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International Poster Journal of Dentistry and Oral Medicine
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Int Poster J Dent Oral Med 9 (2007), No. 1     15. Mar. 2007

Int Poster J Dent Oral Med 2007, Vol 9 No 01, Poster 352

Subgingival Pathogen Microflora in Romanian Patients with Periodontitis

Language: English

Authors:
Assist. Prof. Dr. Dr. Stefan-Ioan Stratul, Victor Babes University of Medicine, Timisoara, Romania
Dr.Alin Dinca , Dr.Mirona Mesaros, Dr.Anca Benta, Dental Clinic Dr.Stratul, Timisoara, Romania

Date/Event/Venue:
26 - 30 October 2005
Gemeinsame Tagung der wissenschaftlichen Gesellschaften der ZMK
ICC Berlin, Germany

Introduction

Large amounts of information on the periodontitis-related germs are available in the literature, from data originating in various parts of the world. Studies demonstrate a lower prevalence of Aa in European and American than Asian population, and subjects with periodontitis harbor Aa more than twice as frequently in Thailand as in Romania or Holland (Basak et al., 2003).To date, except for one prevalence study (Ali et al., 1996), no recent information exists on the characteristics of periodontal microflora in Romanian subjects.

Objectives

To determine, by PCR technique the occurrence of the most common periodontopathogenic species in Romanian subjects with various periodontal conditions, the interspecies relationship and the relationship with the basic clinical parameters.

Material and Methods

The study population consisted of 54 patients referred with the clinical diagnosis of localized aggressive periodontitis (LagP = 16), generalized aggressive periodontitis (GagP = 24) and chronic periodontitis (CP = 14) during May through September 2004. Periodontists (SS, AD, MM, AB) assessed the Pocket depth (PD) and the Clinical attachment level (CAL) with a PCP 15 probe (Hu-Friedy Co., Chicago, USA), the Plaque Index (PI - Silness and Loe), the bleeding on probing (BOP) and performed radiographic periodontal examinations. The criteria for inclusion in the study were: 1) patients were Romanian and long-term inhabitants of the city of Timisoara and surrounding regions; 2) they were free from systemic diseases; 3) they had never received periodontal surgery; 4) they have not received SRP or antibiotics within the preceeding 6 months; 5) they had at least 20 natural teeth; 6) patients had at least one molar with PD > 4mm and CAL > 5 mm in 2 quadrants. Subgingival microbiological samples were collected from all patients with sterile paper points (Hain Lifescience GmbH, Nehren, Germany). In each patient, a total of 5 pockets with PD > 5 mm and CAL > 6 mm were chosen for sampling. At least half of the pockets were from different quadrants. The samples were pooled in a single vial for each patient. The samples were subject to PCR analysis by the Hain Lifescience GmbH laboratories (Nehren, Germany). The samples were processed within 4 days after sampling. All samples were tested for the presence of Aa, Pg, Tf, Td and Pi. The chi-square and Kruskall-Wallis non-parametric tests were used to assess the differences between the 3 diagnostic groups.

Results

In all germs, excepted Aa, the detection frequency did not significantly differ between the CP, LAgP and GAgP groups. The detection frequency of Aa significantly differs, continuously increasing between the CP (14.3%), LAgP (43.8%) and GAgP (45.8%) groups (p=0.016). Additionally, the detection frequency of Pi was significantly higher in patients with LagP (81.3%) than in patients with CP (14.3%). The mean proportions of Aa was higher in GAgP than in LAgP and CP respectively (p=0.005). The mean proportion of Td was higher in LAgP than in CP and GAgP respectively (p=0.028). Significant positive correlations were found between the levels of Aa and Pg, and between the levels of Pg and Tf in all periodontal conditions. Same positive correlations between the germs were found in patients with GagP, with additional positive correlations between the mean overall PD, CAL and Td. In LagP patients, significant positive correlations were found between PI and the level of Pg, between the BOP and the level of Td, and a strong positive correlation between the mean overall CAL and the level of Pi. In the CP group, a positive correlation was found between the PI and the Bf level, as between the Pg level and the Bf level. In the same group, a significant positive correlation existed between the mean overall PD and the Td level.

Fig.1 Subgingival bacterial species detected in patients with different periodontal conditions. Chi-square test.

Fig.2 Mean proportions of the identified subgingival bacterial species in patients with different periodontal conditions

Fig.3 The mean proportions of Aa was higher in GAgP than in LAgP and CP respectively (p=0.005). The mean proportion of Td was higher in LAgP than in CP and GAgP respectively (p=0.028). Kruskall-Wallis test

Table 1.Correlation coefficients and their significance for the clinical parameters and identified species in all periodontal conditions
PD_OVER CAL_OVER BOP PI AA PG BF TD PrI
PD_OVER 1,00
CAL_OVER 0,86** 1,00
BOP 0,30** 0,33** 1,00
PI -0,07 -0,03 0,07 1,00
Aa 0,10 0,09 0,05 -0,12 1,00
Pg 0,09 0,11 -0,08 -0,15 0,42** 1,00
Tf -0,04 -0,01 0,10 0,17 0,16 0,30** 1,00
Td 0,05 -0,01 -0,22 0,04 -0,03 -0,12 0,00 1,00
Pi -0,02 0,06 0,20 0,03 0,16 -0,04 0,11 -0,02 1,00
**Correlation is significant at the 0.01 level (2-tailed).

Table 2. Correlation coefficients and their significance for the clinical parameters and identified species in generalized aggressive periodontitis (GagP) patients
PD_OVER CAL_OVER BOP PI AA PG BF TD PrI
PD_OVER 1,00
CAL_OVER 0,84** 1,00
BOP 0,46* 0,48* 1,00
PI 0,14 0,33 0,18 1,00
Aa 0,04 -0,04 -0,09 -0,27 1,00
Pg 0,10 0,13 -0,29 -0,24 0,44** 1,00
Tf -0,18 -0,08 -0,15 0,01 0,39 0,49* 1,00
Td -0,41* -0,43** -0,10 0,04 0,00 -0,13 0,22 1,00
Pi 0,07 0,01 0,30 0,15 0,22 -0,10 0,16 0,03 1,00
** Correlation is significant at the 0.01 level (2-tailed).
* Correlation is significant at the 0.05 level (2-tailed).

Table 3. Correlation coefficients and their significance for the clinical parameters and identified species in localized aggressive periodontitis (LagP) patients
PD_OVER CAL_OVER BOP PI AA PG BF TD PrI
PD_OVER 1,00
CAL_OVER 0,93** 1,00
BOP 0,13 0,20 1,00
PI -0,35 -0,38 0,19 1,00
Aa 0,21 0,15 0,20 0,14 1,00
Pg 0,36 0,27 0,12 -0,55* 0,15 1,00
Bf -0,27 -0,30 0,22 -0,21 -0,04 -0,17 1,00
Td 0,20 0,21 -0,51* 0,12 -0,06 -0,45 -0,08 1,00
Pi 0,27 0,59* 0,30 -0,36 -0,03 0,10 -0,13 -0,05 1,00
** Correlation is significant at the 0.01 level (2-tailed).
* Correlation is significant at the 0.05 level (2-tailed).

Table 4. Correlation coefficients and their significance for the clinical parameters and identified species in chronic periodontitis (CP) patients
PD_OVER CAL_OVER BOP PI AA PG BF TD PrI
PD_OVER 1,00
CAL_OVER 0,86** 1,00
BOP 0,22 0,21 1,00
PI -0,17 -0,28 -0,05 1,00
Aa -0,06 0,31 -0,01 -0,19 1,00
Pg -0,11 -0,20 0,02 0,10 -0,22 1,00
Tf 0,12 0,12 0,17 0,40* -0,07 0,33* 1,00
Td 0,38* 0,29 0,28 0,12 -0,14 -0,14 0,16 1,00
Pi -0,26 -0,14 0,07 0,05 0,00 0,00 0,17 0,02 1,00
** Correlation is significant at the 0.01 level (2-tailed).
* Correlation is significant at the 0.05 level (2-tailed).

Conclusions

Results demonstrate that the five periodontal pathogens analyzed are strongly associated with Romanian periodontitis. In particular, Aa are more significantly associated with generalized aggressive periodontitis, while Td are more significantly associated with localized aggressive periodontitis. Aa, Pg and Tf levels seemed to be correlated in all studied periodontal conditions, especially in generalized aggressive periodontitis. No characteristic pattern of correlation between the clinical parameters and the levels of studied pathogens was found.


Abbreviations

AA - Actinobacillus actinomycetemcomitans
PG - Porphyromonas gingivalis,
TF - Tannerella forsythensis
TD - Treponema denticola
PrI - Prevotella intermedia.
GagP - generalized aggressive periodontitis
LagP - localized aggressive periodontitis
CP - chronic periodontitis
PD - pocket depth
BOP - bleeding on probing
PI - Plaque Index


This Poster was submitted by Assist. Prof. Dr. Dr. Stefan-Ioan Stratul.

Correspondence address:
Assist. Prof. Dr. Dr. Stefan-Ioan Stratul
Victor Babes University of Medicine
Str.Em.Gojdu no.5
300176 Timisoara
Romania