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博士打算将肾移植受者（RTRs）口腔疾病的研究与培训计划相结合，以扩大她在口腔医学和流行病学方面的背景。 本项5年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;以及2）确定下颌骨的分形维数的变化是否预示着各种骨骼部位的骨矿物质密度的变化，并且可以用作诊断工具来检测该高危人群中的骨质疏松症。 将从UCSF肾脏移植后诊所招募RTR（N = 360），并每隔1年进行随访。 测量将包括口腔软组织检查，牙周参数的评价，垂直咬翼片，和采访。 此外，将对牙科X光片进行分形分析，并由放射学副教授Majumdar博士在参与者的子样本上测量两个骨骼部位的骨矿物质密度。该奖项的培训方面将在两名导师的指导下进行。 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方面。 伊拉泰格医生将为候选人提供关于具有复杂病史的免疫抑制受试者的纵向研究中固有的方法学困难的建议。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，作为个人牙科科学家奖的一部分。 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和扩展到患有各种潜在全身性疾病（例如，甲状旁腺功能亢进;糖尿病）。 候选人打算把80%的精力投入到提议的项目中。

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.