Putative periodontal pathogens, antibody titres and avidities to them in a longitudinal study of patients with resistant periodontitis

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Abstract
To study changes in antibody titres and antibody avidities to putative periodontal pathogens in patients with resistant periodontitis and to compare these findings with the result of culture of these pathogens. Patients meeting strict clinical criteria in whom periodontal therapy had failed to prevent disease progression were studied microbiologically and immunologically over a 75-week period. Particular reference was made to the isolation of Actinobacillus actinomycetemcomitans (Aa) and Porphyromonas gingivalis (Pg) together with changes in antibody titres and avidities to these organisms between baseline examination and week 75. Pg was eliminated following antibiotic treatment but metronidazole and amoxycillin therapy failed to remove Aa in all cases. Antibody avidities to these pathogens were higher in patients than in matched controls but no change in avidity was noted during the course of treatment. Most antibody titres were not significantly higher in patients than in controls. Continued disease progression characterised these patients who, nevertheless, mounted an immune response to the periodontal pathogens but this appeared to be inadequate to stop the disease.