Letters to RDH eVillage

April 25, 2008
OraTec president explains decision to become distributor for periodontal testing services.

Dear RDH eVillage:

Last month, there was some speculation regarding a letter ADDx customers received notifying them that ADDX would no longer be distributing the "Micro-IDent plus" and "GenoType PST plus" tests after April 16th. I wasn't at liberty then to end the speculation, but am free to do so now.

Hain Lifescience, the DNA testing laboratory that developed the test technology and conducts the analyses, has selected OraTec to be the sole and exclusive distributor for Micro-IDent plus and GenoType PST plus testing in North America, beginning April 17th. We've been working together for some time now developing new product literature, test kits, analysis reports and to ensure a smooth transition with no interruption in service to customers.

You many not be familiar with Hain Lifescience. Far from going out of business, they are the largest DNA testing laboratory in Europe. Most of their testing is performed for medical specialties. The dental tests are a relatively new service, but one that is growing, both in Europe and the United States by leaps and bounds.

As most of you already know, OraTec already provides two, in-office microbiological tests, the BANA Enzyme test and BioScan phase contrast video microscopy. The addition of DNA testing will provide our customers with even more testing options. Each type of test has advantages and disadvantages. I suspect all three will continue to be utilized, but I think it likely that DNA testing will become the new gold standard against which all other tests are measured. One study that compared cultural analysis to DNA testing already arrived at the same conclusion.

For those unfamiliar with DNA and genetic testing, here's a brief explanation of both DNA tests:

Micro-IDent plus — Periodontal pathogen testing

Sulcular samples are obtained via sterile paper points and returned for analysis. The DNA is extracted and multiplied using PCR cycling and compared to the unique DNA markers of 11 periodontal pathogens, including Socransky's RED and ORANGE complexes and well as the BLUE and GREEN complexes. The test also quantifies each positive species. Additionally, positive species are tested for antibiotic specificity, enabling clinicians to select the most effective antibiotic for each individual patient. Currently, the reports are sent via email but, over the summer, will become available online the moment the analysis is completed.

GenoType PST plus — Genetic proclivity testing

As you know, some patients have considerable inflammation despite having little plaque or calculus. It's possible that some of these patients may be infected unusual strains of bacteria, but there is a sizable chance that they have a genetic mutation in the genes that code for interleukin-1. GenoType PST plus uses a sterile swab to sample cheek cells. Like the Micro-IDent plus test, the genetic material on the swabs is extracted and amplified using PCR. Three genetic sites on the DNA are then analyzed for mutations. Two of the sites code for interleukin-1 production. Mutations at these sites result in an overproduction of interleukin-1 with an exaggerated inflammatory response. The third site codes the interleukin-1 antagonist. A mutation there prevents the normal feedback mechanism that controls the production of interleukin-1 resulting again in an exaggerated inflammatory response even if the genes that code production are normal. About 4 to 6% of the population tend to have mutations at these sites.

Patients with mutations should probably be treated pro-actively with earlier treatment and earlier referrals even if they have low levels of pathogens because the risk of refractory disease is higher.

Bill Landers
President, OraTec