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Resin infiltration을 시행한 법랑질 초기 우식 병소의 특성

THE CHARACTERISTICS OF RESIN INFILTRATED INCIPIENT CARIOUS LESIONS

  • 김은영 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 권민석 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 김신 (부산대학교 치의학전문대학원 소아치과학교실) ;
  • 정태성 (부산대학교 치의학전문대학원 소아치과학교실)
  • Kim, Eun-Young (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Kwon, Min-Seok (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Kim, Shin (Department of Pediatric Dentistry, School of Dentistry, Pusan National University) ;
  • Jeong, Tae-Sung (Department of Pediatric Dentistry, School of Dentistry, Pusan National University)
  • 투고 : 2011.08.20
  • 심사 : 2012.01.10
  • 발행 : 2012.02.29

초록

본 연구는 infiltrant resin을 침투시킨 초기 우식 병소의 특성을 평가하기 위해 법랑질의 깊이에 따른 경도를 측정하고, 병소 내로의 레진 침투양상을 분석하며, 미세누출 정도를 관찰하여 다음의 결과를 얻었다. 건전 법랑질에 대한 초기 우식 법랑질의 경도 백분율은 표층(5~40 ${\mu}m$) 64.6%, 병소본체(60~350 ${\mu}m$) 24.6%였으며, infiltrant resin을 침투시킨 병소의 경도 백분율은 72.1%로 나타났다. 5~350 ${\mu}m$의 전 깊이에서, infiltrant resin을 침투시킨 병소는 비처치 우식 병소보다 경도가 유의하게 높았지만 정상 법랑질에 비해서는 경도가 유의하게 낮았다(p<0.05). FESEM 관찰 결과 탈회된 법랑질 내부로 비교적 균일하게 침투한 레진 테그가 관찰되었으며, 침투깊이는 433 ${\mu}m$(282-501)로 측정되었다. 열순환 처리 후 13개의 치아에서 미세누출이 관찰되지 않았고, 5개에서 병소 외측 절반, 2개에서 병소 내측 절반까지 미세누출이 관찰되었다.

The concept of resin infiltration which was born in an innovative philosophy to arrest the incipient caries. However, the structural changes of resin infiltrated lesions have not yet explained completely. The liquid resin might contribute not only to maximizing the penetration but to deteriorating physical stability. This study was performed to examine some physical and histological features of resin infiltrated incipient carious lesions. With the specimen of resin infiltrated lesions, microhardness by nanoindentation in depth profile, morphology of resin tags were revealed after HCl dissolution, and degree of microleakage were assessed. The percentage of microhardness of surface layer and lesion body of untreated specimen to sound enamel was 64.6% and 24.6% respectively, while that of resin-infiltrated lesions was 72.1%, showing significant difference (p<0.05). The resin tags observed under SEM had relatively homogeneous length of 433(282~501) ${\mu}m$ on the average. Among 20 specimens for microleakage assessment, 13 specimens showed no leakage while 5 and 2 showed leakage into outer and inner half of lesion respectively. It was thought the infiltrant resin penetrates deeply and homogeneously into lesion body and improves its hardness with relatively good physical stability.

키워드

참고문헌

  1. Paris S, Meyer-Lueckel H, Kielbassa AM : Resin infiltration of natural caries lesions. J Dent Res, 86:662-666, 2007. https://doi.org/10.1177/154405910708600715
  2. Meyer-Lueckel H, Paris S : Progression of artificial enamel caries lesions after infiltration with experimental light curing resins. Caries Res, 42:117-124, 2008. https://doi.org/10.1159/000118631
  3. Ekstrand KR, Bakhshandeh A, Martignon S : Treatment of proximal superficial caries lesions on primary molar teeth with resin infiltration and fluoride varnish versus fluoride varnish only: efficacy after 1 year. Caries Res, 44:41-46, 2010. https://doi.org/10.1159/000275573
  4. 김민정, 이동수, 김신 등 : 초기 우식 병소의 표층 처리에 따른 Resin infiltration의 우식 저지 능력 평가. 대한소아치과학회지, 37:412-421, 2010.
  5. Paris S, Hopfenmuller W, Meyer-Lueckel H : Resin infiltration of caries lesions: an efficacy randomized trial. J Dent Res, 89:823-826, 2010. https://doi.org/10.1177/0022034510369289
  6. Paris S, Meyer-Lueckel H : Inhibition of caries progression by resin infiltration in situ. Caries Res, 44:47-54, 2010. https://doi.org/10.1159/000275917
  7. Kielbassa AM, Muller J, Gernhardt CR : Closing the gap between oral hygiene and minimally invasive dentistry: a review on the resin infiltration technique of incipient (proximal) enamel lesions. Quintessence Int, 40:663-681, 2009.
  8. Phark JH, Duarte S Jr, Meyer-Lueckel H, et al. : Caries infiltration with resins: a novel treatment option for interproximal caries. Compend Contin Educ Dent, 30:13-17, 2009.
  9. Duckworth RM : The Teeth and Their Environment. Karger, Basel, 105-131, 2006.
  10. Kugel G, Arsenault P, Papas A : Treatment modalities for caries management, including a new resin infiltration system. Compend Contin Educ Dent, 30:1-10, 2009.
  11. Qvist V : Resin restorations: leakage, bacteria, pulp. Endod Dent Traumatol, 9:127-152 1993. https://doi.org/10.1111/j.1600-9657.1993.tb00265.x
  12. Wiegand A, Stawarczyk B, Kolakovic M, et al. : Adhesive performance of a caries infiltrant on sound and demineralised enamel. J Dent, 39:117-121, 2011. https://doi.org/10.1016/j.jdent.2010.10.010
  13. Yoshikawa T, Burrow MF, Tagami J : A light curing method for improving marginal sealing and cavity wall adaptation of resin composite restorations. Dent Mater, 17:359-366, 2001. https://doi.org/10.1016/S0109-5641(00)00095-6
  14. Coy HD : Direct resin fillings. J Am Dent Assoc, 47:532-537, 1953. https://doi.org/10.14219/jada.archive.1953.0212
  15. Meyer-Lueckel H, Paris S : Improved resin infiltration of natural caries lesions. J Dent Res, 87:1112- 1116, 2008. https://doi.org/10.1177/154405910808701201
  16. Chaitra TR, Subba Reddy VV, Devarasa GM, et al. : Flowable resin used as a sealant in molars using conventional, enameloplasty and fissurotomy techniques: an in vitro study. J Indian Soc Pedod Prev Dent, 28:145-150, 2010. https://doi.org/10.4103/0970-4388.73786
  17. Meyer-Lueckel H, Paris S, Kielbassa AM : Surface layer erosion of natural caries lesions with phosphoric and hydrochloric acid gels in preparation for resin infiltration. Caries Res, 41:223-230, 2007. https://doi.org/10.1159/000099323
  18. Pitts N :" ICDAS"-an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management. Community Dent Health, 21:193-198, 2004.
  19. Oliver WC, Pharr GM : Improved technique for determining hardness and elastic modulus using load and displacement sensing indentation experiments. J Mater Res, 7:1564-1583, 1992. https://doi.org/10.1557/JMR.1992.1564
  20. International Organization for Standardization : Dental materials: guidance on testing of adhesion to tooth structure. Technical Report ISO TR - 11405. International Organization for Standardization, Genebra, 1994.
  21. Robinson C, Brookes SJ, Kirkham J, et al. : In vitro studies of the penetration of adhesive resins into artificial caries-like lesions. Caries Res, 35:136-141, 2001. https://doi.org/10.1159/000047445
  22. 김은영, 안울진, 김신 등 : 전치부의 발육 결함 및 교정 후 탈회 병소의 심미적 개선을 위한 resin infiltration. 대한소아치과학회지, 37:218-224, 2010.
  23. Fejerskov O, Kidd E : Dental Caries: The Disease and Its Clinical Management. Blackwell Munksgaard, Oxford, 20-48, 2008.
  24. Bergman G, Lind PO : A quantitative microradiographic study of incipient enamel caries. J Dent Res, 45:1477-1484, 1966. https://doi.org/10.1177/00220345660450053701
  25. Huang TT, He LH, Darendeliler MA, et al. : Correlation of mineral density and elastic modulus of natural enamel white spot lesions using X-ray microtomography and nanoindentation. Acta Biomater, 12:4553-4559, 2010.
  26. Huang TT, He LH, Darendeliler MA, et al. : Nanoindentation characterisation of natural carious white spot lesions. Caries Res, 44:101-107, 2010. https://doi.org/10.1159/000286214
  27. Asmussen E : Penetration of restorative resins into acid etched enamel. II. Dissolution of entrapped air in restorative resin monomers. Acta Odontol Scand, 35:183-191, 1977. https://doi.org/10.3109/00016357709004653
  28. Belli R, Rahiotis C, Schubert EW, et al. : Wear and morphology of infiltrated white spot lesions. J Dent, 39:376-385, 2011. https://doi.org/10.1016/j.jdent.2011.02.009
  29. S, Do¨rfer CE, Meyer-Lueckel H : Surface conditioning of natural enamel caries lesions in deciduous teeth in preparation for resin infiltration. J Dent, 38:65-71, 2010. https://doi.org/10.1016/j.jdent.2009.09.001
  30. Paris S, Meyer-Lueckel H, Mueller J, et al. : Progression of sealed initial bovine enamel lesions under demineralizing conditions in vitro. Caries Res, 40:124-129, 2006. https://doi.org/10.1159/000091058
  31. Meyer-Lueckel H, Paris S : Infiltration of natural caries lesions with experimental resins differing in penetration coefficients and ethanol addition. Caries Res, 44:408-414, 2010. https://doi.org/10.1159/000318223
  32. Paris S, Bitter K, Renz H, et al. : Validation of two dual fluorescence techniques for confocal microscopic visualization of resin penetration into enamel caries lesions. Microsc Res Tech, 72:489-494, 2009. https://doi.org/10.1002/jemt.20701
  33. Bjarnason S, Dietz W, Hoyer I, et al. : Bonded resin sealant on smooth surface dental enamel-an in vitro study. Swed Dent J, 27:167-174, 2003.
  34. da Silva Neto JM, dos Santos RL, Sampaio MC, et al. : Radiographic diagnosis of incipient proximal caries: an ex-vivo study. Braz Dent J, 19:97-102, 2008. https://doi.org/10.1590/S0103-64402008000200002

피인용 문헌

  1. Abrasion of resin infiltrated enamel by tooth brushing vol.37, pp.1, 2013, https://doi.org/10.11149/jkaoh.2013.37.1.9