TREATMENT OF PERIODONTAL INFECTIONS

该项目旨在评估根除由腹泻病病原体引起的感染的最有希望的方法。考虑到刮治和根面平整（SRP）可能是必不可少的，以摆脱牙菌斑生物膜和感染的结石的网站，四个预防策略似乎可能大大有助于传播，消毒病原体水库和消除环境，支持牙周病原体的生长。基于我们以前的研究和文献中描述的微生物学反应的综述，确定了最有可能消除或抑制牙周病原体的策略。将通过向所有受试者提供电动牙刷和三氯生/共聚物牙膏来减少龈上菌斑。治疗结束后，将通过洗必泰（CHX）漱口液控制病原体传播两周。通过在所有> 3 mm的囊袋中应用四环素（TC）纤维对病原体储库进行消毒。牙周手术将消除支持牙周病原体生长的环境。该提案描述了一种独特的2/3析因设计，其中将局部抗生素、全身抗生素和牙周手术作为接受电动牙刷和三氯生共聚物牙膏的受试者在SRP后的连续治疗进行比较。实验设计通过对8个实验组中的4个进行联合分析来评价主效应，从而提供了高统计敏感性的可能性。此外，该模型还提供了一种方法来评估每种受试治疗之间的重要相互作用。虽然这项研究解决了与临床实践相关的重要问题，但它也提供了各种形式治疗的生物学效应的信息，并确定了未来研究中最重要的方向。

This project seeks to evaluate the most promising means to eradicate infections caused by 0eriodontal disease pathogens. Considering that scaling and root planing (SRP) is likely to be essential to rid sites of plaque biofilms and infected calculus, four adjunctive strategies appear likely to substantially contribute to the transmission, disinfection of pathogen reservoirs and elimination of environments that support growth of periodontal pathogens. Based on a review of microbiologic responses described in our previous studies and in the literature, the strategies most likely to eliminate or suppress the periodontal pathogens were identified. Reduction of supragingival plaque will be achieved by providing powered toothbrushes and triclosan/co-polymer dentifrice to all subjects. Control of pathogen transmission will be by chlorhexidine (CHX) mouth-rinses for two weeks following completion of therapy. Disinfection of pathogen reservoirs will be by application of tetracycline (TC) fibers in all pockets > 3mm. Elimination of environments that support growth of periodontal pathogens will be by periodontal surgery. The proposal describes a unique 2/3 factorial design in which local antibiotics, systemic antibiotics and periodontal surgery will be compared as adjunctive treatments following SRP in subjects receiving electric toothbrushes and triclosan-co-polymer dentifrice. The experimental design provides the potential for high statistical sensitivity by evaluating main effects through combined analysis of 4 of the 8 experimental groups. In addition, the model provides a means to evaluate important interactions between each of the treatments being tested. Although this study addresses important questions related to clinical practice, it also provides information on biological effects of various forms of therapy and identifies the most important directions to be taken in future investigations.