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A FEM study on stress distribution of tooth-supported and implant-supported overdentures retained by telescopic crowns

텔레스코픽 크라운 임플란트 지지 피개의치와 치아 지지 피개의치의 하악골내 응력분포에 관한 유한요소분석

  • Paek, Jang-Hyun (Department of Prosthodontics, School of Dentistry, Kyung-Hee University) ;
  • Lee, Chang-Gyu (Department of Prosthodontics, School of Dentistry, Kyung-Hee University) ;
  • Kim, Tae-Hun (Department of Prosthodontics, School of Dentistry, Kyung-Hee University) ;
  • Kim, Min-Jung (Department of Prosthodontics, School of Dentistry, Kyung-Hee University) ;
  • Kim, Hyeong-Seob (Department of Prosthodontics, School of Dentistry, Kyung-Hee University) ;
  • Kwon, Kung-Rock (Department of Prosthodontics, School of Dentistry, Kyung-Hee University) ;
  • Woo, Yi-Hyung (Department of Prosthodontics, School of Dentistry, Kyung-Hee University)
  • 백장현 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 이창규 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 김태훈 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 김민정 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 김형섭 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 권긍록 (경희대학교 치의학전문대학원 치의학과 치과보철학교실) ;
  • 우이형 (경희대학교 치의학전문대학원 치의학과 치과보철학교실)
  • Received : 2011.10.12
  • Accepted : 2011.12.30
  • Published : 2012.01.31

Abstract

Purpose: The purpose of this study was to investigate the stress distribution in mandibular implant-supported overdentures and tooth-supported overdentures with telescopic crowns. Materials and methods: The assumption of this study was that there were 2, 3, 4 natural teeth and implants which are located in the second premolar and canine regions in various distributed conditions. The mandible, teeth (or implants and abutments), and connectors are modeled, and analyzed with the commercial software, ANSYS Version 10.1. Stress distribution was evaluated under 150 N vertical load bilaterally on 3 experimental conditions - between canine areas, canine and $2^{nd}$ premolars, 10 mm posterior to $2^{nd}$ premolars. Results: Overall, the case of the implant group showed more stress than the case of the teeth group in stress distribution to bone. In stress distribution to superstructures of tooth and implants, there was no significant difference between TH group and IM group and the highest stress appeared in TH-IV and IM-IV. The stress caused from bar was much higher than those of implant and tooth. TH group showed less stress than IM group in stress distribution to abutment teeth and implant. Conclusion: The results shows that it is crucial to make sure that distance between impact loading point and abutment tooth does not get too far apart, and if it does, it is at best to set abutment tooth on premolar tooth region. It will be necessary to conduct more experiments on effects on implants, natural teeth and bone, in order to apply these results to a clinical treatment.

연구 목적: 이 연구의 목적은 텔레스코픽 크라운 하악 임플란트 지지 피개의치와 치아 지지 피개의치에서 지대치의 수와 위치에 따른 응력 분산을 비교하기 위함이다. 연구 재료 및 방법: 본 연구에서는 임플란트를 4개 식립하고 임플란트 지지 피개의치로 설계하였고, 식립 위치를 견치와 소구치 부위에 위치 별로 3개 또는 2개존재시를 실험군으로 설정하였다. 자연치아를 갖는 경우도 견치와 제2소구치 4개를 가진 경우를 대조군으로 설정하고 부위별로 3개 또는 2개를 가지는 경우를 실험군으로 설정하였다. ANSYS Version 10.1(Swanson, Inc., USA)로 분석하였다. 결과: 악골내 응력의 경우, 전반적으로 임플란트(IM)로만 구성된 경우가 치아(TH)로만 구성된 경우에 비해 응력이 크게 발생하였다. 상부구조의 경우, 치아군(TH)과 임플란트군(IM) 사이의 차이는 크게 없었으며 편측 견치와 제2소구치에 지대치 또는 임플란트가 위치하는 경우 가장 큰 응력이 나타났고 바(bar)에서 발생된 응력이 임플란트와 치아에서 발생되는 응력에 비해 상대적으로 훨씬 크게 발생하였다. 지대치와 임플란트의 경우, 치아군(TH)이 임플란트군(IM)보다 응력이 작게 발생하였다. 결론: 본 연구의 결과로부터 지대치(임플란트 또는 치아)를 설정할 때는 하중작용점과 지대치 사이의 거리가 너무 길어지지 않도록 지대치의 수와 위치를 확보해야 하며 소구치 자리에 지대치를 확보하는 것이 유리하다. 앞으로, 실제 임상에 적용하였을 경우, 임플란트 및 자연치아와 악골에 미치는 결과에 대한 연구가 더 필요할 것으로 생각된다.

Keywords

References

  1. Brewer AA. Overdentures. 2nd ed. Mosby, St. Louis; 1980.
  2. Fanuscu MI, Caputo AA. Influence of attachment systems on load transfer of an implant-assisted maxillary overdenture. J Prosthodont 2004;13:214-220. https://doi.org/10.1111/j.1532-849X.2004.04041.x
  3. van Kampen F, Cune M, van der Bilt A, Bosman F. Retention and postinsertion maintenance of bar-clip, ball and magnet attachments in mandibular implant overdenture treatment: an in vivo comparison after 3 months of function. Clin Oral Implants Res 2003;14:720-726. https://doi.org/10.1046/j.0905-7161.2003.00961.x
  4. Heckmann SM, Schrott A, Graef F, Wichmann MG, Weber HP. Mandibular two-implant telescopic overdentures. Clin Oral Implants Res 2004;15:560-569. https://doi.org/10.1111/j.1600-0501.2004.01064.x
  5. Engquist B, Bergendal T, Kallus T, Linden U. A retrospective multicenter evaluation of osseointegrated implants supporting overdentures. Int J Oral Maxillofac Implants 1988;3:129-134.
  6. Hutton JE, Heath MR, Chai JY, Harnett J, Jemt T, Johns RB, McKenna S, McNamara DC, van Steenberghe D, Taylor R, et al. Factors related to success and failure rates at 3-year follow- up in a multicenter study of overdentures supported by Branemark implants. Int J Oral Maxillofac Implants 1995;10:33-42
  7. Johns RB, Jemt T, Heath MR, Hutton JE, McKenna S, McNamara DC, van Steenberghe D, Taylor R, Watson RM, Herrmann I. A multicenter study of overdentures supported by Branemark implants. Int J Oral Maxillofac Implants 1992;7:513-522.
  8. Lekholm U, Zarb GA. Patient selection and preparation. In: Branemark PI, Zarb GA, Albrektsson T, editors. Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago: Quintessence; 1985. p. 199-209.
  9. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999;81:537-552. https://doi.org/10.1016/S0022-3913(99)70208-8
  10. Naert I, De Clercq M, Theuniers G, Schepers E. Overdentures supported by osseointegrated fixtures for the edentulous mandible: a 2.5-year report. Int J Oral Maxillofac Implants 1988;3:191-196.
  11. Yokoyama S, Wakabayashi N, Shiota M, Ohyama T. Stress analysis in edentulous mandibular bone supporting implantretained 1-piece or multiple superstructures. Int J Oral Maxillofac Implants 2005;20:578-583.
  12. Ralph WJ. The effects of dental treatment on biting force. J Prosthet Dent 1979;41:143-145. https://doi.org/10.1016/0022-3913(79)90296-8
  13. Heckmann SM, Winter W, Meyer M, Weber HP, Wichmann MG. Overdenture attachment selection and the loading of implant and denture-bearing area. Part 2: A methodical study using five types of attachment. Clin Oral Implants Res 2001;12:640-647. https://doi.org/10.1034/j.1600-0501.2001.120613.x
  14. Menicucci G, Lorenzetti M, Pera P, Preti G. Mandibular implantretained overdenture: finite element analysis of two anchorage systems. Int J Oral Maxillofac Implants 1998;13:369-376.
  15. Krennmair G, Seemann R, Weinlander M, Piehslinger E. Comparison of ball and telescopic crown attachments in implantretained mandibular overdentures: a 5-year prospective study. Int J Oral Maxillofac Implants 2011;26:598-606.
  16. Curry J. The mechanical adaptations of bones. Princeton University Press. 1984.

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