• 제목/요약/키워드: Cortical thickness

검색결과 163건 처리시간 0.02초

임플란트의 직경과 길이 변화가 초기 안정성에 미치는 영향 (Influence of implant diameter and length changes on initial stability)

  • 조재명;조욱;윤미정;정창모;전영찬
    • 대한치과보철학회지
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    • 제47권3호
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    • pp.335-341
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    • 2009
  • 연구목적: 충분한 골질과 골량은 임플란트의 조기 실패 방지와 초기 안정성을 위해서 중요한 사항으로 알려져 있다. 임플란트 길이나 직경이 초기 안정성에 미치는 영향을 연구한 다수의 실험들이 골과의 접촉면적을 달리하였기 때문에 직경과 길이만이 초기 안정성에 미치는 실제 영향을 파악하는데 한계가 있다. 이에 유사한 표면적을 가지는 임플란트를 통하여 길이와 직경 상대적 변화가 초기 안정성에 미치는 영향을 알아보고자 하였다. 연구 재료 및 방법: 골질에 따라 피질골과 해면골의 두께가 다른 4종류의 폴리우레탄 모형골을 임플란트 식립에 사용하였다. 유사한 표면적과 형태를 가지나 직경과 길이가 서로 다른 임플란트 ($3.5{\times}13.0\;mm$, $4.0{\times}11.5\;mm$, $4.5{\times}10.0\;mm$, $5.0{\times}8.5\;mm$) 10개를 식립하고 식립 회전력과 공진 주파수를 측정하였다. 결과 및 결론: 초기 안정성에 영향을 미치는 주 요소는 골질이었으며 (P < .05), 식립 회전력과 공진 주파수 모두 골질이 우수할수록 높은 측정치를 보였다. 2. D1, D2, D3 모형골에서 임플란트의 직경이 커지고 길이가 짧아짐에 따라 공진 주파수는 유의한 차이를 보이지 않았으나 (P >.05), 식립 회전력은 증가하였다 (P <.05). 3. D4 모형골에서는 임플란트의 직경이 커지고 길이가 짧아짐에 따라 공진주파수와 식립 회전력 모두 감소하였다 (P <.05). 이상의 결과로부터 골질이 양호한 조건에서는 길이가 짧더라도 직경이 큰 임플란트의 사용이 초기 안정성 측면에서 부가적 수술의 대안이 될 수 있을 것으로 생각된다.

생체골의 열전도성 및 열처리된 골의 염전력 변화에 대한 실험적 연구 (Experimental Studies on Heat Conductivity of Human Bone and Torsional Strength of Pasteurized Porcine Tibia)

  • 박일형;김신근;신동규;인주철
    • 대한골관절종양학회지
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    • 제1권1호
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    • pp.7-16
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    • 1995
  • 인체골 4 시편(specimen)과 돼지 경골 25쌍을 이용하여, 생체골의 열전도성 측정과 열처리후 열처리온도와 시간에 따른 골의 염전력을 실험한 결과를 요약하면 다음과 같다. 인체골에 있어서 골수강을 제거하지 않고 $60^{\circ}C$의 항온식염수에서 열처리하면, 골심부의 온도가 $20^{\circ}C$에서 $58^{\circ}C$에 도달하는데 소요된 시간은 경골근위부가 32분 50초, 대퇴골 원위부가 30.분, $80^{\circ}C$ 항온조에서는 경골근위부가 12분 50초, 대퇴골 원위부가 11분 10초 소요되었다. 돼지 경골간부의 피질골내부(endosteum)에 열전대를 부착하고 뼈 양끝을 밀봉하여 같은 실험을 행한 결과 $50^{\circ}C$까지는 시간에 비례해서 일정한 비율로 온도상승이 이루어 졌으며, $20^{\circ}C$에서 $58^{\circ}C$에 이르는 시간이 $60^{\circ}C$ 항온조에서는 7분, $70^{\circ}C$에서는 3분 30초, $80^{\circ}C$에서는 2분이었다. 따라서 임상에서 골수강을 제거 후 장골의 간부(shaft) 만을 항온조에 달굴때는 골구강내에도 데워진 심염수로 가득차게 되므로 상기 시간의 절반이 못되는 짧은 시간내에 피질골의 내부가 $58^{\circ}C$에 이르리라고 판단되었다. 골수강을 소파하지 않은 돼지 경골을 각각 4쌍씩 우측만을 $60^{\circ}C$ 35분, $80^{\circ}C$ 15분 열처리한 후 실험군의 최대염전력은 대조군과 비교할 때 +7.0%, -5.1%, -3.2%, -4.2%의 변화가 있었고, $80^{\circ}C$ 15분 열처리후는 -4.3%, -3.8%, -1.4%(1예는 실험 오류로 제외됨)의 변화가 있었다. 골수강을 완전 제거한 되재 경골을 각각 4쌍씩 우측만을 $60^{\circ}C$, $70^{\circ}C$, $80^{\circ}C$에서 15분 열처리 후 실험군의 최대염전력은 대조군과 비교할 때 -3.4%, -4.2%, -0.7%, +2.7%의 변화가 있었고, $70^{\circ}C$ 15분 열처리후는 -2.8%, -3.9%, -2.1%(1예는 실험 오류로 제외됨)의 변화가 있었으며, $80^{\circ}C$ 15분 열처리후는 +5.2%, -4.4%, -2.9%, -0.3%의 염전력 변화가 있었다. 그러므로 골수강을 제거하지 않고 $80^{\circ}C$ 35분, $60^{\circ}C$ 15분 열처리 하거나, 골수강을 완전소파 후 $60^{\circ}C$ 15분, $70^{\circ}C$ 15분, $80^{\circ}C$ 15분 열처리해서는 각군사이에 염전력의 유의한 차이는없었다. 이상의 결과로 돼지 경골의 경우 $60^{\circ}C$ 항온에서는 35분까지, $80^{\circ}C$이하의 항온에서는 15분까지 열처리하여도 골강도에는 거의 영향이 없는 것으로 나타났다.

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임플랜트 식립부위 형성시 골조직의 온도변화에 관한 연구 (A STUDY ON THE TEMPERATURE CHANGES OF BONE TISSUES DURING IMPLANT SITE PREPARATION)

  • 김평일;김영수;장경수;김창회
    • 대한치과보철학회지
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    • 제40권1호
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    • pp.1-17
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    • 2002
  • The purpose of this study is to examine the possibility of thermal injury to bone tissues during an implant site preparation under the same condition as a typical clinical practice of $Br{\aa}nemark$ implant system. All the burs for $Br{\aa}nemark$ implant system were studied except the round bur The experiments involved 880 drilling cases : 50 cases for each of the 5 steps of NP, 5 steps of RP, and 7 steps of WP, all including srew tap, and 30 cases of 2mm twist drill. For precision drilling, a precision handpiece restraining system was developed (Eungyong Machinery Co., Korea). The system kept the drill parallel to the drilling path and allowed horizontal adjustment of the drill with as little as $1{\mu}m$ increment. The thermocouple insertion hole. that is 0.9mm in diameter and 8mm in depth, was prepared 0.2mm away from the tapping bur the last drilling step. The temperatures due to countersink, pilot drill, and other drills were measured at the surface of the bone, at the depths of 4mm and 8mm respectively. Countersink drilling temperature was measured by attaching the tip of a thermocouple at the rim of the countersink. To assure temperature measurement at the desired depths, 'bent-thermocouples' with their tips of 4 and 8mm bent at $120^{\circ}$ were used. The profiles of temperature variation were recorded continuously at one second interval using a thermometer with memory function (Fluke Co. U.S.A.) and 0.7mm thermocouples (Omega Co., U.S.A.). To simulate typical clinical conditions, 35mm square samples of bovine scapular bone were utilized. The samples were approximately 20mm thick with the cortical thickness on the drilling side ranging from 1 to 2mm. A sample was placed in a container of saline solution so that its lower half is submerged into the solution and the upper half exposed to the room air, which averaged $24.9^{\circ}C$. The temperature of the saline solution was maintained at $36.5^{\circ}C$ using an electric heater (J. O Tech Co., Korea). This experimental condition was similar to that of a patient s opened mouth. The study revealed that a 2mm twist drill required greatest attention. As a guide drill, a twist drill is required to bore through a 'virgin bone,' rather than merely enlarging an already drilled hole as is the case with other drills. This typically generates greater amount of heat. Furthermore, one tends to apply a greater pressure to overcome drilling difficulty, thus producing even greater amount heat. 150 experiments were conducted for 2mm twist drill. For 140 cases, drill pressure of 750g was sufficient, and 10 cases required additional 500 or 100g of drilling pressure. In case of the former. 3 of the 140 cases produced the temperature greater than $47^{\circ}C$, the threshold temperature of degeneration of bone tissue (1983. Eriksson et al.) which is also the reference temperature in this study. In each of the 10 cases requiring extra pressure, the temperature exceeded the reference temperature. More significantly, a surge of heat was observed in each of these cases This observations led to addtional 20 drilling experiments on dense bones. For 10 of these cases, the pressure of 1,250g was applied. For the other 10, 1.750g were applied. In each of these cases, it was also observed that the temperature rose abruptly far above the thresh old temperature of $47^{\circ}C$, sometimes even to 70 or $80^{\circ}C$. It was also observed that the increased drilling pressure influenced the shortening of drilling time more than the rise of drilling temperature. This suggests the desirability of clinically reconsidering application of extra pressures to prevent possible injury to bone tissues. An analysis of these two extra pressure groups of 1,250g and 1,750g revealed that the t-statistics for reduced amount of drilling time due to extra pressure and increased peak temperature due to the same were 10.80 and 2.08 respectively suggesting that drilling time was more influenced than temperature. All the subsequent drillings after the drilling with a 2mm twist drill did not produce excessive heat, i.e. the heat generation is at the same or below the body temperature level. Some of screw tap, pilot, and countersink showed negative correlation coefficients between the generated heat and the drilling time. indicating the more the drilling time, the lower the temperature. The study also revealed that the drilling time was increased as a function of frequency of the use of the drill. Under the drilling pressure of 750g, it was revealed that the drilling time for an old twist drill that has already drilled 40 times was 4.5 times longer than a new drill The measurement was taken for the first 10 drillings of a new drill and 10 drillings of an old drill that has already been used for 40 drillings. 'Test Statistics' of small samples t-test was 3.49, confirming that the used twist drills require longer drilling time than new ones. On the other hand, it was revealed that there was no significant difference in drilling temperature between the new drill and the old twist drill. Finally, the following conclusions were reached from this study : 1 Used drilling bur causes almost no change in drilling temperature but increase in drilling time through 50 drillings under the manufacturer-recommended cooling conditions and the drilling pressure of 750g. 2. The heat that is generated through drilling mattered only in the case of 2mm twist drills, the first drill to be used in bone drilling process for all the other drills there is no significant problem. 3. If the drilling pressure is increased when a 2mm twist drill reaches a dense bone, the temperature rises abruptly even under the manufacturer-recommended cooling conditions. 4. Drilling heat was the highest at the final moment of the drilling process.