Bacteriological and immunological assessment of periodontal infection during comprehensive periodontal therapy in a patient with generalized aggressive periodontitis：a case report

• Published in: Nihon Shishubyo Gakkai Kaishi (Journal of the Japanese Society of Periodontology) Vol. 55; no. 4; pp. 340 - 348
• Main Authors: Tomikawa, Kazuya, Kono, Takayuki, Yamamoto, Tadashi, Iwamoto, Yoshihiro, Shimoe, Masayuki, Yamaguchi, Tomoko, Hongo, Shoichi, Miyamoto, Manabu, Maeda, Hiroshi, Takashiba, Shogo
• Format: Journal Article
• Language: Japanese
• Published: JAPANESE SOCIETY OF PERIODONTOLOGY 28.03.2014
• Subjects: bacterial DNA test; comprehensive periodontal therapy; generalized aggressive periodontitis; serum IgG antibody titer
• ISSN: 0385-0110; 1880-408X
• DOI: 10.2329/perio.55.340

It is necessary to suppress disease activity under strict infection control in the treatment of patients suffering from aggressive periodontitis, since they are at a high risk of developing periodontal infection. In particular, longitudinal infection control is important to apply orthodontic therapy to patients with pathologic tooth migration and tooth crowding. Nevertheless, no consensus exists on any clinical index for the initiation of orthodontic therapy in patients suffering from aggressive periodontitis. Here, we report a case of comprehensive periodontal therapy in a 22-year-old woman suffering from generalized aggressive periodontitis caused by Agregatibacter actinomycetemcomitans (Aa). We performed not only clinical examinations, but also measurement of the serum IgG antibody titers to periodontal bacteria and bacterial DNA testing by quantitative real-time polymerase chain reaction for immunological and bacteriological assessment of the periodontal infection and disease activity. In the re-evaluation of the effects of periodontal surgery, the bacterial DNA test showed no detection of Aa and also the IgG titer against Aa had decreased to the healthy control level. Thus, we were confident that our comprehensive periodontal therapy had resulted in significant reduction of the disease activity,and subsequently undertook orthodontic therapy. In the present case, we conclude that bacterial DNA testing and measurement of the serum IgG titers against Aa could provide certain evidence for determination of the initiation of orthodontic therapy in patients with generalized aggressive periodontitis. Nihon Shishubyo Gakkai Kaishi (J Jpn Soc Periodontol) 55(4)：340-348, 2013.