CONTROL OF PERIODONTAL INFECTIONS

牙周病是由存在于龈缘或龈缘以下的微生物引起的传染病。因此，从逻辑上讲，控制它们的最佳方法在于消除或抑制致病物种。因此，该计划的长期目标是通过抑制或消除引起牙周感染的微生物来控制牙周感染。这一过程的障碍包括定义特定病原的不确定性，我们对牙周结构的复杂生态系统的理解缺乏秩序，难以在进行治疗、预防或生态学研究所需的大量样本中列举广泛的分类群，以及即使已知病原体也缺乏有效的治疗方式。这些障碍在一定程度上已被克服。收集和分析描述口腔内流行和生物数量的大规模数据库的方法为描述牙龈下生态系统提供了新的见解和一定程度的秩序。相关微生物物种的复合物似乎在斑块发育中形成了一个序列。由连翘拟杆菌、牙龈卟啉单胞菌和牙密螺旋体组成的“红色复合体”似乎是常见成人牙周炎的主要病因，因此是抗微生物策略的主要目标。在了解口腔生态学方面取得进展的同时，也引入了新的实验室方法。由于诸如棋盘DNA-DNA杂交等技术的效率，抗菌方法的有效性研究变得可行。控制牙周感染的改进方法也得到了发展。这些措施包括有效的抗菌牙膏和漱口水、电动牙刷、局部给药系统和更好的全身抗菌疗法。此应用程序中的项目将利用这些开发。ore将为所有项目提供核心服务，包括管理、临床招募和监测、棋盘杂交和生物统计。在项目1（预防）和项目B（治疗）中评估靶向消除红色复合物的方法。项目c将评估这些程序产生的不良影响，如产生不需要的或耐抗生素的物种。项目D将研究口腔物种及其栖息地的生态关系。

Periodontal diseases are infectious diseases caused by the microorganisms that exist at or below the gingival margin. As such, the optimum method for their control logically lies in the elimination or suppression of the etiologic species. Thus, the long-term objective of this Program Project grant is to control periodontal infections by suppressing or eliminating the organisms that cause them. Barriers to this process have included uncertainty in defining specific etiologic gents, lack of order in our understanding of the complex ecosystem that colonizes the periodontal structures, difficulty in enumerating a wide range of taxa in the very large numbers of samples required to perform treatment, prevention or ecology studies and lack of effective therapeutic modalities even if the agent(s) were known. These barriers have in part been overcome. Means to assemble and analyze large scale data bases describing intraoral prevalence and numbers of organisms have provided new insight and a degree of order in describing the sub- gingival ecosystem. Complexes of associated microbial species appear to form a succession in plaque development. One complex, determined the "red complex," consisting of Bacteroides forsythus, Porphyromonas gingivalis and Treponema denticola appears to be a major etiologic contributor to the common adult forms of periodontitis and thus a prime target for anti-microbial strategies. Parallel to the advances in understanding oral ecology, new laboratory methods have been introduced. Studies of the efficacy of antimicrobial approaches become feasible due to the efficiency of techniques such and checkerboard DNA-DNA hybridization. Improved methods for control of periodontal infections have also been developed. These include effective antibacterial dentifrices and mouthwashes, powered toothbrushes, local drug delivery systems and better systemic antimicrobial therapies. The Projects in this application will take advantage of these developments. ore will provide services central to all Projects including administration, clinical recruitment and monitoring, checkerboard hybridization and biostatistics. Methods for the targeted elimination of the red complex will be evaluated in Project 1 (prevention) and B (treatment). Adverse effects arising from these procedures in terms of emergence of undesired or antibiotic resistant species will be evaluated in Project C. Project D will examine the ecological relationships of oral species and their habitat.