즉시 부하 교정용 미니임플랜트의 안정성 평가를 위한 Periotest 의 유효성

차정열,유형석,황충주 대한치과교정학회 2010 대한치과교정학회지 Vol.40 No.3

Objective: The aim of this study was to validate the Periotest values for the prediction of orthodontic mini-implants’ stability. Methods: Sixty orthodontic mini-implants (7.0 mm x Ø1.45 mm; ACR, Biomaterials Korea, Seoul, Korea) were inserted into the buccal alveolar bone of 5 twelve month-old beagle dogs. Insertion torque (IT) and Periotest values (PTV) were measured at the installation procedure, and removal torque (RT) and PTV were recorded after 12 weeks of orthodontic loading. To correlate PTV with variables, the cortical bone thickness (mm) and bone mineral density (BMD) within the cortical bone and total bone area were calculated with the help of CT scanning. Results: The BMD and cortical bone thickness in mandibular alveolus were significantly higher than those of the maxilla (p < 0.05). The PTV values ranged from -3.2 to 4.8 for 12 weeks of loading showing clinically stable mini-implants. PTV at insertion was significantly correlated with IT (-0.51), bone density (-0.48), cortical bone thickness (-0.42) (p < 0.05) in the mandible, but showed no correlation in the maxilla. PTV before removal was significantly correlated with RT (-0.66) (p < 0.01) in the mandible. Conclusions: These results show that the periotest is a useful method for the evaluation of mini-implant stability, but it can only be applied to limited areas with thick cortical and high density bone such as the mandible. Periotest는 보철용 임플랜트 식립 3 - 4개월 후 골유착 정도를 평가하기 위해 사용되는 동요도 측정 기기로 교정용 미니임플랜트 안정성 평가에 적용가능성이 높다. 본 연구는 교정용 미니임플랜트의 안정성 평가를 위해 Periotest 의 유효성을 검증하고자 하였다. 성견 다섯 마리의 상악, 하악 협측골에 교정용 미니임플랜트를 식립하고, 식립 시 식립 토오크와 동요도를 측정하고 12주 동안 교정력을 부여한 후, 제거 시 제거 토오크와 동요도를 측정하였다. 동요도 (Periotest value, PTV) 측정은 재현성을 위해 동일 부위에 2회 측정하였다. PTV와 다른 변수와의 상관성 분석을 위해 모든 실험견은 CT 촬영 후 식립 부위의 골밀도와 피질골 두께를 계측하였다. 동요도 측정에 대한 재현성은 0.96 의 상관계수를 나타내 매우 높았으며 (p < 0.001) 골밀도와 피질골 두께에 있어 하악골 협측치조골이 상악골에 비해 유의하게 컸다 (p < 0.05). 12주 동안 PTV 값은 -3.2에서 4.8의 범위를 나타내며 모든 임플랜트는 임상적으로 안정적이었다. 식립 시 PTV 값은 하악에서 식립 토오크(-0.51), 골밀도(-0.48), 피질골 두께(-0.42)와 상관성이 있었으나 (p < 0.05), 상악에서는 상관성이 없었다. 제거 시 PTV 값은 하악에서 제거 토오크(-0.66)와 상관성이 있었으며 (p < 0.05), 상악에서는 상관성이 없었다. 이상의 결과는 Periotest 를 이용하여 교정용 미니임플랜트의 안정성을 간접적으로 평가할 수 있으나 골밀도가 높고 피질골이 두꺼운 부위에서 제한적으로 응용할 수 있음을 시사한다.

보철물 조건에 따른 Periotest수치의 실험적 평가

한중석,Han, Jung-Suk 대한치과보철학회 1997 대한치과보철학회지 Vol.35 No.4

Periotest(Siemens, Germany) has been used to test mobility of the implants clinically, however the effects of target materials and connection methods on the PTVs(Periotest Values) have not been evaluated. Periotest has been regarded as a reliable and objective tool to test implant and natural teeth mobility clinically, however this instrument showed different PTVs under various test conditions. This in vitro study was designed to compare PTVs of different veneering materials and prosthodontic designs (single and bridge restorations). To compare the effects of veneering materials on PTVs, 1 mm thickness of five different testing materials (porcelain, type III gold alloy, pure titanium, composite resin, acrylic resin) were placed on the resin block. Three full length of 13 mm Mark II implant fixtures were embedded into autopolymerizing resin block to fabricate single and bridge restorations. To evaluate effects of the connection method in single restorations, PTVs of screw retained(UCLA type) and cementation type(Cera-One system) were compared. Finally, to test reliability of PTVs of the final restorations, screw retained three unit short span PFM bridges were fabricated on the standard and Estheti-Cone abutments. All testing components were tightened with torque controller and PTVs of all specimens were measured 15 times for statistical analysis with SAS program. Following conclusions were made within the limit of this in vitro study. 1. PTVs of type III gold alloy, grade II titanium, composite resin veneering materials showed no significant differences, however acrylic resin and porcelain showed significant differences (P<0.05). 2. Single tooth restorations showed consistent PTVs as long as proper torque force was applied. 3. PTVs of bridge type prostheses was inconsistent regardless of abutment types. 4. PTVs of the prostheses showed higher scores and standard deviations than those of abutments regardless types of connection (P<0.05).

Nonsubmerged 임프란트 식립후 조직형태학적 반응과 시간경과에 따른 Periotest? 측정값에 대한 연구

김태인,이재일,양복렬,송태식 한국생체재료학회 2003 생체재료학회지 Vol.7 No.4

The purposes of this study was to evaluate Periotest values regarding to functional changes and compare Periotest values(PTV) to histologic findings with a nonsubmerged "Protect-447" dental implant. In the first part of the study, PTV measurements of 10 nonsubmerged implant were done immediately after implant placement and repeated every 2 weeks up to 3 months in beagle dogs. Mean PTV for nonsubmerged implants increased on 2 weeks after surgery and then decreased gradually from 4 weeks after implant placement. After 3 month of experimentation, in the 2nd part, PTV of the each implant were measured and the implants with surrounding bone were removed for the histomorphometric analysis. The results were as follows. 1. Histomorphometric analysis after 3 months showed that osseointegration was obtained successfully without fibrous connective tissue at the interface and bone-implant contact ratio was 64.43%±10.53 in beagle dogs. 2. PTV measurements during the 3 months experiments showed that Protect-447 dental implant could be osseointegrated with an excellent primary stability.

난소절제술한 백서에 식립한 임플란트에 대한 PostGraft$^{TM}$의 경구 투여 효과

조춘일,김세원,최유성,조인호,Cho, Chun-Il,Kim, Se-Won,Choi, Yu-Sung,Cho, In-Ho 대한치과보철학회 2011 대한치과보철학회지 Vol.49 No.4

연구 목적: 본 연구에서는 난소절제술을 시행한 백서의 골결손부에 골이식을 시행하고 소형 임플란트를 제작하여 식립한 후 PostGraft$^{TM}$를 투여하여 임플란트의 골유착 및 안정성에 미치는 영향에 대해 알아보고자 하였다. 연구 재료 및 방법: 난소절제술을 시행한 백서 48 마리의 골결손부에 Biocera$^{TM}$를 사용하여 골이식을 시행하고 소형 임플란트를 제작하여 식립한 후 PostGraft$^{TM}$를 투여한 군 24마리와 투여하지 않은 대조군 24마리를 식립 2, 4, 6주 후 Periotest$^{(R)}$를 이용한 임플란트 안정성, 골밀도, 골-임플란트 접촉률 측정 및 조직학적 검사 등을 통하여 비교 분석하였다. 결과: Periotest$^{(R)}$ 측정 결과 시간이 지남에 따라 실험군과 대조군에서 모두 측정값이 감소하였고 실험군에서 더 낮은 값을 나타내었으나 각 군 간에 유의한 차이는 관찰되지 않았다. 골밀도 값은 골다공증으로 인해, 시간이 경과함에 따라 실험군과 대조군에서 모두 감소하였고 실험군에서 더 적은 감소량을 보였으나 각 군 간에 유의한 차이는 관찰되지 않았다. 골-임플란트 접촉률 측정 결과 시간이 경과함에 따라 실험군과 대조군 모두 증가하였고 실험군에서 더 높은 값을 보였으나 2주와 4주에서는 각 군 간에 유의한 차이가 없었고 6주에서는 각 군 간에 유의한 차이가 관찰되었다(P<.05). 조직학적 검사 결과 시간이 경과함에 따라 실험군과 대조군 모두 골반응이 증가하였으며 실험군에서 더 활발한 골형성이 이루어졌다. 결론: PostGraft$^{TM}$의 경구 투여가 난소절제술을 시행한 백서의 경골에 식립한 임플란트의 골유착과 골형성을 향상시키는 효과가 있을 수 있다. Purpose: This study evaluated PostGraft$^{TM}$ which enhances implant stability and bone density. Materials and methods: Forty eight implants were installed at the tibia of ovariectomized rats. The group administrated with PostGraft$^{TM}$ was the experimental group, and the control group was not administrated. Implant stability was evaluated at the $2^{nd}$, $4^{th}$ and $6^{th}$ week by Periotest value, bone mineral density, bone-to-implant contact. These values were analyzed statistically with Mann-Whitney U test (P<.05). Histological analysis was evaluated at the $2^{nd}$, $4^{th}$ and $6^{th}$ week. Results: According to the Periotest$^{(R)}$ measurement, both experimental and control groups showed decrease in values as time elapsed. Greater decrease was observed in the experimental group but there was no significant difference. By examining the radiographic images, both experimental and control groups showed tendency of increase in bone density. Greater increase was seen in the experimental group but there was no significant difference. According to the bone-to-implant contact measurement, both experimental and control groups showed increase in values as time elapsed. Greater increase was seen in the experimental group. At the $2^{nd}$ and $4^{th}$ week, there was no significant difference. But at the $6^{th}$ week, there was significant difference (P<.05). By histological analysis, both experimental and control groups showed increase in bone formation as time elapsed. In addition, greater increase was seen in the experimental group. Conclusion: It could be concluded that the PostGraft$^{TM}$ medicated group showed better results in the bone density and osseointegration.

Longitudinal measurements of tooth mobility following orthodontic treatment

Hwang, Hyeon-Shik,Kim, Wang-Sik,Kim, Jeong-Moon,James A. McNamara,Jr 대한치과교정학회 2010 대한치과교정학회지 Vol.40 No.1

Objective: The aim of the present study was to evaluate the changes in tooth mobility following orthodontic treatment and to obtain information regarding the guideline of retainer wear duration during the post-treatment period. Methods: The sample consisted of twenty patients who had been treated with edgewise appliances. The mobility of the maxillary teeth from the central incisor to the first molar was measured bilaterally by way of the Periotest?, a non-invasive, electronic device that provides an objective measurement of the reaction of the periodontium to a defined impact load. Tooth mobility was monitored at the time of the removal of the orthodontic appliances and subsequently at three-month intervals during the two years following appliance removal. Results: Tooth mobility decreased rapidly for the first six months and then decreased at a slower rate during the next six months; no statistically significant decrease in mobility was observed during the second year following appliance removal. Conclusions: The results of the present study suggest that adequate tooth stabilization is critical during the first six months following appliance removal and that continued wearing of retainers is recommended at least until twelve months after the completion of orthodontic treatment. 본 연구는 교정치료 종료 후 치아동요도의 종단적 계측을 통해 치아 주위조직의 안정화가 언제 나타나는지 살펴봄으로써 교정치료 후 유지장치 장착기간 설정에 도움이 되고자 시행되었다. 고정식 교정장치로 치료가 종료된 20명의 환자를 대상으로 교정장치 제거 직후 그리고 2년까지 3개월 간격으로 Periotest를 이용하여 상악 양측 중절치부터 제1대구치까지 치아동요도를 계측하고 교정치료 후 시간 경과에 따른 동요도 감소 양상을 비교 분석한 결과, 처음 6개월은 급한 양상으로, 다음 6개월은 보다 완만한 양상으로 감소하였고, 이후는 계속 감소하는 양상을 보였으나 통계적으로 유의한 차이를 보이지 않았다. 이상의 결과는 교정치료 후 치아 주위조직의 안정화는 1년이 지나서야 어느 정도 이루어짐을 그리고 처음 6개월은 매우 불안정함을 나타내는 것으로, 교정장치 제거 후 유지장치가 치료 후 1년간은 필요함을, 특히 처음 6개월 동안은 매우 중요함을 시사하였다.

국산 임프란트 시스템의 다기관 전향적 임상 연구

김영균(Young-Kyun Kim),황정원(Jung-Won Hwang),윤필영(Pil-Young Yun),김수관(Su-Gwan Kim),정재헌(Chae-Heon Chung),최용근(Yong-Gun Choi),송승일(Sung-Il Song) 대한치과의사협회 2004 대한치과의사협회지 Vol.42 No.12

교정적 치아이동 후 치아동요도 변화에 관한 연구

황현식,김재혁,최준규,김종철 대한치과교정학회 1998 대한치과교정학회지 Vol.28 No.3

올바른 교정치료계획이나 보정계획 수립을 위해서는 교정력 제거후 치주조직 재형성 양상 및 시기의 규명이 필요하다. 동적교정치료가 종료된 환자 6명을 대상으로 교정장치 제거일과 제거일로부터 1주, 2주, 3주, 4주, 6주, 8주, 10주, 12주, 16주, 20주, 24주에 상악의 경우 중절치부터 제1대구치까지, 하악의 경우 중절치부터 견치까지 좌우 치아의 동요도를 Periotest를 사용하여 측정하고 비교분석한 결과 다음과 같은 결론을 얻었다. 1. 교정장치 제거시 치아동요도는 개인에 따라 매우 다양하게 나타났으며 견치, 소구치, 대구치보다 절치에서 크게 나타났다. 2. 교정장치 제거 후 동요도는 시간 경과에 따라 감소하였는데 그 감소양상은 24주까지 지속되었다. 3. 상악절치는 장치제거 후 24주간 내내 지속적 감소양상을 보인 반면 나머지 치아는 처음 12주간은 급격한, 자중 12주간에서는 완만한 감소양상을 나타내었다. 4. 교정장치 제거 후 동요도 감소양상은 상악 제2소구치에서 가장 일관성있게 나타났다. 5. 연구기간 중 전치부 교합접촉 과다 정도에 따른 좌우 치아간 동요도는 통계학적 유의차를 보이지 않았다. 이상의 연구 결과는 치아이동 후 치주조직 재형성이 장치제거 6개월 후에도 완성되지 않음을 시사하였다. The purpose of the present study was to evaluate the change of tooth mobility following orthodontic tooth movement. Six orthodontic patients which had been treated with edgewise appliance were used. Tooth mobility was measured with Periostest at the time of the removal of orthodontic appliance and 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24 weeks after appliance removal. Following results were obtained : 1. Tooth mobility upon the removal of orthodontic appliance showed individual variation while incisor showed greater mobility than the other teeth. 2. Tooth mobility showed continued decrease pattern until 24 weeks after appliance removal. 3. While maxillary incisors showed continued decrease pattern during the study period, the other teeth showed steep decline pattern during the first 12 weeks and gentle slope during the second 12 weeks. 4. The tooth mobility of the maxillary second premolar showed the most typical change in terms of the consistency of the decline. 5. There were no significant differences of tooth mobility between heavy- and light-contacted anterior teeth during experimental period. The results of the present study suggested that periodontal reorganization is not completed even in 24 weeks following orthodontic tooth movement.

$Periotest^{(R)}$를 이용한 임프란트지지 보철물의 적합도 평가에 관한 연구

김영민,배정식,Kim, Young-Min,Bae, Jeong-Sik 대한치과보철학회 1998 대한치과보철학회지 Vol.36 No.4

In this study, the Periotest value was measured with Periotest to evaluate precision fit of the 2-unit and 3-unit implant-supported prosthesis by modifying the size and location of ill-fitted conditions. The 2-unit prosthesis was fabricated with the right implant fitted incorrectly and the 3-unit prosthesis with the right and center implant fitted incorrectly. To evaluate the effects of the ill-fitted sizes, 4 groups were divided.:The control group being the accurately fabricated sample group fitted properly. Group 1 was constructed with $40{\mu}m$ ill-fitted conditions, group 2 with $70{\mu}m$ and group 3 with $100{\mu}m$ ill-fitted conditions. The Periotest value was measured at each implant site after tightening 10Ncm. The result was follows : 1. The PTV on the ill-fitted area in the 2-unit implant-supported prosthesis increased as the ill-fitted conditions increased. There was a statistically significant difference among groups(p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated a statistically significant difference (p<0.05) 2. The PTV on the ill-fitted area of the 3-unit implant-supported with an ill-fitted condition in the right implant increased as the ill-fitted conditions increased. There was a significant difference among groups (p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated a statistically significant difference (p<0.05). 3. In the 3-unit implant-supported prosthesis with ill fitting conditions in the center implant, the PTV on the ill-fitted area demonstrated a statistically significant difference between the control group, group 1 and group 2 (p<0.05). In the same ill-fitted sample, the PTV depending on the measured location demonstrated significant difference between the gap side and the adjacent side with over $70{\mu}m$ ill-fitted conditions (p<0.05). The results suggest that Periotest is a valuable objective method for evaluating the precision fit of an implant superstructure.

$Periotest^(R)$ Value와 Implant Stability Quotient에 영향을 미치는 요소

이영아,차인호,이호용,한동후,Yi Young-Ah,Cha In-Ho,Lee Ho-Yong,Han Dong-Hoo 대한치과보철학회 2006 대한치과보철학회지 Vol.44 No.1

Statement of problem: $Periotest^(R)\;and\;Osstell^{TM}$ were known as the most objective and quantitative mobility tests available for evaluating stability of implant in vivo. Although a correlation between PTV widely used and ISQ recently introduced exist, a PTV was corresponded to various ISQ. A correct evaluation of implant stability could be obtained only after one has a thorough understanding of the limitations of devices and factors that affect measurements. Purpose: The purpose of this study was to investigate the causes of variables in the values obtained with these two tests. Material and method: A total of 333 implants 134 $Br{\aa}nemark$, 5 Silhouette and 194 ITI implants were investigated. Result: 1. There was a correlation between PTV and ISQ (Spearman correlation =0.39, p<0.0001) 2. The factors that affected ISQ were diameter of implant future, location of implant and implant system (submerged type vs non-submerged type). 3. The factors that affected W were dimeter of implant future, location of implant, and elapsed time after implant placement. 4. There was no significant difference between different surface treatments of RBM, smooth surface and ti-unite on PTY and ISQ. 5. In radiographic finding, no saucerization or bone resorption has been detected in implants with ISQ values that were above the average level of each PTV. These higher values had higher bone densities around the implant fixture. Saucerization was observed in the most impants with ISQ values that were below the average level of each PTV. Conclusion: There was a correlation between ISQ and PTV. However, each measuring methods had factors influencing the measured values. PTV were less sensitive to marginal bone resorption and influenced with the striking point on an implant to the level of bone. With ISQ, the height of implant from bone level to transducer should be considered.

$PerioTest^{(R)}$를 이용한 임플란트 동요도에 관한 임상적 연구

김선재,한동후,Kim, Sun-Jai,Han, Dong-Hoo 대한치과보철학회 1998 대한치과보철학회지 Vol.36 No.5

Assessment of implant mobility is an important and reliable method to clinically evaluate implant stability. PerioTest is a precise and reproducible device that cam dynamically measure the reaction of damping characteristics of peri-implant tissue. The aim of this study is to evaluate the effects of amount of implant surface area, diameter, type, implantation site, degrees of cortical engagement, and length of time in function on PTVs and to find out the most determining factor on PTVs. The results are as follows 1. 5.0mm diameter implants show significantly lower PTV than that of 3.75mm diameter implants. 2. PTV in the mandible is significantly lower than that of the maxilla 3. In the maxilla, there is no significant difference in PTV during the first year of implant function, but during the second year a significant decrease in PTV is noted. 4. In the mandible, there is a significant decrease in PTV during the first and second year of implant function. 5. Implantation site seems to be the most determining factor on PTV among the influencing factors in this study. In conclusion, the amount of implant surface area, type, degrees of cortical engagement had no significant effect on PTV, but installation site and diameter influenced significantly on PTV