도재 수복물 합착시 상아질 접착 술식이 레진 시멘트의 전단결합강도에 미치는 영향
An effect of Dentin Bonding Procedure on the Shear Bond Strength of Resin Cement to Porcelain Restoration
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본 연구에서는 ClearfilTMSEBond와 AdapterTMSingleBond2를 사용하여 즉시 상아질 접착을 하였을 때 지연 상아질 접착을 하였을 때와 비교해 전단결합강도 및 파절 양상을 관찰하였다. 발치된 구치를 네 군으로 나누어 1군은 대조군으로 치아 삭제 직후 시편을 상아질 접착제를 광중합 후 합착하였고 2군과 3군은 치아 삭제 직후 각각 ClearfilTMSEBond와 AdapterTMSingleBond2로 즉시 상아질 접착을 한 후 열 순환기에 교대침수 시키고 상아질 접착제를 광중합하지 않고 합착하였다. 4군은 삭제 후 아무 처리를 하지 않고 열 순환 후 상아질 접착제를 광중합하지 않고 합착하였다. 이후 만능 시험기로 모든 시편의 전단결합강도를 측정하였으며, 광학현미경으로 파절 양상을 관찰하였다. 측정 결과 대조군이 가장 높은 결합력을 보였고 지연 상아질 접착을 시행한 군에서 가장 낮은 결합력을 보였다. ClearfilTMSEBond로 즉시 상아질 접착을 한 군은 대조군과 유의한 차이를 보이지 않았고, 4군보다 유의하게 높은 결합력을 보였다. AdapterTMSingleBond2를 이용하여 즉시 상아질 접착을 한 군은 4군보다 높은 결합력을 보였으나 유의한 차이를 보이지 않았다. 파절 양상에서는 대조군과 2군이 4군에 비해 유의하게 혼합형 파절이 많이 나타났다(p<0.05). 이상의 결과로 보아, 도재 수복물의 합착에 있어서 치아 삭제 후 즉시 상아질 접착제를 적용하는 것이 바람직하다고 사료된다. 하지만 이때 사용되는 상아질 접착제의 선택에 있어서는 실제 임상 조건에서의 더 많은 연구가 필요하리라 사료된다.
Abstract
The purpose of this study was to determine whether there were differences in shear bond strength to human dentin using IDS technique compared with DDS. Forty freshly extracted human molars were and devided into 4 groups. The control group specimens were, on the morrow of tooth preparation, light-cured after application of dentin bonding agent and cemented with resin cement. The IDS/SE(immediate dentin sealing, ClearfilTM SE Bond) and IDS/SB (immediate dentin sealing, AdapterTM Single Bond 2) specimens were, on the morrow of tooth preparation, light-cured after application of dentin bonding agent(ClearfilTM SE Bond and AdapterTM Sing Bond 2, respectively), whereas DDS specimens were not treated with any dentin bonding agent. IDS/SE, IDS/SB and DDS specimens were thermocycled. Following that delay, specimens were cemented with resin cement. The dentin bonding agent was left unpolymerized until the application of porcelain restoration. Shear bond strengths were measured using a universal testing machine. Specimens also were evaluated for mode of fracture using an optical microscope. The mean shear bond strengths of control group and IDS/SE groups were not statistically different from one another. The bond strength of IDS/SE group had a significantly higher mean than that of DDS group. There was no significant difference in the mean shear bond strength between IDS/SB(4.11MPa) and DDS group. The evaluation of failure modes indicates that most failures in the control group and IDS/SE groups were mixed, whereas failures in the DDS group were interfacial. When preparing teeth for indirect ceramic restoration, IDS with ClearfilTM SE Bond results in improved shear bond strength compared with DDS.
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