Relationship of sulcular sulfide level to severity of periodontal disease and BANA test

Background: Volatile sulfur compounds (VSC), such as hydrogen sulfide and methyl mercaptan, are toxic metabolites produced by periodontal pathogens. Their relationship to periodontal disease severity is not yet fully understood. Hence, the aims of this study were to: 1) examine the relationship between sulcular sulfide (pS) levels and severity of periodontal disease and 2) examine the link between pS level and the BANA (benzoyl-DL-arginine-naphthylamide) test. Methods: Seventy systemically healthy subjects with a mean age of 53.0 +/- 13.8 years participated. Three sites were selected from each subject based upon radiographic bone loss (RBL): RBL <2 mm, healthy; RBL <greater than or equal to>2 to <4, low to moderate; RBL <greater than or equal to>4 mm, severe. Periodontal parameters, probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP), were recorded. The pS level was measured using a portable sulfide monitor in a digital score ranging from 0.0 (<10(-7) M of S) to 5.0 (<greater than or equal to>10(-2) M of S) in increments of 0.5. The presence of specific bacteria in subgingival plaque was detected using BANA test. Results: The mean pS level was 0.10 +/- 0.23, 0.36 +/- 0.48, and 1.10 +/- 0.87 for healthy, low to moderate, and severe disease sites, respectively, and was statistically different (P<0.001). The pS level was positively correlated with the BANA test, and was higher in untreated subjects than maintenance subjects (P <0.01). Conclusions: The pS level may be a potential indicator for detecting severity of periodontal disease and identifying bacteria that are capable of hydrolyzing BANA.