THE VALUE OF THE MICROBIOLOGICAL EXAMINATION IN THE DIAGNOSIS AND MONITORING OF PERIODONTITIS

Abstract

The properties of subgingival niches are selective and influence the colonization of microorganisms as minority or majority members of the microbial community. Usually there is a harmonious relationship between the host and subgingival resident flora. The impairment of the subgingival homeostasis could predispose to the development of periodontitis because it allows the colonization of exogenous pathogens or the increase of the minority bacteria by exploring the new environmental opportunities. When the host could not manage the initial microbial insult, the nature of the local response to the dysbiotic subgingival biofilm provides conditions for selecting other pathogens that would amplify periodontal inflammation. As other chronic diseases, periodontitis is a polymicrobian infection in which tooth-associated biofilm plays a crucial role in the initiation and progression of the disease but it is not enough for periodontitis to develop. It is primarily the host inflammatory response that inflicts the irreversible damage to the periodontal tissues. A distinction between chronic and aggressive periodontitis is not possible based on the subgingival microbial fingerprint as revealed by traditional laboratory methods. Even though, mapping subgingival flora is an important aid in treatment planning as well as for monitoring the risk of recurrence in periodontitis patients. More advanced molecular techniques such as MALDI-TOF (matrix-assisted laser desorption ionization– time of flight) could eventually provide supplementary information that would allow the distinction between the chronic and aggressive periodontal diseases.

Keywords

• maxillary sinus
• implant migration
• infectious complications
• aspergillosis