Periodontal Disease Diagnosis in the Context of Oral Rehabilitation Approaches

Abstract

Periodontal diseases generally correspond to a disturbance in the balance between the host’s defense and the micro-organisms colonizing the periodontal environment. The exact mechanisms underlying the destruction of the periodontium remain to be fully elucidated. Our study aims to quantify the main bacteria pool involved in periodontal pathology and associate it with other factors involved in the onset of periodontal disease so that an accurate diagnosis with profound implications for the therapeutic algorithm can be developed. Micro-Ident tests, based on the polymerase chain reaction (PCR) technique, were used for the study group, chosen for their high specificity in identifying periodontopathogenic bacteria and determining their relative numbers. The results of our study indicate an increased concentration of 4.50 (number of strains) for Capnocytophaga, followed by Tannerella forsythia, in a concentration of 3.50; the next highest concentration percentages are for Treponemei denticola, and Prevotela intermedia, low concentrations were found for Fusobacterium nucleatum and Porphyromonas. The concentration of each type of bacteria is reflected in the clinical picture and constitutes the starting point for a targeted antibiotic therapy. Following the effects of antibiotic-targeted therapy obtained from the evaluation of the micro-IDent B test results on the periodontium of the supporting teeth, we observed that the values of the periodontal indices change slightly at 3-month intervals with a predominance of plaque, bleeding, and gingival indices, and less in the indices concerning the depth of the probing pocket and the loss of attachment on the buccal and oral surfaces. In conclusion, our study emphasizes a direct relationship between the subgingival tartar presence and the patients age, gingival recession, presence of periodontal pockets, dental mobility, as well as the periodontal indexes: plaque index, bleeding index, and gingival index. The correlation of negative values of periodontal indices with the nature of the involved bacteria materializes in relevant starting points in the elaboration of the periodontal diagnosis of the therapeutic plan and predictability of the prognosis of oral rehabilitation.