미니플레이트의 골내 고정원 적용 시 초기 안정성에 영향을 주는 요인에 대한 3차원 유한요소법적 연구 = Factors influencing primary stability of miniplate anchorage : a three-dimensional finite element analysis

국문 초록 (Abstract)

본 연구는 골내 고정원으로 사용하는 미니플레이트 시스템의 초기 안정성에 영향을 주는 요인에 대해 알아보기 위해 시행하였다. 미니플레이트의 고정에 사용되는 미니스크류의 길이, 수 및 적용되는 교정력의 방향에 따른 골내응력 분포 양상과 미니스크류의 변위 정도를 분석하기 위하여 3차원 유한요소분석을 시행하였다. 단순화한 골 모델에 6 hole의 곡선형 미니플레이트를 위치하고 직경 2 mm의 미니스크류로 고정하되 각각 6 mm와 4 mm 길이의 두 가지 종류로 세 개 또는 두 개로 고정한 총 네 개의 유한요소모델을 제작한 후 각각의 모델에서 4 N의 교정력을 미니플레이트의 고정되지 않은(unfixed) 가장 원심측 두 개의 hole을 연결한 가상의 축에 대해 0˚, 30˚, 60˚, 90˚ 방향으로 각각 적용하였다. 미니플레이트를 고정하는 미니스크류가 동일 길이일 경우 개수가 작을수록, 동일 개수일 경우 길이가 짧을수록 골에 나타나는 최대 응력과 미니스크류의 최대 변위가 증가되었다. 골에 나타나는 최대 응력은 해면골에 비해 피질골에 집중되어 응력의 대부분은 피질골에서 흡수되었다. 미니플레이트의 가상의 축에 대해 교정력의 견인방향이 증가할수록 골내의 최대 응력과 미니스크류의 최대 변위가 증가되었다. 골내의 최대 응력과 미니스크류의 최대 변위는 적용된 견인력 지점에서 가장 가까운 미니스크류 고정 부위였다. 이상의 결과로 미니플레이트 시스템의 초기 안정성을 위해 2 mm 직경의 미니스크류를 사용 시 4 mm보다는 6 mm 길이의 미니스크류를, 2개보다는 3개식립하는 것이 더 유리하며, 미니플레이트의 가상의 축에 대해 적용하는 교정력의 견인방향이 가급적 일치되도록 미니플레이트를 위치시키는 것이 좋을 것으로 생각된다.

다국어 초록 (Multilingual Abstract)

Objective: The purpose of this study was to evaluate the stress distribution in bone and displacement distribution of the miniscrew according to the length and number of the miniscrews used for the fixation of miniplate, and the direction of orthodontic force. Methods: Four types of finite element models were designed to show various lengths (6 mm, 4 mm) and number (3, 2) of 2 mm diameter miniscrew used for the fixation of six holes for a curvilinear miniplate. A traction force of 4 N was applied at 0˚, 30˚, 60˚, and 90˚ to an imaginary axis connecting the two most distal unfixed holes of the miniplate. Results: The smaller the number of the miniscrew and the shorter the length of the miniscrew, the more the maximum von Mises stress in the bone and maximum displacement of the miniscrew increased. Most von Mises stress in the bone was absorbed in the cortical portion rather than in the cancellous portion. The more the angle of the applied force to the imaginary axis increased, the more the maximum von Mises stress in the bone and maximum displacement of the miniscrew increased. The maximum von Mises stress in the bone and maximum displacement of the miniscrew were measured around the most distal screw-fixed area. Conclusions: The results suggest that the miniplate system should be positioned in the rigid cortical bone with 3 miniscrews of 2 mm diameter and 6 mm length, and its imaginary axis placed as parallel as possible to the direction of orthodontic force to obtain good primary stability.

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