Abstract
Priodontal diseases are known to progress as chronic inflammations but it has been shown that an acute phase occasionally occurs. There have been a few microbiological investigations of this acute phase. This study was designed to characterize subgingival flora in the acute phase of adult periodontitis using an immunofluorescence technique and bacterial culture method.
Subgingival plaque samples were obtained from 1) 12 periodontally healthy subjects, 2) 13 adult periodontitis patients, and 3) acute sites in 31 patients with adult periodontitis. As criteria for the acute phase, patients who had at least two clinical symptoms of pain, swelling, redness, or a feeling of warmth in periodontal pockets were selected. In some acute phase studies, samples were taken from control sites of matched pocket depth. For the indirect immunofluorescence technique, species-specific rabbit antibodies against 4 Periodontopathic bacteria, Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia and Campylobacter rectus, were used for the investigations of subgingival plaque. In some cases, a bacterial culture method was also employed. For treatment of the acute phase of adult periodontitis, slow release Minocycline (Periocline ®) w as administered locally. Changes in the clinical parameters and microflora were investigated before and one week after the application of Minocycline.
Neither A. actinomycetemcomitans, P. gingivalis, nor C. rectus could be detected in the healthy subjects. In adult periodontitis patients, the total number of bacteria and the proportions of P. gingivalis, P. intermedia and C. rectus correlated significantly with pocket depth. In the acute phase, the total number of bacteria as well as the percentage of P. gingivalis and C. rectus in the acute site showed a tendency to be increased, as compared to those in the control site. A. actinomycetemcomitans and P. intermedia showed no such tendency. Administration of slow release Minocycline in the acute phase led to clinical improvement in most cases, and the percentages of P. gingivalis and C. rectus were significantly reduced.
The results indicate that elevations in the proportions of P. gingivalis and C. rectus might participate in development of the acute phase.
