BIOLOGIC BASIS OF REFRACTORY PERIDONTAL DISEASE

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可以在其他CRISP条目中表示。所列机构为 中心，但不一定是研究者所在的机构。 虽然大多数牙周病患者可以通过患者教育，刮治，手术和抗生素治疗的某种组合成功治疗，但有些患者继续崩溃，这对患者和牙医来说都是非常令人沮丧和不安的。我们将这组患者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交付和成本的影响。难治性牙周病的生物学基础知之甚少，但我们假设它是由于感染特定的细菌物种（可能是新认识的或“uncultivable”）或细菌复合体在宿主可能是微妙的免疫功能低下。此外，疱疹病毒的存在可能有助于疾病的发病机制。长期目标为水平，诊断，并制定有效的治疗方法，预防和治疗难治性牙周病。目前，约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。本研究的目的是通过对微生物和宿主因素的分析，验证难治性牙周病与非难治性牙周病不同的假设。

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.