구강회복응용과학지 (Journal of Dental Rehabilitation and Applied Science)

  • 제35권4호
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  • Pages.235-243
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  • 2019
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  • 2384-4353(pISSN)
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  • 2384-4272(eISSN)
대한턱관절교합학회 (Korean Academy of Stomatognathic Function and Occlusion)
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임플란트 매식체 파절로 제거된 임플란트 골계면의 조직학적 분석 증례

Histological analysis of explanted implant-bone interface: a case report

  • 김대동 (단국대학교 치과대학 치주과학교실) ;
  • 강대영 (단국대학교 치과대학 치주과학교실) ;
  • 조인우 (단국대학교 치과대학 치주과학교실) ;
  • 송영균 (단국대학교 치과대학 보철학교실) ;
  • 신현승 (단국대학교 치과대학 치주과학교실) ;
  • 박정철 (단국대학교 치과대학 치주과학교실)
  • Kim, Dae-Dong (Department of Periodontology, College of Dentistry, Dankook University) ;
  • Kang, Dae-Young (Department of Periodontology, College of Dentistry, Dankook University) ;
  • Cho, In-Woo (Department of Periodontology, College of Dentistry, Dankook University) ;
  • Song, Young-Gyun (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Shin, Hyun-Seung (Department of Periodontology, College of Dentistry, Dankook University) ;
  • Park, Jung-Chul (Department of Periodontology, College of Dentistry, Dankook University)
  • 투고 : 2019.08.31
  • 심사 : 2019.09.23
  • 발행 : 2019.12.31
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초록

골유착은 기능 하중을 받는 임플란트에 치조골이 직접적으로 접촉하는 역동적인 과정이라고 보고되었다. 골유착을 평가하기 위한 다양한 방법들이 시도되었고 그 중 골-임플란트 접촉 비율을 측정하는 방법이 가장 흔히 사용되고 있다. 골-임플란트 접촉 비율은 조직학적 분석을 통해서만 측정이 가능하지만 인간에서 성공적으로 골유착을 형성한 임플란트에 조직학적 분석을 시행한 연구는 많지 않다. 임플란트가 부적절한 위치에 식립되었거나, 식립 후 통증이나 감각 장애가 있는 경우, 임플란트 구조물이 파절된 경우와 같이 임플란트 제거가 필요한 경우에서만 골-임플란트 접촉 비율을 측정할 수 있기에 이는 매우 특별한 기회라고 할 수 있다. 본 증례에서는 3년간의 기능 하중을 받은 후 매식체 파절로 제거된 임플란트에서 조직학적 분석을 시행하였다. 조직 형태학적 연구 결과 임플란트 전체를 기준으로 골-임플란트 접촉 비율을 측정한 경우 대비 치조제 하부만 포함하여 골-임플란트 접촉 비율을 측정한 경우 각각 접촉 비율은 53.1%, 70.9%로 나타났다. 본 증례를 통해 비록 임플란트는 파절되었으나 생체 내에서 높은 수치의 골-임플란트 접촉 비율이 확인되었다.

Osseointegration has been reported to be a dynamic process in which the alveolar bone comes in direct contact with the implant. Various methods were tried to evaluate degree of osseointegration and the measurement of bone-implant contact (BIC) have been commonly used among them. To properly assess the BIC, only histologic analysis is available. However, few studies evaluated BIC of successfully osseointegrated implants in humans. Thus, this is a unique opportunity when implants should be explanted due to inappropriate positioning of implant, presence of pain or sensory disturbance, or broken screw or fixture. This report presents a case of the implant underwent 3-year functional load and a histologic analysis after the fixture fracture. The histomorphometric analysis revealed 53.1% of BIC measured along the whole implant and 70.9% measured only in subcrestal area, respectively. In the present study, although the implant was fractured, a high degree of BIC was observed.

키워드

참고문헌

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