CONTROL OF PERIODONTAL INFECTIONS

牙周病是由存在于龈缘或龈缘下的微生物引起的感染性疾病。因此，控制它们的最佳方法逻辑上在于消除或抑制病原种。因此，该计划项目赠款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在定义特定病因学方面的不确定性，在我们对定植于牙周结构的复杂生态系统的理解中缺乏秩序，难以在进行治疗、预防或生态学研究所需的非常大量的样品中列举广泛的分类群，以及缺乏有效的治疗方式，即使已知药剂。这些障碍已部分克服。收集和分析描述口内患病率和微生物数量的大规模数据库的方法为描述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体似乎在菌斑发育中形成了一个连续性。一种复合物，确定为“红色复合物”，由拟杆菌、牙龈卟啉单胞菌和齿垢密螺旋体组成，似乎是常见成人形式牙周炎的主要病原学贡献者，因此是抗微生物策略的主要目标。在理解口腔生态学的同时，新的实验室方法也被引入。由于技术的有效性，如棋盘式DNA-DNA杂交，抗菌方法的有效性研究变得可行。还开发了用于控制牙周感染的改进方法。这些措施包括有效的抗菌药物和漱口水，电动牙刷，局部药物输送系统和更好的全身抗菌治疗。本申请中的项目将利用这些发展。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。将在项目1（预防）和B（治疗）中评价靶向消除红色络合物的方法。将在项目C中评价这些程序产生的不良反应（出现非预期或抗生素耐药菌种）。项目D将研究口腔物种与其生境的生态关系。

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.