title: Clinical and microbiological effects of subgingival antimicrobial irrigation with citric acid as evaluated by an enzyme immunoassay and culture analysis.
abstract: The purpose of the present study was to compare an enzyme immunoassay with culture samples from untreated and non-surgically treated periodontal pockets and to assess the clinical and microbiological effects of citric acid irrigation as a supplement to scaling and root planing. The enzyme immunoassay used in this study is a chairside diagnostic tool aimed at identifying the presence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans. Six sites with pocket depths > or = 6 mm in each of 16 patients were monitored for 24 weeks using clinical and microbiological parameters. In two out of the six sites, scaling and root planing was supplemented with subgingival citric acid irrigation of the pocket after completion of the mechanical treatment. The sensitivity of the immunoassay in relation to culture was calculated to 85.5% and the specificity to 90.2%. The immunoassay corresponded to a detection level of 10(4) as estimated by culture. Sites treated with a combination of scaling and irrigation with citric acid demonstrated a similar healing pattern as sites treated with scaling and root planing alone. The profile of the marker bacteria was almost parallel for the two groups. The results of this investigation thus indicated that the immunoassay can be used as a screening tool for selected periodontal pathogens and that adjunctive irrigation with citric acid has no measurable clinical or microbiological effects.
authors.affiliation: School of Dental Hygiene, Kristianstad University College of Health Sciences, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Renvert
authors.forename: G
authors.initials: G
authors.lastname: Dahlén
authors.forename: B
authors.initials: B
authors.lastname: Snyder
mesh_terms: D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects* / Q000302:isolation & purification; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D019343:Citric Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D003774:Dental Plaque Index; D012534:Dental Scaling; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000473:pathology / Q000628:therapy; D010514:Periodontal Pocket / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D016966:Porphyromonas gingivalis / Q000187:drug effects* / Q000302:isolation & purification; D018713:Prevotella intermedia / Q000187:drug effects* / Q000302:isolation & purification; D016745:Root Planing; D012680:Sensitivity and Specificity; D013492:Suppuration; D007507:Therapeutic Irrigation; D014945:Wound Healing
chemical_list: D000900:Anti-Bacterial Agents; D019343:Citric Acid