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Journal of Clinical Microbiology, December 2007, p. 3859-3869, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.00653-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.

Aggregatibacter actinomycetemcomitans and Its Relationship to Initiation of Localized Aggressive Periodontitis: Longitudinal Cohort Study of Initially Healthy Adolescents{triangledown}

Daniel H. Fine,1* Kenneth Markowitz,1 David Furgang,1 Karen Fairlie,1 Javier Ferrandiz,1 Cebile Nasri,1 Marie McKiernan,1 and John Gunsolley2

Department of Oral Biology, New Jersey Dental School, University of Medicine and Dentistry of New Jersey, Newark, New Jersey 07103,1 Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia 232982

Received 23 March 2007/ Returned for modification 28 June 2007/ Accepted 4 October 2007

Aggregatibacter actinomycetemcomitans is frequently associated with localized aggressive periodontitis (LAP); however, longitudinal cohort studies relating A. actinomycetemcomitans to initiation of LAP have not been reported. A periodontal assessment was performed on 1,075 primarily African-American and Hispanic schoolchildren, ages 11 to 17 years. Samples were taken from each child for A. actinomycetemcomitans. A cohort of 96 students was established that included a test group of 38 A. actinomycetemcomitans-positive students (36 periodontally healthy and 2 with periodontal pockets) and 58 healthy A. actinomycetemcomitans-negative controls. All clinical and microbiological procedures were repeated at 6-month intervals. Bitewing radiographs were taken annually for definitive diagnosis of LAP. At the initial examination, clinical probing attachment measurements indicated that 1.2% of students had LAP, while 13.7% carried A. actinomycetemcomitans, including 16.7% of African-American and 11% of Hispanic students (P = 0.001, chi-square test). A. actinomycetemcomitans serotypes a, b, and c were equally distributed among African-Americans; Hispanic students harbored predominantly serotype c (P = 0.05, chi-square test). In the longitudinal phase, survival analysis was performed to determine whether A. actinomycetemcomitans-positive as compared to A. actinomycetemcomitans-negative students remained healthy ("survived") or progressed to disease with attachment loss of >2 mm or bone loss (failed to "survive"). Students without A. actinomycetemcomitans at baseline had a significantly greater chance to remain healthy (survive) compared to the A. actinomycetemcomitans-positive test group (P = 0.0001). Eight of 38 A. actinomycetemcomitans-positive and none of 58 A. actinomycetemcomitans-negative students showed bone loss (P = 0.01). A. actinomycetemcomitans serotype did not appear to influence survival. These findings suggest that detection of A. actinomycetemcomitans in periodontally healthy children can serve as a risk marker for initiation of LAP.

* Corresponding author. Mailing address: University of Medicine and Dentistry of New Jersey, Department of Oral Biology, 185 South Orange Avenue, MSB, Room C-636, Newark, NJ 07101. Phone: (973) 972-3728. Fax: (973) 972-0045. E-mail: finedh{at}umdnj.edu

{triangledown} Published ahead of print on 17 October 2007.

Journal of Clinical Microbiology, December 2007, p. 3859-3869, Vol. 45, No. 12
0095-1137/07/$08.00+0     doi:10.1128/JCM.00653-07
Copyright © 2007, American Society for Microbiology. All Rights Reserved.



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