Periodontal pathogens and associated factors in aggressive periodontitis: results 5-17 years after active periodontal therapy.
OBJECTIVE
To assess the association between presence of periodontal pathogens and recurrence of disease in patients with aggressive periodontitis (AgP) after active periodontal therapy (APT) and further influencing factors.


METHODS
Microbiological samples were taken from 73 patients with AgP 5-17 years after APT at 292 sites (deepest site per quadrant). Real-time polymerase chain reactions were used to detect the periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Uni- and multivariate analyses evaluated the associations between pathogens and recurrence of disease, smoking and adjunctive antibiotic therapy.


RESULTS
At re-examination A. actinomycetemcomitans could be detected in six patients (8.2%), P. gingivalis in 24 (32.9%), T. forsythia in 31 (42.5%) and T. denticola in 35 (48.0%). Increased levels of T. forsythia and T. denticola at re-examination were significantly associated with recurrence of disease in multivariate analyses (OR: 12.72, p < 0.001; OR 5.55, p = 0.002 respectively). Furthermore, high counts of T. denticola were found in patients with increased percentage of sites with clinical attachment levels (CAL) ≥ 6 mm compared to those with low counts (13.8% versus 3.2%, p = 0.005).


CONCLUSIONS
In patients with recurrence of disease T. forsythia and T. denticola were detected more frequently and in higher counts. Furthermore, T. denticola was found more frequently in patients with increased CAL.
Section of Periodontology, Department of Conservative Dentistry, Clinic for Oral, Dental and Maxillofacial Diseases, University Hospital Heidelberg, Heidelberg, Germany.
Amelie
A
Meyer-Bäumer
Sigrun
S
Eick
Christian
C
Mertens
Lorenz
L
Uhlmann
Daniel
D
Hagenfeld
Peter
P
Eickholz
Ti-Sun
TS
Kim
Raluca
R
Cosgarea
D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification; D010520:Aggressive Periodontitis / Q000382:microbiology* / Q000628:therapy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D058491:Bacterial Load; D001439:Bacteroides / Q000302:isolation & purification; D003131:Combined Modality Therapy; D003774:Dental Plaque Index; D005260:Female; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000145:classification; D006090:Gram-Negative Bacteria / Q000145:classification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification / Q000382:microbiology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000382:microbiology; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D012008:Recurrence; D012907:Smoking; D013357:Subgingival Curettage / Q000379:methods; D016388:Tooth Loss / Q000145:classification; D048373:Treponema denticola / Q000302:isolation & purification
D000900:Anti-Bacterial Agents
Aggregatibacter actinomycetemcomitans; Aggressive periodontitis; adjunctive antibiotic therapy; periodontal pathogens; recurrence of disease