Monitoring of Subgingival Bacteroides Gingivalis and Actinobacillus Actinomycetemcomitans in The Management of Advanced Periodontitis

¹ Departments of Oral Biology and Periodontology, Periodontal Disease Clinical Research Center, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New ork 14214, U.S.A.
² The Department of Periodontology, Public Dental Services, Helsingborg, Sweden
³ Departments of Oral Biology and Periodontology, Periodontal Disease Clinical Research Center, School of Dental Medicine, State University of New York at Buffalo, Buffalo, New York 14214, U.S.A.

In a series of clinical trials involving 79 adult periodontitis patients, we evaluated the clinical and microbiological effects of H₂O₂, NaHCO₃, and a commercially available povidine solution, as adjuncts to mechanical periodontal debridement. Each trial included a placebo as a control. The healing response was monitored clinically by measurement of changes in probing attachment levels after treatment. The current report includes data from single-rooted teeth only.

In general, healing in severely advanced periodontal lesions (initial pocket depth 7 mm) was enhanced by the use of the listed topical antimicrobial agents administered subgingivally during mechanical debridement.

Correlations were sought between changes in probing attachment levels 12 months after treatment, and the presence of subgingival B. gingivalis and A. actinomycetemcomitans in the periodontal lesions. For a total of 428 lesions included in this report, B. gingivalis was detected in 53.1% of lesions showing probing attachment loss (1.5 mm), but in only 4.7% of lesions showing gain ( 1.5 mm). Either B. gingivalis or A. actinomycetemcomitans was detected in 70.1% of the lesions showing loss and in only 4.8% of those showing gain. These studies indicate the benefits of the adjunctive antimicrobial therapy described, and the usefulness of specific microbiological monitoring as an aid to clinical measurements in the evaluation of success or failure of treatment of chronic adult periodontitis.

Note:

This study was supported in part by USPHS Research Grant DE04898 from the National Institute of Dental Research, National Institutes of Health, Bethesda, MD 20892. The authors would also like to express their sincere thanks to Mr. Homer Reynolds for technical assistance, and to Ms. Phyllis Hill for preparing the manuscript.

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