The goal of Project 0006 will be to examine in detail the biological basis of """"""""treatment failure"""""""". The first series of experiments will examine a possible microbial component of treatment failure and include the hypotheses that: 1) the etiologic species are resistant to the adjunctive antibiotic employed; 2) the antimicrobial agent does not reach periodontal sites in levels sufficient to suppress the pathogens, 3) the pathogens are of a distinct, highly virulent clonal type; 4) the etiologic organisms colonize sites which are inaccessible to mechanical and/or antimicrobial treatment. A second set of experiments will examine the host component of treatment failure and include the hypotheses that: 1) the host's """"""""response system"""""""" (PMNs, antibody, complement) cannot kill the subject's subgingival species; 2) the host mounts an inadequate immunological response manifested by an over or under production of antibody, or production of ineffective antibody; 3) the host responds to subgingival species with an """"""""overly exuberant"""""""" (damaging) inflammatory response. Subjects in Project 0005 identified as treatment failures (test) will enter Project 0006 (minimum n=30). A matched, """"""""treatment success"""""""" subject (control) will be identified for each test subject, who is of the same race, sex, age, and medical status group. Clinical, demographic, microbiological and immunological characteristics of both test and control subjects will be available from data collected in Project 0005. All test and control subjects will be evaluated at the baseline visit of Project 0006 for the following additional parameters: 1) the presence of species resistant to tetracycline, 2) clonal type of P. gingivalis and C. rectus, 3) level of enteric organisms and yeasts, and the presence of unusual species (by PCR), 4) ability to deliver systemically-administered tetracycline to periodontal sites, 5) ability of host defense system to kill the subject's subgingival pathogens, 6) antibody response to subgingival species and 7) levels of local inflammatory mediators. If these data suggest an """"""""appropriate therapy"""""""", that therapy will be instituted. When an """"""""appropriate therapy"""""""" is not apparent, 1 of 2 intensive antimicrobial therapies will be instituted. If during the course of treatment, a tooth must be extracted for periodontal reasons, microorganisms in penetrating the dentinal tubules of the root will be sought and identified. Three, 6 and 12 months after completion of therapy, all subjects will be monitored using clinical and laboratory assessments.

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Specialized Center (P50)
Project #
5P50DE004881-19
Application #
5210082
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
19
Fiscal Year
1996
Total Cost
Indirect Cost
Craig, Ronald G; Yip, Julie K; Mijares, Dindo Q et al. (2003) Progression of destructive periodontal diseases in three urban minority populations: role of clinical and demographic factors. J Clin Periodontol 30:1075-83
Craig, Ronald G; Boylan, Robert; Yip, Julie et al. (2002) Serum IgG antibody response to periodontal pathogens in minority populations: relationship to periodontal disease status and progression. J Periodontal Res 37:132-46
Craig, R G; Boylan, R; Yip, J et al. (2001) Prevalence and risk indicators for destructive periodontal diseases in 3 urban American minority populations. J Clin Periodontol 28:524-35
Feres, M; Haffajee, A D; Allard, K et al. (2001) Change in subgingival microbial profiles in adult periodontitis subjects receiving either systemically-administered amoxicillin or metronidazole. J Clin Periodontol 28:597-609
Cugini, M A; Haffajee, A D; Smith, C et al. (2000) The effect of scaling and root planing on the clinical and microbiological parameters of periodontal diseases: 12-month results. J Clin Periodontol 27:30-6
Ximenez-Fyvie, L A; Haffajee, A D; Socransky, S S (2000) Microbial composition of supra- and subgingival plaque in subjects with adult periodontitis. J Clin Periodontol 27:722-32
Ximenez-Fyvie, L A; Haffajee, A D; Socransky, S S (2000) Comparison of the microbiota of supra- and subgingival plaque in health and periodontitis. J Clin Periodontol 27:648-57
Sakellari, D; Goodson, J M; Kolokotronis, A et al. (2000) Concentration of 3 tetracyclines in plasma, gingival crevice fluid and saliva. J Clin Periodontol 27:53-60
Ximenez-Fyvie, L A; Haffajee, A D; Som, S et al. (2000) The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota. J Clin Periodontol 27:637-47
Socransky, S S; Haffajee, A D; Smith, C et al. (2000) Microbiological parameters associated with IL-1 gene polymorphisms in periodontitis patients. J Clin Periodontol 27:810-8

Showing the most recent 10 out of 156 publications