CLINICAL AND MICROBIOLOGICAL EFFECTS OF SUBGINGIVAL ANTIMICROBIAL IRRIGATION WITH CITRIC-ACID AS EVALUATED BY AN ENZYME-IMMUNOASSAY AND CULTURE ANALYSIS

THE PURPOSE OF THE PRESENT STUDY was to compare an enzyme immunoassay with culture samples from untreated and non-surgically treated periodo ntal pockets and to assess the clinical and microbiological effects of citric acid irrigation as a supplement to scaling and root planing. T he enzyme immunoassay used in this study is a chairside diagnostic too l aimed at identifying the presence of P. gingivalis, P. intermedia, a nd A. actinomycetemcomitans. Six sites with pocket depths greater than or equal to 6 mm In each of 16 patients were monitored for 24 weeks u sing clinical and microbiological parameters. In two out of tile six s ites, scaling and root planing was supplemented with subgingival citri c acid irrigation of the pocket after completion of the mechanical tre atment. The sensitivity of the immunoassay in relation to culture was calculated to 85.5% and the specificity to 90.2%. The immunoassay corr esponded to a detection level of 10(4) as estimated by culture. Sites treated with a combination of scaling and irrigation with citric acid demonstrated a similar healing pattern as sites treated with scaling a nd root planing alone. The profile of the marker bacteria was almost p arallel for the two groups. The results of this investigation thus ind icated that the immunoassay can be used as a screening tool for select ed periodontal pathogens and that adjunctive irrigation with citric ac id has no measurable clinical or microbiological effects.