SPECTRUM OF THE PERIODONTAL POCKET MICROFLORA IN PATIENTS WITH CHRONIC PERIODONTITIS OF MODERATE SEVERITY

Abstract

The purpose of the study. To evaluate the quantitative composition of the microflora of the periodontal pocket in patients with chronic generalized periodontitis of moderate severity. Materials and methods. The study group included 39 patients, of which: 41% (16/39) were men, 59% (23/39) were women, with chronic generalized periodontitis of moderate severity at the age of 48.9±2.3 years. To determine the dental status, clinical research methods were used (questioning, examination), determination of the Green-Vermillion Oral Hygiene Index (OHI-S), (PMA) modified by Parma, the Mulleman-Cowell bleeding index, the degree of pathological tooth mobility was determined using the Miller scale (Miller) modified by Flesar, the complex periodontal index (CPI), identified furcation defects according to the classification of Lindhe J. (1983).Quantitative assessment of the periodontal pockets microflora was performed. Reagent kits “RIBO-prep” (Next-Bio LLC, Russia), DENTOSKRIN® (NPF Litech LLC, Russia) were used to isolate RNA/DNA from clinical material and subsequent analysis by polymerase chain reaction. Spectrum of identifiable bacteria: Porphyromonas endodontalis, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Treponema denticola, Fusobacterium nucleatum, Prevotella intermedia, Tannerella forsythia.The results of the study and their discussion. Fusobacterium nucleatum was found in 84.6% (33) of patients in periodontal pockets, 30.8% (12) – Treponema denticola, 28.2% (11) – Prevotella intermedia, 17.9% (7) – Porphyromonas gingivalis and Porhyromonas endodontalis. Aggregatibacter actinomycetemcomitans was isolated only in 5.1% (2) of individuals, Tannerella forsythia – in 2.6% (1). Combinations of 4 microorganisms were detected in 20.5% (8), from 3 - in 12.8% (5), from 2 - 15.4% (6). In 12.8% (5) of the examined patients were not isolated from any of the studied periodontal pathogens. When checking correlations between the level of hygiene and the number of pathogenic microorganisms detected, a moderate direct relationship was established between the value of the OHI-S index and the amount of Fusobacterium nucleatum r=0.36 (p<0.05) and Prevotella intermedia r=0.30 (p<0.05), as well as a moderate direct relationship between the value of the PMA index and the amount of Porphyromonas gingivalis r=0.33 (p<0.05), Porphyromonas endodontalis r=0.31 (p<0.05), Prevotella intermedia r=0.30.Conclusion. In patients with chronic periodontitis of moderate severity, a microbial biofilm is formed on the surface of the periodontium, represented by anaerobic bacteria. In periodontal pockets, the amount of Fusobacterium nucleatum and Prevotella intermedia increases with the deterioration of the hygienic condition of the oral cavty. With the development of inflammation in the gum tissues, periodontal pathogens Porphyromonas gingivalis and Porphyromonas endodontalis are more often detected, having more aggressive invasive and toxic properties in relation to periodontal tissues.