[논문]임플란트 식립시 발생한 열에 의한 골괴사: 증례보고

조규홍; 윤규호; 박관수; 배정호; 유경하; 한지훈; 신재명; 백지선; 전인성; 정정권

doi:10.5125/jkaoms.2011.37.5.406

임플란트 식립시 발생한 열에 의한 골괴사: 증례보고
Thermally induced bone necrosis during implant surgery: 3 case reports 원문보기

大韓口腔顎顔面外科學會誌 = Journal of the Korean Association of Oral and Maxillofacial Surgeons, v.37 no.5, 2011년, pp.406 - 414

조규홍 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실) , 윤규호 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실) , 박관수 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실) , 배정호 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실) , 유경하 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실) , 한지훈 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실) , 신재명 () , 백지선 () , 전인성 , 정정권 (인제대학교 의과대학 상계백병원 구강악안면외과학 교실)

Abstract ▼ AI-Helper

Thermally induced bone necrosis during implant surgery is a rare phenomenon and a potential contributing factor to implant failure. The frictional heat generated at the time of surgery causes a certain degree of necrosis of the surrounding differentiated and undifferentiated cells. The bone necrosis occurred in the mandible in all three cases, leading to a soft tissue lesion and pain. In each case, radiolucent areas appeared in the middle and apical portions of the implant 4 weeks after surgery. Thermally induced bone necrosis did not improve following systemic antibiotic medication, necessitating surgical treatment. The nonintegrated implants were removed, and meticulous debridement of dead bone and granulation tissue was performed. Then, new implants were implanted along with the placement of autogenous and xenogenic bone covered with a collagen membrane. No further complications occurred after re-operation. The radiolucencies around the new implants gradually resolved entirely, and the soft tissue lesions healed successfully. At 4-5 months after reoperation, implant loading was initiated and the implant-supported restorations have been functioning. The aim of this case report is to present the successful clinical treatment of three cases suspected to be caused by thermally induced bone necrosis after implant drilling.

주제어

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문제 정의

Thus, although the exact cause of implant failure in our case report remains undetermined, thermally induced bone necrosis may be the most likely cause of implant failure. This article presents three cases of implant failures suspected to be caused by thermally induced bone necrosis during implant surgery.

가설 설정

1. He did not smoke more than 10 cigarettes per day.
C: Bony dehiscence was noted after 4 weeks. D: The implant was removed, and a bone defect was observed. E: The Osstem implant (GS type 3.
The implants were removed, and a large bony defect was seen. F: New implants were placed along with bone grafts.

제안 방법

Surgery was performed under local anesthesia (2% lidocaine with 1:100,000 epinephrine), raising a full thickness flap in the affected zone. Implants were removed easily by reverse torque, and curettage of the inflamed tissue and necrotic bone was performed.

대상 데이터

A 57-year-old woman with a medical history of hypertension presented with a partially edentulous lower jaw. Implants were placed in the positions #45 and 47(Fig.
A 58-year-old woman with no significant medical history presented with a partially edentulous lower jaw. Two implants were placed on the mandibular incisor area, and implant failure occurred in area #32(Fig.
B: Postoperative radiography. Implants were placed on areas #36, 37, 45, 46, and 47 in the mandible.

성능/효과

The patients’clinical characteristics are summarized in Table 1. Each of the patients experienced pain within 1 week after surgery, which did not subside despite the administration of antibiotics and analgesics. In 1 patient, persistent gingival inflammation was noted; however, no noticeable swelling or suppuration was observed in any of the patients.
Although 1 implant was mobile, no mobility was noted in the others. After 3-4 weeks, the obvious changes of radiolucency were confirmed on radiologic study, and the middle portion of the radiolucency was noted to be greater than the coronal and apical portions in each case. On raising the flap, varying degrees of bone loss were noted; in some instances(Figs.
2. A) After 4 weeks, a large radiolucent area was noted, with a larger diameter in the middle portion of the implants as compared to the coronal and apical portions. Reoperation was performed, and a new implant was placed on area #46 because of a large bone defect in area #45(Figs.

후속연구

Surgical trauma is significantly reduced with the use of wellsharpened drills under saline cooling and graduated-step drilling. More research is needed to establish the criteria for replacing drills and to clarify the effect of heat on bone marrow rather than on cortical bone.

참고문헌 (35)

Branemark PI, Adell R, Breine U, Hansson BO, Lindstrom J, Ohlsson A. Intra-osseous anchorage of dental prostheses. I. Experimental studies. Scand J Plast Reconstr Surg 1969;3:81- 100.

상세보기
Higuchi KW, Folmer T, Kultje C. Implant survival rates in partially edentulous patients: A 3-year prospective multicenter study. J Oral Maxillofac Surg 1995;53:264-268.

상세보기
Mazzocchi A, Passi L, Moretti R. Retrospective analysis of 736 implants inserted without antibiotic therapy. J Oral Maxillofac Surg 2007;65:2321-2323

상세보기
Li W, Chow J, Hui E, Lee PKH, Cjow R. Resprospective study on immediate functional loading of edentulous maxillas and mandibles with 690 implants, up to 71 months of follow-up. J Oral Maxillofac Surg 2009;67:2653-2662

상세보기
Buser D, Schenk RK, Steinemann S, Fiorellini JP, Fox CH, Stich H. Influence of surface characteristics on bone integration of titanium implants. A histomorphometric study in miniature pigs. J Biomed Mater Res 1991;25:889-902.
Pye AD, Lockhart DEA, Dawson MP, Murray CA, Smith AJ. A review of dental implants and infection. J of Hospital Infection 2009;72:104-110
Bashutski JD, D`Silva NJ, Wang HL. Implant compression necrosis: Current understanding and case report. J Periodontol 2009;80:700-704.

상세보기
Quirynen M, De Soete M, Van Steenberghe D. Infectious risks for oral implants: A review of the literature. Clin Oral Implants Res 2002;13:1-19.
Branemark PI, Zarb GA, Albrektsson T. Tissue integrated prostheses: Osseointegration in clinical dentistry. Chicago, IL: Quintessence 1985:129-143.
Eriksson R, Albrektsson T. Temperature thresholds for heat induced bone tissue injury: A vital-microscopic study in the rabbit. J Prosthet Dent 1983;50:101-107.

상세보기
Eriksson R, Albrektsson T. The effect of heat on bone regeneration: An experimental study in the rabbit using the bone growth chamber. J Oral Maxillofac Surg 1984;42:705-711.

상세보기
Sharawy M, Misch CE, Weller N, Tehemer S. Heat generation during implant drilling: The significance of motor speed. J Oral Maxillofac Surg 2002;60:1160-1169.

상세보기
Chacon GE, Bower DL, Larsen PR, McGlumphy EA, Beck FM. Heat production by 3 implant drill systems after repeated drilling and sterilization. J Oral Maxillofac Surg 2006; 64:265-269.？

상세보기
Eriksson R, Adell R. Temperatures during for the placement of implants using the osseointegration technique. J Oral Maxillofac Surg 1986;44:4-7.

상세보기
Cordioli G, Majzoub Z. Heat generation during implant site preparation: An in vitro study. Int J Oral Maxillofac Implants 1997;12:186-193.

상세보기
Ercoli C, Funkenbusch PD, Lee HJ, Moss ME, Graser GN. The influence of drill wear on cutting efficiency and heat production during osteotomy preparation for dental implants: A study of drill durability. Int J Oral Maxillofac Implants 2004;19:335-349.

상세보기
Queiroz TP, Souza FA, Okamoto R, Margonar R, Pereira-Filho VA, Garcia Junior IR et al. Evaluation of immediate bone-cell viability and of drill wear after implant osteotomies: Immunohistochemistry and scanning electron microscopy analysis. J Oral Maxillofac Surg 2008;66:1233-1240.

상세보기
Yoshida K, Uoshima K, Oda K, Maeda T. Influence of heat stress to matrix on bone formation. Clin. Oral Impl. Res. 2009;20:782-790.
Cem Sener B, Dergin G, Gursoy B, Kelesoglu E, Slih I. Effects of irrigation temperature on heat control in vitro at different drilling depths. Clin. Oral Impl. Res. 2009;20:294-298.？
Misir AF, Sumer M, Yenisey M, Ergioglu E. Effect of surgical drill guide on heat generated from implant drilling. J Oral Maxillofac Surg 2009;67:2663-2668.

상세보기
Piattelli A, Piattelli M, Mangano C, Scarano A. A histologic evaluation of eight cases of failed dental implants: Is bone overheating the most probable cause? Biomaterials 1998;19:683-690.

상세보기
Piattelli A, Scarano A, Balleri P, Favero GA. Clinical and histologic evaluation of an active" Implant Periapical Lesion": A case report. Int J Oral Maxiilofac Implants 1998;13:713-716.
Penarrocha-Diage M, Boronat-Lopez A, Garcia-Mira B. Inflammatory implant periapical lesion: Etiology, diagnosis, and treatment - presentation of 7 cases. J Oral Maxillofac Surg 2009;67:168-173.

상세보기
Sverzut AT, Vitti Stabile GA, Moraes M, Mazzonetto R, Fernandes Moreira RW. The influence of tobacco on early dental implant failure. J Oral Maxillofac Surg 2008;66:1004-1009.

상세보기
Piattelli A, Scarano A, Piattelli M. Abscess formation around the apex of a maxillary root form implant: Cinical and microscopical aspects. A case report. J Periodontol 1995;66:899-903.

상세보기
Alsaadi G, Quirynen M, Komarek A, van Steenberghe D. Impact of local and systemic factors on the incidence of oral implant failures, up to abutment connection. J Clin Periodontol. 2007;34: 610-617.

상세보기
Pommer B, Frantal S, Willer J, Posch M, Watzek G, Tepper G.. Impact of dental implant length on early failure rates: a metaanalysis of observational studies. J Clin Periodontol. 2011; 38:856-863.

상세보기
Park JC, Ha SR, Kim SM, Kim MJ, Lee JB, Lee JH. A randomized clinical 1-year trial comparing two types of non-submerged dental implants. Clin Oral Implants Res. 2010;21:228-236.
Matthews LS, Hirsch C. Temperature measured in human cortical bone when drilling. J Bone joint Surg[Am] 1972;54:297-308.

상세보기
Rhinelander F, Nelson CL, Steward RD, Steward CL. Experimental reaming of the proximal femur and acrylic cement implantation. Vascular and histologic effects. Clin Orthop 1979;141:74-89.
Turkyilmaz I, Sennerby L, McGlumphy EA, Tozum TF. Biomechanical aspects of primary implant stability: A human cadaver study. Clin Implant Dent Relat Res 2009;11:113-119.
Tehemar SH. Factors affecting heat generation during implant site preparation: A review of biologic observations and future considerations. Int J Oral Maxillofac Implants 1999;14:127-136.

상세보기
Lundskog J. Heat and bone tissue. An experimental investigation of the thermal properties of bone and threshold levels for thermal injury. Scand J Plast Reconstr Surg 1972;9:1-80.

상세보기
Lavelle C, Wedgwood D. Effect of internal irrigation on frictional heat generated from bone drilling. J Oral Surg 1980;38:499- 503.
Sutter F, Krekeler G, Schwammberger AE, Sutter FJ. Atraumatic surgical technique and implant bed preparation. Quintessence Int 1992;23:811-816.

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