임플란트 구성요소의 파절면에 관한 주사전자현미경적 연구 : Part II - 임플란트 유지나사

Fracture Analysis of Implant Components using Scanning Electron Microscope : Part II - Implant Retaining Screw

  • 임광길 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 김대곤 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 조리라 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소) ;
  • 박찬진 (강릉원주대학교 치과대학 치과보철학교실 및 구강과학연구소)
  • Lim, Kwang-Gil (Department of Prosthodontics and Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Kim, Dae-Gon (Department of Prosthodontics and Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Cho, Lee-Ra (Department of Prosthodontics and Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University) ;
  • Park, Chan-Jin (Department of Prosthodontics and Institute of Oral Science, College of Dentistry, Gangneung-Wonju National University)
  • 투고 : 2010.06.25
  • 심사 : 2010.12.25
  • 발행 : 2010.12.30

초록

보철물의 실패는 파절로 인해 다수 발생하게 되지만 파절 발생시 그 원인을 파악하는 것은 어렵다. 보철물의 실패를 예방하고 예후를 예측하기 위해 보철물의 원인을 분석하는 것이 중요하며, 원인을 밝히기 위해 파절면 분석을 시행하게 된다. 파절면 분석은 파절면 뿐 아니라 주위 환경(응력 상황)에 대한 분석이 동반되며, 이를 이용하여 균열 진행, 파절 양상, 파절 원인 등을 파악하게 된다. 이 연구의 목적은 임상적으로 기능 시 파절된 임플란트 유지나사의 파절면 분석을 시행하여 파절 기전 및 파절 원인(하중 양상)을 밝히는 것이다. 파절된 임플란트 유지나사는 3년간 강릉-원주 대학교에 임플란트 유지나사의 파절을 주소로 내원한 환자를 대상으로 수집하였다. 먼저 임상 및 방사선 사진 분석을 시행하였으며, 시편 세척 과정을 거쳐 주사 전자 현미경을 이용한 파절면 분석을 시행하였다. 임플란트 파절면 분석 시 피로 줄무늬, 톱니바퀴 모양, 벽개 파절, 딤플 파절 등의 파절 지표를 통해 제작 금속, 파절 시 하중상태에 따른 각기 다른 파절 양상을 관찰할 수 있었다.

Fracture causes serious problems in many instance of prosthetic failures. But it is hard to find the definite causes when fractures occur. Fractography encompasses the examination of fracture surfaces that contain features resulting from the interaction of the advancing crack with the microstructure of the material and the stress fields. All fractured specimens(implant retaining screw) retrieved from Gangneung-Wonju national university dental hospital for 3 years(from 2007 to 2009). After pretreatment of samples, the scanning electon microscope were used for surface examination and fracture analysis. In case of most of the fractured specimens, fracture took place by fatigue fracture and fractured surface represents fatigue striation. Fatigue striation indicate the progression of the crack front under cyclic loading, are characteristic of stage 2 crack growth. The site of crack initiation and stage 1 crack growth were not easily identified in any of the failure, presumably because of the complex microstructural features of the polycrystalline sample. In case of fractured by overload, dimpled or cleavage surface were observed. Using the interpretation of characteristic markings(ratchet mark, fatigue striation, dimple, cleavage et al) in fracture surfaces, failure events containing the crack origin, crack propagation, material deficiency could be understand. Using the interpretation of characteristic markings in fracture surfaces, cause and mechanism of fractures could be analyzed.

키워드

참고문헌

  1. Powell GW, Mahmond SE, Mills K. Failure analysis and prevention. ASM Handbook, volume 11. ASM international; 1992.
  2. Scherrer SS, Quinn JB, Quinn GD, Kelly JR. Failure analysis of ceramic clinical cases using qualitive fractography. Int J Prosthodont 2006;19:185-192.
  3. Mills K, Davis JR, Destefani JD, Dieterich D. ASM Handbook, volume 12, Fractography. ASM international; 1992.
  4. Scherrer SS, Quinn GD, Quinn JB. Fractographic failure analysis of $Procera^{\circledR}$ Allceram crown using stereo and scanning electron microscopy. Dent Mater 2008;24:1107-1113. https://doi.org/10.1016/j.dental.2008.01.002
  5. Taskonak B, Yan J, Mecholsky JJ. Fractographic analyses of zirconia-based fixed partial dentures. Dent Mater 2008;24:1077-1082. https://doi.org/10.1016/j.dental.2007.12.006
  6. Kelly JR, Campbell SD, Bowen HK. Fracture-surface analysis of dental ceramics. J Prosthet Dent 1989;62:536-541. https://doi.org/10.1016/0022-3913(89)90075-9
  7. Bates JF, Scott J. Studies related to the fracture of partial dentures-Fractography of Cobalt-chromium alloys. J Biomed Mater Res 1973;7:419-429.
  8. Gapido CG, Kobayashi H, Miyakawa O, Kohno S. Fatigue resistance of cast occlusal rests using Co-Cr and Ag-Pd-Cu-Au alloys. J Prosthet Dent 2003;90: 261-269. https://doi.org/10.1016/S0022-3913(03)00367-6
  9. Iwama CY, Preston JD. Cobalt-Chromium-Titanium alloy for removable partial dentures. Int J Prosthodont 1997;10:309-317.
  10. Davis DM, Waters NE. An investigation into the fracture behavior of a particulate-filled bis-GMA resin. J Dent Res 1987;66:1128-1133. https://doi.org/10.1177/00220345870660060701
  11. Yamini S, Young R. The mechanical properties of epoxy resins. J Mater Sci Mater Med 1980;15: 1823-1831. https://doi.org/10.1007/BF00550603
  12. David DM, Waters NE. Fractography of a bis-GMA resins. J Dent Res 1989;68:1194-1198. https://doi.org/10.1177/00220345890680071001
  13. Branemark PI, Adell R, Lekholm U, Rockler B. A 15-year study of osseointegrated implants in the treatment the edentulous jaw. Int J Oral Surg 1981;10:387-416. https://doi.org/10.1016/S0300-9785(81)80077-4
  14. Quirynen M, Assche NV, Botticelli D, Berglundh T. How does the timing of implant placement to extraction affect outcome? Int J Oral Maxillofac Implant 2007;22:203-223.
  15. Jokstad A, Carr AB. What is the effect on outcomes of time to loading of a fixed or removable prosthesis placed on implant? Int J Oral Maxillofac implants 2007;22:19-48.
  16. Weber HP, Sukotjo C. Does the type of implant prosthesis affect outcomes in the partially edentulous patient? Int J Oral Maxillofac Implants 2007;22:140-172.
  17. Bryant SR, Jankowski DM, Kim KS. Does the type of implant prosthesis affect outcomes for the completely edentulous arch. Int J Oral Maxillofac Implants 2007;22:117-139.
  18. Lekholm U, Steenberghe DV, Herrmann I, Bolender C. Osseointegrated implants in the treatment of partially edentulous jaws: a prospective 5-year multicenter study. Int J Oral Maxillofac Implants 1994;9:627-635.
  19. Hemmings KW, Schmitt A, Zarb GA. Complications and maintenance requirements for fixted prostheses and overdentures in the edentulous mandible: a 5-year report. Int J Oral Maxillofac Implants 1994;9:191-196.
  20. Goodacre CJ, Kan JY, Rungcharassaeng K. Clinical complications of osseointegrated implants. J Prosthet Dent 1999;81:537-552. https://doi.org/10.1016/S0022-3913(99)70208-8
  21. Versluis A, Korioth TWP, Cardoso AC. Numerical analysis of a dental implant system preloaded with a washer. Int J Oral Maxillofac Implants 1999;14:337-341.
  22. Huang HM, Tsai CM, Chang CC, Lin CT, Lee SY. Evaluation of loading conditions on fatigue-failed implants by fracture surface analysis. Int J Oral Maxillofac Implants 2005;20:854-859.
  23. Jabbari YS, Fournelle R, Ziebert G, Toth J, Lacopino M. Mechanical behavior and failure analysis of prosthetic retaining screws after long-term use in vivo. part4: failure analysis of 10 fractured retaining screws retrieved from three patients. J Prosthodont 2008;17:201-210. https://doi.org/10.1111/j.1532-849X.2007.00291.x
  24. Tonetti MS, Schmitt A. Pathogenesis of implant failures. Periodontology 2000 1994;4:127-138. https://doi.org/10.1111/j.1600-0757.1994.tb00013.x
  25. Eckert SE, Woollan PC. Retrospective review of 1170 endosseous implants placed in partially edentulous jaws. J Prosthet Dent 1998;79:415-421. https://doi.org/10.1016/S0022-3913(98)70155-6
  26. Jemt T, Laney WR, Harris D, Henry PJ, Krogh P. Osseointegrated implants for single tooth replacement: a 1-year report from a multicenter prospective study. Int J Oral Maxillofac Implants 1991;6:29-36.
  27. Morgan MJ, James DF, Pillar RM. Fractures of the fixture component of an osseointegrated implant. Int J Oral Maxillofac Implants 1993;8:409-414.
  28. Manda MG, Psyllaki PP, Tsipas DN, Koidis PT. Clinical device-related article observations on an in-vivo failure of a titanium dental implant/abutment screw system: a case report. J Biomed Master Res Part B: appl Biomater 89B: 264-273. https://doi.org/10.1002/jbm.b.31211