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기성 지대주와 맞춤형 CAD-CAM 지대주의 적합 및 나사 안정성 비교

A comparative study on the fit and screw joint stability of ready-made abutment and CAD-CAM custom-made abutment

  • 김종욱 (조선대학교 치과대학 치과보철학교실) ;
  • 허유리 (조선대학교 치과대학 치과보철학교실) ;
  • 김희중 (조선대학교 치과대학 치과보철학교실) ;
  • 정재헌 (조선대학교 치과대학 치과보철학교실)
  • Kim, Jong-Wook (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Heo, Yu-Ri (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Kim, Hee-Jung (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Chung, Chae-Heon (Department of Prosthodontics, School of Dentistry, Chosun University)
  • 투고 : 2013.08.19
  • 심사 : 2013.10.01
  • 발행 : 2013.10.31

초록

연구 목적: 본 연구에서는 기성 지대주와 맞춤형CAD-CAM 지대주의 적합성 및 나사 사이의 안정성 대해 알아보고자 한다. 연구 재료 및 방법: 오스템 임플란트 시스템을 이용하였다. 동일회사에서 제작된 기성 지대주(Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea) 및 맞춤형CAD-CAM 지대주(CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea)와 국내 외주 제작된 맞춤형CAD-CAM 지대주(Myplant, Raphabio Co., Seoul, Korea)를 5개씩 선택, 제작하였으며 나사는 각 회사에서 제공되는 것을 사용하였다. 제조사의 지시에 따라 고정체와 지대주를 30 Ncm으로 조인 후 초기 풀림 토크를 3회 반복 측정한 후 통계 분석하였다(${\alpha}=.05$). 고정체-지대주 연결체를 에폭시 레진에 매몰 후 습식 절삭 및 연마하여 계면 사이의 적합성을 FE-SEM으로 관찰하였다. 결과: 지대주의 초기 풀림 토크 값은 각각 기성 지대주(Transfer abutment)에서 $26.0{\pm}0.30Ncm$, 동일 회사에서 제작된 맞춤형CAD-CAM 지대주(CustomFit abutment)에서 $26.3{\pm}0.32Ncm$, 외주로 제작된 맞춤형CAD-CAM 지대주(Myplant abutment)에서 $24.7{\pm}0.67Ncm$였다. 국내 외주 제작된 맞춤형CAD-CAM 지대주에서 유의적으로 낮은 초기 풀림 토크 값을 보였으며(P=.027), 고정체-지대주 계면에서 변연 간극이 관찰되었다. 결론: 본 실험의 한계 내에서 국내 외주 제작된 맞춤형CAD-CAM 지대주는 동일 회사에서 제작된 기성 지대주나 맞춤형CAD-CAM 지대주에 비해 더 낮은 나사 안정성 및 적합성을 보인다고 볼 수 있다.

Purpose: The purpose of this study was to investigate the fit and screw joint stability between Ready-made abutment and CAD-CAM custom-made abutment. Materials and methods: Osstem implant system was used. Ready-made abutment (Transfer abutment, Osstem Implant Co. Ltd, Busan, Korea), CAD-CAM custom-made abutment (CustomFit abutment, Osstem Implant Co. Ltd, Busan, Korea) and domestically manufactured CAD-CAM custom-made abutment (Myplant, Raphabio Co., Seoul, Korea) were fabricated five each and screws were provided by each company. Fixture and abutments were tightening with 30Ncm according to the manufacturer's instruction and then preloding reverse torque values were measured 3 times repeatedly. Kruskal-Wallis test was used for statistical analysis of the preloading reverse torque values (${\alpha}=.05$). After specimens were embedded into epoxy resin, wet cutting and polishing was performed and FE-SEM imaging was performed, on the contact interface. Results: The pre-loading reverse torque values were $26.0{\pm}0.30Ncm$ (ready-made abutment; Transfer abutment) and $26.3{\pm}0.32Ncm$ (CAD-CAM custom-made abutment; CustomFit abutment) and $24.7{\pm}0.67Ncm$ (CAD-CAM custom-made abutment; Myplant). The domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) presented lower pre-loading reverse torque value with statistically significant difference than that of the ready-made abutment (Transfer abutment) and CAD-CAM custom-made abutment (CustomFit abutment) manufactured from the same company (P=.027) and showed marginal gap in the fixture-abutment interface. Conclusion: Within the limitation of the present in-vitro study, in domestically manufactured CAD-CAM custom-made abutment (Myplant abutment) showed lower screw joint stability and fitness between fixture and abutment.

키워드

참고문헌

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  3. Comparative study of two CAD software programs on consistency between custom abutment design and the output vol.34, pp.3, 2018, https://doi.org/10.14368/jdras.2018.34.3.157
  4. Considerations for Fabrication of CAD-CAM Abutments: Part I. Selection of Titanium Block and Fabrication Process vol.23, pp.1, 2013, https://doi.org/10.32542/implantology.2019005