Persistence of extracrevicular bacterial reservoirs after treatment of XXXX .

@entity1 @entity1216 @entity527 @entity146 @entity14148 @entity3288 @entity3289 @entity3841 @entity2523
BACKGROUND: The purpose of this study was to test the hypothesis that periodontal pathogens associated with @entity146 persist in extracrevicular locations following scaling and root planing, systemic antibiotics, and antimicrobial rinses. METHODS: Eighteen @entity1 with @entity146 received a clinical examination during which samples of @entity527 and buccal epithelial cells were obtained. Treatment consisted of full-mouth root planing, systemic antibiotics, and @entity1216 rinses. Clinical measurements and sampling were repeated at 3 and 6 months. Quantitative polymerase chain reaction determined the number of @entity3841 (previously @entity3841 ), @entity3288 , @entity2523 , @entity3289 (previously @entity3289 ), and @entity14148 in the plaque. Fluorescence in situ hybridization and confocal microscopy determined the extent of intracellular invasion in epithelial cells. RESULTS: Clinical measurements improved significantly following treatment. All bacterial species except @entity2523 were significantly reduced in plaque between baseline and 3 months. However, all species showed a trend to repopulate between 3 and 6 months. This increase was statistically significant for log @entity14148 counts. All species were detected intracellularly. The percentage of cells infected intracellularly was not affected by therapy. CONCLUSIONS: The 6-month increasing trend in the levels of plaque bacteria suggests that subgingival recolonization was occurring. Because the presence of these species within epithelial cells was not altered after treatment, it is plausible that recolonization may occur from the oral mucosa. Systemic antibiotics and topical @entity1216 did not reduce the percentage of invaded epithelial cells. These data support the hypothesis that extracrevicular reservoirs of bacteria exist, which might contribute to recurrent or refractory disease in some @entity1 .
