Smart Self-Sterilizing Dental Composites for Class V Restorations

总结 龋齿仍然是一个公共卫生问题，特别是在服务不足的地区， 不幸的是，特别是随着人口老龄化，数百人 每年有成千上万的树脂复合材料制品因反复腐烂而被更换， 骨折根据一些队列研究，这类人的平均寿命 修复期为7年或更短，取决于患者的龋齿风险水平和 恢复性程序的复杂性。V类病变，本质上是龋性或非龋性的， 由于边缘的位置（通常在牙本质/牙骨质中）而特别难以修复， 在牙齿的这个区域中的负荷分布的复杂性和更大的生物膜的趋势 在颈部附近积聚。该提案代表了开发新pH的努力- 响应性、自杀菌的甲基丙烯酰胺复合物， 解决上述困难，并延长V类阀门的使用寿命，从而节省 每年花费数百万美元，以及额外牙齿结构的不必要损失。拟议 该方法将通过以下方式提高V类设备的寿命：1.设计单体，基于 生物相容性羧基甜菜碱（CB）化学，能够响应酸性 在口腔环境中的挑战和执行口腔表面的双重功能（在 中性pH）和杀菌表面（在低pH下）。2.利用可聚合官能团， 离开水/酯酶不稳定的甲基丙烯酸酯。甲基丙烯酰胺因其 抗水解降解，并且本文提出的系统也将对 酶攻击（通过使用叔甲基丙烯酰胺）。3.淬火增韧 基于预聚合的硫代氨基甲酸酯的添加剂，其不仅降低了 可聚合官能团（因此减少收缩），但也可延迟聚合物胶凝 (thus减少压力）。此外，低聚物将被官能化以用作聚合物的载体。 CB部分。4.促进基材和基材之间的自粘合、离子/共价相互作用 粘合剂层，除了已经存在的微机械联锁。这将允许 为了使用较低侵蚀性（如果有的话）的基底酸蚀刻， 有害的基质金属蛋白酶。

Summary Dental caries continues to be a public health issue, especially more evident in underserved populations throughout the U.S. Unfortunately, especially with an ageing population, hundreds of thousands of resin composite restorations are replaced each year due to recurring decay and fracture. According to a number of cohort studies, the average life-span of this type of restoration is 7 years or less, depending on the caries risk level of the patient and on the complexity of the restorative procedure. Class V lesions, carious or non-carious in nature, are particularly challenging to restore due to the location of the margins (often in dentin/cementum), the complexity of load distribution in this area of the tooth and the tendency for greater biofilm accumulation near cervical areas. This proposal represents an effort to develop novel pH- responsive, self-sterilizing methacrylamide composites capable of overcoming the aforementioned difficulties and increasing service life of class V restorations, thus saving millions of dollars annually and the unnecessary loss of additional tooth structure. The proposed approach will improve the longevity of class V restorations by: 1. Designing monomers, based on biocompatible carboxybetaine (CB) chemistry, that are capable of responding to acidic challenges in the oral environment and performing the dual function of antifouling surfaces (at neutral pH) and bactericidal surfaces (at low pH). 2.Utilizing polymerizable functionalities that depart from the water/esterase-labile methacrylates. Methacrylamides are well known for their resistance to degradation by hydrolysis, and the systems proposed here will also be stable to enzymatic attack (through the use of tertiary methacrylamides). 3. Incorporating toughening additives, based on pre-polymerized thiourethanes, which not only reduce the concentration of polymerizable functionalities (thus reducing shrinkage), but can also delay polymer gelation (thus reducing stress). In addition, the oligomer will be functionalized to work as a carrier of the CB moiety. 4. Promoting self-adhesive, ionic/covalent interaction between the substrate and the adhesive layer, in addition to the already existing micro-mechanical interlocking. This will allow for the use of less aggressive (if any) acid etching of the substrate, decreasing activation of deleterious MMPs.