- 대한치과보철학회지 Vol. 30 No. 1, 1992 - 니켈 - 크롬합금과 Porcelain laminate 의결합력에관한연구 원광대학교치과대학보철학교실 이승로 진태호 동진근 < 목차 > Ⅰ. 서론 Ⅱ. 연구재료및방법 Ⅲ. 연구성적 Ⅳ. 총괄및고찰 Ⅴ. 결론참고문헌영문초록 I. 서론 치과용도재가 Charles Land에의해소개된이래로우수한심미성으로인하여치아의수복재료로널리사용되어져왔다 (42). 치과용도재는도재전장주조관, 도재재킷관, 의치용도재치아, porcelain laminate veneer및 porcelain inlay등에사용되고있으며점차다양한범위에서응용되어지고있다 (1, 2, 4, 13, 16, 25, 33, 35, 37, 38, 40). 도재전장주조관은 1956년이래치과임상에서활발이사용되어져왔으며이기간동안합금, 도재, 매몰재의물리적성질및성분, 재료를다루는방법, design에서많은개선이있어왔다. 그러나이러한개선에도불구하고도재의파절은아직도여전히발생되고있다 (2). 도재수복물의구강내에서의파절의원인은부적절한 metal support, 과다한도재의두께, 기술적인결함, 그리고부적절한교합등이있다 (3). 도재파절시몇몇 porcelain repair system이통상적으로사용되어지는데이 system은파절된도재와 repair material(composit) 사이의결합을향상시키기위해 silane coupling agent를사용한다 (15). Silane coupling agent는결합촉진제로서 1960년대에상품으로소개되었고점차적인연구로컴포짓레진을개발하여응용이확대되고있다 (33, 35, 36). 그러나컴포짓레진은구강에서쉽게마모되고, 시간이지남에따라물리적, 화학적변화가일어나심미적인외양이변하게된다 (31). 본연구는탈락된도재전장주조관의도재부회복방법으로서 porcelain laminate veneer 를이용하는것도하나의좋은회복방법이라고보아그기초연구로서금속면의처리방법에따른도재전장주조관용금속과 porcelain laminate veneer와의결합강도를측정하여다소의지견을얻었기에보고하는바이다. Ⅱ. 연구재료및방법 1. 금속시편제작 도재를접착시킬금속시편을제작하기위하여두께 2mm, 직경 5mm의 stainless steel의주형을만든다음분리재를바르고 inlay wax로 wax pattern을얻은후에 18gauge wsz로강도측정시사용될직경 4mm의고리를부착하여치과용고온인산염계매몰재 (Hi -Temp, Whip Mix, U.S.A.) 로매몰후에 Ni -Cr계비금속합금 (Rexillium Ⅲ, Generic Gold co., U.S.A.) 으로통법에의해주조하였다. 주조된시편은 #150 #400사포로연마한후에 15개씩 3군으로나누어다음과같이금속피착면을처리하였다. 1) 식각처리금속피착면을 etching agent(g -CERA porcelain bonding system, G -C CO.,Japan) 로 5분간식각하여흐르는물에서 1분간수세한후건조하였다. 85

2) Sandblaster에의한기계적처리평균입자크기 50μm 산화알루미나를 40psi압력으로 nozzle과시편과의거리 5mm를유지하여 5초간 sandblaster(cleanjet, YOSHIDA Co., Japan) 로 sandblasting한다음초음파세척기로 3분간세척후에건조시켰다. 3) Sandblaster에의한기계적처리및식각처리금속피착면을평균입자크기 50μm 산화알루미나로 5초간 sandblasting하고초음파세척기로세척후에건조시킨다음 etching agent로 5분간식각시키고흐르는물에서 1분간수세한후건조시켰다. 2. 도재시편제작직경 10mm, 두께 2mm의도재시편을제작하기위하여 porcelain laminate veneer용매몰재 (G -C vest, G -C co., Japan) 로음형을제작하였다. 이매몰제로제작된음형을 degassing하기위하여소환소성로 (YDF 1001, YOSHIDA Co., Japan) 에넣어분당 7~8 의속도로승온시켜 700 까지올린후다시도재용소성로 (Mark Ⅲ- MODULAR, NEY, U.S.A.) 로옮겨분당 50~60 로 1000 까지올린후에 5분간계류시키고실온까지서서히냉각시켰다. 도재의축성은 laminate용 porcelain powder(g -C porcelain powder, G -C Co., Japan) 를이용하였는데아래쪽에서부터 masking denting층 0.4mm, denti층 0.9mm, enamel층 0.5mm, 그리고 translucent층 02 mm의두께가되도록 mechanical condenser를이용하여축성하였으며잉여수분은흡수지를이용하여제거하였다. 축성된도재시편은제조회사의지시에따라소성로입구에서 650 로 10~15분간건조시킨후 720~760mmHG 진공상태에서분당 50~60 로 940 까지올려소성시켰으며다시소성로입구에서 10~15분간식힌후에꺼내서서서히냉각시켰다. 냉각된시편은기공용 bur를이용하여매몰재를제거한후에 glazing하였다. 금속시편과접착될면은 #150, #400사포로연마하고 5% 불화수소산으로 5분간부식시켰으며 3분간초음파세척기로세척한후수세건조시켰다. 3. 접착및결합강도측정 도재시편의접착면에시척제 (G -C CLEANER, G -E Co., Japan) 를면구에묻혀잘닦은후에 primer(g -C PRIMER, G -C Co.,Japan) 를바르고 air syringe로건조시켰다. 이와같이처리된금속및도재시편은접착용컴포짓레진시멘트 (G -C porcelain bond, G -C Co., Japan) 을사용하여 finger pressure로접착시킨후여분의시멘트는면구로제거하고 visible light curing instrument(white light, DOKUYAMA SODA, Japan) 로 40 초간중합시켰다 (Fig. 1). 중합은 2~3회반복하여시행하였으며접착된시편은 37 생리식염수에서 48시간동안보관한후에 Fig. 1과같이부속장치를이용하여도재부를파지 ( 把持 ) 하고결합강도측정을위해만능시헙기 (Instron. Model 4201, U.S.A.) 를이용하여분당 1mm의 cross head speed로결합강도를측정하였다 (Fig. 2). Fig.1. Diagram of Test specimenfig.1. Diagram of Test specimen Fig.2. Instron Universal Testing Machine 86

Ⅲ. 연구성적 Sandblaster로기계적처리를하고 etching 시킨경우가 62.78 kg/cm² 으로가장높았으며 sandblasting만한경우가 39.02 kg/cm² 이었고 etching만시킨경우가 10.52 kg/cm² 로가장낮았다 (Table 1, Fig.3). 각군간의유의수준을검정하기위하여 ANOVA( 일원변량분석 ) 를사용하여 99% 의유의수준에서검정한결과각군간에유사한차이 (p<0.01) 를보였다. 한편시편이탈락양상을금속현미경 (Olympus Model PME E, Olympus optical Co., Japan) 으로관찰한결과탈락은주로금속과레진시멘트사이에서일어났다. Table 1. Mean values of bonding strength 방법도사용되어진다 (2, 13, 46). Newburg와 Pameijer (33) 는치과용도재에컴포짓레진을결합시키기전에실란용액을사용하면유지력등에크게증가시킬수있다는것을발견했다. 또, Semmelman 과Kulp (40) 는실란을결합재로평가하고실란이아크릴릭레진과도재의치의유지력을증가시킨다고보고하였다. Simonsen과 Calamia (6, 43) 는불화수소산으로 porcelain laminate veneer을부식처리함으로써접합을개선시켰고, Bertolotti (14) 등은불산과 ADFgel등을도재면에부식처리하여결합력이증가됨을보고하였다. 이밖에도 Calamia (7), Horn (21), Simonsen과 Calamia (43), 이 (48) 등이불화수소산과 silane coupling agent의처리방법을 porcelain laminate veneer에도입시켜임상응용이가능한결합력을얻었다고보고하였다. Silane coupling agent의분자식은 X -(CH2) 3Si - (OR) 3로이루어졌는데무기질과유기질양쪽에화학결합을할수있고 (15) 도재에흡착되어표면을변화시켜줌으로써물리화학적과정을통하여상호결합의촉진작용을한다 (1 7). Silane coupling agent는결합을위하여도재표면에 (2, 13, 14, 32, 화학적인처리를하기위하여개발되어져왔다 34, 35). 최근에실란결합제가함유된불화수소산이 (5, 8, 9, 18, 19, 20, porcelain laminate system에도입되었다 21, 23). Fig.3. Histigram of bonding strength Ⅳ. 총괄및고찰 도재수복물이널리사용되면서부터 porcelain repair system의필요성이점차증대되어왔으며 (24) 많은연구자들이파절된도재전장주조관이나 porcelain jacket crown 의 repair system에대하여연구하였다 (25, 33, 39). 도재전장주조관의파절시에는 overcasting pin retained casting으로수복하는방법이있으며최근에는컴포짓레진을사용하여구강내에서직접수복하는 Silane coupling agent가함유된불화수소산을사용해서얻어진도재에대한컴포짓레진의결합력은 Calamia와 Simonson (8) 은 2078pai, Hsu (22) 는 3485psi 라고불화수소산을도재식각제로사용함으로써도재표면의 microporosity를증가시켜기계적인유지력을증가시킨다 (20, 21, 33). Calamia (10) 등은 5%, 7.5%, 10% 의불화수소산으로 2 분 30 초와 20 분간도재부식시결합강도를비교연구해보고했으며, Stangel (44) 등은컴포짓레진을부착시키기위한도재의식각에는 20% 의불화수소산을 2분 30초간적용시키는것이가장적합하다고보고하였다. Sheyth (41) 등과 Lacy (29) 등은도재의내면처리가접착용레진과의결합강도에미치는영향을보고하였다. 87

Cooly (21) 등은금속과 4 -META함유레진과인산 ester계레진의결합강도를비교하여모두도재의결합력 (15) 에비해금속과의결합력이낮았다고보고한바있다. 본실험에서도시편탈락양상이주로금속시편과레진시멘트사이에서일어났는데이는 sandblaster로금속피착면을처리했음에도불구하고레진과금속간의결합강도가레진과도재의결합강도보다낮음을의미한다. 금속이동반된도재전장주조관이파절시금속과레진간의결합력개선을위해 Cooly (12), Carpenter (11), Jochen과 Caputo (28), Lacy (29), Shimizu (42) 등은 diamond bur 나 sandblaster를이용하여기계적유지형태를부여했으며 Livaditis와 Thompson (30) 은금속을전해부식시켜서유지를얻었다고보고했다. 1979년에 Tanaka (43) 는금속에대하여레진의유지력을증가시킬목적으로 Ni -Cr -Cu합금을 pittting corrosion처리를하였다. Ni -Cr계합금에대한기계적처리방법으로산화알루미나로 sandblasting하는방법이있는데 300μm 와 50μm 의산화알루미나로 sandblasting한것이 300μm 의산화알루미나로처리한것보다미세한요철구조를얻었으며 4 -META함유접착성레진인 Super -Bond로접착하여결합강도를측정한결과50μm 의산화알루미나로 sandblasting한쪽이약2배의결합강도와내수성이있는것을보여주었다 (47). 본실험에서단지 etching한군이낮은결합강도를나타내었는데이러한결과는산화알루미나로 sandblasting하여얻은미세한요철구조가기계적인유지력으로작용하여결합강도에커다란영향을주는것을알수있다. Porcelain laminate veneer와레진시멘트간의결합강도를살펴보면 sandblasting과 etching을실시한군과 sandblasting만실시한군이단지 etching만실시한군보다약4~6배의높은결합강도를나타내었는데 porcelain laminate veneer를탈락된도재전장주조관에이용할때는반드시 sandblasting하는것이좋다고사료된다. 또, 시편의탈락양상이금속현미경으로보아서대부분이금속시편과레진시멘트사이에서일어났는데이것은불화수소산으로처리된도재시편과레진시멘트사이의 결합력은 porcelain laminate veneer를탈락된도재전장주조관에응용할수있을만큼충분한결합력을얻기위해서는보완이필요하고금속의투영으로인한색조의영향에대하여많은연구가진행된다면 porcelain laminate veneer가심미적으로우수하므로임상적용에활성화를기할수있다고사료된다. Ⅴ. 결론 본연구는탈락된도재전장주조관의수복방법으로서 porcelain laminate veneer의임상적이용에보탬이되고자금속피착면처리를달리하여 porcelain laminate veneer를레진시멘트로접착시켜결합강도를측정한결과다음과같은결론을얻었다. 1. Sandblasting시킨후 etching시킨경우가 sandblasting 이나etching을단독으로시킨경우보다높은결합강도를나타내었다. 2. Etching만시킨경우보다는 sandblasting만시킨경우가높은결합강도를나타내었다. 3. 시편의탈락양상은주로금속시편과레진시멘트사이에서일어났다. Reference 1) Babram Ghassemi Tray : Direct bonding to porcelain an in vivo study Am J Orthod 76 : 80 1979 2) Barreto M T and Bottaro B F : A practical approach to porcelain repair J Prosthet Dent 148 : 349 351 1982 3) Bello Antonio J et al : Bond strength and microleakage of porcelain repair material J Prosthet Dent 54 : 788 1985 4) Bowen R L : Properties of a silica-resin forced polymer for dental restoration JADA 66 : 57 1963 5) Boyer D B and Chalkley Y : Bonding between acrylic laminate and composite resin J Dent Res 61 : 489 492 1982 6) Calamia J R : Etched porcelain facial veneers : A 88

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33) Newburg R and Pameijer C H : Composite resin bonded to porcelain with silane solution J Am Dent Associ 96 : 288 1978 34) Newman G V : Bonding to porcelain I C O Inc 17 : 53 55 1983 35) Nowlin T P Barghi N and Norling B K : Evaluation of the bonding of three porcelain repair systems J Prosthet Dent 46 : 516 1981 36) O Brien W J and Ryge G : An outline of dental materials and their selection W B saunders Co Philadelphia 1978 37) Paffenbarger George C et al : Bonding porcelain teeth to carylic resin denture bases JADA 74 : 1018 1967 38) Pedersen John D : Type Ⅲ or Ⅳ gold alloy crowns with soldered porcelain fused to metal facing J Prosthet Dent 43 : 634 1980 39) Rehany A Zalkind N and Revah A : Repair of fractured porcelain jacket crowns with a composite resin J Prosthet Dent 46 : 455 1981 40) Semmelman J O and Kulp P R : Silane bond porcelain theeth to acrylic J Am Dent Associ 76 : 69 1968 41) Sheth J Jensen M and Tolliver D : Effect of surface treatment on etched porcealin bond strength to enamel Dent Mater 4 : 328 337 1988 42) Shimizu M Nitta Y Nakajima A et al : Evaluation of varous surface treatment for the maximun adhesion between a new resin cement three types of alloys Dent Mater 4 : 254 266 1985 43) Simonsen R J and Calmia J R : Tensile bond strength of etched porcelain J Dent Res 61 : 297 1983 44) Stangel I Nathanson D and Hsu C S : Shear strength of the comsite bond to ecthed porcelain J Dent Res 66 : 1460 1465 1987 45) Tanaka T Atsutz M Uchiyama Y Kawashima I : Pitting corrosion for acrylic resin facings J Prosthet Dent 42 : 282 2 1979 46) Welsh Stephen L and Schwab Joel T : Repair technique for porcelain fused to metal restoration J Prosthet Dent 38 : 61 1977 47) 산하정 : A dental adhesive and its clinical application Quint publishing Co 齒科接着性レシンの기...Tokyo 1983 48) 이종갑 : Etched porcelain laminate의접합강도에관한연구, 대한치과의사협회지, 24 : 243, 1986. 90

=Abstract= BONDING STRENGTH OF THE PORCELAIN ALMINATE TO Ni - Cr ALLOY Seung -Lo Lee, D.D.S., Tai -Ho Jin, D.D.S., Ph. D.,Jin -Keun Dong, D.D.S., Ph.D. Department of Prosthodontics, School of Dentistry, Wonkwang University The purpose of this study was to evaluate the bonding strength between porcelain lamivate and Ni-Cr alloy in the various surface treatments of the bonding faces. For this study the metal surface of specimens were treated : 1) etching only, 2) sandblasting only, and 3) sandblasting and etching. The porcelain laminate were made and bonded to the metal specimens with light curing composite resin cement. Instron testing machine was used to measure their bonding strength ; and the result was obtained as follows : 1. The bonding strength of the double treatment of the sandblasting and etching group was higher than that of the single treatment of sandblasting or the etching group. 2. The bonding strength of the sand blasting group was higher than that of the etching group. 3. The debonding were mainly occurred between the Ni-Cr alloy and the composite resin cement. 91