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SEM과 3차원 재구성법을 이용한 수복면의 위치와 와동 크기에 따른 미세누출도 분석

Microleakage of the class V cavity according to restoration site and cavity size using SEM and three-dimensional reconstruction techniques

신동훈|양인서
대한치과보존학회 (Korean Academy Of Conservative Dentistry)|2005.03|Restorative Dentistry and Endodontics|제30권 제2호|pp. 112-120

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주제분류치의학

초록

본 연구에서는 수복면의 위치와 와동의 크기에 따른 미세누출도의 차이를 확인하기 위해 3차원 재구성법에 의한 색소 침투량과 주사전자현미경 검경을 통한 변연틈새의 비율을 측정하였다. 32개의 건전한 대구치의 협/설면과 인접면에 각기 2 x 2 x 1.5 mm의 작은 와동과 4 x 2 x 1.5 mm 크기의 큰 5급 와동을 형성한 다음, 자가부식형 접착시스템으로 치면 처리하고 혼합형 복합레진인 Esthet X로 단일 충전하였다. 5도와 55도 사이에서 1000회의 열순환을 시킨 다음, 레진 복제물을 제작하고 SEM 검경을 통해 전체 변연길이에 대한 변연틈새의 비율을 측정하였다. 또한 열순환된 치아에 50% 질산은 용액으로 색소를 침투시킨 후 자가중합형 레진에 포매하여 0.25 mm두께의 간격으로 연속적으로 갈아내면서 각각의 단면상을 채득하였다. 각 단면상을 3차원으로 재구성하여 미세누출도를 정량적으로 평가하였다. 3차원 색소 침투량의 유의성 검정에는 Two-way ANOVA와 independent T-test를, 변연틈새의 비율에는 Mann-Whitney U test를 사용하였으며, 두 방법 사이의 Spearman's rho test로 평가하여 다음과 같은 결과를 얻었다. 1. 미세누출도는 수복면의 위치와 와동의 크기에 의해 영향을 받았다. 즉 협/설면과 작은 와동보다는 인접면과 큰 와동에서 더 많은 미세누출을 보였다. 2. 두 방법 사이에는 높은 상관 관계를 보였다 (상관계수 = 0.614 / P = 0.000). 이상의 연구 결과로 볼 때, 협/설면과 작은 와동의 수복물보다는 인접면과 큰 와동의 수복물에서 더 많은 미세누출을 보였으므로, 불필요한 치질 삭제를 줄임으로써 변연부의 노출이 커지는 것을 막아야 할 것이다.

Abstract

This study was done to evaluate whether there were any differences in microleakage of class V composite restorations according to restoration site and cavity size. Total sixty-four restorations were made in molar teeth using Esthet-X. Small (2 x 2 x 1.5 mm) and large (4 x 2 x 1.5 mm) restorations were made at the buccal/lingual surface and the proximal surface each. After 1,000 times of thermocycling (5oC - 55oC), resin replica was made and the percentage of marginal gap to the whole periphery of the restoration was estimated from SEM evaluation. Thermocycled tooth was dye penetrated with 50% silver nitrate solution. After imbedding in an auto-curing resin, it was serially ground with a thickness of 0.25 mm. Volumetric microleakage was estimated after reconstructing three dimensionally. Two-way ANOVA and independent T-test for dye volume, Mann-Whitney U test for the percentage of marginal gap, Spearman's rho test for the relationship between two techniques were used. The results were as follows: 1. The site and size of the restoration affected on the microleakage of restoration. Namely, much more leakage was seen in the proximal and the large restorations rather than the buccal/lingual and the small restorations. 2. Close relationship was found between two techniques (Correlation coefficient = 0.614 / P = 0.000). Within the limits of this study, it was noted that proximal and the large restorations leaked more than buccal/lingual and the small restorations. Therefore, it should be strictly recommended large exposure of margins should be avoided by reducing unnecessary tooth reduction.

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