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：该提案的目标是确定预防牙釉质和牙根龋所需的氟化物的最低浓度。由于缺乏对“口腔环境中氟化物的目标浓度以优化其防龋潜力”的了解，NIDCR 发布了一项计划公告 (PA-01-121)，表明该主题的高度优先地位。经过 60 年的社区水氟化，我们仍然不知道需要多少氟来预防龋齿。这可能是因为没有人系统地进行体外研究，在密切模拟口腔环境的条件下分离重要因素，然后在口腔内研究中验证这些发现。该提案详细介绍了这样一项系统研究，以确定与氟化物预防龋齿功效相关的重要因素及其相互作用。考虑到每个人的情况的预测模型将从体外研究中开发出来，然后通过口腔内研究进行验证。在口腔中，氟化物要么来自唾液，浓度相对较低且相当恒定（0.1 ppm；Carey 等人，1986），要么来自氟化物冲洗液、凝胶和牙膏，这种情况是短暂的，浓度范围可达 15,000百万分之一。在目标 1 中，当氟化物浓度始终稳定、低时，连续流模型用于优化预防牙釉质龋齿所需的氟化物量。目标 2 的重点是确定每天两次推注氟化物时预防牙釉质龋齿所需的氟化物量。认识到根牙本质是与牙釉质截然不同的基质，目标 3 和 4 的重点是确定在持续暴露（目标 3）和周期性高浓度氟化物暴露（目标 4）条件下预防根龋所需的氟化物治疗量。目标 5 将确定当蛋白质或其他选择性渗透大分子吸附在牙釉质或牙根牙本质表面时预防龋齿所需的氟化物量。在目标 6 中，将使用口腔内模型来测试通过连续流动模型建立的唾液成分、唾液流量和预防龋齿所需的氟化物量之间的关系。在本目标 6 中，将确定氟化物暴露对预防龋齿的影响。这些研究应该首次能够证明具有预防作用所需的最低氟化物治疗水平。此外，该项目开发预测模型的潜力特别重要，该模型可用于指示作为特定环境函数的所需 F 量，因为专业人士将能够适当定制 F 制度。这对于高危人群的治疗尤为重要。