title: Subgingival Microbial and Inflammatory Cell Morphotypes Associated with Chronic Periodontitis Progression in Treated Adults.
abstract: OBJECTIVE
  In a secondary data analysis, this pilot study evaluated the relationship between subgingival biofilm morphotypes and chronic periodontitis progression in treated adults.
  
  
  METHODS
  Periodontal parameters in 47 adults with chronic periodontitis were assessed by a calibrated examiner at baseline and a mean 4.5 years after a non-surgical periodontal therapy regimen. Microbial and inflammatory cell morphotypes in subgingival biofilm specimens from each patient were evaluated with phase-contrast microscopy at baseline, and at post-treatment intervals. Chronic periodontitis progression in patients was defined as ≥ 2 teeth exhibiting ≥ 3 mm interproximal clinical periodontal attachment loss from baseline evaluations. Bivariate and odds ratio analysis assessed baseline and post-treatment variables relative to chronic periodontitis progression.
  
  
  RESULTS
  Eight (17%) patients had chronic periodontitis progression. No baseline clinical, radiographic or microbiological variables, and no post-treatment clinical variables demonstrated statistically significant relationships with chronic periodontitis progression. Elevated post-treatment counts of subgingival spirochetes, medium to large-sized motile rods, and crevicular leukocytes, both alone and concurrently, appeared more frequently in patients experiencing chronic periodontitis progression. A post-treatment occurrence of high concurrent counts of subgingival spirochetes and crevicular leukocytes exhibited the strongest association with chronic periodontitis progression (odds ratio = 10.1; 95% Cl = 2.2, 45.4; p = 0.004), which was greater than with either morphotype alone.
  
  
  CONCLUSIONS
  Joint morphotype analysis of subgingival spirochetes and crevicular leukocytes, as simplified biomarkers of pathogenic biofilm infection and host inflammatory responses in periodontal pockets, may be diagnostically useful in assessing risk of progressive disease in treated chronic periodontitis patients.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Keyes
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Rams
mesh_terms: D000328:Adult; D001419:Bacteria / Q000145:classification*; D058491:Bacterial Load; D018441:Biofilms / Q000145:classification; D055113:Chronic Periodontitis / Q000382:microbiology* / Q000473:pathology / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000382:microbiology* / Q000473:pathology; D006801:Humans; D007962:Leukocytes / Q000473:pathology*; D008297:Male; D008858:Microscopy, Phase-Contrast; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000382:microbiology / Q000473:pathology; D010514:Periodontal Pocket / Q000382:microbiology / Q000473:pathology; D010865:Pilot Projects; D013144:Spirochaetales / Q000302:isolation & purification