• 제목/요약/키워드: Prosthesis loosening

검색결과 68건 처리시간 0.027초

시멘트 유지형 임플란트 보철물의 신개념 유지 방식: Fiber post의 설측 수평 삽입에 의한 유지력 보완 (A new retaining method of cement-retained restoration with linguo-horizontal insertion of fiber post)

  • 윤나리;이성복;이석원;안수진;박수정
    • 대한치과보철학회지
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    • 제55권1호
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    • pp.71-78
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    • 2017
  • 임플란트 보철물을 지대주 및 임플란트에 연결하는 방법은 크게 나사 유지방식과 시멘트 유지방식으로 나눌 수 있다. 나사 유지형의 장점은 탈착 가능성과 잔류 시멘트가 남지 않는다는 점이나 상대적으로 나사 풀림이나 파절의 비율이 시멘트 유지방식에 비해 높다는 단점이 있다. 반면 시멘트 유지형은 심미적이고 상대적으로 적은 비용으로 보철물을 제작할 수 있으나 탈착의 용이성이 불리하다는 단점이 있다. 이 두 가지의 장점을 조합한 방식으로 SCRP방식이 소개되었다. 그러나 역시 이상적인 임플란트 식립 위치를 전제로 한다. 이러한 여러 가지 보철 방식의 단점들을 해결하기 위하여 잔여 시멘트를 남기지 않으면서 연조직 염증을 예방할 수 있는 fiber post 유지형 보철 연결방식을 새롭게 소개하고자 한다.

나사 시멘트 유지형 임플란트 보철물의 잔여 전부하 및 시멘트 파손에 대한 임상평가 (Clinical evaluation of retained preload and cement washout in screw- and cement-retained implant prosthesis)

  • 정재헌;손미경;김석규
    • 대한치과보철학회지
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    • 제53권4호
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    • pp.301-309
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    • 2015
  • 목적: 이 연구의 목적은 지대주 나사 잔여 전부하 비율과 시멘트 파손유무 평가를 통해 나사 시멘트 유지형 임플란트 보철물(screw- and cement-retained implant prosthesis: SCP)의 임상적 수행 능력을 알아보는 것이다. 재료 및 방법: 구치부 부분 무치악 환자들을 대상으로 임플란트가 식립되었으며 3 - 6개월의 치유기간 후 SCP임플란트 보철물이 장착되었다. 추적관찰을 통해 임플란트의 생존율이 평가되고 보철물 성공률도 평가되었다. SCP 보철물의 나사 잔여 전부하 비율 및 시멘트 파손 비율이 측정되었다. 결과: 20명의 환자로부터 21개의 SCP보철물(43개의 임플란트)이 최대 64개월까지 관찰되었다. 관찰기간(평균 34개월) 동안 골융합에 실패한 임플란트는 하나도 없었다. 지대주, 나사, 도재 혹은 보철물 프레임 파절이나 나사 풀림 등은 없었으므로 보철물 성공율은 100%였다. SCP 보철물의 나사 잔여 전부하 비율은 97.61% (${\pm}16.29$), 그리고 시멘트 파손비율은 9.5%이었다. 결론: 본 실험의 한계 내에서, 나사 풀림과 시멘트 파손이란 관점에서 SCP 디자인의 임플란트 보철물은 양호한 단기 임상 결과를 보였다.

고정성 임플란트 보철물을 이용한 완전 무치악 환자의 구강회복 증례 (Full mouth rehabilitation of edentulous patient with fixed implant prosthesis)

  • 신희현;김종진;백진;차현석;이주희
    • 구강회복응용과학지
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    • 제37권3호
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    • pp.147-156
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    • 2021
  • 완전 무치악 환자의 구강 회복은 통상적 총의치, 하이브리드 보철물, 임플란트 지지 고정성 보철물 등 다양한 치료 옵션을 통해 이루어질 수 있다. 전악 임플란트 고정성 보철 수복의 경우 가철성 수복과 비교해 최종적인 보철물의 형태를 고려하여 정확한 위치에 임플란트를 식립해야 한다는 어려움이 따른다. 본 증례에서는 치아우식과 만성 치주염으로 전악 발거를 요하는 환자의 전악 임플란트 고정성 수복을 진행하였다. 임플란트 식립 단계에서 최종 보철물 형태를 고려하여 제작된 수술용 가이드를 이용하여 원하는 위치에 임플란트를 식립 하였으며 고정성 임시 수복물 단계에서 수정 및 재제작을 통해 기능과 심미를 평가하였다. 이렇게 제작된 임시 수복물을 바탕으로 금속 도재관의 최종 수복물을 장착하였다. 나사 풀림 및 도재 파절 등의 합병증에 대처하기 위해 구치부의 경우 나사 유지형 보철물, 전치부는 나사 시멘트 유지형 보철물로 제작하였다. 그 결과 환자는 최종 보철물 장착 후 기능적 심미적 측면에서 개선된 예후를 보였다.

인공관절에 사용되는 UHMWPE의 내마모성 향상에 관한 연구 (An enhancement in wear property of UHMWPE used in joint prosthesis)

  • 김경태;이창우;최재봉;최귀원
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1996년도 추계학술대회
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    • pp.3-6
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    • 1996
  • The Ultra-high molecular weight polyethylene (UHMWPE) is exclusivity used as the articulation component with metal or ceramic materials in artificial joint prosthesis because of its good mechanical properties. In the long term however, wear of UHMWPE causes complex problems and hence causes loosening of He prosthesis. In this study, we tried to enhance the wear property of UHMWPE by attaching a hydrophilic graft on the UHMWPE surface and by improving surface hardness without deteriorating the mechanical properties of UHMWPE. This was achieved by ion implantation and by ${\gamma}$-irradiation to the surface in acrylic acid solution and by photo-polymerization in divinylbenzen (DVB), diallysophthalate (DAIP) solution. The wear test was performed by a wear testing machine of ball-on-disk type devised by the authors. The UHMWPE with hydrophlic surface and increased surface hardness developed by above treatments showed less volumetric wear.

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악궁의 만곡도 및 임플랜트 위치에 따른 삼차원적 유한요소 응력분석 (A STUDY ON THE THREE DIMENSIONAL FINITE ELEMENT ANALYSIS OF THE STRESSES ACCORDING TO THE CURVATURE OF ARCH AND PLACEMENT OF IMPLANTS)

  • 이돈오;정재헌;조규종
    • 대한치과보철학회지
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    • 제33권1호
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    • pp.98-129
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    • 1995
  • The purpose of this study was to evaluate how mandibular implant-supported fixed complete prosthesis, implant and mandible responded mechanically, according to curvature of arch, number and location of fixture, and amounts of load. The shape of mandibular arch was tapered or square form and, 4 or 6 fixtures were implanted in each arch model. A vertical load of 10kg was applied at the center of prosthesis and a vertical load of 20kg was applied at the location of the 10mm or 20mm cantilever posterior to the most distal implant. Three-dimensional finite element analysis was performed for stress distribution and deflection using commercial software(ABAQUS program) for Sun-SPARC Workstation. The results were as follows : 1. The case square arch form was more stable to compare with that of tapered arch form in respect of stress distribution and displacement under vertical load on the center of prosthesis. 2. 6-implants cases were more stable than 4-implants cases for decreasing bending torque under vertical load on the center of prosthesis. 3. Under vertical load on cantilever extension, the case of 10mm long cantilever was more stable than that of 20mm long cantilever in respect of stress distribution and displacement. 4. Under vertical load on cantilever extension, 6-implants cases had a tendency to reduce displacement and to increase the reaction force of supporting point due to increasing of the bending stiffness of the prosthesis than 4-implant case. 5. When the ends of 10mm or 20mm long cantilever were loaded, the most distal implant was under compressive stress but the second most distal implant was under the highest tensile stress and the remaining implants were under varying tensile stress. 6. Because 6-implants cases had smaller displacement than 4-implants cases, 6-implants cases were more favorable in respect of prevention of screw loosening under repeated loadings.

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Effects of Ginsenosides Rg1 on Osteoblasts Cultured with Ti Particles

  • Lin, Yu;Wu, Yinsheng;He, Jiacheng;Huang, Yunmei;Lin, Yanping
    • Biomolecules & Therapeutics
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    • 제20권1호
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    • pp.75-80
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    • 2012
  • The aim of this study was to explore the role and effect of ginsenosides Rg1 on osteoblasts cultured with Ti particles. Osteoblasts from neonatal rats were cultured with particles and different doses of Rg1, the main active ingredient in ginsenosides Rg1. We found that the COX-2, $PGE_2$, TNF-${\alpha}$, IL-1, and IL -6 concentrations in the medium of cells cultured with Ti particles significantly increased as compared with that of the control cells (p<0.05 or p<0.01). In addition, cells cultured with Ti particles alone exhibited the highest concentrations of these molecules. The $PGE_2$, TNF-${\alpha}$, IL-1, and IL-6 levels in the medium of cells cultured with Rg1 were in between those of the control cells and the cells cultured with Ti particles alone. The IL-1ra level in the group cultured with Ti and medium-dose Rg1 was the highest followed by the cells cultured with Ti and high-dose Rg1 and those cultured with Ti and low-dose Rg1 (p<0.05). In conclusion, ginsenosides can reduce the levels of infl ammatory cytokines produced by osteoblasts on induction with Ti particles and can prevent prosthesis loosening.

Numerical modeless of the damage, around inclusion in the orthopedic cement PMMA

  • Mohamed, Cherfi;Smail, Benbarek;Bouiadjra, Bachir;Serier, B.
    • Structural Engineering and Mechanics
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    • 제57권4호
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    • pp.717-731
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    • 2016
  • In orthopedic surgery and more especially in total arthroplastie of hip, the fixing of the implants generally takes place essentially by means of constituted surgical polymer cement. The damage of this materiel led to the fatal rupture and thus loosening of the prosthesis in total hip, the effect of over loading as the case of tripping of the patient during walking is one of the parameters that led to the damage of this binder. From this phenomenon we supposed that a remain of bone is included in the cement implantation. The object of this work is to study the effect of this bony inclusion in the zones where the outside conditions (loads and geometric shapes) can provoke the fracture of the cement and therefore the aseptic lousing of the prosthesis. In this study it was assumed the presence of two bones -type inclusions in this material, one after we analyzed the effect of interaction between these two inclusions damage of damage to this material. One have modeled the damage in the cement around this bone inclusion and estimate the crack length from the damaged cement zone in the acetabulum using the finite element method, for every position of the implant under the extreme effort undergone by the prosthesis. We noted that the most intense stress position is around the sharp corner of the bone fragment and the higher level of damage leads directly the fracture of the total prosthesis of the hip.

THE EFFECT OF INTERNAL IMPLANT-ABUTMENT CONNECTION AND DIAMETER ON SCREW LOOSENING

  • Ha, Chun-Yeo;Kim, Chang-Whe;Lim, Young-Jun;Jang, Kyung-Soo
    • 대한치과보철학회지
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    • 제43권3호
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    • pp.379-392
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    • 2005
  • Statement of problem. One of the common problems of dental implant prosthesis is the loosening of the screw that connects each component, and this problem is more common in single implant-supported prostheses with external connection, and in molars. Purpose. The purposes of this study were: (1) to compare the initial abutment screw detorque values of the six different implant-abutment interface designs, (2) to compare the detorque values of the six different implant-abutment interface designs after cyclic loading, (3) to compare the detorque values of regular and wide diameter implants and (4) to compare the initial detorque values with the detorque values after cyclic loading. Material and methods. Six different implant-abutment connection systems were used. The cement retained abutment and titanium screw of each system were assembled and tightened to 32Ncm with digital torque gauge. After 10 minutes, initial detorque values were measured. The custom titanium crown were cemented temporarily and a cyclic sine curve load(20 to 320N, 14Hz) was applied. The detorque values were measured after cyclic loading of one million times by loading machine. One-way ANOVA test, scheffe’s test and Mann-Whitney U test were used. Results. The results were as follows : 1. The initial detorque values of six different implant-abutment connections were not significantly different(p>0.05). 2. The detorque values after one million dynamic cyclic loading were significantly different (p<0.05). 3. The SS-II regular and wide implant both recorded the higher detorque values than other groups after cyclic loading(p<0.05). 4. Of the wide implants, the initial detorque values of Avana Self Tapping Implant, MIS and Tapered Screw Vent, and the detorque values of MIS implant after cyclic loading were higher than their regular counterparts(p<0.05). 5. After cyclic loading, SS-II regular and wide implants showed higher detorque values than before(p<0.05).

Stability of the prosthetic screws of three types of craniofacial prostheses retention systems

  • Lanata-Flores, Antonio Gabriel;Sigua-Rodriguez, Eder Alberto;Goulart, Douglas Rangel;Bomfim-Azevedo, Veber Luiz;Olate, Sergio;de Albergaria-Barbosa, Jose Ricardo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제42권6호
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    • pp.352-357
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    • 2016
  • Objectives: This study aimed to evaluate the stability of prosthetic screws from three types of craniofacial prostheses retention systems (bar-clip, ball/O-ring, and magnet) when submitted to mechanical cycling. Materials and Methods: Twelve models of acrylic resin were used with implants placed 20 mm from each other and separated into three groups: (1) bar-clip (Sistema INP, São Paulo, Brazil), (2) ball/O-ring (Sistema INP), and (3) magnet (Metalmag, São Paulo, Brazil), with four samples in each group. Each sample underwent a mechanical cycling removal and insertion test (f=0.5 Hz) to determine the torque and the detorque values of the retention screws. A servo-hydraulic MTS machine (810-Flextest 40; MTS Systems, Eden Prairie, MN, USA) was used to perform the cycling with 2.5 mm and a displacement of 10 mm/s. The screws of the retention systems received an initial torque of 30 Ncm and the torque values required for loosening the screw values were obtained in three cycles (1,080, 2,160, and 3,240). The screws were retorqued to 30 Ncm before each new cycle. Results: The sample was composed of 24 screws grouped as follows: bar-clip (n=8), ball/O-ring (n=8), and magnet (n=8). There were significant differences between the groups, with greater detorque values observed in the ball/O-ring group when compared to the bar-clip and magnet groups for the first cycle. However, the detorque value was greater in the bar-clip group for the second cycle. Conclusion: The results of this study indicate that all prosthetic screws will loosen slightly after an initial tightening torque, also the bar-clip retention system demonstrated greater loosening of the screws when compared with ball/O-ring and magnet retention systems.

내부연결 임플란트의 보철 수복 후 성공률에 미치는 위험요소에 관한 10년간의 후향적 연구 (A 10-year retrospective study on the risk factors affecting the success rate of internal connection implants after prosthetic restoration)

  • 이서인;김민정
    • 대한치과보철학회지
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    • 제61권2호
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    • pp.113-124
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    • 2023
  • 목적: 본 연구의 목적은 임플란트 보철물의 종류 및 특성과 생존율 분석을 통해 성공률을 높이는데 도움이 되는 데에 있다. 대상 및 방법: 원광대학교 치과대학 산본치과병원에서 2011~2020년에 식립한 임플란트 중 한 명의 보철전문의에 의해 수복된 사례에 대하여 그 특성과 실패에 대한 상관관계 등을 조사하였다. 실패의 원인은 골유착 실패, 임플란트주위염, 고정체 파절, 지대주 파절, 나사 파절, 나사 풀림, 보철물 파절, 보철물 유지력 상실 등으로 분류했다. 보철방식, 캔틸레버 여부, 식립 위치 등과 임플란트 실패와의 연관성을 분석했다. 결과 분석은 SPSS ver 25.0 (IBM, Chicago, IL, USA)을 이용하여 Chi-square test, Kaplan-Meier 생존분석 등을 통하여 도출했다. 결과: 총 2587개의 임플란트가 식립되었으며, 그 중 1141개의 임플란트가 단일관(Single Crown)으로, 1446개의 임플란트가 고정성 국소의치(Fixed Partial Denture)로 수복되었고 누적생존율은 88.1%이었다. SC의 성공률은 86.2% (984개), FPD의 성공률은 89.6% (1295개)로 통계적으로 유의한 차이를 보였으며 그 중 유의한 차이가 있었던 요인은 지대주 파절, 나사 파절, 나사 풀림 등이었다 (P < .05). 결론: 10년간의 추적조사 결과 생물학적인 요인보다는 생역학적인 요인으로 인한 실패가 더 많이 발생했고 임플란트의 성공률은 보철방식 별로 상이했으며 영향을 미치는 요인도 상이했다. 추후 임플란트의 성공에 관한 추가적인 연구가 더 필요할 것이다.