ARTICLE The effect of conventional mechanical periodontal treatment on red complex microorganisms and clinical parameters in Down syndrome periodontitis patients: a pilot study M. H. Tanaka & T. O. Rodrigues & L. S. Finoti & S. R. L. Teixeira & M. P. A. Mayer & R. M. Scarel-Caminaga & E. M. A. Giro Received: 28 May 2014 /Accepted: 20 October 2014 /Published online: 4 November 2014 # Springer-Verlag Berlin Heidelberg 2014 Abstract Periodontal disease (PD) is induced by a complex microbiota, such as Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola (together called the red complex), which triggers intense inflammatory reaction. Down syndrome (DS) individuals demonstrate a high preva- lence of PD compared with those who are otherwise chromo- somally normal (euploids). This pilot study aimed to evaluate the effect of non-surgical periodontal treatment in DS chronic periodontitis patients on clinical and microbiological parame- ters. Patients with chronic periodontitis, 23 DS and 12 eu- ploids (control group), were submitted to non-surgical me- chanical periodontal treatment, followed by maintenance for 45 days. Clinical parameters after periodontal treatment were similar in diseased and healthy sites, independent of the ge- netic background. Diseased sites of DS and control patients harbored similar levels of P. gingivalis and T. forsythia at baseline, but significantly higher levels of T. denticola were found in DS patients. Increased levels of P. gingivalis at healthy sites were found in DS individuals. Non-surgical periodontal therapy decreased the levels of red complex mi- croorganisms and improved the tested clinical parameters of diseased sites in both groups. However, the levels of red complex bacteria were higher in diseased sites of DS patients after the periodontal treatment. We conclude in this pilot study that, although the mechanical periodontal treatment seemed to be effective in DS subjects over a short-term period, the red complex bacteria levels did not decrease significantly in dis- eased sites, as occurred in controls. Therefore, for DS patients, it seems that the conventional non-surgical periodontal thera- py should be improved by utilizing adjuvants to reduce the presence of periodontopathogens. Introduction Periodontal disease (PD) is an inflammatory disease that affects supporting structures of the teeth, constituting one of the most prevalent forms of bone destructive pathology in humans [1, 2]. Periodontopathogenic bacteria, such as Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola (together called the red complex), trig- ger an intense inflammatory reaction [3–6]. The clinical out- comes of PD are not induced only by microbial agents, but also by the interaction of host defense mechanisms, as well as genetic and environmental factors [7–9]. Individuals with Down syndrome (DS) have an increased prevalence of PD compared with otherwise chromosomally normal (euploid) and other mentally handicapped patients of similar age [10]. The DS genetic background may lead to an altered immune response, which, in turn, might affect M. H. Tanaka : T. O. Rodrigues : E. M. A. Giro Department of Orthodontics and Pediatric Dentistry, School of Dentistry, UNESP—Universidade Estadual Paulista, Câmpus de Araraquara, São Paulo, SP, Brazil M. H. Tanaka : L. S. Finoti : R. M. Scarel-Caminaga Department of Morphology, School of Dentistry, UNESP—Universidade Estadual Paulista, Câmpus de Araraquara, São Paulo, SP, Brazil S. R. L. Teixeira : M. P. A. Mayer Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, SP, Brazil E. M. A. Giro (*) Department of Orthodontics and Pediatric Dentistry, Araraquara School of Dentistry, UNESP—Universidade Estadual Paulista, Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil e-mail: egiro@foar.unesp.br Eur J Clin Microbiol Infect Dis (2015) 34:601–608 DOI 10.1007/s10096-014-2268-7