Novel Polymer Matrix for Dental Applications

用于牙科应用的新型聚合物基质

• 批准号: 8646407
• 负责人: ROBERT D BOLSKAR
• 金额: $ 18.25万
• 依托单位: TDA RESEARCH, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2017-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8646407
• 关键词: Acids; Adopted; Area; Bacteria; Benzoxazines; Characteristics; Chemicals; Chemistry; Child; Childhood; Collaborations; Complement; Consult; Dental; Dental Care; Dental Enamel; Dental General Practice; Dental Offices; Dental Staff; Dental caries; Dentistry; Dentists; Development; Disease; Drug Formulations; Effectiveness; Environment; Evaluation; Expenditure; Extravasation; Failure; Fatigue; Fluorides; Future; Government; Growth; Health; Health Care Costs; Health Services; High temperature of physical object; Hydrogen Bonding; Hydrolysis; In Vitro; Letters; Link; Longevity; Manufacturer Name; Mastication; Mechanics; Medicaid; Methacrylates; Methods; Minnesota; Molecular; Mono-S; Odors; Oral; Oral cavity; Oral health; Painless; Patients; Performance; Persons; Phase; Pit and Fissure Sealants; Plant Resins; Polymers; Prevention; Preventive; Procedures; Property; Public Health; Research; Research Peer Review; Resistance; Saliva; School Dentistry; Simulate; Site; Small Business Innovation Research Grant; Statutes and Laws; Surface; Technology; Temperature; Testing; Tooth structure; Toxic effect; United States; Universities; Water; Work; absorption; antimicrobial; base; clinically relevant; cost; cost effective; crosslink; cytotoxicity; deciduous tooth; dental adhesive; dental resin; design; experience; flexibility; glass ionomer; health economics; improved; innovation; interest; microbial; mineralization; minimally invasive; monomer; novel; permanent tooth; polymerization; polymerization shrinkage; premature; prevent; restoration; seal; tool; tooth surface; uptake

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.

描述（由申请人提供）：龋齿是美国最常见的儿童疾病。牙科密封剂是涂在健康牙齿的凹坑和裂隙上以防止龋齿或其他形式的腐烂的材料。这种方法可以防止细菌进入和酸溶解，并针对牙齿表面约 90% 发生腐烂的部分。同行评审的研究无可争议地证实，密封剂可以安全有效地预防乳牙和恒牙的龋齿（密封表面的龋齿减少超过 90%）。密封剂的应用是微创、无痛的，通常深受患者接受，并且密封剂是降低总体牙科护理成本的宝贵工具。两类主要材料已被用作密封剂：玻璃离聚物和树脂基密封剂。玻璃离聚物释放氟化物，提供一定的抗菌和再矿化活性；然而，它们的吸水率较高，保留性较差，微渗漏分数较高。光固化甲基丙烯酸酯树脂具有更好的保留率，但故障率仍然高得令人无法接受；它们在使用后几年内就会脱离牙齿表面并脱落，并且不能持续整个童年。为了使这种预防性处理更具成本效益，需要显着延长密封剂的使用寿命。密封剂过早流失会降低这种预防性治疗的有效性，这也是其在美国未得到充分利用的原因之一，只有不到 50% 的儿童接受了这种治疗。据信，基于甲基丙烯酸酯的密封剂的保留性差是由于聚合物基体的水解降解和机械故障的组合，特别是与咀嚼力下的疲劳有关。牙科行业正在等待开发一种现代的、更耐用的树脂基密封剂。这项研究将开发一种用于密封剂的新型聚合物基质，其特点是在循环疲劳下具有优异的机械性能，聚合收缩率接近于零，并且对口腔环境中的水解降解不敏感。除了改善儿科健康之外，美国卫生服务的经济利益也是惊人的。仅儿童医疗补助牙科支出预计将从 2010 年的 48 亿美元增加到 2020 年的 126 亿美元以上。由于大部分支出用于治疗龋齿，因此 开发一种新型耐用、延长使用寿命的牙科密封剂材料，提供更有效、更广泛采用的预防措施，可以显着减少这些费用。如果开发出具有最佳保留率的密封剂，则这种预防性治疗的成本与其效益相比将会较低，特别是考虑到可以由私人牙科诊所或场外公共卫生倡议的兼职牙科人员来实施。因此，对新颖且改进的牙科密封剂的需求是显着的。此外，由于牙医和患者接受度的提高以及提供更广泛的预防性牙科护理机会的新立法的推动，对窝沟封闭剂的需求预计每年增长 7% 以上。