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博士打算将一项关于肾移植受者口腔疾病(RTRS)的研究与一个培训计划结合起来，以扩大她在口腔医学和流行病学方面的背景。这项为期5年的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病率和下颌骨结构变化的长期副作用；2)确定下颌骨分形维的变化是否可以预测不同骨骼部位骨密度的变化，并可作为诊断工具在这一高危人群中检测骨质疏松。RTR(N=360)将从加州大学旧金山分校肾脏移植后诊所招募，并每隔1年进行一次跟踪。测量将包括口腔软组织检查、牙周参数评估、垂直咬合X线片和访谈。此外，放射学副教授马琼达尔博士还将对牙科X光照片进行分形分析，并探索与参与者的两个骨骼部位测量的骨密度之间的关系。该奖项的培训方面将在两名导师的指导下进行。约翰·格林斯潘博士将帮助候选人学习与她的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博士将建议候选人在对有复杂病史的免疫抑制受试者进行纵向研究时，存在方法学上的困难。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，这是个人牙医科学家奖的一部分。拟议的职业发展奖将使ShiBoski博士能够将她作为临床口腔流行病学家的技能应用于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.