DOI QR코드

DOI QR Code

불소 바니쉬 도포 후 초기 치근 우식 발현에 대한 정량원소분석

Elemental analysis of the fluoride varnish effects on root caries initiation

  • 박세은 (서울대학교 치의학전문대학원 치과보존학교실) ;
  • 이기욱 (한국기초과학지원연구원) ;
  • 김혜영 (고려대학교 보건대학) ;
  • 손호현 (서울대학교 치의학전문대학원 치과보존학교실) ;
  • 장주혜 (서울대학교 치과병원)
  • Park, Se-Eun (Department of Conservative Dentistry, Seoul National University School of Dentistry and Dental Research Institute) ;
  • Yi, Kee-Wook (Geochronology Team, Korea Basic Science Institute) ;
  • Kim, Hae-Young (Department of Dental Laboratory Science and Engineering, Korea University College of Health Science) ;
  • Son, Ho-Hyun (Department of Conservative Dentistry, Seoul National University School of Dentistry and Dental Research Institute) ;
  • Chang, Ju-Hea (Clinic for Persons with Disabilities, Seoul National University Dental Hospital, Dental Research Institute, Seoul National University School of Dentistry)
  • 투고 : 2011.04.16
  • 심사 : 2011.06.17
  • 발행 : 2011.07.29

초록

연구 목적: 우식 저 위험군에서 저 농도 불소 바니쉬가 초기 치근 우식 예방 및 치료에 미치는 영향을 검증하고자 한다. 연구 재료 및 방법: 건전한 하악 소구치 10개를 준비하여 치관부를 제거하고 협설, 근원심 방향으로 치아 장축에 평행하게 절단 후 백악-법랑질 경계부 4 mm 하방에서 절단하여 40개의 시편을 제작하였다. 각각의 치근 표면에 형성된 4 mm ${\times}$ 1 mm 크기의 창에 Fluor Protector (1,000 ppm 불소 함유)를 도포하였다. 한 치아에서 나온 4 개의 시편을 다음과 같은 4개 실험군에 각각 배정하였다. A군: pH cycling 없이 불소 바니쉬 도포; B군: pH cycling시행 후 불소 바니쉬 도포; C군: 불소 바니쉬 도포 후 pH cycling시행; D군: pH cycling을 시행한 뒤 불소 바니쉬 도포 후 pH cycling 재 시행. 시편을 정중부에서 절단하고 단면 부위를 연마한 뒤 전자현미경으로 표면을 관찰하였다. X선 분광분석을 통하여 Ca과 P의 중량 비를 측정하고 공 초점 레이저 현미경으로 바니쉬가 도포된 치근 면을 관찰하였다. 결과: 치근 표면에는 평균 12.3 (2.6) ${\mu}m$ (single cycling) 과 19.6 (3.8) ${\mu}m$ (double cycling) 깊이의 우식이 형성되었다. 표층의 칼슘 함량은 정상 치근에 비해 유의할만한 차이가 없었으나(p > 0.05), 표층 하 탈회 영역의 칼슘 함량은 유의할만하게 감소하였다(p < 0.05). 불소 바니쉬의 적용은 건전한 치근이나 초기 우식이 있는 치근에 적용했을 경우 모두에서 유의할만한 차이를 가져오지 않았다(p > 0.05). 바니쉬의 치근 상아질 투과 깊이는 표면 15 ${\mu}m$ 이내에 한정되었다. 결론: 표층이 건전한 20 ${\mu}m$ 이내의 초기 치근 우식 병소의 양상과 산 공격에 대한 변화를 관찰한 결과, 저 농도의 불소 바니쉬를 단기간 적용하는 것은 치근의 탈회 반응에 영향을 주지 못하였다.

Objectives: The usage of fluoride varnish for a moderate to low caries-risk group has not been well validated. This study aimed to evaluate the preventive and therapeutic efficacies of fluoride varnish on the initiated root caries. Materials and Methods: Ten premolars were sectioned into quarters, further divided into two windows, one of which was painted with Fluor Protector (1,000 ppm fluoride, Ivoclar Vivadent). An initial lesion with a well-preserved surface layer was produced by pH cycling. Scanned line analysis using energy dispersive spectrometry determined the weight percentages of Ca and P in the demineralized layer. Scanning Electron microscopy and confocal laser scanning microscopy (CLSM) evaluated the varnish-applied root surfaces. Results: The mean lesion depth (SD) was 12.3 (2.6) ${\mu}m$ (single cycling) and 19.6 (3.8) ${\mu}m$ (double cycling). Double cycling extended the lesion depth, but induced no more mineral loss than single cycling (p < 0.05). The mean weight percentages of Ca and P between groups with and without varnish were not significantly different (p < 0.05). A CLSM showed varnish remained within 15 ${\mu}m$ of the surface layer. Conclusions: When a mild acid challenge initiated root tissue demineralization, the application of low-concentration fluoride varnish did not influence the lesion depth or the mineral composition of the subsurface lesion.

키워드

참고문헌

  1. Heijnsbroek M, Paraskevas S, Van der Weijden GA. Fluoride interventions for root caries: a review. Oral Health Prev Dent 2007;5:145-152.
  2. Hoppenbrouwers PM, Driessens FC, Borggreven JM. The mineral solubility of human tooth roots. Arch Oral Biol 1987;32:319-322. https://doi.org/10.1016/0003-9969(87)90085-9
  3. Beltran-Aguilar ED, Goldstein JW, Lockwood SA. Fluoride varnishes. A review of their clinical use, cariostatic mechanism, efficacy and safety. J Am Dent Assoc 2000;131:589-596. https://doi.org/10.14219/jada.archive.2000.0232
  4. Strohmenger L, Brambilla E. The use of fluoride varnishes in the prevention of dental caries: a short review. Oral Dis 2001;7:71-80. https://doi.org/10.1034/j.1601-0825.2001.70202.x
  5. Petersson LG, Twetman S, Dahlgren H, Norlund A, Holm AK, Nordenram G, Lagerlof F, Soder B, Kallestal C, Mejare I, Axelsson S, Lingstrom P. Professional fluoride varnish treatment for caries control: a systematic review of clinical trials. Acta Odontol Scand 2004;62:170-176. https://doi.org/10.1080/00016350410006392
  6. Weintraub JA. Fluoride varnish for caries prevention: comparisons with other preventive agents and recommendations for a community-based protocol. Spec Care Dentist 2003;23:180-186. https://doi.org/10.1111/j.1754-4505.2003.tb00309.x
  7. Damen JJ, Buijs MJ, ten Cate JM. Fluoride-dependent formation of mineralized layers in bovine dentin during demineralization in vitro. Caries Res 1998;32:435-440. https://doi.org/10.1159/000016484
  8. Herkstroter FM, Witjes M, Arends J. Demineralization of human dentine compared with enamel in a pH-cycling apparatus with a constant composition during de- and remineralization periods. Caries Res 1991;25:317-322. https://doi.org/10.1159/000261385
  9. Ettinger RL, Olson RJ, Wefel JS, Asmussen C. In vitro evaluation of topical fluorides for overdenture abutments. J Prosthet Dent 1997;78:309-314. https://doi.org/10.1016/S0022-3913(97)70031-3
  10. Hong L, Watkins CA, Ettinger RL, Wefel JS. Effect of topical fluoride and fluoride varnish on in vitro root surface lesions. Am J Dent 2005;18:182-187.
  11. Ole Fejerskov EK, Edwina Kidd, Benten Yvad, and Vibeke Baelum. Dental caries: the disease and its clinical management. 2nd ed. Oxford, UK: Wiley-Blackwell; 2008.
  12. Arnold WH, Cerman M, Neuhaus K, Gaengler P. Volumetric assessment and quantitative element analysis of the effect of fluoridated milk on enamel demineralization. Arch Oral Biol 2003;48:467-473. https://doi.org/10.1016/S0003-9969(03)00087-6
  13. Rehder Neto FC, Maeda FA, Turssi CP, Serra MC. Potential agents to control enamel caries-like lesions. J Dent 2009;37:786-790. https://doi.org/10.1016/j.jdent.2009.06.008
  14. Hara AT, Queiroz CS, Freitas PM, Giannini M, Serra MC, Cury JA. Fluoride release and secondary caries inhibition by adhesive systems on root dentine. Eur J Oral Sci 2005;113:245-250. https://doi.org/10.1111/j.1600-0722.2005.00214.x
  15. Kawasaki K, Ruben J, Tsuda H, Huysmans MC, Takagi O. Relationship between mineral distributions in dentine lesions and subsequent remineralization in vitro. Caries Res 2000;34:395-403. https://doi.org/10.1159/000016614
  16. Rex T, Kharbanda OP, Petocz P, Darendeliler MA. Physical properties of root cementum: Part 4. Quantitative analysis of the mineral composition of human premolar cementum. Am J Orthod Dentofacial Orthop 2005;127:177-185. https://doi.org/10.1016/j.ajodo.2003.12.022
  17. Lee C, Darling CL, Fried D. Polarization-sensitive optical coherence tomographic imaging of artificial demineralization on exposed surfaces of tooth roots. Dent Mater 2009;25:721-728. https://doi.org/10.1016/j.dental.2008.11.014
  18. Arends J, Christoffersen J. Nature and role of loosely bound fluoride in dental caries. J Dent Res 1990;69 Spec No:601-5;discussion 634-636. https://doi.org/10.1177/00220345900690S118
  19. Wefel JS. Root caries histopathology and chemistry. Am J Dent 1994; 7:261-265.
  20. Smith PW, Preston KP, Higham SM. Development of an in situ root caries model. A. In vitro investigations. J Dent 2005;33:253-267. https://doi.org/10.1016/j.jdent.2004.10.020
  21. Arends J, Duschner H, Ruben JL. Penetration of varnishes into demineralized root dentine in vitro. Caries Res 1997;31:201-205. https://doi.org/10.1159/000262399
  22. Monticelli F, Osorio R, Tay FR, Sadek FT, Ferrari M, Toledano M. Resistance to thermo-mechanical stress of different coupling agents used as intermediate layer in resin-fiber post bonds. Am J Dent 2007;20:416-420.
  23. Scholtanus JD, Schuthof J, Arends J. Influence of fluoridating varnishes on dentine in vitro. Caries Res 1986;20:65-70. https://doi.org/10.1159/000260921

피인용 문헌

  1. The combined occluding effect of sodium fluoride varnish and Nd:YAG laser irradiation on dentinal tubules-A CLSM and SEM study vol.38, pp.6, 2016, https://doi.org/10.1002/sca.21309
  2. studies: an evaluation of experimental protocols vol.39, pp.3, 2014, https://doi.org/10.5395/rde.2014.39.3.164
  3. Evaluation of release of fluoride from dental varnishes marketed in Korea vol.38, pp.3, 2014, https://doi.org/10.11149/jkaoh.2014.38.3.131