다양한 교정용 브라켓 원재료에 부착하는 mutans streptococci 양의 비교분석
Quantitative analysis of mutans streptococci adhesion to various orthodontic bracket materials in vivo
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법랑질 탈회는 교정 치료 중에 발생하는 대표적인 부작용으로서 특히 교정용 브라켓에 대한 세균 부착이 그 원인이 될 수 있다. 본 연구의 목적은 서로 다른 표면 특성을 가진 세 종류의 브라켓을 구강 내 장착했을 때 각 재료의 표면에 대한 mutans streptococci 부착 정도를 측정하여 브라켓 재료에 따른 법랑질 탈회 및 치아 우식 발생 가능성을 분석하는 것이었다. 상하악 및 치아 부위별 mutans streptococci 부착 정도의 차이를 배제하고 브라켓 원재료에 따른 차이만을 검출하기 위하여 균형완전블록 실험계획을 설계하였다. 피실험자인 30세 여성의 구강 내에 장착할 수 있는 tooth positioner 형태로 3세트의 플라스틱 맞춤 트레이를 제작하였으며, 이 트레이에 직육면체의 형태(4 x 3 x 2 mm)로 제작한 stainless steel, monocrystalline sapphire, polycrystalline alumina 조각을 세트마다 서로 다른 순서로 전치부와 구치부 순면에 부착하였다. 이렇게 제작된 3종류의 실험장치를 12시간 동안 피실험자의 구강 내에 장착한 후, 각 브라켓 재료 표면에 형성된 치태를 채취하여 bacitracin이 포함된 mitis salivarius배지에서 48시간 배양 후 colony counting을 통해 그 표면에 부착된 mutans streptococci 양을 비교하였다. 이와 같은 방법으로 3세트의 실험장치에 대해서 각각 5회씩 총 15회의 실험을 시행하였다. 그 결과 상하악 및 치아 부위별 및 브라켓 재료별 세균 부착 정도는 모두 유의한 차이를 보이지 않았다. 결론적으로 본 연구의 결과 in vivo condition에서 브라켓 재료의 차이는 mutans streptococci 부착에 영향을 미치지 못하는 것으로 보였다.
Abstract
Objective: To estimate the effects of bracket material type on enamel decalcification during orthodontic treatment, this study analyzed the adhesion level of mutans streptococci (MS) to orthodontic bracket materials in vivo. Methods: Three different types of orthodontic bracket materials were used: stainless steel, monocrystalline sapphire, and polycrystalline alumina. A balanced complete block design was used to exclude the effect of positional variation of bracket materials in the oral cavity. Three types of plastic individual trays were made and one subject placed the tray in the mouth for 12 hours. Then, the attached bacteria were isolated and incubated on a mitis salivarius media containing bacitracin for 48 hours. Finally, the number of colony forming units of MS was counted. The experiments were independently performed 5 times with each of the 3 trays, resulting in a total of 15 times. Mixed model ANOVA was used to compare the adhesion amount of MS. Results: There was no difference in colony forming units among the bracket materials irrespective of jaw and tooth position. Conclusions: This study suggested that the result of quantitative analysis of MS adhesion to various orthodontic bracket materials in vivo may differ from that of the condition in vitro.
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