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A new non-invasive preventive measure in cariology: laser-based tooth coating. Investigation of tooth-protective, material science and laser technical aspects.

龋病学中一种新的非侵入性预防措施：激光牙齿涂层。

基本信息

批准号：
253578142
负责人：
Professorin Dr. Marcella Esteves Oliveira, Ph.D.
金额：
--
依托单位：
Lehrstuhl für Lasertechnik (LLT)
依托单位国家：
德国
项目类别：
Research Grants
财政年份：
2014
资助国家：
德国
起止时间：
2013-12-31 至 2018-12-31
项目状态：
已结题

来源：
https://gepris.dfg.de/gepris/projekt/253578142?language=en
关键词：
new non invasive preventive measure

项目摘要

According to the world health organization (WHO) currently 60-90% of school children worldwide still have dental caries. Most of the new caries lesions occur in fissures and pits of the first molars until the age of 12 years. Unfortunately, fluoride is less effective in these areas and sealing of these fissures with composite materials presents only limited effectiveness. Clinical studies show 30 to 55% failure rates after 5 years, mostly due to the poor adhesion between the filling material and the tooth surface. Additionally to the caries problem, there has been an increase, of another condition causing tooth substance loss, the dental erosion. This latter condition may cause extensive tooth destruction, which can be even worse when combined with mechanical factors (e.g. tooth-brushing), the abrasion. Also these destructive oral disorders are only mildly controlled by the currently available preventive measures (diet changes / fluoride) and strongly dependent on patient compliance. Thus, there is still a great demand for innovative methods which can protect these highly affected tooth surfaces from acid dissolution, related both to caries and erosion.Therefore the aim of this project is to test a new non-invasive tooth surface coating procedure for achieving an increased caries and erosion protection, on predilection tooth sites of patients at high risk for caries or exaggerated dental erosion. For this, a laser-based method will be tested, which allows the transformation of materials applied on the tooth surface into a ceramic protective layer. Through a fundamental understanding of the material modifications and the chemical and structural changes at the dental hard tissues during the laser irradiation should be possible to achieve a tight connection between the surface of the natural teeth and the ceramic coat. The major challenge within this study plan is, however the dichotomy between the high peak temperatures required for a successful transformation of the particulate material into a homogeneous coating and the very low heat stabilities of the tooth. At the pulp, for example, a temperature increase of 5,5 °C leads already to irreversible tissue damage.One of the approaches to solve the difficulties in the present project will be the use of a customized glass ceramic coating material that presents a significantly reduced melting temperature compared to a pure ceramic. Furthermore, the exact temporal and local controllability of the laser will allow for a fine adjusting of the laser-induced temperature-time-profile, so that tooth damage can be avoided.Finally, the obtained coatings will be systematically tested using clinically similar carious, erosive and mechanical challenges (in vitro and in situ) in order to investigate their clinical and preventive applicability.

根据世界卫生组织（世卫组织）的数据，目前全世界60-90%的学龄儿童仍然患有龋齿。在12岁以前，大多数新的龋病发生在第一磨牙的裂缝和凹处。不幸的是，氟化物在这些区域的效果较差，用复合材料密封这些裂缝的效果有限。临床研究表明，5年后的失败率为30% ~ 55%，主要原因是充填材料与牙面粘连不良。除了龋齿问题外，另一种导致牙齿物质流失的情况也在增加，那就是蛀牙。后一种情况可能导致广泛的牙齿破坏，如果再加上机械因素（例如刷牙）和磨损，情况会更糟。此外，这些破坏性口腔疾病只能通过目前可用的预防措施（饮食改变/氟化物）得到轻度控制，并且在很大程度上取决于患者的依从性。因此，对创新方法的需求仍然很大，这些方法可以保护这些高度受影响的牙齿表面免受酸溶解，涉及龋齿和侵蚀。因此，本项目的目的是测试一种新的无创牙齿表面涂层方法，以实现对龋齿高风险或严重牙齿侵蚀的患者偏爱的牙齿部位的增强龋齿和侵蚀保护。为此，将测试一种基于激光的方法，该方法允许将应用于牙齿表面的材料转化为陶瓷保护层。通过对激光照射过程中牙齿硬组织的材料变化和化学结构变化的基本了解，可以实现天然牙齿表面与陶瓷涂层之间的紧密连接。然而，这项研究计划的主要挑战是，将颗粒材料成功转化为均匀涂层所需的高峰温度与牙齿非常低的热稳定性之间的矛盾。例如，在牙髓，温度升高5.5°C就会导致不可逆的组织损伤。解决当前项目中困难的方法之一是使用定制的玻璃陶瓷涂层材料，与纯陶瓷相比，该材料的熔化温度显着降低。此外，激光的精确时间和局部可控性将允许对激光诱导的温度-时间曲线进行精细调整，从而避免牙齿损伤。最后，获得的涂层将使用临床类似的龋齿，侵蚀和机械挑战（体外和原位）进行系统测试，以研究其临床和预防适用性。