The association between periodontal microbial biomarkers and primary therapy outcome

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Clinical Oral Investigations Pub Date : 2024-09-13 DOI:10.1007/s00784-024-05904-y

Nils Werner, Iris Frasheri, Katrin Heck, Christina Ern, Richard Heym, Caspar Victor Bumm, Matthias Folwaczny

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Abstract

Objective

This study aims to analyse the association between the baseline microbial load of selected periodontopathogenic bacteria collected from gingival crevicular fluid (GCF) and the primary outcome of steps I and II therapy.

Materials and methods

222 patients with stage III periodontitis were included into this retrospective analysis that received steps 1 and 2 periodontal therapy without adjunctive systemic antibiotics. Baseline GCF samples were quantitatively analysed using ELISA-based kits for levels of periodontopathogens (Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans (Aa), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn), Treponema denticola (Td), and Tannerella forsythia (Tf)) and associated with the primary therapy outcome using a “treat-to-target” therapy endpoint (TE) defined as ≤ 4 sites with PD ≥ 5 mm six months after therapy.

Results

38.2% of the patients achieved TE. Patients failing to achieve TE revealed significantly increased levels of Pg, Fn, and Tf at baseline (Pg: p = 0.010, Fn: p = 0.008 Tf: p = 0.004). Multivariate binary logistic regression adjusted for sex, mean probing depth, diabetes, and current smoking status showed an independent relationship between Tf and the TE (aOR 2.570, p = 0.023).

Conclusion

Increased microbial load is associated with decreased responsiveness to therapy. The findings suggest that specifically baseline Tf levels are associated with poorer treatment outcomes and might improve the accuracy of periodontal diagnosis.

Clinical relevance

The findings of this study support the concept of a critical biomass that is sufficient to induce and maintain an immune response within the periodontal pocket, which ultimately leads to irreversible tissue destruction. However, calculating this level in advance may serve as an early indicator for intervention.

Key finding

Baseline Tannerella forsythia levels are associated with poorer treatment outcome.

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牙周微生物生物标志物与初级治疗效果之间的关系

本研究旨在分析从牙龈缝隙液（GCF）中收集的特定牙周致病菌的基线微生物量与第一步和第二步治疗的主要结果之间的关系。材料和方法 222 例 III 期牙周炎患者被纳入本回顾性分析，这些患者接受了第一步和第二步牙周治疗，但没有辅助使用全身性抗生素。使用基于 ELISA 的试剂盒对基线 GCF 样本中的牙周病原体（牙龈卟啉单胞菌 (Pg)、放线菌属 (Aa)、中间前驱菌 (Pi)、核分枝杆菌 (Fn)、治疗终点（TE）定义为治疗后 6 个月 PD ≥ 5 mm 的部位少于 4 个。结果38.2%的患者达到了TE。未能达到 TE 的患者基线 Pg、Fn 和 Tf 水平明显升高（Pg：p = 0.010，Fn：p = 0.008，Tf：p = 0.004）。经性别、平均探查深度、糖尿病和当前吸烟状态调整的多变量二元逻辑回归显示，Tf 与 TE 之间存在独立关系（aOR 2.570，p = 0.023）。临床相关性本研究的结果支持一个临界生物量的概念，该生物量足以诱导并维持牙周袋内的免疫反应，最终导致不可逆的组织破坏。然而，提前计算出这一水平可作为干预的早期指标。主要发现连翘担子菌的基线水平与较差的治疗效果有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Oral Investigations 医学-牙科与口腔外科

CiteScore

6.30

自引率

5.90%

发文量

484

审稿时长

3 months

期刊介绍： The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.