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Concept and application of implant connection systems: Part I. Placement and restoration of internal conical connection implant

임플란트 연결부의 개념과 적용: Part 1. 원추형 내부연결 임플란트의 식립과 보철

  • Ko, Kyung-Ho (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Kang, Hyeon-Goo (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Huh, Yoon-Hyuk (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Research Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University)
  • 고경호 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 강현구 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 허윤혁 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소) ;
  • 조리라 (강릉원주대학교 치과대학 보철학교실 및 구강과학연구소)
  • Received : 2020.09.17
  • Accepted : 2020.11.20
  • Published : 2020.12.31

Abstract

The typical biomechanical properties of an internal conical connection (ICC) are axial displacement and loss of preload. The axial displacement of an ICC without a vertical stop can cause the loss of preload and a lowered occlusion. The stress of an ICC is concentrated on the contact interface of the abutment and not on the screw, and during placement, it is important to choose a wider coronal wall thickness as much as possible. The ICC should also be placed below the level of the bone crest. During the restoration of an ICC, care should be taken to ensure an appropriate abutment shape and an accurate connection. To get the best clinical results, it is important to select its wall thickness and place it in the appropriate position to restore it adequately.

원추형 내부연결 임플란트의 독특한 생역학적 현상이 수직침하와 전하중 상실이다. 원추형 내부연결 임플란트에서 수직적 정지점의 부재로 발생하는 수직침하에 의해 나사의 전하중이 상실되고 교합이 낮아지는 현상이 유발된다. 원추형 내부연결 임플란트에 발생하는 응력은 나사가 아니라 지대주가 접촉하는 계면에 집중되므로 식립할 때는 가급적 상부직경이 두꺼운 임플란트를 선택하는 것이 중요하다. 원추형 내부연결 임플란트는 치조정보다 하방에 식립해야 하며 수복 시에는 적절한 지대주 형태와 정확한 연결을 가지는지 주의해야 한다. 최상의 임상적 결과를 얻기 위해서는 상부 직경을 잘 선택하고 적절한 위치에 식립하여 수복하는 것이 필요하다.

Keywords

References

  1. Bonfante EA, Coelho PG. A critical perspective on mechanical testing of implants and prostheses. Adv Dent Res 2016;28:18-27. https://doi.org/10.1177/0022034515624445
  2. Sutter F, Weingart D, Mundwiler U, Sutter FJ, Asikainen P. ITI implants in combination with bone grafts: design and biomechanical aspects. Clin Oral Implants Res 1994;5:164-72. https://doi.org/10.1034/j.1600-0501.1994.050307.x
  3. Norton MR. An in vitro evaluation of the strength of an internal conical interface compared to a butt joint interface in implant design. Clin Oral Implants Res 1997;8:290-8. https://doi.org/10.1034/j.1600-0501.1997.080407.x
  4. Levine RA, Clem DS 3rd, Wilson TG Jr., Higginbottom F, Solnit G. Multicenter retrospective analysis of the ITI implant system used for single-tooth replacements: results of loading for 2 or more years. Int J Oral Maxillofac Implants 1999;14:516-20.
  5. Baggi L, Cappelloni I, Di Girolamo M, Maceri F, Vairo G. The influence of implant diameter and length on stress distribution of osseointegrated implants related to crestal bone geometry: a threedimensional finite element analysis. J Prosthet Dent 2008;100:422-31. https://doi.org/10.1016/S0022-3913(08)60259-0
  6. Weng D, Nagata MJ, Bell M, Bosco AF, de Melo LGN, Richter E. Influence of microgap location and configuration on the periimplant bone morphology in submerged implants. An experimental study in dogs. Clin Oral Implants Res 2008;19:1141-7. https://doi.org/10.1111/j.1600-0501.2008.01564.x
  7. Weng D, Nagata MJH, Bell M, de Melo LGN, Bosco AF. Influence of microgap location and configuration on peri-implant bone morphology in nonsubmerged implants: an experimental study in dogs. Int J Oral Maxillofac Implants 2010;25:540-7.
  8. Lee JH, Kim DG, Park CJ, Cho LR. Axial displacements in external and internal implant-abutment connection. Clin Oral Implants Res 2014;25:e83-9. https://doi.org/10.1111/clr.12062
  9. Seol HW, Heo SJ, Koak JY, Kim SK, Kim SK. Axial displacement of external and internal implantabutment connection evaluated by linear mixed model analysis. Int J Oral Maxillofac Implants 2015;30:1387-99. https://doi.org/10.11607/jomi.3857
  10. Braian M, De Bruyn H, Fransson H, Christersson C, Wennerberg A. Tolerance measurements on internal- and external-hexagon implants. Int J Oral Maxillofac Implants 2014;29:846-52. https://doi.org/10.11607/jomi.3242
  11. Winkler S, Ring K, Ring JD, Boberick KG. Implant screw mechanics and the settling effect: overview. J Oral Implantol 2003;29:242-5. https://doi.org/10.1563/1548-1336(2003)029<0242:ISMATS>2.3.CO;2
  12. Bulaqi HA, Mashhadi MM, Safari H, Samandari MM, Geramipanah F. Dynamic nature of abutment screw retightening: finite element study of the effect of retightening on the settling effect. J Prosthet Dent 2015;113:412-9. https://doi.org/10.1016/j.prosdent.2014.09.017
  13. Merz BR, Hunenbart S, Belser UC. Mechanics of the implant-abutment connection: an 8-degree taper compared to a butt joint connection. Int J Oral Maxillofac Implants 2000;15:519-26.
  14. Bozkaya D, Muftu S. Mechanics of the tapered interference fit in dental implants. J Biomech 2003;36:1649-58. https://doi.org/10.1016/S0021-9290(03)00177-5
  15. Baixe S, Fauxpoint G, Arntz Y, Etienne O. Microgap between zirconia abutments and titanium implants. Int J Oral Maxillofac Implants 2010;25:455-60.
  16. Teoh SH, Thampuran R, Seah KHW, Goh JCH. The development of P/M titanium-graphite triphasic composites for biomedical applications. J Mater Sci Ltr 1997;16:639-41. https://doi.org/10.1023/A:1018567216717
  17. Cho WR, Huh YH, Park CJ, Cho LR. Effect of cyclic loading and retightening on reverse torque value in external and internal implants. J Adv Prosthodont 2015;7:288-93. https://doi.org/10.4047/jap.2015.7.4.288
  18. Jeon BS, Kim SK, Lee JJ, Seo JM. Possibility and limitation of applying occlusal adjustment on implant prosthesis similar to natural teeth. Implantology 2018;22:162-72. https://doi.org/10.32542/implantology.20180014
  19. Theoharidou A, Petridis HP, Tzannas K, Garefis P. Abutment screw loosening in single-implant restorations: a systematic review. Int J Oral Maxillofac Implants 2008;23:681-90.
  20. Coppede AR, de Mattos MG, Rodrigues RCS, Ribeiro RF. Effect of repeated torque/mechanical loading cycles on two different abutment types in implants with internal tapered connections: an in vitro study. Clin Oral Implants Res 2009;20:624-32. https://doi.org/10.1111/j.1600-0501.2008.01690.x
  21. Piermatti J, Yousef H, Luke A, Mahevich R, Weiner S. An in vitro analysis of implant screw torque loss with external hex and internal connection implant systems. Implant Dent 2006;15:427-35. https://doi.org/10.1097/01.id.0000245440.09464.48
  22. Pessoa RS, Muraru L, Junior EM, Vaz LG, Sloten JV, Duyck J, Jaecques SVN. Influence of implant connection type on the biomechanical environment of immediately placed implants - CT-based nonlinear, three-dimensional finite element analysis. Clin Implant Dent Relat Res 2010;12:219-34.
  23. Cho SY, Huh YH, Park CJ, Cho LR. ThreeDimensional Finite Element Analysis of the Stress Distribution at the Internal Implant-Abutment Connection. Int J Periodontics Restorative Dent 2016;36:e49-58.
  24. Jimbo R, Halldin A, Janda M, Wennerberg A, Vandeweghe S. Vertical fracture and marginal bone loss of internal-connection implants: a finite element analysis. Int J Oral Maxillofac Implants 2013;28:e171-6. https://doi.org/10.11607/jomi.3052
  25. Yi Y, Koak JY, Kim SK, Lee SJ, Heo SJ. Comparison of implant component fractures in external and internal type: A 12-year retrospective study. J Adv Prosthodont 2018;10:155-62. https://doi.org/10.4047/jap.2018.10.2.155
  26. Cha HS, Kim YS, Jeon JH, Lee JH. Cumulative survival rate and complication rates of single-tooth implant; focused on the coronal fracture of fixture in the internal connection implant. J Oral Rehabil 2013;40:595-602. https://doi.org/10.1111/joor.12065
  27. Lee JH, Huh YH, Park CJ, Cho LR. Effect of the Coronal Wall Thickness of Dental Implants on the Screw Joint Stability in the Internal Implant-Abutment Connection. Int J Oral Maxillofac Implants 2016;31:1058-65.
  28. Lee JH, Lee W, Huh YH, Park CJ, Cho LR. Impact of Intentional Overload on Joint Stability of Internal Implant-Abutment Connection System with Different Diameter. J Prosthodont 2019;28:e649-56. https://doi.org/10.1111/jopr.12661
  29. Parpaiola A, Cecchinato D, Toia M, Bressan E, Speroni S, Lindhe J. Dimensions of the healthy gingiva and peri-implant mucosa. Clin Oral Implants Res 2015;26:657-62. https://doi.org/10.1111/clr.12359
  30. Lindhe J, Berglundh T. The interface between the mucosa and the implant. Periodontol 2000 1998;17:47-54. https://doi.org/10.1111/j.1600-0757.1998.tb00122.x
  31. Hansson S. The implant neck: smooth or provided with retention elements. A biomechanical approach. Clin Oral Implants Res 1999;10:394-405. https://doi.org/10.1034/j.1600-0501.1999.100506.x
  32. Monje A, Galindo-Moreno P, Tozum TF, SuarezLopez del Amo F, Wang H. Into the Paradigm of Local Factors as Contributors for Peri-implant Disease: Short Communication. Int J Oral Maxillofac Implants 2016;31:288-92.
  33. Ko KH, Park JH, Cho LR. Considerations for fabrication of cad-cam abutments: Part I. Selection of titanium block and fabrication process. Implantology 2019;23:46-58. https://doi.org/10.32542/implantology.2019005
  34. Ko KH, Park JH, Cho LR. Considerations for fabrication of cad-cam abutments: Part II. Designing abutment. Implantology 2019;23:112-25. https://doi.org/10.32542/implantology.2019010
  35. Blanco J, Pico A, Caneiro L, Novoa L, Batalla P, Martin-Lancharro P. Effect of abutment height on interproximal implant bone level in the early healing: A randomized clinical trial. Clin Oral Implants Res 2018;29:108-17.
  36. Zabler S, Rack T, Rack A, Nelson K. Fatigue induced deformation of taper connection in dental titanium implants. Int J Mat Res 2012;103:207-16. https://doi.org/10.3139/146.110666
  37. Rack T, Zabler S, Rack A, Riesemeier H, Nelson K. An in vitro pilot study of abutment stability during loading in new and fatigue-loaded conical dental implants using synchrotron-based radiography. Int J Oral Maxillofac Implants 2013;28:44-50. https://doi.org/10.11607/jomi.2748
  38. Cho SY, Huh YH, Park CJ, Cho LR. Three-dimensional finite element analysis on stress distribution of internal implant-abutment engagement features. Int J Oral Maxillofac Implants 2018;33:319-27. https://doi.org/10.11607/jomi.5789