결론: 즉시 식립 임플란트를 성공적으로 시행하기 위해서는 심고자 하는 위치의 해부학적 구조를 잘 이해하여야 한다. 남아있는 잔존골을 잘 이용하여 적절한 초기고정을 얻는 것 뿐 아니라 보철적으로나 장기적으로 좋은 예후를 갖기 위해서는 알맞은 직경과 형태의 임플란트를 선택하여 적절한 위치에 식립하는 것이 중요하다.
[영문]
Objective: The purpose of this study was to measure the thickness of buccal and lingual plate, the thickness of cortical bone between the roots, the diameter of the root, and the distance between the roots, in order to use them as a guide in determining the shape, diameter, and position of the implant in immediate implantation.
Materials and Methods: The horizontal section of 20 mandibles and 20 maxillas were measured and analyzed to obtain the average values. The following measurements were performed:
1. The thickness of the facial and palatal (lingual) residual bone at each root
surface
2. The thickness of the facial and palatal (lingual) cortical bone at the interdental
region
3. The diameter of all roots of the each section
(faciolingual and mesiodistal)
4. The interroot distance
5. The buccopalatal (buccolingual) and mesiodistal diameter of the septal bone
Three specimens with measurements close to the average values were chosen and 3-dimensional images were reconstructed.
Results:
1. The thickness of the facial and palatal (lingual) residual bone at each root surface
Maxillary and mandibular canines had less buccal bone compared to central and
lateral incisors(0.4~1.0mm).
2. The thickness of the facial and palatal (lingual) cortical bone at the interdental region
In the maxilla, the buccal cortical bone was thicker in the posterior region compared to the anterior region. The thickness of mandibular cortical bone increased from anterior to posterior region and from coronal to apical.
3. The diameter of all roots of the each section (faciolingual and mesiodistal)
In the maxillary central incisor, the buccolingual width of the root was less than 4mm when the depth was greater than 10 mm, and the mesiodistal width was less than 4mm when the depth was greater than 8mm. In the maxillary lateral incisor, the buccolingual width and the mesiodistal width were less than 4mm at depths greater than 10mm and 5mm, respectively.
In the mandibular central and lateral incisor, the buccolingual root width was less than 4mm at depths greater than 8mm and 9mm, respectively. The maximum mesiodistal root width was 3.0mm and 3.3mm, respectively.
4. The interroot distance
The alveolar bone thickness between the roots increased from anterior to posterior region and from coronal to apical in both the maxilla and the mandible. The thickness between the mandibular incisors was 1.4~1.7mm.
Conclusions: In order to achieve successful immediate implantation, thorough understanding of the anatomic structure of the implantation site is critical. Selecting the implant of appropriate diameter and shape and placing it at an appropriate position is essential for initial stability, prosthodontic success, and good long-term prognosis.