Site‐Specific Development of Periodontal Disease Is Associated With Increased Levels of Porphyromonas gingivalis, Treponema denticola, and Tannerella forsythia in Subgingival Plaque

Background: Porphyromonas gingivalis , Treponema denticola , and Tannerella forsythia (previously T. forsythensis ), which are regarded as the principal periodontopathogenic bacteria, exist as a consortium in subgingival biofilms. We aimed to examine quantitative relationships between P . gingivalis , T . denticola , and T . forsythia in subgingival biofilms and the relationship between the quantity and prevalence of these three bacteria and site‐specific periodontal health. Methods: This study was cross‐sectional. The study population consisted of 35 adult subjects who visited the Kyushu Dental College Hospital. Plaque samples were collected from 105 periodontal pocket sites. Quantitative analyses of each of the three periodontopathogenic bacteria were performed using real‐time polymerase chain reaction with species‐specific primers and hybridization probes. Results: The plaque samples were divided into four groups based on the presence or absence of a periodontal pocket (probing depth [PD] ≥4 mm) and bleeding on probing (BOP), regardless of attachment loss. The proportions of all three target bacteria detected in samples from sites of periodontal disease (with PD and BOP) were markedly higher than those in the other sample groups. Cell numbers of P. gingivalis , T. denticola , and T. forsythia in the subgingival plaque of each sampling site were significantly mutually correlated and were increased in the plaque of sites of periodontal disease with PD ≥4 mm and BOP. Conclusion: The symbiotic effects of P . gingivalis , T . denticola , and T . forsythia , which coaggregate and exist concomitantly in subgingival biofilms, may be associated with the local development of periodontitis.