Antimicrobial Dental Devices and Waterlines

描述(由申请人提供)：牙科水管的细菌污染是现代牙科的一个主要问题，可能会导致免疫系统受损的牙科患者感染。这包括癌症、糖尿病或艾滋病患者；经常在牙科治疗前需要预防性抗生素的心脏病患者；老年人、幼儿和孕妇。牙科用水管道中的细菌水平可以达到美国牙科协会推荐的安全上限的5000倍。美国牙科协会和疾病控制中心都主张定期进行感染控制程序，对输水管进行消毒。目前的消毒方法(长时间冲洗、每日排水、过滤器、化学消毒剂)需要定期维护和使用，这在繁忙的牙科诊所可能是不可行的。细菌通常存在于生物膜中，这是一种致密粘稠的细胞外基质，其中大多数细菌处于休眠的代谢状态。这些休眠细菌通常不会受到常规抗生素的影响。常规的牙线消毒剂很少去除这种生物膜。一个更有说服力的解决方案是首先防止生物膜的形成。在这个第二阶段的STTR项目中，我们将跟进我们第一阶段项目的结果，以生产一种商业上可行的牙科用水管道，以抵抗细菌生物膜的形成。在第一阶段，我们展示了如下内容：1.我们开发了几种将有机硒共价连接到聚氨酯(用于制造牙科水线的主要聚合物)上的方法。2.经环氧乙烷处理后，有机硒可以均匀地涂覆在聚氨酯管材的管腔上。3.我们发现附着在聚氨酯管腔上的硒抑制了生物膜的形成。4.结果表明，在磷酸盐缓冲盐水中浸泡90天后，附着在聚氨酯上的硒是稳定的。在该项目的第二阶段，我们将：1)优化我们开发的用于在牙科水管内侧附着硒的环氧乙烷技术；2)开发可用于商业的涂层工艺；以及3)在牙科实践环境中测试该管的商业化潜力。 公共卫生相关性：美国牙科协会和疾病控制中心已将牙科水管的细菌污染确定为公共卫生问题，特别是对免疫系统受损的患者，并倡导定期使用感染控制程序来解决这一问题。传统的消毒治疗需要牙科工作人员的定期关注和维护。我们在第一阶段已经证明，我们可以将硒附着到用于牙科水线的聚氨酯管材的管腔上，并永久阻止细菌附着。在这个第二阶段的项目中，我们将做以下工作：1)优化我们开发的用于在牙科水管内侧附着硒的环氧乙烷技术，2)开发可商业使用的硒涂层工艺，以及3)在牙科实践环境中测试涂层管道的商业化潜力。

DESCRIPTION (provided by applicant): Bacterial contamination of dental water lines is a major concern in modern dentistry and may cause infection in dental patients with compromised immune systems. This includes patients with cancer, diabetes, or AIDS; cardiac patients who often require prophylactic antibiotics prior to dental treatment; the elderly, young children, and pregnant women. Bacterial levels in dental water lines can reach 5,000 times the American Dental Association's recommended upper limit for safety. Both the American Dental Association and the Centers for Disease Control advocate regular infection control procedures to disinfect the waterlines. Current disinfection methods (prolonged flushing, daily draining, filters, chemical disinfectants) require regular maintenance and application, which may be impracticable in a busy dental practice. Bacteria often reside in a biofilm, a dense slimy extracellular matrix in which the majority of bacteria are in a dormant metabolic state. These dormant bacteria are often unaffected by conventional antibiotics. Regular dental line disinfectants rarely remove this biofilm. A more compelling solution would be to prevent biofilm formation in the first place. In this Phase II STTR project, we will follow up on the results from our Phase I project to produce a commercially viable dental water line that resists bacterial biofilm formation. In Phase I we showed the following: 1. We developed several methods for covalently attaching organo-selenium to polyurethane (the main polymer used to make dental waterlines). 2. We showed that organo-selenium could be uniformly coated on the lumen of polyurethane tubing following prior treatment with ethylene oxide. 3. We showed that selenium attached to the lumen of polyurethane tubing inhibited biofilm formation. 4. We showed that the selenium attached to the polyurethane was stable after 90 days of soaking in phosphate buffered saline. In Phase II of this project we will: 1) optimize the ethylene oxide technique that we have developed for the attachment of selenium on the inside of dental waterline tubing; 2) develop a coating process that can be used commercially; and 3) test the tubing in a dental practice setting for its potential for commercialization. PUBLIC HEALTH RELEVANCE: The American Dental Association and Centers for Disease Control have identified bacterial contamination of dental water lines as a public health concern, particularly for patients with compromised immune systems, and advocate regular use of infection control procedures to address this issue. Conventional disinfecting treatments require regular attention and maintenance by dental staff. We have shown in phase I that we can attach selenium to the lumen of the polyurethane tubing used in dental waterlines and permanently block bacterial attachment. In this phase II project we will do the following: 1) optimize the ethylene oxide technique that we have developed for the attachment of selenium on the inside of dental waterline tubing, 2) develop a selenium coating process that can be used commercially, and 3) test the coated tubing in a dental practice setting for its potential for commercialization.