EFFECTIVENESS OF TREATMENT OF ADULT PERIODONTITIS

拟议的R-29研究计划解决了 治疗口腔疾病、成人牙周炎。成虫 牙周炎是一种破坏性的细菌性疾病，尤其流行。 在少数族裔中，这最终会导致牙齿死亡。的目标是 牙周治疗是为了降低牙齿死亡率。由于高企 随着这种疾病的流行，美国每年都要花更多的钱。 关于牙周治疗而不是对慢性病的治疗 艾滋病和乳腺癌。现有的证据表明 牙周治疗成功降低牙齿死亡率含糊不清 因为牙周治疗效果的研究一直集中在 代孕标记，而不是牙齿死亡率。目标：(一)评估 是否可以使用代理标记进行有效的推断 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 向基于结果的研究过渡。建议的研究项目有四项： (L)估计两者之间的数量和质量关系 两个队列中牙周炎和牙齿死亡率的替代标记物 研究：挪威纵向研究(n=565)和牙科 纵向研究(n=L，211)。这些研究将确定 代用标志物对牙齿死亡率的预测能力。(2) 评估牙周替代物是否能捕捉到 5项随机对照试验中牙齿死亡率的治疗 (随机对照试验)：4项甲硝唑试验(n=273)和一项老年预防试验 牙科试验294例。这些研究将提供以下信息： 短期研究中基于替代物的结论是否一致 在长期研究中得出基于牙齿死亡率的结论。(3) 使用嵌套式病例评估牙周治疗效果- Kaiser恒牙系统的对照研究流程： 牙周护理将与牙齿死亡率挂钩使用计算机化 服务代码与图表审核相结合(n约等于 8,322)。这三个项目的结果将首先进行评估 关于使用代用品所固有的牙齿死亡率的假设 并将导致第四个项目；(4)可行性研究和 规划以获取证据为目标的终审性审判 牙周治疗给患者带来了实实在在的好处。

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.