Novel Polymer Matrix for Dental Applications

描述（由申请人提供）：龋齿是美国最常见的儿童疾病。牙科密封剂是应用于健康牙齿的凹坑和裂缝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，并针对牙齿表面的部分，其中约90%的蛀牙发展。同行评审的研究无可争议地证实，密封剂在预防乳牙和恒牙龋齿方面是安全有效的（密封表面的龋齿减少> 90%）。密封剂的应用是微创的，无痛的，并且通常被患者很好地接受，并且密封剂是降低整体牙科护理成本的有价值的工具。两大类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，提供一些抗微生物和再矿化活性;然而，它们具有较高的吸水率、较差的保留和较高的微渗漏分数。光固化甲基丙烯酸酯基树脂具有更好的固位力，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脱粘并从牙齿表面脱落，并且不会持续到童年。为了使这种预防性处理更具成本效益，需要显著增加密封剂的寿命。过早的密封剂损失降低了这种预防性处理的有效性，这是它在美国未得到充分使用的原因之一，据信，甲基丙烯酸酯基密封剂的不良保持力是由于聚合物基质的水解降解和机械失效的组合，特别是与咀嚼力下的疲劳有关。牙科行业期待着开发出一种现代化的、更耐用的树脂基密封剂。这项研究将开发一种新型的密封剂聚合物基质，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，美国医疗服务的经济风险是惊人的;仅用于儿童的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。由于大部分开支用于治疗龋齿， 开发一类新的耐用的、延长寿命的牙科密封剂材料，其提供更有效和更广泛采用的预防，可以显著降低这些费用。如果开发出具有最佳留存率的密封剂，则与其益处相比，这种预防性治疗的成本将较低，特别是考虑到可以由私人牙科诊所的辅助牙科人员或非现场公共卫生倡议来实施。因此，对新型和改进的牙科密封剂的需求是显著的。此外，由于牙医和患者的接受度提高以及新立法提供了更广泛的预防性牙科护理，预计对窝沟封闭剂的需求每年将增长7%以上。

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.