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Effect of Sodium Fluoride Varnish and Potassium Iodide on Remineralization Efficacy of Silver Diamine Fluoride

불화나트륨 바니쉬와 요오드화 칼륨이 Silver Diamine Fluoride의 재광화 효과에 미치는 영향

  • Lee, Kunho (Department of Pediatric Dentistry, College of Dentistry, Dankook University) ;
  • Ahn, Junyong (Department of Biomaterials Science, College of Dentistry, Dankook University) ;
  • Kim, Jong Soo (Department of Pediatric Dentistry, College of Dentistry, Dankook University) ;
  • Han, Miran (Department of Pediatric Dentistry, College of Dentistry, Dankook University) ;
  • Lee, Joonhaeng (Department of Pediatric Dentistry, College of Dentistry, Dankook University) ;
  • Shin Jisun (Department of Pediatric Dentistry, College of Dentistry, Dankook University)
  • 이건호 (단국대학교 치과대학 소아치과학교실) ;
  • 안준용 (단국대학교 치과대학 생체재료학교실) ;
  • 김종수 (단국대학교 치과대학 소아치과학교실) ;
  • 한미란 (단국대학교 치과대학 소아치과학교실) ;
  • 이준행 (단국대학교 치과대학 소아치과학교실) ;
  • 신지선 (단국대학교 치과대학 소아치과학교실)
  • Received : 2021.05.07
  • Accepted : 2021.09.01
  • Published : 2021.11.30

Abstract

The purpose of this study was to compare the effect of sodium fluoride(NaF) varnish and potassium iodide(KI) on remineralization efficacy of silver diamine fluoride(SDF) by measuring microhardness and evaluating surface morphology by scanning electron microscope(SEM). Artificial caries lesions were induced on extracted primary molars and vickers microhardness was measured. Specimens were randomly separated into 4 groups for treatment. The specimens in group I were treated with SDF, group II with NaF varnish after SDF, group III with KI after SDF and group IV with distilled water. After 8 days of pH cycling, vickers microhardness was measured and difference before and after treatment was calculated. For SEM, 2 samples were evaluated respectively after enamel polishing, lesion formation and after pH cycling. Group III showed highest increase in microhardness. Group I showed higher increase in microhardness than Group II but without statistical difference. Group IV showed lowest increase in microhardness value among 4 groups. On SEM image, group I, II and III showed smoother and less irregular surface compared to group IV. Amorphous crystal pellicles were observed in group III. In conclusion, SDF, SDF and NaF, SDF and KI groups showed smoother surface and increase in microhardness suggesting the possibility that remineralization effect might take place in oral conditions. In addition, in limited conditions of this study, applying NaF varnish after SDF did not increase the remineralization efficacy of SDF while KI significantly increased the remineralization efficacy of SDF. However, additional study considering various conditions that might affect demineralization and remineralization in clinical situations need to be conducted.

이 연구의 목적은 silver diamine fluoride(SDF)를 도포할 때 불화나트륨(sodium fluoride, NaF) 바니쉬와 요오드화 칼륨(potassium iodide, KI)이 SDF의 재광화 효과에 미치는 영향을 유치의 법랑질 인공 우식 병소에서 미세경도의 변화를 통해 측정하고, 도포 전과 후의 표면 형태를 주사전자현미경(scanning electron microscopy, SEM)을 통해 관찰하여 비교하는 것이다. 발치된 유구치의 인접면에 법랑질 인공 우식병소를 형성하고 비커스 미세경도를 측정한 후, 4개의 군으로 나누어 I군에는 SDF, II군에는 SDF와 NaF 바니쉬, III군에는 SDF와 KI, 그리고 IV군에는 증류수를 처리하였다. 8일 간 pH cycling을 시행한 후 비커스 미세경도를 다시 한번 측정하여 미세경도의 변화량을 계산하였다. 또한 치아 연마 후, 인공 우식 유발 후, 그리고 pH cycling 이후 각 군에 대하여 각각 2개의 시편을 이용하여 SEM를 촬영하여 표면의 형태를 관찰하였다. 연구결과 미세경도는 III군에서 가장 크게 증가했다. I군과 II군 모두 미세경도의 증가를 보였으나 두 군 사이에는 통계학적으로 유의한 차이가 없었다. IV군에서도 미세경도의 증가를 보였으나 그 변화 정도는 가장 적게 나타났다. SEM 관찰 결과 I, II, III군이 우식 유발 직후나 IV군과 비교하여 표면이 더 균일해지고 불규칙성이 감소된 양상을 보였으며, III군에서 무정형의 피막 형태의 침착이 나타났다. 이러한 결과를 종합해 보면 SDF만을 도포한 군과 SDF와 NaF, SDF와 KI를 함께 도포한 경우 모두 표면 형태가 균일해지고 미세경도가 증가하였으며 이와 같은 결과를 기반으로 구강 내의 환경에서도 재광화 효과를 가질 수 있을 것으로 사료되었다. 또한 이 연구의 제한된 조건 하에서 NaF 바니쉬를 사용하였을 때에는 SDF의 재광화 효과를 증가시키지 못했으며, SDF와 KI를 함께 도포한 경우 SDF의 재광화가 효과가 증가되는 결과를 보였으나 추후 실제 구강 내에서의 다양한 상황을 고려한 추가적인 연구가 필요할 것으로 생각된다.

Keywords

Acknowledgement

This study was supported by the National Research Foundation of Korea (NRF) grant founded by the Ministry of Science and ICT (NRF-2020R1G1A1009155). The Department of Dentistry (Pediatric dentistry) was supported through the Research-Focused Department Promotion Project as a part of the University Innovation Support Program for Dankook University in 2021.

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