Collaborative Research: Smart Dental Implant System for Ambulatory Dental Care

在美国，每年大约有500万颗种植体被植入以替换缺失的牙齿。虽然牙科种植体实践显示初始成功率高，但许多研究报告种植体周围疾病的发生率很高，在安装10年后高达50%。这些种植体周围疾病可能会导致患者不适，疼痛和昂贵的手术更换失败的种植体，甚至整体口腔健康崩溃。特别是，老年人，吸烟者，或有慢性牙周炎或糖尿病史的患者更容易患上种植体周围疾病。大量研究表明，种植体周围疾病的根本原因是牙菌斑在软组织-种植体界面的积聚和随后的局部炎症。今天，许多抗菌剂是可用的，潜在地减少牙冠表面上的细菌活性。然而，这些药物中的大多数可能不适合长期使用，因为这些药物可能会破坏生态微生物群并随着时间的推移诱导耐药性。此外，由于治疗剂逐渐损失到周围环境中，抗微生物涂层表面没有取得很大成功。因此，本项目的总体目标是建立一种实用的策略，通过增强外周软组织对细菌感染的免疫力来预防种植体周围疾病。此外，该项目通过指导研究生和本科生（包括代表性不足的少数民族和女性学生），将研究与教育场所相结合，开发跨学科课程，以弥合工程和生物医学研究之间的差距。该项目利用跨越工程和牙科医学的跨领域创新，创建一个流动牙科护理平台，即人类口腔运动驱动的智能牙科植入物（SDI）系统。SDI系统可以在疾病多发区域附近进行原位、高效、有针对性的低水平光疗。SDI系统代表了改善种植体周围疾病预防的重要机会。该项目1）阐明了人类口腔生物力学能量收集作为可靠电源的前所未有的潜力，2）了解近接触低水平光治疗新模式中光子-细胞-微生物相互作用的潜在机制，3）使用临床相关的种植体周围炎动物模型验证SDI系统。该奖项的结果将为预防和控制种植体周围疾病的发生提供新的视角。此外，能量收集技术的成功演示将同时扩大在任何需要近零功率应用的领域的适用范围。最后，类似的概念也可以复制在其他微生物引起的炎症，如皮肤伤口愈合和维持骨科植入物。这个奖项反映了NSF的法定使命，并已被认为是值得通过使用基金会的智力价值和更广泛的影响审查标准进行评估的支持。

Every year, approximately 5 million implants are placed to replace missing teeth in the United States. Although the dental implant practice shows initial high success rates, many studies reported high occurrences of peri-implant diseases, up to 50% after 10 years of installation. These peri-implant diseases can potentially lead to patient discomfort, painful and costly surgical replacement of failed implants, and even the overall oral health breakdown. In particular, the geriatric population, smokers, or patients with a history of chronic periodontitis or diabetes were more vulnerable to peri-implant diseases. A significant body of studies indicates that the root causes of peri-implant disease are the accumulation of dental plaque at the soft tissue-implant interface and the subsequent local inflammation. Today, numerous antimicrobial agents are available, potentially reducing bacterial activity on the dental crown surface. However, most of these agents may not be appropriate for long-term use because these may disrupt ecological microbiota and induce drug resistance over time. In addition, antimicrobial coating surfaces have not been a great success due to the gradual loss of therapeutic agents into the surrounding environment. As such, the overall objective of this project is to build a practical strategy to prevent peri-implant disease by enhancing the immunity of peripheral soft tissue against bacterial infection. Furthermore, the project integrates the research with educational venues by mentoring graduate and undergraduate students, including underrepresented minorities and female students, developing interdisciplinary curricula to bridge the gap between engineering and biomedical research.The project leverages cross-cutting innovations spanning engineering and dental medicine to create an ambulatory dental care platform, a human oral motion-powered Smart Dental Implant (SDI) system. The SDI system enables in situ, highly effective, and targeted low-level light therapy in proximity to disease-prone areas. The SDI system represents a significant opportunity to improve the prevention of peri-implant disease. This project 1) elucidates the unprecedented potential of human oral biomechanical energy harvesting as a reliable power source, 2) understands the underlying mechanism of the photon-cell-microbe interaction in the new mode of near-contact low-level light therapy, and 3) validates the SDI system using a clinically relevant animal model of peri-implantitis. The outcome of this award will provide new perspectives on preventing and controlling the onset of peri-implant diseases. In addition, a successful demonstration of the energy harvesting technology will simultaneously extend the range of applicability in any field requiring near-zero power application. Finally, a similar concept can also be replicated in other microbially induced inflammations, such as skin wound healing and sustaining orthopedic implants.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.