Polyetherketoneketone의 연마 특성이 Candida albicans의 부착에 미치는 영향
Polishing characteristics of polyetherketoneketone on Candida albicans adhesion
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목적: 최근 치과에 도입된 polyetherketoneketone (PEKK)의 연마 특성이 Candida albicans의 부착에 미치는 영향을 기존 의치상재료인 polymethylmethacrylate (PMMA)와 비교하고자 하였다. 재료 및 방법: PEKK(그룹 E)와 PMMA(그룹 M)를 사용하여 직경 8 mm, 두께 2 mm인 원판 형태 시편을 제작한 후 연마 정도에 따라 각각 2개 그룹으로 세분하였다(ER, MR: rough; EP, MP: polished, 각 그룹당 시편 12개). 연마는 SiC 연마지로 시행하였으며, ER과 MR 그룹에서는 600 grit SiC 연마지만으로, EP와 MP 그룹에서는 600, 800, 1,000, 1,200 grit SiC 연마지로 단계적으로 연마하였다. 표면의 평균 거칠기는 원자력간 현미경(AFM)을 사용하여 Sa값을 측정하였고 주사전자 현미경으로 1,000배와 20,000배 확대하여 표면을 관찰하였다. 24-well 세포배양 용기에 연마된 시편 및 C. albicans 현탁액을 넣고 37℃에서 2시간 동안 배양하여 C. albicans의 부착을 유도하였으며, 부착된 진균을 피펫팅을 통해 분리하고 현탁액을 10 배씩 단계적으로 103 배까지 희석한 후, Sabouraud dextrose 고체배지에 스프레더를 이용하여 접종하였다. 48시간 후 각 고체배지에 형성된 집락의 개수(CFU/plate)를 세어 기록하였다. 측정된 값들의 통계적 차이를 확인하기 위해 one-way ANOVA와 Tukey HSD test를 수행하고 유의수준을 0.05로 정하였다. 결과: 평균 Sa 값은 MR 그룹이 다른 그룹에 비해 유의하게 더 높게 나타나 단계적 연마지 연마법은 PMMA 시편에서만 유의한 효과가 있었음을 확인할 수 있었다 (P < .05). MP 그룹과 EP 그룹간에 Sa 값은 유의한 차이가 없었다. 주사전자현미경 관찰결과 PEKK 시편들의 표면에서 다수의 보풀 같은 돌기가 형성되어 있는 것을 볼 수 있었고 EP 그룹에서 더 심해진 것을 관찰할 수 있었다. CFU/plate의 평균값은 EP 그룹에서 가장 높게 나왔으며 가장 낮은 MP 그룹과 유의한 차이를 보였다 (P < .05). 결론: PMMA와 비교하여 PEKK에서는 단계적 연마지를 이용한 연마를 시행 시 C. albicans의 부착 증가로 이어질 수 있으며, 임상에서도 이러한 점에 대한 신중한 고려가 필요할 것으로 사료된다.
Abstract
Purpose: To compare the polishing characteristics and their influence on Candida albicans adhesion to the recently introduced polyetherketoneketone (PEKK) and the conventional polymethylmethacrylate (PMMA) denture resin material. Materials and methods: Specimens from PEKK (Group E) and PMMA (Group M) were made in dimensions of 8 mm in diameter and 2 mm in thickness. The specimens were further divided into sub-groups according to the extent of polishing (ER, MR: rough; EP, MP: polished, N = 12 each). The specimens were polished using polishing machine and SiC foil. ER and MR group specimens were polished with 600 grit SiC foil only. EP and MP groups were further polished with 800, 1,000, 1,200 grit SiC foils sequentially. To measure the surface roughness values (Sa) of specimens, atomic force microscope (AFM) was used and scanning electron microscope (SEM) observation under 1,000, and 20,000 magnifications was performed to investigate surface topography. The polished specimens were soaked in C. albicans suspension for 2 hours with shaking to promote adhesion. The attached C. albicans were detached from the surface with 10 times of pipetting. The suspension of detached C. albicans was performed by serial dilution to 103 times, and the diluted suspensions were inoculated on Sabouraud dextrose agar plates using spread plate method. After incubating the plate for 48 hours, colony forming unit (CFU)/plate of C. albicans was counted. Statistical analysis was performed using one-way ANOVA and Tukey HSD test to confirm significant difference between the groups (α=.05). Results: Average Sa value was significantly higher in MR group compared to other groups (P<.05), meaning that additional polishing steps reduced surface roughness effectively only in the PMMA specimens. There was no significant difference in Sa values between MP and EP groups. In SEM images, PEKK specimens showed numerous spikes of abraded material protruding from the surface and this phenomenon was more significant in EP group. The mean CFU/plate value was the highest in EP group and this was significant when it was compared to MP group (P<.05) which was the lowest. Conclusion: Polishing PEKK using serial SiC abrasive foil may result in higher adhesion of C. albicans. In clinic, this should be considered carefully.
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