Microbial Diagnostics in Periodontology

Bacteria and their metabolic products contribute to periodontal and peri-implant tissue loss. Continued presence of bacteria in periodontal or peri-implant pockets is required for the progression of infection.

Subgingival plaque is a biofilm consisting of more than 500 different bacterial species. Not all bacteria present in periodontal pockets are considered equally important for the course of disease. The origin and progression of periodontal disease as well as complications with implants (peri-implantitis) are associated with characteristic microbiota.

Current diagnostic methods for classical clinical findings

(such as probing depth, attachment loss, bleeding after probing)

• enable limited prognosis
• show risk areas only when essentially irreversible tissue
  damage has already occurred
• do not allow to predict the need for or to select appropriate
  adjuvant antibiotic therapy

Advantages of microbial diagnostics

• high prognostic value
• help in planning an appropriate treatment strategy
• enable targeted antibiotic therapy
• allow for monitoring the success of periodontal treatment
• offer a high degree of security, even with cost-intensive
  interventions

Requirements for a microbial determination method

To yield useful and applicable information for periodontal treatment, the method has to

• be reproducible
• show a high degree of specificity and sensitivity
• enable the accurate quantification of bacteria
• enable standardized sampling