The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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The influence of magnet on tissue healing after immediate implantation in fresh extraction sites in dogs

성견에서 발치 후 즉시 식립 임플란트에 설치한 자석이 주위 조직에 미치는 영향

  • Yu, Seok-Min (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Cho, In-Ho (Department of Prosthodontics, College of Dentistry, Dankook University) ;
  • Shin, Soo-Yeon (Department of Prosthodontics, College of Dentistry, Dankook University)
  • 유석민 (단국대학교 치과대학 치과보철학교실) ;
  • 조인호 (단국대학교 치과대학 치과보철학교실) ;
  • 신수연 (단국대학교 치과대학 치과보철학교실)
  • Published : 2009.10.30
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Abstract

Statement of problem: The clinical use of electric and electomagnetic fields for fracture healing applications began in the early 1970s. Since then, several technologies have been developed and shown to promote healing of fractures. Developments of these devices have been aided in recent years by basic research and several well controlled clinical trials not only in the medical field but in dentistry. Purpose: The purpose of this study was to compare alveolar bone reduction following immediate implantation using implants onto which magnets were attached in fresh extracted sockets. Material and methods: Four mongrel dogs were involved. Full buccal and lingual mucoperiosteal flaps were elevated and third and fourth premolars of the mandible were removed. Implants with magnets and implants without magnets were installed in the fresh extracted sockets and after 3 months of healing the animals were sacrificed. The mandibles were dissected and each implant sites were sampled and processed for histological examination. Results: The marginal gaps that were present between the implant and walls of the sockets at the implantation stage disappeared in both groups as a result of bone fill and resorption of the bone crest. The buccal bone crests were located apical of its lingual counterparts. At the 12 week interval the mean of marginal bone resorption in the control group was significantly higher than that of the magnet group. The majority of specimens in magnet group presented early bone formation and less resorption of the buccal marginal bone compared to the control group. Conclusion: Within the limitations of this study, it could be concluded that implants with magnets attached in the early stages of implantation may provide more favorable conditions for early bone formation and reduce resorption and remodeling of marginal bone.

연구목적: 전기장과 전자기장은 1970년대부터 여러 기술들이 개발되어 골절의 치유가 어려운 경우에도 치유를 촉진하는 것으로 알려져 왔다. 한편 임플란트 술식이 성공하려면 임플란트가 견고하게 골과 결합하여 오랫동안 기능성 부하에 견딜 수 있어야 한다. 그러나 이 과정은 통상 6-12개월의 오랜 기간이 소요되며, 발치 후에는 치조제가 전반적으로 감소하며 치조제의 근단측, 협설측 흡수가 일어난다. 그래서 이러한 문제점들을 극복하기 위해 임플란트의 즉시 식립이 제시되었다. 그러나 여전히 치아 상실 후 즉시 임플란트를 식립하여도 발치와 함께 일어나는 골개조가 억제되지는 않았고, 치아 발거 후에는 치조제 높이가 지속적으로 감소한다고 하였다. 이에 본 연구에서는 이러한 가설 즉, 정적 자기장을 형성하는 영구자석을 임플란트 즉시 식립 후 임플란트 상부에 설치하여 신선 발치와에서 생리적으로 일어나는 조직개조에 의한 골흡수를 억제시킬 수 있는지를 알아보고자 하였다. 연구재료 및 방법: 임플란트는 직경 4.0 mm, 길이 8.5 mm로 실험군, 대조군 각각 8개씩 총 16개를 실험에 이용하였다. 30 kg 전후 성견 4마리의 하악 양측 제 3, 4 소구치 발거 후 임플란트를 즉시 식립하였고, 실험군은 임플란트 상부에 자석을 부착한 후에, 대조군은 임플란트 상부에 cover screw을 연결한 후에 결손부에 골이식재나 차폐막 없이 판막을 재 위치시키고 봉합하였다. 형광현미경 관찰을 위하여 식립 1주, 6주, 11주에 각각 oxytetracycline hydrochloride, calcein, 그리고 alizarin red S 순서로 정맥주사 하였다. 12주의 치유과정을 거친 후 희생시켜 조직 시편을 제작하였고 광학현미경과 형광현미경 하에서 골-임플란트 접촉율 및 골면적율을 측정하고 치조골 흡수량을 측정하여 관찰하였다. 결과 및 결론: 골접촉율 측정 결과 설측에서의 골접촉율 비교시 유의성이 없었으나 협측에서는 실험군이 유의성 있게 높았다 (P<.05). 골면적율 측정 결과 실험군이 대조군에 비해 높았으나 유의성은 없었다. 또한 치조정 높이의 소실은 실험군이 대조군에 비해 유의하게 더 적었고 (P<.05), 협설골벽의 치조정 높이의 소실은 협측이 설측에 비해 유의하게 더 컸다 (P<.05). 이상의 결과로 볼 때 성견 하악에서 발치 후 즉시 임플란트 식립시 설측벽에 비해 협측벽의 골소실이 다소 크나, 발치 후 즉시 임플란트를 식립하고 자석을 부착할 경우 골형성에 유리한 조건을 제공하여, 치아 발거 후 발생하는 생리적인 골개조 반응으로 인한 골흡수를 최소화할 뿐만 아니라 임플란트 안정과 성공에 기여할 수 있을 것으로 생각된다.

Keywords

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