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Aggregatibacter actinomycetemcomitans -induced localized aggressive periodontitis (LAP) in African-American adolescents has been documented but is poorly understood. Two thousand fifty-eight adolescents aged 11 to 17 years were screened for their periodontal status and the presence ofA. actinomycetemcomitans in their oral cavity. Seventy-oneA. actinomycetemcomitans -negative and 63A. actinomycetemcomitans -positive periodontally healthy subjects were enrolled, sampled, examined, and radiographed yearly for 3 years. Gingival and periodontal pocket depth and attachment levels were recorded. Disease presentation was characterized by bone loss (BL). Subgingival sites were sampled every 6 months to assess (i) the role ofA. actinomycetemcomitans in BL and (ii) the association ofA. actinomycetemcomitans and other microbes in their relationships to BL. Sixteen of 63 subjects withA. actinomycetemcomitans developed BL (the other 47 subjects withA. actinomycetemcomitans had no BL). NoA. actinomycetemcomitans -negative subjects developed BL. Human oral microbe identification microarray (HOMIM) was used for subgingival microbial assessment. On a subject level, pooled data fromA. actinomycetemcomitans -positive subjects who remained healthy had higher prevalences ofStreptococcus andActinomyces species, whileA. actinomycetemcomitans -positive subjects with BL had higher prevalences ofParvimonas micra ,Filifactor alocis ,A. actinomycetemcomitans , andPeptostreptococcus sp. human oral taxon 113 (HOT-113). At vulnerable sites,A. actinomycetemcomitans ,Streptococcus parasanguinis , andF. alocis levels were elevated prior to BL. In cases where the three-organism consortium (versusA. actinomycetemcomitans alone) was detected, the specificity for detecting sites of future BL increased from 62% to 99%, with a sensitivity of 89%. We conclude that detecting the presence ofA. actinomycetemcomitans ,S. parasanguinis , andF. alocis together indicates sites of future BL in LAP. A synergistic interaction of this consortium in LAP causation is possible and is the subject of ongoing research.

journal of clinical microbiology

A Consortium of Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, and Filifactor alocis Is Present in Sites Prior to Bone Loss in a Longitudinal Study of Localized Aggressive Periodontitis