季铵盐化二氧化硅生物玻璃对粪肠球菌临床分离株的杀灭作用及抑制其粘附过程的机制研究

Enterococcus faecalis (E. faecalis) as well as its biofilm are the main reasons for the failure of root canal treatment (RCT). A long-term effective bactericidal effect of root canal sealer against E. faecalis and its biofilm is important to ensure the long-term effectiveness of RCT. However, it is almost impossible for currently used root canal sealers to meet this requirement. Previously, we developed a novel kind of material of quaternary-ammonium-polymethacrylate-containing silica-based bioactive glass (SBG-QAPM). Resluts showed that the SBG-QAPM presented a long-term effective bactericidal effect against the planktonic form of the E. faecalis standard strain. Basing on the results of our previous study, the aims of present project are to investigate the bactericidal effect both in vitro and in vivo of SBG-QAPM aginst the E. faecalis clinical isolate from endodontically treated canals and its biofilm by means such as direct contact test and manmade infected root canal model of minipig tooth, and to further illuminate the adhesion inhibition effect as well as the possible molecular mechanism of SBG-QAPM on biofilm formation of E. faecalis by using techniques including SEM, EDS, Real-time PCR, and Western blot. Investigations above will provide both theoretical and experimental evidence to the development and clinical application of the SBG-QAPM as a novel root canal sealer with a long-term bactericidal effect, and will provide a new approach for reducing the occurrence of RCT failure, which as a result is of great theoretical and clinical research significance.

粪肠球菌（E.faecalis）及其生物膜是导致根管治疗失败的主要原因之一，根管封闭剂对他们发挥长期有效的杀灭作用对保证根管治疗的远期疗效有重要意义，但现有根管封闭剂很难做到这一点。申请人前期研制了一种季铵盐化二氧化硅生物玻璃（SBG-QAPM）材料，它对浮游态E.faecalis标准株表现出长效的杀灭作用。本项目拟在前期研究基础上，以直接接触法和小型猪感染根管模型等手段研究SBG-QAPM对再感染根管内E.faecalis临床分离株及其生物膜的体内外杀灭作用；进一步以SEM、EDS、Real-time PCR和Western blot等技术明确SBG-QAPM抑制E.faecalis生物膜形成粘附过程的作用及其可能分子机制。以上研究可以为SBG-QAPM用于长效杀菌根管封闭剂的研发和临床应用提供理论和实验依据，也能为减少根管治疗失败的发生提供新的思路，有重要的理论和临床研究意义。

粪肠球菌（E. faecalis）及其生物膜是导致根管治疗失败的主要原因之一，根管封闭剂对他们发挥长期有效的杀灭作用对保证根管治疗的远期疗效有重要意义，但现有根管封闭剂很难做到这一点。项目负责人前期初步合成了一种季铵盐化二氧化硅生物玻璃（SBG-QAPM）材料，它对浮游态E. faecalis标准株表现出长效的杀灭作用。基于当前根管封闭剂发展的现状和局限性，本项目拟在前期研究基础上探索一种可用于新型长效抗菌根管封闭剂研发的新材料，以为牙髓根尖周病的临床治疗提供新的思路和选择。. 本项目的主要研究内容包括（1）完善SBG-QAPM的合成流程、参数，明确其相关理化性能，并测定其细胞毒性作用及组织相容性；（2）明确SBG-QAPM对再感染根管内E. faecalis临床分离株及其生物膜的体内、外杀灭作用及可能机制。通过研究，本项目主要取得了如下成果：（1）完善了新材料（SBG-QAPM）的合成流程及参数，并对其进行了理化性能的表征；（2）测定了SBG-QAPM的最小抑菌浓度和最小杀菌浓度，筛选出了杀菌作用相对最强的BGs-HA；（3）体内外研究明确了BGs-HA对E. faecalis浮游菌及生物膜具有长期、有效、稳定的抗菌作用；（4）体内外研究明确了BGs-HA细胞毒性小、组织相容性好；（5）BGs-HA为接触抑菌，能够从源头上抑制E. faecalis生物膜的形成。综上，本研究为新型长效杀菌根管封闭剂的研发和临床应用提供了充分的理论和实验依据，也为减少根管治疗失败的发生提供了新的思路，有重要的理论研究意义和临床应用前景。. 此外，相关研究结果发表学术论文4篇，其中SCI 1篇；出版学科专著3部，其中英文专著1部；获中华口腔医学会科技奖二等奖；授权国家发明专利1项，实用新型专利1项；参加国内外学术交流10余次；培养博士、硕士研究生8名，其中2人已毕业。.

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