Dental Biologics for Underserved Populations

面向服务不足人群的牙科生物制剂

• 批准号: 7777011
• 负责人: Jeremy Mao
• 金额: $ 20万
• 依托单位: INNOVATIVE ELEMENTS, LLC
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-30 至 2011-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7777011
• 关键词: Address; Adopted; African American; Animal Model; Anterior; Area; Be++ element; Beryllium; Biocompatible; Biocompatible Materials; Biotechnology; Bone Transplantation; Businesses; Cells; Classification; Clinical Trials; Connective Tissue; Connective and Soft Tissue; Data; Dental; Dental Cementum; Dental Enamel; Dental Implants; Dental Pulp; Dental caries; Dentin; Dentists; Disadvantaged; Dose; Drug Formulations; Edentulous Mouth; Elements; Endodontics; Esthesia; Ethnic group; Extravasation; Faculty; Gel; Goals; Growth Factor; Healthcare; Hispanics; Homeostasis; Homing; Human; Incidence; Individual; Intellectual Property; Kinetics; Knee joint; Lead; Letters; Literature; Liver; Location; Medicine; Microscope; Native Americans; Natural regeneration; Operative Surgical Procedures; Oral health; Organ; Organ Transplantation; Patients; Phase; Population; Procedures; Prosthesis; Pulp Canals; Pulpitis; Reporting; Roentgen Rays; Root Canal Therapy; Science; Side; Small Business Innovation Research Grant; Surgeon; Technology; Temporomandibular Joint; Time; Tissues; Tooth Fractures; Tooth structure; Translating; Trauma; Underserved Population; United States; Universities; base; college; cost; cytokine; design; dosage; health disparity; in vivo; innovation; instrument; nerve supply; novel; public health relevance; regenerative; research and development; scaffold; secondary infection; socioeconomics

DESCRIPTION (provided by applicant): Disparities of oral health care are a significantly under-addressed area of health disparities. A substantial population, primarily those who are socioeconomically disadvantaged and of ethnic groups including Hispanics, African Americans and Native Americans, have alarmingly poor access to oral health care. Dental pulp is vascularized connective tissue in the central core of a tooth, and maintains homeostasis of the tooth as a biologically viable organ. When caries or trauma involves dental pulp, endodontic therapies are indicated. In irreversible pulpitis, the dentist or endodontist extirpates dental pulp, and obturates the instrumented root canal with bioinert materials. A total of approximately 16 million endodontic procedures are performed each year in the United States alone. However, individuals of socioeconomically disadvantaged populations have little access to root canal therapy, and frequently have their infected teeth extracted. Whereas root canal therapy is one of the successful dental treatments, complications have been repeatedly documented in the literature. Secondary infections due to coronal leakage or undetected accessory canals are not uncommon, and require re-treatment. A substantial amount of tooth structure is removed during root canal treatment, leading to increased incidences of tooth fracture. Root canal treated teeth are devoid of innervation and pulpal sensation, and thus are deprived of the ability to detect secondary infections. Our preliminary data demonstrate, for the first time, that endodontically treated human teeth are recellularized and revascularized in vivo. Accordingly, the overall goal of this SBIR/Phase-I proposal is to develop biologically based approaches for dental pulp regeneration at a cost that is substantially less than the current root canal therapy and readily accessible by underserved populations who currently have little access to conventional root canal therapy. PUBLIC HEALTH RELEVANCE: This SBIR/Phase I project will address a substantial disparity in oral health care by developing novel therapies for dental pulp regeneration. A total of approximately 16 million endodontic procedures are performed each year in the United States alone. However, current root canal therapy is an expensive dental treatment with alarmingly poor access by socioeconomically disadvantaged populations, and yet leads to de-vitalized pulp tissue. We have generated preliminary data to demonstrate that dental pulp regeneration can be realized in human teeth at a fraction of the cost of current root canal therapy. We propose to take advantage of the SBIR mechanism to develop biologically based, regenerative root canal therapy that is affordable and accessible by underserved populations.

描述（由申请人提供）：口腔卫生保健的差异是一个显著的健康差异未得到充分解决的领域。相当多的人口，主要是那些社会经济上处于不利地位的人和包括西班牙裔、非洲裔美国人和美洲土著人在内的族裔群体，获得口腔保健的机会少得惊人。牙髓是牙齿中央核心中的血管化结缔组织，并且维持牙齿的稳态， 一个生物活性器官当龋齿或创伤涉及牙髓时，需要进行牙髓治疗。在不可逆的牙髓炎中，牙医或牙髓病医生拔除牙髓，并用生物惰性材料封闭器械根管。仅在美国，每年就进行约1600万例牙髓手术。然而，社会经济上处于不利地位的人群很少有机会接受根管治疗，并且经常拔掉他们的感染牙齿。根管治疗是一种非常有效的牙科治疗方法，但其并发症却在文献中被反复报道。 由于冠状渗漏或未被发现的副管引起的继发感染并不少见，需要再次治疗。在根管治疗过程中，大量的牙齿结构被去除，导致牙齿骨折的发生率增加。根管治疗的牙齿缺乏神经支配和牙髓感觉， 因此被剥夺了检测继发感染的能力。我们的初步数据首次表明，经过根管治疗的人类牙齿在体内进行了再细胞化和血管重建。因此，SBIR/Phase-I提案的总体目标是开发用于牙髓再生的基于生物学的方法，其成本大大低于当前的根管治疗，并且易于为目前很少获得传统根管治疗的服务不足的人群所获得。 公共卫生关系：该SBIR/第一阶段项目将通过开发牙髓再生的新疗法来解决口腔保健中的巨大差距。共 仅在美国每年就进行大约1600万根管治疗。然而，目前的根管治疗是一种昂贵的牙科治疗，社会经济上处于不利地位的人群获得的机会少得令人担忧，而且还导致牙髓组织去活力。我们已经产生了初步的数据，以证明牙髓再生可以实现在人类牙齿的一小部分，目前的根管治疗的成本。我们建议利用SBIR机制来开发基于生物学的再生根管治疗，这种治疗是负担得起的，也是服务不足的人群可以获得的。