Journal of the korean academy of Pediatric Dentistry (대한소아치과학회지)

Korean Academy of Pediatric Dentistry (대한소아치과학회)
권호 표지

A STUDY OF MICROLEAKAGE AND PENETRATION ABILITY OF A PIT AND FISSURE SEALANT APPLIED ON CARIOUS FISSURES

우식성 열구에 적용한 치면열구전색제의 미세누출과 침투도에 관한 연구

  • Im, El (Department of Pediatric Dentistry, School of Dentistry, Chosun University) ;
  • Lee, Sang-Ho (Department of Pediatric Dentistry, School of Dentistry, Chosun University) ;
  • Lee, Nan-Young (Department of Pediatric Dentistry, School of Dentistry, Chosun University)
  • 임엘 (조선대학교 치과대학 소아치과학교실) ;
  • 이상호 (조선대학교 치과대학 소아치과학교실) ;
  • 이난영 (조선대학교 치과대학 소아치과학교실)
  • Received : 2010.05.18
  • Accepted : 2010.08.08
  • Published : 2010.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

The purpose of this study is to compare microleakage and penetration depths of sealants applied in carious and sound fissures. Extracted premolars(n=80) were divided into 4 groups according to caries status. 1; sound, 2; stained, 3; initial caries, 4; enamel caries. Sealants were applied to the occlusal groove as per manufacturers' instructions, and specimens were thermocycled, stained, sectioned, and examined for microleakage and penetration ability. The results of the present study are as follow: 1. It showed significantly higher microleakage scores in group I than group Two, Three, Four(p<0.05), but no significant difference was found between group Two, Three, and IV(p>0.05). 2. It showed significantly higher penetration scores in group Four (p<0.05), followed by group One, Two, Three, but no significant difference was found between group One, Two, and Three(p>0.05). Based on the results of present study, when the borders of the fissure sealant are on carious enamel, a significantly higher microleakage must be expected. It is considered that depth of enamel caries in the fissure should be taken into account when applying a fissure sealant.

본 연구에서는 교합면 열구우식에 대한 진단학적 기준을 기존의 시각에만 의존하지 않고 레이저형광을 이용한 광학적 우식진단법을 추가로 도입하여 우식의 상태를 건전, 착색, 초기 우식, 법랑질 우식의 4가지 단계로 세부 분류하여 치면열구전색제를 도포하고 미세누출과 침투도를 조사함으로써 치면열구전색제의 적용 기준에 대한 임상적 지침을 마련하고자 하였다. 시진과 탐침으로 검사하여 충전물, 파절, 표면 결함이 없고, 방사선사진을 통해 상아질 우식증이 존재하지 않는 영구 소구치 80개를 실험대상으로 사용하였다. 교합면 우식성 열구에 치면열구전색이 가능한지 여부를 평가하기 위해 시진 및 탐침, 그리고 레이저형광을 이용한 치아우식증 진단기기인 DIAGNOdent$^{(R)}$ (Kavo, Biberach, Germany)를 사용하여 교합면 열구의 상태를 건전, 착색, 초기우식, 법랑질우식의 4가지 단계로 분류하였다. 제조회사의 지시대로 치면열구전색을 시행한 후 전색제의 미세누출과 침투도를 비교 평가한 결과는 다음과 같았다. 1. 법랑질우식인 제Four군에서 미세누출이 가장 크게 나타났으며, 건전, 착색, 초기우식군인 제I군, II군, III군과 비교했을 때 통계학적 유의차를 나타냈다(p<0.05). 2. 치면열구전색제의 침투도가 가장 높은 제I군은 제II군, III군, IV군과 비교했을 때 통계학적 유의차를 나타냈고(p<0.05), I군>II군>III군>IV군 순으로 침투도가 감소하였으나 통계학적 유의차는 없었다(p>0.05). 이상의 결과를 종합하여 볼 때, 열구가 착색된 경우나 초기우식이 있는 경우에도 치면열구전색이 가능하나 임상적으로 탐침을 통해 감지할 수 있을 정도의 법랑질 우식 열구는 치면열구전색을 시행할 경우 이차우식과 같은 부작용을 초래할 수 있음을 예상할 수 있다.

Keywords

References

  1. Eriksen HM : Has caries merely been postponed? Acta Odontol Scand, 56:173-175, 1998. https://doi.org/10.1080/000163598422938
  2. Marthaler TM, O'Mullane DM, Vrbic V : The prevalence of dental caries in Europe. Update 1990-1995. ORCA Saturday Afternoon Symposium, 30:237-255, 1995.
  3. Cueto EI, Buonocore MG : Sealing of pits and fissures with an adhesive resin: its use in caries prevention. J Am Dent Assoc, 75:121-128, 1967.
  4. Gwinnett AJ, Ripa LW : Penetration of pit and fissure sealants into conditioned human enamel in vivo. Arch Oral Biol, 18:435-439, 1973. https://doi.org/10.1016/0003-9969(73)90168-4
  5. Handelman SL, Buonocore MG, Heseck DJ : A preliminary report on the effect of fissure sealant on bacteria in dental caries. J Prosthet Dent, 27: 390-392, 1972. https://doi.org/10.1016/0022-3913(72)90287-9
  6. Welbury R, Raadal M, Lygidakis NA : European academy of paediatric dentisrty EAPD guidelines for the use of pit and fissure sealants. Eur J Paediatr Dent, 5:179-184, 2004.
  7. Feigal JF, Donly KJ : The use of pit and fissure sealants. Pediatr Dent, 28:143-150, 2006.
  8. Mertz-Fairhurst EJ, Schuster GS, Fairhurst CW : Arresting caries by sealants: results of a clinical study. J Am Dent Assoc, 112:194-197, 1986.
  9. Handelman SL, Leverett DH, Espeland M, Curzon J : Retention of sealants over carious and sound tooth surfaces. Community Dent Oral Epidemiol, 15:1-5, 1987. https://doi.org/10.1111/j.1600-0528.1987.tb00470.x
  10. Kervanto-Seppa S, Pietila I, Meurman JH, et al. : Pit and fissure sealants in dental public health - application criteria and general policy in Finland. BMC Oral Health, 9:5-15, 2009. https://doi.org/10.1186/1472-6831-9-5
  11. Beauchamp JB, Caufield PW, Crall JJ, et al. : Evidencebased clinical recomendations for the use of pit and fissure sealants. J Am Dent Assoc, 139: 257-268, 2008.
  12. Celiberti P, Lussi : Penetration ability and microleakage of a fissure sealant applied on artificial and natural enamel fissure caries. J Dent, 35:59-67, 2007. https://doi.org/10.1016/j.jdent.2006.04.007
  13. Hevinga MA, et al. : Microleakage and sealant penetration in contaminated carious fissures. J Dent, 35:909-914, 2007. https://doi.org/10.1016/j.jdent.2007.09.001
  14. Fejerskov O, Kidd EAM : Dental caries: the disease and its clinical management. Oxford: Blackwell Munksgaard, 2003.
  15. Kidd EAM : How 'clean' must a cavity be before restoration? Caries Res, 38:305-313, 2004. https://doi.org/10.1159/000077770
  16. Feldens EG, Feldens CA, de Araujo FB, et al.: Invasive technique of pit and fissure sealants in primary molars: a SEM study. J Clin Peiatr Dent, 18: 187-190, 1994.
  17. Creanor SL, et al. : The prevalence of clinically undetected occlusal caries in Scottish adolescents. Br Dent J, 169:126-129, 1990. https://doi.org/10.1038/sj.bdj.4807295
  18. Lussi A : Comparison of different methods for the diagnosis of fissure caries without cavitation. Caries Res, 27:409-416, 1993. https://doi.org/10.1159/000261572
  19. Lussi A, et al. : Performance and reproducibility of a laser fluorescence system for detection of occlusal caries in vitro. Caries Res, 33:261-266, 1999. https://doi.org/10.1159/000016527
  20. Heinlich-Weltzien R, et al. : Comparison of different DIAGNO-dent cut-off limits for in vivo detection of occlusal caries. Oper Dent, 28:672-680, 2003.
  21. Anttonen V, Seppa L, Hausen H : Clinical study of the use of the lase fluorescence device DIAGNOdent for detection of occlusal caries in children. Caries Res, 37:17-23, 2003. https://doi.org/10.1159/000068227
  22. Khalife MA, et al. : In vivo evaluation of DIAGN Odent for the quantification of occlusal dental caries. Oper Dent, 34:136-141, 2009. https://doi.org/10.2341/08-54
  23. Krause F, Jepsen S, Braun A : Comparision of two laser fluorescence devices for the detection of occlusal caries in vivo. Eur J Oral Sci, 115: 252-256, 2007. https://doi.org/10.1111/j.1600-0722.2007.00456.x
  24. Lussi A, Reich E : The influence of tooth pastes and prophylaxis pastes on fluorescence measurements for caries detection in vitro. Eur J Oral Sci, 113: 39-48, 2005.
  25. Wendt SL, McInnes PM, Dickinson GL : The effect of thermocycling in microleakage analysis. Dent Mater, 8:181-184, 1992. https://doi.org/10.1016/0109-5641(92)90079-R
  26. 구현정, 이상훈, 한세현 : 예방적 레진수복의 미세누출에 관한 연구. 대한소아치과학회지, 28:504-511, 2001.
  27. Geiger SB, Gulayev S, Weiss EI : Improving fissure quality: mechanical preparation and filling level. J Dent, 28:407-412, 2000. https://doi.org/10.1016/S0300-5712(00)00016-6
  28. Borem LM, Feigal RJ : Reducing microleakage of sealants under salivary contamination: digital-image analysis evaluation. Quintessence Int, 25:283-289, 1994.
  29. Gale MS, Darvell BW : Thermal cycling procedures for laboratory testing of dental restorations. J Dent, 27:89-99, 1999. https://doi.org/10.1016/S0300-5712(98)00037-2
  30. Munksgaard EC, Itoh K, Jorgensen KD : Dentin-polymer bond in resin fillings tested in vitro by thermo- and load-cycling. J Dent Res, 64:144- 146, 1985. https://doi.org/10.1177/00220345850640021001
  31. Taylor MJ, Lynch E : Microleakage. J Dent, 20:3-10, 1992. https://doi.org/10.1016/0300-5712(92)90002-T
  32. 이상호 : 치면열구전색의 유지력. 대한소아치과학회지, 33:336-346, 2006.
  33. Handelman SL, Buonocore MG, Schoute PC : Progress report on the effect of a fissure sealant on bacteria in dental caries. JADA, 87:1189-1191, 1973.
  34. Going RE, Loesche WJ, Grainger DA, Syed SA : The viability of microorganisms in carious lesions five years after covering with a fissure sealant. J Am Dent Assoc, 97:455-462, 1998.
  35. Theilade E, Fejerskov O, Migasena K, Prachyabrued W : Effect of fissure sealing on the microflora in occlusal fissures of human teeth. Arch Oral Biol, 22:251-259, 1977. https://doi.org/10.1016/0003-9969(77)90110-8
  36. Mass E, Eli I, Lev-Dor-Samovici B, Weiss EI : Continuous effect of pit and fissure sealing on S. mutans presence in situ. Pediatr Dent, 21:164-168, 1999.
  37. Carlsson A, et al. : Pit and fissure sealing and mutans streptococci level in saliva. Am J Dent. 5: 280-282, 1992.
  38. Mjor IA : Clinical diagnosis of recurrent caries., 135:1426-1433, 2005.
  39. Kidd EA, Joyston-Bechal S, Beighton D : Marginal ditching and staining as a predictor of secondary caries around amalgam restorations: a clinical and microbiological study. J Dent Res, 74:1206-1211, 1995. https://doi.org/10.1177/00220345950740051001