컴퓨터 영상을 이용한 임플란트 식립부위의 골밀도와 조직학적 연구 (BONE DENSITY AND HISTOMORPHOMETRY ASSESSMENT OF DENTAL IMPLANT USING COMPUTERIZED TOMOGRAPHY)

서지정보

· 발행기관 : 대한악안면성형재건외과학회
· 수록지 정보 : Maxillofacial Plastic Reconstructive Surgery / 31권 / 2호 / 136 ~ 142페이지
· 저자명 : 손장호, 조영철, 성일용, 이지호, 최병환, 박수원, 변기정

초록

Bone density in the recipient implant site seems to be an important factor for long term success of
endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the
treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify
suitable implant sites, thereby improving the success rate of the procedure.
Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively
with computerized tomography and histologically measured bone density by bone biopsy.
Patients and methods; Twenty seven patients were selected. All the patients were in good health, with
no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate
Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery
2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed
using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and
insertion torque values were recorded.
Results; The highest histomorphometric values was found in the posterior mandible 32.3±3.8, followed
by 29.9±2.6 for the posterior maxilla, 29.4±2.6 for the anterior maxilla, 28.6±2.3 for the anterior
mandible(p=0.214). The hounsfield unit was 989.2±258.1 in the posterior mandible, 845.0±241.5 in the
anterior maxilla, 744.5± 92.6 in the anterior mandible, 697.3±136.9 in the posterior maxilla(p=0.045).
This results may suggest that there are strong correlation between the histomorphometric values and
hounsfield unit(ｒ=0.760, p<0.05). The RF measurements were 81.9±2.4 ISQ in the posterior mandible,
79.0±1.4 ISQ in the anterior mandible, 78.3±4.6 ISQ in the posterior maxilla, 76.5±5.0 ISQ in the anterior
maxilla(p=0.048). The insertion torque values was 43.2±4.2 Ncm in the posterior mandible, 42.0±
0.0 Ncm in the anterior mandible, 41.3±4.1 Ncm in the posterior maxilla, 40.8±3.8 Ncm in the anterior
maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield
unit and the insertion torque values(ｒ=0.494, p<0.05), the histomorphometric values and the insertion
torque values(ｒ=0.689, p<0.05). But there was no correlation between histomorphometric values and
ISQ. There was no statistical significance in age and gender effect on parameters.
Conclusions; There was significant correlations between bone density and implant stability parameters.
The bone density measurements using preoperative CT may help clinicians to predict primary stability
before implant insertion, which is associated with implant survival rates.

영어초록

Bone density in the recipient implant site seems to be an important factor for long term success of
endosseous implants. Preoperative evaluation of bone density is very helpful to assist the clinician with the
treatment planning of implant therapy. Accurate information on bone density will help the surgeon identify
suitable implant sites, thereby improving the success rate of the procedure.
Purpose; The aim of this study was to evaluate a correlation between bone density measured preoperatively
with computerized tomography and histologically measured bone density by bone biopsy.
Patients and methods; Twenty seven patients were selected. All the patients were in good health, with
no systemic disorder and additional bone graft. Preoperatively the patients underwent CT scanning to evaluate
Houmsfield Unit(HU). Each patients wore a surgical template for implant placement. During surgery
2mm in diameter and 6mm in length specimens were taken. Histomorphometric analysis was performed
using digitalized image analysis software Axiovision 4.3. Also, the Resonance frequency analysis(RFA) and
insertion torque values were recorded.
Results; The highest histomorphometric values was found in the posterior mandible 32.3±3.8, followed
by 29.9±2.6 for the posterior maxilla, 29.4±2.6 for the anterior maxilla, 28.6±2.3 for the anterior
mandible(p=0.214). The hounsfield unit was 989.2±258.1 in the posterior mandible, 845.0±241.5 in the
anterior maxilla, 744.5± 92.6 in the anterior mandible, 697.3±136.9 in the posterior maxilla(p=0.045).
This results may suggest that there are strong correlation between the histomorphometric values and
hounsfield unit(ｒ=0.760, p<0.05). The RF measurements were 81.9±2.4 ISQ in the posterior mandible,
79.0±1.4 ISQ in the anterior mandible, 78.3±4.6 ISQ in the posterior maxilla, 76.5±5.0 ISQ in the anterior
maxilla(p=0.048). The insertion torque values was 43.2±4.2 Ncm in the posterior mandible, 42.0±
0.0 Ncm in the anterior mandible, 41.3±4.1 Ncm in the posterior maxilla, 40.8±3.8 Ncm in the anterior
maxilla(p=0.612). This results may suggest that there are statistical significance between the hounsfield
unit and the insertion torque values(ｒ=0.494, p<0.05), the histomorphometric values and the insertion
torque values(ｒ=0.689, p<0.05). But there was no correlation between histomorphometric values and
ISQ. There was no statistical significance in age and gender effect on parameters.
Conclusions; There was significant correlations between bone density and implant stability parameters.
The bone density measurements using preoperative CT may help clinicians to predict primary stability
before implant insertion, which is associated with implant survival rates.

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