EFFECTIVENESS OF TREATMENT OF ADULT PERIODONTITIS

拟议的R-29研究计划解决了以下问题的有效性： 治疗口腔疾病成人牙周炎。成人 牙周炎是一种破坏性的细菌性疾病， 在少数民族中，这最终导致牙齿死亡。的目标 牙周病治疗是为了降低牙齿死亡率。由于高 随着疾病的流行，美国每年花费更多的钱。 牙周病治疗比治疗慢性疾病， 艾滋病和乳腺癌。现有证据表明， 牙周治疗成功地降低牙齿死亡率是模棱两可的 因为牙周治疗效果的研究主要集中在 替代标记，而不是牙齿死亡率。目标：㈠评价 替代标记是否可用于进行有效推断 关于牙齿死亡率，（ii）评估 牙周治疗对牙齿死亡率的影响，以及（iii）启动一项 转向基于结果的研究。提出了四个研究项目： (l)估计以下方面的定量和定性关系： 两个队列中牙周炎和牙齿死亡替代标志物 研究：挪威纵向研究（n=565）和牙科 纵向研究（n= 1，211）。这些研究将决定 替代标记物对牙齿死亡率的预测能力。（二） 评估牙周替代物是否能捕获 5项随机对照试验中治疗对牙齿死亡率的影响 （RCT）：4项甲硝唑试验（n=273）和一项老年预防性试验 牙科试验（n=294）。这些研究将提供信息， 短期研究中基于替代物的结论是否符合 长期研究中基于牙齿死亡率的结论。（三） 使用嵌套病例评估牙周治疗效果- Kaiser Permanente Dental System的对照研究。过程 牙周护理将与牙齿死亡率联系起来， 服务代码与图表审计相结合（n约等于 8，322）。这三个项目的结果将是第一个评估 使用替代物时对牙齿死亡率的假设 并将导致第四个项目;（4）可行性研究， 规划最终审判，以获取证据为目标 牙周治疗能给病人带来实实在在的好处

The proposed R-29 research program addresses the effectiveness of treatments for the oral disease, adult periodontitis. Adult periodontitis is a destructive bacterial disease, especially prevalent in minorities, that ultimately leads to tooth mortality. The goal of periodontal therapy is to reduce tooth mortality. Due to the high prevalence of the disease, more money is spent each year in the U.S. on periodontal treatments than on treatments for chronic diseases such as AIDS and breast cancer. The evidence available to show that periodontal treatments successfully reduce tooth mortality is equivocal because periodontal treatment effectiveness research has focused on surrogate markers, not on tooth mortality. Goals: (i) To evaluate whether surrogate markers can be used to make valid inferences regarding tooth mortality rates, (ii) to evaluate the effect of periodontal treatments on tooth mortality, and (iii) to initiate a transition to outcome based research. Four Study Projects are Proposed: (l) Estimating the quantitative and qualitative relationships between surrogate markers of periodontitis and tooth mortality in two cohort studies: the Norwegian Longitudinal Study (n=565) and the Dental Longitudinal Study (n= l ,211). These studies will determine the predictive abilities of surrogate markers for tooth mortality. (2) Evaluating whether periodontal surrogates capture the effect of treatment on tooth mortality rates in 5 randomized controlled trials (RCTs): 4 metronidazole trials (n=273) and a geriatric preventive dental trial (n=294). These studies will provide information as to whether surrogate-based conclusions in short-term studies correspond to tooth mortality-based conclusions in long-term studies. (3) Estimating periodontal treatment effectiveness using a nested case- control study in the Kaiser Permanente Dental System. Processes of periodontal care will be linked to tooth mortality using computerized service codes in combination with chart audits (n equals approximately 8,322). Findings from these 3 projects will be the first to evaluate the assumptions about tooth mortality inherent in the use of surrogates and will lead to the 4th project; (4) a study of the feasibility and planning of a definitive trial with as goal the procurement of evidence that periodontal therapy provides tangible patient benefits.