The Survival Rate of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, and Bacteroides forsythus Following 4 Randomized Treatment Modalities

Abstract

The overall goal of this clinical study was to determine the short-term anti-infective effects of four randomized treatment modalities on Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Bacteroides forsythus (Bf) and determine the effects of bacterial survival on treatment outcomes in patients with adult periodontitis. Twelve adult patients requiring therapy for moderate periodontitis were selected for this study. All patients had at least one tooth in each quadrant that had an inflamed pocket of probing depth > or =5 mm with probing attachment loss that harbored at least one of the following three periodontal pathogens: Aa, Pg, or Bf. The number of target organisms per site was determined pre-operatively, at 1 week, and 1 month and 3 months postoperatively utilizing DNA probes. One quadrant in each patient was randomly assigned to each one of the following four treatment groups: 1) scaling and root planing (SRP group); 2) pocket reduction through osseous surgery and apically-positioned flap (OS group); 3) modified Widman flap (MWF group); and 4) modified Widman flap and topical application of saturated citric acid at pH 1 for 3 minutes (CA group). The 4 treatment modalities were performed in one appointment. No postoperative antibiotics were used. Patients were instructed to supplement their daily oral hygiene with chlorohexidine oral rinse during the study. The results of this investigation indicated that: 1) none of the treatment modalities was effective in eliminating the target species; 2) the incidence of infected sites for all groups was 100% preoperatively; 62.5%, 33.3%, and 31.3% at 1 week, and 1 and 3 months postoperatively, respectively; 3) these infected sites lost 1.1 +/- 0.4 mm of probing attachment compared to gain of 0.0 +/- 0.3 mm for uninfected sites; 4) the infected sites had higher plaque and bleeding on probing 0.9 +/- 0.3, 73 +/- 12%, respectively, compared to 0.3 +/- 0.1 and 30 +/- 8% for the uninfected sites; and 5) no statistically significant differences were detected among the infected sites in regard to gingival index (1.0 +/- 0.2 vs. 0.8 +/- 0.1) or probing depth (3.5 +/- 0.4 vs. 3.0 +/- 0.1 mm). These results indicate that bacterial survival negatively affects the short-term clinical outcomes of non-surgical and surgical periodontal therapy.

Influence of periodontal surgery on the subgingival microbiome—A systematic review and meta‐analysis

“…Follow‐up time points varied and ranged from 6 weeks to 12 months after surgical procedure. Microbiological follow‐up time points were reported as follows: 3 months in 75% (21 out of 28), 25,28,30,32,34,36–51 6 months in 57% (16 out of 28), 8,25,27,30,32–34,36,38,39,42,44–46,50,51 12 months in 29% (8 out of 28), 8,25,27,31,33,34,42,50 9 months in 11% (3 out of 28), 25,30,34 1.5 months 26 and 2 months 52 in 7% (2 out of 28) and 4 months 52 and 10 months 35 in 4% (1 out of 28) 35 of the studies.…”

“…In the majority of the studies, subgingival plaque samples were collected with a sterile periodontal curette (57%) 8,25,26,28,30,33,34,36,37,44–48,52,54 . The second most common sampling method used was sterile paper points (35%) 27,31,32,40–43,49–51 . One study collected subgingival plaque samples with a toothpick 39 and one study did not provide any information about the sampling methodology 38 .…”

“…Variation was observed within this sampling method in regard to the number of paper points per site, size of paper points and length of time the paper points were kept in the periodontal pocket. The length of time varied from 10 s 27,49,50 to 30 s 32,42 . Whilst some studies collected samples only from one site of the mouth, for example the deepest site or the surgical site, 28,30,45,46 other studies collected samples on various or even all teeth present 25,35,37 .…”

Spezielle Diagnostik zur Therapie der aggressiven Parodontitis

“…zur Kontrolle nach Abschluss der Therapie eingesetzt werden [9,11,12]. Zahlreiche klinische Studien belegten den Zusammenhang zwischen erkrankten Stellen und einer erhöhten Anzahl an parodontopathogenen Keimen [4,5,14].…”

“…Zahlreiche klinische Studien belegten den Zusammenhang zwischen erkrankten Stellen und einer erhöhten Anzahl an parodontopathogenen Keimen [4,5,14]. In weiteren klinischen Studien konnte gezeigt werden, dass mit parodontopathogenen Keimen wie Pg und Bacteroides forsythus (Bf) besiedelte Stellen im Vergleich zu nicht infizierten Stellen mehr Attachmentund Knochenverlust sowie mehr Stellen mit Blutung nach Sondierung aufwiesen [9,10]. Zusätzlich zeigte sich bei diesen Patienten eine deutliche klinische Verbesserung der Stellen mit geringeren Werten an Pg [2].…”