임플랜트 지지 상부구조물에서 나사조임순서와 조임방법이 풀림토크값에 미치는 영향

최정한; 김창회; 임영준; 김명주; 이석형

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임플랜트 지지 상부구조물에서 나사조임순서와 조임방법이 풀림토크값에 미치는 영향
THE EFFECT OF SCREW TIGHTENING SEQUENCE AND TIGHTENING METHOD ON THE DETORQUE VALUE IN IMPLANT-SUPPORTED SUPERSTRUCTURE

대한치과보철학회지 2007년 45권 5호 p.653 ~ 664

최정한, 김창회, 임영준, 김명주, 이석형,

소속 상세정보

최정한 ( Choe Jeong-Han ) - 서울대학교 치과대학 치과보철학교실
김창회 ( Kim Chang-Whe ) - 서울대학교 치과대학 치과보철학교실
임영준 ( Lim Young-Jun ) - 서울대학교 치과대학 치과보철학교실
김명주 ( Kim Myung-Joo ) - 서울대학교 치과대학 치과보철학교실
이석형 ( Lee Seok-Hyeong ) - 성균관대학교 의과대학 삼성서울병원 보철과

KMID : 0362420070450050653

Abstract

Statement of Problem:The screw detorque value is a measure of the preload remaining in the screw just before detorquing. Purpose: This study evaluated the effect of different screw tightening sequences and tightening methods on detorque values for a well-fitting implant superstructure.

Material and Method: An implant superstructure that connected directly to four implants (Astra Tech) was fabricated on a fully edentulous mandibular acrylic resin model. Six well-fitting dental stone casts were made with a pickup impression of the superstructure from the acrylic resin model. To evaluate the effect of three screw tightening sequences (1-2-3-4, 2-4-3-1, and 2-3-1-4) and two tightening methods (2-step and 1-step) on the stability of screw joint, the detorque values for a well-fitting implant superstructure were measured twice after screw tightening using 20 Ncm. Detorque values were analyzed using multi-way analysis of variance and two-way analysis of variance at a .05 level of significance.

Results:1. The mean detorque values for three screw tightening sequences were 12.3 Ncm, 12.6 Ncm, and 12.0 Ncm, respectively. 2. The mean detorque values for two screw tightening methods were 12.0 Ncm, and 12.2 Ncm, respectively. 3. The mean of mimimum detorque values for three screw tightening sequences and for two tightening methods were 10.6 Ncm, 11.1 Ncm, 10.5 Ncm, and 9.8 Ncm, respectively. 4. No statistically significant differences among the variables of screw tightening sequence and tightening method were found (p>.05) for detorque values and for mimimum detorque values.

Conclusion:Within the limitations of this study, the screw tightening sequence and tightening method did not have a significant effect on the detorque values for a well-fitting implant superstructure.