MICROBIAL RISK FACTORS FOR DENTAL IMPLANTS

虽然骨结合牙种植体通常有很高的成功率， 大约10%的植入物失败。 本提案的总体目标 旨在确定在植入物失效中起作用的微生物风险因素，以及 评估抗菌治疗在预防和 失败的牙科植入物的治疗。 第一个具体目标包括一个主要的培养研究失败 牙科植入物 骨结合成功与失败的微生物学研究 将对植入物进行比较。 植入物将通过临床 使用标准化X线照片测量，附着水平，移动性， 和炎症，包括植入物周围温度测量。 将使用荧光底物试验对微生物进行表征， 生化反应性和聚丙烯酰胺凝胶电泳。 分离株 将通过与参比品的特征比较来识别 包括新物种和重新分类的物种。 分离株 未知物种将通过rRNA测序和DNA探针来表征。 第二个具体目标将评估抗菌的潜力 治疗失败的植入物。 失败的植入物将被处理 使用非手术的积极的抗菌疗法 植入体将 使用来自第一特定目标的临床测量来监测。 成功治疗将通过骨密度增加和/或 使用减影X线摄影测量身高。 治疗后的微生物群 处理过的种植体将使用主要的培养方法进行表征 就像第一个目标一样。 治疗前和治疗后微生物群的比较 从成功和不成功治疗的种植体中获得的样本将 提供额外的数据，以区分与 植入失败。 长期目标是提高种植牙的成功率。 本提案中的信息将有助于确定具体的 失败种植体的治疗方案。 目标是确定 介导、指示或预测植入成功的微生物，或 失败 然后可以制定预防措施，以改善 种植牙成功的概率。

Although osseointegrated dental implants generally have a high success rate, about 10% of implants fail. The broad objectives of this proposal are to identify microbial risk factors operative in implant failure, and assess the potential for antibacterial therapy in the prevention and treatment of failing dental implants. The first specific aim includes a predominant cultivable study of failing dental implants. The microbiotas of successful and failing osseointegrated implants will be compared. Implants will be Characterized by clinical measurements using standardized radiographs, attachment level, mobility, and inflammation including peri-implant temperature measurements. Microorganisms will be characterized using fluorescent substrate tests for biochemical reactivity, and polyacrylamide gel electrophoresis. Isolates will be identified by comparison of characteristics with those of reference strains of species, including new and reclassified species. Isolates of unknown species will be characterized by rRNA sequencing and DNA probes. The second specific aim will assess the potential of antibacterial treatment to treat failing Implants. Failing implants will be treated using a non-surgical, aggressive antimicrobial therapy. Implants will be monitored using the clinical measurements from the first specific aim. Successful treatment will be indicated by increases in bone density and/or height using subtraction radiography. The post-treatment microbiota of treated implants will be characterized using predominant cultural methods as in the first aim. Comparison of pre- and post-treatment microbiota from samples obtained from successfully and unsuccessfully treated implants will provide additional data to differentiate species associated with implant-failure. The long-term objective is to improve the success-rate of dental implants. Information from this proposal will contribute to determining specific treatment regimens for failing implants. The objective is to identify microorganisms that mediate, indicate or predict for implant success or failure. Preventive measures may then be devised to improve the probability of dental implant success.