Translational Basic-Clinical Analysis of Implant-Borne Ceramic Bridge Survival

种植陶瓷牙桥存活率的转化基础临床分析

• 批准号: 8230630
• 负责人: Kenneth John Anusavice
• 金额: $ 36.2万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 1983
• 资助国家: 美国
• 起止时间: 1983-03-01 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8230630
• 关键词: Applied Research; Back; Basic Science; Biological Factors; Caring; Ceramics; Clinical; Clinical Research; Clinical Trials; Complement; Computer software; Contralateral; Corrosion; Data; Dental Porcelain; Dental caries; Dental crowns; Elements; Environment; Environmental Exposure; Evaluation; Event; Failure; Fatigue; Fixed Partial Denture; Fractals; Fracture; Grant; Growth; Height; Implant; Implantation procedure; In Vitro; Lasers; Life; Link; Macor; Measures; Mechanics; Mentored Patient-Oriented Research Career Development Award; Mentors; Modeling; Monitor; Natural regeneration; Performance; Periodontal Diseases; Phase; Predisposition; Probability; Procedures; Process; Property; Prosthesis; Prosthesis Design; Pulpitis; Radial; Recruitment Activity; Research; Resistance; Scientist; Simulate; Site; Specimen; Stress; Stress Fractures; Surface; System; Testing; Thick; Time; Titania; Titanium; Tooth structure; Validation; Water; Yttrium; Zirconium; clinical practice; comparative; cost effective; design; environmental change; fluorapatite; human subject; in vitro Model; in vivo; interfacial; phase change; physical property; public health relevance; translational study; treatment effect; yttria; zirconium oxide

DESCRIPTION (provided by applicant): This revised proposal complements a K23 grant, which is focused on analyzing in vivo variables that control the survival of three-unit, implant-supported, all-ceramic bridges. Dr. Anusavice is the primary mentor for Dr. Josephine Esquivel-Upshaw, the PI of the K23 award who is currently recruiting 128 human subjects for the five-year clinical study. The overall objective of this R01 proposal is to design and validate a systematic process for accurately predicting, through cyclic and dynamic fatigue tests of the same trilayer ceramic system, the survival probabilities of the ceramic bridges to be monitored in the K23 study. This study will test the hypothesis that fracture survival probabilities predicted from dynamic fatigue test data of the same ceramic component materials, processing variables, and thermal treatments, will not be significantly different than those estimated from cyclic fatigue data. The experimental phase will characterize the potential effects of surface processing damage, thermal treatment effects, microstructural changes, and environmental effects that control the chipping and fracture susceptibility of the three-unit prostheses of either the zirconia core ceramic, the ceramic liner, or the fluorapatite glass-ceramic veneer. The analytical phase will employ finite element stress analysis to determine the stress distributions in the simulated K23 grant implant-supported prostheses and the Cares/Life software to calculate the time-dependent probability of fracture. The following five aims are proposed: Aim 1. Characterize the type and depth of localized microstructural phase changes in the yttria- stabilized zirconia core ceramic (Y-TZP) produced by same surface grinding procedures that will be used in the K23-supported clinical study and by the thermal regeneration process used to convert transformed zirconia phases in the core ceramic surface back to the tetragonal zirconia phase. Aim 2. Identify the effects of surface damage in the zirconia core ceramic on the interfacial toughness of the trilayer zirconia/liner/veneer ceramic system. Aim 3. Analyze the effect of the water exposure on the dynamic fatigue fracture resistance and stress corrosion susceptibility of the zirconia core and glass-ceramic veneer. Aim 4. Characterize the effect of thermal processing on microstructural changes, the estimated time-dependent fracture probability, and the probable mode of failure. Aim 5. Test the hypothesis that dynamic fatigue tests will provide slow crack growth and Weibull parameters comparable to those from cyclic fatigue. Thus, dynamic fatigue parameters will yield comparable time-dependent fracture probabilities that are indicators of potential clinical performance in the clinical study supported by the K23 grant. PUBLIC HEALTH RELEVANCE: This basic-clinical translational study represents a unique opportunity to integrate bench-top research on the fracture resistance of a dental ceramic system and survival predictions for simulated all-ceramic prostheses with on-going clinical research on the performance of implant-supported three-unit ceramic bridges made from the same materials and processes. The comparative evaluation of results from the two studies will provide critically important validation of a cost-effective in vitro model for systematically evaluating new ceramic materials.

描述（由申请人提供）：此修订后的提案是对 K23 资助的补充，该资助的重点是分析控制三单元、种植体支持的全瓷牙桥存活的体内变量。 Anusavice 博士是 Josephine Esquivel-Upshaw 博士的主要导师，Josephine Esquivel-Upshaw 博士是 K23 奖项的 PI，目前正在招募 128 名人类受试者进行为期五年的临床研究。该 R01 提案的总体目标是设计和验证一个系统过程，通过对同一三层陶瓷系统进行循环和动态疲劳测试，准确预测 K23 研究中要监测的陶瓷桥的生存概率。这项研究将检验这样一个假设：根据相同陶瓷部件材料、加工变量和热处理的动态疲劳测试数据预测的断裂生存概率与根据循环疲劳数据估计的断裂生存概率不会有显着差异。实验阶段将表征表面加工损伤、热处理效应、微观结构变化和环境影响的潜在影响，这些影响控制氧化锆核心陶瓷、陶瓷内衬或氟磷灰石玻璃陶瓷贴面的三单元假体的碎裂和断裂敏感性。分析阶段将采用有限元应力分析来确定模拟 K23 grant 种植体支持的假体中的应力分布，并使用 Cares/Life 软件来计算随时间变化的骨折概率。提出以下五个目标： 目标 1. 表征氧化钇稳定氧化锆核心陶瓷 (Y-TZP) 中局部微观结构相变的类型和深度，该氧化钇稳定氧化锆核心陶瓷 (Y-TZP) 是通过 K23 支持的临床研究中使用的相同表面研磨程序以及用于将核心陶瓷表面中的转化氧化锆相转化回四方氧化锆的热再生过程生产的。 阶段。目标 2. 确定氧化锆芯陶瓷表面损伤对三层氧化锆/内衬/贴面陶瓷系统界面韧性的影响。目标 3. 分析水暴露对氧化锆芯材和微晶玻璃贴面的动态疲劳断裂抗力和应力腐蚀敏感性的影响。目标 4. 表征热处理对微观结构变化的影响、估计的随时间变化的断裂概率以及可能的失效模式。目标 5. 检验动态疲劳测试将提供与循环疲劳相当的缓慢裂纹扩展和威布尔参数这一假设。因此，动态疲劳参数将产生可比较的随时间变化的骨折概率，这些概率是 K23 资助支持的临床研究中潜在临床表现的指标。 公共健康相关性：这项基础临床转化研究提供了一个独特的机会，可以将牙科陶瓷系统抗断裂性的实验室研究和模拟全瓷修复体的生存预测与正在进行的由相同材料和工艺制成的种植体支撑三单元陶瓷桥性能的临床研究相结合。这两项研究结果的比较评估将为系统评估新型陶瓷材料的具有成本效益的体外模型提供至关重要的验证。