BONE DENSITY--A RISK FACTOR FOR ORTHODONTIC SIDE EFFECTS

在这个为期 5 年的职业发展奖期间，Shiboski 博士打算将肾移植受者 (RTR) 口腔疾病的研究与培训计划结合起来，以扩大她在口腔医学和流行病学方面的背景。 拟议的5年前瞻性队列研究的目标是1）调查皮质类固醇和新一代免疫抑制剂对口腔软组织疾病发生率和下颌骨结构变化的长期副作用； 2）确定下颌骨分形维数的变化是否可以预测各个骨骼部位骨矿物质密度的变化，并且可以用作检测该高危人群骨质疏松症的诊断工具。 RTR（N = 360）将从 UCSF 肾脏移植后诊所招募，并每 1 年进行一次随访。 测量包括口腔软组织检查、牙周参数评估、垂直咬翼X光片和面谈。 此外，放射学副教授 Majumdar 博士还将对牙科 X 光照片进行分形分析，并探讨与在参与者子样本的两个骨骼部位测量的骨矿物质密度的关系。该奖项的培训方面将在两位导师的指导下进行。 约翰·格林斯潘博士将协助候选人学习与其研究领域相关的分子免疫病理学和免疫组织化学方面的知识。 Ira Tager 博士将为候选人提供有关对具有复杂病史的免疫抑制受试者进行纵向研究所固有的方法学困难的建议。该候选人获得了流行病学博士学位，并接受了口腔医学研究生培训，作为个人牙医科学家奖的一部分。 拟议的职业发展奖将使 Shiboski 博士能够应用和扩展她作为临床口腔流行病学家的技能，研究患有各种潜在系统性疾病（例如甲状旁腺功能亢进症、糖尿病）的长期免疫抑制人群的口腔疾病。 候选人打算将 80% 的精力投入到拟议的项目中。

During this 5-year career development award Dr. Shiboski intends to integrate a study of oral disease in renal transplant recipients (RTRs) with a training plan that would expand her background in Oral Medicine and Epidemiology. The objectives of the proposed 5-year prospective cohort study are to 1) investigate the long-term side effects of corticosteroids and new generation immunosuppressants on the incidence of oral soft tissue disease and on changes in mandibular bone structure; and 2) determine if change in the fractal dimension of mandibular bone predicts change in bone mineral density of various skeletal sites, and may be used as a diagnostic tool to detect osteoporosis in this high risk population. RTRs (N = 360) will be recruited from the UCSF kidney post-transplant clinic, and followed at 1-year intervals. Measurements will include an oral soft tissue examination, evaluation of periodontal parameters, vertical bitewing radiographs, and an interview. In addition, fractal analysis will be conducted on dental radiographs and explored in relation to bone mineral density measured on two skeletal sites on a sub-sample of participants by Dr. Majumdar, an Associate Professor in Radiology. The training aspect of the award will be under the guidance of two mentors. Dr. John Greenspan will assist the candidate in learning aspects of molecular immunopathology and immunohistochemistry that are relevant to her research area. Dr. Ira Tager will advise the candidate about methodologic difficulties inherent in a longitudinal study of immunosuppressed subjects with complex medical histories. The candidate earned a PhD in Epidemiology and received post- graduate training in Oral Medicine as part of an individual Dentist Scientist Award. The proposed career development award would allow Dr. Shiboski to apply and expand her skills as a clinical oral epidemiologist to the study of oral disease in a chronically immunosuppressed population with various underlying systemic disorders (e.g., hyperparathyroidism; diabetes). The candidate intends to devote 80 percent effort to the proposed project.