FLUORIDE REQUIREMENTS FOR THERAPEUTIC EFFICACY

治疗效果的氟化物要求

基本信息

批准号：
7840802
负责人：
Clifton M Carey
金额：
$ 1.17万
依托单位：
AMERICAN DENTAL ASSOCIATION FOUNDATION
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-06-01 至 2010-05-31
项目状态：
已结题

项目摘要

DESCRIPTION: The goal of this proposal is to establish the minimum concentration of fluoride needed to prevent enamel and root caries. The lack of knowledge about "the target concentration of fluoride required in the oral environment to optimize its potential for caries prevention" has inspired the NIDCR to issue a program announcement (PA-01-121) indicating a high priority status for this subject. After 60 years of community water fluoridation we still do not know how much F is required to prevent caries. This may be because no one has systematically performed in vitro studies that separate the significant factors under conditions that closely mimic those of the oral environment and then validated those findings in intraoral studies. This proposal details such a systematic study to identify the significant factors and their interactions as related to the efficacy of fluoride to prevent caries. A predictive model that takes into account the conditions of each person is to be developed from in vitro studies and then validated through intraoral studies. In the mouth, fluoride originates either from the saliva at a relatively low and fairly constant concentration (0.1 ppm; Carey et al., 1986) or from fluoride rinses, gels, and dentifrices, which is transient and can range in concentration up to 15,000 ppm. In Aim 1 the continuous flow model is used to optimize the amount of fluoride that is needed to prevent enamel caries when there is a steady, low concentration of fluoride at all times. Aim 2 is focused on determining the amount of fluoride on a time-weighted basis that is required to prevent enamel caries when the fluoride is provided as a bolus treatment twice daily. Recognizing that root dentin is a very different substrate than enamel, Aims 3 and 4 are focused on determining the therapeutic amounts of fluoride required to prevent root caries under conditions of constant exposure (Aim 3) and periodic high concentration fluoride exposures (Aim 4). Aim 5 will establish the amount of fluoride required to prevent caries when proteins or other permselective macromolecules are adsorbed on the surfaces of the enamel or root dentin. In Aim 6, the relationships between saliva composition, salivary flow and the amount of fluoride required to prevent caries established with the continuous flow model will be tested by use of an intraoral model. In this Aim 6 the effect of fluoride exposure on the prevention of caries will be determined. Together these studies should, for the first time, be able to demonstrate the minimum therapeutic levels of fluoride necessary to have a prophylactic effect. Additionally, the potential of this project to develop predictive models that can be used to indicate the required amount of F as a function of a specific environment is particularly significant because the profession will be able to tailor F regimes as appropriate. This is particularly important in the treatment of populations that are at higher risk.

描述：该提案的目的是建立防止牙釉质和根龋所需的最低含氟浓度。缺乏有关“在口腔环境中需要氟化物的目标浓度来优化其预防龋齿潜力”的知识，这激发了NIDCR发布计划公告（PA-01-121），表明该主题具有很高的优先状态。经过60年的社区水氟化，我们仍然不知道预防龋齿需要多少F。这可能是因为没有人会系统地进行体外研究，可以在密切模仿口腔环境的条件下将重要因素分开，然后在口腔内研究中验证了这些发现。该建议详细介绍了这样的系统研究，以确定与氟化物预防龋齿的功效有关的重要因素及其相互作用。考虑到每个人的条件的预测模型应从体外研究中发展，然后通过口腔内研究进行验证。在口中，氟化物以相对较低且相当恒定的浓度起源于唾液（0.1 ppm； Carey等，1986），或者来自氟化物Rinses，Gels和Dentifrices，这是短暂的，浓度最高可达15,000 ppm。在AIM 1中，连续流模型用于优化在始终存在稳定，低浓度的氟化物时所需的氟化物量。 AIM 2的重点是按时间加权确定氟化物的量，这是在每天两次提供氟化物作为推注作为推注作为推注时所必需的。认识到根牙本质与牙釉质是非常不同的底物，AIM 3和4专注于确定在持续暴露条件下（AIM 3）和周期性高浓度氟化物暴露所需的氟化物治疗量（AIM 4）。 AIM 5将在蛋白质或其他允许的大分子被吸附在搪瓷或根牙本质的表面上时，建立预防龋齿所需的氟化物量。在AIM 6中，唾液组成，唾液流量与预防连续流模型建立的龋齿所需的氟化物之间的关系将通过使用内模型测试。在此目标6将确定氟化物暴露对预防龋齿的影响。这些研究共同第一次应该能够证明具有预防作用所需的氟化物的最低治疗水平。此外，该项目开发可用于指示所需数量的F作为特定环境的函数的预测模型的潜力尤其重要，因为该行业将能够适当地量身定制F制度。这在治疗面临较高风险的人群中尤其重要。