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The Prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis , and Bacteroides forsythus in Humans 1 Year After 4 Randomized Treatment Modalities
Author(s) -
Shiloah Jacob,
Patters Mark R.,
Dean John W.,
Bland Paul,
Toledo Gilbert
Publication year - 1998
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.1998.69.12.1364
Subject(s) - actinobacillus , medicine , dentistry , gingival and periodontal pocket , porphyromonas gingivalis , bleeding on probing , scaling and root planing , prevotella intermedia , gingival recession , periodontitis , randomized controlled trial , bacteroides , clinical attachment loss , quadrant (abdomen) , treponema denticola , fusobacterium nucleatum , chlorhexidine , chronic periodontitis , surgery , biology , bacteria , genetics
T he relationship between probing attachment changes in treated periodontal pockets and the prevalence of selected periodontal pathogens was assessed in 10 patients with adult periodontitis 1 year following randomized therapy. All patients had at least 1 tooth in each quadrant with an inflamed pocket of probing depth ≥5 mm and clinical attachment loss and harbored at least one of the following 3 major periodontal pathogens: Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis , or Bacteroides forsythus . The number of target organisms per site was determined preoperatively; at 1 week; and at 1, 3, 6, and 12 months postoperatively utilizing DNA probes. The following clinical parameters were measured and recorded preoperatively and at 1, 3, 6, and 12 months post‐treatment: gingival fluid flow, gingival index, plaque index, probing depth, probing attachment level, gingival recession, and bleeding on probing. One quadrant in each patient was randomly assigned to 1 of the following 4 treatments: 1) scaling and root planing; 2) pocket reduction through osseous surgery and apically‐positioned flap; 3) modified Widman flap; and 4) modified Widman flap and topical application of saturated citric acid at pH 1 for 3 minutes. All 4 treatments were rendered in one appointment using local anesthesia. No postoperative antibiotics were used, but patients rinsed with 0.12% Chlorhexidine for the first 3 months postoperatively and received a prophylaxis every 3 months. This investigation revealed: 1) 30.0% of the sites were infected by at least 1 species at 3, 6, and 12 months postoperatively. 2) Failing sites were infected by a high number of both Pg and Bf . These sites had a mean of 24.2 ± 9.0 × 10 3 Pg and 93.1 ± 42.0 × 10 3 Bf , while stable sites had a mean of 6.8 ± 0.5 × 10 3 Pg and 7.2 ± 1.2 × 10 3 Bf ( P = 0.06 and P = 0.05, respectively). 3) The infected sites lost significantly more mean clinical attachment at 12 months (1.5 ± 0.5 mm compared to a loss of 0.2 ± 0.3 mm for uninfected sites, P = 0.017). 4) The infected sites had a significantly greater BOP (67 ± 14% versus 25 ± 8% for uninfected sites at 12 months, P = 0.012). 5) The choice of treatment modality did not affect the prevalence of the target species at 1 year post‐treatment. These results suggest that prevalence of microbial pathogens negatively affects the 1 year outcome of periodontal surgical and nonsurgical therapy. J Periodontol 1998;69:1364–1372 .