Answers for chronic gingivitis in hygiene treatment and experimental gingivitis. Clinical, microbiological and metabolic changes

Purpose

Comparison of clinical, microbiological and metabolic profiles of people with high and low levels of chronic gum bleeding during a controlled intervention oral hygiene, including successive phases of strict therapeutic oral hygiene followed by experimental gingivitis (EC).

Methods

Two groups of skilled individuals with differences were entered into the study bleeding of the gums at detection levels in the basic clinical examination. These two groups were followed through three separate study phases, including the initial 1 week phase, a 2 week strict oral hygiene phase including dental prophylaxis and a 3 week EG phase without oral hygiene to encourage gingivitis recurrence. The 58 people were assessed during each phase of the study for clinical presentation of gingivitis and at the same time had plate sampling for microbiological polymerase chain reaction characterisation real-time (RTPCR) and saliva wash samples to assess metabolic 'systems biology' by 1H-NMR.

Results

 People who have different levels of bleeding gums on detection on entry into the study responded differently to strict oral hygiene. In particular, the high bleeding group responded slowly to strict oral hygiene and developed significantly greater recurrence in gingivitis during the test. RTPCR analysis showed changes in bacterial populations associated with the phases of the study, particularly the increases in potential periodontal pathogens during EG. However, the microbiological profiles of patients with bleeding gums with high and low sensitivity were largely similar. The metabolic analysis also revealed significant changes in metabolite composition during the phases of the study associated with differences in plaque toxicity, especially short-chain carboxylic acid propionates and n-butyrate, which tracked clinical changes in gingivitis severity. Systems analysis of metabolic changes suggested differences between groups, although the analysis to date has not clarified whether these differences are causal (predictive of the population) or merely diagnostic of the clinical situation in the populations.