EFFECTIVENESS OF TREATMENT OF ADULT PERIODONTITIS

成人牙周炎治疗的有效性

• 批准号: 6164418
• 负责人: PHILIPPE P HUJOEL
• 金额: $ 11.56万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 1997
• 资助国家: 美国
• 起止时间: 1997-03-15 至 2002-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6164418
• 关键词: biomarker; clinical research; dentistry; disease /disorder prevention /control; epidemiology; human data; human therapy evaluation; outcomes research; periodontitis; tooth loss

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.

拟议的 R-29 研究计划旨在解决以下问题的有效性： 治疗口腔疾病、成人牙周炎。成人 牙周炎是一种破坏性细菌性疾病，尤其流行 在少数群体中，这最终会导致牙齿死亡。目标是 牙周治疗的目的是降低牙齿死亡率。由于高 随着这种疾病的流行，美国每年花更多的钱 牙周治疗比慢性病治疗更重要 如艾滋病和乳腺癌。现有证据表明 牙周治疗能否成功降低牙齿死亡率尚不明确 因为牙周治疗效果研究的重点是 替代标记，而不是牙齿死亡率。目标： (i) 评估 替代标记是否可用于做出有效的推论 关于牙齿死亡率，(ii) 评估效果 牙周治疗可降低牙齿死亡率，以及 (iii) 启动 过渡到基于结果的研究。提出了四个研究项目： (l) 估计之间的定量和定性关系 两组中牙周炎和牙齿死亡率的替代标志物 研究：挪威纵向研究 (n=565) 和牙科 纵向研究（n=l，211）。这些研究将决定 替代标记对牙齿死亡率的预测能力。 (2) 评估牙周替代物是否具有以下效果 5 项随机对照试验对牙齿死亡率的治疗 (RCT)：4 项甲硝唑试验 (n=273) 和一项老年预防药物 牙科试验（n=294）。这些研究将提供以下信息： 短期研究中基于替代的结论是否相符 长期研究中基于牙齿死亡率的结论。 (3) 使用嵌套案例估计牙周治疗效果 凯撒永久牙科系统的对照研究。的流程 使用计算机化技术将牙周护理与牙齿死亡率联系起来 服务代码与图表审核相结合（n 大约等于 8,322）。这 3 个项目的调查结果将首先进行评估 使用替代物时固有的关于牙齿死亡率的假设 并将导致第四个项目； （四）可行性研究 规划最终审判，以获取证据为目标 牙周治疗为患者带来了切实的好处。