CONTROLLED-RELEASE SEALANT TO PREVENT SECONDARY CARIES

控释封闭剂可预防继发龋

• 批准号: 6523885
• 负责人: Kenneth John Anusavice
• 金额: $ 27.77万
• 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/6523885
• 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)中国牙科保健费用 1995年，美国为458亿美元。更换牙科修复体 占所有手术工作的75%，而继发性龋齿 修复体的边缘是最常见的原因 更替(Kidd，1996)。因此，牙科患者可以实现相当大的成本 如果有缺陷的修复体的寿命延长，节省和改善口腔保健 可以通过使用牙齿保存疗法来扩展。整体而言 这项研究的目的是检验假设，应用于边际 释放洗必泰和/或氟化物的密封树脂的缝隙(当 PH降至6.0以下)可延长缺陷银汞合金的使用寿命 和复合修复体，增强脱矿的再矿化 相邻的牙釉质。我们建议检验以下假设-(1)聚合物 单独负载洗必泰的微球，一种分散的 氟化钙或氟化锌和二醋酸氯己定，或这些氟化物中的一种 当溶液的pH值时，单独的试剂将表现出离子释放的开始 降低到6.0以下，当pH增加到以上时，将终止离子释放 6.0；(2)载于树脂基质中的控释微球(双 GMA/TEGDMA/HEMA)，当溶液pH值为0时，将表现出初始释放速率 当溶液pH降至6.0以下时，其释放速率会降低 提高到6.0以上；(3)检验微生物积累的假设 (菌斑)和邻近牙釉质上变形链球菌的位置特异性水平 有缺陷的银汞合金或复合修复体是更好的预测因素 超过边缘缝隙宽度的继发性龋齿；整个口腔 变形链球菌的水平；以及(4)含有分散的 洗必泰和氟化物微球的混合物将更有效 抑制牙釉质脱矿，促进牙釉质再矿化 复合修复体比只含有这两种治疗性树脂之一的树脂 探员们。该项目的临床相关方面包括：(1)使用 用单抗试验对所选菌株进行位点特异性分析 使用银汞合金或复合修复体的近牙面；(2)使用 聚合物微球的分散混合物，将释放出一种抗菌剂 试剂(洗必泰)与再矿化剂(氟化物)同时进行 就地预防继发性龋病；(3)拔除的修复牙的分析 确定四个继发性龋齿预测因子中最好的一个(菌斑水平-在 修复体边缘、变形链球菌全口浓度、部位 银汞合金和复合体边缘的变形链球菌的特定水平 修复体，以及银汞合金和银汞合金相邻边缘缝隙的宽度 复合修复体)。