Rapid Diagnosis of Periodontitis Based on Enzymatic Activity Derived from Periodontopathic Bacteria

Evaluation of the Efficacy of Periodontal Pocket Curettage by SK-013

Abstract

The purpose of the present study was to examine the diagnostic value of SK-013 (Sunstar, Osaka) in evaluating the efficacy of periodontal pocket curettage. SK-013 is a highly sensitive reagent which is used to measure the specific peptidase activities produced by Treponema denticola, Bacteroides (Porphyromonas) gingivalis and Bacteroides forsythus. Sixty-four periodontitis patients were selected for the study. Of the 64 patients, 33 were treated by plaque control instruction and periodontal pocket curettage (T group), and the other 31 patients received no treatment for periodontal disease (NT group). One site was monitored in each patient. The clinical status of each site was assessed using clinical indices such as the gingival index (GI), plaque index (PH), probing depth (PD), attachment level (AL), bleeding on probing (BOP) and tooth mobility. In the T group, the clinical and enzymatic examinations were made at five separate appointments as follows: (1) at baseline prior to plaque control instruction; (2) 4 weeks after plaque control instruction; and (3) 2, 4, and 8 weeks after periodontal pocket curettage. The same examinations were performed but, only at baseline and after 12 weeks, in the NT group. As a result, periodontal pockets were reduced in depth following plaque control instruction, while the enzymatic activity showed no significant change before and after plaque control. Two weeks after periodontal pocket curettage, both clinical indices (GI, PD, AL, BOP) and SK-013 activity were significantly reduced and these improvements were maintained for 4 weeks. No significant discrepancy was observed in the NT group between clinical assessment and enzymatic activity during the experimental period. This finding suggested that SK-013 is a clinically useful diagnostic method for assessing the effect of initial periodontal therapy.