CARIES MANAGEMENT BY RISK ASSESSMENT

通过风险评估进行龋齿管理

• 批准号: 6176762
• 负责人: JOHN D FEATHERSTONE
• 金额: $ 36.27万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-15 至 2002-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6176762
• 关键词: Lactobacillus; Streptococcus mutans; adult human (21+); chlorhexidine; clinical research; clinical trials; dental adhesive /sealant; dental caries; dental prosthesis; dental radiography; disease /disorder proneness /risk; human subject; human therapy evaluation; oral bacteria; outcomes research; patient care management; preventive dentistry; saliva; topical fluoride therapy

DESCRIPTION: (From applicant abstract) Caries and its sequelae remain the major reasons for dental treatment and tooth loss in the USA. Caries is not uniformly distributed; 80% of the total caries burden in children is found in 25% of the population. This skewed distribution of disease calls for methods to identify those at greatest risk and apply appropriate interventions. Recent advances have led to the introduction of diagnostic, preventive and therapeutic technologies which hold the promise of enduring cure of the disease. The overall objective of this study is to provide clinical evidence that the use of scientifically based caries risk assessment in conjunction with aggressive preventive and therapeutic measures to restore the balance between pathological and protective factors, and conservative restorations will result in little or no further caries increment compared to conventional treatment. The specific aims are: (1) To conduct a 2.5 year randomized, controlled clinical trial, to compare an "intervention" group (148 patients), whose caries will be managed based upon their low or high caries risk status (assessed by salivary microbiological and chemical assays) to a control group (148 patients) that receives "conventional" restorative treatment without knowledge of risk status The hypothesis to be tested is that caries management (primarily chlorhexidine fluorides, sealants) and conservative restorative treatment based on caries-risk status will significantly reduce the need for caries restorative treatment over two (plus) years compared to usual dental treatment. Study participants will be adult patients with at least one frank carious lesion who enter the comprehensive care clinic at UCSF. (2) To determine caries increment proportion and number of new restorations due to caries, changes in mutans streptococci (MS), lactobacilli (LB), and fluoride (F) in whole saliva, and dichotomized caries risk category in both the test (intervention) and control group patients. If successful this study will markedly change the teaching and practice of caries management.

描述：（从申请人摘要中）龋齿及其后遗症仍然存在 美国牙科治疗和牙齿脱落的主要原因。 龋齿不是均匀分布的；总计80％的龋齿负担 在25％的人口中发现了儿童。 这个偏斜的分布 疾病要求使用最大风险的方法，并且 采用适当的干预措施。 最近的进步导致了 引入诊断，预防和治疗技术 这有望持续治愈该疾病。 总体 这项研究的目的是提供临床证据表明 基于科学的性风险评估与 积极的预防和治疗措施以恢复平衡 在病理和保护因素之间以及保守派之间 修复体将很少或根本没有龋齿增加 与常规治疗相比。 具体目的是：（1） 进行2。5年的随机对照临床试验，以比较 “干预”组（148名患者），他们的龋齿将基于 在低性或高性风险状态下（通过唾液评估 对照组的微生物和化学分析）（148例患者） 在不了解的情况下接受“常规”修复治疗 风险状态要检验的假设是龋齿管理 （主要是氟乙胺，密封剂）和保守的 基于龋齿风险状态的恢复性治疗将显着 减少对两年（加）年内龋齿恢复治疗的需求 与通常的牙科治疗相比。 研究参与者将成年 至少有一个弗兰克·鲁特病变的患者进入 UCSF的综合护理诊所。 （2）确定龋齿增加 由于龋齿引起的新修复体的比例和数量 整体 两种测试中 （干预）和对照组患者。 如果成功的这项研究 将明显改变龋齿管理的教学和实践。