C-factor와 충전법이 복합레진의 중합 수축에 의한 치질에서의 수축 응력에 미치는 영향
Effect of c-factor and layering technique on the contraction force of composite resin restoration to toothsurface
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와동 형성시 C-factor와 충전방법이 복합레진 수복물에서의 수축 응력에 미치는 영향을 평가하고자 발거된 소구치를 대상으로 C-factor가 3.6과 1.0인 와동을 각각 형성한 후 hybrid 형 복합레진인 Filtek Z-250TM(3M ESPE, U.S.A.)과 flowable형 복합레진인 Filtek flowTM(3M ESPE, U.S.A.)를 사용하여 layering을 시행하고 광중합하면서 strain gauge법을 이용하여 치질에서의 수축 응력을 측정하였다. 시편을 절단하여 레진과 상아질 사이 계면의 접착상태를 주사전자현미경으로 관찰한 결과 다음과 같은 결과를 얻었다. 1.C-factor에 따른 수축 응력을 측정한 결과 C-factor가 3.7인 제 1군과 제 2군, 그리고 제 5군이 900초 후 각각 0.11, 0.07, 0.07 MPa로 C-factor가 1.0인 제 3군과 제 4군의 0.05와 0.04 MPa에 비해 크게 나타났다(P<0.05). 1,800초 후에는 제 1군, 제 5군, 제 2군, 제 3군, 제 4순으로 크게 나타났으나 제 2군과 제 3군, 그리고 제 3군과 제 4군 사이에는 유의성이 없었다. 2.재료에 따른 수축 응력의 차이는 C-factor가 3.7인 와동의 경우 hybrid형 레진인 Filtek Z-250TM이 flowable 레진인 Filtek flowTM에 비해 수축 응력이 크게 나타났으나(P<0.05), C-factor가 1.0인 와동의 경우 재료의 차이에 따른 수축 응력의 유의한 차이가 없었다. 3.Layering에 따른 수축 응력은 Filtek Z-250TM을 layering 없이 bulk 충전한 제 1군에 비해 flowable 레진을 layering한 제 5군이 전 측정 시간대에 걸쳐 수축 응력이 유의하게 낮게 나타났다(P<0.05). 4. C-factor가 3.7인 제 1군과 제 2군, 제 5군은 900초까지 수축 응력이 증가하다 이후 점차 감소하는 경향을 보였다. 5. C-factor가 1.0인 와동의 경우 충전용 레진 종류에 관계없이 레진과 와동벽 사이에 긴밀한 접착 상태를 보였으나 C-factor가 3.7인 와동의 경우 부분적으로 틈이 관찰되었다. 전반적으로 와동저에 비해 와동벽에서 틈이 더 많이 관찰되었다. 이상의 결과를 종합하여 보면 복합레진 수복시 수축 응력에 따른 합병증을 예방하기 위해 C-factor를 크지 않게 와동을 설계, 형성하여야 하며 C-factor가 클 경우 flowable 레진을 이장하는 등 재료적인 면에서의 선택과 적용법이 중요할 것으로 사료된다.
Abstract
The aim of this study was to investigate the relationship between the C-factor and shrinkage strain values of composite resin and examine the strain values in different incremental filling techniques. Experiment consisted two aims. First, we compared with strain value in two different C-factors(3.7 and 1.0). Second, we examined the strain values in three different filling techniques. The results of the present study can be summarized as follows: 1.High C-factor groups showed higher contraction stress values than low C-factor groups at 900 sec after polymerization. 2.Hybrid resin showed higher contraction stress values than flowable resin in high C-factor cavities. But contraction stress was not revealed significant difference between hybrid resin and flowable resin in low C-factor cavities(P>0.05). 3.Bulk filling with hybrid resin(Group 1) showed high contraction stress and lining with flowable resin followed hybrid resin(Group 5) showed lower contraction stress. 4.Contraction stress were increased during 900 sec after polymerization in high C-factor groups but decreased gradually after 900 sec. 5. Low C-factor groups showed tight marginal seal between resin and cavity wall but high C-factor groups showed gaps formed between resin and cavity wall in part. On the basis above results, layering techniques in high C-factor cavity showed advantages in reducing contraction stress and gap formation between cavity wall and resin restoration.
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