CONTROLLED-RELEASE SEALANT TO PREVENT SECONDARY CARIES

控释封闭剂可预防继发龋

• 批准号: 6653960
• 负责人: Kenneth John Anusavice
• 金额: $ 29.36万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2001
• 资助国家: 美国
• 起止时间: 2001-09-15 至 2005-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6653960
• 关键词: Streptococcus mutans; acidity /alkalinity; antibacterial agents; chlorhexidine; clinical research; composite resins; dental adhesive /sealant; dental amalgam; dental caries; dental plaque; disease /disorder prevention /control; drug delivery systems; drug design /synthesis /production; drug screening /evaluation; fluoride ion; human subject; microcapsule; monoclonal antibody; normal ossification; oral facial restoration material; prognosis; slow release drug; tissue /cell culture; tooth enamel

DESCRIPTION: (Applicant's abstract verbatim) The cost of dental care in the United States was $45.8 billion in 1995. Replacement of dental restorations accounts for 75 percent of all operative work, and secondary caries at the margins of restorations is the most frequently identified reason for replacement (Kidd, 1996). Thus, dental patients can realize considerable cost savings and improved oral health care if the lifetime of defective restorations can be extended through the use of tooth preservation therapies. The overall objective of this study is to test the hypothesis that application to marginal crevices of a sealing resin that releases chlorhexidine and/or fluoride (when the pH decreases to below 6.0) can extend the service life of defective amalgam and composite restorations and enhance remineralization of demineralized adjacent enamel. We propose to test the following hypotheses- (1) polymer microspheres loaded with chlorhexidine diacetate alone, a dispersed mixture of either CaF2 or ZnF2 and chlorhexidine diacetate, or one of these fluoride agents alone will exhibit an onset of ion release when the solution pH decreases below 6.0 and will terminate ion release when the pH increases above 6.0; (2) the controlled-release microspheres when loaded in a resin matrix (bis GMA/TEGDMA/HEMA), will exhibit an initial release rate when the solution pH decreases below 6.0 and will reduce its release rate when the solution pH increases above 6.0; (3) Test the hypothesis that microbial accumulation (plaque) and site specific levels of S. mutans on tooth enamel adjacent to defective amalgam or composite restorations are significantly better predictors of secondary caries than the width of the marginal crevice and; whole mouth levels of S. mutans; and (4) a crevice-sealing resin containing a dispersed mixture of chlorhexidine and fluoride microspheres will more effectively inhibit demineralization and enhance remineralization of enamel adjacent to composite restorations than resins containing only one of these two therapeutic agents. Clinically relevant aspects of this project include: (1) use of a monoclonal antibody test for site specific analyses of S. mutans on selected approximal tooth surfaces with amalgam or composite restorations; (2) use of a dispersed mixture of polymer microspheres that will release an antibacterial agent (chlorhexidine) simultaneous with a remineralizing agent (fluoride) to prevent secondary caries in situ; and (3) analysis of extracted restored teeth to determine the best of four predictors for secondary caries (plaque levels-at the margins of restorations, whole mouth concentrations of S. mutans, site specific levels of S. mutans at the margins of amalgam and composite restorations, and the width of marginal crevices adjacent to amalgam and composite restorations).

描述：（申请人的摘要逐字）在牙科护理的成本 美国1995年为458亿美元。更换牙齿矫正器 占所有手术工作的75%， 利润率是最常见的原因， 替换（Kidd，1996）。因此，牙科患者可以实现可观的成本 节省和改善口腔保健，如果有缺陷的牙齿的寿命， 可以通过使用牙齿保存疗法来延长。整体 本研究的目的是检验这一假设，即应用于边缘 释放氯己定和/或氟化物的密封树脂的裂缝（当 pH值降低到6.0以下）可以延长有缺陷的汞合金的使用寿命 和复合絮凝剂，并增强脱矿质 相邻的釉质。我们建议测试以下假设：（1）聚合物 微球装载有单独的二醋酸氯己定，分散的混合物， CaF 2或ZnF 2和二醋酸氯己定，或这些氟化物中的一种 当溶液的pH值低于100时，单独的试剂将显示离子释放的开始。 降低到6.0以下，当pH值升高到6.0以上时， 6.0;（2）当负载在树脂基质中时的控释微球（bis GMA/TEGDMA/HEMA）在溶液pH为1.5时将表现出初始释放速率。 当溶液pH值低于6.0时， 增加到6.0以上;（3）检验微生物积累的假设 （斑块）和位点特异性水平的S.牙釉质上的变异体 有缺陷的银汞合金或复合材料替代物是明显更好的预测因子 继发龋比边缘缝隙的宽度和;整个口腔 S的水平。（4）含有分散的变形菌的缝隙密封树脂， 氯己定和氟化物微球的混合物将更有效地 抑制邻近釉质脱矿和增强釉质矿化 与仅含有这两种治疗剂之一的树脂相比， 剂.该项目的临床相关方面包括：（1）使用 单克隆抗体试验用于对S.选定的变异 用汞合金或复合材料修复近牙面;（2）使用 将释放抗菌剂的聚合物微球的分散混合物 试剂（氯己定）同时与矿化剂（氟化物）， 预防原位继发龋;（3）分析拔除的修复牙 为了确定继发性龋的四个预测因子中最好的（牙菌斑水平-在 口缘、全口S. mutans，站点 特定水平的S。银汞合金和复合材料边缘的变异体 边缘裂缝的宽度，以及邻近汞合金和 复合材料）。