Potential Risk for Localized Aggressive Periodontitis in African American Preadolescent Children

Abstract

Purpose: This study aimed to evaluate the potential risk for localized aggressive periodontitis (LAgP) in African American children by detection of the potential periodontal pathogen Aggregatibacter actinomycetemcomitans (Aa) using polymerase chain reaction (PCR) and microbiome analysis.

Methods: Twenty-one pre-adolescents (age range equals 10.7 to 13.1 years old) were recruited, for this IRB-approved study. Oral examination included limited periodontal examination determining bleeding index (BOP) and periodontal probing (PD). An oral mucosa sample was used for analysis.

Results: Nine of 21 children were Aa+ by PCR. The Aa+ group had a significantly higher proportion of teeth with BOP and PD greater than four mm than the Aa- group (P=0.014 and 0.006 for percent BOP and percent PD equal to or greater than four mm, respectively; Mann Whitney Test). No significant differences in microbe abundance or composition were found from comparison of Aa+ versus Aa- samples.

Conclusions: Detection of Aa from preadolescent African American children was associated with signs of periodontal inflammation. Although none of these children were diagnosed with LAgP, PCR targeting Aa could be a risk factor. Further study is indicated; however, the usefulness of PCR in dental practice setting to assess risk may be cost-effective for early diagnosis and prevention of LAgP.

Fig. 1

Average Percent of sites that resulted in bleeding on probing (BOP). Scatterplot (■, %BOP, 6 sites probed per tooth for permanent incisors and first molar teeth) with Mean (●), Median (—), and 95% confidence interval (shaded box) for 12 subjects that did not have Aa detected by PCR analysis of oral samples (+) and 9 subjects that were Aa positive (+). Aa + group significantly higher by t-test (p = 0.014).

Fig. 2

Average Percent of pocket depths greater than 4 mm. Scatterplot (■, %PD>4, 6 measurements per tooth for permanent incisors and first molar teeth) with Mean (●), Median (—), and 95% confidence interval (shaded box) for 12 subjects that did not have Aa detected by PCR analysis of oral samples (−) and 9 subjects that were Aa positive (+). Aa + group significantly higher by t-test (p = 0.006).

Fig. 3

Proportion of phylums among total OTUs. Scatterplot (■) of the proportion of the total operational taxonomic units (OTU) for each of five most common phylums for microbiome analysis, with Mean (●), Median (—), and 95% confidence interval (shaded box) for 12 subjects that did not have Aa detected by PCR analysis of oral samples (−) and 9 subjects that were Aa positive (+). No significant association at p < 0.05 (Kruskal-Wallis test) at the phylum level of bacterial identification was associated with Aa presence in samples from PCR.