The impact of the presence of Porphyromonas gingivalis on periodontal health in a group of patients with periodontitis in Erbil

* Department of basic science, college of dentistry, Hawler Medical University, Erbil, Iraq. ** Medical Research Center, HMU, Erbil, Iraq. *** Department of periodontology, college of dentistry, Hawler Medical University, Erbil, Iraq. Introduction Periodontitis is a local infection and inflammation of the supporting structures of the tooth. The most common form is chronic periodontitis (CP) which is characterized by localized or generalized destruction of the periodontal ligament, alveolar bone and gingiva resulting in various degrees of periodontal attachment loss. In the absence of treatment, the disease can ultimately results in loss of the affected tooth. Anaerobic, gram-negative bacteria present in subgingival biofilm are usually involved in the initiation and progression of the disease. One of these bacteria is Porphyromonas gingivalis (P. gingivalis) that is frequently detected from subgingival plaque samples of chronic periodontitis patients, whereas much lower detection rate is usually recorded in periodontally healthy individuals. This bacterium was known to be a potent periodontopathogen because of a number of virulence factors possessed by the organism such as cysteine proteases, collagenases, heamagglutinins, lipopolysaccharide (LPS), and fimbriae that facilitate local colonization and tissue destruction through direct cytotoxic effect of these products on the periodontium and, on the other hand, induction of a potent immune response that results in a further damage. Diagnosis and initial treatment of periodontal diseases are usually based on certain clinical parameters such as clinical attachment loss (CAL) and probing pocket depth (PPD). To complement the clinical diagnosis, monitor the response Background and objective: Chronic periodontitis is the destruction of the tooth supporting structures as a result of a complex interaction between bacteria colonizing the gingival crevice and host’s immune responses. Porphyromonas gingivalis is one of the main periodontopathogens with multiple virulence factors. The aim of this study was to investigate the detection rate of Porphyromonas gingivalis in chronic periodontitis patients versus healthy subjects using PCR assay, and its association with increased pocket depth and clinical attachment loss. Methods: Seventy subjects (35 patients with chronic periodontitis and 35 healthy subjects) meeting the inclusion criteria of this study were selected. All the subjects were clinically assessed for probing pocket depth and clinical attachment loss then subgingival microbial samples were collected using sterile paper points and analyzed for the presence of Porphyromonas gingivalis using polymerase chain reaction assay. Results: A significant difference in Porphyromonas gingivalis detection rate between chronic periodontitis and healthy groups was recorded. Porphyromonas gingivalis was significantly associated with deep pockets. The detection rate increased with the increase in the severity of the disease, although, this correlation was not statistically significant. Conclusion: A positive association was observed between Porphyromonas gingivalis and increased pocket depth. The recovery rate was higher in severe cases.