대한치과보철학회지 (The Journal of Korean Academy of Prosthodontics)

  • 제47권1호
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  • Pages.53-60
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  • 2009
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  • 0301-2875(pISSN)
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  • 2005-3789(eISSN)
대한치과보철학회 (The Korean Academy of Prosthodonitics)
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심미적 포스트 코어의 종류에 따른 미세누출에 관한 연구

Microleakage of endodontically treated teeth restored with three different esthetic post and cores

  • 박지근 (이화여자대학교 의학전문대학원 치과보철과 대학원) ;
  • 박지만 (이화여자대학교 의학전문대학원 치과보철과 대학원) ;
  • 박은진 (서울대학교 치의학대학원 치과보철과)
  • Park, Ji-Geun (Department of Dental Prosthodontics, School of Medicine, Ewha Womans University) ;
  • Park, Ji-Man (Department of Dental Prosthodontics, School of Medicine, Ewha Womans University) ;
  • Park, Eun-Jin (Department of Prosthodontics, School of Dentistry, Seoul National University)
  • 발행 : 2009.01.30
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초록

연구목적: 오늘날 심미적 요구의 증가로 치아색 포스트 코어에 대한 많은 관심이 모아지고 있으며 다양한 연구가 진행 중이다. 현재 화이버 포스트 (ParaPost fiber White, Coltene Whaledent, Cuyahoga Falls, USA), 지르코니아 포스트 (CosmoPost, Ivoclar Vivadent, Schann, Germany) 등에 관한 논문은 다소 나와 있으나 요즘 여러 분야에서 관심을 받고 있는 CAD/CAM (computer-aided design/computer-aided manufacturing) 방식으로 지르코니아를 가공한 절삭형 지르코니아 포스트 코어에 대한 연구는 많지 않은 실정이다. 이 연구의 목적은 CAD/CAM을 이용한 지르코니아를 비롯하여 근관치료된 치아에서 사용된 세 가지 다른 치아색 포스트 코어에 대해 미세누출 (microleakage)을 비교해 보는 것이다. 연구 재료 및 방법: 발치된 건전한 상악 절치 27개를 채택하여 백악법랑질경계 (CEJ)에서 절단하여 근관치료를 시행하고, 세군 (각 9개)으로 나누었다. 각군들은 화이버 포스트와 콤포짓트 레진 코어 (1군), 지르코니아 포스트와 열가압형 세라믹 코어 (2군), CAD/CAM 절삭형 지르코니아 포스트 코어 (3군)로 수복하였다. $5-55^{\circ}C$ 1000회 열순환 처리 (thermocycling)를 시행하고, 2% 메틸렌 블루로 $37^{\circ}C$에서 24시간 염색하였다. 치아장축과 평행하게 순설방향으로 절단하여 미세누출을 현미경과 컴퓨터 프로그램을 사용하여 분석을 하였다. 데이터는 one-way ANOVA와 Scheffe's multiple range test (${\alpha}=0.05$)로 분석하였다. 결과: 모든 군에서 미세누출을 보였으며, 지르코니아 포스트와 열가압형 세라믹 코어군 (2군)에서 치근계면 입구에서는 다소 많은 미세누출을 보였으나 포스트 끝에 이르러서는 거의 미세누출이 없는 결과를 보였다. 화이버 포스트와 콤포짓트 레진 코어군 (1군)과CAD/CAM 절삭형 지르코니아 포스트 코어군 (3군)에서는 부위별로 균등한 미세누출을 보였다. 결론: 화이버 포스트와 콤포짓트 레진 코어군, 지르코니아 포스트와 열가압형 세라믹 코어군, CAD/CAM 절삭형 지르코니아 포스트 코어군 모두에서 미세누출을 보였고, 이 중에서 지르코니아 포스트와 열가압형 세라믹 코어군이 좀 더 큰 미세누출에 대한 저항성을 보였으며 화이버 포스트와 콤포짓트 레진 코어군, CAD/CAM 절삭형 지르코니아 포스트 코어군은 유사한 양상을 보였으나, 각 실험군 간에 통계적으로 유의한 차이는 인정되지 않았다. (P>.05)

Statement of problem: At present, as the esthetic demands are on the increase, there are many ongoing studies for tooth-colored post and cores. Most of them are about fiber post and prefabricated zirconia post, but few about one-piece milled zirconia post and core using CAD/CAM (computer-aided design/computer-aided manufacturing) technique. Purpose: The objective of this study was to compare microleakage of endodontically treated teeth restored with three different tooth-colored post and cores. Material and methods: Extracted 27 human maxillary incisors were cut at the cementoenamel junction, and the teeth were endodontically treated. Teeth were divided into 3 groups (n=9); restored with fiber post and resin core, prefabricated zirconia post and heat-pressed ceramic core, and CAD/CAM milled zirconia post and core. After the preparation of post space, each post was cemented with dual-polymerized resin cement (Variolink II). Teeth were thermocycled for 1000 cycles between $5-55^{\circ}C$ and dyed in 2% methylene blue at $37^{\circ}C$ for 24 hours. Teeth were sectioned (bucco-lingual), kept the record of microleakage and then image-analyzed using a microscope and computer program. The data were analyzed by one-way ANOVA and Scheffe's multiple range test (${\alpha}=0.05$). Results: All groups showed microleakage and there were no significant differences among the groups (P>.05). Prefabricated zirconia post and heat-pressed ceramic core showed more leakage in dye penetration at the post-tooth margin, but there was little microleakage at the end of the post. Fiber post and resin core group and CAD/CAM milled zirconia post and core group indicated similar microleakage score in each stage. Conclusion: Prefabricated zirconia post and heat-pressed ceramic core group demonstrated better resistance to leakage, and fiber post and resin core group and CAD/CAM milled zirconia post and core group showed the similar patterns. The ANOVA test didn't indicate significant differences in microleakage among test groups. (P>.05)

키워드

참고문헌

  1. Heydecke G, Butz F, Hussein A, Strub JR. Fracture strength after dynamic loading of endodontically treated teeth restored with different post-and-core systems. J Prosthet Dent 2002;87:438-45. https://doi.org/10.1067/mpr.2002.123849
  2. Hudis SI, Goldstein GR. Restoration of endodontically treated teeth: a review of the literature. J Prosthet Dent 1986;55:33-8. https://doi.org/10.1016/0022-3913(86)90068-5
  3. Morgano SM, Milot P. Clinical success of cast metal posts and cores. J Prosthet Dent 1993;70:11-6. https://doi.org/10.1016/0022-3913(93)90030-R
  4. Shillingburg HT, Kessler JC. Restoration of the endodontically treated tooth. Chicago; Quintessence; 1982. pp.131- 45.
  5. Kwon TH, Hwang JW, Kim SH, Shin SW. Finite element analysis of the influence of esthetic posts on incisors. J Korean Acad Prosthodont 2003;41:582-95.
  6. King PA, Setchell DJ. An in vitro evaluation of a prototype CFRC prefabricated post developed for the restoration of pulpless teeth. J Oral Rehabil 1990;17:599-609 https://doi.org/10.1111/j.1365-2842.1990.tb01431.x
  7. Purton DG, Payne JA. Comparison of carbon fiber and stainless steel root canal posts. Quintessence Int 1996;27:93-7.
  8. Torbjorner A, Karlsson S, Syverud M, Hensten-Pettersen A. Carbon fiber reinforced root canal posts. Mechanical and cytotoxic properties. Eur J Oral Sci 1996;104:605-11. https://doi.org/10.1111/j.1600-0722.1996.tb00149.x
  9. Cales B, Stefani Y, Lilley E. Long-term in vivo and in vitro aging of a zirconia ceramic used in orthopaedy. J Biomed Mater Res 1994;28:619-24. https://doi.org/10.1002/jbm.820280512
  10. Zhang YX, Zhang WH, Lu ZY, Wang KL. Fracture strength of custom-fabricated Celay all-ceramic post and core restored endodontically treated teeth. Chin Med J 2006;119:1815-20.
  11. Dilmener FT, Sipahi C, Dalkiz M. Resistance of three new esthetic post-and-core systems to compressive loading. J Prosthet Dent 2006;95:130-6. https://doi.org/10.1016/j.prosdent.2005.11.013
  12. Friedel W, Kern M. Fracture strength of teeth restored with all-ceramic posts and cores. Quintessence Int 2006;37:289-95.
  13. Jung SH, Min KS, Chang HS, Park SD, Kwon SN, Bae JM. Microleakage and fracture patterns of teeth restored with different posts under dynamic loading. J Prosthet Dent 2007;98:270-6. https://doi.org/10.1016/S0022-3913(07)60100-0
  14. Streacker AB, Geissberger M. The milled ceramic post and core: A functional and esthetic alternative. J Prosthet Dent 2007;98:486-7. https://doi.org/10.1016/S0022-3913(07)60151-6
  15. Reid LC, Kazemi RB, Meiers JC. Effect of fatigue testing on core integrity and post microleakage of teeth restored with different post systems. J Endod 2003;29:125-31. https://doi.org/10.1097/00004770-200302000-00010
  16. Raygot CG, Chai J, Jameson DL. Fracture resistance and primary failure mode of endodontically treated teeth restored with a carbon fiber-reinforced resin post system in vitro. Int J Prosthodont 2001;14:141-5.
  17. Akkayan B. An in vitro study evaluating the effect of ferrule length on fracture resistance of endodontically treated teeth restored with fiber-reinforced and zirconia dowel systems. J Prosthet Dent 2004;92:155-62. https://doi.org/10.1016/j.prosdent.2004.04.027
  18. Demirel F, Saygili G, Sahmali S. Microleakage of endodontically treated teeth restored with prefabricated posts and tooth-colored restorative materials. Int J Periodontics Restorative Dent 2005;25:73-9.
  19. Toksavul S, Tu ¨rku ¨n M, Toman M. Esthetic enhancement of ceramic crowns with zirconia dowels and cores: a clinical report. J Prosthet Dent 2004;92:116-9. https://doi.org/10.1016/j.prosdent.2004.03.032
  20. Salameh Z, Sorrentino R, Ounsi HF, Goracci C, Tashkandi E, Tay FR, Ferrari M. Effect of different all-ceramic crown system on fracture resistance and failure pattern of endodontically treated maxillary premolars restored with and without glass fiber posts. J Endod 2007;33:848-51. https://doi.org/10.1016/j.joen.2007.01.017
  21. D’Arcangelo C, De Angelis F, Vadini M, Zazzeroni S, Ciampoli C, D’Amario M. In vitro fracture resistance and deflection of pulpless teeth restored with fiber posts and prepared for veneers. J Endod 2008;34:838-41. https://doi.org/10.1016/j.joen.2008.03.026
  22. Johnson JK, Sakumura JS. Dowel form and tensile force. J Prosthet Dent 1978;40:645-9. https://doi.org/10.1016/0022-3913(78)90063-X
  23. Zahran M, El-Mowafy O, Tam L, Watson PA, Finer Y. Fracture strength and fatigue resistance of all-ceramic molar crowns manufactured with CAD/CAM technology. J Prosthodont 2008;17:370-7. https://doi.org/10.1111/j.1532-849X.2008.00305.x
  24. Persson AS, Andersson M, Ode´n A, Sandborgh-Englund G. Computer aided analysis of digitized dental stone replicas by dental CAD/CAM technology. Dent Mater 2008;24:1123-30. https://doi.org/10.1016/j.dental.2008.01.008
  25. Bergman B, Lundquist P, Sjogren U, Sundquist G. Restorative and endodontic results after treatment with cast posts and cores. J Prosthet Dent 1989;61:10-5. https://doi.org/10.1016/0022-3913(89)90099-1
  26. Creugers NH, Mentink AG, Ka ¨yser AF. An analysis of durability data on post and core restorations. J Dent 1993;21:281-4. https://doi.org/10.1016/0300-5712(93)90108-3
  27. Isidor F, Odman P, BrØndum K. Intermittent loading of teeth restored using prefabricated carbon fiber posts. Int J Prosthodont 1996;9:131-6.
  28. Fredriksson M, Astb¨a ck J, Pamenius M, Arvidson K. A retrospective study of 236 patients with teeth restored by carbon fiber-reinforced epoxy resin posts. J Prosthet Dent 1998;80:151-7. https://doi.org/10.1016/S0022-3913(98)70103-9
  29. Chan RW, Bryant RW. Post-core foundations for endodontically treated posterior teeth. J Prosthet Dent 1982;48:401-6. https://doi.org/10.1016/0022-3913(82)90074-9
  30. Oliva RA, Lowe JA. Dimensional stability of composite used as a core material. J Prosthet Dent 1986;56:554-61. https://doi.org/10.1016/0022-3913(86)90421-X
  31. LLarsonTD, Jensen JR. Microleakage of composite resin and amalgam core material under complete cast crowns. J Prosthet Dent 1980;44:40-4. https://doi.org/10.1016/0022-3913(80)90044-X
  32. Kovarik RE, Breeding LC, Caughman WF. Fatigue life of three core materials under simulated chewing conditions. J Prosthet Dent 1992;68:584-90. https://doi.org/10.1016/0022-3913(92)90370-P
  33. Yun MJ, Lee SH, Yang JH. Effect of type and cementation method of post-core on microleakage. J Korean Acad Prosthodont 1994;32:225-33.
  34. Mixson JM, Eick JD, Moore DL, Tira DE. Effect of two dentin bonding agents on microleakage in two different cavity designs. J Prosthet Dent 1992;67:441-5. https://doi.org/10.1016/0022-3913(92)90069-M
  35. Crim GA. Influence of bonding agents and composites on microleakage. J Prosthet Dent 1989;61:571-4. https://doi.org/10.1016/0022-3913(89)90278-3
  36. Crim GA, Garcia-Godoy F. Microleakage: the effect of storage and cycling duration. J Prosthet Dent 1987;57:574-6. https://doi.org/10.1016/0022-3913(87)90339-8
  37. Sparrius O, Grossman ES. Marginal leakage of composite resin restorations in combination with dentinal and enamel bonding agents. J Prosthet Dent 1989;61:678-84. https://doi.org/10.1016/S0022-3913(89)80041-1
  38. Paek SH, Chang IT, Lee SH, Yang JH, Heo SJ. A study of core type and luting cements on complete cast crown retention. J Korean Acad Prosthodont 2000;38:169-77.
  39. Gregory WA, Griffiths L, Irwin G. Effects of intra-core mechanical interlocks and cement type on full crown retention. Am J Dent 1991;4:29-32.
  40. Hoag EP, Dwyer TG. A comparative evaluation of three post and core techniques. J Prosthet Dent 1982;47:177-81. https://doi.org/10.1016/0022-3913(82)90183-4
  41. Butz F, Lennon AM, Heydecke G, Strub JR. Survival rate and fracture strength of endodontically treated maxillary incisors with moderate defects restored with different postand- core systems: an in vitro study. Int J Prosthodont 2001;14:58-64.
  42. Heydecke G, Butz F, Strub JR. Fracture strength and survival rate of endodontically treated maxillary incisors with approximal cavities after restoration with different post and core systems: an in-vitro study. J Dent 2001;29:427-33. https://doi.org/10.1016/S0300-5712(01)00038-0