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

DOI 14 References
  • Tomikawa Kazuya
    Department of General Oral Care, Kyushu University Hospital
  • Kono Takayuki
    Department of Comprehensive Dental Clinic, Okayama University Hospital
  • Yamamoto Tadashi
    Department of Periodontics and Endodontics, Okayama University Hospital
  • Iwamoto Yoshihiro
    Department of Periodontics and Endodontics, Okayama University Hospital Shinohara Dental Clinic (Marugame City)
  • Shimoe Masayuki
    Department of Pathophysiology-Periodontal Science, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Yamaguchi Tomoko
    Department of Periodontics and Endodontics, Okayama University Hospital
  • Hongo Shoichi
    Department of Periodontics and Endodontics, Okayama University Hospital
  • Miyamoto Manabu
    Miyamoto Dental and Orthodontic Clinic (Kobe City)
  • Maeda Hiroshi
    Department of Pathophysiology-Periodontal Science, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
  • Takashiba Shogo
    Department of Pathophysiology-Periodontal Science, Okayama University, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

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  • 細菌感染度を評価しながら包括的歯周治療を行った 広汎型侵襲性歯周炎患者の一症例

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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.

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