Periodontal Pathogens and Localized Aggressive Periodontitis In Israel

Objectives: Localized Aggressive Periodontitis (LAP) is a chronic bacterial infectious disease aggressively affecting the periodontal tissues of young patients (adolescence- 40 years old) leading eventually, to tooth exfoliation of otherwise healthy patients. Although Aggregatibacter actinomycetemcomitans (Aa) is mostly associated with this disease, in recent years a large bulk of data was accumulated, suggesting that varied bacteria may be active in different ethnic groups. We propose that an accurate identification of the bacteria causing LAP in Israel is important for proper treatment, and the establishment of a treatment protocol.

Methods: 18 Israeli patients suffering from LAP formed the test group. Following a comprehensive clinical periodontal examination, bacterial samples were collected from the deepest periodontal pockets by a periodontal gracy curette. At the laboratory the samples were analyzed by both culture and PCR techniques.

Results: All samples revealed 1-2 bacterial species grown on culture and at least 1 bacterial species diagnosed by PCR (range 1-8 species). Prevotella species were diagnosed in the majority of cultures (10/18, 55.6%), mainly Prevotella melaninogenica (4/18, 22.22%). Utilizing PCR technique Aa was the predominant pathogen (12/18, 66.67%), followed by Tannerella forsythensis (11/18, 61.11%) and Fusobacterium nucleatum (9/18, 50%).

Conclusion: Although Aa seems to play a major role in the pathogenesis of LAP, other bacterial species are also playing active parts in disease progression in Israel. These data should be considered when anti infective regimens are prescribed for LAP patients in Israel.