Integrative/Molecular Studies Of Pain And Pain Control

一个早发性牙周炎队列被用来调查的程度偏差估计的患病率和牙周附着丧失的严重程度，由于各种部分记录协议（PRP的）。研究了266名年龄在19-25岁之间的受试者。完整的检查包括最多168次测量，所有28颗牙齿上每颗牙齿6个部位。然而，PRP？由于后勤方面的考虑，在国家口腔健康调查中通常使用。因此，有很大的兴趣，在获得估计的真实患病率和牙周病的严重程度的基础上使用的NIDCR PRP在我们的国家调查。本研究中考虑的PRP包括以下部位组合的全口评估：MB、B、DB、ML、L、DL，分别为（MB、B）、（MB、B、DB）、（MB、B、DL）、（ML、L、DL）和（MB、DB、BL、DL）。所有PRP均系统性低估了疾病患病率。根据全口评分，附着丧失大于3 mm的患病率为64.7%。然而，相应的估计是：20%至25%的牙齿中间的网站，43.6%至45.1%之间的4个邻间的网站，单独的; 47.7%的（MB，B）对，54.5%至56.8%的三个网站的组合，和62%的邻间四联体。根据全口评分，附着丧失严重度为1.17 mm。相应的估计数为：牙中位点分别为0.62和0.66 mm，4个邻间位点分别为1.39 - 1.48 mm;（MB，B）对为1.07 mm，三位点组合为1.15 - 1.18 mm，邻间四位点为1.43 mm。对于早发性牙周炎受试者，附着丧失（大于3 mm）的患病率被低估了大约15%的三个网站的评分，30%的（MB，B）和邻间单网站的评分，超过60%的单中牙评分。对于疾病的严重程度，三个部位评分存在轻微偏差（小于2%），（MB，B）对低估9%，邻间单个部位评分高估20%至25%，单个牙齿中间部位评分低估45%。这些研究的影响，部分记录有助于阐明真实的模式的牙周病估计获得的NHANESIII和NHANESIV调查。然而，由于本研究参与者的年龄范围有限，因此只能估计20-30岁队列的疾病模式。作为随访的一部分，我们建议对NHANESIV中确定的口腔健康检查的受试者子集进行全口牙周检查，然后将这些数据用于估计整个美国成年人群的疾病发生率和严重程度。目前，NCHS推迟了对NHANEES IV参与者子集进行全口检查的计划。我们正试图确定一个基础广泛的成年人群体，他们将接受全口牙周病检查，以获得NHANES IV检查过程中固有的疾病患病率低估程度的估计。

An early-onset periodontitis cohort was used to investigate the degree of bias in estimates of prevalence and severity of periodontal attachment loss produced due to various partial recording protocols (PRP's). 266 subjects, ages 19-25 years, were studied. A complete examination consisted of a maximum of 168 measurements, six sites per tooth on all 28 teeth. However, PRP?s are routinely used in national surveys of oral health because of logistical considerations. Thus, there is substantial interest in obtaining estimates of the true prevalence and severity of periodontal diseases based on the NIDCR PRP used in our national surveys. The PRP's considered in this study included full mouth assessments for the following combinations of sites: MB, B, DB, ML, L, DL, separately, (MB, B), (MB, B, DB), (MB, B, DL), (ML, L, DL) and (MB, DB, BL, DL). Prevalence of disease was systematically underestimated by all PRP's. The prevalence of attachment loss greater than 3 mm was 64.7 percent based on the full mouth score. However, the corresponding estimates were: 20 to 25 percent for mid-tooth sites, 43.6 to 45.1 percent among the 4 interproximal sites, individually; 47.7 percent for the (MB, B) pair, 54.5 to 56.8 percent for the triple site combinations, and 62 percent for the interproximal quadruplet. Attachment loss severity was 1.17 mm based on the full mouth score. The corresponding estimates were: 0.62 and 0.66 mm for mid-tooth sites, 1.39 to 1.48 mm among the 4 interproximal sites, individually; 1.07 mm for the (MB, B) pair, 1.15 to 1.18 mm for the triple site combinations, and 1.43 mm for the interproximal quadruplet. For early onset periodontitis subjects the prevalence of attachment loss (greater than 3 mm) was underestimated by roughly 15 percent for triple site scores, 30 percent for the (MB, B) and interproximal single site scores, and over 60 percent for the single mid-tooth scores. For severity of disease there was a slight bias (less than 2 percent) for the triple site scores, a 9 percent underestimate for the (MB, B) pair, a 20 to 25 percent overestimate by interproximal single site scores, and a 45 percent underestimate for the single mid-tooth site scores. These studies of the effects of partial recording help elucidate the real patterns of periodontal disease estimates obtained in the NHANESIII and NHANESIV surveys. However, due to the restricted age range of the participants in this study the diseas patterns can only be estimated for the 20-30 year old cohort. As a follow-up component we have proposed a subset of subjects identified for an oral health examination in NHANESIV be given a full-mouth periodontal exam. These data will then be used to estimate the patterns of disease prevanelce and severity for the entire U.S. adult population. Currently the plan to include a full-mouth examination for a subset of NHANEES IV participants has been postponed by NCHS. We are attempting to identify a broad-based group of adults who will be examined for periodontal disease on a full-mouth basis to obtain estimates of the degree of underestimation of diesase prevalence inherent in the NHANES IV esamination process.