복합레진 수복 시 재접착 술식이 미세누출에 미치는 영향 = INFLUENCE OF REBONDING PROCEDURES ON MICROLEAKAGE OF COMPOSITE RESIN RESTORATIONS

국문 초록 (Abstract)

복합레진 수복시, 일반적으로 연마, 산부식, 수세 및 건조 단계를 거쳐 저점도 레진을 적용하는 재접착 술식을 통해 예상되는 수축간극을 봉쇄한다. 그러나, 이 과정은 재접착제 적용 이전에 물이나 잔사가 간극을 매워버릴 수 있어 그 효과가 의심된다. 본 실험에서는 연마 단계 이전, 즉 복합레진을 중합한 직후에 재접착제를 도포한다면 변연누출을 더 줄일 수 있을 것이라는 가설을 검증하고자 하였다. 실험을 위해 35개의 발거한 대구치에서 협면과 설면에 교합면 변연은 법랑질에, 치은측 변연은 상아질에 위치하는 5급 와동을 형성하였다. 와동은 Z250 (3M ESPE, USA)로 충전하였고, 접착제로는 AdperTM Single Bond 2(3M ESPE)을 사용하였다. 재접착제로는 Biscover LV (Bisco, USA) 레진 전색제와 ScotchBond Multi-purpose system(3M ESPE)의 접착제, 및 점도가 낮은 실험용 접착제를 연마 전 또는 일련의 연마 및 산부식 후 수복물의 변연에 적용하였다. 2% 메틸렌 블루 용액에 네 시간 동안 침적한 뒤 교합측 및 치은측 변연에서의 색소 침투 깊이를 광학 입체 현미경으로 측정하였다. 재접착제의 점도와 변연미세누출의 상관관계도 평가하였다. 재접착 술식, 재접착제, 및 변연의 위치, 그 각각에서는 통계적으로 유의한 차이를 관찰할 수 없었다. 그러나, 재접착 술식을 시행하지 않은 대조군의 경우에는 세 가지 재접착제를 사용한 재접착군에 비해 치은측 변연에서 미세누출이 통계적으로 유의하게 크게 나타났다(p < 0.05). 대조군과 재접착군의 미세누출의 차이는 교합측 변연에서는 관찰되지 않았다. 연마 및 산부식 후 치은변연에 재접착제를 적용한 경우에서 약한 음의 상관관계(r = -0.326, p = 0.041)를 보인 경우를 제외하고는, 재접착제의 점도와 미세누출은 유의한 상관관계를 보이지 않았다.

다국어 초록 (Multilingual Abstract)

During a composite resin restoration, an anticipating contraction gap is usually tried to seal with low-viscosity resin after successive polishing, etching, rinsing and drying steps, which as a whole is called rebonding procedure. However, the gap might already have been filled with water or debris before applying the sealing resin. We hypothesized that microleakage would decrease if the rebonding agent was applied before the polishing step, i.e., immediately after curing composite resin. On the buccal and lingual surfaces of 35 extracted human molar teeth, class V cavities were prepared withthe occlusal margin in enamel and the gingival margin in dentin. They were restored with a hybrid composite resin Z250 (3M ESPE, USA) using an adhesive AdperTM Single Bond 2 (3M ESPE). As rebonding agents, BisCover LV (Bisco, USA), ScotchBond Multi-Purpose adhesive (3M ESPE) and an experimental adhesive were applied on the restoration margins before polishing step or after successive polishing and etching steps. The infiltration depth of 2% methylene blue into the margin was measured using an optical stereomicroscope. The correlation between viscosity of rebonding agents and mciroleakage was also evaluated. There were no statistically significant differences in the microleakage within the rebonding procedures, within the rebonding agents, and within the margins. However, when the restorations were not rebonded, the microleakage at gingival margin was significantly higher than those groups rebonded with 3 agents (p < 0.05). The difference was not observed at the occlusal margin. No significant correlation was found between viscosity of rebonding agents and microleakage, except very weak correlation in case of rebonding after polishing and etching at gingival margin (r = -0.326, p = 0.041).

참고문헌 (Reference)

1 조영곤, "복합레진 수복물의 변연 미세누출에 관한 Biscover ™ 전색제의 효과" 대한치과보존학회 30 (30): 355-362, 2005

2 조영곤, "복합레진 수복물의 미세누출 감소를 위한 레진 전색제의 효과" 대한치과보존학회 31 (31): 282-289, 2006

3 Ferracane JL, "Using posterior composites appropriately" 123 (123): 53-58, 1992

4 Vankerckhoven H, "Unreacted methacrylate groups on the surfaces of composite resins" 61 (61): 791-795, 1982

5 McLean JW, "The use of glass-ionomer cements in bonding composite resins to dentine" 158 (158): 410-414, 1985

6 Erhardt MC, "The effect of rebonding on microleakage of class V aesthetic restorations" 27 (27): 396-402, 2002

7 Reid JS, "The effect of bonding agent and fissure sealant on microleakage of composite resin restorations" 22 (22): 295-298, 1991

8 Jayasooriya PR, "The effect of a “resin coating”on the interfacial adaptation of composite inlays" 28 (28): 28-35, 2003

9 Koo BJ, "The effect of C-factor and volume on microleakage of composite resin restorations with enamel margins" 31 (31): 452-459, 2006

10 Judes H EI, "Rebonding as a method of controlling marginal microleakage in composite resin restoration" 52 : 137-143, 1982

11 Pameijer CH, "Microleakage of “surfacesealing” materials" 8 (8): 43-46, 1995

12 Garcia-Godoy F, "Microleakage of posterior composite restorations after rebonding" 8 (8): 606-609, 1987

13 Tjan AH, "Microleakage at gingival margins of Class V composite resin restorations rebonded with various low-viscosity resin systems" 22 (22): 565-573, 1991

14 Hansen EK, "Marginal adaptation of posterior resins: effect of dentin-bonding agent and hygroscopic expansion" 5 (5): 122-126, 1989

15 Staninec M, "Interfacial space, marginal leakage, and enamel cracks around composite resins" 11 (11): 14-24, 1986

16 Unterbrink GL, "Influence of light intensity on two restorative systems" 23 (23): 183-189, 1995

17 Yu XY, "Influence of finishing technique on microleakage" 2 (2): 142-144, 1990

18 Munro GA, "In vitro microleakage of etched and rebonded Class 5 composite resin restorations" 21 (21): 203-208, 1996

19 Htang A, "Fatigue resistance of composite restorations: effect of filler content" 11 (11): 7-13, 1995

20 Torstenson B, "Effects of bonding agent types and incremental techniques on minimizing contraction gaps around resin composites" 5 (5): 218-223, 1989

21 Ramos RP, "Effect of three surface sealants on marginal sealing of Class V composite resin restorations" 25 (25): 448-453, 2000

22 Barone-Smith CE, "Effect of surface sealing on the microleakage of bonded restorations" 78 : 155-, 1999

23 Owens BM, "Effect of new generation surface sealants on the marginal permeability of Class V resin composite restorations" 31 (31): 481-488, 2006

24 Kubo S, "Effect of low-viscosity resin-based composite on the microleakage of cervical restorations" 16 (16): 244-248, 2003

25 May KN, Jr, "Effect of a surface sealant on microleakage of Class V restorations" 9 (9): 133-136, 1996

26 Marais JT, "Depth of cure of light-cured composite resin with light-curing units of different intensity" 52 (52): 403-407, 1997

27 Burgess JO, "Dental materials for the restoration of root surface caries" 8 (8): 342-351, 1995

28 Pashley DH, "Clinical considerations of microleakage" 16 (16): 70-77, 1990

29 Estafan D, "Class V lesions restored with flowable composite and added surface sealing resin" 48 (48): 78-80, 2000

30 Prati C, "Changes in enamel and dentin interface around composite class V restorations" 71 : 1014-, 1992

31 Dickinson GL, "Assessing the long-term effect of a surface penetrating sealant" 124 (124): 68-72, 1993

32 Ramos RP, "Assessing microleakage in resin composite restorations rebonded with a surface sealant and three low-viscosity resin systems" 33 (33): 450-456, 2002

33 Buonocore MG, "A simple method of increasing the adhesion of acrylic filling materials to enamel surfaces" 34 (34): 849-853, 1955

34 Torstenson B, "A new method for sealing composite resin contraction gaps in lined cavities" 64 (64): 450-453, 1985