| dc.description.abstract | Open contacts causing food impaction are thought to be a contributing factor to localized periodontal destruction. The extent that interproximal open contacts and the dimensions of the open contact contribute to periodontal destruction has not been quantitatively assessed. The purpose of this clinical study is to quantify the relationship between the presence of an interproximal open contact, the dimension of the interproximal open contact to periodontal attachment loss and associated subgingival microbiome.
Twenty-five patients with active periodontal disease with at least one open contact (test) and a contralateral/adjacent closed contact (control) were evaluated by one examiner. The open contact width (mm) was measured using a thickness gauge and subgingival bacterial sampling was performed. The subgingival samples were tested against a 10 species periodontal panel via quantitative polymerase chain reaction (qPCR) by a blinded outside lab. Periodontal parameters including probing depth (PD), recession (REC), clinical attachment loss (CAL), bleeding on probing (BOP), plaque index (PI), and patient-reported food impaction (FI) were recorded. Spearman correlations between open contact dimension and periodontal parameters were analyzed, while differences were examined using Mann-Whitney U, McNemar test and Wilcoxon signed-rank test. Bonferroni corrections were used to control for Type I errors when evaluating periodontal pathogens.
The median width of the open contact assessed with the thickness gauge was 0.53 mm. The open versus closed sites differed significantly with regard to BOP, CAL, and PD (p≤0.001, p≤0.001 and p=0.038, respectively). PD and CAL were increased in the open contact site compared to the closed control site (p<0.001). Increased width of the open contact was associated with increased PD and CAL (p=0.003, p<0.001). FI was not related to open contact width (p=0.335). Significant differences were found in the amount of P. gingivalis (p=0.004) and C. rectus (p=0.003) in test vs control sites. Marginal increases were noted in the amount of T. forsythia, T. denticola and Peptostreptococcus micros (0.0045<p<0.05).
Findings of the current study are consistent with previous studies that demonstrated interproximal open contacts are an important factor in periodontal disease. This study demonstrates quantitatively for the first time that the dimension of the interproximal open contact is directly related to parameters of periodontal destruction. Furthermore, the pathogenicity of the subgingival bacterial profile is directly associated with the presence interproximal open contacts. The findings of this study demonstrate the impact of interproximal open contacts in periodontal disease showing the importance of detection and management of open contacts in clinical practice. | |
