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The effect of fluoride varnish and acidulated phosphate fluoride gel on artificial caries lesion - A Microcomputed Tomographic Study

이상훈|이재천|김영재|장기택|한세현|문성권
대한소아치과학회 (The Korean Academy Of Pediatric Dentistry)|2004.06|대한소아치과학회지 (Journal of the Korean academy of pediatric dentistry)|제31권 제2호|pp. 212-222

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참고문헌

키워드

Remineralization재광화Fluoride varnish미세 전산화 단층 촬영Acidulated phosphate fluoride gel인공우식 병소Artificial caries lesionMicrocomputed tomography
주제분류치의학

초록

치아 우식의 예방에 있어서 불소 도포는 효과적인 방법으로 재광화를 촉진하고 탈회를 억제한다. APF gel은 전문가 불소 도포용으로 가장 일반적인 방법이었으나 최근 fluoride varnish가 소개되면서 그 사용이 증가되고 있다. 이번 연구의 목적은 fluoride varnish와 acidulated phosphate fluoride(APF) gel이 인공우식 병소에 미치는 영향을 시편의 화학적 고정이나 절단 없이 미세전산화 단층 촬영과 3차원 영상을 이용하여 재광화 효과를 비교해 보고자 함이다. 48개의 우식이 없는 건전한 영구 소구치에 인공우식을 유발하고 각 군당 16개씩, 세 군으로 나누었다. 1군은 대조군으로 어떠한 처치도 시행하지 않았다. 2군은 APF gel을 도포하고 1분 후에 gel을 거즈로 제거하여 수세하고 3군은 fluoride varnish를 도포한 후 45분 후에 얇은 varnish 막을 외과용 칼로 조심스럽게 제거하였다. 그 후 각 시편을 50ml의 인공타액에 3개월 동안 담그어 둔 후 그 사이 기간동안 매달 미세전산화 단층 촬영을 이용하여 3차원 영상을 얻었다. 3차원 영상분석 프로그램으로 재광화 부위의 밀도를 측정하고 다음과 같은 결과를 얻었다. 1. 모든 군에서 시간이 지남에 따라 인공우식 부위의 밀도는 증가하였다. 2. APF gel 군과 fluoride varnish 군에서 한 달, 두 달, 세 달 후 밀도가 대조군보다 통계학적으로 유의성 있게 높았다(P<0.05). 3. APF gel 군과 fluoride varnish 군에서 처치전과 처치 한 달 후의 밀도 차이가 대조군보다 통계학적으로 유의성 있게 높았으며 fluoride varnish 군에서 처치 한 달 후와 처치 두달 후의 밀도 차이가 대조군과 APF gel 군보다 유의성 있게 높았다(P<0.05). 4. Fluoride varnish가 APF gel보다 불소 처치 후 두 달, 세 달 후 재광화 효과가 더 우수하였고 오래 지속되었다.

Abstract

The application of acidulated phosphate fluoride gel(APF) and fluoride varnishes are the most common topical fluoride therapy. The purpose of this in vitro study was to compare the remineralization effects of two topical fluoride agents, APF gel and fluoride varnish with microtomograph and 3D image analyzer without sample preparation and chemical fixation. For the purpose of the study, the artificial caries lesion was caused on the caries-free permanent premolar and 48 specimens were divided into three groups each containing 16 specimens. No application was performed on group 1, which acted as control group. Group 2 was treated with APF gel and was removed after a minute. Group 3 was treated with the topical application of fluoride varnish and removed after 45 minutes. Each specimen was placed into a closed container with 50ml of a artificial saliva during three months and the 3D images of the remineralization area were taken using the SkyScan each month. Using the density-measuring program in V worksTM , the density value of the remineralization area was measured. The following results were obtained: 1. All groups demonstrated an increase in the density of artificial caries lesion with time. 2. The density was significantly higher in APF gel and fluoride varnish group than control group at 1 month, 2 months, 3 months after the treatment(P<0.05). 3. The difference of the density between that "prior to treatment" and that "1 month after treatment" in Group 2 and Group 3 was significantly higher than that of Group 1 and, the difference of the density between that "1 month after treatment" and that "2 month after treatment" in Group 3 was significantly higher than that of Group 1 and 2(P<0.05). 4. The fluoride varnish was more effective after 2 and 3 months and continuous than the APF gel.

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