대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제54권4호
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  • Pages.370-378
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  • 2016
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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Micro-CT를 이용한 맞춤형 CAD-CAM 지대주의 적합성 분석

Fit analysis of CAD-CAM custom abutment using micro-CT

  • 민광석 (조선대학교 치과대학 치과보철학교실) ;
  • 정재헌 (조선대학교 치과대학 치과보철학교실) ;
  • 김희중 (조선대학교 치과대학 치과보철학교실)
  • Min, Gwang-Seok (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Chung, Chae-Heon (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Kim, Hee-Jung (Department of Prosthodontics, School of Dentistry, Chosun University)
  • 투고 : 2016.06.10
  • 심사 : 2016.09.12
  • 발행 : 2016.10.31
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초록

목적: Biomet 3i 시스템과 Astra 시스템의 내측 연결형 임플란트 고정체에 국내에서 제작된 맞춤형 CAD-CAM 지대주를 체결하여 구성 성분 간의 적합성과 나사의 안정성을 평가하고자 하였다. 재료 및 방법: 24개 3i 임플란트 중 12개의 임플란트에 기성 지대주를 연결하고, 나머지 임플란트에는 맞춤형 CAD-CAM 지대주를 연결하여 각각 Group 1과 Group 2로 분류하였다. 동일 개수와 동일한 방법으로 Astra 임플란트를 각각 Group 3와 Group 4로 분류하였다. 각각의 고정체에 지대주를 장착하여 각 계면 사이의 적합성을 micro-CT로 관찰하고 초기 풀림 토크를 측정한 후 평가하였다. 결과: 고정체-지대주의 접촉길이는 Group 1과 Group 2 사이 뿐만 아니라 Group 3와 Group 4 사이에도 유의한 차이가 없었다(Mann-Whitney test, P>.05). 하지만, 지대주와 나사의 계면 및 고정체와 나사의 계면에서 Group 2와 Group 4가 Group 1와 Group 3에 비해 각기 더 큰 접촉양상을 보여주었다(Mann-Whitney test, P<.05). 또한, Group 2와 Group 4가 Group 1과 Group 3에 비해 각기 더 낮은 나사의 초기 풀림 토크를 기록하였다(Student t-test, P<.05). 결론: CAD-CAM지대주는 임상에 적용할 만한 적합성을 지니고 있으나, 광범위한 임상 적용을 위해서는 풀림 토크가 향상되어야 할 것으로 사료된다.

Purpose: The purpose of this study was to investigate screw joint stability and sagittal fit between internal connection implant fixtures of two different manufacturers and customized abutments. Materials and methods: Internal connection implant systems from two different manufacturers (Biomet 3i system, Astra Tech system) were selected for this study (n=24 for each implant system, total n=48). For 3i implant system, half of the implants were connected with Ti ready-made abutments and the other half implants were connected with Ti CAD-CAM custom ones of domestic-make (Myplant, Raphabio Co., Seoul, Korea) and were classified into Group 1 and Group 2 respectively. Astra implants were divided into Group 3 and Group 4 in the same way. Micro-CT sagittal imaging was performed for fit analysis of interfaces and preloading reverse torque values (RTV) were measured. Results: In the contact length of fixture-abutment interface, there were no significant differences not only between Group 1 and Group 2 but also between Group 3 and Group 4 (Mann-Whitney test, P>.05). However, Group 2 and Group 4 showed higher contact length significantly than Group 1 and Group 3 in abutment-screw interface as well as fixture-screw one (Mann-Whitney test, P<.05). In addition, RTV was lower in CAD-CAM custom abutments compared to ready-made ones (Student t-test, P<.05). Conclusion: It is considered that domestically manufactured CAD-CAM custom abutments have similar fit at the fixture abutment interface and it could be used clinically. However, RTV of CAD-CAM custom abutments should be improved for the increase of clinical application.

키워드

참고문헌

  1. Sumi T, Braian M, Shimada A, Shibata N, Takeshita K, Vandeweghe S, Coelho PG, Wennerberg A, Jimbo R. Characteristics of implant-CAD/CAM abutment connections of two different internal connection systems. J Oral Rehabil 2012;39:391-8. https://doi.org/10.1111/j.1365-2842.2011.02273.x
  2. Lang LA, Sierraalta M, Hoffensperger M, Wang RF. Evaluation of the precision of fit between the Procera custom abutment and various implant systems. Int J Oral Maxillofac Implants 2003;18:652-8.
  3. Bichacho N. Achieving optimal gingival esthetics around restored natural teeth and implants. Rationale, concepts, and techniques. Dent Clin North Am 1998;42:763-80.
  4. Kim HS. Fabrication of custom abutment using dental CAD/CAM system. J Korean Dent Assoc 2012;50:118-25.
  5. Lewis SG, Llamas D, Avera S. The UCLA abutment: a four-year review. J Prosthet Dent 1992;67:509-15. https://doi.org/10.1016/0022-3913(92)90082-L
  6. Wu T, Liao W, Dai N, Tang C. Design of a custom angled abutment for dental implants using computer-aided design and nonlinear finite element analysis. J Biomech 2010;43:1941-6. https://doi.org/10.1016/j.jbiomech.2010.03.017
  7. Sailer I, Zembic A, Jung RE, Siegenthaler D, Holderegger C, Hammerle CH. Randomized controlled clinical trial of customized zirconia and titanium implant abutments for canine and posterior single-tooth implant reconstructions: preliminary results at 1 year of function. Clin Oral Implants Res 2009;20:219-25. https://doi.org/10.1111/j.1600-0501.2008.01636.x
  8. Kerstein RB, Castellucci F, Osorio J. Ideal gingival form with computer-generated permanent healing abutments. Compend Contin Educ Dent 2000;21:793-7.
  9. Priest G. Virtual-designed and computer-milled implant abutments. J Oral Maxillofac Surg 2005;63:22-32.
  10. Martin WC, Woody RD, Miller BH, Miller AW. Implant abutment screw rotations and preloads for four different screw materials and surfaces. J Prosthet Dent 2001;86:24-32. https://doi.org/10.1067/mpr.2001.116230
  11. Boggan RS, Strong JT, Misch CE, Bidez MW. Influence of hex geometry and prosthetic table width on static and fatigue strength of dental implants. J Prosthet Dent 1999;82:436-40. https://doi.org/10.1016/S0022-3913(99)70030-2
  12. Abrahamsson I, Berglundh T, Lindhe J. Soft tissue response to plaque formation at different implant systems. A comparative study in the dog. Clin Oral Implants Res 1998;9:73-9. https://doi.org/10.1034/j.1600-0501.1998.090202.x
  13. Quirynen M, Bollen CM, Eyssen H, van Steenberghe D. Microbial penetration along the implant components of the Branemark system. An in vitro study. Clin Oral Implants Res 1994;5:239-44. https://doi.org/10.1034/j.1600-0501.1994.050407.x
  14. Henriksson K, Jemt T. Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-year follow-up study. Int J Prosthodont 2003;16:626-30.
  15. Canullo L. Clinical outcome study of customized zirconia abutments for single-implant restorations. Int J Prosthodont 2007;20:489-93.
  16. Swain MV, Xue J. State of the art of Micro-CT applications in dental research. Int J Oral Sci 2009;1:177-88. https://doi.org/10.4248/IJOS09031
  17. Pelekanos S, Koumanou M, Koutayas SO, Zinelis S, Eliades G. Micro-CT evaluation of the marginal fit of different In-Ceram alumina copings. Eur J Esthet Dent 2009;4:278-92.
  18. Suomalainen AK, Salo A, Robinson S, Peltola JS. The 3DX multi image micro-CT device in clinical dental practice. Dentomaxillofac Radiol 2007;36:80-5 https://doi.org/10.1259/dmfr/30358216
  19. Siamos G, Winkler S, Boberick KG. Relationship between implant preload and screw loosening on implant-supported prostheses. J Oral Implantol 2002;28:67-73. https://doi.org/10.1563/1548-1336(2002)028<0067:TRBIPA>2.3.CO;2
  20. Kim JW, Heo YR, Kim HJ, Chung CH. A comparative study on the fit and screw joint stability of ready-made abutment and CADCAM custom-made abutment. J Korean Acad Prosthodont 2013;51:276-83. https://doi.org/10.4047/jkap.2013.51.4.276
  21. Kim NH, Chung CH, Son MK, Back DH. A study on the fit of the fixture-abutment-screw interface. J Korean Acad Prosthodont 2003;41:503-18.
  22. Jung SH, Ma JS, Chung CH. A comparative study on the fit in prostheses using premade gold cylinder and plastic cylinder. J Korean Acad Prosthodont 1999;37:825-34.
  23. Lee HT, Chung CH. Fit of fixture / abutment interface of internal connection implant systems. J Korean Acad Prosthodont 2004;42:192-209.
  24. de Morais Alves da Cunha T, de Araujo RP, da Rocha PV, Amoedo RM. Comparison of fit accuracy between $Procera^{(R)}$ custom abutments and three implant systems. Clin Implant Dent Relat Res 2012;14:890-5. https://doi.org/10.1111/j.1708-8208.2010.00323.x
  25. Binon PP. Evaluation of machining accuracy and consistency of selected implants, standard abutments, and laboratory analogs. Int J Prosthodont 1995;8:162-78.
  26. Jang HS, Kim HJ, Chung CH. Detorque force and surface change of coated abutment screw after repeated closing and opening. J Korean Acad Prosthodont 2008;46:500-10. https://doi.org/10.4047/jkap.2008.46.5.500
  27. Yeo IS, Lee JH, Kang TJ, Lee SY. The effect of abutment screw length on screw loosening in dental implants with external abutment connections after thermocycling. Int J Oral Maxillofac Implants 2014;29:59-62. https://doi.org/10.11607/jomi.3125
  28. Lee JR, Lee DH, Hwang JW, Choi JH. Detorque values of abutment screws in a multiple implant-supported prosthesis. J Korean Acad Prosthodont 2010;48:280-6. https://doi.org/10.4047/jkap.2010.48.4.280
  29. Lee CJ, Yang SE, Kim SG. Evaluation of reverse torque value of abutment screws on CAD/CAM custom-made implant abutments. J Korean Acad Prosthodont 2012;50:122-8.
  30. Haack JE, Sakaguchi RL, Sun T, Coffey JP. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofac Implants 1995;10:529-36.