BIOLOGIC BASIS OF REFRACTORY PERIDONTAL DISEASE

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。虽然大多数牙周患者可以通过患者教育、磨砂、手术和抗生素治疗的某种组合来成功地治疗，但也有一些患者持续到崩溃，这对患者和牙医来说都是非常令人沮丧和不安的。我们将这一群体定义为患有难治性牙周病。我们认为，了解难治性牙周炎是目前牙周研究面临的最重要的问题，因为消除治疗失败将对牙周护理的提供和成本产生影响。难治性牙周疾病的生物学基础尚不清楚，但我们推测这是由于感染了特定的细菌种类(可能是新发现的或不能培养的)或宿主中可能存在微妙的免疫损害的细菌复合体。此外，疱疹病毒的存在可能与该病的发病机制有关。对于难治性牙周病的水平、诊断和开发有效的治疗方法的长期目标。目前，约有10%至15%的牙周炎患者对常规治疗反应不佳，被认为是难治性的。这项建议的目标是基于对微生物和宿主因素的分析，检验难治性疾病与非难治性牙周病人群不同的假设。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. While most periodontal patients can be treated successfully by some combination of patient education, scaling, surgery, and antibiotic therapy, some patients contunue to break down which is extremely frustrating and disturbing for both patients and dentists. We define this group as having refractory periodontal disease. We believe that understanding refractory periodontitis is the most significant problem currently facing periodontal research because of the impact that eliminating treatment failure would have on the delivery and cost of periodontal care. The biologic basis for refractory periodontal diseases is poorly understood, but we hypothesize that it is due to infection with specific bacterial species (possibly newly recognized or "unticultivable") or bacterial complexes in a host that may be subtly immuno-compromised. Furthermore, the presence of herpes viruses may contribute to the pathogenesis of the disease. The long-term goals for the level, to diagnose, and to develop effective therapies for prevention and treatment of refractory periodontal disease. Currently about 10 to 15% of periodontitis patients fail to respond well to conventional therapy and are deemed refractory. The goals of this proposal are to examine the hypothesis that refractory disease is distinct from non-refractory periodontal disease population based upon analyses of microbial and host factors.