Pn. Papapanou et al., "Checkerboard" assessments of peridontal microbiota and serum antibody responses: A case-control study, J PERIODONT, 71(6), 2000, pp. 885-897
Background: We explored the association between subgingival microbial profi
les and serum IgG responses to periodontal microbiota in relation to clinic
al periodontal status.
Methods: One hundred thirty-one (131) periodontitis patients aged 29 to 74
years (mean 51.8) were age- and gender-matched with 74 periodontally intact
controls (range 26 to 77, mean 49.3). Smoking habits and health history we
re recorded and assessments of plaque, bleeding on probing, probing depth,
and attachment level were performed at 6 sites per tooth on all present tee
th, excluding third molars. Subgingival plaque samples were obtained from e
ach tooth in one upper and one lower quadrant (maximum 14 samples/subject;
2,440 samples total) and analyzed with respect to 19 species by means of wh
ole genomic DNA probes. Serum IgG antibodies against the same 19 species we
re assessed by an immunoassay.
Results: Cases displayed an average of 22.7 teeth, 20.3 sites with probing
depth greater than or equal to6 mm, and 18.9 sites with attachment loss gre
ater than or equal to6 mm. Corresponding figures for controls were 27.1, 0.
1, and 1.0, respectively. Heavy smoking was 3 times more frequent among cas
es than controls (32.1% versus 9.6%). Higher levels of Porphyromonas gingiv
alis, Porphyromonas endodontalis, Prevotella intermedia, Prevotella nigresc
ens, Prevotella melaninogenica, Bacteroides forsythus, Fusobacterium nuclea
tum, Treponema denticola, Eubacterium nodatum, Peptostreptococcus micros, a
nd Campylobacter rectus were found in cases and higher levels of Eikenella
corrodens, Veillonella parvula, and Actinomyces naeslundii in controls. Cas
es displayed higher IgG levels against P. gingivalis and Actinobacillus act
inomycetemcomitans, while controls displayed higher levels against F nuclea
tum, T. denticola, E. nodatum, and Capnocytophaga ochracea. Positive correl
ations between bacterial colonization and antibody responses were identifie
d for 9 species in controls. In cases, however, statistically significant c
orrelations were observed for only 3 species out of which only one was posi
tive (V. parvula). Both bacterial levels and antibody responses declined in
ages over 55 years. A logistic regression employing selected elements of b
acterial colonization and antibody responses as independent variables resul
ted in 81.1% correct diagnosis, with sensitivity of 83.1%, specificity of 7
7.8%, positive predictability of 86%, and negative predictability of 73.7%.
Smoking did not reach statistical significance in this model.
Conclusion: A combined microbial colonization/antibody response profile can
effectively discriminate between periodontitis patients and periodontally
intact controls.