PERIODONTITIS AND HOST DEFENSE IN JUVENILE DIABETES

我们已经评估了约300名患者的牙周状况， 青少年糖尿病（胰岛素依赖型糖尿病，IDDM）。 我们发现 牙周炎开始于12-13岁， 增加涉及约1/4的19岁或以上的患者。 这些 牙周炎病变特征性地开始于第一磨牙， 然后逐渐扩散到其他部位。 我们还发现了一个 胰岛素依赖型糖尿病牙周炎中独特的细菌植物群群， 与其他形式的牙周炎中发现的那些基本上不同。 因此，我们确定了一组约300例IDDM患者， 牙周并发症的发展特点是 关于（1）发病年龄，（2）早期病变部位，和（3） 估计这些病变可能发展的频率。 这样一群 胰岛素依赖型糖尿病患者将提供一个机会，研究 牙周炎的发病机制。 我们的目标 这一建议是：（1）纵向和前瞻性评价 牙周状况的队列300例胰岛素依赖型糖尿病患者的文件 牙周并发症的发生率、患病率和进展 与胰岛素依赖型糖尿病相关，（2）致病性 与IDDM患者牙周感染相关的细菌和（3）研究 微生物植物群和宿主因素的变化， 牙周炎的发展，其表现似乎符合 与胰岛素依赖型糖尿病青春期的发病有关。

We have evaluated the periodontal conditions of about 300 patients with Juvenile Diabetes (Insulin Dependent Diabetes Mellitus, IDDM. We found that periodontitis starts at the age of 12-13 years and progressively increases to involve about 1/4 of patients 19 years or older. These periodontitis lesions characteristically started at the first molars and incisors and progressively spread to other sites. We have also found a unique constellation of bacterial flora in periodontitis in IDDM which is substantially different from those found in other forms of periodontitis. Thus, we have identified a cohort of about 300 patients with IDDM in whom the development of periodontal complication has been characterized with respect to (1) the age of onset, (2) sites of early lesions, and (3) the estimated frequency with which those lesions may develop. Such a cohort of patients with IDDM would provide an opportunity for a study of the pathogenetic mechanisms for the development of periodontitis. Our aims of this proposal are: (1) Longitudinal and prospective evaluation of periodontal conditions in a cohort of 300 patients with IDDM to document the incidence, prevalance, and progression of periodontal complications associated with IDDM, (2) Isolation and characterization of pathogenic bacteria associated with the periodontal infections in IDDM and (3) Study of the changes in microbial flora and host factors which may play a role in the development of periodontitis, whose manifestation appears to coincide with the onset of puberty in IDDM.