Assessing the progression of chronic periodontitis using subgingival pathogen levels: a 24-month prospective multicenter cohort study

Abstract

Background: The diagnosis of the progression of periodontitis presently depends on the use of clinical symptoms (such as attachment loss) and radiographic imaging. The aim of the multicenter study described here was to evaluate the diagnostic use of the bacterial content of subgingival plaque recovered from the deepest pockets in assessing disease progression in chronic periodontitis patients. Methods: This study consisted of a 24-month investigation of a total of 163 patients with chronic periodontitis who received trimonthly follow-up care. Subgingival plaque from the deepest pockets was recovered and assessed for bacterial content of Porphyromonas gingivalis, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans using the modified Invader PLUS assay. The corresponding serum IgG titers were measured using ELISA. Changes in clinical parameters were evaluated over the course of 24 months. The sensitivity, specificity, and prediction values were calculated and used to determine cutoff points for prediction of the progression of chronic periodontitis. Results: Of the 124 individuals who completed the 24-month monitoring phase, 62 exhibited progression of periodontitis, whereas 62 demonstrated stable disease. The P. gingivalis counts of subgingival plaque from the deepest pockets was significantly associated with the progression of periodontitis (p < 0.001, positive predictive value = 0.708). Conclusions: The P. gingivalis counts of subgingival plaque from the deepest pockets may be associated with the progression of periodontitis.

Willingness to Work and the Working Environment of Japanese Dental Hygienists

“…Several studies have shown that work tasks and variations in work are associated with job satisfaction and motivating factors among dental hygienists [ 13 , 16 , 18 , 23 ]. The Japanese Dental Hygienist Law restricts the job range of dental hygienists to include the mechanical removal of dental plaque and dental calculi, the topical application of medicament on the tooth surface, dental treatment assistance, and health guidance.…”

“…The root mean square error of approximation (RMSEA) was used for the fitness index [ 20 ]. To determine the characteristics of the minority subjects who answered strongly disagree for the items regarding willingness to work, a classification and regression tree (CART) analysis was conducted [ 21 – 23 ]. For the correlation of daily job contents with willingness to work, cross tabulations were constructed and chi-square tests were carried out.…”

Site-level progression of periodontal disease during a follow-up period

“…In total, 124 subjects successfully completed the study protocol. These 124 patients level analysis are described in our previous report [ 23 , 24 ].…”

“…Bacterial variables were dichotomized based on previous reports [ 22 , 27 – 29 ]. To differentiate sites based on whether they had more or less than 3 mm of CAL progression, cut-off values were set to minimize the difference between sensitivity and specificity [ 22 – 24 , 29 ]. The cut-off value of A .…”

The effects of different restorative materials on periodontopathogens in combined restorative-periodontal treatment

“…It has been suggested that some members of this composition, known as “keystone pathogens”, could regulate biofilm virulence and modulate the host immune response 9 , 11 , 13 . Longitudinal studies have shown that periodontal disease progression can be predicted by the levels of Porphyromonas gingivalis ( Pg ) and Treponema denticola ( Td ) in subgingival plaque 3 , 9 , 12 . Moreover, it has been reported that Pg and Prevotella intermedia ( Pi ) are more frequently associated with deeper periodontal pockets 31 .…”