변연골 흡수가 내측연결 임플란트 매식체의 응력분포에 미치는 영향

윤미정,윤민철,엄태관,허중보,정창모 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.2

Purpose: The change of the marginal bone around dental implants have significance not only for the functional maintenance but also for the esthetic success of the implant. The purpose of this study was to investigate the load transfer of internal conical joint type implant according to marginal bone resorption by using the three-dimensional finite element analysis model. Materials and methods: The internal conical joint type system was selected as an experimental model. Finite element models of bone/implant/prosthesis complex were constructed. A load of 300 N was applied vertically beside 3 mm of implant axis. Results: The pattern of stress distribution according to marginal bone resorption was similar. The maximum equivalent stress of implant was increase according to marginal bone resorption and the largest maximum equivalent stress was shown at model of 1 mm marginal bone resorption. Although marginal bone loss more than 1mm was occurred increasing of stress, the width of the stress increase was decreasing. Conclusion: According to these results, the exposure of thin neck portion of internal conical joint type implant is most important factor in stress increasing. 연구 목적: 지금까지 성공적인 임플란트 치료를 위해 많은 연구가 진행되어 왔으며, 임플란트 주변 골 흡수 현상에 대한 연구는 매우 관심이 높은 분야 중 하나이다. 이에 본 연구에서는 삼차원 유한요소응력분석을 이용하여 변연골 흡수가 내측연결 임플란트 매식체의 기계적 안정성에 미치는 영향을 간접적으로 확인하고자 하였다. 연구 재료 및 방법: 악골에 식립된 내측연결 형태의 임플란트 매식체에 티타늄 소재의 임플란트 지대주를 지대주 나사로 연결하고 상부에 금합금관을 장착하는 삼차원 유한요소모형을 설계하였다. 0, 1, 2, 3 mm의 변연골 흡수 상태를 적용하고, 교합면 중심에서부터 3 mm 편측에 300 N의 수직 하중을 가하여 임플란트 매식체에 발생하는 최대 주응력을 계산하였다. 결과: 유한요소분석결과 변연골 흡수에 따른 임플란트 매식체의 최대 주응력 분포는 유사한 양상을 보였으며, 임플란트 매식체 상단에서 가장 높은 응력 집중이 나타났다. 최대 주응력은 처음 1 mm 변연골 흡수를 가정하였을 때 가장 크게 증가하였고, 이후 변연골 흡수가 증가할수록 응력은 증가하였지만 응력 증가의 폭은 감소하는 경향을 보였다. 결론: 이러한 결과로부터 내측연결 임플란트에서 매식체 두께가 얇은 경부의 노출은 변연골 흡수로 인한 응력 증가에 가장 큰 원인임을 알 수 있었으며, 매식체의 변형, 균열 및 파절 등의 기계적 실패를 감소시키기 위해서는 이에 대한 외과적, 보철적 고려가 필요할 것으로 생각된다.

임플란트 hexagon 높이에 따른 임플란트와 주위 조직의 응력분포 평가

박성재,김주현,김소연,윤미정,고석민,허중보 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

PURPOSE. To analyze the stress distribution of the implant and its supporting structures through 3D finite elements analysis for implants with different hexagon heights and to make the assessment of the mechanical stability and the effect of the elements. MATERIALS AND METHODS. Infinite elements modeling with CAD data was designed. The modeling was done as follows; an external connection type ∅4.0 mm×11.5 mm OsstemUSII (Osstem Co., Pusan, Korea) implant system was used, the implant was planted in the mandibular first molar region with appropriate prosthetic restoration, the hexagon (implant fixture’s external connection) height of 0.0, 0.7, 1.2, and 1.5 mm were applied. ABAQUS 6.4 (ABAQUS, Inc., Providence, USA) was used to calculate the stress value. The force distribution via color distribution on each experimental group’s implant fixture and titanium screw was studied based on the equivalent stress (von Mises stress). The maximum stress level of each element (crown, implant screw, implant fixture, cortical bone and cancellous bone) was compared. RESULTS. The hexagonal height of the implant with external connection had an influence on the stress distribution of the fixture, screw and upper prosthesis and the surrounding supporting bone. As the hexagon height increased, the stress was well distributed and there was a decrease in the maximum stress value. If the height of the hexagon reached over 1.2 mm, there was no significant influence on the stress distribution. CONCLUSION. For implants with external connections, a hexagon is vital for stress distribution. As the height of the hexagon increased, the more effective stress distribution was observed. 연구 목적: 본 연구는 hexagon 높이에 따른 임플란트 각 부위와 주위 지지조직의 응력분포를 3차원 유한요소 해석을 통해 평가하여 hexagon 높이가 기계적 안정성에 미치는 영향을 평가하고자 시행되었다. 연구 재료 및 방법: 외측 연결 형태의∅L4.0 mm×11.5 mm USII (Osstem Co., Pusan, Korea) 임플란트 시스템을 이용하여 하악 제 1대구치 부위에 임플란트를 식립하여 보철 수복한 경우를 연구 모델로 가정하고 임플란트 고정체의 외측 연결부인 hexagon의 높이를 각각 0.0 mm, 0.7 mm, 1.2 mm, 1.5 mm로 적용한 CAD data를 유한요소 모형화하였다. ABAQUS 6.4 (ABAQUS Inc., Providence, RI, USA)를 이용하여 산출된 응력 값 중에서 등가응력을 기준으로 각 요소(상부 치관, 지대주 나사, 고정체, 치밀골, 해면골)에서 나타나는 최대 응력 값을 비교 하였다. 결과:외측 연결을 갖는 임플란트의 hexagon의 높이는 고정체, 지대주 나사, 상부 보철물 그리고 주위 지지골에 대해 응력 분산에 영향을 주었다. Hexagon의 높이가 증가할 수록 임플란트의 응력 분산은 더 잘 이루어졌으며, 최대 응력 값의 감소를 보였다. Hexagon의 높이가 1.2 mm 이상이 되면 응력 분포에 더 이상 크게 기여하지 않았다. 결론: 외측연결을 갖는 임플란트에서 hexagon은 응력 분산에 필수적인 요소이며 그 높이가 증가할수록 더욱 효과적인 응력의 분산이 나타났다.

임플란트의 collar design이 변연골과 연조직에 미치는 영향

유현상,강선녀,정창모,윤미정,허중보,전영찬 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

연구 목적: 임플란트 경부가 잘 설계된 경우 양호한 연조직 반응을 통해 변연골을 보존하는데 도움이 된다. 본 실험에서는 연, 경조직 경계부에 가장 가까이 위치하는 임플란트의 collar design이 변연골 변화와 연조직 반응에 미치는 영향을 동물실험을 통해 알아보고자 하였다. 연구 재료 및 방법: 2마리의 건강한 Beagle dog에 임플란트 collar design만 다른 두 종류의 임플란트(Neobiotech Co. Seoul, Korea)를 식립하였다. Collar에 bevel 을 부여한 군(Bevel 군)과 "S"자 형태를 부여한 군(Bioseal 군)으로 나누어 마리 당 7개, 군당 7개, 총 14개의 임플란트를 무작위로 식립한 후 Healing abutment를 즉시 체결하였다. 디지털 표준구내 방사선사진을 이용해 4주 간격으로 총 12주간 근원심 변연골 변화를 관찰하였고, 12주에 희생하여 조직학적 분석을 통해 협설 변연골 흡수 및 임플란트 주변 연조직 반응을 평가하였다. Mann-Whitney test를 통해 동일한 방사선 사진 촬영 시점에서 근원심 변연골 변화량 및 조직계측치를 군 간 비교하였고, Kruskal-Wallis test를 통해 방사선 사진상 근원심 변연골 변화량이 시간에 따른 차이가 있는지 군 내 분석 한 후 Duncan test를 통해 사후 검증하였다(α=.05). 결과: 방사선학적 분석 결과 각 촬영 시점에서 두 군간 근원심 변연골 변화량의 차이를 보이지 않았다(P>.05). 군 내에서 시간에 따른 근원심 변연골의 흡수량을 분석한 결과 Bevel 군에서는 시간에 따른 차이를 보이지 않았으나 (P>.05), Bioseal 군에서는 시간에 따른 차이를 보였으며, 4주및8주와 비교했을 때 12주에서 변연골의 증가를 보였다(P<.05). 조직학적 분석 결과 협설측 변연골 흡수량에서 두 군간 차이를 보이지 않았으나 (P>.05), Bevel 군에 비해 Bioseal 군에서 더 견고한 결합조직부착을 관찰할 수 있었으며, 생물학적 폭경의 값은 두 집단 간 차이를 보이지 않은 반면에 (P>.05), 접합상피부착은 Bevel 군에서 유의하게 길었고, 결합조직부착은 Bioseal 군에서 더 길게 나타났다(P<.05). 결론: Bevel 군에 비해 Bioseal 군에서 결합조직부착은 길게 형성된 반면에 접합상피부착은 더 짧게 나타났으며, 생물학적 폭경과 초기 변연골 흡수에는 차이가 없음을 알 수 있었다. 연조직 반응의 차이가 실제 기능하중 하에서 변연골 변화에 미치는 영향에 대해서 향후 연구가 필요할 것으로 생각된다. PURPOSE. The purpose of this study was to investigate the effects of implant collar design on marginal bone change and soft tissue response by an animal test. MATERIALS AND METHODS. Two types of Implant (Neobiotech Co. Seoul, Korea) that only differs in collar design were planted on two healthy Beagle dogs. The implants were divided into two groups, the first group with a beveled collar (Bevel Group) and the second group with "S" shaped collar (Bioseal group). Standardized intraoral radiographs were used to investigate the mesio-distal change of the marginal bone. Histological analysis was done to evaluate the bucco-lingual marginal bone resorption and the soft tissue response adjacent to the implant. Mann-Whitney test was done to compare the mesio-distal marginal bone change at equivalent time for taking the radiographs and the tissue measurements between the groups. RESULTS. Radiographic and histological analysis showed that there was no difference in marginal bone change between the two groups (P>.05). Histological analysis showed Bioseal group had more rigid connective tissue attachment than the Bevel group. There was no difference in biological width (P>.05). Bevel group showed significantly longer junctional epithelium attachment and Bioseal group showed longer connective tissue attachment (P<.05). CONCLUSION. For three months there were no differences in marginal bone change between the Bevel group and the Bioseal group. As for the soft tissue adjacent to the implant, Bioseal group showed longer connective tissue attachment while showing shorter junctional epithelium attachment. There were no differences in biologic width.

금 합금 보철물의 교합면 삭제로 인한 임플란트-골 계면으로의 열전달에 관한 연구

조재영,강선녀,정창모,윤미정,허중보,전영찬 대한치과보철학회 2012 대한치과보철학회지 Vol.50 No.1

연구 목적: 임플란트-골 계면에서 발생하는 과도한 열은 골유착을 저해하여 임플란트의 실패를 유발한다. 이에 이번 연구에서는 임플란트 금 합금 보철물의 교합면 삭제시 임플란트-골 계면으로의 열전달 양상과 냉각 방식의 효율성을 알아 보고자 하였다. 연구 재료 및 방법: 온도 감지 장치 제작을 위하여 Internal cone 연결형태의 임플란트에 16개의K형 열전대를 부착하여 아크릴릭 레진에 포매하였다. 치과용 금 합금과 주조용 abutment를 사용하여 교합면에 3개의 요철을 가지는 시편을 10개 제작하였고, 연결 나사를 이용하여 임플란트와 연결한 뒤 온도 감지 장치를 37℃로 유지되는 수조에 위치시켰다. 저속 핸드피스와 green stone bur를 이용하여 30초 동안 보철물의 요철을 삭제하였는데, 무냉각군, 공기 냉각 군, 물 분사 냉각 군으로 나누어 요철을 삭제하였다. 보철물이 삭제 되는 동안 임플란트의 부위별로 온도가 0.05초 간격으로 기록되었고, 삭제를 멈춘 뒤에도 무 냉각 군의 경우 임계 온도인 47℃ 이하로 온도가 하강할 때까지, 공기 냉각군과 물 분사 냉각군의 경우 삭제 중단 후 30초 동안 추가로 온도를 기록하였다. 냉각 방식에 따른 임플란트-골 계면의 온도를 알아보고, 임플란트의 부위별 온도변화의 유의차를 알아보기 위하여 one-way ANOVA를 실시하였고, Turkey HSD 이용하여 95% 유의수준에서 사후 검증하였다. 결과: 무 냉각 군은 임플란트-골 계면의 온도가 47℃ 이상으로 상승하였으며, 임플란트의 경부에서 유의하게 높은 열이 측정되었다(P>.05). 공기냉각군과 물분사 냉각군은 임플란트-골 계면의 온도가 47℃ 이하로 유지되었다. 무 냉각 군에서 임플란트 경부의 온도가 47℃에 도달되는 데는 약 10.8 ± 1.5초가 소요되었다. 공기 냉각 군과 물 분사 냉각 군 사이에서는 임플란트-골 계면 온도의 유의차가 없었다(P>.05) 결론: 이상의 결과로부터 임플란트 금 합금 보철물의 교합면 삭제 시, 임플란트 주위 조직에 위해를 가할 수 있는 임계 온도 이상의 열이 발생했음을 알 수 있었으며, 냉각방식은 공기 냉각과 물 분사 냉각 모두 효과적이라고 생각된다. PURPOSE. The purpose of this study was to analyze temperature change along the implant-bone interface induced by grinding the occlusal surface of implant gold prosthesis and to compare the temperature generated by grinding of prosthesis with different cooling methods. MATERIALS AND METHODS. The experimental gold prostheses were fabricated with dental gold alloy and castable abutment. The prostheses had 3 cylindrical protrusions on the occlusal surface with 1mm in height. Temperature was measured using 16 thermocouple wires attached to the implant fixture surface and the fixture was embedded in an acrylic resin block inside the 37℃ water bath. Cylinders were grinded for a period of 30 second with a low-speed handpiece with green stone point. One cylindrical protrusion was grinded without cooling, the second one was grinded with air blow, and the third one was grinded with water-spray. RESULTS. The mean maximum temperature was measured more than 47℃ of the implant and the maximum temperature was measured at the cervical portion of the implant in the group without cooling. There was statistically significant difference between the group without cooling and the groups with cooling (P<.05). However, there was no significant difference at all portion of implant in the groups with cooling (P>.05). CONCLUSION. The results of this study support that the grinding of implant gold prosthesis without cooling may damage the peri-implant tissue. The continuous use of air blow and water-spray adjacent to prosthesis during the grinding of implant gold prosthesis may prove to be beneficial for cooling of the implant.

Effect of denture cleansers on Candida albicans biofilm formation over resilient liners

Huh, Jung-Bo,Lim, Younghun,Youn, Hye-In,Chang, Brian Myung,Lee, Jeong-Yol,Shin, Sang-Wan The Korean Academy of Prosthodonitics 2014 The Journal of Advanced Prosthodontics Vol.6 No.2

PURPOSE. The purpose of this study was to analyze the effect of denture cleansers on Candida albicans biofilm formation over resilient liners and to evaluate compatibility between resilient liners and denture cleansers. MATERIALS AND METHODS. Acrylic resin (Lucitone 199$^{(R)}$) and 3 resilient liners (COE-SOFT$^{TM}$, GC RELINE$^{TM}$ and SOFRELINER TOUGH TOUGH$^{(R)}$) were incubated in denture cleansers (Polident$^{(R)}$ and Cleadent$^{(R)}$) for 8 hours a day and in unstimulated saliva for 16 hours a day (n=25/gp) for 60 days. Two-way and three-way repeated measures ANOVA were performed to compare the surface roughness (Ra), pH and C. albicans binding level by radioisotope (${\alpha}$=0.05). The statistical significance of the relation between Ra and adhesion was evaluated by correlation analysis. RESULTS. The degree of Ra was significantly decreased in the following order: COE-SOFT$^{TM}$, acrylic resin, GC RELINE$^{TM}$ and SOFRELINER TOUGH$^{(R)}$. The immersion in denture cleansers significantly increased Ra of resilient liners, except for SOFRELINER TOUGH$^{(R)}$ in Cleadent$^{(R)}$. No significant differences in pH curves were observed among groups immersed in distilled water and denture cleansers. The binding levels of C. albicans were significantly decreased in the following order: COE-SOFT$^{TM}$, GC RELINE$^{TM}$, SOFRELINER TOUGH$^{(R)}$, and acrylic resin. The immersion in Cleadent$^{(R)}$ seemed to decrease C. albicans binding level on GC RELINE$^{TM}$ and SOFRELINER TOUGH$^{(R)}$. CONCLUSION. Based on the C. albicans binding levels results, it is not recommended to immerse COE-SOFT$^{TM}$ in denture cleansers, and GC RELINE$^{TM}$ and SOFRELINER TOUGH$^{(R)}$ should be immersed in Cleadent$^{(R)}$.

Physical stability of arginine-glycine-aspartic acid peptide coated on anodized implants after installation

Huh, Jung-Bo,Lee, Jeong-Yeol,Jeon, Young-Chan,Shin, Sang-Wan,Ahn, Jin-Soo,Ryu, Jae-Jun The Korean Academy of Prosthodonitics 2013 The Journal of Advanced Prosthodontics Vol.5 No.2

PURPOSE. The aim of this study was to evaluate the stability of arginine-glycine-aspartic acid (RGD) peptide coatings on implants by measuring the amount of peptide remaining after installation. MATERIALS AND METHODS. Fluorescent isothiocyanate (FITC)-fixed RGD peptide was coated onto anodized titanium implants (width 4 mm, length 10 mm) using a physical adsorption method (P) or a chemical grafting method (C). Solid Rigid Polyurethane Foam (SRPF) was classified as either hard bone (H) or soft bone (S) according to its density. Two pieces of artificial bone were fixed in a customized jig, and coated implants were installed at the center of the boundary between two pieces of artificial bone. The test groups were classified as: P-H, P-S, C-H, or C-S. After each installation, implants were removed from the SRPF, and the residual amounts and rates of RGD peptide in implants were measured by fluorescence spectrometry. The Kruskal-Wallis test was used for the statistical analysis (${\alpha}$=0.05). RESULTS. Peptide-coating was identified by fluorescence microscopy and XPS. Total coating amount was higher for physical adsorption than chemical grafting. The residual rate of peptide was significantly larger in the P-S group than in the other three groups (P<.05). CONCLUSION. The result of this study suggests that coating doses depend on coating method. Residual amounts of RGD peptide were greater for the physical adsorption method than the chemical grafting method.

Effects of the immobilization of heparin and rhPDGFBB to titanium surfaces for the enhancement of osteoblastic functions and anti-inflammation

Jung-Bo Huh,Jeong-Yol Lee,Kyung-Lae Lee,Sung-Eun Kim,Mi-Jung Yun,Ji-Suk Shim,June-Sung Shim,Sang-Wan Shin 대한치과보철학회 2011 The Journal of Advanced Prosthodontics Vol.3 No.3

PURPOSE This study was to investigate the effects of recombinant human platelet-derived growth factor (rhPDGF-BB) and heparin to titanium surfaces for enhancement of osteoblastic functions and inhibition of inflammation activity. MATERIALS AND METHODS The anodized titanium discs, not coated with any material, were used as a control group. In heparinized- Ti group, dopamine was anchored to the surface of Ti substrates, and coated with heparin. In PDGF-Ti group, rhPDGF-BB was immobilized onto heparinized Ti surface. The surface morphologies were investigated by the scanning electron microscope in each group. The release kinetics of rhPDGF-BB were analyzed, and cytotoxicity tests for each group were conducted. The biocompatibilities were characterized by measuring cell proliferation, alkaline phosphatase activity, and calcium deposition using MG-63 cells. Statistical comparisons were carried out by one-way ANOVA tests. Differences were considered statistically significant at *P<.05 and **P<.001. RESULTS The combination of rhPDGF-BB and heparin stimulated alkaline phosphatase activity and OCN mRNA expression in osteoblastic cells (*P<.05 and **P<.001). MG-63 cells grown on PDGF-Ti had significantly higher amounts of calcium deposition than those grown on anodized Ti (**P<.001). Heparinized Ti was more anti-inflammatory compared to anodized Ti, when exposed to lipopolysaccharide using the transcript levels of TNF-α and IL-6 of proinflammatory cytokine (*P<.05 and **P<.001). CONCLUSION The result of this study demonstrated that the incorporation of rhPDGF-BB and heparin onto Ti surface enhanced osteoblastic functions and inhibited inflammation.

Effect of two-phase fabrication method for the optimum fit of light-polymerized record bases

Jung-Bo Huh,Min-Goo Kang,Sang-Wan Shin,Jae-Jun Ryu 대한치과보철학회 2010 The Journal of Advanced Prosthodontics Vol.2 No.3

PURPOSE. The aims of this study were to suggest a method of fabrication of the record base using a light-polymerized resin by applying the two-phase fabrication method for the improvement of the fit of the record base and to compare the degree of fit according to the separation site. MATERIALS AND METHODS. In the edentulous cast of maxilla, four test groups were considered. In the first, second, third, and fourth test groups (n = 12 in each group) the separation was done at 0, 5, 10, and 15 mm, respectively below the alveolar crest along the palatal plane. For the control group, the record base was made without separating the two sections. The light-body silicone material was injected into the fitting surface of the record base. It was then placed onto the cast and finger pressure was applied to stabilize it in a seated position followed by immediate placement onto the universal test device. Finally, the mass of the impression material was measured after it was removed. ANOVA was performed using the SAS program. For the post-hoc test, the Wilcoxon Rank-Sum test and the Tukey-Kramer HSD test were performed (α= 0.05). RESULTS. The control group and Group 3, 4 showed significant differences. The Group 3 and 4 showed significantly smaller inside gaps than the control group which was not made with the two-phase fabrication method. CONCLUSION. The two-stage polymerized technique can improve the fit of the denture base particularly when the separation was made at 10 to 15 mm from the alveolar crest.

How far has 3D printing technology come in dentistry

Jung-Bo Huh 대한치과재료학회 2017 대한치과기재학회 학술대회 Vol.2017 No.4

Effect of denture cleansers on Candida albicans biofilm formation over resilient liners

Jung-Bo Huh,Younghun Lim,Hye-In Youn,Brian Myung Chang,Jeong-Yol Lee,Sang-Wan Shin 대한치과보철학회 2014 The Journal of Advanced Prosthodontics Vol.6 No.2

PURPOSE. The purpose of this study was to analyze the effect of denture cleansers on Candida albicans biofilm formation over resilient liners and to evaluate compatibility between resilient liners and denture cleansers. MATERIALS AND METHODS. Acrylic resin (Lucitone 199®) and 3 resilient liners (COE-SOFT™ GC RELINE™ and SOFRELINER TOUGH TOUGH®) were incubated in denture cleansers (Polident® and Cleadent®) for 8 hours a day and in unstimulated saliva for 16 hours a day (n=25/gp) for 60 days. Two-way and three-way repeatedmeasures ANOVA were performed to compare the surface roughness (Ra), pH and C. albicans binding level by radioisotope (α=0.05). The statistical significance of the relation between Ra and adhesion was evaluated by correlation analysis. RESULTS. The degree of Ra was significantly decreased in the following order: COE-SOFT™ acrylic resin, GC RELINE™and SOFRELINER TOUGH®. The immersion in denture cleansers significantly increased Ra of resilient liners, except for SOFRELINER TOUGH® in Cleadent®. No significant differences in pHcurves were observed among groups immersed in distilled water and denture cleansers. The binding levels of C. albicans were significantly decreased in the following order: COE-SOFT™ GC RELINE™ SOFRELINER TOUGH®, and acrylic resin. The immersion in Cleadent® seemed to decrease C. albicans binding level on GC RELINE™and SOFRELINER TOUGH®. CONCLUSION. Based on the C. albicans binding levels results, it is not recommended to immerse COE-SOFT™in denture cleansers, and GC RELINE™and SOFRELINER TOUGH® should be immersed in Cleadent®.