Influence of Anti-Infective Periodontal Therapy on Subgingival Microbiota Evaluated by Chair-Side Test Compared to qPCR—A Clinical Follow-Up Study

Abstract

A chair-side test (CST) for five periodontal pathogens (Aggregatibacter actinomycetemcomitans, A.a.; Porphyromonas gingivalis, P.g.; Prevotella intermedia, P.i.; Treponema denticola, T.d.; Tannerella forsythia, T.f.) was compared with qPCR in a previous clinical study on 100 periodontitis patients at first diagnosis (T0). Following non-surgical treatment alone (SRP) or in combination with systemic or local antibiotics, 74 patients (57.4 ± 13.5 years) were again tested at the same sites from 14 to 24 months after T0. Bacterial elimination (%; compared to T0) was determined for each single species and compared between both test systems. In all patients, all five pathogens could not be fully eliminated regardless of therapy or test method. Tested with CST, the mean elimination ranged from 90% for SRP + Amoxicillin/Metronidazole to 59.13% for SRP only. The corresponding qPCR values were 30% and 29.6%. Only A.a. was eradicated in 100% by SRP + Amoxicillin/Metronidazole tested by CST, and it was 80% when qPCR was the test method. CST agreed with qPCR in 98.7% in the detection of A.a., and 74.3%, 78.4%, 73.0%, and 48.7% for P.g., P.i., T.d., and T.f., respectively. Neither conventional treatment nor the additional use of antibiotics—even with the correct indication—could completely eradicate the tested pathogens or prevent pocket reinfection.