Prospective Longitudinal Changes in the Periodontal Inflamed Surface Area Following Active Periodontal Treatment for Chronic Periodontitis.

Yasuo Nomura ,Shogo Takashiba,Atsutoshi Yoshimura,Satoshi Sekino,Nobuhiro Hanada,Mitsuo Fukuda,Naoyuki Sugano,Hiroaki Kobayashi,Toshiya Morozumi,Yorimasa Ogata,Toshiaki Nakamura,Yukihiro Numabe,Taneaki Nakagawa,Tsutomu Sugaya,Nobuo Yoshinari,Masato Minabe,Kazuyuki Noguchi,Soh Sato,Fusanori Nishimura,Erika Kakuta,Keiso Takahashi,Koichi Tabeta,Hideki Takai,Yohei Nakayama,Makoto Umeda,Atsushi Saitô ,Fujio Suzuki

doi:10.3390/jcm10061165

Abstract

Periodontal disease is a chronic inflammatory disease of the periodontal tissue. The periodontal inflamed surface area (PISA) is a proposed index for quantifying the inflammatory burden resulting from periodontitis lesions. This study aimed to investigate longitudinal changes in the periodontal status as evaluated by the PISA following the active periodontal treatment. To elucidate the prognostic factors of PISA, mixed-effect modeling was performed for clinical parameters, tooth-type, and levels of periodontal pathogens as independent variables. One-hundred-twenty-five patients with chronic periodontitis who completed the active periodontal treatment were followed-up for 24 months, with evaluations conducted at 6-month intervals. Five-times repeated measures of mean PISA values were 130+/−173, 161+/−276, 184+/−320, 175+/−417, and 209+/−469 mm2. Changes in clinical parameters and salivary and subgingival periodontal pathogens were analyzed by mixed-effect modeling. Plaque index, clinical attachment level, and salivary levels of Porphyromonas gingivalis were associated with changes in PISA at the patient- and tooth-level. Subgingival levels of P. gingivalis and Prevotella intermedia were associated with changes in PISA at the sample site. For most patients, changes in PISA were within 10% of baseline during the 24-month follow-up. However, an increase in the number of bleeding sites in a tooth with a deep periodontal pocket increased the PISA value exponentially.

Highlights

Periodontal disease is a chronic inflammatory disease of the periodontal tissue
P. gingivalis and P. intermedia, were observed to be significantly associated with the periodontal inflamed surface area (PISA) of
This study aimed to investigate the changes in the periodontal status, as evaluated by the PISA during a longitudinal follow-up, and to identify the factors that associate with the PISA

Summary

Introduction

Periodontal disease is a chronic inflammatory disease of the periodontal tissue. Its progression has been associated with a regression of the mean clinical parameters of most of the oral sites, including teeth. Most patients are generally stable or exhibit a linear type of progression [1,2,3,4]. A small fraction exhibit burst-type progressions [1,5,6]. The active periodontal treatment aims to reduce inflammatory response by removing pathogenic bacterial deposits. Supportive periodontal therapy (SPT) is employed to reduce the probability of periodontal disease progression

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