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임플란트 연결부의 개념과 적용: Part 2. 안착형 외부 및 내부 연결형 임플란트의 식립과 보철

Concept and application of implant connection systems: Part II. Placement and restoration of external connection implant and tissue level implant

  • 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)
  • 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)
  • 투고 : 2020.09.16
  • 심사 : 2020.10.13
  • 발행 : 2020.12.31

초록

안착형 외부 연결 임플란트를 적절히 사용하기 위해서는 식립 시에 임플란트 간의 간격에 주의해야 하며 2차 수술 시에 임플란트 상부로 올라간 골을 다듬어야 한다. 육각형태를 가진 지대주가 원형 지대주에 비해 유용하다. 외부 연결형 임플란트는 악간간격이 제한된 경우에 적용할 수 있다. 안착형 외부연결(조직수준) 임플란트는 상부 직경의 두께로 인한 생역학적 장점과 내재된 점막관통부로 인한 생물학적 장점을 가지고 있다. 조직수준 임플란트를 수복할 때 지대주 수준과 임플란트 수준의 변연 중 악간공간에 따라 선택한다. 어떤 한 가지 임플란트 종류로는 모든 증례를 만족시키기 어려우므로 교합력 및 골조건을 고려하여 적절한 임플란트를 선택하는 것이 필요하다.

To use the external connection implant (EXT) appropriately, the inter-implant distance should be carefully considered during placement, and the bones raised above the implants should be trimmed during the second surgery. The hex abutment is more useful than the non-hex abutment. EXT is particularly useful when the inter-arch space is limited. The tissue level (TL, internal butt connection) implant has a biomechanical advantage of coronal wall thickness and a biological advantage of an inherent transmucosal smooth surface. During TL implant restoration, an abutment can be selected using the abutment and fixture margins with considerations for the inter-arch space. Since no single type of implant can satisfy all the cases, it is necessary to select the appropriate type, considering the occlusal force and the bone condition.

키워드

참고문헌

  1. Weng D, Nagata MJ, Bell M, Bosco AF, de Melo LG, Richter EJ. 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
  2. Weng D, Nagata MJ, Bell M, de Melo LG, Bosco AF. Influence of microgap location and configuration on peri-implant bone morphology in nonsubmerged implants: an experimental study in dogs. Int J Oral axillofac Implants 2010;25:540-7.
  3. 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.
  4. 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
  5. 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.
  6. Asvanund P, Morgano SM. Photoelastic stress analysis of external versus internal implant-abutment connections. J Prosthet Dent 2011;106:266-71. https://doi.org/10.1016/S0022-3913(11)60128-5
  7. de Almeida Prado Naves Carneiro T, Dietrich L, Prudente MS, da Silva Neto JP, do Prado CJ, de Araujo CA, das Neves FD. Fracture Resistance of Internal Conical and External Hexagon: Regular and Narrow Implant-Abutment Assemblies. Implant Dent 2016;25:510-4. https://doi.org/10.1097/ID.0000000000000446
  8. Monje A, Galindo-Moreno P, Tozum TF, SuarezLopez del Amo F, Wang HL. Into the Paradigm of Local Factors as Contributors for Peri-implant Disease: Short Communication. Int J Oral Maxillofac Implants 2016;31:288-92.
  9. Tarnow DP, Cho SC, Wallace SS. The effect of inter-implant distance on the height of inter-implant bone crest. J Periodontol 2000;71:546-9. https://doi.org/10.1902/jop.2000.71.4.546
  10. Cardaropoli G, Wennstrom JL, Lekholm U. Periimplant bone alterations in relation to inter-unit distances. A 3-year retrospective study. Clin Oral Implants Res 2003;14:430-6. https://doi.org/10.1034/j.1600-0501.2003.00895.x
  11. Jo DW, Yi YJ, Kwon MJ, Kim YK. Correlation between interimplant distance and crestal bone loss in internal connection implants with platform switching. Int J Oral Maxillofac Implants 2014;29:296-302. https://doi.org/10.11607/jomi.3141
  12. Lee H, So JS, Hochstedler JL, Ercoli C. The accuracy of implant impressions: a systematic review. J Prosthet Dent 2008;100:285-91. https://doi.org/10.1016/S0022-3913(08)60208-5
  13. Gracis S, Michalakis K, Vigolo P, von Steyern PV, Zwahlen M, Sailer I. Internal vs. external connections for abutments/reconstructions: a systematic review. Clin Oral Implants Res 2012;23 Suppl 6:202-16. https://doi.org/10.1111/j.1600-0501.2012.02556.x
  14. Cardoso M, Torres MF, Lourenco EJ, de Moraes Telles D, Rodrigues RCS, Ribeiro RF. Torque removal evaluation of prosthetic screws after tightening and loosening cycles: an in vitro study. Clin Oral Implants Res 2012;23:475-80. https://doi.org/10.1111/j.1600-0501.2011.02165.x
  15. 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
  16. 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
  17. Hermann JS, Buser D, Schenk RK, Cochran DL. Crestal bone changes around titanium implants. A histometric evaluation of unloaded non-submerged and submerged implants in the canine mandible. J Periodontol 2000;71:1412-24. https://doi.org/10.1902/jop.2000.71.9.1412
  18. Hermann JS, Buser D, Schenk RK, Schoolfield JD, Cochran DL. Biologic Width around one- and twopiece titanium implants. Clin Oral Implants Res 2001;12:559-71. https://doi.org/10.1034/j.1600-0501.2001.120603.x
  19. Behneke A, Behneke N, d'Hoedt B. A 5-year longitudinal study of the clinical effectiveness of ITI solid-screw implants in the treatment of mandibular edentulism. Int J Oral Maxillofac Implants 2002;17:799-810.
  20. Buser D, von Arx T. Surgical procedures in partially edentulous patients with ITI implants. Clin Oral Implants Res 2000;11 Suppl 1:83-100. https://doi.org/10.1034/j.1600-0501.2000.011S1083.x
  21. Buser D, Mericske-Stern R, Dula K, Kang NP. Clinical experience with one-stage, non-submerged dental implants. Adv Dent Res 1999;13:153-61. https://doi.org/10.1177/08959374990130010501
  22. Morton D, Gallucci G, Lin WS, Pjetursson B, Polido W, Roehling S, Sailer I, Aghaloo T, Albera H, Bohner L, Braut V, Buser D, Chen S, Dawson A, Eckert S, Gahlert M, Hamilton A, Jaffin R, Jarry C, Karayazgan B, Laine J, Martin W, Rahman L, Schlegel A, Shiota M, Stilwell C, Vorster C, Zembic A, Zhou W. Group 2 ITI Consensus Report: Prosthodontics and implant dentistry. Clin Oral Implants Res 2018;29 Suppl 16:215-23.
  23. Alves CC, Munoz F, Cantalapiedra A, Ramos I, Neves M, Blanco J. Marginal bone and soft tissue behavior following platform switching abutment connection/disconnection-a dog model study. Clin Oral Implants Res 2015;26:983-91. https://doi.org/10.1111/clr.12385
  24. Fontijn-Tekamp FA, Slagter AP, Van Der Bilt A, Van't Hof MA, Witter DJ, Kalk W, Jansen JA. Biting and Chewing in Overdentures, Full Dentures, and Natural Dentitions. J Dent Res 2000;79:1519-24. https://doi.org/10.1177/00220345000790071501
  25. Morneburg TR, Proschel PA. Measurement of masticatory forces and implant loads: a methodologic clinical study. Int J Prosthodont 2002;15:20-7.