The effect of SRP on the clinical and microbiological parameters of periodontal diseases

Abstract

The purpose of the present investigation was to examine the effect of SRP on clinical and microbiological parameters in 57 subjects with adult periodontitis (mean age 47 +/- 11 years). Subjects were monitored clinically and microbiologically prior to and 3, 6 and 9 months after full-mouth SRP under local anaesthesia. Clinical assessments of plaque, redness, suppuration, BOP, pocket depth and attachment level were made at 6 sites per tooth. The means of duplicate attachment level measurements taken at each visit were used to assess change between visits. Clinical data were averaged within each subject and then averaged across subjects for each visit. Subgingival plaque samples were taken from the mesial aspect of each tooth and the presence and levels of 40 subgingival taxa were determined using whole genomic DNA probes and checkerboard DNA-DNA hybridization. The mean levels and % of sites colonized by each species (prevalence) was computed for each subject at each visit. Differences in clinical and microbiological parameters before and after SRP were sought using the Wilcoxon signed ranks test or the Quade test for more than 2 visits. Overall, there was a mean gain in attachment level of 0.11 +/- 0.23 mm (range -0.53 to 0.64 mm) 3 months post-therapy. There was a significant decrease in the % of sites exhibiting gingival redness (68 to 57%) and BOP (58 to 52%) as well as a mean (+/-SEM) pocket depth (3.3 +/- 0.06 to 3.1 +/- 0.05 mm). Sites with pre-therapy pocket depths of < 4 mm showed a non-significant increase in pocket depth and attachment level, 4.6 mm pockets showed a significant decrease in pocket depth and a non-significant gain in attachment post-therapy, while > 6 mm pockets showed a significant decrease in pocket depth and attachment level measurements post-therapy. Significant clinical improvements were seen in subjects who had never smoked or were past smokers but not in current smokers. Mean prevalences and levels of P. gingivalis, T. denticola and B. forsythus were significantly reduced after SRP, while A. viscosus showed a significant increase in mean levels. The mean decrease in prevalence of P. gingivalis was similar at all pocket depth categories, while B. forsythus decreased more at shallow and intermediate pockets and A. viscosus increased most at deep sites. P. gingivalis. B. forsythus and T. denticola were equally prevalent among current, past and never smokers pre-therapy, decreased significantly post-SRP in never and past smokers but increased in current smokers. Clinical improvement post-SRP was accompanied by a modest change in the subgingival microbiota, primarily a reduction in P. gingivalis, B. forsythus and T. denticola, suggesting potential targets for therapy and indicating that radical alterations in the subgingival microbiota may not be necessary or desirable in many patients.

Identification of oral bacteria associated with crevicular epithelial cells from chronic periodontitis lesions

“…Species related to periodontal health, such as V. parvula and streptococci, tended to be more prevalent on epithelial cells from sites without disease. These results are consistent with other studies that associate a greater frequency of streptococci with periodontal health (Haffajee et al, 1997;Dibart et al, 1998;Socransky et al, 1998). Actinomyces species are among the most dominant micro-organisms in supra-and subgingival biofilms (Ximenez-Fyvie et al, 2000).…”

“…Clinical measurements were computed for all sites and the sampled sites in each subject, and then averaged across subjects within the group. Microbial data were expressed as the mean percentage of colonized sites (prevalence) and mean levels (610 4 cells) of each species in the 49 subjects (Haffajee et al, 1997;Colombo et al, 2002). The percentage of samples positive for each species was computed for each subject and averaged across all patients.…”

Prevalence of "non-oral" pathogenic bacteria in subgingival biofilm of subjects with chronic periodontitis

“…Two calibrated examiners performed all measurements for each subject. After clinical measurements, subjects with evidence of destructive periodontal disease received full mouth scaling and root planing under local anesthetic and instructions in proper home care procedures (12).…”

Prevalence of periodontopathogens and Candida spp. in smokers after nonsurgical periodontal therapy – a pilot study

“…Scaling and root planing is the most usual periodontal therapy, leading to improvements in clinical parameters and to the reestablishment of the microbiota. 29 Although repeated treatment of recurrent/refractory pockets in the supportive phase may produce additional reductions in PPD and in BOP and increases in clinical attachment level, the response to periodontal treatment is slower in SM than in NS. T he negat ive ef fects of smok i ng on t he immunoinflammatory and healing systems may explain the worse response of SM to periodontal treatment.…”