Microbiological assays as predictors of the response to periodontal therapy

Thirty-four patients with periodontal disease each had subgingival plaque samples collected from four sites (one from each quadrant) in their mouths. The relative proportions of spirochaetes, motile rods and cocci were determined using dark field microscopy and the proportion of anaerobic to aerobic microorganisms was calculated after culture. In addition, clinical recordings were made at these sampled sites. The patients then underwent a course of periodontal treatment and were placed on a maintenance programme. The clinical recordings were repeated and the results examined to ascertain if the original microbiological or clinical measurements could have been used to predict the response to therapy. Of the baseline recordings, the initial probing depth, the initial attachment level and the presence of suppuration all showed a positive correlation with the degree of pocket reduction or attachment gain produced by treatment. The percentage of cocci in the subgingival plaque correlated negatively with the treatment response. Suppuration seemed to be associated primarily with the original pocket depth while the percentage of cocci in subgingival plaque showed a true relationship with the amount of attachment gained after periodontal therapy. The significance of this finding is discussed.