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Utility of 5 major putative periodontal pathogens and selected clinical parameters to predict periodontal breakdown in patients on maintenance care
Author(s) -
Rams Thomas E.,
Listgarten Max A.,
Slots Jørgen
Publication year - 1996
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/j.1600-051x.1996.tb00556.x
Subject(s) - prevotella intermedia , periodontitis , actinobacillus , gingival and periodontal pocket , medicine , dentistry , porphyromonas gingivalis , clinical attachment loss , chronic periodontitis , microbiology and biotechnology , biology
The predictive utility of 5 major putative periodontopathic microbial species, “superinfecting” organisms, and several clinical periodontal parameters were assessed relative to periodontitis recurrence over a 12‐month period in 78 treated adult patients participating in a 3‐month maintenance care program. At baseline, pooled subgingival microbial samples were collected from each patient, and whole‐mouth evaluations of probing depth, relative periodontal attachment level, furcation involvement, and indices of plaque and gingival inflammation were carried out. 67 (85.9%) subjects were culture‐positive at baseline for presence of either Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia. Campylobacter rectus or Peptostreptococcus micros, with 48 (61.5%) subjects yielding one or more of these species at or above designated threshold proportions of ≥0.01% for A. actinomycetemcomitans, ≥0.1% for P. gmgivalis , ≥2.5% for P. intermedia , ≥2.0% for C. rectus , and ≥3.0% for P. micros. Subgingival yeasts were recovered from 12 subjects, staphylococci from 7, and enteric rods/pseudomonads from 6; however, no subjects revealed 21.0% baseline proportions of these “superinfecting” organisms in subgingival specimens. Periodontitis recurrence in subjects was defined as any periodontal site exhibiting either a probing depth increase of 2:3 mm from baseline, or a probing depth increase of 22 mm from baseline together with a loss in relative periodontal attachment of 22 mm from baseline. 15 (19.2%) study subjects showed periodontitis recurrence within 6 months of baseline, and 25 (32.1%) within 12 months. The mere baseline presence of the 5 major test species and “superinfecting” organisms were not significant predictors of periodontilis recurrence over 12 months. However, a 2.5 relative risk for periodontitis recurrence over 12 months was found for subjects yielding one or more of the 5 major test species at or above the designated baseline threshold proportions (p=0.022. Mantel‐Haenszel %2 test). The positive predictive value for periodontitis recurrence of a microbiologic analysis encompassing the 5 major test species at or above the designated threshold proportions improved with increasing time from baseline, up to approximately 42% at 12 months. Baseline variables jointly providing in multiple regression analysis the best predictive capability for periodontitis recurrence in subjects over a 12‐month period were recovery of one or more of the 5 major test species at or above designated threshold proportions, the proportion of sites per subject with 25 mm probing depth, and the mean whole‐mouth probing depth. These findings indicate that one or more of 5 major putative periodontal pathogens in elevated subgingival proportions together with increased probing depth predispose adults on maintenance care to recurrent periodontitis.