title: Factors associated with different responses to periodontal therapy.
abstract: In a study of the efficacy of modified Widman flap surgery and scaling and root planning accompanied by 1 of 4 systemic adjunctive agents, Augmentin, tetracycline, ibuprofen or placebo, it was observed that subjects differed in their response to therapy. The difference was only partially accounted for by the adjunctive agent employed. The purpose of the present investigation was to examine clinical and microbiological features in subjects who showed different levels of attachment change post-therapy. 40 subjects were subset into 3 groups based on mean attachment level change post-therapy. 10 poor response subjects showed mean attachment loss; 19 moderate response subjects showed mean attachment gain between 0.02-0.5 mm and 11 good response subjects showed a mean gain of attachment > 0.5 mm. Clinical parameters were measured at 6 sites per tooth both pre- and post-therapy. Microbiological samples were taken from the mesial aspect of each tooth and evaluated individually for their content of 14 subgingival taxa using a colony lift method and DNA probes. % of sites colonized by each species was computed for each subject both pre- and post-therapy. Significant differences were observed among treatment response groups for mean probing pocket depth, attachment level and % of sites with plaque pre-therapy. The poor response subjects had the lowest mean probing pocket depth and attachment level, but the highest plaque levels. Post-therapy, the poor response group exhibited the greatest degree of gingival inflammation as assessed by gingival redness and bleeding on probing.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Periodontology, Forsyth Dental Center, Boston, MA, USA.
authors.forename: A D
authors.initials: AD
authors.lastname: Haffajee
authors.forename: S
authors.initials: S
authors.lastname: Dibart
authors.forename: R L
authors.initials: RL
authors.lastname: Kent
authors.forename: S S
authors.initials: SS
authors.lastname: Socransky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000658:Amoxicillin / Q000008:administration & dosage / Q000627:therapeutic use; D019980:Amoxicillin-Potassium Clavulanate Combination; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification; D017024:Chemotherapy, Adjuvant; D002969:Clavulanic Acids / Q000008:administration & dosage / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003773:Dental Plaque / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D012534:Dental Scaling; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005884:Gingival Hemorrhage / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D005891:Gingivitis / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage / Q000627:therapeutic use; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000382:microbiology / Q000473:pathology / Q000628:therapy*; D010514:Periodontal Pocket / Q000382:microbiology / Q000473:pathology / Q000628:therapy; D010919:Placebos; D016745:Root Planing; D013524:Surgical Flaps; D013752:Tetracycline / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D002969:Clavulanic Acids; D010919:Placebos; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin; D013752:Tetracycline; D007052:Ibuprofen