含氟高嶺土-丙烯醯胺複合樹脂作為兒童牙科溝隙封填材料之氟離子釋放模式研究

Abstract

目的 由國立台灣大學臨床牙醫研究所與國立台北科技大學材料科學與工程研究所共同研發的新型溝隙封填材料—含氟高嶺土/丙烯醯胺複合樹脂，和臨床常使用的含氟溝隙封填劑ClinproTM比較，有較佳的韌性，較強的硬度以及較低黏稠度，且其不具生物毒性，我們欲進一步了解新研發的含氟高嶺土/丙烯醯胺複合樹脂與市售其他二種—聚合樹脂類（ClinproTM）與玻璃離子體類（ClinproTM XT）—溝隙封填劑的氟離子釋放過程與再吸收結果，並加以比較。 材料與方法 本實驗所用來比較的三種材料：實驗組—含氟高嶺土/丙烯醯胺複合樹脂；對照組—ClinproTM、ClinproTM XT。材料釋放氟離子於乾淨無雜質的去離子水中，利用離子層析儀分析溶液內氟離子濃度的變化，再進行不同實驗部分的分析。本實驗分為三部分，第一部分為以56天長時間觀察材料釋氟的型態，與參考文獻中的公式對照，計算出含氟新材料的釋氟模式，並與市售其他二種材料比較；第二部分觀察不同聚合成熟時間對於材料釋氟的影響；第三部分給予材料不同的再次吸收氟離子之時間點，觀察是否會因再補充時間的延後而有所改變。最後，並試圖將各材料的化學與物理組成與氟離子釋放過程的動力學做相關聯的探討。 結果 根據56天氟離子累積釋放量對時間所作圖形，經非直線迴歸分析，ClinproTM在氟離子釋放的起先56天最符合之迴歸曲線方程式為[F]c = a*t/(b+t)+c*t/(d+t)+e*t；K-acrylamide CR為[F]c=([F]I*t/(t1/2+t)) + ([F]I’*t/(t1/2’+t)) + Ns*t；ClinproTM XT為[F]c=([F]I*t/(t1/2+t)) + ([F]I’*t/(t1/2’+t))。 聚合成熟時間實驗部分，改變材料遇水時間（光聚合後立即遇水與24小時後再遇水），對於ClinproTM XT氟離子釋放量的影響較ClinproTM和高嶺土/丙烯醯胺複合樹脂來得大，其聚合成熟時間愈短，釋放量愈多。 相異時間點氟化物再補充實驗部分，三種材料都具有氟離子再補充與再釋放能力，無論再補充的時間點為何，三種材料的再釋放量都仍能維持一定程度。若從氟離子吸收與再釋放量以及型態來分析，再補充的能力優劣依序為ClinproTM XT＞高嶺土/丙烯醯胺複合樹脂＞ClinproTM。 結論 含氟高嶺土/丙烯醯胺複合樹脂作為溝隙封填劑，氟離子釋放及再補充能力較市售常用的ClinproTM較好，雖然與玻璃離子體的ClinproTM XT相比較差，但具有樹脂類封填劑較佳的物理磨耗與化學侵蝕抵抗性，操作上因適當控制所含填料之重量百分比而具有良好流動性，仍有未來發展性。又根據本實驗中56天氟離子累積釋放量觀察，分別獲得樹脂類（ClinproTM、高嶺土/丙烯醯胺複合樹脂）與玻璃離子類溝隙封填劑之氟離子累積釋放量方程式，更能進一步分析材料的氟離子釋放過程。

Objectives The newly-developed pit and fissure sealant, fluoride-containing kaolinite-acrylamide composite resin, has the better fracture toughness, hardness and the less viscosity when compared with ClinproTM. It is also proved that the new material has no biological toxicity. The purpose of the study is to further understand the processes of fluoride release and recharge of the new material and other two pit and fissure sealants (ClinproTM and ClinproTM XT), and make the advanced comparison. Materials and methods Three materials were used in the study— fluoride-containing Kaolinite-acrylamide composite resin, ClinproTM and ClinproTM XT. The last two materials were the control groups. Fluoride was released from the materials into the deionized water, and fluoride in the water was analyzed by the ion chromatography for different purposes. The present study included three parts. Part I was “56 days fluoride elution experiment” and to figure out the equations which were the most representative for the plots of the fluoride cumulative release of the three materials. Part II was ”maturation experiment”. Part III was “different time points for NaF recharge” Results At the Part I, the most representative equation for the plot of the fluoride cumulative release of ClinproTM was [F]c = a*t/(b+t)+c*t/(d+t)+e*t；the equation for K-acrylamide CR was [F]c=([F]I*t/(t1/2+t)) + ([F]I’*t/(t1/2’+t)) + Ns*t; the equation for ClinproTM XT was [F]c=([F]I*t/(t1/2+t)) + ([F]I’*t/(t1/2’+t)). At the Part II, the different maturation time had more effect on the fluoride release amount of ClinproTM XT than on ClinproTM and K-acrylamdie CR. At the Part III, the three materials all had the ability of fluoride recharge and re-release. No matter what time point of the fluoride recharge was, there was no significant change in the fluoride re-release amount of the three materials. The ability of fluoride recharge: ClinproTM XT＞K-acrylamide CR＞ClinproTM。 Conclusion Fluoride-containing kaolinite-acrylamide composite resin as a pit and fissure sealant has better results of fluoride release and recharge than ClinproTM though worse results than ClinproTM XT. However, the new material, resin-based, was more resistant to wear and chemical irritants than ClinproTM XT. When applying to pits and fissures, it was also more convenient to use the new material because of the less viscosity. According to the equations acquired, we could get the advanced information of fluoride release process.