인접면 초기 우식 병소의 깊이에 따른 therapeutic sealing의 유효성 평가

EVALUATION OF THE EFFECTIVENESS OF THERAPEUTIC SEALING ACCORDING TO THE LESION DEPTHS OF PROXIMAL EARLY CARIES

  • 이금랑 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 안명기 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 정태성 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 김신 (부산대학교 치의학전문대학원 소아치과학교실)
  • Lee, Geum-Lang (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Ahn, Myung-Ki (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)
  • 발행 : 2009.08.31

초록

인접면 초기 우식병소에 대하여 레진 접착제를 도포하는 최소 침습적 개념의 therapeutic sealing은 치질 삭제가 불필요하다는 점에서 의미있는 술식으로 인정된다. 그러나 이 방법이 초기 우식병소의 법랑질 내 침투 깊이와 무관하게 여전히 유효할 것인지에 대해 의문이 들어 이번 연구는 그 유효성을 평가해 보기 위해 시도되었다. 인접면에 초기 우식병소를 보이는 발거된 소구치 21개를 대상으로 하고, micro-CT 촬영을 통해 병소의 깊이에 따라 분류하였다. 전체 시편을 병소가 법랑질 외층에 국한된 시편의 표면 절반에 접착제를 도포한 1군과 하지 않은 2군, 병소가 법랑질 내층까지 진행된 시편의 표면 절반에 접착제를 도포한 3군과 하지 않은 4군, 비와동성 초기 병소가 법랑-상아 경계까지 진행된 시편의 표면 절반에 접착제를 도포한 5군과 하지 않은 6군으로 분류하였다. 열순환 후 2주간 인공 우식을 유발하고 분류과정과 동일한 평면을 찾아 micro-CT를 촬영하고 병소의 방사선 밀도 변화를 관찰하여 다음과 같은 결과를 얻었다. 1. 인접면 초기 우식병소의 침투 깊이가 증가할수록 병소 본체의 방사선 밀도는 낮아지는 것이 관찰되었다. 2. 병소의 깊이에 무관하게, 레진 접착제를 도포한 모든 실험군에서 처리하지 않은 대조군에 비하여 인공 우식 처리 전후의 방사선 밀도 변화 가 작게 나타났다(p<0.05). 3. 병소가 법랑-상아 경계에 도달한 5군에서도 레진 접착제를 도포하고 인공 우식 처리시, 실험 전후의 유의한 방사선 밀도 변화가 나타나지 않았다(p<0.05).

As the minimally invasive approach against white spot like early caries lesions in proximal surfaces of the teeth, therapeutic sealing has been introduced and studied for effective materials and methods to arrest the early caries lesion effectively, which is still going on. This study was performed for the purpose of evaluating its validity for the non-cavitated lesions according to the depth from surface using therapeutic sealing followed by artificial caries induction and evaluation with micro-CT, and we obtained the results as follows. 1. It was revealed that the deeper the caries lesions are, the lower radiation intensity at lesion body areas in pre-treatment specimen. 2. In the sealed groups, there were no differences in radiation intensity between pre- and post-treatment, whereas there were significant decreases in unsealed groups(p<0.05). 3. Even in the specimens with the lesions reaching deeply into DEJ, the effect of sealing was significant(p<0.05). Conclusively, it was thought therapeutic sealing can be an effective tool against the early caries lesions, regardless of their depth into tooth, unless cavitated.

키워드

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