Microbiological Diagnostics in Periodontics
You will receive 1 credit(s) of continuing education credit upon successful completion of this course. The purchase price of this course is $49.00


This course attempts to determine the usefulness of various microbiological testing systems for the management of periodontitis patients.

Learning Objectives:

Upon completion of this course, participants should be able to do the following:

  • Identify microorganisms that have been implicated in periodontal disease.
  • Explain the importance of antimicrobial susceptibility testing.
  • Discuss the purpose of microbial testing during the treatment evaluation phase.


Microbiological tests in periodontics can be of great help in determining the characteristics of a pathogenic infection, prescribing the optimal antibiotic regimen and monitoring the effectiveness of treatment. However, they are not without potential pitfalls. Current microbiological tests vary considerably in sensitivity and specificity. A false positive test result may lead to unnecessary therapy and patient distress. A false negative test result may prompt the withholding of necessary therapy and the subsequent progression of disease. Also, diagnostic tests can be relatively expensive and uncomfortable for patients. This article attempts to determine the usefulness of various microbiological testing systems for the management of periodontitis patients.




  1. Introduction
  2. Microbial Analysis in Periodontics
    1. Specific Pathogens
    2. Sensitivity and Specificity
  3. Microbial Composition and Antibiotic Therapy
    1. Sampling Considerations
    2. Methods of Microbial Diagnostics
      1. Patient and Method Selection
  4. Summary

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  2. Slots J. Systemic antibiotics in periodontics (position paper). J Periodontol. 1996; 67:831-838.
  3. Levy D, Csima A, Birek P, et al. Impact of microbiological consultation on clinical decision making: a case-control study of clinical management of recurrent periodontitis. J Periodontol. 1993; 64:1029-1039.
  4. Slots J. Microbial analysis in supportive periodontal therapy. Periodontol 2000. 1996; 12:56-59.
  5. Rams TE, Listgarten MA, Slots J. Utility of 5 major putative periodontal pathogens and selected clinical parameters to predict periodontal breakdown in patients on maintenance care. J Clin Periodontol. 1996; 23:346-354.
  6. Slots J, Schonfeld SE. Actinobacillus actinomycetemcomitans in localized juvenile periodontitis. In Hamada S, Holt SC, McGhee JR (eds). Periodontal Disease: Pathogens & Host Immune Responses. Tokyo, Quintessence Publishing Co Ltd. 1991: pp 53-64.
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  8. Wennström JL, Dahlen G, Svensson J, et al. Actinobacillus actinomycetemcomitans, Bacteroides gingivalis and Bacteroides intermedius: predictors of attachment loss? Oral Microbiol Immunol. 1987; 2:158-163.
  9. Listgarten MA, Slots J, Nowotny AH, et al. Incidence of periodontitis recurrence in treated patients with and without cultivable Actinobacillus actinomycetemcomitans, Prevotella intermedia and Porphyromonas gingivalis: a prospective study. J Periodontol. 1991; 62:377-386.
  10. Haffajee AD, Socransky SS, Smith C, et al. Relation of baseline microbial parameters to future periodontal attachment loss. J Clin Periodontol. 1991; 18:744-750.
  11. Brown LF, Beck JD, Rozier RG. Incidence of attachment loss in community-dwelling older adults. J Periodontol. 1994; 65:316-323.
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  13. Slots J, Taichman NS, Oler J, et al. Does the analysis of the subgingival flora have value in predicting periodontal breakdown? In Guggenheim B (ed): ERGOB Proceedings on the Conference "Periodontology Today." Basal, Switzerland, S. Karger AG, pp 132-140, 1988.
  14. Van Winkelhoff AJ, Rams TE, Slots J. Systemic antibiotic therapy in periodontics. Periodontol2000. 1996; 10:45-78.
  15. Fine DH. Microbial identification and antibiotic sensitivity testing, an aid for patients refractory to periodontal therapy. A report of 3 cases. J Clin Periodontol. 1994; 21:98-106.
  16. Walker CB. The acquisition of antibiotic resistance in the periodontal microflora. Periodontol 2000. 1996; 10:79-88.
  17. Gunsolley JC, Chinchilli VN, Savitt ED, et al. Analysis of site-specific periodontal bacteria sampling schemes. J Periodontol. 1992; 63:507-514.
  18. Slots J, Rams TE. Methods for the study of oral microorganism. In Slots J, Taubman MA (eds): Contemporary Oral Microbiology and Immunology. St. Louis, Mosby. 1992: pp 275-282.
  19. Ashimoto A, Chen C, Bakker I, et al. Polymerase chain reaction detection of Eight putative periodontal pathogens in subgingival plaque of gingivitis and advanced periodontitis lesions. Oral Microbiol Immunol. 1996; 11:266-173.
  20. Contreras A, Slots J. Mammalian viruses in human periodontitis. Oral Microbiol Immunol. 1996; 11:381-386.
  21. Keilty RA. The present state of our knowledge of gingivitis. J Lab Clin Med. 1928; 13:451-468.

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