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심미적 포스트 코어의 종류에 따른 미세누출에 관한 연구

Microleakage of endodontically treated teeth restored with three different esthetic post and cores

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주제분류치의학

초록

연구목적: 오늘날 심미적 요구의 증가로 치아색 포스트 코어에 대한 많은 관심이 모아지고 있으며 다양한 연구가 진행 중이다. 현재 화이버 포스트 (ParaPost fiber White, Coltene Whaledent, Cuyahoga Falls, USA), 지르코니아 포스트 (CosmoPost, Ivoclar Vivadent, Schann, Germany) 등에 관한 논문은 다소 나와 있으나 요즘 여러 분야에서 관심을 받고 있는 CAD/CAM (computer-aided design/computer-aided manufacturing) 방식으로 지르코니아를 가공한 절삭형 지르코니아 포스트 코어에 대한 연구는 많지 않은 실정이다. 이 연구의 목적은 CAD/CAM을 이용한 지르코니아를 비롯하여 근관치료된 치아에서 사용된 세 가지 다른 치아색 포스트 코어에 대해 미세누출 (microleakage)을 비교해 보는 것이다. 연구 재료 및 방법: 발치된 건전한 상악 절치 27개를 채택하여 백악법랑질경계 (CEJ)에서 절단하여 근관치료를 시행하고, 세군(각 9개)으로 나누었다. 각군들은 화이버 포스트와 콤포짓트 레진 코어 (1군), 지르코니아 포스트와 열가압형 세라믹 코어 (2군), CAD/CAM 절삭형 지르코니아 포스트 코어 (3군)로 수복하였다. 5 - 55℃ 1000회 열순환 처리 (thermocycling)를 시행하고, 2% 메틸렌 블루로 37℃에서 24시간 염색하였다. 치아장축과 평행하게 순설방향으로 절단하여 미세누출을 현미경과 컴퓨터 프로그램을 사용하여 분석을 하였다. 데이터는 one-way ANOVA와 Scheffe’s multiple range test (α= 0.05)로 분석하였다. 결과: 모든 군에서 미세누출을 보였으며, 지르코니아 포스트와 열가압형 세라믹 코어군 (2군)에서 치근계면 입구에서는 다소 많은 미세누출을 보였으나 포스트 끝에 이르러서는 거의 미세누출이 없는 결과를 보였다. 화이버 포스트와 콤포짓트 레진 코어군 (1군)과CAD/CAM 절삭형 지르코니아 포스트 코어군 (3군)에서는 부위별로 균등한 미세누출을 보였다. 결론: 화이버 포스트와 콤포짓트 레진 코어군, 지르코니아 포스트와 열가압형 세라믹 코어군, CAD/CAM 절삭형 지르코니아 포스트 코어군 모두에서 미세누출을 보였고, 이 중에서 지르코니아 포스트와 열가압형 세라믹 코어군이 좀 더 큰 미세누출에 대한 저항성을 보였으며 화이버 포스트와 콤포짓트 레진 코어군, CAD/CAM 절삭형 지르코니아 포스트 코어군은 유사한 양상을 보였으나, 각 실험군 간에 통계적으로 유의한 차이는 인정되지 않았다. (P> .05)

Abstract

Statement of problem: At present, as the esthetic demands are on the increase, there are many ongoing studies for tooth-colored post and cores. Most of them are about fiber post and prefabricated zirconia post, but few about one-piece milled zirconia post and core using CAD/CAM (computer-aided design / computer-aided manufacturing) technique. Purpose: The objective of this study was to compare microleakage of endodontically treated teeth restored with three different tooth-colored post and cores. Material and methods: Extracted 27 human maxillary incisors were cut at the cementoenamel junction, and the teeth were endodontically treated. Teeth were divided into 3 groups (n = 9); restored with fiber post and resin core, prefabricated zirconia post and heat - pressed ceramic core, and CAD/CAM milled zirconia post and core. After the preparation of post space, each post was cemented with dual-polymerized resin cement (Variolink II). Teeth were thermocycled for 1000 cycles between 5 - 55℃ and dyed in 2% methylene blue at 37℃ for 24 hours. Teeth were sectioned (bucco - lingual), kept the record of microleakage and then image-analyzed using a microscope and computer program. The data were analyzed by one-way ANOVA and Scheffe′s multiple range test (α= 0.05). Results: All groups showed microleakage and there were no significant differences among the groups (P > .05). Prefabricated zirconia post and heat-pressed ceramic core showed more leakage in dye penetration at the post - tooth margin, but there was little microleakage at the end of the post. Fiber post and resin core group and CAD/CAM milled zirconia post and core group indicated similar microleakage score in each stage. Conclusion: Prefabricated zirconia post and heat-pressed ceramic core group demonstrated better resistance to leakage, and fiber post and resin core group and CAD/CAM milled zirconia post and core group showed the similar patterns. The ANOVA test didn’t indicate significant differences in microleakage among test groups. (P > .05)

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