従来のタバコ喫煙および最近の加熱式タバコ製品がCAD/CAM修復材料に及ぼす影響

Effect of conventional cigarette smoking and recent heated tobacco products on CAD/CAM restorative materials.

抄録

目的:

従来のタバコ喫煙（CS）と最近の加熱式タバコ製品（HTP）が、さまざまな間接修復材料の表面粗さと色調安定性に及ぼす影響を明らかにすること。

OBJECTIVE: To determine the effects of conventional cigarette smoking (CS) and recent heated tobacco products (HTPs) on the surface roughness and color stability of different indirect restorative materials.

材料と方法:

3種類の異なるCAD/CAM修復材料（二ケイ酸リチウムガラスセラミック（IPS e.max CAD; Ivoclar Vivadent, Liechtenstein）、ジルコニア（BruxZir® Zirconia, Glidewell, USA）、ポリエーテルエーテルケトン（BioHPP® bredent GmbH, Germany）で100個の円盤状サンプルを作製した。IPS e.max CADとBruxzirのサンプルのうち、20サンプルは艶出し、20サンプルは研磨を行い、BioHPPのサンプルはすべてメーカーの指示に従って研磨を行った。50のサンプルは、従来のタバコ喫煙（LM、Philip Morris International Inc.、エジプト）に供した（Groups：IPS e.max CAD_GlazedによるCS喫煙（LD_G_Cig）、IPS e.max CAD_PolishedによるCS喫煙（LD_P_Cig）、Bruxzir_GlazedによるCS喫煙（Zr_G_Cig）、Bruxzir _PolishedによるCS喫煙（Zr_P_Cig）、BioHPPによるCS喫煙（PEEK_Cig）、および50個のサンプルを加熱式タバコ製品喫煙（Heets、Russet selection、Philip Morris International Inc：IPS e.max CAD_HTP（LD_G_HTP）、IPS e.max CAD_HTP（LD_P_HTP）、Bruxzir_HTP（Zr_G_HTP）、Bruxzir CAD_HTP（Zr_P_HTP）、BioHPP（PEEK_HTP）。中程度の喫煙行動（20本/日）の30日間に相当する600本/シートを使用した。煙への暴露の前後で、すべてのサンプルの表面粗さをJITAI8101表面粗さ試験機（北京吉泰科技検出器有限公司、中国）を用いて測定し、色パラメータをVITA Easyshade Advance 4.01（VITAシェード、VITA製、VITA）を用いて評価した。データは、一元配置分散分析（One-way ANOVA）、対の標本t検定、独立標本t検定を用いて分析した。有意水準はα<0.05とした。表面形状は走査型電子顕微鏡（SEM）で評価し、表面の化学組成の変化を調べるためにエネルギー分散型X線（EDX）分光法を用いて分析した。

MATERIALS AND METHODS: One hundred disc-shaped samples were constructed of three different restorative CAD/CAM materials: lithium disilicate glass-ceramic (IPS e.max CAD; Ivoclar Vivadent, Liechtenstein), zirconia (BruxZir® Zirconia, Glidewell, USA) and polyetheretherketone (BioHPP® bredent GmbH, Germany). Of the IPS e.max CAD and the Bruxzir samples, 20 samples were glazed, and 20 samples were polished, while the BioHPP samples were all polished according to the manufacturer's instructions. Fifty samples were subjected to conventional cigarette smoking (LM, Philip Morris International Inc., Egypt) (Groups: IPS e.max CAD_Glazed exposed to CS (LD_G_Cig), IPS e.max CAD_Polished exposed to CS (LD_P_Cig), Bruxzir_Glazed exposed to CS (Zr_G_Cig), Bruxzir _Polished exposed to CS (Zr_P_Cig) and BioHPP exposed to CS (PEEK_Cig) and fifty samples were exposed to heated tobacco product smoking (Heets, Russet selection, Philip Morris International Inc., Italy) (Groups: IPS e.max CAD_Glazed exposed to HTP (LD_G_HTP), IPS e.max CAD_Polished exposed to HTP (LD_P_HTP), Bruxzir_Glazed exposed to HTP (Zr_G_HTP), Bruxzir CAD_Polished exposed to HTP (Zr_P_HTP) and BioHPP exposed to HTP (PEEK_HTP).. Six hundred cigarettes/heets representing 30 days of medium smoking behavior (20 cigarettes/day) were used. Before and after exposure to smoke, the surface roughness of all the samples was measured using JITAI8101 surface roughness tester (Beijing Jitai Tech Detection Device Co., Ltd, China, and the color parameters were assessed using VITA Easyshade Advance 4.01 (VITA shade, VITA made, VITA). The data were analyzed using One-way ANOVA, paired sample t-test and independent sample t-test. The significance level was set at α < 0.05. The surface topography was evaluated by scanning electron microscopy (SEM) and analyzed using energy-dispersive X-ray (EDX) spectroscopy to determine changes in the surface chemical composition.

結果:

いずれのタイプの喫煙も、すべての試料の表面粗さに有意な増加をもたらした。表面仕上げが異なるすべての材料において、CSとHTPの間で色の変化に有意差があり（P<0.01）、ジルコニアが色の変化に最も大きな影響を与えた（P<0.001）。対照的に、ポリエーテルエーテルケトン（PEEK）"BioHPP "は、最も影響が少なかった（P<0.001）。

RESULTS: Both types of smoking caused significant increases in the surface roughness of all the samples. There was a significant difference in color change between CS and HTP for all materials with different surface finish (P < 0.01) and zirconia had the greatest effect on color change (P < 0.001). In contrast, polyetheretherketone (PEEK) "BioHPP" had the least effect (P < 0.001).

結論:

さまざまな種類の喫煙にさらされると、さまざまな審美修復材料の表面形状と色調に変化が生じる。HTPと比較して、従来のタバコの煙は審美修復材料の表面粗さと色の安定性に大きな影響を及ぼす。釉薬表面は研磨表面よりも表面トポグラフィーの変化が少なかった．ジルコニアは、ポリエーテルエーテルケトン（PEEK）と比較して、より優れた色調安定性を示した。

CONCLUSION: Exposure to different types of smoking induce changes in the surface topography and color of different esthetic restorative materials. Compared with HTP, conventional cigarette smoke has a greater effect on the surface roughness and color stability of esthetic restorative materials. The glazed surfaces showed less change in surface topography than did the polished surfaces. Zirconia showed better color stability when compared to polyetheretherketone (PEEK).