Add-picture 방법을 이용한 교합접촉점 분석
Analysis of Occlusal Contacts Using Add-picture Method
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교합접촉 분석에 이용되는 T-Scan Ⅲ® (Tekscan, South Boston, MA, USA)의 정확도 및 신뢰도를 Add picture 방법을 통해 평가하였다. 두 방법에서 공통적인 교합접촉점의 분포 및 교합접촉면적을 비교하여 교합진단 및 조정술식에서 T-Scan 방법의 적용 시 고려점을 밝히고자 하였다. Angle Ⅰ급 교합관계, 정상치열자 한 사람의 구강을 대상으로 부가중합형 실리콘인상재를 이용하여 상하악치열궁을 10회 인상채득하였으며, 10쌍의 초경석고 모형을 제작하였다. 자체제작한 하중장치에 모형을 자석과 경석고를 이용하여 부착한 후 최대감합위와 최대교합력을 재현하기 위해 78.9kg의 하중을 가하였다. T-Scan 측정 시에는 상하악 모형과 T-Scan 센서의 위치가 변하지 않는 상태에서 2번 반복 측정하였다. Add Picture의 경우 상하악모형을 동일한 하중을 가하여 최대감합위에서 폴리이써 교합인기재를 이용하여 교합을 인기하였다. 교합접촉 양상은 접촉점 수와 총 교합면적에 대한 접촉면적 백분율을 측정하여 비교하였다. T-Scan 방법은 포토샵 프로그램 상에서 픽셀수를 계산하여 색상에 따른 면적을, Add picture 방법은 빛 투과 정도에 따라 인상재 두께를 0~10㎛, 0~30㎛, 0~60㎛의 3가지로 나누고, 이에 따른 면적을 실측하여 계산하였다. 총 교합면면적은 접촉면을 표시한 모형의 촬영상에서 픽셀수를 계산하여 함께 촬영된 격자를 기준으로 제곱미터값으로 변환하였다. 대응표본 t-검정을 이용하여 통계분석하였다. T-Scan 방법에서 분홍색상 및 붉은 색상으로 표시된 면적의 일부가 Add picture 방법에서 0~10㎛, 0~30㎛, 0~60㎛의 상하악 치아 간 거리에 해당하는 면적에 상응하였다. 교합접촉점 분포 비교 시 T-Scan 방법과 Add picture 방법은 유사하였다. 교합접촉면적 비교 시 T-Scan 방법에서 확대된 결과가 관찰되었으며, 전체교합면적에 대한 접촉면적 백분율 비교에서도 T-Scan 방법과 Add picture 방법의 백분율값은 유의한 차이를 보였다(P<.05). T-Scan에서 분홍색상 및 붉은 색상으로 표시된 부위의 면적값은 Add picture의 0~10㎛, 0~30㎛ 부위의 면적값보다 크고(P<.05), 0~60㎛ 부위와는 유사한 값을 보였다(P>.05). T-Scan에서의 교합접촉상은 실제보다 확대되어 나타났으며, 따라서 교합접촉에 대한 진단 및 조정 술식에서 보조적인 수단으로 활용하는 것이 추천된다.
Abstract
The purpose of this study was to analyze the area of occlusal contact points using visual method. One subject was selected who had Angle Class Ⅰ, normal dentition, without dental caries, periodontal disease and temporomandibular disorders. Forty times PVS impressions were taken and 10 pairs casts were fabricated using dental super hard stone. After mounting the casts with customized loading apparatus, 78.9kg/f force was loaded as a maximum biting force. In T-Scan method, occlusal contact points measurement was repeated twice. Then, using Photoshop program (Adobe photoshop CS3, Adobe. San Jose, USA), the pixels which indicated occlusal contact points by color was recognized, and the distribution of recognized pixels were calculated to area. In Add picture method, polyether bite material applied to the occlusal surface of the casts. Then, the image of the translucent areas was recorded and classified 0~10㎛, 0~30㎛, 0~60㎛ area by the amount of transmitted light. To acquire occlusal surface, the numbers of pixels from the photograph of the contact area indicated cast converted to mm2. The mean occlusal contact area by two methods was statistically analyzed (paired t-test). Part of the red and pink area in T-Scan image were almost equivalent to the 0~10㎛, 0~30㎛, 0~60㎛ area in Add picture image. The distribution of occlusal contact points were similar, but the average area of occlusal contact points was wider in T-scan image (P<.05). Pink and red area in T-scan image was wider than 0~10㎛, 0~30㎛ area in Add picture image (P<.05), but similar to 0~60㎛area in Add picture image (P>.05). Occlusal contact points in T-scan image did not indicate real occlusal contact points. Occlusal contact areas in T-scan method were enlarged results comparing with those in Add picture method.
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