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하악 구치 단일임플란트 수복에서 임플란트 길이에 따른 치관-임플란트 비율이 임플란트안정성 및 변연골소실에 주는 영향

Influence of crown-to-implant ratio of short vs long implants on implant stability and marginal bone loss in the mandibular single molar implant

  • 백연화 (서울대학교 치의학대학원 치과보철학교실) ;
  • 김봉주 (서울대학교 치과병원 치의생명과학연구원) ;
  • 김명주 (서울대학교 치의학대학원 치과보철학교실) ;
  • 권호범 (서울대학교 치의학대학원 치과보철학교실) ;
  • 임영준 (서울대학교 치의학대학원 치과보철학교실)
  • Baek, Yeon-Wha (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kim, Bongju (Dental Life Science Research Institute and Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital) ;
  • Kim, Myung-Joo (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Kwon, Ho-Beom (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University) ;
  • Lim, Young-Jun (Department of Prosthodontics and Dental Research Institute, School of Dentistry, Seoul National University)
  • 투고 : 2018.09.07
  • 심사 : 2018.10.10
  • 발행 : 2018.12.31

초록

목적: 이 연구의 목적은 임플란트의 길이 및 치관-임플란트 비율(crown-to-implant (C/I) ratio)이 임플란트의 안정성과 임플란트 변연골 소실량(MBL)에 영향을 주는지 알아보기 위함이다. 연구 재료 및 방법: 연구대상자로 하악 구치부에 단일치를 상실한 46명의 환자를 선별하였다. 대조군에는 총 19개의 직경 5.0 mm, 길이 10 mm의 임플란트(CMI IS-III $active^{(R)}$ long implant)를 식립하였고, 실험군에는 직경 5.5 mm, 길이 6.6, 7.3, 8.5 mm의 임플란트 총 27개(CMI IS-III $active^{(R)}$ short implant)를 식립하였다. 각각의 임플란트는 디지털 방식으로 술 전 제작한 수술가이드를 사용하여 식립하였고 임시보철물을 장착하여 즉시부하를 시행하였다. 술 후 3개월에 CAD-CAM 방식으로 제작한 지르코니아 크라운으로 최종 수복하였다. 술 후 48주에 ISQ 값과 변연골 소실량을 측정하여 치관-임플란트 비율과 ISQ 및 변연골 소실량 간의 상관관계를 비교하였다. 결과: 두 그룹 모두 안정도 및 변연골 소실량 면에서 성공적인 결과를 나타내었다. 술 후 48주에 측정한 두 그룹간 ISQ와 변연골 소실량 값은 통계적으로 유의미한 차이가 없었다(P > 0.05). 치관-임플란트 비율과 안정성 및 치관-임플란트 비율과 변연골 소실량 간에 어떤 상관관계도 관찰되지 않았다(P > 0.05). 결론: 두 그룹의 하악 단일 임플란트에서 치관-임플란트 비율은 안정성 및 변연골 소실량에 영향을 주지 않는 것으로 나타났다. 골높이가 부족한 하악에서 단일 임플란트 수복 시, 짧은 임플란트는 상대적으로 높은 치관-임플란트 비율에도 불구하고 제한된 조건 하에서 적절한 대안이 될 수 있다.

Purpose: The purpose of this randomized clinical trial is to determine whether implant length and the crown-to-implant (C/I) ratio influence implant stability and peri-implant marginal bone loss (MBL). Materials and Methods: 46 patients with single tooth missing in the posterior molar region of the mandible were included in this study. 19 implants (CMI IS-III $active^{(R)}$ long implant) of 5.0 mm diameter and 10 mm length were installed for the control group, while 27 implants (CMI IS-III $active^{(R)}$ short implant) of 5.5 mm diameter and 6.6, 7.3 or 8.5 mm length were placed for the experimental group. Each implant was inserted and immediately loaded using the digitally pre-fabricated surgical template and provisional restoration. The CAD-CAM monolithic zirconia crown was fabricated at 3 months after the surgery as a definitive restoration. The ISQ value and the MBL was measured at 48 weeks after the surgery. The correlation between the C/I ratio, MBL, and secondary implant stability was analyzed. Results: Successful results in terms of ISQ and MBL were achieved with both groups. There was no significant difference between the groups in terms of ISQ values and MBL at 48 weeks after the surgery (P > 0.05). No significant correlation was found between the C/I ratio and secondary stability as well as the C/I ratio and the MBL (P > 0.05). Conclusion: The influence of C/I ratio in both groups was not shown on the stability nor the marginal bone loss in implants supporting single crown of the mandible. Short implant could be a preferable alternative option in the reduced bone height mandible under the limited condition despite its higher C/I ratio.

키워드

참고문헌

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