CONTROL OF PERIODONTAL INFECTIONS

牙周病是由存在于牙周边缘或牙周边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病原性物种。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：定义特定病原学的不确定性，我们对定植于牙周结构的复杂生态系统缺乏了解，难以在进行治疗、预防或生态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(S)也缺乏有效的治疗方式。这些障碍在一定程度上已经被克服。汇编和分析描述口腔内流行率和微生物数量的大型数据库的方法为描述牙龈下生态系统提供了新的见解和有序度。在斑块的发展过程中，相关微生物物种的复合体似乎形成了一个序列。一种由福赛氏杆菌、牙龈卟啉单胞菌和齿密螺旋体组成的“红色复合体”似乎是常见成人牙周炎的主要病因学因素，因此是抗微生物策略的主要目标。在了解口腔生态学的同时，也引入了新的实验室方法。由于棋盘状DNA-DNA杂交等技术的有效性，抗菌方法的有效性研究成为可能。还开发了控制牙周感染的改进方法。这些措施包括有效的抗菌牙膏和漱口水、电动牙刷、当地药物输送系统和更好的系统抗菌疗法。此应用程序中的项目将利用这些发展。ORE将提供所有项目的核心服务，包括行政管理、临床招募和监测、棋盘杂交和生物统计。有针对性地消除红色复合体的方法将在项目1(预防)和B(治疗)中进行评估。项目C将评估这些程序产生的不良影响，包括出现不受欢迎或对抗生素有抗药性的物种。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.