Antibiofilm tubing to reduce occupational exposure to biohazards in dentistry

描述（申请人提供）：每个牙科单元都配备了小口径塑料管，用于将水输送到空气/水注射器，超声波清洗机和高速手片。由于塑料管内表面的微生物生物膜的形成和随后的脱落，牙科用水被微生物和内毒素严重污染。在牙科治疗过程中，被污染的水会被牙科设备雾化，将微生物和内毒素传播到空气中。口腔卫生保健人员每天和长期反复暴露于这些职业生物危害中，可能导致口腔卫生保健人员的呼吸道感染、职业性哮喘甚至死亡。本项目的长期目标是利用n -卤胺基可充电抗菌膜管控制牙单元水线生物膜的形成，以减少DHCP的职业暴露于生物危害。N-halamines的抗菌功效与次氯酸盐漂白剂相似，次氯酸盐漂白剂是牙科和医院环境中最广泛使用的消毒剂之一，但N-halamines更稳定，腐蚀性更小，并且产生卤化碳氢化合物的倾向更小。预计在将n -卤胺共价结合到塑料管上后，新管将能够使任何接近的浮游细胞失活，以防止微生物粘附/定植，这是形成生物膜的第一步。因此，在牙科手术过程中，管子的内表面将没有生物危害，提高牙科单位水和气溶胶的微生物质量。抗菌膜的活性预计在相当长的一段时间内保持稳定（例如，超过一个月），如果由于广泛使用而失去活性，当牙科装置不使用时，可以很容易地通过次氯酸盐漂白剂处理管道以再生抗菌膜功能。拟建R03研究的具体目的是：(1)研制n -卤胺基抗生素膜牙科单元水线管；(2)评价新型管道在口腔水输送系统中的有效性和安全性。为了实现这些目标，本研究的第一部分将把n -卤胺前体共价结合到目前用于牙科诊所水线的塑料管中，从而将抗菌作用引入到塑料管中，从而实现长时间的生物膜控制时间。接下来将进行一系列研究，以提供有关新管的机械性能，抗菌活性，可充电性以及充电对机械性能的影响的详细信息。然后，将在模型牙科送水系统中对新管道进行混合水细菌的评估，以确定新方法在减少DHCP职业性暴露于水生和空气中微生物和内毒素方面的有效性和安全性。抗菌膜管材方法是控制牙科单元水线生物膜以提高牙科保健人员职业安全和健康的一个有吸引力的进展。此外，本研究开发的抗生素膜塑料管材料可能会在其他临床重要表面上得到应用，这将为更好和更安全的医疗环境做出重大贡献。

DESCRIPTION (provided by applicant): Every dental unit is equipped with small-bore plastic tubing to bring water to the air/water syringe, the ultrasonic scaler, and the high-speed hand piece. Because of the formation and subsequent sloughing off of microbial biofilms from the inner surfaces of the plastic tubing, dental water is heavily contaminated with microorganisms and endotoxin. During dental procedures, the contaminated water will be aerosolized by dental equipment to spread the microbes and endotoxin into air. Dental health care personnel (DHCP) are exposed to these occupational biohazards repeatedly on a daily and long-term basis, which could cause respiratory infection, occupational asthma, and even fatality in DHCP. The long-range goal of this project is to use N-halamine-based rechargeable antibiofilm tubing to control the formation of dental unit waterline biofilms so as to reduce occupational exposure of DHCP to the biohazards. N-halamines have antimicrobial efficacy similar to that of hypochlorite bleach, one of the most widely used disinfectants in dental and hospital settings, but N-halamines are more stable, less corrosive, and have much less tendency to generate halogenated hydrocarbons. It is anticipated that after covalently binding N-halamines onto plastic tubes, the new tubes will be able to inactivate any approaching planktonic cells to prevent microbial adhesion/colonization, the first step in the formation of biofilms. Thus, the tubes' inner surfaces will be free of biohazards during dental operations, improving the microbial quality of dental unit water and aerosols. The antibiofilm activity is anticipated to be stable for a reasonably long period of time (e.g., more than a month), and if it is lost due to extensive use, the tubing can be easily recharged by a hypochlorite bleach treatment when the dental units are not in use to regenerate the antibiofilm function. The specific aims of the proposed R03 study are to: (1) develop N-halamine-based antibiofilm dental unit waterline tubing; and (2) evaluate the efficacy and safety of the new tubes in model dental water delivery systems. To achieve these goals, the first part of the proposed research will covalently bind N-halamine precursors into plastic tubing currently used in dental clinic waterlines, so as to introduce antimicrobial effects into the tubing to achieve long biofilm-controlling durations. This will be followed by a series of studies to provide detailed information on the mechanical properties, antimicrobial activity, rechargeability, and effects of recharging on the mechanical properties of the new tubes. Then the new tubes will be evaluated with mixed species of water bacteria in model dental water delivery systems to determine the efficacy and safety of the new approach in reducing occupational exposure of DHCP to waterborne and airborne microorganisms and endotoxin. The antibiofilm tubing approach is an attractive advance in controlling dental unit waterline biofilms to improve the occupational safety and health of dental health care personnel. In addition, the antibiofilm plastic tube materials to be developed in this study may find applications in other clinically important surfaces, which will make significant contributions to a better and safer healthcare environment.