BONE DENSITY--A RISK FACTOR FOR ORTHODONTIC SIDE EFFECTS

在这5年的职业发展奖励中，Shiboski博士打算将肾移植受者（RTRs）的口腔疾病研究与培训计划结合起来，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的是：1)研究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)确定下颌骨分形维数的变化是否能预测各骨骼部位骨密度的变化，并可作为该高危人群骨质疏松症的诊断工具。rtr （N = 360）将从UCSF肾脏移植后诊所招募，每隔1年随访一次。测量将包括口腔软组织检查、牙周参数评估、垂直咬合x光片和面谈。此外，分形分析将在牙科x光片上进行，并探索由放射学副教授Majumdar博士在参与者的子样本上测量的两个骨骼部位的骨矿物质密度的关系。该奖项的培训方面将由两位导师指导。John Greenspan博士将协助候选人学习与其研究领域相关的分子免疫病理学和免疫组织化学。Ira Tager博士将建议候选人在对具有复杂病史的免疫抑制受试者进行纵向研究时所固有的方法学困难。该候选人获得流行病学博士学位，并获得口腔医学研究生培训，作为个人牙医科学家奖的一部分。拟议的职业发展奖将允许Shiboski博士应用和扩展她作为临床口腔流行病学家的技能，以研究慢性免疫抑制人群的口腔疾病，并伴有各种潜在的全身性疾病（例如，甲状旁腺功能亢进；糖尿病）。候选人打算在提议的项目中投入80%的精力。

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.