대한치과보철학회지 :Vol. 40, No. 2, 2002 수종인상재의혼합방법에따른기포형성과표면재현력에관한연구 단국대학교치과대학보철학교실 류형선 임헌송 임주환 조인호 Ⅰ. 서론우수한보철물을제작하기위해서는정확한인상과정이선결조건이며우수한인상을채득하기위해서는인상재의취급성, 미

대한치과보철학회지 :Vol. 40, No. 2, 2002 수종인상재의혼합방법에따른기포형성과표면재현력에관한연구 단국대학교치과대학보철학교실 류형선 임헌송 임주환 조인호 Ⅰ. 서론우수한보철물을제작하기위해서는정확한인상과정이선결조건이며우수한인상을채득하기위해서는인상재의취급성, 미세부재현성, 탄성, 체적안정성등이우수해야하며혼합후기포의형성이적어야한다. 인상채득시에기포형성은피할수없으며기포는혼합방법 1-12), syringe-tip 직경 1,3,13,14,15), 점도 2,13,16) 등에영향을받으며인상체의찢김강도를저하시키고모형상에작은결절을형성하여보철물의정확성에영향을준다고하였다. 인상재의미세부재현성은점주도, 젖음성, 기포, 취급성에영향을받으며 16,17) 정밀한주조수복물의제작에사용되는인상재는 ADA specification No. 19 에제시된너비 20μm 선을재현할수있어야한다고보고되고있다. 16,18) Stackhouse 12) 가고무인상재의 hand mixing과 mechanical mixing에따른기포수를측정하여비교하였고, Keck 4) 과 Chong 등 2,13) 은탄성인상재의 hand-mixing과 auto-mixing이기포형성에미치는영향에대해비교한바있다. Pratten과 Novetsky 16) 는수종의인상재에대한미세부재현성을측정하여비교하였고, Johnson과 Drennon 17) 은삭제된단일치아의인상채득에대한임상적연구에서인상재의점주도가미세부재현성과기포형성에영향을준다고보고하였으며또한임상에서는타액, 습기, 혈액, 온도, 지혈제등이미세부재현성에영향을준다고보고되어있다. 16) 인상재의혼합방법은 hand mixing, mechanical mixing, auto mixing이있으며, hand mixing은일반적으로사용되는방법으로써혼합과정에서공기의유입이발생하며그로인해찢김강도와같은물리적성질에영향을줄수있다. 19) 또한표면에발생하는기포는부정확한모형을야기한다. Mechanical mixing에사용되는다양한혼합기가개발되어왔으며 mechanical mixing은빠르고간편하며기포가감소하는장점을가지고있으나 mechanical mixing을시행한경우작업시간도또한감소한다는것을고려하여야한다. Auto mixing은사용이용이하며 hand mixing시발생하는문제점을보완해줄수있고인상재소비가적어저렴하고술자간의변이성이적다. 7) 보철학영역에서인상채득은아주중요한과정이며기포형성은인상채득실패의주된이유중의하나이다. 또한지대치변연부위의우수한미세부재현성은정확한보철물제작을위한필요조건이다. 따라서기포형성을감소시킬수있는방법이나재료들에대해비교하는연구들이많이시행되어왔다. 그러나인상재혼합방법이미세부재현성에미치는효과에관한연구는미흡한실정이다. 이에본연구에서는임상적으로주로사용되는비가역성하이드로콜로이드인상재와폴리썰파이드인상재, 부가중합형실리콘인상재를이용하여두가지혼합방법 (hand mixing, mechanical mixing) 으로시편을제작한후이를입체현미경을이용하여기포수측정, 표면재현력측정을하여다소의지견 140

을얻었기에이에보고하는바이다. Ⅱ. 실험재료및방법 성된 free cutting steel로써표면재현력측정을위한균일한시편을제작하기위해사용하였다 (Fig. 2, 4). 1. 실험재료및기구본실험에서는다음과같은재료및기구를사용하였다. 1) 비가역성하이드로콜로이드인상재 TOKUSO A-1α (Tokuyama Co., Japan) CAVEX IMPRESSIONAL (Cavex Co., Holland) AROMA FINE DF Ⅲ (GC Co., Japan) 6) MixQueen TM (Oscotec, Korea) 237mm 270mm 300mm 규격을가지며진동및회전혼합방식을채택하여각종인상재및모형재의혼합이가능한 mechanical-mixing machine (Fig. 5). 7) Stereomicroscope SZ-PT (Olympus, Japan) 각시편에서기포수, 표면재현력을 18 배의배율로측정하였다 (Fig. 6). 2) 폴리썰파이드인상재 Permlastic light bodied(kerr., U.S.A.) 3) 부가중합형실리콘인상재 Panasil contact(kettenbach., Germany) 4) Metal tray 10mm 20mm 43mm 규격을가지며 9개의 transverse slots으로구성되어있으며기포수측정을위한균일한시편을제작하기위해사용하였다 (Fig. 1, 3). 2. 실험방법 1) 기포형성관찰을위한비가역성하이드로콜로이드인상재시편제작비가역성하이드로콜로이드인상재인 TOKUSO A-1α, CAVEX IMPRESSIONAL, AROMA FINE DF Ⅲ 를제조사의지시에의한혼수비에따라 hand mixing과 mechanical mixing 방법으로혼합한후금속트레이 (10mm 20mm 43mm, 9 transverse slots) 를이용하여각각 50 개씩총 300 개의균일한시편들을제작하였다 (Table Ⅰ, Fig. 1, 3, 7). 5) ADA apparatus for testing detail reproduction 길이 25mm, 너비 20μm, 50μm, 75μm 선으로구 2) 기포형성관찰을위한 3종류인상재시편제작비가역성하이드로콜로이드인상재인 TOKUSO A-1α, 폴리썰파이드인상재인 Permlastic light Fig. 1. Design of metal tray. 141

Fig. 2. Design of detail reproduction apparatus. Table. Ⅰ. Classification of experimental groups in comparison of void formation according to mixing methods of alginates Mixing methods Hand mixing Mechanical mixing TOKUSO A-1α n=50 n=50 Irreversible hydrocolloid CAVEX IMPRESSIONAL n=50 n=50 AROMA FINE DF Ⅲ n=50 n=50 Total : n=300 Table. Ⅱ. Classification of experimental groups in comparison of void formation according to mixing methods of 3 types of impression materials Hand mixing Mechanical mixing Irreversible hydrocolloid TOKUSO A-1α n=50 n=50 Polysulfide Permlastic light bodied n=50 n=50 Additional reaction type Panasil contact n=50 n=50 Total : n=300 bodied, 부가중합형실리콘인상재인 Panasil contact을제조사의지시에따라 hand mixing과 mechanical mixing 방법으로혼합한후금속트레이 (10mm 20mm 43mm, 9 transverse slots) 를이용하여각각 50개씩총 300개의균일한시편들을제작하였다 (Table Ⅱ, Fig. 1, 3, 7). 3) 미세부재현성관찰을위한시편제작비가역성하이드로콜로이드인상재인 TOKUSO A-1α, 폴리썰파이드인상재인 Permlastic light bodied, 부가중합형실리콘인상재인 Panasil contact을제조사의지시에따라 hand mixing과 mechanical mixing 방법으로혼합한후 ADA specification No. 19에따른미세부재현성기구를이용 142

Table. Ⅲ. Classification of experimental groups in comparison of detail reproduction according to mixing methods of 3 types of impression materials Hand mixing Mechanical mixing Irreversible hydrocolloid TOKUSO A-1α n=10 n=10 Polysulfide Permlastic light bodied n=10 n=10 Additional reaction type Panasil contact n=10 n=10 Total : n=60 Table. Ⅳ. Scoring criteria Score Criteria 1 20μm 선이명확하고예리하게재현됨 2 20μm 선이연속적이나명확성이떨어짐 3 20μm 선이재현은되었으나연속이지않음 4 20μm 선이재현이안됨 Ⅲ. 실험결과실험군의분류에따른기포수측정과미세재현성에대해연구한결과는다음과같았다. 1. 비가역성하이드로콜로이드인상재의기포형성 하여각각 10개씩총 60개의시편을제작하였다 (Table Ⅲ, Fig. 2, 4, 8). 4) 기포수측정, 표면재현성측정입체광학현미경 (Stereomicroscope SZ-PT (Olympus, Japan) 을이용하여 18배의배율로 6μm 크기이상의기포수측정과 20μm 선의재현성을 scoring criteria에따라평가하였다 (Table Ⅳ). 5) 통계처리본실험결과의통계처리에는 SPSS V 10.0 for win(spss Inc., USA) 을사용하여 one-way ANO- VA test, Scheffe test, Mann-Whitney test를이용하여 95% 유의수준으로검증하였다. 1) 혼합방법간의기포수비교본실험에서측정한기포수측정치는 K-S test 결과각군에서정규분포를이루었으며 independent t- test 결과 hand mixing군보다 mechanical mixing군에서기포형성의감소가있었으며, 통계적으로유의한차이를보였다 (p<0.05, Table Ⅴ). 2) 비가역성하이드로콜로이드인상재의혼합방법에따른기포수비교 TOKUSO A-1α, CAVEX IMPRESSIONAL, AROMA FINE DF Ⅲ 의 hand mixing과 mechanical mixing시기포형성에대한 one-way ANOVA test 결과, 각재료간에유의한차이를보이지않았다 (Table Ⅵ, Table Ⅶ). Table. Ⅴ. Mean and standard deviation of void formation according to mixing methods of alginate groups (Unit : number) Impression material Mixing method Mean±SD t-test TOKUSO A-1α Hand 123.14±8.51 Mechanical 18.38±3.53 Irreversible CAVEX IMPRESSIONAL Hand 126.14±8.26 hydrocolloid Mechanical 19.56±4.36 AROMA FINE DF Ⅲ Hand 124.56±5.74 Mechanical 20.28±4.61 p<0.05 p<0.05 p<0.05 143

Table. Ⅵ. Results of one way ANOVA test for void formation according to hand mixing of alginate groups Sum of Squares df Mean Square F Sig Between Groups 225.21 2 Within Groups 8498.36 147 1.95 0.15 Total 8723.57 149 Table. Ⅶ. Results of one way ANOVA test for void formation according to mechanical mixing of alginate groups Sum of Squares df Mean Square F Sig Between Groups 92.01 2 Within Groups 2584.18 147 2.62 0.08 Total 2676.19 149 Table. Ⅷ. Mean and standard deviation of void formation according to mixing methods of 3 types of alginate groups (Unit : number) Impression material Mixing method Mean±SD t-test Irreversible Hand 123.14±8.51 p<0.05 TOKUSO A-1α hydrocolloid Mechanical 18.38±3.53 Permlastic Hand 165.12±6.37 p<0.05 Polysulfide light bodied Mechanical 7.32±3.05 Additional Hand 119.24±8.07 p<0.05 Panasil contact reaction type Mechanical 0.94±0.89 Table. Ⅸ. Results of multiple range test for void formation according to hand mixing of 3 types of impression material groups Panasil contact TOKUSO A-1α * Panasil contact TOKUSO A-1α Permlastic light bodied (119.24±8.07) (123.14±8.51) (165.12±6.37) Permlastic light bodied * * *denotes pair of groups significantly different at the 0.05 level 144

Table. Ⅹ. Results of multiple range test for void formation according to mechanical mixing of 3 types of impression material groups Panasil contact Permlastic light bodied * Panasil contact Permlastic light bodied TOKUSO A-1α (0.94±0.89) (7.32±3.05) (18.38±3.53) TOKUSO A-1α * * *denotes pair of groups significantly different at the 0.05 level Table. ⅩⅠ. Results of Mann-Whitney test for detail reproduction according to mixing methods of 3 types of impression material groups Impression material Mixing method Hand 10 Irreversible hydrocolloid TOKUSO A-1α Mechanical 10 Permlastic Polysulfide Hand 10 light bodied Mechanical 10 Hand 10 Additional reaction type Panasil contact Mechanical 10 Score Mann-Whitney 1 2 3 4 test p>0.05 p>0.05 p>0.05 2. 3 종류인상재의기포형성 보였다 (p<0.05)(table Ⅸ, Table Ⅹ). 1) 혼합방법간의기포수비교각군의평균과표준편차는 Table Ⅱ와같으며 hand mixing시기포형성은 Permlastic light bodied군에서 165.12±6.37개로가장많았으며 mechanical mixing시 Panasil contact군에서 0.94±0.89 개로가장적었다. 본실험에서측정한기포수측정치는 K-S test 결과각군에서정규분포를이루었으며 independent t-test 결과 hand mixing군보다 mechanical mixing군에서기포형성의감소가있었으며, 통계적으로유의한차이를보였다 (p<0.05) (Table Ⅷ). 2) 3종류인상재의혼합방법에따른기포수비교 3종류인상재인 TOKUSO A-1α, Permlastic light bodied, Panasil contact의 hand mixing과 mechanical mixing시기포형성에대한 multiple range test의결과로써각군간에유의성이있음을 3. 3종류인상재의혼합방법에따른미세재현성미세재현성의 scoring criteria는 Table Ⅳ와같으며 3종류인상재인 TOKUSO A-1α, Permlastic light bodied, Panasil contact의미세재현성에대한 Mann-Whitney test의결과 hand mixing군과 mechanical mixing군간에유의한차이를보이지않았으며혼합방법에관계없이 TOKUSO A-1α, Panasil contact, Permlastic light bodied 순으로우수하였으며통계적으로유의한차이를보였다 (p<0.05) (Table ⅩⅠ). Ⅳ. 총괄및고안보철치료의궁극적목적은우수한보철물을제작하여상실된구강조직을수복해줌으로써환자의기능과심미성을회복해주는데있다. 고정성또는 145

가철성보철치료과정에서환자의구강내상태를정확히인기하는것은우수한보철물제작의필수조건이다. 따라서인상재의종류, 혼합방법그리고인상채득방법등에대한연구가보고되어왔다. 1-4,6-7,9-13,15,16,20-23) 치과용인상재는구강조직을복제할때사용하는재료이며, 전체악궁을복제하거나하나의치아또는무치악악궁을복제하게된다. 대개의경우석고산물을인상음형내로주입하여구강조직의모형이나다이를제작하기때문에이러한복제는정확해야한다. 인상재는여러가지방법으로분류할수있으며, 넓은의미에서탄성과비탄성으로분류할수있다. 다양한종류의탄성인상재가비탄성인상재대신에사용되어왔다. 이러한탄성재료들은치아에서제거할때변형없이복원되어음형을정확하게재현할수있다. 탄성인상재는하이드로콜로이드인상재와고무인상재로분류되며하이드로콜로이드인상재는가역성인아가와비가역성인알지네이트로나뉘어지고, 아가는치과에서사용된최초의탄성인상재로서정밀도가우수하고친수성이며탄성이우수한반면에크기안정성이낮고, 과열될경우치수나구강연조직에화상의위험이있고비교적값비싼장비가필요하다. 24) 알지네이트는혼합과사용이용이하며, 점도조절이용이하고저렴한가격으로예비인상이나진단모형제작을위해가장널리사용되고있으나, 체적안정성과표면재현력이떨어지는단점이있다. 24,25) 탄성고무인상재는 elastomer라불리우며, ADA specification No. 19 18) 에따르면화학성분에따라서폴리썰파이드, 축중합형실리콘, 부가중합형실리콘, 폴리이써로구분된다. 폴리썰파이드인상재는찢김저항성, 탄성회복이우수하며축중합형실리콘인상재는찢김저항성, 영구변형이폴리썰파이드보다더우수하고부가중합형실리콘은가장수축이적고우수한미세부재현성을가진다. 그러나폴리썰파이드인상재, 축중합형인상재, 부가중합형인상재는소수성으로인해인상채득시와모형제작시기포발생의단점을가진다. 폴리이써인상재는중합수축이적고체적안정성이우수하며친수성을가진다. 24) 최근의인상재는미세부재현성이우수하면서간 단한방법으로정밀인상을채득할수있는방법으로개발되고있다. 임상적으로기포형성없는인상채득은드물며인상채득시발생하는기포는다음과같은과정에서발생할수있다 ; 첫번째는인상재의혼합과정이고, 두번째는인상재를트레이또는 syringe에담는과정이며, 세번째는삭제된지대치주위에인상재를주입하는과정이다. 15) 인상재내기포발생에영향을미치는요소에대해서많은연구가끊임없이진행되어왔다. 1983년 Stackhouse 12) 는고무인상재의 hand mixing과 mechanical mixing에따른기포수를측정하여비교한결과 hand mixing의경우 stropping 혼합방법에서 stirring 혼합방법에서보다기포가더적게발생되었고 mechanical mixing에서 hand mixing보다더적은기포발생이있었다고보고하였다. 따라서 hand mixing시에는 stirring 혼합방법보다 stropping 혼합방법이추천된다. 1986년 Scrabeck 등 10) 은진공하에기계적혼합방법을추천하였다. Chong 등 2) 과 Keck 등 4) 은 auto-mixing을통해기포감소, 오염방지, 정확한기저재 / 촉진재비율를맞춰줄수있다고보고하였다. 1992년 Lim 등 7) 은 auto mixing이기포를감소시킨다고하였고인상재내기포는찢김강도의저하를일으킨다고보고하였다. 1985년 Stackhouse 15) 는 syringe tip 직경과기포형성에대한연구에서직경이작을수록적은기포가발생하며 syringe 에서주입된부가중합형실리콘인상재내기포를비교측정한결과첫절반에서나머지절반보다기포가많이포함되어있다고하였다. 따라서인상채득시중요한변연부위는나중에주입할것을추천하고있다. 본연구에서사용한 mechanical mixing machine 인 MixQueen TM (Oscotec, Korea) 은국내최초로제작된인상재및모형재혼합기로서진동및회전혼합방식을채택하고있으며, 빠르고간편하며, 기포형성감소, 진료시간단축, 분진최소화로진료환경의개선을가져올수있을것으로사료된다. 측정결과를평가해보면첫번째로각각의인상재에서 hand mixing군보다 mechanical mixing군에서기포형성의감소가있었으며동일한혼합방법시알지네이트군간의기포형성에서는유의성이없었다. 따라서모든인상재에서기포형성을감소시키기위 146

해서 mechanical mixing 방법을이용하는것이추천된다. 그러나 mechanical mixing시모든인상재에서작업시간, 경화시간의감소가일어났으며그이유는혼합속도증가로인하여분자반응이촉진되었기때문인것으로사료된다. 두번째로 hand mixing시 Permlastic light bodied군에서기포형성이가장많았으며 Panasil contact군에서기포가가장적었다. 이와같은결과는인상재혼합시, 금속트레이에인상재를담을때 Permlastic light bodied의취급성이좋지않아공기의유입이더많이일어난결과로사료된다. 세번째로 mechanical mixing시 Panasil contact 군에서기포형성이가장적었고 TOKUSO A-1α 군에서기포발생이가장많았다. 네번째로 TOKUSO A-1α, Permlastic light bodied, Panasil contact 인상재에서 hand mixing군과 mechanical mixing군간에미세부재현성은차이가없었으며또한관찰자사이의차이도보이지않았다. 재료에있어서 Permlastic light bodied가가장우수하였으며 TOKUSO A-1α 에서가장낮았다. 이러한결과는 Ayers 26) 등이아가, 알지네이트, 폴리썰파이드, 실리콘의미세부재현성에대한비교연구에서폴리썰파이드가가장우수하였으며알지네이트가가장낮은재현성을나타냈다고보고한바와일치하였다. 또한 Johnson과 Drennon 17) 은인상재의점주도가미세부재현성과기포형성에있어서가장중요한요인이라고보고하였다. 따라서, 미세부재현성은혼합방법보다점주도, 흐름성과같은인상재의고유성질에더많은영향을받는결과로생각된다. 본연구의결과로보아인상채득시에기포형성감소를위해 mechanical mixing 방법으로혼합하는것이더우수한결과를가져올것으로기대되나작업시간, 경화시간이감소하기때문에보다더숙련된기술이요구되며미세부재현성은혼합방법보다는인상재의고유성질에의해더많은영향을받으므로인상재의성질에대해항상주지하고있어야한다고생각되며또한아직까지 mechanical mixing을이용하는경우에정확한혼수비, 기저재 / 촉진재비율을맞추기위해서는저울을이용해야하며인상트레이와 syringe에 spatula를이용하여담아야하는번거로움을피할수가없는데앞으로 mechanical mixing 의자동화와그에따른우수한인상채득을얻기위 한좀더다양한임상적연구가이루어져야하리라사료된다. Ⅴ. 결론본연구에서는인상재의종류와혼합방법이기포형성과미세부재현성에미치는영향에대해알아보기위해임상적으로많이사용되는비가역성하이드로콜로이드인상재와폴리썰파이드인상재, 부가중합형실리콘인상재를이용하였고두가지혼합방법으로시편을제작한후입체광학현미경으로기포수측정, 표면재현력측정을하여다음과같은결론을얻었다. 1. 혼합방법에따른비교시각각의인상재에서 hand mixing군보다 mechanical mixing 군에서기포형성의감소가있었으며통계적으로유의한차이가있었다 (p<0.05). 2. Hand mixing시 TOKUSO A-1α, CAVEX IMPRESSIONAL, AROMA FINE DF Ⅲ 군간의기포형성에는유의한차이가없었으나 Panasil contact, TOKUSO A-1α, Permlastic light bodied군에서는순서대로기포형성의증가가있었으며통계적으로유의한차이가있었다 (p<0.05). 3. Mechanical mixing시 TOKUSO A-1α, CAVEX IMPRESSIONAL, AROMA FINE DF Ⅲ 군간의기포형성에는유의한차이가없었으나 TOKUSO A-1α, Permlastic light bodied, Panasil contact군에서는순서대로기포형성의감소가있었으며통계적으로유의한차이가있었다 (p<0.05). 4. 미세부재현성은혼합방법에따른비교시 TOKU- SO A-1α, Permlastic light bodied, Panasil contact 인상재에서 hand mixing 군과 mechanical mixing 군간에통계적으로유의한차이가없었다. 5. 미세부재현성은혼합방법에관계없이 TOKU- SO A-1α, Panasil contact, Permlastic light bodied 순으로우수하였으며통계적으로유의한차이가있었다 (p<0.05). 147

이상의결과로볼때인상재혼합방법이기포형성에영향을미치고미세부재현성은혼합방법보다는인상재의고유성질에의해영향을받으므로인상채득시에적합한인상재선택과 mechanical mixing 방법을선택하는것이우수한보철물을제작하는데유리하리라사료된다. 참고문헌 1. 유소정, 이근우, 김경남 : 부가중합형실리콘인상재에서발생하는수소기체가경석고표면에미치는영향. 대한치과보철학회지, 34 (2):349-357,1996. 2. Chong, Y. H., Soh, G., and Wickens, J. L. : The effect of mixing technique on void formation in elastomeric impression materials. Int. J. Prosthodont., 2:323-326,1989. 3. Craig, R. G. : Evaluation of an automatic mixing systems for an addition silicone impression material. J. Am. Dent. Assoc., 110:213,1985. 4. Keck, S. C. : Automixing : A new concept in elastomeric impression material systems. J. Prosthet. Dent., 54:479,1985. 5. Koski, R. E. : Comparative study of selected alginate materials and devices. J. Am. Dent. Assoc., 94:713,1977. 6. Lepe, X., Johnson, G. H., Berg, J. C., and Aw, T. C. : Effect of mixing technique on surface characteristics of impression materials. J. Prosthet. Dent., 79:495,1998. 7. Lim, K. C., Chong, Y. H., and Soh, G. S. : Effect of operator variability on void formation in impression made with an auto-mixed addition silicone. Austr. Dent. J., 37:35,1992. 8. Morford, H. T., Tames, R. R., and Zardiackas, L. D. : Effects of vaccum and pressure on accuracy, reproducibility, and surface finish of stone casts made from polyvinyl siloxane. J. Prosthet. Dent., 55(4):466,1986. 9. Reisbick, M. H., Garrett, R., and Smith, D. D. : Some effect of device versus hand mixing hydrocolloids. J. Prosthet. Dent., 47:92,1982. 10. Scrabeck, J. G., Eames, W. B., and Hicks, M. J. : Spatulation methods and porosities in investment and impression material. J. Prosthet. Dent., 55:332,1986. 11. Stackhouse, J. A., Harris, W. T., Mansour, R. M., and Stanley, V. Hagen. : A study of bubbles in a rubber elastomer manipulated under clinical conditions. J. Prosthet. Dent., 57(5):591,1987. 12. Stackhouse, J. A. : Voids in a mixed elastomeric impression material. J. Prosthet. Dent., 50(6):762,1983. 13. Chong, Y. H., Soh, G., and Lim, K. C. : Effect of loading and syringing on void formation in automixed addition silicone elastomers. J. Oral. Rehabil., 20:631-636,1993. 14. Kishimoto, M., Shillingburg, H. T., and Duncanson, M. G. : A comparison of six impression syringes. J. Prosthet. Dent., 43:546,1980. 15. Stackhouse, J. A. : Relationship of syringetip diameter to voids in elastomer impressions. J. Prosthet. Dent., 53:812,1985. 16. Pratten, D. H., and Novetsky, M. : Detail reproduction of soft tissue : A comparison of impression materials. J. Prosthet. Dent., 65:188,1991. 17. Johnson, G. H., and Drenon, D. G. : Clinical evaluation of detail reproduction of elastomeric impression materials [Abstract]. J. Dent. Res., 66:361,1987. 18. Council on Dental Materials and Devices. Revised American Dental Association Specification No. 19 for Non-Aqueous Elastomeric Dental Impression Materials. J. Am. Dent. Assoc., 94:741,1977. 19. Keck, S. C., and Douglas, W. H. : Tear 148

strength of non-aqueous impression materials. J. Dent. Res., 63:155,1984. 20. 김경남, 최용석 : 수종치과용색변화알지네이트인상재의 ph와석고친화성에관한연구. 연세치대논문집, 9:81-87,1994. 21. Chee, W. W. L., and Donovan, T. E. : Fine detail reproduction of very high viscosity polyvinylsiloxane impression materials. Int. J. Prosthodont., 2:368-370,1989. 22. Hosada, H., and Fusayama, T. :Surface reproduction of elastic impression materials. J. Dent. Res., 38:932,1959. 23. Johnson, G. H., Chellis, K. D., Gordon, G. E., and Lepe, X. : Dimensional stability and detail reproduction of irreversible hydrocolloid and elastomeric impressions disinfected by immersion. J. Prosthet. Dent., 79:446,1998. 24. Phillips, R. W. : Skinner s Science of Dental Materials. 9:135,1991. 25. Johnston, W. M., and Rashid, R. G. : Irreversible hydrocolloid and gypsum interactions. Int. J. Prosthodont., 10:7,1997. 26. Ayers, H. D., Phillips, R. W., Dell, A., and Henry, R. W. : Detail duplication test used to evaluate elastic impression materials. J. Prosthet. Dent., 10:374-380,1960. 27. Cullen, D. R., and Sandrik, J. L. : Wettability of elastomeric impression and voids in gypsum casts. J. Prosthet. Dent., 66:261,1991. 28. Drennon, D. G., and Johnson, G. H. : The effect of immersion disinfection of elastomeric impressions on the surface detail reproduction of improved gypsum casts. J. Prosthet. Dent., 63:233,1990. 29. Gerrow, J. D., and Schneider, R. L. : A comparison of the compatibility of elastomeric impression materials, type IV dental stones, and liquid media. J. Prosthet. Dent., 57(3):292,1987. 30. Gerrow, J. D., and Price, R. B. : Comparison of the surface detail reproduction of flexible die material systems. J. Prosthet. Dent., 80:485,1998. 31. Inoue, K., Song, Y. X., Fujii, K., Kadokawa, A., and Kanie, T. : Consistency of alginate impression materials and their evaluation. J. Oral. Rehabil., 26:203,1999. 32. International Standard ISO No. 4823 : Dental elastomeric impression material. International Organization for Standardization. 1:13,1992. 33. McCabe, J. F., and Arikawa, H. : Rheological properties of elastomeric impression materials before and during setting. J. Dent. Res., 77(11):1874,1998. 34. Millar, B. J., Dunne, S. M., and Brett, R. P. : The effect of a surface wetting agent on void formation in impressions. J. Prosthet. Dent., 77:54,1997. 35. Mohammed, A. A. : Effect of frequency and amplitude of vibration on void formation in dies poured from polyvinyl siloxane impressions. J. Prosthet. Dent., 80:490,1998. 36. Pratten, D. H., and Craig, R. G. : Wettability of hydrophilic addition silicone impression materials. J. Prosthet. Dent., 61:197,1989. Reprint request to: Hyeong-Seon Ryu Department of Prosthodontics, College of Dentistry, Dankook University 7-1, Shinpoo-Dong, Chunan, Chungnam, 330-716, Korea Tel. 82-41-550-1990, 1994 149

논문사진부도 Fig. 3. Metal tray(10mm 20mm 43mm, 9 transverse slots) to contain the mixed charges of impression material Fig. 4. Detail reproduction apparatus Fig. 5. MixQueen TM (Oscotec, Korea) Fig. 6. Stereomicroscope SZ-PT (Olympus, Japan) Fig. 7. Completed specimens before void formation measurement Fig. 8. Completed specimens before detail reproduction measurement Fig. 9. Photograph of TOKUSO A-1α, Hand mixing( 18) Fig. 10. Photograph of TOKUSO A-1α, Mechanical mixing( 18) Fig. 11. Photograph of CAVEX IMPRESSIONAL, Hand mixing( 18) Fig. 12. Photograph of CAVEX IMPRESSIONAL, Mechanical mixing( 18) Fig. 13. Photograph of AROMA FINE DF Ⅲ, Hand mixing( 18) Fig. 14. Photograph of AROMA FINE DF Ⅲ, Mechanical mixing( 18) Fig. 15. Photograph of Permlastic light bodied, Hand mixing( 18) Fig. 16. Photograph of Permlastic light bodied, Mechanical mixing( 18) Fig. 17. Photograph of Panasil contact, Hand mixing( 18) Fig. 18. Photograph of Panasil contact, Mechanical mixing( 18) Fig. 19. Photograph of TOKUSO A-1α, Hand mixing( 18) Fig. 20. Photograph of TOKUSO A-1α, Mechanical mixing( 18) Fig. 21. Photograph of Permlastic light bodied, Hand mixing( 18) Fig. 22. Photograph of Permlastic light bodied, Mechanical mixing( 18) Fig. 23. Photograph of Panasil contact, Hand mixing( 18) Fig. 24. Photograph of Panasil contact, Mechanical mixing( 18) 150

사진부도 1 Fig. 3 Fig. 4 Fig. 5 Fig. 6 Fig. 7 Fig. 8 151

사진부도 2 Fig. 9 Fig. 10 Fig. 11 Fig. 12 Fig. 13 Fig. 14 152

사진부도 3 Fig. 15 Fig. 16 Fig. 17 Fig. 18 Fig. 19 Fig. 20 153

사진부도 4 Fig. 21 Fig. 22 Fig. 23 Fig. 24 154

ABSTRACT A STUDY ON THE VOID FORMATION AND DETAIL REPRODUCTION ACCORDING TO THE VARIOUS IMPRESSION MATERIALS AND MIXING METHODS Hyeong-Seon Ryu, Heon-Song Lim, Ju-Hwan Lim, In-Ho Cho Department of Prosthodontics College of Dentistry, Dankook University Void-free impression taking is important for the fabrication of accurate dental restorations. One of the essential properties of an impression material used for indirect fabrication of precision castings is the reproduction of the fine detail. The objective in this study was to determine the influence of mixing methods on the number of voids and surface detail reproduction. The number of voids and surface detail reproduction were evaluated with the stereomicroscope SZ-PT and photographed. The results were as follows; 1. In comparison of the void formation according to mixing methods of all impression materials, mechanical mixing was better than hand mixing and there was significant difference(p<0.05). 2. In comparison of the void formation according to hand mixing of alginate impression materials(tokuso A-1α, CAVEX IMPRESSIONAL, AROMA FINE DF Ⅲ ), there was no significant difference among alginate groups. But the number of void was increased in the order of Panasil contact, TOKUSO A-1α, Permlastic light bodied and there was significant difference(p<0.05). 3. In comparison of the void formation according to mechanical mixing of alginate impression materials(tokuso A-1α, CAVEX IMPRESSIONAL, AROMA FINE DF Ⅲ ), there was no significant different among alginate groups. But the number of void was decreased in order of TOKUSO A-1α, Permlastic light bodied, Panasil contact and there was significant difference(p<0.05). 4. In comparison of the surface detail reproduction according to mixing methods of 3 types of impression materials(tokuso A-1α, Permlastic light bodied, Panasil contact), there was no significant difference between hand mixing and mechanical mixing method 5. The surface detail reproduction was only influenced by impression materials, and produced better in order of TOKUSO A-1α, Panasil contact, Permlastic light bodied. There was significat difference among 3 type of impression materials(p<0.05). From the above results, void formation is influenced by mixing methods and surface detail reproduction is influenced by impression materials than mixing methods. Therefore, to fabricate accurate restorations, proper impression material and mechanical mixing method are more effective and available clinically. 155