Document Detail


Persistence of extracrevicular bacterial reservoirs after treatment of aggressive periodontitis.
MedLine Citation:
PMID:  19053921     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to test the hypothesis that periodontal pathogens associated with aggressive periodontitis persist in extracrevicular locations following scaling and root planing, systemic antibiotics, and antimicrobial rinses.
METHODS: Eighteen patients with aggressive periodontitis received a clinical examination during which samples of subgingival plaque and buccal epithelial cells were obtained. Treatment consisted of full-mouth root planing, systemic antibiotics, and chlorhexidine rinses. Clinical measurements and sampling were repeated at 3 and 6 months. Quantitative polymerase chain reaction determined the number of Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Prevotella intermedia, Porphyromonas gingivalis, Tannerella forsythia (previously T. forsythensis), and Treponema denticola in the plaque. Fluorescence in situ hybridization and confocal microscopy determined the extent of intracellular invasion in epithelial cells.
RESULTS: Clinical measurements improved significantly following treatment. All bacterial species except P. gingivalis were significantly reduced in plaque between baseline and 3 months. However, all species showed a trend to repopulate between 3 and 6 months. This increase was statistically significant for log T. denticola counts. All species were detected intracellularly. The percentage of cells infected intracellularly was not affected by therapy.
CONCLUSIONS: The 6-month increasing trend in the levels of plaque bacteria suggests that subgingival recolonization was occurring. Because the presence of these species within epithelial cells was not altered after treatment, it is plausible that recolonization may occur from the oral mucosa. Systemic antibiotics and topical chlorhexidine did not reduce the percentage of invaded epithelial cells. These data support the hypothesis that extracrevicular reservoirs of bacteria exist, which might contribute to recurrent or refractory disease in some patients.
Authors:
Jason D Johnson; Ruoqiong Chen; Patricia A Lenton; Guizhen Zhang; James E Hinrichs; Joel D Rudney
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Journal of periodontology     Volume:  79     ISSN:  0022-3492     ISO Abbreviation:  J. Periodontol.     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-12-04     Completed Date:  2009-04-28     Revised Date:  2011-08-01    
Medline Journal Info:
Nlm Unique ID:  8000345     Medline TA:  J Periodontol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2305-12     Citation Subset:  D; IM    
Affiliation:
Department of Developmental and Surgical Sciences, Division of Periodontology, School of Dentistry, University of Minnesota, Minneapolis, MN 55455, USA.
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MeSH Terms
Descriptor/Qualifier:
Actinobacillus actinomycetemcomitans / growth & development
Adolescent
Adult
Aged
Aggressive Periodontitis / microbiology*,  therapy
Amoxicillin / therapeutic use
Anti-Bacterial Agents / therapeutic use
Anti-Infective Agents, Local / therapeutic use
Bacteroides / growth & development
Chlorhexidine / therapeutic use
Colony Count, Microbial
Dental Plaque / microbiology
Epithelial Cells / microbiology
Female
Follow-Up Studies
Gram-Negative Bacteria / growth & development*
Humans
Male
Metronidazole / therapeutic use
Middle Aged
Mouth Mucosa / microbiology*
Mouthwashes / therapeutic use
Porphyromonas gingivalis / growth & development
Prevotella intermedia / growth & development
Root Planing
Treponema denticola / growth & development
Young Adult
Grant Support
ID/Acronym/Agency:
DE 14214/DE/NIDCR NIH HHS; R01 DE014214-01/DE/NIDCR NIH HHS; R01 DE014214-02/DE/NIDCR NIH HHS; R01 DE014214-03/DE/NIDCR NIH HHS; R01 DE014214-04/DE/NIDCR NIH HHS; R01 DE014214-05/DE/NIDCR NIH HHS
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Infective Agents, Local; 0/Mouthwashes; 26787-78-0/Amoxicillin; 443-48-1/Metronidazole; 55-56-1/Chlorhexidine
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