Porphyromonas gingivalis may interfere with conception in women

Periodontitis and Its Inflammatory Changes Linked to Various Systemic Diseases: A Review of Its Underlying Mechanisms

Periodontitis is a chronic inflammatory disease of the gums. The incidence of periodontitis is increasing all over the world. In patients with periodontitis, there is gradual destruction of the periodontal ligament and the alveolar bone, and later, in advanced stages, there is tooth loss. Different microorganisms, the host’s immune response, and various environmental factors interact in the progression of this chronic inflammatory disease. In the present review, we discuss the epidemiology, clinical features, diagnosis, and complications of periodontitis. We also discuss the association of chronic inflammation found in periodontitis with various other systemic diseases, which include cardiovascular, respiratory, diabetes, Alzheimer’s, cancer, adverse pregnancy, and multiple myeloma, and also highlight microbial carcinogenesis and the microRNAs involved. The latest updates on the molecular mechanism, possible biomarkers, and treatment procedures may be beneficial for diagnostic and therapeutic purposes.

Self-reported periodontitis and fecundability in a population of pregnancy planners

STUDY QUESTION

Is a history of periodontitis among women associated with reduced fecundability?

SUMMARY ANSWER

A history of periodontitis, as assessed by three different self-reported measures, may be associated with reduced fecundability.

WHAT IS KNOWN ALREADY

Periodontitis is a chronic inflammatory condition affecting the hard and soft tissues surrounding the teeth. Few studies have evaluated the association between periodontitis and time to pregnancy, and findings are mixed. It is hypothesized that periodontitis may adversely affect time to pregnancy.

STUDY DESIGN, SIZE, DURATION

We conducted a prospective cohort study of 2764 female pregnancy planners residing in North America (March 2015-June 2020).

PARTICIPANTS/MATERIALS, SETTING, METHODS

Eligible participants had been attempting pregnancy for six or fewer menstrual cycles at enrollment and were not using fertility treatment. Women answered questions about their oral health. Pregnancy was ascertained via bi-monthly follow-up questionnaires. We used proportional probabilities regression models to estimate fecundability ratios (FRs) and 95% confidence intervals (CIs) for three different measures indicative of a history of periodontitis: ever diagnosed with periodontitis (N = 265), ever received treatment for periodontitis (N = 299), and ever had an adult tooth become loose on its own (N = 83). We adjusted for potential confounders and precision variables. Women at risk of misclassification of periodontitis diagnosis due to pregnancy-related gingivitis were reclassified in a sensitivity analysis.

MAIN RESULTS AND THE ROLE OF CHANCE

All three indices of periodontitis may be associated with reduced fecundability. FRs were 0.89 (95% CI 0.75-1.06) comparing women with and without a previous periodontitis diagnosis, 0.79 (95% CI 0.67-0.94) comparing women with and without previous periodontitis treatment, and 0.71 (95% CI 0.44-1.16) comparing women with and without a tooth that became loose. After reclassification of pregnancy-related gingivitis in the sensitivity analysis, the FR for periodontitis diagnosis was 0.83 (95% CI 0.68-1.00). Weaker FRs were observed among parous women as compared with nulliparous women for periodontitis diagnosis and tooth becoming loose, but not for periodontitis treatment.

LIMITATIONS, REASONS FOR CAUTION

Though we used validated self-report measures of periodontitis, clinical confirmation is the gold standard. These questions may be functioning as markers of different levels of periodontitis severity, but we were unable to measure disease severity in this population. Finally, we cannot eliminate the possibility of unmeasured confounding.

WIDER IMPLICATIONS OF THE FINDINGS

This is the first preconception prospective cohort study to evaluate the association between self-reported periodontitis and fecundability. Our results indicate that periodontitis may be associated with lower fecundability.

STUDY FUNDING/COMPETING INTEREST(S)

This work was partially funded by R01HD086742/Eunice Kennedy Shriver National Institute of Child Health and Human Development and R21HD072326/Eunice Kennedy Shriver National Institute of Child Health and Human Development. PRESTO has received in-kind donations from Swiss Precision Diagnostics, Sandstone Diagnostics, FertilityFriend.com, and Kindara.com for primary data collection. L.A.W. is a fibroid consultant for AbbVie, Inc. J.C.B., S.W., J.Y., K.J.R., E.E.H., and B.H. have no conflicts of interest to disclose.

TRIAL REGISTRATION NUMBER

N/A.

Periodontal and caries status in unexplained female infertility: A case-control study

BACKGROUND

The aim of this study was to investigate the possible association between maternal periodontal disease and dental caries that affect oral health and unexplained infertility.

METHODS

This cross-sectional case-control study included 50 fertile women and 50 women with unexplained infertility aged 21 to 39 years. Dental and periodontal parameters were examined to evaluate the oral health of the participants. According to the new periodontal disease classification, periodontitis severity was determined.

RESULTS

In infertile women, the number of advanced caries lesions, the percentage of bleeding on probing (BOP), gingival index (GI), probing depth (PD), and clinical attachment level (CAL) were higher (P < 0.05). The DMFT and mean plaque index (PI) were not statistically different between the two groups. The PISA and PESA values were higher in women with unexplained infertility than in fertile women (P = 0.005 and P = 0.002, respectively). In multivariate analysis showed that association of DMFT and BOP variables with periodontitis was found to be significant for all women included in the study and for infertile women only (P = 0.000 and P = 0.012 for DMFT, respectively; P = 0.000 and P = 0.016 for BOP, respectively).

CONCLUSION

The chronic inflammatory environment caused by periodontitis and advanced carious lesions in women with unexplained infertility should be of great concern as it may have a role in the etiology of infertility.

Microbiota in Human Periodontal Abscess Revealed by 16S rDNA Sequencing

Periodontal abscess is an oral infective disease caused by various kinds of bacteria. We aimed to characterize the microbiota composition of periodontal abscesses by metagenomic methods and compare it to that of the corresponding pocket and healthy gingival crevice to investigate the specific bacteria associated with this disease. Samples from abscess pus (AB), periodontal pocket coronally above the abscess (PO), and the gingival crevice of the periodontal healthy tooth were obtained from 20 periodontal abscess patients. Furthermore, healthy gingival crevice samples were obtained from 25 healthy individuals. Bacterial DNA was extracted and 16S rRNA gene fragments were sequenced to characterize the microbiota and determine taxonomic classification. The beta-diversity analysis results showed that the AB and PO groups had similar compositions. Porphyromonas gingivalis, Prevotella intermedia, and other Prevotella spp. were the predominant bacteria of human periodontal abscesses. The abundances of Filifactor alocis and Atopobium rimae were significantly higher in periodontal abscesses than in the periodontal pocket, suggesting their association with periodontal abscess formation. In conclusion, we characterized the microbiota in periodontal abscess and identified some species that are positively associated with this disease. This provides a better understanding of the components of periodontal abscesses, which will help facilitate the development of antibiotic therapy strategies.