La plausibilidad biológica entre la periodontitis crónica y el infarto cerebral isquémico / Biological plausibility of the relationship between chronic periodontitis and ischemic stroke

Introducción: Las bolsas periodontales reales constituyen un reservorio importante de bacterias gramnegativas que pueden por diversas vías ejercer influencia en sitios distantes, lo cual provoca alteraciones sistémicas como las enfermedades derivadas de la aterosclerosis. Objetivo: Explicar los fundamentos teóricos que sustentan la propuesta de la periodontitis crónica como un factor de riesgo para el infarto cerebral isquémico. Contenido: 1) La aterosclerosis y las enfermedades cerebrovasculares, generalidades de su patogenia. 2) La microbiota periodontal, fundamentos de su asociación con la aterosclerosis y la enfermedad cerebrovascular isquémica. Exposición del tema: La inflamación es un elemento de vital importancia en todas las fases del proceso aterosclerótico, tanto en su inicio, progresión, como en sus complicaciones. La naturaleza de las enfermedades periodontales inmunoinflamatorias crónicas y la infección subgingival anaerobia asociada a ellas, representa una injuria metastásica que produce y disemina mediadores inflamatorios favorecedores de la ateroesclerosis, participando en la colonización, y ruptura de placas ateromatosas; procesos implicados en la patogenia del infarto cerebral isquémico. Consideraciones finales: El mayor conocimiento de la relación riesgosa entre periodontitis crónica e infarto cerebral isquémico, permitiría una utilización racional de estrategias de prevención y tratamiento de la enfermedad cerebrovascular, basadas en la detección de procesos inflamatorios como las periodontopatías crónicas(AU)

Introduction: True periodontal pockets are an important reservoir of gram-negative bacteria which may exert an influence on distant sites in a variety of manners, bringing about systemic alterations such as diseases derived from atherosclerosis. Objective: Explain the theoretical foundations supporting the proposal of chronic periodontitis as a risk factor for ischemic stroke. Content: 1) Atherosclerosis and cerebrovascular disease, an overview of their pathogenesis. 2) The periodontal microbiota, bases for its association with atherosclerosis and ischemic stroke Topic presentation: Inflammation is an element of vital importance in all the stages of the atherosclerotic process, be it its onset, progress or complications. By their nature, chronic immunoinflammatory periodontal diseases and the associated anaerobic subgingival infection, constitute a metastatic injury that produces and spreads inflammatory mediators leading to atherosclerosis and participating in the colonization and rupture of atheromatous plaques, which are processes involved in the pathogenesis of ischemic stroke. Final considerations: Better knowledge about the risk relationship between chronic periodontitis and ischemic stroke would allow a rational use of strategies for the prevention and treatment of cerebrovascular disease based on detection of inflammatory processes such as chronic periodontal conditions(AU)

Role of 1% alendronate gel as adjunct to mechanical therapy in the treatment of chronic periodontitis among smokers

Abstract Objective Alendronate (ALN) inhibits osteoclastic bone resorption and triggers osteostimulative properties both in vivo and in vitro, as shown by increase in matrix formation. This study aimed to explore the efficacy of 1% ALN gel as local drug delivery (LDD) in adjunct to scaling and root planing (SRP) for the treatment of chronic periodontitis among smokers. Material and Methods 75 intrabony defects were treated in 46 male smokers either with 1% ALN gel or placebo gel. ALN gel was prepared by adding ALN into carbopol-distilled water mixture. Clinical parameters [modified sulcus bleeding index, plaque index, probing depth (PD), and periodontal attachment level (PAL)] were recorded at baseline, at 2 months, and at 6 months, while radiographic parameters were recorded at baseline and at 6 months. Defect fill at baseline and at 6 months was calculated on standardized radiographs by using the image analysis software. Results Mean PD reduction and mean PAL gain were found to be greater in the ALN group than in the placebo group, both at 2 and 6 months. Furthermore, a significantly greater mean percentage of bone fill was found in the ALN group (41.05±11.40%) compared to the placebo group (2.5±0.93%). Conclusions The results of this study showed 1% ALN stimulated a significant increase in PD reduction, PAL gain, and an improved bone fill compared to placebo gel in chronic periodontitis among smokers. Thus, 1% ALN, along with SRP, is effective in the treatment of chronic periodontitis in smokers.

Effects of periodontal treatment on primary sjogren's syndrome symptoms

Abstract The aim of this longitudinal prospective study was to evaluate the effects of periodontal treatment on the clinical, microbiological and immunological periodontal parameters, and on the systemic activity (ESSDAI) and subjective (ESSPRI) indexes in patients with primary Sjögren’s Syndrome (pSS). Twenty-eight female patients were divided into four groups: pSS patients with or without chronic periodontitis (SCP, SC, respectively), and systemically healthy patients with or without chronic periodontitis (CP, C, respectively). Periodontal clinical examination and immunological and microbiological sample collection were performed at baseline, 30 and 90 days after nonsurgical periodontal treatment (NSPT). Levels of interleukin IL-1β, IL-8 and IL-10 in saliva and gingival crevicular fluid (GCF) were evaluated by ELISA, as well as the expression of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans, (Aa) Tannerella forsythia (Tf), and Treponema denticola (Td), by qPCR. Systemic activity and pSS symptoms were evaluated by ESSDAI and ESSPRI. NSPT resulted in improved periodontal clinical parameters in both SCP and CP groups (p>0.05). Pg, Aa, and Tf levels decreased after NSPT only in CP patients (p<0.05). Significantly greater levels of IL-10 in GCF were verified in both SCP and CP groups (p<0.05). SCP patients showed increased salivary flow rates and decreased ESSPRI scores after NSPT. In conclusion, NSPT in pSS patients resulted in improved clinical and immunological parameters, with no significant effects on microbiological status. pSS patients also showed increased salivary flow and lower ESSPRI scores after therapy. Therefore, it can be suggested that NSPT may improve the quality of life of pSS patients.

Gingival crevicular fluid oxidative stress level in patients with periodontal disease and hyperlipidemia

Abstract: This study aimed to assess the impact of hyperlipidemia on healthy and diseased periodontal tissue by evaluating oxidative stress biomarkers in gingival crevicular fluid (GCF). Clinical periodontal parameters and blood serum lipid, GCF malondialdehyde (MDA), protein carbonyl (PC), and total antioxidant capacity (TAOC) levels were evaluated in six age and sex-matched groups (n = 15 each) of normolipidemic and hyperlipidemic individuals as follows: normolipidemic + periodontally healthy (H), normolipidemic + gingivitis (G), normolipidemic + chronic periodontitis (CP), hyperlipidemic + periodontally healthy (HH), hyperlipidemic + gingivitis (HG), and hyperlipidemic + CP (HCP). GCF MDA, and PC levels varied among groups, with patients with periodontitis having the highest MDA and PC levels [CP > G > H (p < 0.01) and HCP > HG > HH (p < 0.01)] and the lowest TAOC levels [CP < G < H (p < 0.01) and HCP < HG < HH (p < 0.01)]. Furthermore, paired comparisons showed MDA and PC levels to be higher and TAOC levels to be lower in HCP compared with NCP (p < 0.01). In patients with hyperlipidemia, GCF, MDA, and PC levels positively correlated with clinical assessments and serum triglycerides (TG), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) levels and negatively correlated with serum high-density lipoprotein cholesterol (HDL) levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG, TC, and LDL levels, but positively correlated with serum HDL levels (p < 0.01). In normolipidemic patients, GCF, MDA, and PC levels positively correlated with clinical assessments and serum TG levels and negatively correlated with serum HDL levels, whereas GCF TAOC levels negatively correlated with clinical assessments and serum TG levels and positively correlated with serum HDL levels (p < 0.01). In conclusion, abnormal serum lipid subfractions could be considered a risk factor for enhancing oxidative stress in GCF in the presence of periodontal disease.

Predictors of smoking cessation in smokers with chronic periodontitis: a 24-month study

Abstract The purpose of this 24-month study was to identify predictors of smoking cessation in a cohort of smokers with chronic periodontitis, attending a multidisciplinary smoking cessation program. Of the 286 subjects screened, 116 were included and received non-surgical periodontal treatment and smoking cessation therapy, which consisted of lectures, cognitive behavioral therapy, and pharmacotherapy, according to their individual needs. During initial periodontal treatment, dentists actively motivated the study subjects to stop smoking, using motivational interviewing techniques. Further smoking cessation counseling and support were also provided by the dentists, during periodontal maintenance sessions at 3, 6, 12 and 24 months of follow-up. Smoking status was assessed by means of a structured questionnaire, and was validated by exhaled carbon monoxide (CO) measurements. The Fagerström Test for Cigarette Dependence was used to assess smoking dependence. Of the 61 individuals that remained up to the 24-month examination, 31, 21 and 18 declared that they were not smoking at 3, 12 and 24 months, respectively. Smoking cessation after 24 months was associated with the male gender (OR = 3.77, 95%CI = 1.16-12.30), baseline CO levels less than 10ppm (OR = 5.81, 95%CI 1.76-19.23), not living or working with another smoker (OR = 7.38, 95%CI 1.76-30.98) and a lower mean Fagerström test score (OR = 5.63, 95%CI 1.55-20.43). We concluded that smoking cessation was associated with demographic, smoking history and cigarette dependence variables.

Efeito do tratamento periodontal nos níveis de osteocalcina sérica em pacientes com diabetes tipo 2 e periodontite crônica severa / Effect of periodontal therapy on serum osteocalcin levels in patients with type 2 diabetes and severe chronic periodontitis

O tecido ósseo é metabolicamente ativo e sofre um processo contínuo de renovação e remodelação. A osteocalcina é um peptídeo secretado pelos osteoblastos. Apesar de ser primariamente depositada na matriz óssea recém-formada, uma pequena fração entra em circulação na corrente sanguínea, sendo considerada como um marcador de formação óssea e interferir na homeostasia da glicose. O objetivo deste estudo foi investigar se o tratamento periodontal afeta os níveis séricos de osteocalcina em pacientes com DM2 e periodontite crônica severa. 26 pacientes foram divididos em grupo teste (n=13, idade média de 55,8 ± 8,4 anos, 9 homens e 4 mulheres) e controle. (n=13, idade média de 59,4± 8.4, 5 homens e 8 mulheres). O grupo teste recebeu tratamento periodontal e grupo controle nãorecebeu tratamento periodontal imediato. O exame periodontal incluiu medidas de IP (Índice de placa), SS (Sangramento à sondagem), PBS (Profundidade de bolsa à sondagem), NIC (Nível de inserção clínica). Exames laboratoriais incluíram HBA1c, glicemia estimada, glicose, triglicerídeo, colesterol total e frações. A concentração de osteocalcina sérica foi analisada pelo ELISA. O exame periodontal, exames laboratoriais e concentração de osteocalcina foram reavaliados 90 dias após. Os resultados mostraram que não houve alterações significativas nos parâmetros periodontais, exames laboratoriais, e níveis de osteocalcina 90 dias após o tratamento periodontal. Conclusão: o tratamento periodotnal não influenciou nos níveis séricos da osteocalcina em pacientes com diabetes melllitus tipo 2 e periodontite crônica severa.

Bone tissue is metabolically active and undergoes a continuous process of resorption and formation. Osteocalcin is a peptide secreted by osteoblasts. Although primarily deposited in newly formed bone matrix, a small fraction enters into circulation in the bloodstream and is considered as a marker of bone formation and interferes with glucose homeostasis. The aim of this study was to investigate whether periodontal treatment affects serum osteocalcin levels in patients with type 2 diabetes and severe chronic periodontitis. 26 patients were divided into test group (n = 13, mean age 55.8 ± 8.4 years, 9 men and 4 women) and control. (n = 13, mean age 59.4 ± 8.4, 5 men and 8 women). The test group received periodontal treatment and untreated control group. Periodontal examination included PI measures (plaque index), BOP (bleeding on probing), PPD (probing pocket depth), CAL (clinical attachment level). Laboratory tests included HbA1c, glucose, triglyceride, total cholesterol and fractions. The concentration of serum osteocalcin was analyzed by ELISA. Periodontal examination, laboratory tests and concentration of osteocalcin were reassessed after 90 days. The results showed no significant changes in periodontal parameters, laboratory tests, and osteocalcin levels 90 days after periodontal treatment. In conclusion, periodontal treatment did not influence the serum levels of osteocalcin in patients with type 2 diabetes and severe chronic periodontitis.

Proteína C reactiva en pacientes con periodontitis crónica / C-reactive protein in patients with chronic periodontitis

La Periodontitis Crónica surge en las últimas décadas como un posible factor de riesgo para el desarrollo de eventos cardiovasculares. Bajo estas premisas, nace un nuevo paradigma que orienta el logro de diagnósticos, formas de prevención, intervención temprana y estrategias en el tratamiento de la Periodontitis Crónica. La Proteína C Reactiva (PCR) ha resultado ser un marcador de inflamación sistémica asociado a la Enfermedad Arterial Coronaria y a la Periodontitis Crónica.Objetivo del estudio: Conocer los niveles de Proteína C Reactiva en pacientes con Periodontitis Crónica Material y métodos: Se seleccionaron 80 pacientes del Postgrado de Periodoncia de la Facultad de Odontología de la Universidad Central de Venezuela. El estudio fue de tipo descriptivo, observacional, prospectivo. La data fue migrada a SPSS 17.0, para el análisis estadístico. Para las variables cuantitativas se utilizó la media y la desviación standart. Para evaluar la correlación entre variables se utilizó el coeficiente de correlación de Pearson, la prueba de Chi cuadrado de independencia y el análisis de Varianza para un solo factor. Resultados: De la muestra poblacional, El nivel sérico de Proteína C Reactiva ultrasensible resultó Factor de Riesgo Cardiovascular en 47 pacientes (58,8 por ciento). Discusión y conclusiones: No existe asociación entre los niveles de la Proteína C Reactiva ultrasensible y la presencia de Periodontitis Crónica generalizada.

Microbiological effects of periodontal therapy plus azithromycin in patients with diabetes: results from a randomized clinical trial

Evidencia actual sugiere que la infección periodontal puede agravar el control de la diabetes. El objetivo de este estudiofue determinar los cambios en la frecuencia de detección de porphyromonas gingivalis, Tannerella forsythia, Treponema denticola y Aggregatibacter actinomycetemcomitans en pacientes con diabetes con el uso de terapia mecánica no quirúrgica mas azitromicina en un estudio clínico controlado aleatorizado.Ciento cinco pacientes (105) con diabetes y perio -dontitis fueron asignados aleatoriamente en tres grupos: terapiamecánica mas azitromicina, terapia mecánica mas placebo y profilaxis supragingival mas azitromicina. Un análisis periodontal completo y detección de patógenos perio dontales por medio de reacción en cadena de la polimerasa (PCR) se realizaron al inicio, 3, 6 y 9 meses después de la terapia pe -riodontal. La frecuencia de detección de Porphyromonas gingivalis, Treponema denticola y Aggregatibacter actinomycetemcomitans disminuyó a los 3 meses en todos los grupos. La frecuencia de detección de Tannerella forsythia se incrementó a los 3 meses en todos los grupos. Todos los patógenosperiodontales mostraron una frecuencia de detección similar a los 9 meses en todos los grupos. La terapia periodontal mas azitromicina no tuvo efectos adicionales sobre la frecuencia dedetección de los patógenos periodontales investigados en pacientes diabéticos...

Serum leveis of inflammatory markers in type 2 diabetes patients with chronic periodontitis

Diabetes has been associated with periodontitis, but the mechanisms through which periodontal diseases affect the metabolic control remain unclear. Objective: This study aimed to evaluate serum leveis of inflammatory markers, IL-8, IL-6 and monocyte chemoattractant protein 1 (MCP-1), in type 2 diabetic patients in the presence of chronic periodontitis. Material and Methods: Forty two individuals were enrolled in this study and assigned to one of five groups: diabetes mellitus with inadequate glycemic control and periodontitis (DMI+P, n = 10), diabetes mellitus with adequate glycemic control and periodontitis (DMA+P, n = 10), diabetes mellitus without periodontitis (DM, n = 10), periodontitis without diabetes (P, n=6), and neither diabetes nor periodontitis (H, n = 6). Periodontal clinical examination included visible plaque index (PL), gingival bleeding index (GB), probing depth (PD), attachment level (AL) and bleeding on probing (BP). Glycemic control was evaluated by serum concentration of glycated hemoglobin (HbAlc). Inflammatory serum markers IL-8, IL-6 and (MCP-1) were measured by ELISA. Results: DMI+P and DMA+P groups presented higher PD (p=0.025) and AL (p=0.003) values when compared to the P group. There were no significant differences among groups for IL-6, IL-8 and MCP-1 serum levels. Conclusions: Although periodontitis was more severe in diabetic patients, the serum levels of the investigated inflammatory markers did not differ among the groups. .

Genetic factors in pathogenesis of chronic periodontitis

Chronic periodontitis is a global health problem that affects the majority of adult population worldwide. The inflammatory destruction of tooth supporting structure is multifactorial in nature. It results from interaction between microbial, environmental, immunologic, and genetic factors. The exact mechanism of action by which genetic factors alter the course of chronic periodontitis and aid in pathogenesis is yet not well understood. Studies suggest association genetic polymorphism and susceptibility to chronic periodontitis. It is recommended that further investigation of a larger sample size with consideration of interaction with other factors that contribute to the pathogenesis of chronic periodontitis

Factores de riesgo y periimplantitis en la terapia implantológica: revisión narrativa / Risk factors and periimplantitis in implant therapy: narrative review

Las enfermedades que involucran a los tejidos que rodean a los dientes y a los implantes osteointegrados son el resultado de una interacción entre algún tipo de agente patológico (bacteriano, viral, etc.) y la respuesta inmunitaria del huésped. Estas interacciones se pueden dar tanto en los tejidos dentarios como en aquellos biomateriales que se introducen para tratar de corregir algún tipo de patología periodontal; los implantes al ser sustitutos biocompatibles de las piezas dentarias no están exentas de este tipo de interacciones que muchas veces cursan con patologías periodontales y periimplantarias. La periimplantitis es un tipo de patología que resulta de dicha interacción; los factores de riesgo e indicadores de riesgo de la periimplantitis son amplios y complejos. El presente artículo resume las múltiples fuentes de información de la literatura científica para abordar al detalle los aspectos de los principales factores de riesgo y la periimplantitis en la terapia implantológica.

Diseases involving tissue around the teeth and osseo integrated implants are the result of an interaction between some type of pathological agent (bacterial, viral, etc.) and host immune response. These interactions can occur both in the dental tissues as those biomaterials which are introduced to attempt to correct some type of periodontal disease, the implant being a biocompatible substitute of the teeth is not free from this type of interaction often enrolled periodontal and peri-implant pathology. The peri-implantitisis a type of disease that results from this interaction, the risk factors and risk indicators of peri-implantitis are broad and complex. This article summarizes the multiple sources of information in the scientific literature to address in detail the aspects of the main risk factors and the peri-implantitis in the peri implant therapy.

Níveis séricos de vitamina D e periodontite crônica em pacientes com doença renal crônica / Serum levels of vitamin D and chronic periodontitis in patients with chronic kidney disease

INTRODUÇÃO A concomitância de periodontite crônica (PC) em pacientes com doença renal crônica (DRC) tem sido associada a desfechos adversos. A deficiência de vitamina D (25(OH)D) parece desempenhar papel importante na PC e níveis inadequados de vitamina D têm sido descritos em pacientes com DRC. OBJETIVO: Examinar a relação entre níveis séricos de vitamina D e PC em pacientes com DRC pré-dialítica. MÉTODO: Estudo de caso-controle, definidos, respectivamente, como pacientes com DRC e PC e DRC sem PC. Os dados demográficos, de exame físico e laboratoriais foram obtidos no dia da consulta. A DRC foi definida e estagiada segundo a NKF QDOKI TM. Os níveis séricos de 25(OH) D foram dosados por quimioluminescência quando da avaliação da PC, a qual foi caracterizada segundo os critérios de Academia Americana de Periodontologia (1999). Os resultados de 25(OH)D foram estratificados em deficiência (< 14 ηg/mL), insuficiência (15-29 ηg/mL) e suficiência (> 30 ηg/mL). RESULTADOS: Um total de 29 pacientes foram estudados, 15 no grupo caso e 14 no grupo controle. Os pacientes casos apresentaram mediana de 25(OH) D inferior a dos pacientes controles (22,6 vs. 28,6 ηg/mL; p < 0,01). A frequência de pacientes casos com insuficiência/deficiência de vitamina D foi maior do que entre os pacientes controles (93,3% vs. 57,1%, p < 0,004). Por outro lado, o percentual de pacientes com suficiência de vitamina D foi maior entre os controles se comparados aos integrantes do grupo casos (42,9% vs. 6,7%, p < 0,004). CONCLUSÃO: Em pacientes com DRC, a deficiência de vitamina D se associa com PC.

INTRODUCTION: Concomitance of chronic periodontitis (CP) in patients with chronic kidney disease (CKD) have been associated with adverse outcomes. Vitamin D (25(OH)D) deficiency my play a role in CP and inadequate vitamin D status is common among patients with CKD. OBJECTIVE: To examine the relationship between vitamin 25(OH)D and CP in patients with CKD not yet on dialysis. METHOD: A case-control study was conducted. Cases and controls were defined as patients with CKD with and without CP, respectively. The demographic, clinical and laboratory data were obtained when the patient was attended in the outpatient clinic. CKD was defined and staged according to the NKF QDOKI TM. Serum 25(OH) D levels were measured by chemiluminescence when assessing the CP, which was definined according to the American Academy of Periodontoly (1999). Serum 25(OH)D levels were stratified into deficient (< 14 ηg/mL), insufficient (15-29 ηg/mL) and sufficiency (> 30 ηg/ mL). RESULTS: A total of 15 cases were compared with 14 controls. Cases had lower median 25(OH)D levels than controls (22.6 versus 28.6 ηg/mL, p < 0.01) and were more likely to be categorized as vitamin D insufficiency/deficiency (93,3% versus 57,1%, p < 0,004). On the other hand, the percentage of controls with vitamin D sufficiency was higher then cases (42,9% versus 6,7%, p < 0,004). CONCLUSION: In patients with CKD not yet on dialysis, vitamin D deficiency is associated with CP.

Occurrence of Aggregatibacter actinomycetemcomitans in Brazilians with chronic periodontitis

Studies have suggested that A. actinomycetemcomitans is involved in the aetiology of aggressive periodontitis as well as in chronic periodontitis. This study was aimed at elucidating the occurrence of A. actinomycetemcomitans in a Brazilian population with chronic periodontitis. A total of 555 (mean age 33.04 ± 12.45) individuals, living in two large areas of the São Paulo State, namely "Baixada Santista" and "Vale do Paraíba", and diagnosed with mild [180 (mean age 29.59 ± 10.94)], moderate [241 (mean age 31.18 ± 11.45)] or severe [134 (mean age 33.04 ± 12.45)] chronic periodontitis were enrolled in this survey. Clinical exams including measurements of Probing Depth, Clinical Attachment Loss, Plaque and Gingival indices and subgingival microbiological assessments were performed at all population. The genomic DNA of A. actinomycetemcomitans was identified by Polymerase Chain Reaction from periodontal pocket samples. The occurrence of A. actinomycetemcomitans among chronic periodontitis subjects as well as its association with age and gender were statistically analysed using the Chi-square and Odds Ratio tests. The significance of differences was established at 5 percent (p < 0.05). A. actinomycetemcomitans was detected in 102 (18.37 percent) individuals: 29 (16.11 percent) mild; 42 (17.42 percent) moderate; and 31 (23.13 percent) severe chronic periodontitis with no statistical difference among groups. A higher occurrence of the searched bacterium was found both in the youngest group (p < 0.05) as well as in the female group (p < 0.05). This study elucidated that A. actinomycetemcomitans harbored subgingival pockets of our target group of chronic periodontitis subjects and that this bacterium seems to be inversely related to age, but related to the female gender.

Prevalence of Porphyromonas gingivalis and Bacteroides forsythus in chronic periodontitis by multiplex PCR

Periodontitis is a common inflammatory and infectious disease which destroys the supporting structure of the teeth. Recent studies show that periodontal infection significantly increases the risk of some systemic diseases. It is generally accepted that bacterial species notably Porphyromonas gingivalis and Bacteroides fosythus are highly associated with periodontium. Molecular methods such as Multiplex PCR seem to be more sensitive and faster. Multiplex PCR alone can lower the limit of bacterial detection. Several pathogens can be detected simultaneously by this method. The Subgingival plaque samples from 61 patients including 34 women and 27 men in the age range of 24-69 years and an average age of 43 suffering from chronic periodontitis with probing depth of PD>/=6, and from 40 periodontally healthy controls including 22 women and 18 men in the age range of 21-69 years and an average age of 41.35 were collected by sterile curette. In this study, two species-specific forward primers were used in combination with a single reverse primer. The samples' DNA was extracted and Multiplex PCR was administered. Porphyromonas gingivalis was detected in 51 samples [81.61%] and 16 samples [40%] of the chronic periodontitis patients and the healthy subjects repectively. Moreover, Bacteroides forsythus was detected 32 samples [52.50%] of the chronic periodontitis patients but it was not detected in any of the samples from the healthy group. P. gingivalis and B. forsythus can be simultaneously detected using Multiplex PCR. The present data suggest that P. gingivalis is a more important factor in the etiology of chronic periodontitis. Further studies are needed to determine the spectrum of pathogenicity of the disease and effective management of diagnosis and treatment in order to decrease the risk of periodontal complications such as systemic infections