TREATMENT OF PERIODONTAL-DISEASE BASED ON MICROBIOLOGICAL DIAGNOSIS -RELATION BETWEEN MICROBIOLOGICAL AND CLINICAL-PARAMETERS DURING 5 YEARS

THE PURPOSE OF THIS STUDY was to assess the clinical effect of treatme nt aimed to suppress Actinobacillus actinomycetemcomitans and Porphyro monas gingivalis below detection level and Prevotella intermedia below 5% of the cultivable periodontal pocket flora. Sixteen patients and a total of 111 periodontal pockets with probing depth greater than or e qual to 6 mm were included in the study. Twelve patients and a total o f 77 sites completed the 5-year study. The results demonstrated clinic al improvement of probing depth and gain of clinical attachment level of 3.4 mm and 1.2 mm, respectively. Treatment to eliminate indicator b acteria continued for 3 years before the aim was fulfilled. In order t o eliminate A. actinomycetemcomitans from a majority of the sites, a c ombination of surgery and generalized tetracycline treatment was perfo rmed. A recolonization or regrowth of the indicator bacteria exceeding detection levels took place in several sites. The presence of A. acti nomycetemcomitans, P. gingivalis, and P. intermedia, alone or in combi nation, correlated with attachment level change on the individual leve l. No such correlation was obtained by using presence of plaque, bleed ing on probing, or three other bacteria (Campylobacter rectus, Eikenel la corrodens, and Fusobacterium nucleatum) not used as treatment goal markers.