• 대한치과보철학회지
• /
• 제46권4호
• /
• pp.396-408
• /
• 2008

연구목적: 임플랜트 치료에서 가장 흔히 발생하는 기계적 문제점 중 하나는 나사의 풀림이다. 지대주 나사에 조임회전력을 가하는 목적은 나사를 신장시켜, 신장된 나사의 인장력에 의한 지대주와 고정체간의 압축력을 통해 연결부의 안정성을 부여하는 데 있다. 조임 회전력의 결과로 나타나는 전하중의 크기는 다양한 요소에 의해 영향을 받기 때문에, 동일한 조임회전력을 적용하였다 할지라도 임플랜트 시스템의 종류에 따라 전하중의 크기가 달라질 수 있다. 따라서 지대주 나사 연결부의 안정성을 위한 다양한 임플랜트 시스템의 적정 조임회전력 크기에 관한 연구가 필요하다. 본 연구에서는 external butt joint와 두 가지 internal cone 연결형태를 갖는 임플랜트 시스템들에서 지대주 나사의 조임회전력이 임플랜트-지대주 나사 연결부의 안정성에 미치는 영향을 하중 전후의 풀림회전력 측정을 통해 알아보고자 하였다. 연구재료 및 방법: External butt joint 형태를 가지는 US II 시스템과 $8^{\circ}$ internal cone 연결형태의 SS II 및 $11^{\circ}$ internal cone 연결형태의 GS II 시스템에서 20 Ncm, 30 Ncm, 그리고 40 Ncm의 각기 다른 조임회전력을 적용한 후 초기 풀림회전력 및 상실률과 $10^5$회의 반복하중 후의 풀림회전력 및 상실률을 비교 분석하였다. 연구결과 및 결론: 1. 초기 풀림회전력과 하중 후 풀림회전력은 조임회전력의 크기가 증가할수록 크게 나타났다 (P < .05). 2. 초기 풀림회전력 상실률은 SS II 시스템에서는 조임회전력 크기에 따른 차이가 없었으나 (P > .05), GS II와 US II에서는 20 Ncm 보다 40Ncm의 조임회전력에서 더 낮게 나타났다 (P < .05). 3. 하중 후 풀림회전력 상실률은 세 시스템 모두 30 Ncm의 조임회전력을 가했을 때 가장 낮게 나타났다 (P < .05). 4. 하중 후 풀림회전력 상실률은 SS II, GS II, 그리고 US II 순으로 높아지는 경향을 보였다. 5. 초기 풀림회전력과 하중 후 풀림회전력 상실률 간에는 상관관계가 없었다 (P > .05). 이상의 결과로부터 임플랜트 시스템의 종류뿐만 아니라 조임회전력의 크기 또한 지대주 나사의 풀림회전력 상실에 영향을 준다는 것을 알 수 있다. 따라서 임플랜트-지대주 나사 연결부 안정성 유지를 위해서는 임플랜트 시스템마다 적정 조임회전력이 제시되어야 하고, 또한 임상에서 이를 준수하는 것이 매우 중요하다고 생각된다.

• 대한치과보철학회지
• /
• 제44권4호
• /
• pp.432-442
• /
• 2006

Statement of problem: One of common problems associated with dental implant is the loosening of abutment screws that retain the implants. Purpose : This study was performed to investigate the influence of abutment screw length and repeated tightening on screw loosening in dental implant. Material and method: Forty nine Hexplants (13mm length, 4.3mm diameter, Ti grade IV, Warantec. Co. Ltd. Seongnam, Korea) and cementation type abutments(straight abutment) and abutment screws (0.4mm/pitch) were divided into 7 groups, depending on abutment screw length. Each implant and abutment was tightened to 30Ncm by torque controller(MGT50, MARK-10 Inc., USA) and the removal torque values were measured during 10 consecutive closure/opening trials. Results and Conclusion: The results of comparing the removal torque value are as follows : 1. There is no significant difference in the removal torque value between groups in 10 consecutive closure/opening trials (p = 0.97). 2. If the fractured abutment screw is engaged in longer than 2.425 thread length, there is no significant difference in the preload between the fractured abutment screw and the new abutment screw when both are equally tightened to 30 Ncm. 3. The removal torque value in the 1st trial(24.510 Ncm) was lower than that in the 2nd, 3rd, 4th, 5th, 6th, 7th trials and the removal torque value in the 2nd trials(25.551 Ncm) was maximum and was decreased in 1311owing trials. The removal torque value in the 1st trial was significantly lower than that in the 2nd, 3rd, 4th trials and was significantly higher than that in the 8th, 9th, l0th trials(p<0.05). 4. In the 2nd, 3rd, 4th, 5th, 6th, 7th trials, the abutment screw was mainly influenced by settling effect and the higher preload was obtained In the 8th, 9th, l0th trials, the abutment screw was mainly influenced by adhesive wear and the progressively lower preload was obtained.

• 대한치과보철학회지
• /
• 제50권3호
• /
• pp.149-155
• /
• 2012

연구 목적: 이 논문은 임플란트 고정체가 골융합이 이루어지기전 의원성 동요가 있을 경우 골결합에 어떤 영향을 미치는지를 알아 보고자 한다. 연구 재료 및 방법: 실험에 사용한 임플란트는 직경 3.73 mm, 길이 4 mm의 순수한 타이타늄과 RBM ($MegaGen^{(R)}$: Ca-P) 처리된 임플란트(Grade IV)를 사용하였다. 몸무게 3.5kg 이상의 토끼(Female, New Zealand White)의 한쪽 경골에 2개씩 양쪽 다리에 임플란트를 식립하여 모두 80개의 임플란트가 식립되었다. 비틀림 제거력(Removal torque)의간격에 따라 그룹 I (6주), 그룹 II (4일+6주), 그룹 III (4일+1주+6주), 그룹 IV (1주+6주), 그룹 V (1주+1주+6주), 그룹 VI (2주+6주), 그룹 VII (2주+1주+6주), 그룹 VIII (3주+6주), 그룹 IX (3주+1주+6주), 그룹 X (10주)으로 10개의 그룹으로 나누었다. 본 실험에서 그룹 I과 그룹X가 대조군이며, 비틀림 제거력은 digital torque gauze (Mark-10, USA)를 사용하여 6주와 10주에 측정하였다. 실험군에서는 마지막 비틀림 제거력을 측정하기 전에 의원성 동요를 가하여 한 번 혹은 두 번 비틀림 제거력을 측정하여 그 수치를 기록하였다. 그 후, 대조군을 제외하고 비틀림 제거력을 측정한 임플란트는 가급적 원래의 위치로 돌려 놓고 봉합을 하였다. 모든 실험군은 마지막 비틀림 제거력 측정전까지 6주간의 치유기간을 주었으며, 마지막 비틀림 제거력은 실험군 첫 번째 또는 두 번째 비틀림 제거력값과 비교하여 결과를 분석하였다. 결과: 마지막 비틀림 제거력 측정값에서 그룹X (10주)의 값이 대조군인 그룹 I (6주)의 값보다 높았으나, 통계적으로는 유의하지 않았다. 실험군과 대조군 사이의 통계적으로 유의한 차이를 보이지 않았다(P>.05). 첫 번째 비틀림 제거력 측정치에서, 실험군(4일혹은1주)에서 다른 실험군(2주혹은3주)의 수치보다 낮은 값을 보였다. 치유기간에 따른 각 실험군의 비교에서, 최종 비틀림 제거력 값이 첫 번째 비틀림 제거력 값 보다 현저히 높은 값을 보였다. 결론: 골유착이 형성되기 전 한 번 또는 두 번 의원성으로 동요는, 만약 충분한 치유기간을 가지게 될 경우 임플란트의 골유착에 영향을 주지 않는다.

• 대한치과보철학회지
• /
• 제46권6호
• /
• pp.561-568
• /
• 2008

STATEMENT OF PROBLEM: Currently, many implant systems are developed and divided into two types according to their joint connection: external or internal connection. Regardless of the connection type, screw loosening is the biggest problem in implant-supported restoration. PURPOSE: The purpose of this study is to assess the difference in stability of abutment screws between the external and internal hexagonal connection types under cyclic loading. MATERIAL AND METHODS: Each of the 15 samples of external implants and internal abutments were tightened to 30 N/cm with a digital torque gauge, and cemented with a hemispherical metal cap. Each unit was then mounted in a $30^{\circ}$ inclined jig. Then each group was divided into 2 sub-groups based on different periods of cyclic loading with the loading machine (30 N/ cm - 300 N/cm,14 Hz: first group $1{\times}10^6$, $5{\times}10^6$ cyclic loading; second group $3{\times}10^6$, $3{\times}10^6$ for a total cyclic loading of $6{\times}10^6$) The removal torque value of the screw before and after cyclic loading was checked. SPSS statistical software for Windows was used for statistical analysis. Group means were calculated and compared by ANOVA, independent t-test, and paired t-test with ${\alpha}$=0.05. RESULTS: In the external hexagonal connection, the difference between the removal torque value of the abutment screw before loading, the value after $1{\tims}10^6$ cyclic loading, and the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was not significant. The difference between the removal torque value after $3{\times}10^6$ cyclic loading and after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. In the internal hexagonal connection, the difference between the removal torque value before loading and the value after $1{\times}10^6$ cyclic loading was not significant, but the value after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading was reduced and the difference was significant (P < .05). In addition, in the internal hexagonal connection, the difference between the removal torque value after $3{\times}10^6$ cyclic loading and the value after $3{\times}10^6$, and additional $3{\times}10^6$ cyclic loading was not significant. CONCLUSION: The external hexagonal connection was more stable than the internal hexagonal connection after $1{\times}10^6$, and additional $5{\times}10^6$ cyclic loading (t = 10.834, P < .001). There was no significant difference between the two systems after $3{\times}10^6$, and additional $3{\times}10^6$ cycles.

• 대한치과보철학회지
• /
• 제46권6호
• /
• pp.628-633
• /
• 2008

STATEMENT OF PROBLEM: The application of a simple, clinically applicable noninvasive test to assess implant stability are considered highly desirable. So far there is still a controversy about correlation of various tests and implant stability. PURPOSE: In order to assess implant stability, the development of a new method is critical. It's possible to assess implant stability by calculating energy and angular momentum during implant installation. The purpose of this study is to evaluate the correlation of energy and implant stability. MATERIAL AND METHODS: Twenty three implants were installed in two different types of pig bone. Type I bone was retrieved from the distal aspect of the rib, with more cortical bone. Type II bone came from a more proximal region with less cortical components and a higher content of bone marrow and spongeous trabeculae. Insertion torque, removal torque, ISQ values and angular momentum and energy were measured. Pearson Correlation test was done to analyze the relation between RFA, maximum insertion torque, mean insertion torque, bone type, energy and removal torque. RESULTS: Type I bone showed higher removal torque than type II bone. Energy value was significantly correlated with maximum insertion torque and mean insertion torque. RFA values were related with insertion torques but the significance was lower than Energy value. CONCLUSION: Within the limitation of this study energy values were considered clinically predictable method to measure the implant stability.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• 제23권5호
• /
• pp.396-405
• /
• 2001

Osseointegrated implants are used for the fixation of dental prosthesis with good long-term clinical results. In an attempt to improve the quantity and quality of the bone-implant interface, numerous implant modification have been used. Implants surface modifications have been used such as titanium-plasma sprayed, hydroxyapatite-coating, sandblasted, sandblasted and acid-etched, acid-etched. Rough surface implants have greater implant surface area and enhance the bone-implant interface and improve stabilization. The purpose of present study was to evaluate light microscopic and scanning microscopic examinations and removal torque value of newly developed calcium phosphate blast and acid-etched implant in the femur of rabbits. Titanium plasma sprayed(TPS) implant served as controls. After 12 weeks of healing of the femurs of 12 rabitts, the implant-containing segments of femur were removed on bloc and bone block including sections. Histologic examination and histomorphometric and removal torque values comparision were made for two implants. Obtained results are follows: 1. Newly developed calcium phosphate blasted and acid-etched implants were in close contact with bone under light microscopic examinations. 2. New implants showed mean bone-to implant contact 59.8%, whereas TPS implants showed mean bone-to implant contact 54.5% (statistically no difference p<0.05). 3. New implants showed mean bone density 56.7%, whereas TPS implants showed mean bone density 49.2% (statistically difference p<0.05). 4. New implants demonstrated mean removal torque values 40.5Ncm, whereas the mean removal torque values of TPS implants ranged 39.3Ncm. No statistical differences(p<0.05) were observed between two groups of implants nor was there any difference between the two implants at the clinical level.

• 대한치과보철학회지
• /
• 제44권6호
• /
• pp.722-733
• /
• 2006

Statement of problem. The use of small diameter implants having less than 3 mm in diameter were restricted because of lack of bonding strength to bone. Purpose. The purpose of this study was to observe how much resorbable blast media pin implants increase the binding force to the bone compared to machined transitional pin implants by measuring removal torque, and whether they can be used as final implants for replacement of small diameter teeth. Material and method. Fifteen rabbits were used in this study. Two kinds of implants (resorbable blast media pin implants and machined transitional pin implants) were inserted in each tibia bicortically. After healing time of 2, 4 and 8 weeks, the removal torque values were recorded and the rabbits were sacrificed for histological analysis. Linear finite element method analyses were conducted to compare bicortical fixation with monocortical fixation. Result and conclusion. Within the limitation of this in vivo study, the following conclusions were drawn: 1) The removal torque value of RBM pin implants showed statistically significant increase compared to machined pin implants at 2, 4, and 8 weeks respectively (p<0.05). 2) The removal torque value of RBM pin implants at 2, 4, and 8 weeks was increased statistically significantly with time (p<0.05). 3) Bicortical fixation showed better stress distribution compared with monocortical fixation in a linear finite element method analysis. 4) RBM pin implants are not recommended as transitional implants because they showed a lot of bone fracture in histologic specimens.

• The Journal of Advanced Prosthodontics
• /
• 제6권2호
• /
• pp.126-132
• /
• 2014

PURPOSE. This study was conducted to evaluate the influence of the implant-abutment connection design and diameter on the screw joint stability. MATERIALS AND METHODS. Regular and wide-diameter implant systems with three different joint connection designs: an external butt joint, a one-stage internal cone, and a two-stage internal cone were divided into seven groups (n=5, in each group). The initial removal torque values of the abutment screw were measured with a digital torque gauge. The postload removal torque values were measured after 100,000 cycles of a 150 N and a 10 Hz cyclic load had been applied. Subsequently, the rates of the initial and postload removal torque losses were calculated to evaluate the effect of the joint connection design and diameter on the screw joint stability. Each group was compared using Kruskal-Wallis test and Mann-Whitney U test as post-hoc test (${\alpha}$=0.05). RESULTS. The postload removal torque value was high in the following order with regard to magnitude: two-stage internal cone, one-stage internal cone, and external butt joint systems. In the regular-diameter group, the external butt joint and one-stage internal cone systems showed lower postload removal torque loss rates than the two-stage internal cone system. In the wide-diameter group, the external butt joint system showed a lower loss rate than the one-stage internal cone and two-stage internal cone systems. In the two-stage internal cone system, the wide-diameter group showed a significantly lower loss rate than the regular-diameter group (P<.05). CONCLUSION. The results of this study showed that the external butt joint was more advantageous than the internal cone in terms of the postload removal torque loss. For the difference in the implant diameter, a wide diameter was more advantageous in terms of the torque loss rate.

• 대한치과보철학회지
• /
• 제41권2호
• /
• pp.169-181
• /
• 2003

Statement of problem : The survival rate of wide diameter implants was lower than of 3.75-mm implants in some clinical researches. Purpose : The purpose of this study was to investigate the influence of implant diameter on the osseointegration of implants in the rabbit femoral condyle and tibial metaphyses by means of removal torque measurements and histomorphometric analysis. Material and Method : Ten adult New Zealand White rabbits were used in this study Two 3.75-mm diameter implants were inserted through one cortical layer in the tibial metaphyses and one 3.75-mm diameter implant was inserted in the femoral condyle. 5.0-mm diameter implants were inserted in the other leg in the same manner. A total of 60 implants (3.75-mm diameter implants:30 : 5.0-mm diameter implants:30) were installed. After a healing time of 4 and 12 weeks, the peak removal torque values required to shear off the implants were recorded. From the removal torque values (Ncm) obtained, the mean shear stress ($N/mm^2$) was calculated. And the percentage of direct bone-to-implant contact and the percentage of bone area inside the thread were measured by Kappa Image Base-metreo. The Student's t-test was undertaken for statistical analysis (p<0.05). Results : The removal torque value of 5.0-mm diameter implants was higher than of 3.75-mm diameter implants (p<0.05). The difference of shear stress value between 3.75-mm and 5.0-mm diameter implants was not statistically significant (p>0.05). The percentage direct bone-to-implant contact had no statistical difference between two groups (p>0.05). The percentage of bone area inside the thread had no statistical difference between two groups (p>0.05). Conclusion It is concluded that the quality f osseointegration is not influenced by increasing implant diameter.

• Journal of Periodontal and Implant Science
• /
• 제43권1호
• /
• pp.41-46
• /
• 2013

Purpose: The objective of this study was to evaluate the effect of microthreads on removal torque and bone-to-implant contact (BIC). Methods: Twelve miniature pigs for each experiment, a total of 24 animals, were used. In the removal torque analysis, each animal received 2 types of implants in each tibia, which were treated with sandblasting and acid etching but with or without microthreads at the marginal portion. The animals were sacrificed after 4, 8, or 12 weeks of healing. Each subgroup consisted of 4 animals, and the tibias were extracted and removal torque was measured. In the BIC analysis, each animal received 3 types of implants. Two types of implants were used for the removal torque test and another type of implant served as the control. The BIC experiment was conducted in the mandible of the animals. The $P_1-M_1$ teeth were extracted, and after a 4-month healing period, 3 each of the 2 types of implants were placed, with one type on each side of the mandible, for a total of 6 implants per animal. The animals were sacrificed after a 2-, 4-, or 8-week healing period. Each subgroup consisted of 4 animals. The mandibles were extracted, specimens were processed, and BIC was analyzed. Results: No significant difference in removal torque value or BIC was found between implants with and without microthreads. The removal torque value increased between 4 and 8 weeks of healing for both types of implants, but there was no significant difference between 8 and 12 weeks. The percentage of BIC increased between 2 and 4 weeks for all types of implants, but there was no significant difference between 4 and 8 weeks. Conclusions: The existence of microthreads was not a significant factor in mechanical and histological stability.