Clinical and A.actinomycetemcomitans outcomes over 6 years in periodontal maintenance therapy

Objectives: Although regular compliance during periodontal maintenance therapy positively impact periodontal clinical status overtime its influence on bacterial levels is not well documented. Thus, this prospective open cohort study of 6 years of follow-up evaluated the levels of Aggregatibacter actinomycetemcomitans and the occurrence of A. actinomycetemcomitans a-b-c-d-e-f-g serotypes and JP2 and non JP2 clones of individuals within a periodontal maintenance therapy program. In addition, total bacterial load and clinical parameters were also evaluated.
Methods: Study population was composed of 28 regular compliers (mean age 54.6±7.5 years) randomly selected from eligible individuals and matched for age and sex with 28 irregular compliers (mean age 52.5±7.3 years). Complete periodontal examination and subgingival samples were obtained 5 times: T1 (prior to active periodontal therapy), T2 (after active periodontal therapy), T3 (2 years), T4 (4 years), and T5 (6 years). Data was compared between regular and irregular compliers overtime (p<0.05).
Results: Irregular compliers showed higher levels of A. actinomycetemcomitans at T2, T3 and T4 in comparison to regular compliers. At T2 and T3 irregular compliers also showed higher frequencies of the JP2 clone. No standard pattern of serotypes had been found when regular compliers had been compared to irregular compliers. Similarly, total bacterial load and clinical parameters had been worse among irregular compliers. Plaque index, percentage of bleeding sites and percentage of sites with probing pocket depth >5mm were lower among the compliers. On the other hand, percentage of sites with clinical attachment level >5mm did not differ between regular and irregular compliers overtime.
Conclusions: Appropriate compliance during maintenance care contributed to a better clinical status and improved Aggregatibacter actinomycetemcomitans profile over a 6-year period.