• 대한소아치과학회지
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• 제30권4호
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• pp.581-592
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• 2003

본연구는 유치와 영구치의 우식상아질을 제거하는 방법에 따른 상아질표면의 변화와 산부식양상, 혼성층의 양상, 그리고 이들이 상아질에 대한 복합레진의 전단결합강도에 미치는 영향을 평가할 목적으로 시행되었다. 92개의 유구치와 92개의 영구 구치를 준비하여 상아질 표면을 노출시키고 인공우식을 유발시켰다. 이중 32개의 유구치와 32개의 영구구치는 $Carisolv^{TM}$과 bur로 삭제후 상아질표면을 SEM관찰하였으며 나머지 치아에서는 레진-상아질간 전단결합강도를 측정하였다. 두가지 접착시스템(Single bond system, self-etching bonding system)과 한 종류의 레진(Z250, 3M)을 사용하였으며 다음과 같은 결과를 얻었다. 1. $Carisolv^{TM}$의 우식치질 제거효과는 영구치보다 유치에서 더 우수하였으며, bur로 제거한 경우보다 더 거친 상아질 표면이 관찰되었다. 2. 산부식처리한 경우 유치와 영구치 모두 우식제거방법과 관계없이 도말층이 제거된 양상을 보였다. 3. Single bond system을 이용한 경우 두터운 $2-4{\mu}m$의 혼성층과 $10-15{\mu}m$의 adhesive layer가 관찰된 반면, self-etching bonding system에서는 비교적 얇은($1-2{\mu}m$) 혼성층만이 형성되었다. 4. 전단결합강도는 유치와 영구치 모두 우식제거방법에 관계없이 Single bonding agent를 적용한 경우에 self-etching bonding agent를 적용한 군보다 유의하게 높게 나타났다(P<0.05). 5. $Carisolv^{TM}$와 self-etching bonding agent 처리군에서 bur와 self-etching system 처리군보다 다소 높은 전단결합강도를 보였으나 유의성은 없었다(P>0.05).

• Journal of Periodontal and Implant Science
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• 제29권1호
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• pp.51-63
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• 1999

Exposure of the root surface due to gingival recession after periodontal surgery, elicit pain response when exposed to mechanical, heat, chemical or osmotic irritation. Especially patients treated with periodontal surgery, show high frequency. There have been reports that the 1 out of 7 patients complains of dentinal hypersensitivity. There have been many studies on the clinical effects of various materials on the treatment of dentinal hypersensitivity. The purposes of this study were to evaluate the effect of sodium chloride and potassium oxalate and to observe the relationship between the dentinal hypersensitivity and surface characteristics such as dentinal tubule size and number. This study included 20 teeth which were scheduled for extraction and had no pulpal disease. These teeth were divided into Root planing group, EDTA group, NaCl group and Oxalate group. Dentinal hypersensitivity is measured by tactile, pressured air and cold water using NRS (Numerical Rating Scales). Teeth were extracted under local anesthesia and each specimen was sectioned to a size about 3 X 5 mm and was examined under the scanning electron microscope (X2,000) The results were as follows, 1. The EDTA group exhibited significantly increased dentinal hypersensitivity comparing with the other groups. 2. The NaCl and Oxalate groups showed significantly reduced dentinal hypersensitivity comparing with the EDTA group. 3. As a method for dentinal hypersensitivity measurement, it was presumed thet tactile sensitivity test was not sensitive method but air blast test and cold water test were adequate method. 4. In a SEM study, the root planing group exhibited amorphous smear layer and showed no dentinal tubule orifice, but the EDTA group showed the large number of dentinal tubules. On the other hand, the NaCl and Oxalate groups did not show exposed dentinal tubules. The NaCl group showed more rough root surface than the EDTA group, and the Oxalate group showed many participates to be presumed as calcium oxalate particle. As the results from this study, root planing couldn't expose the dentinal tubule and NaCl and potassium oxalate occluded exposed dentinal tubule effectively. Dentinal hypersensitivity has close relationship with the exposure of dentinal tubules, especially with it's size and number.

• Journal of Periodontal and Implant Science
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• 제27권4호
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• pp.829-844
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• 1997

Dentin hypersensitivity must be one of the most frequent postoperative complaints in periodontal patients. Obliterating the open dentinal tubules or decreasing the diameter of their orifices would, therefore, be an objective of treatment for hypersensitive teeth. The purpose of this study was to evaluate the effect of a pulsed Nd:YAG laser irradiation on obliteration of dentinal tubules and to determine any difference according to irradiation methods. The 45 posterior teeth that had been extracted due to periodontal disease were initially treated with tetracycline HCI(100 mg/ml, 4 min.) to remove the smear layer after root planing. The root surfaces were then irradiated by a pulsed Nd:YAG laser(EL.EN.EN060, Italy) by different laser beam spot size and different exposure condition: ${\cdot}$ group 1: irradiated group by small spot(beam diameter=1mm, lW, 2 sec) ${\cdot}$ group 2: irradiated group by large spot(beam diameter=10mm, 1W, 200 sec) ${\cdot}$ group 3: irradiated group by gradual increase of watt (from 0.3W to 1.0W), beam diameter=4mm ${\cdot}$ group 4: irradiated group by fixed watt(1.0 W), beam diameter=4mm ${\cdot}$ control group: no irradiation but root planing and tetracycline HCI conditioning only. Additionally, the specimens were retreated with tetracycline HCI(100mg/ml, 4min.) to evaluate the stability of obliteration effect by Nd:YAG laser. Specimens were examined under the scanning electron microscope(JEOL, JSM-840A, Japan). Photomicrographs were taken at ${\times}4,000$ magnification and were analyzed statistically. The results were as follows: l. Scanning electron micrographs of root surface treated by tetracycline HCI alone(control group) showed widened, funnel-shaped dentinal tubules, while those of the root surface irradiated by various methods showed partially or completely obliterated dentinal tubules and various surface alterations, eg, flat, multiple pitted, melted and resolidified surface at the same energy density. 2. There was no significant difference in the obliteration effect of dentinal tubules between group 1 and group 2, and between group 3 and group 4(p>0.05). 3. The obliteration effect of dentinal tubules by a Nd:YAG laser irradiation was relatively stable to tetracycline HCI. The results demonstrate that a pulsed Nd:YAG laser irradiation within 1.0W, regardless of irradiation methods, can obliterate dentinal tubules effectively.

• Restorative Dentistry and Endodontics
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• 제22권1호
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• pp.479-489
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• 1997

The purpose of this study was to evaluate the effect of the Nd : YAG laser on the tooth hypersensitivity by the observation of the morphological changes of the dentinal surface irradiated with Nd : YAG laser by use of SEM. In 40 mandibular and maxillary molars without any carious lesion or restoration, severe attrition and abrasion, Enamel was removed with fine grit diamond bur and exposed dentinal surfaces were polished with Soflex discs. In control group (10 teeth), exposed dentinal surfaces were acid-etched with 10 % Maleic acid for 15 seconds. In the experimental group 1 (10 teeth), acid-etched dentinal surfaces with 10% Maleic acid were prepared by Nd : YAG laser (6 watts power, 1 psi water, 18 psi air) for 2 minutes. In the experimental group 2 (10 teeth), exposed dentinal surfaces were irradiated with Nd: YAG laser (10 watts power, 3 psi water, 10 psi air) until the painted black stains on the dentinal surfaces were completely removed. In the experimental group 3 (10 teeth). dentinal surfaces were prepared with Nd : YAG laser (6 watts power, 1 psi water, 18 psi air) until the painted black stanins on them were completely removed and then the irradiated dentinal surfaces were acid-etched with 10 % Maleic acid for 15 seconds. The specimens were routinely processed and observed with scanning electron microscope. The results were as follows : 1. In the irradiated dentinal surfaces, the characteristics of the melting and recrystalization on the dentinal surfaces were observed. Compared with the results in the control group, we could observe that in the irradiated dentinal surfaces, the aperture of the dentinal tubules were reduced and there were more debris obstructing the dentinal tubules. 2. In the irradiated dentinal surfaces, crater structures were commonly present and in the crater bottoms, there were a lot of bead like melted dentin structures, which had the ruptured opening in the center of them. 3. The melted dentins and cracks in the smear layer were less frequently observed in the irradiated dentinal surfaces using copious cooling water than in the irradiated dentinal surfaces using scare cooling water.

• Restorative Dentistry and Endodontics
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• 제30권3호
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• pp.149-157
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• 2005

본 연구는 우식의 기계적 제거와 기계화학적 제거의 효과를 비교, 평가하고자 하였으며, 기계적 제거방법은 저속의 round bur로, 기계 화학적 제거 방법은 Carisolv로 우식을 제거한 후, 잔존 우식을 확인하여 소요시간을 측정하였고, 또 실험실에서 발치한 우식 대구치 20개를 위 두 가지 방법으로 우식을 제거 후, Villanueva bone stain액으로 염색하고 표본을 제작 후 관찰하여 다음의 결론을 얻었다; 1.우식제거에 평균소요시간은 기계화학적 제거가 기계적인 제거보다 1.5배 더 길게 나타났다 (P < 0.05). 2, 우식제거에 평균소요시간은 소구치보다 대구치에서 더 길었고, 전치에서 가장 적은것으로 나타났다 (P < 0.05) 3 상 · 하악에서는 차이가 없었다 (P > 0.05) 4. 기계화학적 방법으로 우식 상아질을 제거 시 잔존 우식 상아질이 관찰되었으며 두 방법 모두 우식 상아질을 제거한 표면에서는 도말층을 관찰할 수 없었다.

• Restorative Dentistry and Endodontics
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• 제22권2호
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• pp.670-679
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• 1997

The pH changes in 4 small cavities prepared at the facial inner dentin and lingual outer dentin of the cervical and apical portion of root filled with calcium hydroxide pastes were investigated. Forty extracted permanent teeth with single canal were instrumented with step-back method, and then 4 small cavities were prepared. Two inner dentin cavities were cut a distance of about 1.0mm from the canal wall and two outer dentin cavities were cut to a depth of about 0.5mm from the root surface. Root canals and prepared cavities were flushed with 17% EDTA, and then irrigated with 5% NaOCl to remove smear layer. Teeth were randomly divided into four groups. Control group was not filled and the remaining other groups were filled with mixture of calcium hydroxide and distilled water, Vitapex$^{(R)}$ paste and Pulpdent$^{(R)}$ paste respectively. The pH change of the dentin in each cavity was measured at 0, 1, 3, 7, 14, 21, 28, 60, 90 days with pH microelectrode(WPI Co., USA). The results were as follows : 1. The groups obturated with Pulpdent$^{(R)}$ paste and Aqueous calcium hydroxide produced the increased pH level at 1 day and maintained plateau over next 3weeks and decreased after 3weeks. 2. The group obturated with Vitapex$^{(R)}$ paste observed no significant pH change until 2weeks and slight increased pH at 3weeks and sequential increasing after 3weeks. But, the pH in the group obturated with Vitapex$^{(R)}$ paste remained significantly below the pH measured in the other two experimental groups(P<0.05). 3. All experimental groups showed pH level similar to control group after 28 days. 4. The pH of outer dentin is slightly higher than that of inner dentin. There is no significant difference in pH level between apical and cervical dentin throughout the duration of the experiment, though apical dentin showed slightly higher pH than cervical dentin at 1 day(P<0.05).

• Restorative Dentistry and Endodontics
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• 제26권4호
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• pp.350-359
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• 2001

목적 - 근관형성시 근관내 상아질벽에는 항상 도말층(smear layer)이 형성되는데, 이는 상아질, 치수조직 잔사, 조상아세포 돌기, 때로는 미생물 등으로 구성되며, 주사전자현미경상으로는 비규칙적이며, 무정형의 구상(granular)구조물로 관찰된다. 본 연구에서는 도말층의 유무에 따른 혐기성 미생물, Prevotella nigrescens의 근관내 상아질 부착정도를 주사전자현미경으로 평가하고자 한다. 지금까지 사용되었던 실험방법에 비하여 보다 임상적 환경에 가까운 실험방법을 고안, 신빙성 있는 연구결과를 기대할 수 있도록 하였다. 방법 - 치주질환이나 외상 등의 원인으로 발거된 상, 하악 전치 18개를 사용하였다. 각 치아의 치관부를 백악법랑경계부위에서 절단하고, 1군(5개치아)은 10ml의 생리식 염수를, 2군(5개치아)과 3군(5개치아)은 10ml의 3.5% NaOCl을 근관관주용액으로 사용하여 근관형성을 하였다. 근관형성 완료후 1군과 2군은 10ml의 생리식염수로, 3군은 10ml의 0.5M EDTA용액으로 final flush를 시행하여, 3군의 도말층을 제거하였다. 치근수직절단과 ethylene oxide(EO) gas 소독후 1, 2, 3군의 시편(각군10개시편)을 Prevotella nigrescens가 부유된 Brain Heart Infusion with Yeast estract, Hemin and Menadione(BHIYHM) broth내에 37$^{\circ}C$에서 3시간 동안 incubation했다. 4, 5, 6군은 실험과정을 검증하기 위한 대조군으로써, 4군(1개치아)과 5군(1개치아)은 1군, 2군과 같이 각각 생리식염수와 NaOCl만을 이용한 근관형성으로 도말층을 잔존시키고, 6군(1개치아)은 3군과 같이 NaOCl과 EDTA를 적용하여 도말층을 제거한 후, 치근 수직절단과 EO gas 소독을 시행했다. 모든 시편(1, 2, 3, 4, 5, 6군)을 통상의 방법에 따라 처리한 후 주사전자현미경을 통하여 관찰, 근관내면에 부착되어 있는 Prevotella nigrescens의 개수, 모양, 상아세관 및 도말층과의 관계 등을 관찰, 비교, 분석하였다. 결과는 t-test와 one-way ANOVA를 통하여 통계처리 하였다. 결론 - 1. 근관형성 후 근관내 상아질 표면 전체는 도말층으로 덮여 있는 양상을 보였다. 2. 3.5% NaOCl과 0.5M EDTA를 적용하여 근관내 도말층을 효과적으로 제거할 수 있었으며, 상아세관 개구부가 확연히 노출되어 있는 소견을 관찰할 수 있었다. 3. 도말층이 덮인군에서 미생물의 부착이 유의성 있게 높았다(P<0.05). 4. 근관 형성중 형성되어 근관 상아질을 덮고 있는 도말층이 미생물의 부착을 증가시켜, 근관 재감염의 기회를 증가시킴을 알 수 있었다.

• 대한소아치과학회지
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• 제30권4호
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• pp.545-553
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• 2003

상아질 접착력을 높이기 위해서는 적절히 습윤한 상아질 표면을 얻는 것이 중요하다. 이런 방법에는 정확한 지침이 없으며, 주관적이고 술자에 따라 많은 차이가 있다. 본 연구에서는 적절히 습윤한 상아질을 얻는 방법에 관한 연구의 일환으로, 유치의 산부식 후. 여러 가지 방법을 이용해 상아질을 건조시킨 표본의 조직상을 획득하여 상아질 표면의 차이를 비교하고자 하여 다음과 같은 결론을 얻었다. 1. 유치 상아질을 산부식하면, 도말층이 제거되고 상아세관이 노출되며, 관간상아질과 관주상아질이 탈회되고, 교원섬유가 풍부한 이행층이 노출되는 것을 확인할 수 있었다. 2. 산부식된 상아질이 과도하게 건조되면 탈회된 상아질이 수축하여, 관간상아질이 붕괴되어 높이가 점차적으로 낮아지고 상아세관의 직경은 조금씩 감소되는 것으로 나타났다. 3. 유치 산부식 후, 10cm 거리에서 20초 동안 압축 공기로 건조시키면 상아질이 과도하게 건조, 탈수됨을 확인할 수 있었다. 4. 유치 산부식 후, 10cm 거리에서 3초 동안 압축 공기로 건조시키거나 마른 cotton, 젖은 cotton, microbrush, absorbent tissue paper로 건조시키면 상아질이 적절하게 건조됨을 확인할 수 있었다.

• Restorative Dentistry and Endodontics
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• 제20권2호
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• pp.508-526
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• 1995

This experiment was performed to study mechanisms of desensitization by chemical desensitizing agents in hypersensitive dentin and compare effects of these agents by measuring the activity of intradental nerves and observing their occluding aspects on dentinal tubules with SEM over time after application of chemical desensitizing agents to the exposed dentinal surfaces. Canines of adult cats weighing 2-3 kg were cross-sectioned at 1.5 mm from incisal apex, and the smear layer of the exposed dentinal susface was removed by 32 % $H_3PO_4$ for 15 sec. Chemical desensitizing agents such as 10% $SrCl_2$, 5% $KNO_3$ and 30% $K_2C_2O_4$, were applied to the exposed dentin surfaces for 2 minutes. Intradental nerve activity was measured immediately after application of the agents, at 15 minutes and at 30 minutes by stimulating with 4M NaCl. To compare occluding ability of desensitizing agents on dentinal tubules in vivo and in vitro, the structures of the exposed dentinal surfaces of nonvital and vital teeth were morphologically observed by SEM. The results obtained were as follows : 1. Intradental nerve activity was decreased immediately after the application of 10 % $SrCl_2$, 5% $KNO_3$ and 30% $K_2C_2O_4$. (p<0.01), among which 30% $K_2C_2O_4$. showed the highest desensitizing effect(p<0.01). 2. The immediately decreased intradental nerve activity after application of 10 % $SrCl_2$ and 5% $KNO_3$ was increased over time. 10% $SrCl_2$ and 5% $KNO_3$ showed no desensitizing effect respectively at 30 minutes and at 15 minutes after application. 3. The immediately decreased intradental nerve activity after application of 30 % $K_2C_2O_4$ was persistently continued during the period of observation (p<0.01). 4. Precipitates of $SrCl_2$ and $KNO_3$ were not noted on the exposed dentinal surfaces and within dentinal tubules by SEM examination. On the other hand, 30 % $K_2C_2O_4$ produced precipitates on the exposed dentinal surfaces and openings of dentinal tubules without any formed preciptates within dentinal tubules. 5. Ten percent $SrCl_2$, 5 % $KNO_3$ and 30 % $K_2C_2O_4$ showed no differences in their occluding aspects on dentinal tubules either in vivo or in vitro studies and either immediately following application or at 30 minutes. These results suggest that the desensitizing effect of $SrCl_2$ and $KNO_3$ is resulted from their reducing effect on the intradental nerve activity rather than from their precipitates' occluding the dentinal tubules. However, desensitizing effect of 30 % $K_2C_2O_4$, is probably resulted from its precipitates' occluding the openings of the dentinal tubules as well as from it's reducing effect on the intradental nerve actibity.

• Restorative Dentistry and Endodontics
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• 제35권5호
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• pp.313-320
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• 2010

연구목적: 본 연구의 목적은 미세 유체 흐름 측정장치를 이용해서 각 상아질 지각과민 처치제의 적용 과정 중 발생하는 상아 세관액 흐름의 유동을 관찰하고, 상아질 지각과민 처치제 간 적용 후 투과도 감소의 차이를 비교하고자 하는 것이다. 연구 재료 및 방법: CEJ 5 mm 하방에서 절단한 소구치를 미세 흐름 측정장치에 연결하여 20 cm $H_2O$의 정수압을 가하였다. 치경부에 상하 3 mm, 근원심 4 mm, 깊이 2 mm의 V자 형태의 5급 와동을 형성하고 smear layer를 제거하기 위해 15초 동안 산 부식한 후 상아질 지각과민 처치제를 적용하였다. 사용된 상아질 지각과민 처치제는 Seal&Protect (SP), SuperSeal (SS), BisBlock (BB), Gluma desensitizer (GL), Bifluoride 12 (BF) 이다. 상아세관액의 흐름은 지각과민 처치제 도포 전부터 도포 후 5분까지 실시간으로 측정되었다. 결과: 실험에 사용한 모든 상아질 지각과민 처치제는 적용 후의 상아세관액 흐름율이 적용 전에 비해 유의하게 감소하였다(p < 0.05). SP는 GL과 BF에 비해 유의하게 투과도 감소가 나타났다 (p < 0.05). SS와 BB는 BF에 비해 유의하게 투과도 감소를 보였다 (p < 0.05). 결론: 지각과민 처치제의 도포 과정 동안 각 처치제의 특징적인 상아세관액의 유동을 미세 유체 흐름 측정장치를 통해 관찰 할 수 있었다.