지각과민 처치제 후 접착레진 처리가 상아질 투과도에 미치는 영향
The effects of desensitizing agents, bonding resin and tooth brushing on dentin permeability, in vitro
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초록
상아질 지각과민증의 치료를 위해 사용되는 지각과민 처치제의 효과는 일시적인 것으로 보이며 이는 상당부분 칫솔질에 의한 마모소실로 판단된다. 지각과민 처치제의 칫솔질에 의한 마모를 감소시키기 위해 bonding resin을 지각과민 처치제에 추가 도포하여 칫솔질 시행 후 상아질 투과도의 변화에 대해 연구하였다. 재료 및 방법: 우식이 없는 치아를 이용하여 1 mm 두께의 치관부 상아질 디스크를 제작한 다음, All-Bond 2(R), Seal & Protect(R), Gluma(R), MS Coat(R)의 4 종류의 지각과민 처치제만 처리한 시편과 Dentine/Enamel Bonding Resin(R) (Bisco Inc.)을 추가로 도포한 시편에 대해 처리하기 전과 처리한 후, 1주(왕복 140회), 2주(왕복 280회), 6주(왕복 840회)에 해당하는 칫솔질을 적용한 후에 측정한 hydraulic conductance (Lp)와 주사 전자 현미경 사진을 비교 분석하였다. 결과: 지각과민 처치제 만을 처리한 군과 bonding resin (Dentine/Enamel Bonding Resin(R))을 추가 도포한 군 모두에서 처리 직후 hydraulic conductance가 급격히 감소하였다. 지각과민 처치제만 처리한 군과 bonding resin을 추가 도포한 군 간의 hydraulic conductance를 비교한 결과 All-Bond 2(R), Gluma(R), MS Coat(R)와 bonding resin을 도포한 군에서는 1주(왕복 140회), 2주(왕복 280회), 6주(왕복 840회)의 칫솔질을 시행한 후 hydraulic conductance가 지각과민 처치제만 도포한 군에 비해 현저히 낮았고, Seal & Protect(R) 에서는 6주(왕복840회)의 칫솔질을 시행한 후에만 같은 결과를 보였다. 주사 전자 현미경 관찰에서 지각과민 처치제만 처리한 군과 bonding resin을 추가로 도포한 군 모두에서 처리 직후에 상아세관이 완전히 폐쇄되거나 일부만 폐쇄되어 상아세관의 내경이 감소된 양상을 볼 수 있었으나, 6주(왕복 840회) 칫솔질 시행 후에는 bonding resin을 추가 도포한 군에서만 현저하게 폐쇄 또는 내경이 감소된 상아세관이 관찰되었다. 결론: 지각과민 처치제 처리 후 bonding resin (Dentine/Enamel Bonding Resin(R), Bisco Inc.)을 추가 도포하는 것이 지속적인 상아세관 폐쇄에 효과적임을 알 수 있었다.
Abstract
The effects of desensitizing agent are often for a short duration. One of the reasons is believed to be wear of desensitizing agent by tooth brushing. To reduce the wear and make the duration longer, dental bonding resin was applied and the changes of dentin permeability after toothbrushing were measured. Materials and methods: Extracted teeth free from caries were chosen. Coronal dentin discs with thickness of 1 mm were prepared. Using the split chamber device developed by Pashely, hydraulic conductance and scanning electron microscope images (SEM) were compared and contrasted before and immediately after the application of desensitizing agent and bonding resin and then after equivalent tooth brushing of 1 week, 2 weeks, and 6 weeks. Four commercially available desensitizing agents were used in this study; they were All-Bond 2, Seal & Protect, Gluma, and MS Coat. And Dentin/Enamel Bonding resin (Bisco Inc.) was used. The results of this study are as follows. Results: On all specimens, the hydraulic conductance decreased after the application of tooth desensitizing agent and bonding resin. Compared with the specimens treated only with desensitizer, the specimens treated with All-Bond 2, Gluma, MS Coat and plus D/E bonding resin had a little increase in hydraulic conductance after 1, 2 and 6-week tooth brushing. In case of Seal & Protect, the specimens showedthe same result only after 6-week tooth brushing. On examination of SEM, the dentinal tubule diameter had decreased after treatment of desensitizing agents and bonding resin. And the specimens treated with All-Bond2, Seal&Protect, Gluma, MS Coat and plus D/E bonding resin had an significant decrease in diameter of dentinal tubule after 6-week tooth brushing. Conclusion: According to the results of this study, it is effective to use bonding resin after application of desensitizer in reducing the wear by tooth brushing and making the duration longer. In this study, just 6-week tooth brushing was performed, and it is not enough to regard it as a long-term data. So further study is needed and more perfect method for treating dentin hypersensitivity should be developed.
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