불소 바니쉬 도포 후 초기 치근 우식 발현에 대한 정량원소분석
Elemental analysis of the fluoride varnish effects on root caries initiation
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연구 목적: 우식 저 위험군에서 저 농도 불소 바니쉬가 초기 치근 우식 예방 및 치료에 미치는 영향을 검증하고자 한다. 연구 재료 및 방법: 건전한 하악 소구치 10개를 준비하여 치관부를 제거하고 협설, 근원심 방향으로 치아 장축에 평행하게절단 후 백악-법랑질 경계부 4 mm 하방에서 절단하여 40개의 시편을 제작하였다. 각각의 치근 표면에 형성된 4 mm ×1 mm 크기의 창에 Fluor Protector (1,000 ppm 불소 함유)를 도포하였다. 한 치아에서 나온 4 개의 시편을 다음과 같은 4개 실험군에 각각 배정하였다. A군: pH cycling 없이 불소 바니쉬 도포; B군: pH cycling시행 후 불소 바니쉬 도포; C군:불소 바니쉬 도포 후 pH cycling시행; D군: pH cycling을 시행한 뒤 불소 바니쉬 도포 후 pH cycling 재 시행. 시편을 정중부에서 절단하고 단면 부위를 연마한 뒤 전자현미경으로 표면을 관찰하였다. X선 분광분석을 통하여 Ca과 P의 중량 비를 측정하고 공 초점 레이저 현미경으로 바니쉬가 도포된 치근 면을 관찰하였다. 결과: 치근 표면에는 평균 12.3 (2.6) μm (single cycling) 과 19.6 (3.8) μm (double cycling) 깊이의 우식이 형성되었다. 표층의 칼슘 함량은 정상 치근에 비해 유의할만한 차이가 없었으나(p > 0.05), 표층 하 탈회 영역의 칼슘 함량은 유의할만하게 감소하였다(p < 0.05). 불소 바니쉬의 적용은 건전한 치근이나 초기 우식이 있는 치근에 적용했을 경우 모두에서 유의할만한 차이를 가져오지 않았다(p > 0.05). 바니쉬의 치근 상아질 투과 깊이는 표면 15 μm 이내에 한정되었다. 결론: 표층이 건전한 20 μm 이내의 초기 치근 우식 병소의 양상과 산 공격에 대한 변화를 관찰한 결과, 저 농도의 불소 바니쉬를 단기간 적용하는 것은 치근의 탈회 반응에 영향을 주지 못하였다.
Abstract
Objectives: The usage of fluoride varnish for a moderate to low caries-risk group has not been well validated. This study aimed to evaluate the preventive and therapeutic efficacies of fluoride varnish on the initiated root caries. Materials and Methods: Ten premolars were sectioned into quarters, further divided into two windows, one of which was painted with Fluor Protector (1,000 ppm fluoride, Ivoclar Vivadent). An initial lesion with a well-preserved surface layer was produced by pH cycling. Scanned line analysis using energy dispersive spectrometry determined the weight percentages of Ca and P in the demineralized layer. Scanning Electron microscopy and confocal laser scanning microscopy (CLSM) evaluated the varnish-applied root surfaces. Results: The mean lesion depth (SD) was 12.3 (2.6) μm (single cycling) and 19.6 (3.8) μm (double cycling). Double cycling extended the lesion depth, but induced no more mineral loss than single cycling (p < 0.05). The mean weight percentages of Ca and P between groups with and without varnish were not significantly different (p < 0.05). A CLSM showed varnish remained within 15 μm of the surface layer. Conclusions: When a mild acid challenge initiated root tissue demineralization, the application of low-concentration fluoride varnish did not influence the lesion depth or the mineral composition of the subsurface lesion. [J Kor Acad Cons Dent 2011;36(4):290-299.]
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