Severity of localized juvenile periodontitis as related to polymorphonuclear chemotaxis and specific microbial isolates.

Abstract

The purpose of this study was twofold: (a) to determine if an association exists between severity of localized juvenile periodontitis (LJP) and impairment of polymorphonuclear leukocyte (PMN) chemotaxis and/or colonization by specific microbial isolates; (b) to determine if the number of specific microbial isolates, i.e., Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Eikenella corrodens, and Campylobacter rectus correlates to clinical severity of sites with LJP. Thirty-six first molars in nine subjects with LJP were examined. A clinical severity score was computed based on attachment level and vertical bone loss. The mean score of the four sites was designated as the clinical severity score for each subject. A DNA probe was used to quantitate colonization by A. actinomycetemcomitans, P. gingivalis, P. intermedia, F. nucleatum, E. corrodens, and C. rectus. The chemotaxis of isolated peripheral blood PMNs was measured in Boyden chambers using the leading front technique. It was found that the clinical severity score ranged from 7.8 for mild involvement to 32.5 for severe LJP. The chemotaxis result for each patient (micron/90 min) was expressed as a percentage of the value for a paired healthy control and ranged from 40% to 104%. Four of the nine subjects had chemotaxis values less than 70% of control. Linear regression analysis showed: (a) no significant correlation between PMN chemotaxis and severity of LJP in subjects (r = .14); (b) a significant correlation (r = 0.43) between severe sites with LJP and number of specific microbial isolates. Sites with severe LJP had present at least five different microbial isolates as compared with non-severe sites (P < .05). No particular trend of colonization by periodontopathogens was seen in non-severe sites. Further, severe sites of LJP displayed a statistically significant greater colonization by P. intermedia, E. corrodens, and C. rectus than did non-severe sites (P < .05). It may be concluded that neither the degree of PMN chemotactic impairment nor A. actinomycetemcomitans is a reliable indicator of the severity of LJP.