Microbial diagnostics as an essential part of successful treatment

The GEN-TREND Laboratory of Molecular Biology specializes in the development of diagnostics of microbial pathogens in the oral cavity. Although there are many opinions in dentistry that a patient can be diagnosed and successfully treated without identifying the microbial agent only on the basis of the patient's clinical picture, research and development in recent years has shown the justification or even the need for a completely opposite approach.

E.g. In periodontology, the identification of microbial agents appears to be absolutely essential, both in view of the possibilities of more gentle use of antibiotics and in relation to possible connections with other systemic diseases of the patient.

Periodontitis is a disease of the suspension apparatus of the teeth, which is primarily caused by infection with specific types of bacteria. However, the origin, course and success of treatment of this disease is influenced by a number of factors from external influences (such as stress) through personal genetic and immunological characteristics of the patient, to the patient's behavior and habits (smoking, level of dental hygiene, etc.).

Successful treatment of periodontitis is based on reducing the number of periodontopathogenic bacteria and stabilizing the periodontal condition.

Why should VariOr® Dento analysis be part of your practice?

More accurate diagnosis

Where tissue-invasive periodontal bacteria are present, such as Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans, mechanical methods such as root-planing or deep-scaling are often ineffective in eliminating the pathogen. Despite careful treatment, there is a progressive loss of connective tissue and bone. In such cases, concomitant antimicrobial therapy - performed only after microbial diagnosis - is of course much more effective and at the same time has fewer side effects. The choice of appropriate antimicrobial treatment and form of application should be based on the bacterial spectrum and clinical diagnosis of periodontitis.

Targeted treatment

The positive effect of antibiotics in the treatment of periodontitis has been confirmed in the literature (e.g. Haffajee (2003) or Herrera (2002)). These expert studies confirm the benefit of antibiotic systemic therapy in addition to mechanotherapy in patients with periodontitis.

The spectrum of bacteria and their amount can vary considerably between patients in periodontal disease. It is therefore important to determine the type and number of bacteria present and thus to select a suitable active ingredient in a targeted manner and to provide a basis for the responsible use of antibiotics.

Overall health

When the immune system recognizes pathogens from dental plaque and begins to arm against them, pro-inflammatory substances are produced, to help immune cells eliminate pathogens. However, if the cause of inflammation is not eliminated, the inflammation deepens and a number of unwelcome processes occur - platelet aggregation, support of inflammatory changes in the gums (formation of periodontal trunks), increase in levels of systemic inflammatory markers. These processes not only support the development of periodontitis, but also affect the blood vessels of the heart and other organs. Any long-term and unresolved inflammation in the body disrupts the lining of our blood vessels, which becomes “sticky” - platelets and cholesterol aggregate to it, and it can be resided by pathogenic bacteria, which have penetrated into the body from the places of inflammation that bleed (tooth gums) or from unresolved tooth decay. The defensive immune response then acts directly on the lining of the blood vessels. These processes are subsequently the cause of atherosclerosis, myocardial infarction, stroke, or premature birth. Recently, diseases such as osteoarthritis, diabetes and autoimmune diseases have also been linked to tooth decay or periodontitis. Based on the microbial analysis, the dentist should alert the patient to other possible risks and recommend a visit to a specialist. Without knowledge of the specific bacteria causing periodontitis, it is not possible to infer a relationship to other systemic diseases, as shown in the following table:

Sources:

Haffajee AD, Socransky SS, Gunsolley JC. Systemic antiinfective periodontal therapy. A systematic review. Ann Periodontol 2003: 8: 115–181.

Herrera D, Sanz M, Jepsen S, Needleman I, Roldan S. A systematic review on the effect of systemic antimicrobials as an adjunct to scaling and root planingin periodontitis patients. J Clin Periodontol 2002: 29 (Suppl. 3): 136–159.)