The Journal of Korean Academy of Prosthodontics (대한치과보철학회지)

The Korean Academy of Prosthodonitics (대한치과보철학회)
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Fit analysis of CAD-CAM custom abutment using micro-CT

Micro-CT를 이용한 맞춤형 CAD-CAM 지대주의 적합성 분석

  • Min, Gwang-Seok (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Chung, Chae-Heon (Department of Prosthodontics, School of Dentistry, Chosun University) ;
  • Kim, Hee-Jung (Department of Prosthodontics, School of Dentistry, Chosun University)
  • 민광석 (조선대학교 치과대학 치과보철학교실) ;
  • 정재헌 (조선대학교 치과대학 치과보철학교실) ;
  • 김희중 (조선대학교 치과대학 치과보철학교실)
  • Received : 2016.06.10
  • Accepted : 2016.09.12
  • Published : 2016.10.31
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Abstract

Purpose: The purpose of this study was to investigate screw joint stability and sagittal fit between internal connection implant fixtures of two different manufacturers and customized abutments. Materials and methods: Internal connection implant systems from two different manufacturers (Biomet 3i system, Astra Tech system) were selected for this study (n=24 for each implant system, total n=48). For 3i implant system, half of the implants were connected with Ti ready-made abutments and the other half implants were connected with Ti CAD-CAM custom ones of domestic-make (Myplant, Raphabio Co., Seoul, Korea) and were classified into Group 1 and Group 2 respectively. Astra implants were divided into Group 3 and Group 4 in the same way. Micro-CT sagittal imaging was performed for fit analysis of interfaces and preloading reverse torque values (RTV) were measured. Results: In the contact length of fixture-abutment interface, there were no significant differences not only between Group 1 and Group 2 but also between Group 3 and Group 4 (Mann-Whitney test, P>.05). However, Group 2 and Group 4 showed higher contact length significantly than Group 1 and Group 3 in abutment-screw interface as well as fixture-screw one (Mann-Whitney test, P<.05). In addition, RTV was lower in CAD-CAM custom abutments compared to ready-made ones (Student t-test, P<.05). Conclusion: It is considered that domestically manufactured CAD-CAM custom abutments have similar fit at the fixture abutment interface and it could be used clinically. However, RTV of CAD-CAM custom abutments should be improved for the increase of clinical application.

목적: Biomet 3i 시스템과 Astra 시스템의 내측 연결형 임플란트 고정체에 국내에서 제작된 맞춤형 CAD-CAM 지대주를 체결하여 구성 성분 간의 적합성과 나사의 안정성을 평가하고자 하였다. 재료 및 방법: 24개 3i 임플란트 중 12개의 임플란트에 기성 지대주를 연결하고, 나머지 임플란트에는 맞춤형 CAD-CAM 지대주를 연결하여 각각 Group 1과 Group 2로 분류하였다. 동일 개수와 동일한 방법으로 Astra 임플란트를 각각 Group 3와 Group 4로 분류하였다. 각각의 고정체에 지대주를 장착하여 각 계면 사이의 적합성을 micro-CT로 관찰하고 초기 풀림 토크를 측정한 후 평가하였다. 결과: 고정체-지대주의 접촉길이는 Group 1과 Group 2 사이 뿐만 아니라 Group 3와 Group 4 사이에도 유의한 차이가 없었다(Mann-Whitney test, P>.05). 하지만, 지대주와 나사의 계면 및 고정체와 나사의 계면에서 Group 2와 Group 4가 Group 1와 Group 3에 비해 각기 더 큰 접촉양상을 보여주었다(Mann-Whitney test, P<.05). 또한, Group 2와 Group 4가 Group 1과 Group 3에 비해 각기 더 낮은 나사의 초기 풀림 토크를 기록하였다(Student t-test, P<.05). 결론: CAD-CAM지대주는 임상에 적용할 만한 적합성을 지니고 있으나, 광범위한 임상 적용을 위해서는 풀림 토크가 향상되어야 할 것으로 사료된다.

Keywords

References

  1. Sumi T, Braian M, Shimada A, Shibata N, Takeshita K, Vandeweghe S, Coelho PG, Wennerberg A, Jimbo R. Characteristics of implant-CAD/CAM abutment connections of two different internal connection systems. J Oral Rehabil 2012;39:391-8. https://doi.org/10.1111/j.1365-2842.2011.02273.x
  2. Lang LA, Sierraalta M, Hoffensperger M, Wang RF. Evaluation of the precision of fit between the Procera custom abutment and various implant systems. Int J Oral Maxillofac Implants 2003;18:652-8.
  3. Bichacho N. Achieving optimal gingival esthetics around restored natural teeth and implants. Rationale, concepts, and techniques. Dent Clin North Am 1998;42:763-80.
  4. Kim HS. Fabrication of custom abutment using dental CAD/CAM system. J Korean Dent Assoc 2012;50:118-25.
  5. Lewis SG, Llamas D, Avera S. The UCLA abutment: a four-year review. J Prosthet Dent 1992;67:509-15. https://doi.org/10.1016/0022-3913(92)90082-L
  6. Wu T, Liao W, Dai N, Tang C. Design of a custom angled abutment for dental implants using computer-aided design and nonlinear finite element analysis. J Biomech 2010;43:1941-6. https://doi.org/10.1016/j.jbiomech.2010.03.017
  7. Sailer I, Zembic A, Jung RE, Siegenthaler D, Holderegger C, Hammerle CH. Randomized controlled clinical trial of customized zirconia and titanium implant abutments for canine and posterior single-tooth implant reconstructions: preliminary results at 1 year of function. Clin Oral Implants Res 2009;20:219-25. https://doi.org/10.1111/j.1600-0501.2008.01636.x
  8. Kerstein RB, Castellucci F, Osorio J. Ideal gingival form with computer-generated permanent healing abutments. Compend Contin Educ Dent 2000;21:793-7.
  9. Priest G. Virtual-designed and computer-milled implant abutments. J Oral Maxillofac Surg 2005;63:22-32.
  10. Martin WC, Woody RD, Miller BH, Miller AW. Implant abutment screw rotations and preloads for four different screw materials and surfaces. J Prosthet Dent 2001;86:24-32. https://doi.org/10.1067/mpr.2001.116230
  11. Boggan RS, Strong JT, Misch CE, Bidez MW. Influence of hex geometry and prosthetic table width on static and fatigue strength of dental implants. J Prosthet Dent 1999;82:436-40. https://doi.org/10.1016/S0022-3913(99)70030-2
  12. Abrahamsson I, Berglundh T, Lindhe J. Soft tissue response to plaque formation at different implant systems. A comparative study in the dog. Clin Oral Implants Res 1998;9:73-9. https://doi.org/10.1034/j.1600-0501.1998.090202.x
  13. Quirynen M, Bollen CM, Eyssen H, van Steenberghe D. Microbial penetration along the implant components of the Branemark system. An in vitro study. Clin Oral Implants Res 1994;5:239-44. https://doi.org/10.1034/j.1600-0501.1994.050407.x
  14. Henriksson K, Jemt T. Evaluation of custom-made procera ceramic abutments for single-implant tooth replacement: a prospective 1-year follow-up study. Int J Prosthodont 2003;16:626-30.
  15. Canullo L. Clinical outcome study of customized zirconia abutments for single-implant restorations. Int J Prosthodont 2007;20:489-93.
  16. Swain MV, Xue J. State of the art of Micro-CT applications in dental research. Int J Oral Sci 2009;1:177-88. https://doi.org/10.4248/IJOS09031
  17. Pelekanos S, Koumanou M, Koutayas SO, Zinelis S, Eliades G. Micro-CT evaluation of the marginal fit of different In-Ceram alumina copings. Eur J Esthet Dent 2009;4:278-92.
  18. Suomalainen AK, Salo A, Robinson S, Peltola JS. The 3DX multi image micro-CT device in clinical dental practice. Dentomaxillofac Radiol 2007;36:80-5 https://doi.org/10.1259/dmfr/30358216
  19. Siamos G, Winkler S, Boberick KG. Relationship between implant preload and screw loosening on implant-supported prostheses. J Oral Implantol 2002;28:67-73. https://doi.org/10.1563/1548-1336(2002)028<0067:TRBIPA>2.3.CO;2
  20. Kim JW, Heo YR, Kim HJ, Chung CH. A comparative study on the fit and screw joint stability of ready-made abutment and CADCAM custom-made abutment. J Korean Acad Prosthodont 2013;51:276-83. https://doi.org/10.4047/jkap.2013.51.4.276
  21. Kim NH, Chung CH, Son MK, Back DH. A study on the fit of the fixture-abutment-screw interface. J Korean Acad Prosthodont 2003;41:503-18.
  22. Jung SH, Ma JS, Chung CH. A comparative study on the fit in prostheses using premade gold cylinder and plastic cylinder. J Korean Acad Prosthodont 1999;37:825-34.
  23. Lee HT, Chung CH. Fit of fixture / abutment interface of internal connection implant systems. J Korean Acad Prosthodont 2004;42:192-209.
  24. de Morais Alves da Cunha T, de Araujo RP, da Rocha PV, Amoedo RM. Comparison of fit accuracy between $Procera^{(R)}$ custom abutments and three implant systems. Clin Implant Dent Relat Res 2012;14:890-5. https://doi.org/10.1111/j.1708-8208.2010.00323.x
  25. Binon PP. Evaluation of machining accuracy and consistency of selected implants, standard abutments, and laboratory analogs. Int J Prosthodont 1995;8:162-78.
  26. Jang HS, Kim HJ, Chung CH. Detorque force and surface change of coated abutment screw after repeated closing and opening. J Korean Acad Prosthodont 2008;46:500-10. https://doi.org/10.4047/jkap.2008.46.5.500
  27. Yeo IS, Lee JH, Kang TJ, Lee SY. The effect of abutment screw length on screw loosening in dental implants with external abutment connections after thermocycling. Int J Oral Maxillofac Implants 2014;29:59-62. https://doi.org/10.11607/jomi.3125
  28. Lee JR, Lee DH, Hwang JW, Choi JH. Detorque values of abutment screws in a multiple implant-supported prosthesis. J Korean Acad Prosthodont 2010;48:280-6. https://doi.org/10.4047/jkap.2010.48.4.280
  29. Lee CJ, Yang SE, Kim SG. Evaluation of reverse torque value of abutment screws on CAD/CAM custom-made implant abutments. J Korean Acad Prosthodont 2012;50:122-8.
  30. Haack JE, Sakaguchi RL, Sun T, Coffey JP. Elongation and preload stress in dental implant abutment screws. Int J Oral Maxillofac Implants 1995;10:529-36.