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[How sensible are bacteriological tests in periodontology?]
1Vakgroep Parodontologie en Preventieve Tandheelkunde, Katholieke Universiteit, postbus 9101, 6500 HB Nijmegen.
Nederlands Tijdschrift Voor Tandheelkunde
|December 1, 1994
Summary
Bacteriological tests for periodontitis have limited diagnostic value due to varying detection levels and lack of established thresholds. Mechanical plaque removal is often sufficient, questioning the routine use of antibiotics for periodontitis.
Area of Science:
- Microbiology
- Periodontology
- Diagnostic Testing
Background:
- Periodontitis involves subgingival bacteria.
- Common bacteriological tests target specific pathogens like *A. actinomycetemcomitans*, *P. gingivalis*, and *P. intermedia*.
Purpose of the Study:
- To evaluate the diagnostic utility of various bacteriological tests for periodontitis.
- To assess the justification for antibiotic use in periodontitis treatment.
Main Methods:
- Review of bacteriological tests including Microscopy, Culture, Omnigene, Affirm DP, and Evalusite.
- Analysis of detection limits and diagnostic usefulness of these tests.
Main Results:
- Detection limits vary widely (0.01-10%), and thresholds for disease vs. carrier state are not established.
- Low sensitivity and specificity of tests limit their diagnostic value; correlation does not imply causation.
- Tests may lead to overtreatment with antibiotics, like amoxicillin and metronidazole combinations.
Conclusions:
- Mechanical elimination of subgingival plaque is the primary treatment for restoring host-microflora balance.
- Antibiotic use, including metronidazole, should be reserved for specific cases or superinfections confirmed by sensitivity testing.