Perio-Analyse (Periodontal bacteria Identification and quantification)
The first cause of periodontal disease is in the formation of bacterial biofilm. The bacterias implied in the periodontitis are also in weak concentration in the healthy sulcus. The colonization of the mouth by paro-bacteria can take place at an early age, for example following a parental or pet transmission. A great number of cases of periodontitis can be treated in a dentist’s surgery according to the traditional process of mechanical actions, such as radicular surfacing and sub-gingival scaling under control for years.
However, in the presence of periodontopathogenic bacteria that can penetrate the tissue, such as P.gingivalis and A. actinomycetemcomitans, these methods are not enough to eliminate them from the sulcus. Consequently and in spite of the vigilant treatments, a progressive loss or a fast decomposition of the alveolar bone can occur. In this case, only an antibiotic therapy obviously can improve the effectiveness of the treatment , after the bacteriological diagnosis. The choice of the therapy depends on the composition of the sub-gingival microflora and the clinical state of the periodontitis. An antibiotic therapy can be prescribed only in combination with a meticulous cleaning of the pockets. It goes without saying that antibiotic therapy cannot be prescribed without a microbiological analysis. The success of the long-term treatment is insured only if the patient applies a good oral hygiene and follows a monitoring program. The implementation of microbiological diagnosis using microbiological diagnostic solution can assist in decision making process of therapy, e.g. use of antibiotics.
In some cases, the dental treatment requires the recourse to dental implants. The biological complications which appear before implant bone-integration can be related to a surgical trauma, with a post-operative infection or with an overload, while those occurring immediately after the bone-integration of the implant are related to a microbial colonization like the one present in the periodontal pockets before implant installation.
The bacteria associated with peri-implantitis are like those detected around teeth affected with periodontitis but with a different ratio.
Processes of bacterial translocation could be highlighted for the main pathogenic bacteria. Gingivo-dental pockets of the adjacent teeth, as well as surrounding soft tissues, such as the back of the tongue, mucus membranes are as many bacterial tanks likely to ensure the colonization of the implant. According to a recent review of literature, antecedents of periodontitis must be regarded as a risk factor of the prosthetic treatment and the patients presenting an untreated or refractory periodontal disease present an increased risk of complications.
Admittedly, the dental surgeons must be aware of the risks of preoperative contamination , and must be able to anticipate the late infectious risk in order to limit the risk of infection and implant failing. The patients having undergone a periodontal treatment and smokers appear more likely to develop peri-implantitis. Therefore it is important in daily clinical practice to evaluate the biological factors of risk before placing the implants, and attentively supervising the patients after treatment to detect early signs of infection.
The early detection of pathology signs , the reinforcement of measurements of oral hygiene and the treatments will be able to reduce the bacterial loads.
The bacterias & fungus responsible in the periodontitis and peri-implantitis requiring a microbiological analysis are:
- Aggregatibacter actinomycetemcomitans
- Porphyromonas gingivalis
- Tannerella forsythensis
- Treponema denticola
- Prevotella intermedia
- Peptostreptococcus micros
- Fusobacterium nucleatum
- Campylobacter rectus
- Eikenella corrodens
- Candida albicans
The analytical processing is :
- Non-invasive: free of pain and stress
- Quick: gingival sulcus liquid is collected in less than 2 minutes
- Convenient: DNA sample is stable at room temperature for more than 30 days