ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Rapid PCR is an Effective Way to Identify A. Actinomycetemcomitans in Humans
Clinical Question In an adult with localized aggressive periodontitis can we identify A. actinomycetemcomitans using rapid PCR as effectively as with conventional PCR?
Clinical Bottom Line Ultra fast super convection based polymerase chain reaction can correctly identify A. actinomycetemcomitans by cutting identification time to 35 min compared with conventional PCR.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22326236Karched/201240 adolescent patients (20 A.a. positive, and 20 A.a. negative) Case-Control Study
Key resultsConventional PCR takes from 2-4 hours to overnight for processing and identification of A.a. after collecting samples. Rapid PCR can make the identification in 35 minutes. When comparing rapid PCR to conventional PCR for identification of A.a bacteria, there is 85% specificity and 80% sensitivity (in humans), which could be used as a good substitute chair-side A.a. identification tool.
Evidence Search Id ("identification (psychology)"[MeSH Terms] OR ("identification"[All Fields] AND "(psychology)"[All Fields]) OR "identification (psychology)"[All Fields] OR "identification"[All Fields]) AND ("actinobacillus actinomycetemcomitans"[MeSH Terms] OR
Comments on
The Evidence
Rapid PCR and conventional PCR both have 80% sensitivity and 85% specificity in detecting A. actinomycetemcomitans. There were 20 known positive and 20 known negative subjects where they got the diagnosis from cell culture (gold standard) and tested them against both conventional PCR as well as rapid PCR. It turns out they both have the exact same sensitivity as well as the specificity for the bacteria, which makes them interchangeable when determining samples for quick detection. Having an 80% sensitivity and 85% specificity in a good sample size of 40 shows a good evidence-based research.
Applicability Rapid PCR is a good chair side tool for dentists wanting to detect A.actinomycetemcomitans from patient’s intraoral samples in a matter of an hour.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (Periodontics)
Keywords rapid PCR, A. actinomycetemcomitans
ID# 2314
Date of submission: 08/08/2012spacer
E-mail hyun@uthscsa.edu
Author Eirleen Hyun
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Guy Huynh-Ba, DDS
Faculty mentor/Co-author e-mail huynhba@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
by Eirleen Hyun (San Antonio, TX) on 09/17/2012
In conventional PCRs, slow rates of heating and cooling utilized for denaturing, annealing, and replication process decreases the efficiency of DNA replication. Each cycle can take from 3-8 min costing the whole RCR to be completed in 2-3 hours. Ultra fast PCR utilizing super convection method decreases the cycle time to 20.5 seconds giving the total processing time of 15 min for completing 45 cycles (publication PMID: 16525773). This method constitutes complicated three-dimensional internal rotation in a disk-formed rotor that mixes the solution evenly during the rapid heating and cooling phase of the reaction. Heating is distributed by infrared radiation in a three-dimensional flow, whereas cooling is delivered through the wall. This efficient homogenization of mixes with multi-rotational effect shortens the time of overall PCR time.
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