The Effectiveness of Treatment for Adult Periodontitis

成人牙周炎治疗的有效性

• 批准号: 6640702
• 负责人: PHILIPPE P HUJOEL
• 金额: $ 16.12万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6640702
• 关键词: adult human (21+); antimicroorganism antibody; clinical trials; data collection methodology /evaluation; dental disorder chemotherapy; dental health insurance; dental survey; disease /disorder proneness /risk; epidemiology; human subject; human therapy evaluation; longitudinal human study; oral pharyngeal surgery; outcomes research; patient oriented research; periodontitis; quality of life; tooth loss

BACKGROUND: Adult periodontitis is a destructive disease that may lead to tooth loss and decreased quality of life. Currently, little is known regarding the impact of surgical periodontal therapy on tooth loss and oral-specific health- related quality of life (OQOL). GOAL: The aim of this R01 proposal is to initiate a periodontal outcomes study among the members of Washington Dental Service (WDS), a not for-profit dental insurance plan. AIMS: Primary aim: To determine the impact common periodontal procedures on tooth loss and OQOL in a population of 1561 WDS patients with periodontitis using a prospective cohort design. Secondary aims: (i) Relate OQOL to tooth loss, periodontal treatment history, and periodontal disease characteristics. (ii) Investigate subgroups, dose- response relationships, site-specific relationships between periodontal treatments and tooth loss, and specific treatments such as osseous grafts and site-specific anti-microbial treatments. (iii) Study the impact of patient characteristics (e.g., smoking, diabetes) on the therapeutic response. (iv) Estimate the association between non-surgical periodontal therapy and tooth loss and OQOL. (v) Assess the feasibility of conducting randomized trials of simple periodontal treatments among an insured population. PROPOSED STUDY: Study Design: A prospective cohort study (n=1,561;starting date: January 2002), with a retrospective component (n=20,275 patients starting in 1993). Patient clinical characteristics, outcomes, procedure data, and OQOL will be obtained from patient-survey data (mail and telephone) and the WDS data warehouse. Generalized estimating equation models, with time dependent covariates, will be used to relate tooth loss and OQOL to the periodontal treatment history and patient characteristics. PRELIMINARY DATA: The feasibility and design of this study were determined by a periodontal outcome study in Kaiser Permanente Dental Plan, a mail survey of WDS patients regarding patient risk factors for periodontitis, a retrospective analysis of WDS data, and a pre-testing of the OQOL instrument. SIGNIFICANCE: Information will be obtained regarding the tooth loss and OQOL that is associated with real-world clinical decisions, in a broad range of periodontitis patients, in specialist practice settings. This information can help determine in what area of periodontal research definitive clinical trials may offer the greatest contribution.

背景：成人牙周炎是一种破坏性疾病，可导致牙齿脱落和生活质量下降。目前，关于手术牙周治疗对牙齿脱落和口腔特定健康相关生活质量（OQOL）的影响知之甚少。目标：本R01提案的目的是在华盛顿牙科服务（WDS）的成员中发起一项牙周结果研究，这是一项非营利性牙科保险计划。目的：主要目的：采用前瞻性队列设计，确定1561例WDS牙周炎患者常见牙周手术对牙齿脱落和生活质量的影响。次要目的：(i)将OQOL与牙齿脱落、牙周治疗史和牙周病特征联系起来。（ii）调查亚组、剂量-反应关系、牙周治疗与牙齿脱落之间的部位特异性关系，以及骨移植和部位特异性抗菌治疗等特异性治疗。（iii）研究患者特征（如吸烟、糖尿病）对治疗反应的影响。（iv）评估非手术牙周治疗与牙齿脱落和生活质量之间的关系。评估在参保人口中进行简单牙周治疗随机试验的可行性。研究设计：前瞻性队列研究（n= 1561，起始日期：2002年1月），包括回顾性研究（n= 20275例患者，起始时间为1993年）。从患者调查资料（邮件和电话）和WDS数据仓库中获取患者的临床特征、结果、手术数据和生存质量。具有时间相关协变量的广义估计方程模型将用于将牙齿脱落和OQOL与牙周治疗史和患者特征联系起来。初步数据：本研究的可行性和设计是通过Kaiser Permanente Dental Plan的牙周结局研究、对WDS患者牙周炎危险因素的邮件调查、WDS数据的回顾性分析和OQOL仪器的预测试来确定的。意义：将获得与现实世界临床决策相关的牙齿脱落和生活质量的信息，在广泛的牙周炎患者中，在专业实践环境中。这些信息可以帮助确定在牙周研究的哪个领域，决定性的临床试验可能提供最大的贡献。