Prospective longitudinal changes in the periodontal inflamed surface area following active periodontal treatment for chronic periodontitis

Yoshiaki Nomura, Toshiya Morozumi, Atsushi Saito, Atsutoshi Yoshimura, Erika Kakuta, Fumihiko Suzuki, Fusanori Nishimura, Hideki Takai, Hiroaki Kobayashi, Kazuyuki Noguchi, Keiso Takahashi, Koichi Tabeta, Makoto Umeda, Masato Minabe, Mitsuo Fukuda, Naoyuki Sugano, Nobuhiro Hanada, Nobuo Yoshinari, Satoshi Sekino, Shogo TakashibaSoh Sato, Toshiaki Nakamura, Tsutomu Sugaya, Yohei Nakayama, Yorimasa Ogata, Yukihiro Numabe, Taneaki Nakagawa

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Periodontal disease is a chronic inflammatory disease of the periodontal tissue. The periodontal inflamed surface area (PISA) is a proposed index for quantifying the inflammatory burden resulting from periodontitis lesions. This study aimed to investigate longitudinal changes in the periodontal status as evaluated by the PISA following the active periodontal treatment. To elucidate the prognostic factors of PISA, mixed-effect modeling was performed for clinical parameters, tooth-type, and levels of periodontal pathogens as independent variables. One-hundred-twenty-five patients with chronic periodontitis who completed the active periodontal treatment were followed-up for 24 months, with evaluations conducted at 6-month intervals. Five-times repeated measures of mean PISA values were 130+/−173, 161+/−276, 184+/−320, 175+/−417, and 209+/−469 mm2. Changes in clinical parameters and salivary and subgingival periodontal pathogens were analyzed by mixed-effect modeling. Plaque index, clinical attachment level, and salivary levels of Porphyromonas gingi-valis were associated with changes in PISA at the patient-and tooth-level. Subgingival levels of P. gingivalis and Prevotella intermedia were associated with changes in PISA at the sample site. For most patients, changes in PISA were within 10% of baseline during the 24-month follow-up. However, an increase in the number of bleeding sites in a tooth with a deep periodontal pocket increased the PISA value exponentially.

Original languageEnglish
Article number1165
Pages (from-to)1-14
Number of pages14
JournalJournal of Clinical Medicine
Issue number6
Publication statusPublished - 2021 Mar 2


  • Follow-up study
  • Mixed effect modeling
  • Periodontal inflamed surface area
  • Periodontal pathogen

ASJC Scopus subject areas

  • General Medicine


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