Clinical and microbiological effects of a combined mechanic-antibiotic therapy in subjects with Actinobacillus actinomycetemcomitans-associated periodontitis

Abstract

Purpose: To evaluate the clinical and microbiological effects of a combined mechanic-antibiotic periodontal therapy in subjects that were tested positive for subgingival Actinobacillus actinomycetemcomitans (A.a.).

Methods: The postoperative follow-up ranged from 12-115 months (average 39.2 months). This follow-up study analyzed the data of 53 subjects (37 females) aged from 16-59 years, who underwent systemic periodontal therapy with adjunctive systemic antibiotics between 1992-2001 and had their last re-examination including microbiological analysis done in 2003. The antibiotic regime was either amoxicillin/metronidazole or ciprofloxacine/metronidazole. During this study, A.a. was detected with two gene probe tests (IAI PadoTest 4.5 and DMDx/PathoTek) and cultivation on TSBV agar plates. The clinical situation was characterized with the help of pocket probing depths and subsequent categorization into three different groups (< or = 4 mm, 5-6 mm and > or = 7 mm).

Results: After therapy, A.a. was detected with IAI PadoTest 4.5 in a magnitude between 3.0 x 10(3) up to 2.06 x 10(5) counts per specimen in 9 out of 53 subjects. Only two subjects tested positive for A.a. with the DMDx/PathoTek-assays and the agar cultivation. The clinical situation improved significantly in all subjects after systemic periodontal therapy. The treatment results remained stable during the course of the postoperative follow-up. Concerning the clinical data, no differences were found between the subjects that were tested positive and negative for A.a in the postoperative period.