Accuracy of real-time polymerase chain reaction versus anaerobic culture in detection of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis: A meta-analysis

Background: Real-time polymerase chain reaction (PCR) has been used to assist in the detection and quantification of several periodontal pathogens. The aim of this study was to perform a meta-analysis of the diagnostic accuracy of real-time PCR aimed at detecting Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetenicomitans) and Porphyromonas gingivalis. Methods: Studies comparing real-time PCR versus anaerobic bacterial culture were identified via electronic and manual searches. Meta-analyses examined the areas under summary receiver operator characteristic curves (SROCs), and diagnostic odds ratios (DORs) were calculated to evaluate the test accuracy. Results: Five studies met the inclusion criteria and showed some degree of heterogeneity. The areas under SROCs for real-time PCR in identifying A. actinomycetemcomitans and P. gingivalis were 95.9% and 99.5%, respectively. The DORs in detecting A. actinomycetemcomitans and P. gingivalis were 18.5 (95% confidence interval [CI]: 2.25 to 152.02) and 40.47 (95% CI: 1.99 to 822.26), respectively. Conclusions: The present review showed a high diagnostic accuracy of real-time PCR in detecting A. actinomycetemcomitans and P. gingivalis compared to the culture technique. However, the choice of the microbiologic test is determined by several factors, including diagnostic accuracy, cost, availability, and the need for an antibiotic susceptibility test.