[논문]새로운 타이타늄 구성요소를 사용한 내부연결 임플란트용 지르코니아 지대주의 동적하중 후 나사 제거력

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doi:10.4047/jkap.2017.55.2.151

새로운 타이타늄 구성요소를 사용한 내부연결 임플란트용 지르코니아 지대주의 동적하중 후 나사 제거력
Removal torque of a two-piece zirconia abutment with a novel titanium component in an internal connection implant system after dynamic cyclic loading 원문보기

대한치과보철학회지 = The journal of Korean academy of prosthodontics, v.55 no.2, 2017년, pp.151 - 155

이주희 (울산대학교 의과대학 서울아산병원 치과보철과)

초록
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목적: 이 연구의 목적은 새로운 타이타늄 구성요소를 가진 지르코니아 지대주의 나사 제거력의 변화에 대해 알아보는 것이다. 내부연결 임플란트를 위한 새로운 지르코니아 지대주의 동적하중 후 지대주 나사의 제거력을 기존의 타이타늄 지대주와 비교하여 분석하였다. 재료 및 방법: 내측연결 임플란트와 타이타늄 지대주, 타이타늄 구성요소를 가진 지르코니아 지대주를 준비하였다. 12개의 내부연결형 임플란트에 6개의 타이타늄 지대주를 연결하고(대조군), 6개의 타이타늄 구성요소를 가진 지르코니아 지대주(실험군)를 30 Ncm의 토크로 연결한 후 동적하중 전후의 나사 제거력을 측정하였다. 동적 만능재료시험기를 사용하여 연결체의 장축과 30도 각도를 이루도록 하고 300 N 하중크기로 100만번의 하중이 가해졌다. 동적하중 전후의 지대주 나사 제거력을 t검정을 통해 신뢰구간 95%로 통계적 유의성을 검증하였다. 결과: 두 그룹 모두에서 동적하중 후 나사 풀림을 보이지 않았다. 동적 하중 전후의 나사 제거력은 두 그룹 모두에서 통계적으로 유의한 차이가 있게 나타났다(P < .05). 동적 하중 전후의 나사 제거력 차이는 대조군에서 $-7.25{\pm}1.50Ncm$, 실험군에서 $-7.33{\pm}0.93Ncm$ 로 나타났다. 통계분석 결과 두 군간에 나사 제거력 차이에서는 유의한 차이를 보이지 않았다(P > .05). 결론: 이 실험의 결과에 한하여 타이타늄 구성요소를 사용한 지르코니아 지대주의 동적하중 후 지대주 나사 제거력의 변화는 타이타늄 지대주와 통계학적으로 유의한 차이를 보이지 않았다.

Abstract ▼ AI-Helper

Purpose: The aim of this study was to evaluate screw removal torque of the two-piece zirconia abutment with the novel titanium component compared to the conventional one-piece titanium abutment in the internal connection implant before and after dynamic cyclic loading. Materials and methods: Two types of the abutment assemblies with internal connection were prepared and divided into the groups; titanium abutment-titanium abutment screw assemblies as control, and zirconia abutment-titanium socket-titanium abutment screw assemblies as experimental group. A total of 12 abutments and implants were used of six assemblies each group. Each assembly was tightened to 30 Ncm. A cyclic load of 300 N at an angle of 30 degrees in reference to the loading axis was applied until one million cycles or failure. The removal torque values (RTVs) of the abutment screws were measured with a digital torque gauge before and after cyclic loading. The RTVs of the pre load and post load were analyzed with t-test, and P-values < .05 were considered statistically significant. Results: The assemblies of both groups survived all after the dynamic cyclic loading test without screw loosening. The statistically significant differences were found between the mean RTVs before and after the cyclic loading in both groups (P < .05). The RTV differences for the control and the experimental group were $-7.25{\pm}1.50Ncm$ and $-7.33{\pm}0.93Ncm$, respectively. Statistical analysis revealed that the RTV differences in both groups were not significantly different from each other (P > .05). Conclusion: Within the limitation of this study, the two-piece zirconia abutment with the titanium component did not show a significant RTV difference of the abutment screw compared to the titanium abutment after dynamic cyclic loading.

주제어

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문제 정의

However, the author was unable to identify any studies evaluating abutment screw loosening and preload reduction on two-piece zirconia abutments with titanium sockets. Therefore, the purpose of this study was to evaluate abutment screw removal torque of the two-piece zirconia abutments with titanium sockets compared to one-piece titanium abutments in internal connection systems by measuring torque values before and after cyclic loading. Materials and Methods Different types of internal connection implant abutments with antirotational structure were selected and divided into two groups; internal connection titanium abutments (Dual Abutment, Dentium Co.

제안 방법

Therefore, the purpose of this study was to evaluate abutment screw removal torque of the two-piece zirconia abutments with titanium sockets compared to one-piece titanium abutments in internal connection systems by measuring torque values before and after cyclic loading. Materials and Methods Different types of internal connection implant abutments with antirotational structure were selected and divided into two groups; internal connection titanium abutments (Dual Abutment, Dentium Co., Ltd., Seoul, Korea) and titanium abutment screws for control group, and external connection zirconia abutments (ZirAce External, Acucera, Inc., Seoul, Korea) with titanium sockets (Z socket Dentium Regular, Osung MND Co., Ltd., Seoul, Korea) and titanium abutment screws for experimental group (Fig. 1). In the experimental group, the titanium sockets were 4.
Because of the unique dual hex design connecting both the implant fixture and the zirconia abutment, screw loosening is of utmost importance in abutment and prosthetic survival. However, the author was unable to identify any studies evaluating abutment screw loosening and preload reduction on two-piece zirconia abutments with titanium sockets. Therefore, the purpose of this study was to evaluate abutment screw removal torque of the two-piece zirconia abutments with titanium sockets compared to one-piece titanium abutments in internal connection systems by measuring torque values before and after cyclic loading.
Currently, there is a lack of studies with regard to abutment screw loosening in zirconia abutments with a secondary titanium component. In this study, the effect of cyclic loading on screw removal was evaluated by examining the changes in RTVs in the groups. Abnormal damage or wear due to cyclic loading was not observed on the abutment surfaces in either group.
Therefore, the purpose of this study was to evaluate abutment screw removal torque of the two-piece zirconia abutments with titanium sockets compared to one-piece titanium abutments in internal connection systems by measuring torque values before and after cyclic loading. Materials and Methods Different types of internal connection implant abutments with antirotational structure were selected and divided into two groups; internal connection titanium abutments (Dual Abutment, Dentium Co., Ltd., Seoul, Korea) and titanium abutment screws for control group, and external connection zirconia abutments (ZirAce External, Acucera, Inc., Seoul, Korea) with titanium sockets (Z socket Dentium Regular, Osung MND Co., Ltd., Seoul, Korea) and titanium abutment screws for experimental group (Fig. 1). In the experimental group, the titanium sockets were 4.

대상 데이터

The zirconia abutment, the titanium socket and the implant were all fixated with the single screw.¹² internal connection implants (Implantium, Dentium Co., Ltd., Seoul, Korea), which were 4.5 mm in platform diameter, 4.3 mm in body diameter, and 10.0 mm in length, were prepared. The sample size of the abutments was 6 for each group.

데이터처리

Data normality was tested using the KolmogorovSmirnov test, which revealed the possibility of parametric statistical analyses. Paired t-tests were used to compare the RTVs before and after the dynamic cyclic loading of each group. To compare the RTV differences between the groups, independent t-tests were conducted.
Paired t-tests were used to compare the RTVs before and after the dynamic cyclic loading of each group. To compare the RTV differences between the groups, independent t-tests were conducted. A difference was considered significant when P < .

이론/모형

The sample size of the abutments was 6 for each group. Assembly preparation and testing setup were performed basically according to the ISO 14801:2007 protocol. Using the torque gauge, 30 Ncm was applied for the assemblies of both groups.
0 for Windows (IBM, New York, NY, USA). Data normality was tested using the KolmogorovSmirnov test, which revealed the possibility of parametric statistical analyses. Paired t-tests were used to compare the RTVs before and after the dynamic cyclic loading of each group.

성능/효과

After cyclic loading, both sample groups showed decreased RTVs compared to the measurements recorded before the cyclic loading. Based on the analyzed results, the RTV differences between the groups were not significantly different, which indicating that the implant-abutment connection with the zirconia abutment and the titanium socket would not be harmful to the stability of the internally connected implant. However, an additional experiment using larger sample size is necessary to ensure the stability.
^14,18,19 Within the limitations of this in vitro setting, both titanium abutments and two-piece zirconia abutments with a titanium socket survived cyclic loading without screw loosening. The results implied that the screw retained two-piece zirconia abutment assembly with the titanium socket could successfully withstand dynamic functional loading when compared to the conventional titanium abutments.

후속연구

However, an additional experiment using larger sample size is necessary to ensure the stability. Further studies about resistance to persistent thermal stress and clinical evaluations will be needed.

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