Smear layer 처리에 따른 미세누출에 대한 연구 = THE EFFECT OF SMEAR LAYER TREATMENT ON THE MICROLEAHAGE

국문 초록 (Abstract)

본 연구는 도말층 제거 여부에 따른 근관 밀폐효과를 평가하기 위해 단근관 치아를 3% NaOCI 하에서 Ni-Ti file을 이용하여 crown-down 법으로 근관 형성 후 최종세정제로 NaOCI을 사용한 군과 EDTA를 사용한 군, 6개월 보관한 NaOCI-6군과 EDTA-6군으로 분류하였다. Continuous wave법으로 근관 충전 시행 후 색소 침투를 시행한 다음 해부학적 근첨에서 1.5 mm(Level l), 3.0 mm(Level 2), 4.5 mm (Level 3)에서 수평절단 하여 누출률을 측정하였다.
1. 모든 실험군에서 평균 누출률은 치근단부에서 치경부로 갈수록 감소하였다.
2. NaOCI 군의 누출률이 EDTA 군보다 level l, 2, 3에서 높게 나타났으나 level l에서만 통계학적 유의차를 보였다 (p<0.05).
3. NaOCI-6 군의 누출률이 EDTA-6 군보다 Level l, 2, 3에서 높게 나타났으나 level l에서만 통계학적 유의차를 보였다 (p<0.05).
4. NaOCI-6 군의 누출률이 NaOCI 군에 비해 Level l, 2, 3에서 증가하였으나 level l에서만 통계학적 유의차를 보였다 (p<0.05).
5. EDTA-6 군의 누출률이 EDTA 군에 비해 Level l, 2, 3에서 증가하였으나 통계학적 유의차는 없었다.
6. 주사전자현미경 관찰 결과 NaOCI 군과 NaOCI-6 군은 도말층이 제거되지 않아 상아세관내로 sealer 및 근관충전 재가 침투하지 못한 반면, EDTA 군과 EDTA-6 군에서는 도말층이 제거되고 상아세관내로의 sealer와 근관충전 재의 침투가 관찰되었다.
이상의 연구결과 EDTA를 이용하여 도말층을 제거한 경우 근관충전 즉시와 6개월 후 치근단 1/3 부위의 근단부 미세누출을 감소시킬 수 있을 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

The purpose of this study was to compare the sealing ability of root canal obturation with or without the treatment of smear layer. Eighty extracted human teeth with one canal were selected. Instrumentation was performed with crown-down technique. After instrumentation, root canals of the NaOCI group and NaOC1-6 group were irrigated with 3% NaOCI. EDTA group and EDTA-6 group were irrigated with 17% EDTA. Then all teeth were obturated using continuous wave obturation technique.
NaOCI group and EDTA group were immersed in methylene blue solution for 84hours. NaOCI-6 group and EDTA-6 group were immersed in methylene blue solution for 6months. The teeth were sectioned at 1.5 mm (Level 1), 3.0 mm (Level 2) and 4.5 mm (Level 3) from the root apex. The length of dye-penetrated interface and the circumferential length of canal at each level were measured using Sigma-Scan Pro 5.0.
1. The mean leakage ratio was decreased cervically.
2. NaOCI group showed higher mean leakage ratio than EDTA group at each level. But there was significant difference at level 1 only (p<0.05).
3. NaOCI-6 group showed higher mean leakage ratio than EDTA-6 group at each level. But there was significant difference at level 1 only (p<0.05).
4. NaOCI-6 group showed higher mean leakage ratio than NaOCI group at each level. But there was significant difference at level 1 only (p<0.05).
5. EDTA-6 group showed higher mean leakage ratio than EDTA group at each level. But there was no significant difference.
6. In NaOCI group and NaOCI-6 group, scanning electron micrographs of tooth sections generally covered with smear layer. In EDTA group and EDTA-6 group, tooth sections showing the penetration of sealers to opened dentinal tubules.
The results suggest that removal of smear layer was effective to reduce the apical microleakage of the root canal.

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