 나사산의 모양 등 전하중에 영향을 줄 수 있는 요인을 고찰하였다. 전하중이 일정 수준 이하로 떨어지게 되면 나사의 움직임이 발생하게 되는데 이는 장기적으로 축적되어 피로파절 및 응착 마모, 소성 변형 등을 유발하게 되므로 주의해야 한다. 최적의 전하중을 주기 위해서는 토크 렌치를 이용하고 환자의 재내원시 다시 토크를 가하는 방법 등이 추천된다.

Keywords

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