유아기우식증 치료를 위한 레진침투법에서 제단백제재의 사용
A Modified Pretreatment with Deproteinization for Resin Infiltration in Early Childhood Caries
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이 연구는 유전치 비와동성 우식 병소에 레진침투법을 시행할 때 sodium hypochlorite(NaOCl) 제단백 후 phosphoric acid(H3PO4) 산부식 처리에 따른 법랑질 표면구조 및 레진 침투깊이 변화를 알아보았다. 90개의 발치된 비와동성 병소의 유전치를 전처리에 따라 5개 군으로 나누었다 : Ⅰ군 hydrochloric acid(HCl) 2분; Ⅱ군 NaOCl 1분, H3PO4 1분; Ⅲ군 NaOCl 2분, H3PO4 1분; Ⅳ군 NaOCl 1분, H3PO4 2분; Ⅴ군 NaOCl 2분, H3PO4 2분. 그 중 15개는 전계방사주사전자현미경을 통해 표면을 관찰하였고, 75개는 레진침투 후 공초점레이저주사현미경을 통해 병소 깊이와 레진 침투깊이를 측정하여 레진 침투도를 도출했다. NaOCl 적용 시간이 길어질수록 법랑질 산부식 Ⅰ, Ⅱ형 비율이 증가하였다. 레진 침투도는 Ⅴ군이 Ⅱ, Ⅲ군에 비해 통계학적으로 유의하게 높았고(p < 0.05), Ⅳ, Ⅴ군은 유의할 만한 차이가 없었다. 레진침투법은 유전치 초기 우식 병소의 치료로 사용될 수 있으며, 전처리 제로 15% HCl 산부식 대신 5.25% NaOCl 제단백 후 35% H3PO4 산부식이 대안으로 고려될 수 있다.
Abstract
This study aimed to evaluate surface morphology and resin tag penetration of resin infiltration into primary anterior teeth after enamel deproteinization with sodium hypochlorite (NaOCl) prior to phosphoric acid (H3PO4) etching. Ninety primary anterior teeth with non-cavitated caries lesion were devided five groups according to enamel pretreatment as follows, group Ⅰ-15% hydrochloric acid (HCl) 2min. ; group Ⅱ-5.25% NaOCl 1min., 35% H3PO4 1min. ; group Ⅲ-5.25% NaOCl 2min., 35% H3PO4 1min. ; group Ⅳ-5.25% NaOCl 1min., 35% H3PO4 2min. ; group Ⅴ-5.25% NaOCl 2min., 35% H3PO4 2min. Fifteen teeth were examined etched surface structure using field emission-scanning electron microscope. Seventy five teeth were infiltrated with resin, maximum penetration depth and percentage penetration were analysed using dual fluorescence confocal microscopy. As the application time of NaOCl increased, ratio of enamel type Ⅰ, Ⅱ were increased. Percentage penetration (PP) was higher in group Ⅴ than group Ⅱ, Ⅲ (p < 0.05). PP of group Ⅳ, Ⅴ did not show any differences. Non-cavitated caries of primary anterior teeth can be treated with resin infiltration. Enamel deproteinization with NaOCl prior to 35% H3PO4 etching could be an alternative of 15% HCl etching in resin infiltration.
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