Chlorhexidine Nanoparticles in the Management of Peri-implant Diseases

洗必太纳米颗粒治疗种植体周围疾病

• 批准号: MR/N001362/1
• 负责人: Sarah Garner
• 金额: $ 24.19万
• 依托单位: University of Bristol
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2015
• 资助国家: 英国
• 起止时间: 2015 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FN001362%2F1
• 关键词: Chlorhexidine; Nanoparticles; Management; Peri; implant

The aim of this research is to design and optimise a coating for dental implants that prevents infection.Dental implants can be used to replace a missing tooth or teeth. They are titanium screws which are surgically placed into the jaw, acting as an artificial root to which false teeth can be attached. They allow a patient to eat, speak and socialise more normally than they would without teeth. They are used to treat patients who have lost teeth due to decay, gum disease, major trauma such as road traffic accidents, and head and neck cancers. Approximately 1.5 million people in the UK have dental implants, with numbers increasing every year.After implant placement in the jaw, bone cells (osteoblasts) attach to the surface, laying down new bone and securing the implant in position. This important process is known as 'osseointegration', and takes 6-12 weeks. It permanently anchors the implant in the bone.Osseointegration can, however, be compromised by infection. During or after surgery the implant can be colonised by bacteria. This can lead to inflammation and discomfort (peri-implant mucositis), and, if untreated, can destroy surrounding gum and bone (peri-implantitis). This usually means that the implant is no longer functional, and requires removal. There is often not enough bone left to place a new implant, meaning that either a bone graft or denture is necessary to replace teeth. This can impact on the patient's confidence whilst eating, speaking and socialising. These implant infections can occur in any patient, but particularly affects older or unwell patients, such as those who have had cancer or major trauma.An infection can develop at any point within the lifespan of the implant; immediately after placement in the jaw, or months to years later. Up to 43% of implants develop infection and there is no consensus among clinicians or scientists how to best prevent or treat it. Current methods include professional implant cleaning by a dentist, cleaning with one or more chemicals, and use of antibiotics.Recently, tiny particles ('nanoparticles') have been developed that release an antiseptic agent, chlorhexidine. Chlorhexidine is already used widely in healthcare, including as a pre-operative skin cleanser, in mouthrinse to treat oral infection, in eye drops and in wound dressings. It treats infection by killing the organisms which cause it, including bacteria, fungi and some viruses.Previous research has shown a benefit in using chlorhexidine in the prevention and treatment of dental implant infections, but it has not been investigated in nanoparticle form. During my research project, I will coat titanium with these nanoparticles to determine if they could be used to prevent dental implant infections.I will develop methods to produce an even coating that leaves enough titanium uncovered to allow osseointegration. I will test this coating on bacteria taken from patients with implant infections to find the strength of its antibacterial effect. I will also clarify whether the nanoparticles are harmful to osteoblasts. Based on these combined results, I will optimise the coating for dental implants.If the coating is shown to have a long-term antimicrobial effect, whilst not affecting osseointegration, it could offer a simple and effective prevention for dental implant infections. Information gained from this project could also be useful in other areas of medicine, including joint replacements for hips and knees which are also made from titanium and suffer from similar problems with infection. This means the research could have an impact on infection prevention for many types of implant, not just in dentistry.With a rising number of dental implants in an ageing population, a straightforward method for prevention and treatment of implant infections is a priority for dentists. The global increase in antibiotic resistance means a strategy not reliant on antibiotics is essential.

这项研究的目的是设计和优化涂层的牙科植入物，防止感染。牙科植入物可以用来取代缺失的牙齿或牙齿。它们是钛螺钉，通过外科手术植入颌骨，作为假牙可以附着的人工牙根。它们允许患者比没有牙齿的患者更正常地进食，说话和社交。它们用于治疗因蛀牙、牙龈疾病、道路交通事故等重大创伤以及头颈部癌症而失去牙齿的患者。在英国大约有150万人有牙科植入物，每年的数字都在增加。在颌骨植入后，骨细胞（成骨细胞）附着在表面，沉积新骨并将植入物固定在适当的位置。这个重要的过程被称为“骨整合”，需要6-12周。它将种植体永久固定在骨内，但骨整合可能会受到感染的影响。在手术期间或手术后，植入物可能被细菌定植。这可能导致炎症和不适（种植体周围粘膜炎），如果不治疗，可能破坏周围的牙龈和骨骼（种植体周围炎）。这通常意味着植入物不再起作用，需要移除。通常没有足够的骨来放置新的种植体，这意味着需要骨移植或假牙来替换牙齿。这可能会影响患者在吃饭、说话和社交时的信心。这些种植体感染可能发生在任何患者身上，但特别是老年人或身体不适的患者，例如患有癌症或严重创伤的患者。感染可能在种植体使用寿命内的任何时间点发生;植入颌骨后立即发生，或数月至数年后发生。高达43%的种植体会发生感染，临床医生和科学家对于如何最好地预防或治疗感染还没有达成共识。目前的方法包括由牙医进行专业的种植体清洁，使用一种或多种化学品进行清洁，以及使用抗生素。最近，已经开发出微小的颗粒（“纳米颗粒”），可以释放抗菌剂氯己定。氯己定已经广泛用于医疗保健，包括作为术前皮肤清洁剂，用于治疗口腔感染的漱口水，滴眼液和伤口敷料。它通过杀死引起感染的生物体来治疗感染，包括细菌，真菌和一些病毒。以前的研究表明，使用氯己定预防和治疗牙科种植体感染是有益的，但尚未以纳米颗粒的形式进行研究。在我的研究项目中，我将用这些纳米颗粒涂覆钛，以确定它们是否可以用于预防牙科种植体感染。我将开发方法来生产均匀的涂层，使足够的钛暴露出来，以允许骨整合。我将在从植入物感染患者身上提取的细菌上测试这种涂层，以发现其抗菌效果的强度。我还将澄清纳米颗粒是否对成骨细胞有害。基于这些综合结果，我将优化牙科种植体的涂层。如果涂层被证明具有长期的抗菌效果，同时不影响骨结合，它可以提供一个简单而有效的预防牙科种植体感染。从该项目中获得的信息也可能在其他医学领域有用，包括髋关节和膝关节的关节置换术，这些关节也是由钛制成的，并且患有类似的感染问题。这意味着这项研究可能会对许多类型的种植体的感染预防产生影响，而不仅仅是在牙科领域。随着人口老龄化，牙科种植体数量的增加，预防和治疗种植体感染的简单方法是牙科医生的首要任务。全球抗生素耐药性的增加意味着不依赖抗生素的策略至关重要。

项目成果

A novel chlorhexidine-hexametaphosphate coating for titanium with antibiofilm efficacy and stem cell cytocompatibility.

• DOI: 10.1007/s10856-021-06616-5
• 发表时间: 2021-11-20
• 期刊: Journal of materials science. Materials in medicine
• 作者: Garner SJ;Dalby MJ;Nobbs AH;Barbour ME
• 通讯作者: Barbour ME