Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
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HISTOLOGIC FEATURE AND INFILTRATION OF ADHESIVE RESIN ACCORDING TO PRETREATMENT ON PROXIMAL EARLY CARIES LESION

평활면 초기 우식병소의 표면처리에 따른 조직상 및 접착제의 침투 양상 비교

  • Kim, In-Young (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Jeong, Tae-Sung (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Kim, Shin (Department of Pediatric Dentistry, School of Dentistry, Pusan National University)
  • 김인영 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 정태성 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 김신 (부산대학교 치의학전문대학원 소아치과학교실)
  • Published : 2009.02.27
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Abstract

Early enamel caries is commonly remineralized by the patient‘s improved oral hygiene or fluoridation, however the result is clinically unreliable. As an alternative, we tried to seal the lesions with low-viscosity light-curing resin. The aim of the present study was to search the proper methods of the adequate pretreatment prior to applying adhesive resin on natural proximal caries lesions. Thirty nine extracted deciduous molar teeth showing proximal early caries lesion were used for this study. They were divided into 5 groups : Group 1; only carefully cleaned with water, group 2; etched with 15% HCl for 15s, group 3; etched with 35% phosphoric acid for 15s, group 4; etched with 35% phosphoric acid for 30s, and group 5; cleaned with 0.5% NaOCl. Following results were obtained by evaluating with SEM and CLSM after applied with adhesive resin. 1. As a result of SEM evaluation, group 2 showed clearly removed surface layer, group 3,4 showed partially removed surface layer irregularly, group 5 showed slightly removed surface layer. 2. Group 2 showed the deepest infiltration depth, followed by group 4, group 3, group 5, group 1 and besides group 5, other groups showed significantly deep infiltration depth. (p < 0.01) In conclusion, the best methods of the adequate pretreatment on natural proximal caries lesion for deep infiltration of adhesive resin was to etch with 15% HCl for 15s.

초기 법랑질 우식은 환자의 구강 위생 증진 및 국소적 불소 도포를 통해 재광화가 가능하나 이는 환자의 협조도에 전적으로 의존하게 되어 있어 임상적 효과를 확신하기 힘들다. 그 대안으로 병소 진행의 보다 초기 단계에 병소의 미세 다공구조를 광중합 레진으로 전색하는 시도가 행해져 오고 있다. 그러나 법랑질 초기 우식의 표층은 병소 본체에 비해 상대적으로 낮은 세공 용적으로 인하여 접착레진의 침투를 방해할 수 있다. 따라서 적절한 표면 처리를 통한 표층의 일부 혹은 전체의 제거가 접착레진의 침투에 중요하다. 그러나 아직까지 자연적인 법랑질 초기 우식 병소의 표면 처리에 관한 연구는 부족한 실정이다. 이에 본 연구에서는 평활면 법랑질 초기 우식에 대한 접착레진 적용 전 적절한 표면 처리 방법을 알아보고자 시행되었다. 인접면에 법랑질 초기 우식을 보이는 39개의 발거된 유구치를 각기 다른 방법의 표면처리를 시행한 바, 수세만 시행한 대조군인 1군, 15초간 15% 염산 처리한 2군, 15초간 35% 인산 처리한 3군, 30초간 35% 인산 처리한 4군, 0.5% 차아염소산나트륨으로 세척한 5군의 5개 군으로 이루어졌다. 각 군당 3개의 치아는 주사전자현미경으로 관찰하고, 나머지 24개에는 접착레진을 도포하고 그 절단 시편을 공초점 레이저 주사현미경으로 관찰하여 다음과 같은 결론을 얻었다. 1. 주사전자현미경 관찰 결과, 2군에서 가장 명백한 표층 제거가 관찰되었고, 3군과 4군에서는 일부 불규칙적인 표층 제거, 5군에서는 미약한 표층 제거가 나타났다. 2. 각 군의 평균 침투 깊이는 $6.85{\sim}23.09{\mu}m$로 측정되었으며, 침투 깊이의 군간 비교에서는 2군에서 가장 크게, 이어 4군, 3군, 5군, 1군의 순이었으며, 5군을 제외한 모든 실험군에서는 대조군에 비해 크게 나타났다. (p<0.01)

Keywords

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