온도자극이 충전된 치질에 미치는 영향
THE EFFECTS OF THERMAL STIMULI TO THE FILLED TOOTH STRUCTURE
이종한, 노용관, 이영수, 양정숙, 백진아,
소속 상세정보
이종한 ( ) - 전북대학교 치과대학 소아치과학교실
노용관 ( ) - 전북대학교 치과대학 소아치과학교실
이영수 ( ) - 전북대학교 치과대학 소아치과학교실
양정숙 ( ) - 전북대학교 치과대학 소아치과학교실
백진아 ( ) - 전북대학교 치과대학 소아치과학교실
KMID : 0358919990260020339
Abstract
본 연구에서는 수복에 따른 치질 내부 구조물의 열적변화를 평가하기 위하여 와동이 형성된 인공 치아 모형에 아말감 충전, 아말감과 스테인레스 스틸관 수복, 금인레이와 금관수복, ZOE 이장 및 아말감 충전 등으로 수복한 후 온도변화를 관찰하였다. 각 실험군에 4℃와 60℃로 2초와 4초 동안 자극을 가한 후 치아내부의 온도분포를 2차원적으로 분석하였고, 치수 중앙부에서 외측으로 층을 형성하여 3차원적인 해석을 시행한 결과, 다음과 같은 결론을 얻었다.
1. 4℃의 자극이 2초간 가해진 아말감 충전 경우, 아말감 충전과 스테인레스 스틸관을 장착한 경우에서는 1℃ 내외의 차이를 보였으며, 치수와 상아질 경계면에서 3초 경과시에 29℃까지 급격한 온도 하강을 보였으며 9초 후에 25℃에 도달하였다. 또한 금으로 수복한 경우에서는 3초 후 25℃까지 하강하여 그 온도를 유지하였으며, ZOE 이장 경우에서는 최저온도가 4℃ 이상 높게 나타났다.
2. 4℃ 자극을 4초간 가한 경우에서는 9초 후에서 2초 자극시보다 2-3℃ 낮았으며, 금 수복 경우에는 5초 후에 21℃의 최저온도를 보인 후 점차 회복되었다.
3. 아말감 충전 및 스테인레스 스틸관을 같이 장착한 경우에 60℃, 2초간 자극에는 3초 후 40℃ 온도로서 상승하였으나 9초 후에 30℃로 하강 하였으며, 금 수복에서는 2초 후 41℃까지 온도가 상승하였고, 9초 후 28℃를 보여 13℃의 차이가 있었다. ZOE 이장 경우에는 온도차이가 5℃로서 안정된 양상을 보였다.
4. 60℃, 4초 자극에 대한 아말감 충전 및 스테인레스 스틸관을 같이 장착한 경우에서 5초 후 42℃, 9초후 35℃를 보였으나 금 수복 경우에서는 3초 후 49℃, 9초 후 31℃의 온도변화를 나타내었다.
5. 3차원 분석에서 치수 중앙부에서 멀어질수록 온도변화가 심하였다.
The dental structure substituted by restorative materials may produce discomfort resulting from hot or cold stimuli. To investigate the effects of this stimuli on the human teeth, thermal analysis was carried out by calculation of general heat conduction equation in a modeled tooth using numerical method.
The method has been applied to axisymmetric and two-dimensional model, analyzing the effects of constant temperature 41C and 601C. That thermal shock was provided for 2 seconds and - 4 seconds, respectively and recovered to normal condition of 20C until 10 seconds. The thermal behavior of tooth covered with a crown of gold or stainless steel was compared with that of tooth without crown. At the same time, the effects of restorative materials (amalgam, gold and zinc oxide-eugenol(ZOE)) on the temperature of PDJ(pulpo-dentinal junction) has been studied.
The geometry used for thermal analysis so far has been limited to two-dimensional as well as axisymmetric tooth models. But the general restorative tooth forms a cross shaped cavity which is no longer two-dimensional and axisymmetric. Therefore, in this study, the three-dimensional model was developed to investigate the effect of shape and size of cavity. This three-dimensional model might be used for further research to investigate the effects of restorative materials and cavity design on the thermal behavior of the real shaped tooth.
The results were as follows
1. When cold temperature of 4C was applied to the surface of the restored teeth with amalgam for 2 seconds and recovered to ambient temperature of 201C, the PDJ temperature decreased rapidly to 29C until 3 seconds and reached to 25°C after 9 seconds. This temperature decreased rather slowly with stainless steel crown, but kept similar temperature within 1 C differences. Using the gold as a restorative material, the PDJ temperature decreased very fast due to the high thermal conductivity and reached near to 251C but the temperature after 9 seconds was similar to that in the teeth without crown, The effects of coldness could be attenuated with the ZOE situated under the cavity. The low thermal conductivity caused a delay in temperature decrease and keeps 4°C higher than the temperature of other conditions after 9 seconds.
2. The elapse time of cold stimuli was increased also until 4 seconds and recovered to 20C after 4 seconds to 9 seconds. The temperature after 9 seconds was about 2 - 31C lower than the temperature of 2 seconds stimuli, but in case of gold restoration, the high thermal conductivity of gold caused the minimum temperature of 21 C after 5 seconds and got warm to 231C after 9 seconds.
3. The effects of hot stimuli was also investigated with the temperature of 60°C. For 2 seconds stimuli, the temperature increased to 401C from the initial temperature of 351C after 3 seconds of stimuli and decreased to 30°C after 9 seconds in the teeth without crown. This temperature was sensitive to surface temperature in the teeth with gold restoration. It increased rapidly to 411C from the initial temperature of 35C after 2 seconds and decreased to 28°C after 9 seconds, which showed 13°C temperature variations for 9 seconds upon the surface temperature. This temperature variations were only in the range of 5C by using ZOE in the bottom of cavity and showed maximum temperature of 37C after 3 seconds of stimuli.
4. In case of 4 seconds hot stimuli, the temperature increased 42°C after 5 seconds and decreased 35°C after 9 seconds in the teeth without crown. But in gold restoration, showed 491C after 3 seconds and 31°C after 9 seconds temperature variation was up to 18C. Temperature variation of ZOE base case was only 51C.
5. In three-dimensional analysis, we could find higher and lower thermal distribution pattern at the outer layer.
키워드
열분석;수복재료;온도;thermal analysis;restorative material;temperature
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