RISK FACTORS FOR PERIODONTAL DISEASE

牙周病的危险因素

• 批准号: 3732470
• 负责人: JOSEPH J ZAMBON
• 金额: --
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3732470
• 关键词: Actinobacillus actinomycetemcomitans; Bacteroides; Bacteroides gingivalis; bacterial genetics; communicable disease transmission; coping; dental disorder diagnosis; dental plaque; dental radiography; diabetes mellitus; disease /disorder proneness /risk; family; genotype; human subject; immunofluorescence technique; longitudinal human study; microorganism immunology; oral bacteria; periodontitis; polymerase chain reaction; psychoneuroimmunology; questionnaires; serology /serodiagnosis; stress; tobacco abuse

The long term objective of this project is to define clinically important factors associated with increased risk for the development of destructive periodontal disease. Identification of these factors and understanding their mechanism of action will lead to intervention studies in which the risk factor is altered as a strategy to prevent periodontal destruction and loss of teeth. Specifically, we propose a longitudinal study of a large cohort to determine if previously identified risk indicators such as diabetes mellitus, smoking, specific periodontal pathogens and stress/distress, and coping behaviors are associated with an increased incidence of periodontitis. Changes in periodontal status (incidence) will be based on changes in attachment levels accurately measured with an automated periodontal probe, and on changes in alveolar crestal heights measured by computer-assisted analysis of radiographs. Psychosocial factors are assessed using a battery of seven instruments which measure life events, chronic stress, distress, hassles and uplifts, coping; as well as explanatory style, and control over events in daily life. Next, we propose to study periodontitis patients who have diabetes mellitus on who smoke, to determine to what extent these putative risk factors affect the rate of periodontal destruction. This will be accomplished in longitudinal case control studies where the putative risk factors are isolated and controls are matched for age and pathogenic bacteria, and in the case of the diabetics also matched for smoking. The rate of periodontal destruction and incidence of new disease will be assessed by standardized automated periodontal probing and by changes in alveolar crestal heights from computer-assisted analysis of radiographys. A battery of eight subgingival target organisms will be quantitated by specific antibody-based techniques adapted to use for large numbers of samples as generated in these longitudinal samples. Humoral immunity will also be measured. Finally, we propose to evaluate the mode of oral colonization with periodontal pathogens by assessing the clonal distribution of organisms in households and families affected by periodontitis. Colonization studies will be carried out using molecular genetic techniques such as restriction enzyme analysis, and the randomly primed polymerase chain reaction. These studies will assess the distribution of organisms in family members where at least one member has severe periodontitis, and several are infected by the target organisms A. actinomycetemcomitans, P. gingivalis, or B. forsythus. Identification of important risk factors, either causative or predictive, will facilitate efforts to develop and implement preventive measures designed to reduce tooth loss and edentulousness resulting from destructive periodontal disease. These measures then can be targeted to high risk populations and minorities in concert with the oral health objectives of "healthy People: 2000."

该项目的长期目标是定义临床上重要的 与破坏性疾病发展风险增加相关的因素 牙周病。这些因素的识别和理解 他们的作用机制将导致干预研究，其中 改变风险因素作为预防牙周破坏的策略 和牙齿脱落。具体来说，我们提出一项纵向研究 大型队列以确定先前是否已识别出风险指标，例如 如糖尿病、吸烟、特定牙周病原体和 压力/苦恼和应对行为与增加 牙周炎的发生率。牙周状态的变化（发生率） 将基于精确测量的依恋水平的变化 自动牙周探针以及牙槽嵴的变化 通过计算机辅助分析射线照片测量的高度。 使用七种仪器来评估社会心理因素 它衡量生活事件、慢性压力、苦恼、麻烦和振奋， 应对；以及解释风格以及对日常事件的控制 生活。 接下来，我们建议研究患有糖尿病的牙周炎患者 吸烟者的健康状况，以确定这些假定风险的程度 影响牙周破坏率的因素。这将是 在纵向病例对照研究中完成，其中假定的风险 分离因素并匹配年龄和致病性的对照 细菌，对于糖尿病患者来说，也与吸烟相匹配。这 牙周破坏率和新疾病发生率 通过标准化自动牙周探诊和牙周组织变化进行评估 通过计算机辅助放射线分析分析牙槽嵴高度。 一组八种龈下目标微生物将通过以下方法进行定量 基于特定抗体的技术适用于大量 在这些纵向样本中生成的样本。体液免疫会 也可进行测量。 最后，我们建议评估口腔定植模式 通过评估生物体的克隆分布来识别牙周病原体 受牙周炎影响的家庭和家庭。殖民化 将使用分子遗传学技术进行研究，例如 限制性内切酶分析和随机引物聚合酶链 反应。这些研究将评估生物体的分布 至少一名成员患有严重牙周炎的家庭成员，以及 一些被目标生物 A. actinomycetemcomitans 感染， P. gingivalis 或 B. forsythus。识别重要的风险因素， 无论是因果性的还是预测性的，都将促进努力发展和 实施旨在减少牙齿脱落的预防措施 破坏性牙周病导致的无牙颌。这些 然后可以针对高风险人群和少数民族采取措施 与“健康人：2000年”的口腔健康目标相一致。