The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Finite element analysis of peri-implant bone stresses induced by root contact of orthodontic microimplant

치근접촉이 마이크로 임플란트 인접골 응력에 미치는 영향에 대한 유한요소해석

  • Yu, Won-Jae (Department of Orthodontics, School of Dentistry, Kyungpook National University) ;
  • Kim, Mi-Ryoung (Department of Orthodontics, School of Dentistry, Kyungpook National University) ;
  • Park, Hyo-Sang (Department of Orthodontics, School of Dentistry, Kyungpook National University) ;
  • Kyung, Hee-Moon (Department of Orthodontics, School of Dentistry, Kyungpook National University) ;
  • Kwon, Oh-Won (Department of Orthodontics, School of Dentistry, Kyungpook National University)
  • 유원재 (경북대학교 치의학전문대학원 교정학교실) ;
  • 김미령 (경북대학교 치의학전문대학원 교정학교실) ;
  • 박효상 (경북대학교 치의학전문대학원 교정학교실) ;
  • 경희문 (경북대학교 치의학전문대학원 교정학교실) ;
  • 권오원 (경북대학교 치의학전문대학원 교정학교실)
  • Received : 2010.08.04
  • Accepted : 2010.12.06
  • Published : 2011.02.28
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Abstract

Objective: The aim of this study was to evaluate the biomechanical aspects of peri-implant bone upon root contact of orthodontic microimplant. Methods: Axisymmetric finite element modeling scheme was used to analyze the compressive strength of the orthodontic microimplant (Absoanchor SH1312-7, Dentos Inc., Daegu, Korea) placed into inter-radicular bone covered by 1 mm thick cortical bone, with its apical tip contacting adjacent root surface. A stepwise analysis technique was adopted to simulate the response of peri-implant bone. Areas of the bone that were subject to higher stresses than the maximum compressive strength (in case of cancellous bone) or threshold stress of 54.8MPa, which was assumed to impair the physiological remodeling of cortical bone, were removed from the FE mesh in a stepwise manner. For comparison, a control model was analyzed which simulated normal orthodontic force of 5 N at the head of the microimplant. Results: Stresses in cancellous bone were high enough to cause mechanical failure across its entire thickness. Stresses in cortical bone were more likely to cause resorptive bone remodeling than mechanical failure. The overloaded zone, initially located at the lower part of cortical plate, proliferated upward in a positive feedback mode, unaffected by stress redistribution, until the whole thickness was engaged. Conclusions: Stresses induced around a microimplant by root contact may lead to a irreversible loss of microimplant stability.

마이크로 임플란트 시술의 중요한 위험요인 중 하나로 치근접촉 문제가 있으나, 관련 연구는 결과 분석에 치중되어 있고, 치근접촉이 마이크로 임플란트 안정성 상실로 이어지는 기전에 대한 연구는 아직 미흡한 것으로 보인다. 이에, 본 연구에서는 생역학적 측면에서 그 영향을 분석하였다. Absoanchor 마이크로 임플란트(SH1312-7, Dentos Inc., Daegu, Korea) 첨부가 치근에 접촉되어 있을 때, 저작압 전달에 의한 마이크로 임플란트 변위가 인접골에 가하는 압축응력을 축대칭 유한요소모델을 사용하여 계산하였다. 요소별 응력이 해면골의 최대압축강도나, 치밀골의 비정상 골개조 임계능력을 넘을 경우 해당 요소를 순차적으로 해석모델에서 제거하며 실행한 6단계해석의 결과, 마이크로 임플란트에 인접한 해면골의 전체적인 파절과 과부하에 따른 치밀골의 비정상 골개조가 임플란트 지지력 상실에 주 요인이 될 것으로 평가되었다. 치밀골의 과부하 영역은 초기에는 치밀골판의 하부에 존재하였으나 상부로 확장되었고, 응력 재분포로 인한 감소효과 없이 양성 되먹임(positive feedback)으로 결국 치밀골 전 두께로 확대됨을 관찰하였다. 본 연구를 통해 치근접촉된 마이크로 임플란트가 인접골을 훼손시켜 안정성 상실로 이어지는 과정을 모사할 수 있었으며, 이로부터 치근접촉에 따른 마이크로 임플란트의 불량한 예후에 대한 생역학적 측면의 원인을 파악할 수 있었다.

Keywords

Acknowledgement

Supported by : 중소기업청

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