Novel Polymer Matrix for Dental Applications

描述(申请人提供)：龋齿是美国最常见的儿童疾病。牙齿密封剂是一种应用于健康牙齿的凹坑和裂隙以防止龋齿或其他形式的腐烂的材料。这种方法防止细菌进入和酸溶解，并针对~90%的龋齿发生的部分牙齿表面。同行评议的研究无可争议地证实，封闭剂在预防乳牙和恒牙上的龋齿方面是安全有效的(封闭面上的龋齿减少90%)。密封剂的应用是微创、无痛的，通常被患者很好地接受，密封剂是降低整体牙科护理成本的宝贵工具。用作密封剂的材料主要有两类：玻璃离聚体和树脂基密封剂。玻璃离子释放氟化物，提供一定的抗菌和再矿化活性；但它们具有较高的吸水率、较差的保持率和较高的微渗漏分数。光固化甲基丙烯酸酯树脂固位力更好，但失败率仍然高得令人无法接受；它们在应用后几年内就会剥离并剥离牙齿表面，不会持续到儿童时期。为了使这种预防性治疗更具成本效益，需要显著延长密封剂的使用寿命。过早的密封剂丢失降低了这种预防性治疗的有效性，这也是密封剂在美国使用不足的原因之一，在美国，只有不到50%的儿童接受这种治疗。人们认为，甲基丙烯酸酯基密封剂的保持性差是由于聚合物基质的水解性降解和机械故障的共同作用，特别是与咀嚼压力下的疲劳有关。牙科行业正在等待一种现代的、更耐用的树脂基密封剂的开发。本研究将开发一种新型的密封胶聚合物基质，其特点是在循环疲劳下具有优异的力学性能，聚合收缩接近于零，并且对口腔环境中的水解性降解不敏感。除了改善儿科健康，美国医疗服务的经济风险也是惊人的；仅用于儿童的医疗补助牙科支出预计就将从2010年的48亿美元增加到2020年的超过126亿美元。由于这笔支出的大部分用于治疗龋齿， 开发一种新型的耐用、延长使用寿命的牙科密封材料，可以提供更有效和更广泛采用的预防措施，可以显著降低这些费用。如果开发出具有最佳保留率的密封剂，这种预防性治疗的成本将低于其益处，特别是考虑到可以由私人牙科诊所的兼职牙科人员或非现场公共卫生倡议实施。因此，对新型和改进的牙科密封剂的需求是重要的。此外，由于牙医和患者接受度的提高以及提供更广泛预防性牙科护理的新立法的推动，对窝沟密封剂的需求预计将以每年7%以上的速度增长。

DESCRIPTION (provided by applicant): Dental caries are the most common childhood disease in the United States. Dental sealants are materials that are applied to the pits and fissures of healthy teeth to prevent dental caries or other forms of decay. This method prevents bacteria ingress and acid dissolution and targets the portions of the tooth surface where ~90% of the decay develops. Peer-reviewed research incontrovertibly substantiates that sealants are safe and effective in preventing caries on both primary and permanent teeth (> 90% reduction in caries on the sealed surface). The application of sealants is minimally invasive, painless and is typically well-accepted by patients, and sealants are a valuable tool to reduce overall dental care costs. Two major classes of materials have been used as sealants: glass ionomers and resins based sealants. Glass ionomers release fluoride that provides some antimicrobial and re-mineralization activity; however they have a higher water uptake, poorer retention and higher micro-leakage scores. Photo-curable methacrylate-based resins have better retention but failures rates are still unacceptably high; they de-bond and chip off the tooth surface within a few years from application and don't last through childhood. A significant increase of the sealant's lifetime is required to make this preventive treatment more cost- effective. Premature sealant loss reduces the effectiveness of this preventive treatment and it is one of the reasons why it is underused in the U.S., where less than 50% of children receive it. It is believed that poor retention of methacrylate-based sealants is due to a combination of hydrolytic degradation of the polymer matrix and mechanical failure, especially related to fatigue under the forces of mastication. The dental profession awaits the development of a modern, more durable, resin-based sealant. This research will develop a novel polymer matrix for sealants that is characterized by excellent mechanical properties under cyclic fatigue, near-zero polymerization shrinkage, and which is not sensitive to hydrolytic degradation in the oral environment. Aside from improving pediatric health, the economic stakes for U.S. health services are staggering; Medicaid dental expenditures for children alone is projected to increase from $4.8 billion in 2010 to more than $12.6 billion in 2020. Since the majority of this spending is for treating caries, the development of a new class of durable, expanded lifetime dental sealant materials that provide more effective and more widely adopted prevention could significantly reduce these expenses. If sealants with an optimal retention rate are developed, the cost of this preventive treatment will be low compared to its benefit, especially considering that implementation can be carried out by adjunct dental personnel in private dental offices or off-site public health initiatives. The need or novel and improved dental sealants is therefore significant. Further, the demand for pit and fissure sealants is expected to growth by more than 7% annually driven by increased acceptance by dentists and patients and new legislation that provides broader access to preventive dental care.