Micro-CT를 이용한 발거된 유구치의 기성금속관 평가
Micro-CT Evaluation of Stainless Steel Crowns on Extracted Primary Molars
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초록
소아치과 임상에서 기성금속관 수복은 매우 높은 활용성과 사용빈도에도 불구하고 완벽하고 정밀한 수복이 쉽지 않은 항목으로 판단된다. 불량한 변연 적합, 변연부 치태 침착, 인접 영구치의 맹출 장애, 접착제 소실 및 이차 우식, 부적절한 지대치 삭제, 교합면 천공 등이 임상적으로 흔히 관찰되는 문제점들이다. 본 연구는 기성금속관이 장착된 상태로 발치된 유구치를 대상으로 수복 상태를 평가해 봄으로써, 빈번한 결함과 착오들을 찾아낼 목적으로 시도되었다. 부산대학교 치과병원 소아치과에서 발치된 기성금속관 수복 유구치 97개를 대상으로 육안적 평가와 micro-computed tomography(micro-CT) 영상을 분석하였다. 변연 적합도, 접착제 소실, 이차우식, 교모성 천공, 변연부 연마 결함, 선반(ledge) 형성 등의 항목으로 수복상태를 평가하여, 다음과 같은 결과를 얻었다. 조사항목들을 대상치아 기준으로 보았을 때, 접착제 소실이 가장 빈번하였으며(98%), 뒤를 이어 이차우식(42.3%), 변연부 연마 결함(41.2%), 선반(ledge) 형성(29.9%), 교모성 천공(17.5%)의 순으로 나타났다. 변연 간격이 클수록 접착제 소실이 증가하는 경향을 보였고, 접착재 소실은 변연 간격 및 이차 우식과 유의한 상관성을 보였다. 평균 변연간격은 0.31 ±0.26 mm 였으며, 상악 제2 유구치에서 가장 크게 나타났다. 변연이 백악법랑경계 상방에 위치하는 경우가 가장 많았고, 변연이 치관 상방에 위치할수록 변연 간격은 작게 나타났다(p < 0.05).
Abstract
This study was conducted for the purpose of evaluating the stainless steel crowns on extracted primary molarsand thus identifying frequent errors and defects. Visual assessment and micro-computed tomography (micro-CT) image analysis were performed on 97 primary molars for evaluation of the state of marginal adaptation,cement loss, secondary caries, ledge formation, attritive perforation and marginal polishing defect. The resultswere as follows:In the examination of object teeth by evaluation criteria, cement loss was found most frequently (98%),followed by secondary caries (42.3%), marginal polishing defect (41.2%), ledge formation (29.9%) and attritiveperforation (17.5%), in this order. The cement loss at the margins showed a significant relationship withmarginal gap and secondary caries: the larger the marginal gap is, the more frequent is the cement loss (p <0.05). The average marginal gap was 0.31 ± 0.26 mm and showed the highest value in the maxillary 2nd primarymolars. The location of the crown margin above the cementoenamel junction was found most frequentlyand it was found that the higher the crown margin is located, the less the marginal gap becomes (p < 0.05). In conclusion, it is thought very desirable to pay closer attention to crown margins and shapes for stainlesssteel crown restoration in order to minimize the marginal gaps and consequent cement loss.
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