Treatment of periodontal disease based on microbiological diagnosis. Relation between microbiological and clinical parameters during 5 years.
The purpose of this study was to assess the clinical effect of treatment aimed to suppress Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis below detection level and Prevotella intermedia below 5% of the cultivable periodontal pocket flora. Sixteen patients and a total of 111 periodontal pockets with probing depth > or = 6 mm were included in the study. Twelve patients and a total of 77 sites completed the 5-year study. The results demonstrated clinical improvement of probing depth and gain of clinical attachment level of 3.4 mm and 1.2 mm, respectively. Treatment to eliminate indicator bacteria continued for 3 years before the aim was fulfilled. In order to eliminate A. actinomycetemcomitans from a majority of the sites, a combination of surgery and generalized tetracycline treatment was performed. A recolonization or regrowth of the indicator bacteria exceeding detection levels took place in several sites. The presence of A. actinomycetemcomitans. P. gingivalis, and P. intermedia, alone or in combination, correlated with attachment level change on the individual level. No such correlation was obtained by using presence of plaque, bleeding on probing, or three other bacteria (Campylobacter rectus, Eikenella corrodens, and Fusobacterium nucleatum) not used as treatment goal markers.
Renvert
S
S
School of Dental Hygiene, Kristianstad College of Health Sciences, Sweden.
Dahlén
G
G
Wikström
M
M
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D015169:Colony Count, Microbial; D003657:Decision Making; D003774:Dental Plaque Index; D012534:Dental Scaling; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000382:microbiology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology*; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology* / Q000601:surgery; D016966:Porphyromonas gingivalis / Q000187:drug effects; D018713:Prevotella intermedia / Q000187:drug effects; D012044:Regression Analysis; D013752:Tetracycline / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D013752:Tetracycline