REMINERALIZING PULP-CAPPING CEMENTS & BONDING AGENTS

本研究的长期目标是证明先前开发的Ca-PO 4树脂骨水泥（CP-RC）的防龋性能和生物相容性，并研究新型富Ca-PO 4粘合剂（CP-BA）的体外和体内性能。 CP-RC和CP-BA均基于酸性和其他二甲基丙烯酸酯树脂、Ca-PO 4填料和氟化物添加剂。 骨水泥将提供其作为直接或间接盖髓剂的临床使用所需的处理特性。 它在凝固期间和凝固后具有高pH值，适度的氟化物释放，并且已在体外显示出使人工牙齿病变矿化。 然而，虽然骨水泥显示出中等的粘合性能，但与目前的粘合剂相比，其与牙本质的粘合强度较低。此外，初步的测试表明，粘结剂之间的CP-RC和牙本质与人工龋样病变显着降低其再矿化。 因此，需要开发具有抗矿化/防龋特性和对正常和矿物质缺乏的牙本质的强粘附性的新型牙本质粘结剂。 这种粘合剂可用作常规的修复粘合剂和用于盖髓目的。 具体目标是1.评价CP-RC预防相邻牙本质和牙釉质继发龋形成的有效性; 2. (i)定性和定量分析骨水泥中的可沥滤成分;以及（ii）确定体外细胞毒性和对成牙本质细胞培养的影响，并将CP-RC的体外生物相容性和细胞分化与骨水泥盖髓功效的（正在进行的）体内动物研究结果进行比较; 3.研究了与CP-RC相同的粘结树脂和Ca-PO 4填料的粘结体系，并对其生物活性效应和增强机理进行了表征。评价优化的CP-BA的生物相容性和细胞分化; 5.通过评估这种新型生物相容性、生物活性粘合剂的体内盖髓功效，解决了粘合剂是否可以成功应用于盖髓手术的争议性问题。 这项研究的完成将导致一种可矿化的盖髓/衬里粘固剂和一种生物活性的Ca-PO 4牙本质粘合剂。CaPO 4树脂粘固剂将提供一种可靠的方法，通过刺激牙本质桥接的自然形成来治疗机械和小龋坏牙髓暴露，该牙本质桥接具有适度的粘附力以防止渗漏，并且具有允许立即放置永久修复体的强度。 矿化粘合剂将提供粘附到缺乏矿物质的牙本质和覆盖暴露的牙髓的方法。 拟议的研究还将提供体内试验结果与体外牙髓细胞反应的有价值的比较。

The long-term goals of the proposed research are to demonstrate the cariostatic properties and biocompatibility of a previously developed Ca-PO4 Resin Cement (CP-RC) and to investigate the in vitro and in vivo properties of a novel Ca- PO4-enriched Bonding Agent (CP-BA). Both CP-RC and CP-BA are based on acidic- and other dimethacrylate resins, Ca-PO4 fillers and fluoride additives. The cement will provide the handling characteristics necessary for its clinical use as a direct or indirect pulp-capping agent. It has high pH during and after setting, moderate fluoride release, and has been shown in vitro to remineralize artificial tooth lesions. However, while the cement has shown moderate adhesive properties, its bond strength to dentin is low compared to those of current bonding agents. Moreover, preliminary tests showed that bonding agents placed between CP-RC and dentin with artificial caries-like lesions significantly reduced their remineralization. Thus, there is a need to explore novel dentin bonding agents with remineralizing/cariostatic properties and strong adhesion to normal and mineral-deficient dentin. Such adhesives could serve as conventional restorative bonding agents and for pulp-capping purposes. The specific aims are to 1. evaluate CP-RC effectiveness for preventing secondary caries formation in adjacent dentin and enamel; 2. (i) analyze qualitatively and quantitatively leachable components from the cement; and (ii) determine the in vitro cytotoxicity and effects on odontoblast cell culture and compare the in vitro biocompatibility and cytodifferentiation of CP-RC with the results from an (ongoing) in vivo animal study on the pulp-capping efficacy of the cement; 3. investigate bonding systems containing the same adhesive resin and Ca-PO4 fillers as the CP-RC and characterize their bioactivity effects and reinforcing mechanisms 4. evaluate the biocompatibility and cytodifferentiation of an optimized CP-BA and 5. address the controversial question of whether adhesive bonding agents can be successfully applied to pulp-capping procedures by evaluating the in vivo pulp-capping efficacy of this novel biocompatible, bioactive bonding agent. Completion of this research will lead to a remineralizing pulp-capping/lining cement and a bioactive Ca-PO4 dentin adhesive The CaPO4 resin cement will provide a method to reliably treat mechanical and small carious pulp exposures by stimulating the natural formation of dentin bridging with a base that has moderate adhesion to prevent leakage and the strength to allow the immediate placement of a permanent restoration. A remineralizing adhesive will provide methods of adhering to mineral-deficient dentin and for covering exposed pulps. The proposed studies will also provide a valuable comparison of in vivo test results to pulp cell response in vitro.