Er:YAG 레이저를 이용한 법랑질 표면처리가 치면열구전색제의 미세누출에 미치는 영향
Influence of the enamel treatment with Er:YAG laser onthe micrleakage of pit and fissure sealant
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본 연구는 Er:YAG 레이저를 이용한 법랑질의 표면처리가 치면열구전색제의 미세누출에 미치는 영향을 알아보기 위해서 시도되었다. 먼저 법랑질 표면 처리에 적절한 Er:YAG 레이저 조사 수준을 알아보기 위해, 치면열구에 50 mJ에서 300 mJ까지 3 Hz로 레이저를 조사하고, 주사전자현미경으로 표면 변화를 관찰하였다. 교정 목적으로 발거된 건전한 소구치 36개를 치면열구전색 전 법랑질 처리 방법에 따라 아무런 처리 없는 군(1군), 전통적인 산부식 시행한 군(2군), Er:YAG 레이저를 조사한 군(3군), Er:YAG 레이저 조사 후 산부식 시행한 군(4군)으로 나누었다. 치면열구전색 후 1000회의 열순환을 시행하였고, Rhodamine B를 이용해 치아를 염색하였다. 각 치아를 협설 방향으로 절단하여 1 mm 두깨의 시편 3개를 만들었으며, 총 108개의 시편(각 군당 27개)을 얻었고, 형광현미경으로 관찰하여 다음과 같은 결론을 얻었다. 1. 주사전자현미경 관찰 결과, 50 mJ, 3 Hz로 Er:YAG 레이저를 조사하였을 때 산부식과 유사한 법랑질 표면 변화를 관찰할 수 있었으며, 조사 에너지가 증가할수록 법랑질 표면의 용해와 재결정화 및 균열이 관찰되었다. 2. 치면열구전색의 미세누출도 1>3>4>2 군의 순으로 많이 나타났었다. 1, 3, 4군은 미세누출도에서 상호 차이를 나타내지 않았으나(p>0.05), 2군은 1, 3군에 비해 유의하게 적었다(p<0.05). 이상의 결과로 볼 때, 치면열구전색시 미세누출의 감소에 있어 Er:YAG 레이저 조사보다 전통적인 산부식이 우수하다 생각되며, Er:YAG 레이저의 조사조건에 대한 더 많은 연구가 필요할 것으로 사료된다.
Abstract
The aim of this study was to assess the microleakage underneath a pit and fissure sealant bonded to occlusal surfaces treated by Er:YAG laser. To determine the most effective energy density of laser, fourteen specimens were irradiated from 50 mJ to 300 mJ at 3Hz. After irradiation, the lased specimens were observed under the scanning electron microscope. Thirty six non-carious extracted premolars were randomly assigned to four groups of nine teeth: group 1, no treatment on the occlusal surface; group 2, acid etching for 15 seconds; group 3, Er:YAG laser irradiation; group 4, acid etching followed by Er:YAG laser irradiation. The pits and fissures were sealed with unfilled sealant(Helioseal F) and the specimen teeth were thermo-cycled, immersed in 2% Rhodamine B solution, longitudinally sectioned and analyzed for microleakage with fluorescent microscope. The results were as follows: 1. Er:YAG lased surfaces with 50 mJ, 3Hz showed a similar pattern of irregularity with acid etched enamel surfaces. 2. The mean microleakage score increased in the order of group 2, 4, 3 and 1. There was no significant difference among group 1, 3 and 4(p>0.05), however group 2 showed significantly less microleakage compared with group 1 and 3. Conclusively, the laser irradiation seemed not enough to replace the acid etching for proper retention of pit and fissure sealants.
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