유한 요소 분석을 이용해, 임플란트의 즉시 부하 상황을 재현해서 임플란트 주위 골의 응력 분포에 대한 임플란트 디자인의 영향을 연구한 결과는 다음과 같다.
1. 지연 부하와 비교해서 즉시 부하에서는 응력이 피질골 뿐만 아니라, 임플란트-골 계면을 따라 임플란트 근단까지 해면임플란트-골에도 광범위하게 분포하며, 최대 등가 응력도 더 높게 나타났다.
2. 지연 부하에서는, tapered 형 직경 4.3 mm 의 임플란트 모델이 10 mm 에서 11.5 mm 로 길이가 증가 시 최대 응력이 다소 증가하는 양상을 보인 것을 제외하고는, 임플란트의 길이가 길어질수록 최대 응력이 감소했다. 또한 임플란트 직경이 커지면 최대 응력이 감소했으며, tapered 형 임플란트가 straight 형 임플란트보다 최대 응력이 더 높았다.
3. 즉시 부하에서, tapered 형의 임플란트는 길이가 8.5 mm 에서 10 mm 로 증가 시에는 최대 응력이 감소하나, 10 mm 에서 11.5 mm 로 증가 시에는 최대 응력이 증가했으며, 직경이 증가할수록 최대 응력이 감소했다. 바디 형태에서는 4.3 X 8.5 mm 의 임플란트 모델을 제외하고, tapered 형 임플란트가 straight 형 임플란트보다 최대 응력이 더 낮게 나타났다. 즉시 부하 시 임플란트-골 계면의 최대 변위 거리는 허용되는 미세동요도인 50 μm 이하의 값을 나타냄으로써, 골형성을 방해하지 않는 것으로 보인다.
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4. 지연 부하에서는 길이, 직경, 바디 형태들의 변화에 따른 최대 응력에 대한 영향이 비교적 규칙적인 양상을 보였으나, 즉시 부하에서는 이들의 영향이 다양하게 나타나는 모습을 보여주었다. 즉 지연 부하에서의 변수들의 영향과 일치하지 않을 수 있다는 것을 보여주었다.
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Abstract
The effect of implant designs on stress distribution of the bone around immediate loading implants
: A 3-dimensional finite element analysis Jung Yoon Bae
Department of Dentistry
The Graduate School, Yonsei University (Directed by Professor Chong Hyun Han)
Until recently, the healing period from dental implant placement to the prosthesis delivery has become shorter and even immediate loading procedure become popular. Implant primary stability is the most important clinical factor influencing success of immediate loading. The surface area of implant support may be increased by modifications in implant designs, so the stress in the bone be decreased. But, the effect of implant designs in immediately loaded implants has recently been investigated and will affect different compared to in delayed loaded implants. The purpose of this study was to investigate the effect of implant designs on stress distribution of the bone around immediate loading implants by a 3-dimensional finite element analysis and to help to select proper implant for immediate loading treatment.
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A 3-dimensional model of a single implant supported crown substituting a lower first premolar was simulated. The von-Mises stresses of the bone around different implant length (8, 10, 11.5 mm), diameter (4.3, 5.3 mm) and body design (tapered, straight) with delayed loaded and immediately loaded condition were analyzed.
The results were as followings;
1. Compared to the delayed loaded implants, in immediately loaded implants, the stresses were widely distributed in trabecular bone to the implant apex along implant-bone interfaces as well as in cortical bone surrounding the implant neck and the maximum von-Mises stresses were higher.
2. For the delayed loaded implants, except that increasing implant length from 10 mm to 11.5 mm resulted in the maximum stress increasing, in diameter 4.3 mm tapered implants, increasing implant length resulted in the maximum stress reduction. And increasing implant diameter decreased the maximum stress, tapered implants showed higher maximum stresses than straight implants.
3. For the immediately loaded implants, increasing implant length from 8.5 mm to 10 mm resulted in the maximum stress reduction, but increasing implant length from 10 mm to 11.5 mm resulted in the maximum stress increasing and increasing implant diameter resulted in the maximum stress reduction in tapered implants. Except for 4.3 X 8.5 mm implant, tapered implants showed
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lower maximum stresses than straight implants. The maximum sliding distance of model of contact implant-bone interfaces was less than accepted micromotion value (50 μm), so did not disturb osseointegration.
4. For the delayed loaded implants, the effects of the implant length, diameter, and body design on maximum stresses showed relatively regular appearance, but the effect of implant designs in immediately loaded implants showed various appearances, in other words, did not accord in delayed loaded implant
--- Key word : immediate loading, finite element analysis, dental implant, length,
diameter, design, stress