慢性牙周炎龈下菌斑和唾液微生物群落分析

目的:运用DGGE技术检测慢性牙周炎龈下菌斑和唾液微生物群落结构,分析其菌群之间的关系。方法:选取34名慢性牙周炎志愿者,分别采集龈下菌斑和唾液样本,采用PCR扩增细菌16Sr RNA V3区后,运用DGGE技术分析各组样本微生物群落结构。通过数字化软件Im age J将DGGE凝胶图谱转成数字信息,对所得矩阵进行主成分分析(Princ ipal ComponentAnalysis,PCA)、聚类分析(C luster Analysis)和偏最小二乘法(Partial Least Squares,PLS)分析。结果:DGGE图谱显示:龈下菌斑DGGE条带数目为11～28,,平均19;唾液DGGE条带数目为11～24,平均17;PCA结果显示:龈下菌斑与唾液比较有明显的差异;聚类分析显示:龈下菌斑、唾液形成5个明显聚类群,在同一聚类群中相似度高,在不同聚类群中相似度低,表示龈下菌斑与唾液菌群之间有显著差异;PLS结果显示:慢性牙周炎龈下菌斑与唾液菌群有显著差异。结论:DGGE是一种能直观显示微生物群落的指纹技术。通过该技术能检测牙周、唾液微生物群落的结构和组成,本结果显示,慢性牙周炎龈下菌斑与唾液微生物群落结构有明显差异。     

Er: YAG激光对2型糖尿病相关性牙周炎患者龈下菌群动态变化的研究

目的 动态观察2型糖尿病相关性牙周炎患者经Er: YAG激光治疗前后龈下菌群的变化,并与不伴全身疾病的慢性牙周炎龈下菌群进行比较。方法 收集11例2型糖尿病相关性牙周炎患者的13对患牙（26个位点）作为试验组,分别进行Er: YAG激光治疗和超声治疗,采集治疗前及治疗后1、3个月的龈下菌斑;同时收集11例牙周状况相近的不伴全身疾病的中重度慢性牙周炎患者13个位点的龈下菌斑作为对照组,分析试验组是否有菌群种类变化。提取龈下菌斑DNA,进行变性梯度凝胶电泳分离及条带回收测序。结果 试验组与对照组患牙龈下菌斑的优势致病菌存在差异,分别为中间普雷沃菌和福赛斯坦纳菌。激光组治疗前后龈下菌群构成也发生改变,治疗后1个月,有的条带表达减弱或消失,并有新条带出现;测序结果表明,新出现的条带为放线菌的一种,减弱、消失的为福赛斯坦纳菌。结论 Er: YAG激光治疗前后龈下菌群的构成发生变化,治疗后1个月是关键时期;治疗后3个月,激光治疗在阻止细菌再定植方面可能更具优势。     

牙周炎患者龈下菌斑菌群的高通量测序分析

目的利用高通量测序(high?throughput sequencing,HTS)分析广泛型侵袭性牙周炎(generalized ag?gressive periodontitis,GAgP)和重度慢性牙周炎(severe chronic periodontitis,SCP)龈下菌群的组成,利用生物信息学分析其多样性及功能,并观察牙周基础治疗前后龈下菌群的变化。方法选择2018年9月至2019年5月在昆明医科大学附属口腔医院牙周病科就诊的11例GAgP患者和14例SCP患者作为研究对象。在基线及牙周基础治疗后第6周采集龈下菌斑样本并提取DNA,进行MiSeq测序,采用QIIME(quantitative insights in mi?crobial ecology)、Mothur及SPSS等软件分析群落信息,并进行LEfSe差异分析(linear discriminant analysis Effect size,LEfSe)、Network网络分析,使用KEGG PATHWAY数据库(https://www.kegg.jp/kegg/pathway.html)对群落功能进行预测。结果基线时,GAgP和SCP患者的优势菌群相似,均包括拟杆菌门、卟啉单胞菌属和牙髓卟啉单胞菌等。治疗后第6周,GAgP和SCP患者菌群变化相似,由于牙周袋变浅,拟杆菌门、卟啉单胞菌属和牙髓卟啉单胞菌等革兰阴性菌相对丰度降低,变形菌门、放线菌属和空间罗氏菌等革兰阳性菌相对丰度增加;其中放线菌是GAgP治疗后龈下菌群中显著增加的生物标志物;链球菌属是联系牙周炎相关菌属和牙周健康相关菌属的重要菌属。群落功能预测表明基础治疗可降低GAgP和SCP患者群落中的氨基酸代谢、甲烷代谢和肽酶等功能。结论GAgP和SCP患者的龈下菌群相似,链球菌属作为早期定植菌,在龈下菌群由健康向失调转变的过程中可能发挥着促使菌斑生物膜形成及成熟的重要作用;牙周基础治疗可以改变GAgP和SCP患者龈下菌群的组成和结构,降低群落多样性,降低氨基酸代谢、甲烷代谢和肽酶等群落功能。     

用暗视野显微镜法评价牙周炎的治疗效果

对10例经牙周刮治加口服甲硝唑治疗(全身治疗组)和10例经牙周刮治术加洗必太含漱治疗(局部治疗组)的牙周炎患者进行了2周的纵向观察研究。用暗视野显微镜技术监测治疗前后龈下菌丛组成和临床指数的变化。结果表明:两组治疗方法均可使龈下菌丛组成向着健康的菌群组成转变,停药一周后,两组均向基线反跃,且同时伴有临床指数的相应变化.     

牙周病基础治疗前后龈下菌群的动态观察

目的：动态观察龈下细菌治疗前后在口腔内定植的变化，为牙周病病因学研究和治疗方案确定提供依据。方法：选取26例慢性牙周炎患者治疗前、治疗后1周、1个月和3个月时同一位点的龈下菌斑，测量牙周探诊深度，提DNA，洲浓度。扩增全细菌16SrRNA基因片段，变性梯度凝胶电泳分离，选择特异性的DNA条带，回收、测序。结果：测序结果表明治疗后消失的两个DNA条带与牙龈卟啉单胞菌有98％和99％的同源性；治疗后新出现的两个DNA条带与卟啉菌属的一种有99％的同源性。结论：牙龈卟啉单胞菌是慢性牙周炎的重要可疑致病菌。变性梯度凝胶电泳适用于分析大量微生物标本分布和类型。     

基于高通量测序技术研究慢性牙周炎患者龈下刮治和根面平整术治疗前后龈下菌群的变化

目的 采用基于16S核糖体DNA(rDNA)的高通量测序技术,分析10例慢性牙周炎患者接受龈下刮治和根面平整术(SRP)治疗前后龈下菌斑多样性及相对丰度的变化,探讨应用微生物群落的构成变化作为牙周炎诊断及预后评估指标的可行性.方法 选择2014年3—9月在首都医科大学附属北京口腔医院牙周科就诊的10例慢性牙周炎患者作为研究对象,在SRP治疗前及治疗后3个月分别在研究对象的同一位点采集龈下菌斑样本,提取样本基因组DNA,采用Illumina Miseq平台测序,分析各组样本从门到种各水平的菌群分布及相对丰度.结果 在门水平上,共检测到16个菌门,有8个门的细菌在牙周龈下菌斑菌群结构中占主要地位(99%);在属水平上,共检测到128个不同菌属,SRP治疗后3个月坦纳菌属(Tannerella)的相对丰度较治疗前明显降低(P<0.05),纤毛菌属(Leptotrichia)和链球菌属(Streptococcus)的相对丰度较治疗前明显上升(P<0.05);在种水平上,6种牙周可疑致病菌被检出,SRP治疗后3个月福赛坦纳菌(Tannerella forsythia)和中间普氏菌(Prevotella intermedia)的相对丰度较治疗前明显减少(P<0.05).结论 慢性牙周炎患者龈下菌群具多样性,SRP治疗前后,牙周可疑致病菌的相对丰度降低,而有益菌的相对丰度升高,SRP治疗可以明显改变龈下菌群构成.     

义龈修复与牙周菌群变化相关性研究

目的 :通过对牙周菌群在两种义龈修复前后的种属变化探讨义龈修复对严重牙龈退缩患者修复治疗的远期效果及与牙周健康的关系。方法 :严重的牙龈退缩患者经过系统性牙周治疗后随机分为常规义龈修复组及弹性义龈修复组 ,分别提取修复治疗前后各观察时段内龈沟液 ,作细菌培养和分类计数观察。结果 :对细菌形态学的记数比较显示 ,弹性材料组的螺旋体及梭杆菌的改变较常用热凝塑料组慢 ,修复 6个月后才能检测出显著性差异 ,常规材料修复 1个月后即可发现显著性变化 ;对几种特异性的牙周厌氧菌的分类培养显示在常规材料组组内差异明显 ,随时间的延长 ,组间差异更加明显。结论 :弹性塑料由于材料组织相容性好等优点 ,制作的义龈对于患者牙周健康的保持更为有利 ,是一种较为满意的治疗严重牙龈退缩的修复方法     

一次与分次完成牙周基础治疗的微生物学比较研究

目的 比较一次性牙周治疗和传统牙周治疗龈下菌群的变化.方法 选择慢性牙周炎患者20名,随机分为两组,一次性牙周治疗组(实验组)和传统牙周治疗组(对照组).一次性牙周治疗组在24小时内完成全口牙齿的刮治,并进行全口消毒;传统牙周治疗组分4次完成全口牙齿的刮治.刮治前(基线)、刮治后6周分别采集龈下菌斑,进行厌氧培养和涂片检查(刚果红负染色法),进行厌氧菌总数和产黑菌计数,计算螺旋体的百分比.比较两种方法治疗前后细菌计数和螺旋体比例的差异.结果 实验组厌氧菌总数和产黑菌数降低程度较对照组明显(P＜0.05),两组螺旋体比例变化无明显差异.结论 一次性牙周治疗方法可行,疗效肯定,微生物检查结果优于传统牙周治疗.     

松牙固定时机对下颌前牙牙周治疗结果的影响

目的探讨松牙固定时机对中国人群牙周治疗结果的影响。方法 27例中重度牙周炎患者,给予龈上洁治和口腔卫生宣教后随机分成两组。常规组14例,龈下刮治和根面平整完成后行百强固位纤维带粘接固定松动的下颌前牙;试验组13例,完成纤维带粘接固定后行龈下刮治和根面平整。基线、治疗后3个月和治疗后6个月分别评估简化口腔卫生指数、龈沟出血指数、探诊深度、牙周附着丧失4项临床参数,并对数据进行统计学分析。结果常规组和试验组自身前后比较,各组治疗后3个月牙周临床参数与基线时比较有明显改善（P〈0.01）,各组3个月与6个月临床参数变化不明显（P〉0.05）。两组间比较,基线到治疗后3个月和基线到治疗后6个月临床参数的变化,差异均无统计学意义（P〉0.05）。结论龈下刮治和根面平整前或后行松牙固定对中国人群牙周治疗预后没有明显影响。     

单纯机械治疗对慢性牙周炎患者龈下菌群微生态的影响

目的采用16S rRNA高通量测序技术,探讨单纯机械治疗对慢性牙周炎龈下菌群微生态的影响。方法纳入广泛型中重度慢性牙周炎患者,接受口腔卫生宣教,并同时进行龈上洁治。一周后进行超声结合手工龈下刮治及根面平整,在基线、治疗后3个月和治疗后6个月,记录临床指标并采集龈下菌斑。利用Illumina MiSeq平台进行16S rRNA V3-4区测序,比较治疗前后临床指标及微生物群落的特征变化。结果 Alpha多样性分析显示各时间点样本中微生物多样性和丰富度无明显变化,PCoA显示仅治疗后3个月与基线样本微生物群落结构存在显著性差异。治疗后3个月,临床指标探诊深度显著减小,卟啉单胞菌属、密螺旋体属、坦纳氏菌属、产线菌属等致病相关微生物的相对丰度显著降低,二氧化碳噬纤维菌属、金氏菌属等牙周健康相关微生物的相对丰度显著升高;治疗后6个月,虽产线菌属等致病相关微生物的相对丰度仍较基线显著降低,但种类数量较3个月时减少;探诊深度较基线明显降低,但较治疗后3个月显著增加。结论单纯机械治疗有助于缓解牙周炎症并改善龈下菌群的失调状态,在治疗后3个月内治疗效果较为显著。     

牙周炎患者基础治疗后牙龈卟啉单胞菌的定植研究

目的 通过对牙周炎患者龈下菌斑中牙龈卟啉单胞菌(Porphyromonas gingivalu,Pg)的检测,探讨慢性牙周炎(chronic periodontitis,CP)和侵袭性牙周炎(aggressive periodontitis,AgP)患者牙周基础治疗后Pg的定植规律.方法 选取90例CP患者和90例AgP患者,在牙周基础治疗前、治疗后6周、12周共采集龈下菌斑样本1620个,运用AmpliFluor终末点定量聚合酶链反应方法 检测Pg含量.结果 治疗后6周CP和AgP组Pg活动位点分别为61(22.6%)和66(24.4%)个,两者差异无统计学意义(P>0.05);治疗后6周Pg活动位点在治疗前检测的牙周临床指数高于Pg静止位点.治疗后12周两组Pg活动位点分别为96(35.6%)和18(6.7%)个,差异有统计学意义(P<0.05);治疗后12周Pg活动位点在治疗后6周时检测的牙周临床指数高于Pg静止位点.结论 在牙周基础治疗后6周时,CP和AgP患者Pg定植均已开始,仉是两组定植规律存在一定差异.在牙周基础治疗后,治疗前牙周组织炎性反应严重的龈下位点Pg易于定植.     

Nd: YAP激光治疗牙周炎的疗效评价及其对龈下微生物的影响

目的 比较龈下刮治和根面平整术(scaling and root planning, SRP)联合Nd:YAP激光与单纯SRP治疗对牙周炎患者疗效的差异和龈下微生物的影响。方法 选择符合纳入标准的牙周炎患者。每位患者龈上洁治1周后为本研究基线,随机半口分组。试验侧采用SRP联合Nd: YAP激光治疗;对照侧仅采用SRP治疗。每位患者选择一组同颌同名单根牙,进行龈沟液(gingival crevicular fluid, GCF)和龈下菌斑取样。分别在基线、治疗完成后6周和12周进行探诊深度(probing depth, PD)和探诊出血(bleeding on probing, BOP)的数据采集、龈沟液及龈下菌斑样本的采集。ELISA法检测龈沟液中炎症因子白细胞介素6(interleukin-6,IL-6)的浓度。16S rDNA高通量测序对各龈下菌斑样本的菌群构成进行分析和比较。结果 试验侧与对照侧的各项临床指标较基线时均有显著改善(P＜0.05),但两组间无明显差异。两组的IL-6浓度较基线均显著下降,治疗后6周,试验侧的 IL-6浓度明显低于对照组(P＜0.05)。龈下菌斑α多样性分析,治疗后6周及12周,对照侧的Shannon指数高于基线,Simpson指数低于基线(P＜0.05)。测序结果显示,治疗后6周,试验侧的普氏菌属(Prevotella)和Saccharibacteria_incertae_incerta_sedis的相对丰度较基线显著下降;密螺旋体属(Treponema)的相对丰度低于对照侧,嗜二氧化碳噬细胞菌属(Capnocytophaga)的相对丰度高于对照侧(P＜0.05),12周时无明显差异。结论 在本研究中,Nd:YAP激光联合SRP和单纯SRP治疗牙周炎均有明显效果,而两种治疗方法在临床指标上无明显差异,辅助使用Nd:YAP激光在短时间内更有利于GCF IL-6浓度的降低和部分牙周致病菌的控制。     

Impact of smoking on the clinical, microbiological and immunological parameters of adult patients with periodontitis

OBJECTIVES: The aim of the current study was to assess the impact of smoking on the clinical indices, the humoral immune response and the detection frequency of putative periodontal pathogens in patients with periodontitis cross-sectionally and following therapy. MATERIAL AND METHODS: Clinical measurements, subgingival plaque samples, gingival crevicular fluid (GCF) and sera were collected from 40 untreated patients with moderate-to-advanced chronic periodontitis before and after treatment over a period of 6 months. The treatment consisted of the initial therapy of scaling and root planing. Smoking status was self-reported and was confirmed by cotinine enzyme inhibition assay (CEIA). Whole-mouth clinical measurements were recorded with a manual periodontal probe at baseline (BAS) and at 6 months (RAS). Selected-site analyses were performed on the deepest site in each quadrant before and after therapy and clinical indices were recorded with an electronic pressure-sensitive probe. GCF sample volume was quantified using the Periotron 6000. Polymerase chain reaction (PCR) was utilized to determine the presence of Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Treponema denticola and Tanerella forsythensis in subgingival plaque. Enzyme-linked immunosorbent assay examined the systemic antibody titres to these bacteria, and thiocyanate disassociation determined the antibody avidity to these organisms. RESULTS: At baseline, smokers showed significantly less gingival inflammation and lower GCF volume compared with non-smokers. After treatment, a compromised clinical outcome was noted for smokers in terms of pocket depth reduction and gain in attachment levels. No significant differences in the detection of putative periodontal pathogens in subgingival plaque existed between smokers and non-smokers. A consistent trend was noted in that smokers had lower sera immunoglobulin G antibody titres to these organisms before and after treatment (statistically significant for A. actinomycetemcomitans). This pattern was less clear when antibody avidities were considered, revealing only small differences, if any, between the two groups of patients. CONCLUSION: Current data indicate that smokers with periodontal disease have a suppressed inflammatory response, a significantly less favourable clinical outcome and seem to have an altered host antibody response to antigenic challenge than non-smokers. In contrast, the subgingival microflora of smokers appears similar to that of non-smokers.     

牙周基础治疗对慢性牙周炎患者临床指标及5种牙周可疑致病微生物的影响

目的:观察牙周基础治疗对临床指标及5种牙周可疑致病微生物的影响。方法:选取20例慢性牙周炎患者(40个位点),在治疗前和基础治疗后3个月时检测观测位点的临床指标牙周探诊深度(PPD),临床附着丧失(CAL)和探诊出血(BOP),同时采集龈下微生物样本。采用PCR和反杂交的方法对所采集微生物样本中的牙龈卟啉单胞菌、福赛斯坦纳菌,中间普氏菌、伴放线放线杆菌和齿垢密螺旋体进行半定量检测。结果:通过牙周基础治疗后临床指标PPD及BOP的改善具有统计学意义(P<0.001),而CAL的改善不具有统计学意义。治疗后牙龈卟啉单胞菌、福赛斯坦纳菌和齿垢密螺旋体的检出量显著减少(P<0.05或P<0.001)。治疗前PPD>6mm的位点只有福赛斯坦纳菌在治疗后比治疗前有显著减少(P<0.05),而牙龈卟啉单胞菌和齿垢密螺旋体的变化不具有统计学意义。结论:基础治疗是治疗慢性牙周炎的有效方法,可改善临床指标,减少龈下牙龈卟啉单胞菌、福赛斯坦纳菌和齿垢密螺旋体的数量。但在PPD>6mm的位点基础治疗对于这五微生物的影响作用是有限的。     

Doxycycline-resistant bacteria in periodontally diseased individuals after systemic doxycycline therapy and in healthy individuals

The occurrence of doxycycline-resistant bacteria was examined in subgingival plaque and on the tonsils of 12 periodontally healthy and 12 periodontally diseased individuals. The healthy group was examined 6 times at intervals of one month. The diseased group was examined before and 1, 5, 15, 26, 39, and 52 weeks after conventional periodontal therapy supplemented with systemic doxycycline for 3 weeks. The occurrence of doxycycline-resistant bacteria in the healthy group varied on average between 2.0% and 6.6% in subgingival plaque and between 3.0% and 12.4% in the tonsil samples over a 6-month period. In the diseased group the percentage of resistant bacteria increased from 10-20 times for tonsil and subgingival plaque, respectively. About half a year after therapy the values returned to the baselines. For both groups the morphological distributions of resistant bacteria were similar and unaffected by the doxycycline therapy.     

Periodontal bacterial profiles in pregnant women: response to treatment and associations with birth outcomes in the obstetrics and periodontal therapy (OPT) study

BACKGROUND: A recent clinical trial (Obstetrics and Periodontal Therapy [OPT] Study) demonstrated that periodontal therapy during pregnancy improved periodontal outcomes but failed to impact preterm birth. The present study evaluated seven target bacteria, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia (previously T. forsythensis), Prevotella intermedia, Campylobacter rectus, and Fusobacterium nucleatum, in subgingival dental plaque of pregnant women in the OPT Study and their association with birth outcomes. METHODS: Pregnant women were randomly assigned to receive periodontal treatment before 21 weeks' gestation or after delivery. Subgingival plaque was sampled at baseline (13 to 16 weeks; 6 days of gestation) and at 29 to 32 weeks. We analyzed subgingival plaque samples from women who experienced fetal loss, delivered a live preterm infant (preterm women), or delivered a full-term infant (full-term women). Samples were analyzed using quantitative polymerase chain reaction. Associations between preterm birth and bacterial counts and percentages were tested using multiple linear regression. RESULTS: No significant differences were observed at baseline between preterm and full-term women for any measured bacterial species or group of species, after accounting for multiple comparisons. Changes in bacterial counts and proportions during pregnancy also were not associated with birth outcomes. In full-term and preterm women, periodontal therapy significantly reduced (P <0.01) counts of all target species except for A. actinomycetemcomitans. CONCLUSIONS: In pregnant women with periodontitis, non-surgical periodontal therapy significantly reduced levels of periodontal pathogens. Baseline levels of selected periodontal pathogens or changes in these bacteria resulting from therapy were not associated with preterm birth.     

Microbial complexes in supragingival plaque

Background/aims:  To examine microbial communities in supragingival biofilm samples.
Methods:  Supragingival plaque samples were taken from 187 subjects at baseline ( n  = 4745). Fifty-five subjects provided supragingival plaque samples at 1–7 days after professional tooth cleaning ( n  = 1456); 93 subjects provided 8044 samples between 3 and 24 months post-therapy. All samples were individually analyzed for their content of 40 bacterial species using checkerboard DNA–DNA hybridization. Microbial associations among species were sought using cluster analysis and community ordination techniques for the three groups separately.
Results:  Six complexes were formed for the baseline samples. Similar complexes were formed for the samples taken 3–24 months post-therapy. However, distinct changes were observed in microbial communities in samples taken during the 7 days of plaque redevelopment. The complexes related to clinical parameters of periodontal disease.
Conclusion:  There were specific microbial complexes in supragingival plaque that were similar to those found in subgingival plaque samples with a few minor differences. The relation of previously unclustered taxa to the complexes was also described.     

The effect of repeated professional supragingival plaque removal on the composition of the supra- and subgingival microbiota

BACKGROUND, AIMS: The purpose of the present investigation was to determine the effect of weekly professionally administered supragingival plaque removal on the composition of the supra and subgingival microbiota. METHODS: 18 adult subjects with periodontitis who had been treated and were in a maintenance phase of therapy were clinically and microbiologically monitored at baseline, 3, 6 and 12 months. After the baseline visit, the subjects received scaling and root planing followed by professional supragingival plaque removal every week for 3 months. Clinical measures of plaque accumulation, bleeding on probing (BOP), gingival redness, suppuration, pocket depth and attachment level were made at 6 sites per tooth at each visit. Separate supra (N = 1804) and subgingival (N = 1804) plaque samples were taken from the mesial aspect of all teeth excluding third molars in each subject at each time point and evaluated for their content of 40 bacterial taxa using checkerboard DNA-DNA hybridization. Significance of changes in mean counts, prevalence and proportions of bacterial species over time in both supra and subgingival samples were determined using the Quade test and adjusted for multiple comparisons. RESULTS: Mean % of sites exhibiting plaque, gingival redness and BOP were significantly reduced during the course of the study. Significant decreases in mean counts were observed in both supra and subgingival samples. Mean total DNA probe counts (x10(5), +/-SEM) at baseline, 3, 6 and 12 months were: 133+/-19, 95+/-25, 66+/-6, 41+/-6 (p<0.001) for supragingival samples and 105+/-22, 40+/-10, 19+/-4, 13+/-3 (p<0.001) for subgingival samples. Mean counts of 22 of 40 and 34 of 40 species tested were significantly reduced in the supra and subgingival samples respectively over the monitoring period. For example, mean counts of Porphyromonas gingivalis x10(5) at baseline, 3, 6 and 12 months in the subgingival plaque samples were 2.0+/-0.4, 0.5+/-0.2, 0.6+/-0.3, 0.3+/-0.1 (p<0.001); Bacteroides forsythus 2.0+/-0.6, 0.4+/-0.1, 0.4+/-0.2, 0.1+/-0.2 (p<0.001); Treponema denticola 3.4+/-1.1, 0.8+/-0.3, 0.4+/-0.2, 0.3+/-0.3 (p<0.01). Similar reductions were seen in supragingival plaque samples. While counts were markedly reduced by professional plaque removal, the proportion and prevalence of the 40 test species were marginally affected. CONCLUSIONS: Weekly professional supragingival plaque removal profoundly diminished counts of both supra- and subgingival species creating a microbial profile comparable to that observed in periodontal health. This profile was maintained at the final monitoring visit, 9 months after completion of therapy.     

Microbiological assays as predictors of the response to periodontal therapy

Thirty-four patients with periodontal disease each had subgingival plaque samples collected from four sites (one from each quadrant) in their mouths. The relative proportions of spirochaetes, motile rods and cocci were determined using dark field microscopy and the proportion of anaerobic to aerobic microorganisms was calculated after culture. In addition, clinical recordings were made at these sampled sites. The patients then underwent a course of periodontal treatment and were placed on a maintenance programme. The clinical recordings were repeated and the results examined to ascertain if the original microbiological or clinical measurements could have been used to predict the response to therapy.
Of the baseline recordings, the initial probing depth, the initial attachment level and the presence of suppuration all showed a positive correlation with the degree of pocket reduction or attachment gain produced by treatment. The percentage of cocci in the subgingival plaque correlated negatively with the treatment response. Suppuration seemed to be associated primarily with the original pocket depth while the percentage of cocci in subgingival plaque showed a true relationship with the amount of attachment gained after periodontal therapy. The significance of this finding is discussed.