1999 Volume 41 Issue 4 Pages 461-468
The present study aimed to investigate long-term responses to periodontal therapies of periodontitis patients with high levels of serum IgG antibody titers to both A. actinomycetemcomitans and P. gingivalis before treatment. Sixteen patients showing high titers to both pathogens (AaPg group) and 36 patients with high serum antibody responses to P. gingivalis only (Pg group) before treatment participated. Initial alveolar bone-loss ratio per tooth was measured in each patient. Eleven and 13 patients in the AaPg and Pg groups, respectively, were followed up for more than 3 years. Teeth extracted average and the teeth ratio average with severe disease progression per year were determined in all cases. Also the patients were assigned as well maintained (WM), downhill (D), and extreme downhill (ED) cases according to their teeth extracted average. The AaPg group showed significantly higher initial bone-loss ratio (44.6%) as compared to the Pg group (33.2%). In the cases treated for more than 3 years, significantly higher initial bone loss (44.2%), teeth extracted average (0.96), and teeth ratio average with disease progression (4.0%) were observed in the AaPg group than in the Pg group (31.0%, 0.17, 1.0%, respectively). Seven of 11 in the AaPg group were assigned as ED cases, whereas 9 of 13 among the Pg group were categorized as WM cases. Patients showing a mean initial bone loss between 20% and 50% were selected for further comparison between the 2 groups. In such comparison, the AaPg group demonstrated higher in extracted teeth values and in disease progression ratio than the Pg group (0.67 vs 0.14, 2.5% vs 1.1%, respectively) with no significant difference, and 4 of 6 in the AaPg group were categorized as D or ED cases, while 7 of 9 in the Pg group were assigned as WN cases. These results indicate that patients showing high serum antibody titers to the above mentioned pathogens demonstrate severe bone loss and poor responses to periodontal therapies. Therefore, the measurement of serum antibody titers may be a useful tool for diagnosis and/or prognosis of periodontitis. J. Jpn. Soc. Periodontol., 41: 461-468, 1999.
